Objective: To investigate the successful signs of laser photocoagulation or endolaser combined vitrectomy for congenital optic disc pit (ODP) with serous macular detachment. Methods: A retrospective case analysis. Twelve eyes of 12 patients with congenital ODP complicated with serous macular detachment diagnosed in Zhongshan Ophthalmic Center from 2003 to 2018 were included in this study. There were 2 males (2 eyes) and 8 females (8 eyes). The average age was 30.17 years old. Retinal laser photocoagulation and/or vitrectomy were performed in all the eyes. The optic disc and macular area were scanned using the tracking mode of the Germany Heidelberg Spectralis OCT instrument. The "dam-sign" change was a retinal choroidal scar on the channel between the ODP and the macula on the OCT image after treatment. The eyes were divided into a "dam-sign" change group (group A, 10 eyes) and no "dam-sign" change group (group B, 2 eyes). The BCVA of eyes in group A was 0.03-0.6. In group A, 1 eye was treated with laser photocoagulation alone, 9 eyes were treated with vitrectomy combined with laser photocoagulation. The BCVA of eyes in group B was 0.1. All the eyes in group B underwent vitrectomy combined with laser photocoagulation. The follow-up was ranged from 6 to 174 months. The same equipment and method before treatment were used for 1, 3, 6, 12, 18, and 24 months after treatment. The BCVA, absorption of subretinal fluid (SRF) and the formation of "dam-sign" change were observed. Results: At the last follow-up, the BCVA of eyes in group A was 0.4-1.0 (0.4 in 1 eye, 0.5 in 3 eyes, 0.6 in 2 eyes, 0.8 in 3 eyes, 1.0 in 1 eye). In 9 eyes treated with vitrectomy combined with laser photocoagulation, SRF was completely absorbed. In 1 eye treated with laser photocoagulation alone, SRF remained in small amount. The BCVA of the two eyes in group B was 0.03 and 0.3, respectively; and SRF was not absorbed in both of them. Conclusions The "dam-sign" change near optic disc after laser photocoagulation can promote SRF absorption and improve BCVA. It can be used as a success indicator after treatment.

Objective: To determine the influencing factors of electronic screen time of urban preschoolers before and after the COVID-19 outbreak, so as to provide a scientific basis for the control of digital screen use and early prevention of myopia among preschoolers. Methods: Using multi stage cluster random sampling method, a cross sectional survey of 8 244 kindergarten students in a district of Shanghai was implemented, through parent questionnaire collecting the time child spent on various electronic screens before and after the COVID-19 outbreak, estimated the weighting screen time, and emphatically analyzed the relationship between family electronic screen supervision behavior and preschoolers weighting screen time. Results: The proportion of daily over use time on average of mobile phones, computers and TV/projection screens among the surveyed preschool children during COVID-19 was 30.52%, 51.40% and 56.82%, respectively. On school days before the epidemic, the proportion was 21.94%, 41.80% and 47.51% respectively. After controlling for primary covariates, parents frequent control of children s electronic screen use, parents guidance for electronic screen use were significantly associated with lower weighted screen refractive time ( OR =0.60-0.77, P < 0.05 ). The use of electronic screen when parents accompanied their children, the use of electronic screen time by parents but not strictly implemented were significantly associated with higher weighted screen refractive time and increased screen refractive time ( OR =1.18-1.80, P <0.05). Conclusion Urban preschoolers electronic screen time was high during and before COVID-19. In the control measures of preschool children s electronic screen time, attention should be paid to the management of electronic screen use within the family and parents role model.

Objective: To development teacher health literacy on students visual protection questionnaire for kindergarten, primary and middle schools, and to provide a basis for quantitative assessment of visual protection health literacy of school teachers. Methods: Based on official documents related to prevention and control of myopia as well as the integrated definition of health literacy of WHO Europe, the framework for technical evaluation was established. Totally 24 multi disciplinary experts in related fields conducted two round Delphi expert consultation. Evaluation items, questions and corresponding weights were determined based on experts opinions and scores. Results: In two rounds of Delphi consultation, the response rates were 83.3% and 79.2% respectively, and the authority coefficient was 0.91. The final questionnaire was composed by dimensions of core knowledge of myopia, daily instruction, guidance for myopic behaviors, promotion of outdoor activities, and creation of teaching light environment, including 30 and 23 items for middle and primary school teachers and kindergarten teachers respectively. The coefficient of variation ( CV ) of the five dimensions ranged from 0.07 to 0.15, and that of each question ranged from 0.08 to 0.29. Expert opinions were accordant and credible. Conclusion A reliable questionnaire of teacher health literacy on students visual protection health literacy for school teachers is established, which can be used as the entry point and effectiveness evaluation basis for the school based intervention of myopia.

