0.2ml autoplasma was injected intracamerally following paracentesis to form a quantitative and reproducible model for intraocular fibrin deposition in 14 rabbits(14 eyes).Twenty-four hours after clot formation,the rabbits were separated at random into two equal groups.One group received anterior chamber injection of t-PA(4?g),and the other group received physiological saline(PS).The tissue plasminogen activator(t-PA)treated group produced clotlysis in 5 hours,while the control group did so in 7 days.Toxicity,as measured by slit-lamp bio- microscopy,intraocular pressure,specular microscopy, and light microscopy,was not seen.

Objective To investigate the characteristics and diagnostic value of fundus fluorescein angiography(FFA)for familial exudative vitreoretinopathy(FEVR).Methods 34 children(68 eyes)with FEVR and 64 parents(1 28 eyes)were included.All the clients were received examinations of slit-lamp biomicroscopy and indirect ophthalmoscopy.Meanwhile the children were examined by Retcam Ⅱ,the best corrected visual acuity of parents were recorded.The children and their parents were classified according to the ocular findings.Among 68 eyes of children,3 eyes(4.41% )were normal,4 eyes(5.88% )were in stage 1,7 eyes(10.29% )were in stage 2,2 eyes(2.94% )were in stage 3,8 eyes(11.76% )were in stage 4 and 44 eyes(64.71% )were in stage 5.Among 128 eyes of parents,74 eyes(57.81% )were normal,51eyes(39.84% )were in stage 1,1 eyes(O.78% )were in stage 2 and 2 eyes(1.56% )were in stage 5.FFA was performed on the children with RetcamⅡunder anesthesia and on the parents with HR2 in order to observe the FFA characteristics in different stage.Results FFA characte ristics in children included uncompleted vascularization of the periphery,peripheral avascular zone(stage 1);neovascularization and/or peripheral subretinal and intraretinal exudation(stage 2);subtotal retinal detachment with attached foyea (stage 3);subtotal retinal detachment with detached foyea(stage 4)and total retinal detachment(stage 5).FFA characteristics in parents included abrupt cessation of the peripheral retinal capillary network and a peripheral avascular zone(stage 1); abnormal peripheral arteriovenous shunts, neovascularization or exudation(stage 2)and atrophia bulbi(stage 5).Conclusions FEVR in different stage has different FFA characteristics.FFA plays an important role in early diagnosis of FEVR.

High myopia is frequently associated with retinal degenerative changes (such as myopic foveoschisis, macular hole and its related retinal detachment, and choroidal neovascularization) which are the major causes of visual loss in high myopic eyes. Optical coherence tomography may help us to understand the macular lesions in high myopia. Peeling of internal limiting membrane and removal of posterior vitreous cortex at an appropriate time, are believed to facilitate restoring the retinal flexibility and resolution of myopic foveoschisis, and promote the macular hole closure and retinal reattachment. Anti-angiogenesis treatment combined with photodynamic therapy and (or) corticosteroid therapy are the future options to treat myopic choroidal neovascularization. Correctly understanding and mastering the methods and timing of diagnosis and treatment of high myopia-related macular degeneration, and taking targeted interventions to enable patients to be rational and effective treated, are the keys to further reduce the damage of visual function in patients with high myopia.

Objective To observe the inhibitory effect of Bevacizumab on retinal neovascularization in oxygen-induced retinopathy in the mouse. Methods 90 one-week-old C57BL/6J mice were divided into four groups at random.15 mice in the 1st group as normal control group,15 mice in the 2nd group as oxygen control group,30 mice in the 3rd group as high-dose Bevacizumab treatment group,30 mice in the 4th group as low-dose Bevacizumab treatment group.The 2nd,3rd and 4th groups were exposed to 75%oxygen for 5 days and then to room air.At the 12th day,One eye of each mouse of two control groups were received an intravitreal injection with Bevacizumab at 2μl、1μl respectively,and the same volume of BSS was injected into the other eye of the mice.The adenosine diphosphatase(ADPase)histochemical technique was used for retinal flat mount to assess the oxygen-induced changes of retinal vessels.The number of the endothelium cell nuclei of proliferative neovascularization was quantified by retinal microtome chromoscopy.Real-time PCR analysis was performed to examine the expression of VEGF mRNA. Results Comparing with oxygen control group,regular distributions,reduced density of retinal vascular and reduced endothelium cell nuclei which extending retinal membrane were observed in the treatment groups(P＜0.001).But the differences between two treatment groups are not statistically significant(P＞0.05).The expression of VEGF mRNA was not significantly different in oxygen control group whatever it whether accepted Bevacizumab treatment or high or low dose(P＞0.05). Conclusion Intravitreal injection with Bevacizumab can effectively inhibits the retinal neovascularization in oxygeninduced retinopathy in the mouse.Intravitreal injection with Bevacizumab might become to the new method to treat retinopathy of premature.

