The hallmark of the recent latest advances in diagnostic fundus imaging technology is combination of complex hierarchical levels and depths,as well as wide-angle imaging,ultra-wide imaging.The clinical application of wide-angle and ultra-wide imaging,not only can reevaluate the role of the peripheral retina,the classification types and treatment modalities of central retinal vein occlusion,and enhance the reliability of diabetic retinopathy screening,improve the classification and therapeutic decision of diabetic retinopathy,and but also can help guide and improve laser photocoagulation.However we must clearly recognize that the dominant role of ophthalmologists in the diagnosis of ocular fundus diseases cannot be replaced by any advanced fundus imaging technology including wide-angle imaging.We emphasize to use the three factors of cognitive performance (technology,knowledge and thinking) to improve the diagnosis of ocular fundus diseases in China.

Objective hole.Research demonstrated that amnion promotes the proliferation of and its mechanism.Methodswhite rabbit.The cells were primarily cultured and passaged in DM/F12 with 10% fetal bovine serum and identified with glial fibrillary acidic using 0.25% trypsin and 0.05%EDTA and suspended in 10% fetal bovine serum+DMEM/F12.0.5 mL of the amnion supernatant was added to the medium for 12 hours.The expression of EGFR in the cells was detected by immunohistochemistry.The difference of EGFR expression with or without the amnion was evaluated.ResultsCultured cells showed a positive response for GFAP and S-100.The intermediate filaments with a length of 8-10 nm were exhibited under the transmission electron microscope.EGFR was fainly expressed in cultured hours,the expression of EGFR was obviously increased with a significant difference in the gray scale between the two groups(571 588.80±67 862.68 vs.1 000 352.00±98 386.22)(t=4.035,P＜0.01).Conclusion

Background Central retinal vein occlusion (CRVO) is a common retinal vascular disease.Macular edema is a common complication and can lead to the decrease of visual acuity.Intravitreal injection of antivascular endothelial growth factor (VEGF) drugs and triamcinolone acetonide has become the important treatment on macular edema.Objective This study was to systematically evaluate the clinical effects of anti-VEGF drugs and triamcinolone in patients with macular edema caused by CRVO.Methods The Databases including PubMed,Cochrane Library (Issue 11,2012),EMbase,CBM,CNKI,VIP and WanFang Database were electronically searched for the trials about the effects of anti-VEGF drugs and triamcinolone in patients with macular edema caused by CRVO from the date of establishment of the databases to September 2015.The combined effect was analyzed by using Review Manager 5.3 software.Results A total 7 trials involving 345 patients and 348 eyes were included.Meta-analysis showed that there was no statistical difference in best corrected visual acuity (BCVA) and macular central thickness between anti-VEGF drugs and triamcinolone in the 6-month follow-up (mean difference [MD] =-0.03,95％ confidence interval[CI]:-0.11-0.05,P =0.52;MD =-15.37,95％ CI:-36.29-5.55,P =0.15),but there was statistical difference in intraocular pressure (MD =-2.73,95％ CI:-3.59--1.86,P＜0.000 01).Twenty-two cases of lens opacity and 8 cases elevated intraocular pressure were observed in the triamcinolone group.Only 2 cases of lens opacity were observed in the anti-VEGF drugs group.Conclusions Anti-VEGF drugs and triamcinolone have similar improvement of BCVA and decrease of macular central thickness in CRVO patients,while the triamcinolone is accompanied with more side effects such as high intraocular pressure and progressing cataract.

Objective To observe the effect of amniotic homogenate on closing holes in experimental rhegmatogenous retinal detachment and investigate its mechanism.Methods Forty rabbits were randomly divided into group A,B,C and D with 10 rabbits in each group.Group A and C were the treatment groups,and group B and D were the control groups.All eyes of rabbits underwent pars plana vitrectomy,retinectomy,and fluid-air exchange.The surface of the breaks was treated with 0.1 ml amniotic homogenate in experimental groups and 0.1 ml PBS in control groups.At the end of operation,20% SF6 was tamponaded and the retina reattaced.The animals were executed 14 (group A and B) and 28 days (group C and D) after the surgery.The tissue sections were observed by light microscope,electron microscope and immunocytochemistry method.Results Fourteen days after the surgery,the retina reattached in 6 eyes in group A (60%) and 2 eyes in group B (20%) (P=0.021),Twenty-eight days after the surgery,the retina reattached in 8 eyes in group C (80%) and 3 eyes in group D (30%) (P=0.046).The difference of the rate of retinal reattachment among the 4 groups were statistical significant (P<0.05).Light postoperative inflammation of ocular anterior segment was observed,which was controlled 3-5 days after treated with topical steroids.The result of light microscopy showed that the eyes in treatment groups had multilayer of fibroblast like cells around the retinal breaks,adhering to the choroid and retinal pigment epithelial cells.The proliferative cells around the retinal breaks obvious less in control groups than that in the treatment groups,and the retina could not adhere to the choroid.The results of electron microscopy were the same as that of light microscopy.Immunohistochemistry staining of the fibroblast-like cells revealed positve glial fibrillary acidic protein,which suggested that the proliferative cells around the retinal breaks were retinal glial cells.Conclusions Amniotic homogenate helps to seal retinal breaks and promote retinal reattachment by stimulating the proliferation of retinal glial cells around the breaks.