Objective: The current situation and associated factors of primary and middle school students screen time and related eye hygiene in different periods before and after COVID-19 were investigated, so as to provide a scientific basis for taking targeted measures of preventing and controlling myopia among those students. Methods: A total of 11 402 students were selected from 24 primary schools, 18 junior high schools and 16 high schools by multi stage stratified cluster sampling method. And a questionnaire survey was conducted among students and their parents to understand students screen time and screen hygiene behaviors and related factors in different periods before and after the outbreak of COVID-19. Results: The rate of screen overuse was 7.26%, 9.12% and 35.30% during school days, weekends and home study, respectively. The overuse rate of mobile phones and tablets at home increases with the increase of school stage. Totally 16.30% of students use mobile phones for online learning. The screen overuse rate of those who have not been diagnosed with myopia was lower than that of those who have been diagnosed during home study( OR=0.77, P <0.05). The higher the parents educational level was, the lower the screen overuse rate of children during the weekends became( P <0.05). In any period, the high proportion of screens used in homework and poor home screen eye environment increased the risk of screen overuse and poor eye hygiene ( P <0.05). Parental good behavior was conducive to reducing the risk( OR= 0.65-0.97, P <0.05). When the family had regulation on the screen use time, the implementation of laxity would increase the risk of screen overuse ( OR=1.18-2.48, P <0.05). Conclusion The screen overuse rate of urban primary and middle school students during home study is high, and a certain proportion of students still use mobile phones for online learning. The proportion of screens used in homework, home screen eye environment and screen use management are related to screens overuse. More attention should be paid to those with myopia and low educational level of parents.

White matter hyperintensity (WMH) is one of the major imaging markers of cerebral small vascular disease, which is prevalent in the elderly. At present, the pathogenesis of WMH is not clear, most of the previous studies focused on the arterial system, but the role of the venous system in WMH is attracting more and more attention. Small venous collagen hyperplasia, downstream intracranial venous dilatation and internal jugular venous reflux may be involved in the formation and development of white matter hyperintensity.

With the development of neuroimaging technology, cerebral small vessel disease has become a hot research topic in recent years. It has been clearly related to cognitive decline, dementia and gait instability. However, recent studies have found that small cerebral vascular disease with white matter hyperintensities is the main cause of chronic dizziness in the elderly, but the pathogenesis is not completely clear, which may be related to brain neural network disconnection, visual dependence, eye movement disorder caused by abnormal brain tissue structure, oxidative stress regulation disorder, cerebral blood flow self-regulation disorder, and the interaction mechanism between vestibular system and emotional disorder.

Background The altered expressions of hippocampal N-methyl-D-aspartate (NMDA) receptors induced by benzo[ɑ]pyrene (BaP) causes short-term spatial learning and memory impairment in humans and animals, but whether BaP causes alterations of NMDA receptor subunits in other brain regions and the associated neurotoxic mechanism is still essentially unknown. Objective To observe the mRNA expressions of NR1, NR2A, and NR2B of NMDA receptor subunits in different brain regions in SD rat model with subchronic exposure to BaP, and to provide a basis for in-depth study of the mechanism of BaP-induced neurotoxicity. Methods Forty male SD rats were selected and randomly divided into a control group and 1.00, 2.50, and 6.25 mg·kg⁻¹ BaP exposure groups with 10 rats in each group. The exposure rats received intraperitoneal injection of BaP every other day for 90 d.The average latency to platform, the average total distance, and the duration spent in previous quadrant were measured by the Morris Water Maze. Real-time fluorescence quantitative PCR was used to detect the mRNA expressions of NR1, NR2A, and NR2B in hippocampus, cortex, cerebellum, and striatum of rats. Results The average latency to platform and the average total distance in the 2.50 and 6.25 mg·kg⁻¹ BaP groups were significantly prolonged compared with the control group (P<0.05), and the duration that rats spent in previous quadrant in the 6.25 mg·kg⁻¹ BaP group was significantly shortened (P<0.05). Compared with the control group, the mRNA expressions of NR1 and NR2B in the hippocampus in the 2.50 and 6.25 mg·kg⁻¹ BaP groups were significantly reduced (P<0.05), and the NR2A mRNA expression in the hippocampus in the 6.25 mg·kg⁻¹ BaP group was significantly reduced (P<0.05); the mRNA expressions of NR1 and NR2B in the cortical tissue in the 6.25 mg·kg⁻¹ BaP group were significantly reduced (P<0.05), and the mRNA expression of NR2A in the cortical tissue in the 1.00 mg·kg⁻¹ BaP group was reduced; the mRNA expression of NR2B in the cerebellar tissue in the 6.25 mg·kg⁻¹ BaP group was significantly reduced (P<0.05); there were no differences in the mRNA expressions of NMDA receptor subunits in the striatum tissue (P>0.05). Conclusion Subchronic BaP exposure can cause short-term spatial learning and memory impairment in rats, which may be related to the down-regulation of mRNA expressions of NR1, NR2A, and NR2B in hippocampus, changes of mRNA expressions of NR1, NR2A, and NR2B in cortical area, and the down-regulation of NR2B mRNA expression in cerebellum.