Objective To observe the clinical effects of vitrectomy for advanced retinopathy of prematurity (ROP) and evaluate influence factors of anatomical recovery for stage 5 ROP.Methods Fiftyeight eyes of 40 infants with advanced ROP who underwent vitrectomy were retrospectively analyzed.There were 16 eyes of stage 4a,7 eyes of stage 4b,and 35 eyes of stage 5 ROP.Eighteen eyes received laser photocoagulation,2 eyes received cryotherapy,and 11 eyes received intravitreous injection of Bevacizumab (IVB) before surgery.The average follow-up time was 17.01 months.Anatomical outcome of retina after surgery was recorded by indirect ophthalmoscope and RetCam Ⅱ digital camera system.Visual outcome was measured by grating acuity test(lea gratingTM),and was converted to Snellen acuity values for analysis.For those who cannot cooperate to accomplish the test,we use hand move,light perception and non-light perception to record visual outcome. Results All 16 eyes of stage 4a were anatomically recovered (100.00％).5/7 eyes of stage 4b were anatomically recovered (71.43％) and 2/7 eyes were anatomically failed(28.57％).12/35 eyes of stage 5 were anatomically recovered (34.29％); 10/35 eyes were partial anatomically recovered (28.57％); 13 eyes were anatomically failed (37.14％). Anatomical outcome of stage 4a or 4b was better than stage 5 statistically(x2 =22.55,P＜0.05).Of 16 eyes of stage 4a,3 eyes were absent for visual function test.In the rest 13 eyes of stage 4a,VA of 6 eyes (46.15％) was between 0.03 and 0.07; 5 eyes (38.46％) were hand move; 2 eyes (15.39％) were light perception.Of 7 eyes of stage 4b,2 eyes (28.57％) accomplished grating acuity test with VA of 0.008 and 0.017 respectively; 1 eye (14.29％) was hand move; 2 eyes (28.57％) were light perception; 2 eyes (28.57％) were non-light perception.Of 35 eyes of stage 5,5 eyes were absent for visual function test.In the rest 30 eyes of stage 5,VAof2 eyes (6.67％) was 0.004; 4 eyes (13.33％) were hand move; 12 eyes (40.00％) were light perception; 12 eyes (40.00％) were non-light perception.Visual outcome of stage 5 was worse than stage 4a or 4b statistically(x2=15.734,P＜0.05).There was no statistically significant relationship between anatomical outcome and birth weight,gestational weeks,age at surgery,IVB therapy,laser or cryotherapy before surgery.Conclusions Vitrectomy can effectively control the lesions progress of stage 4a ROP,and achieve partially anatomically recovery of some stage 4b/5 patients.There was no statistically significant relationship between anatomical outcome and birth weight,gestational weeks,age at surgery,IVB,laser or cryotherapy before surgery.

Early detection and timely treatment hold the key to cure retinopathy of prematurity (ROP).ROP screening is carried out unevenly in China.Examination equipments and personnel experiences are the major factors to constraint ROP screening.In addition to strengthening personnel training,it is necessary to establish a standard guideline and pipeline for ROP consultation and referral. Laser photocoagulation and cryotherapy are the first options for the threshold ROP and Type 1 pre-threshold ROP.Scleral buckling or vitrectomy is needed for advanced ROP when retinal detachment occurs. The clinical efficacy of intravitreal injection of bevacizumab (an anti-vascular endothelial growth factor monoclonal antibody) for severe ROP is encouraging,but needs further verification.Genetic interference and stem cell therapy will be the prosperous futures in the treatment of ROP.The screening and treatment of ROP in China is becoming more common and improved,but it is still a long way to go considering the huge population of China.