0.05). But the mean light sensitivity at central 10? eccentricity were significantly decreased 3 months after photocoagulation (P

Objective To observe the clinical characteristics of patients with macular branch retinal vein occlusion (MBRVO) and the changes of the area of foveal avascular zone (FAZ). Methods The data of 69 eyes of 69 patients with MBRVO , who had been diagnosed by ophthalmoscopy, slit-lamp examination and fluorescein angiography, were retrospectively studied. The relationship of locations between artery and vein on the obstructive site, and the characteristics of fundus pictures, retinal vasculature changes and the complications were analyzed. In 69 patients with MBRVO, 36 had the course of disease for more than 3-6 months, of whom the area of FAZ was compared with that of 30 healthy people. Results In 69 patients, superior MBRVO occurred in 45 eyes (65.22%), and inferior MBRVO occurred in 24 eyes (34.78%). Most of the arteries were anterior to the veins at the obstructive site. Four clinical types of MBRVO were found, and the main complication was macular edema. There was a significant difference in area of FAZ between patients with MBRVO and healthy people (P

Objective To investigate the preoperative design and application of the minimum foveolar translocation distance and angle of macular translocation. Methods The fundus fluorescein and indocyanine green angiographies were performed on 53 eyes of 53 patients with classic subfoveal choroidal neovascularization (SCNV), including 42 with exudative age-related macular degeneration and 11 with high myopic macular degeneration. The actual area of macular SCNV and the minimum foveolar translocation distance and angle were analyzed. Results The actual area of SCNV was 0.39~18.00 mm 2 with the mean of (3.08?3.22) mm 2. The designed minimum superior translocation distance was 67~2 240 ?m with the mean of (845.72?425.23) ?m;the minimum designed minimum inferior translocation distance was 53~ 2 430 ?m with the mean of (912.17?547.77) ?m. The minimum designed superior translocation angle was 1~32? with the mean of (13.23?6.68)?;the minimum designed inferior translocation angle was 1~35? with the mean of (14.06?8.46)?. The individual difference of the minimum designed superior and inferior translocation distance was more than 500 ?m in 16 eyes (30.19%), and the difference of translocation angle was more than 10? in 11(20.75%). Conclusion Preoperative design of minimum translocation distance and angle of macular translocation may be helpful to choose the operation program.

Objective To observe the characteristics of indocyanine green angiography and fundus fluorescein angiography (ICGA& FFA) in anterior ischemic optic neuropathy ( AION ) , and to investigate the etiology of AION and the value of ICGA and FFA in the diagnosis and study of AION. Methods Simultaneous ICGA and FFA were performed on 32 eyes of 31 AION patients and 38 eyes of 38 non AION patients. Results The eyes that all or a part of the optic disc lies in the watershed zones of the choroidal blood supply were significantly more in the AION group than those in the non AION group (P

Objective To establish a matrine delivery system in vitreous is very important for the dynamic treatment of proliferative vitreoretinopathy(PVR) . Present study was to evaluate the efficacy of matrine polyactic acid microsphere(MAT-PLA-MS) in prevention of PVR. Methods The suspension of cultured fibroblasts was injected into vitreous cavity of 30 healthy adult New Zealand albino rabbits to induce PVR. Then the experimental rabbits were divided into 3 groups and 10 rabbits for each. The animals received intravitreal injection of 0.3 mL MAT-PLA-MS(4 mg) matrine in MAT-PLA-MS group. Free matrine normal sodium solution 0.3 mL(containing 2mg matrine) was injected in vitreous cavity in free matrine group. 0. 3 mL normal saline solution was injected into the vitreous of the left eyes and the equivalent volume of blank polyaetic acid microsphere(blank-PLA-MS) into the right eyes in control group. The changes of cornea, aqueous humor, lens, vitreous and fundus were examined and recorded by slit lamp biomicroscope, indirect ophthalmoscope, fundus color camera and B ultrasonogram on the 1st, 3rd, 7th, 14th, 21st, 28th and 35th day following injection of drug. The inhibition effect of matrine on PVR was evaluated according to Ryan' s grading criteria of PVR. Results On the 14th days after implantation of MAT-PLA-MS, the rate of retinal detachment was 60%, 10%, 5% and 60% in normal saline group, free matrine group, MAT-PLA-MS group and blank-PLA-MS group respectively. Statistically significant difference was found among normal saline group, blank-PLA-MS group, MAT-PLA-MS group and free matrine group(P ＜0. 05). On the 21st day after injection of fibroblasts, the morbidity of retinal detachment was 80%, 30%, 10% and 80% in normal saline group, free matrine group, MAT-PLA-MS group and blank-PLA-MS group respectively, showing a significant difference among different groups. On the 28th day, the incidence rate of retinal detachment was 90%, 50%, 15% and 90% respectively, presenting statistical difference among various groups (P ＜ 0. 05) as well as between free matrine group and MAT-PLA-MS group (P＜0. 05). On the 35th day, considerably difference also was seen in the morbidity of retinal detachment among various groups (90%, 60%, 15% and 90% respectively) (P＜0.05). Conclusion Implantation of MAT-PLA-M S into vitreous cavity can effectively inhibit the development of PVR induced by fibroblasts in rabbit model.

Lots of blinding diseases are caused by retinal ganglion cells apoptosis, but there is no the effective and ideal therapy in clinic currently. Recent study showed that stem cells can be an alternative renewable source of retinal ganglion cells, and they may be potential to repair the visual function. These results provide a new model of optic nerve regeneration for the treatment of these blinding diseases. But, some problems in clinical applications are waiting for further solving. Applications of stem cells in optic nerve regeneration is reviewed in this paper.