Objective To observe the image features of high myopia with retinoschisis by spectraldomain optical coherence tomography (SD-OCT). Methods The clinical data of eight patients (eight eyes)of high myopia with retinoschisis were retrospective analyzed. All patients were diagnosed by SD-OCT (Topcon 3D OCT-1000), had no macular holes and underwent vitrectomy including internal limiting membrane (ILM) peeling and gas tamponade. All patients also underwent visual acuity, refraction,pre-mirror fundus examination and A/B-mode ultrasound examination. Visual acuity and SD-OCT were followed up at one, three and six months after surgery. Before surgery, pre-mirror fundus examination revealed shallow foveal detachment in 3/8 eyes, posterior scleral staphyloma in 7/8 eyes. SD-OCT showed concave arc stripes in 7/8 eyes, and outer retinoschisis in 8/8 eyes, middle or inner retinoschisis in 5/8 eyes and foveal detachment in 5/8 eyes. Results Six months after surgery, posterior retinoschisis disappeared in six eyes, foveal detachment still presented in one eye and parafoveal hole occurred in one eye. The corrected visual acuity improved from the 0. 15 to 0. 8 in one eye which had a restored continuous inner segment/outer segmen (IS/OS) line by SD-OCT. The corxected visual acuity improved from 0. 01 to 0. 1 in one eye, from 0. 05 to 0. 15 in one eye, not changed in five eyes. There was no continuous IS/OS line in those patients by SD-OCT. Conclusions SD-OCT shows a variety of morphological features of myopic retinoschisis which could be cured anatomically and functionally by vitrectomy combined ILM peeling. The continuity of IS/OS layer from SD-OCT could help to interpret the vision recovery after the operation.

Choroidal neovascularization is one of the common causes resulting in vision loss in patients with pathologic myopia, and the irreversible central vision lose is often found. This article reviews the epidemiology of pathologic myopia, pathogenesis, clinical manifestation and anti-VEGF therapy of choroidal neovascularization secondary to pathologic myopia.

Recently,the new term lamellar hole-associated epiretinal proliferation was introduced to describe a specific epiretinal proliferation.Different from conventional epimacular retinal membrane,lamellar hole-associated epiretinal proliferation (LHEP) can be found around the edge of lamellar macular holes and part of full thickness macular holes.It is defined as a thick homogenous layer of yellowish material without any contractive properties on the epiretinal surface with medium reflectivity on optical coherence tomography images.Immunocytochemical analysis showed the presence of glial cells,fibroblasts,hyalocytes and collagen type Ⅱ.Electron microscopy revealed fibroblasts and hyalocytes as predominant cell types,densely packed in cell agglomerations.LHEP is a secondary event in lamellar macular hole formation and may represent a repair process after large and deep retinal defect.Further studies on its clinical features and clinical significance are still required.

Objective To describe the morphological characteristics of foveal retinoschisis and retinal detachment in highly myopic eyes. Design Retrospective observational case series. Participants Twenty-nine patients (38 eyes) of high myopia with foveal retinoschisis and retinal detachment. Methods All patients with foveal retinoschisis and retinal detachment were performed complete ophthalmic examinations, B-scan and studied cross-sectional images of the maculae with optical coherence tomography (OCT). 10 eyes underwent vitreous surgery. Main Outcome Measures Morphological characteristics. Results On biomicroscopy, the maculae of all 38 eyes had a microcystic appearance and shallow elevation without macular hole. B-scan showed posterior retinal edema or with 0.5 to 2mm detachment. OCT disclosed foveal retinoschisis and retinal detachment in all eyes. The neuroretina splitted into a thick inner layer and a thin outer layer or a thin inner layer and a thick outer layer or a thin inner layer, a thick inter layer and a thin outer layer. A hyperreflective preretinal structure resembling the posterior hyaloid was stretched over the retinoschisis and drew the retina. Vitreous surgery performed on 10 eyes, including posterior vitreous detachment, removal of the premacular vitreous cortex. In all eyes, foveal detachment and retinoschisis gradually decreased in height, and attained foveal attachment finally. Conclusion Foveal retinoschisis and retinal detachment in highly myopic eyes with staphyloma is better characterized with OCT than with biomicroscopy. Vitreomacular traction forms the posterior hyaloid and the staphyloma maybe the major cause of it.