In recent years,the incidence of age-related macular degeneration (AMD) gradually increased,but the definite cause of AMD is still unclear,and the recent study have found that the immune and inflammation in retinal play an important role in the occurrence and development of AMD,so this article will give a brief review of the latest advances in immune and inflammatory mechanisms of AMD.

Objective To analyze the correlation of the macular retinal ganglion cells-inner plexiform layer (GCIPL) thickness and the axial length and refractive power in myopia,thereby providing guidance for GCIPL thickness analysis in myopic glaucoma patients.Methods A total of 95 patients (190 eyes) with different degrees of myopia were recruited from October 2015 to September 2016 in Shenyang HE Eye Hospital,with age ranging from 18 to 36 years.Variables including gender,age,axial length,medical optometry diopter (spherical equivalent),GCIPL thickness (the mean,minimum,superior,inferior,temporal superior,temporal inferior,nasal inferior and nasal superior parameter) were recorded.According to diopter,all patients were divided into A group (-0.25 to-3.00D),Bgroup (-3.25 to-6.00 D),C group (＞-6.00 D);moreover,according to the axial length,they were assigned into A1 group (22 to 24 mm),B1group (＞24 to 26 mm) and C1 group (＞26 mm),and all above variables were compared.Single factor analysis of variance was used to analyze the differences in GCLIP thickness parameters between the 3 groups and Pearson correlation analysis was used to analyze the correlation of GCIPL thickness with different diopters and axial length.Results There was no significant difference in gender and age,but there were significant differences in the mean diopter and axial length among the 3 groups (F =523.963,P =0.000;F =57.452,P =0.000).And a negative correlation was presented between axis length and refractive power (r =-0.707,P =0.000) in all patients.There were significant differences in GCIPL thickness (the mean,minimum,superior,inferior,temporal superior,temporal inferior,nasal inferior and nasal superior parameter) among A,B and C group (F =3.231-16.500,all P ＜ 0.05) as well as among A1,B1 and C1 group (F =5.234-19.999,all P ＜ 0.05).The thickness of GCIPL was negatively correlated with refraction power (r =-0.419 to-0.153,all P ＜ 0.05),and the axial length(r =-0.407 to-0.241,all P ＜ 0.05).Conclusion With the increase of diopter and axial length,the thickness of GCLIP gets thinner in myopic patients.The effect of axial length should be taken into consideration when the GCLIP thickness of myopic glaucoma patients is evaluated.

Objective To observe the visual outcomes of big-bubble deep anterior lamellar keratoplasty (DALK) for the treatment of keratoconus using a femtosecond laser.Methods A total of 30 patients (50 affected eyes) with keratoconus were enrolled in the study by the self control observation method.All the patients were treated with femtosecond laser assisted DALK by large bubble method,and the curative effect was observed.Results All the 30 patients underwent the surgery successfully.In the early time after the surgery,the corneal grafts were transparent,the corneal physiological thickness was restored,and the grafts fitted the implant bed elastic layer well.The uncorrected visual acuity and the best corrected visual acuity on day 7,1 month,6 months and 1 year after surgery were higher than those before surgery (all P ＜ 0.05),but there was no significant difference between above time points (all P ＞ 0.05).The corneal curvature and corneal astigmatism were significantly decreased after surgery,the thickness of the thinnest cornea was significantly increased after surgery (all P ＜0.05),but there was no significant difference between the different time points after surgery (all P ＞ 0.05).The endothelial cell density before surgery and 1 year after surgery was (2989.34 ±294.52) · mm-2 and (2821.19 ±325.51) · mm-2,while loss rate of endothelial cell was (5.62 ± 0.56)％,but there was no significant difference between different time points after surgery (all P ＞ 0.05).There were no complications during the surgery,but wound dehiscence occurred in 1 eye,loose suture in 1 eye,and stromal rejection in 1 eye,and there was no other complication after surgery.Conclusion It is safe and effective of femtosecond-laser assisted DALK by a big-bubble method to treat keratoconus,and it is a good choice for patients with advanced keratoconus.

Objective To evaluate the changes in epithelial thickness profile and its relationship with diopter following small incision lenticule extraction (SMILE) for moderate and high myopia.Methods Together 46 myopia or myopic astigmatism (92 eyes) who underwent SMILE were included under the informed consent from January 2016 to March 2017 and were decided into 2 groups according to the diopter:moderate myopia group (58 eyes)and high myopia group (34 eyes).Epithelial thickness profile was measured using spectral-domain optical coherence tomography at different corneal zones (0-2 mm,＞ 2-5 mm and ＞ 5-6 mm cornea) preoperatively before surgery and 1 month and 6 months after surgery for observing the changes in epithelial thickness and its correction with diopter.Results The mean epithelial thickness in the central zone was (55.68 ± 3.61) μm before surgery,and,6 months after surgery,it was thickened by (3.85-±3.99),(3.46 ±3.29) and (2.85 ±3.18) μm in the 0-2 mm,＞2-5 mum and ＞5-6 mm cornea respectively,and the difference was statistically significant among the three zones (P ＜ 0.01).After surgery for 6 months,the epithelial thickness in the high myopia group was thickened more obviously compared with the moderate myopia group (t =1.440,P =-0.047).And no correlation was found between changes in the epithelial thickness at 0-2 mm cornea and diopter after surgery(moderate myopia group:r =0.219,P=0.633;high myopia group:r =0.197,P =0.585).Conclusion Significant epithelial thickening was observed after SMILE,presenting the thickened epithelium.The higher the diopter was,the more thickened the epithelium was.The epithelial changes does not appear to affect the diopter after SMILE.

Objective To observe the changes in the circumpapillary thickness parameters measured by optical coherence tomography (OCT) in patients with optic disc edema (ODE).Methods Together 36 patients (36 eyes) diagnosed with ODE from October 2012 to October 2015 were included in the study,and 51 age-and gendermatched control subjects (51 eyes) were recruited from among healthy individuals with no history or evidence of current ocular disease.All the subjects were examined for visual acuity,slit lamp,fundus and fundus photography,and all the eyes underwent OCT scan to detect the circumpapillary retinal nerve fiber layer thickness (cpRNFLT) and circumpapillary total retinal thickness (cpTRT).Results After OCT scan,25 ODE patients (5 mild,14 moderate and 6 severe patients) and 30 patients (5 mild,15 moderate and 10 severe patients) were in line with the requirements of cpRNFLT analysis and cpTRT analysis respectively;there were 50 controls meeting the requirements of this study.There was no significant difference in age and sex between ODE patients and the controls (all P ＞0.05).The mean cpRNFLT and cpRNFLT in each quadrant of ODE patients were significantly thickened than those of controls,and the superior cpRNFLT was the thickest,followed by the inferior,then the nasal and temporal cpRNFLT,and the difference was statistically significant (P ＜0.001).The mean cpTRT and cpTRT in each quadrant of ODE patients were significantly thickened than those of controls,and the inferior cpRNFLT was the thickest,followed by the superior,then the nasal and temporal cpRNFLT,and the difference was statistically significant (P ＜0.001).Conclusion Significantly thickening of cpRNFLT and cpTRT has been observed in patients with ODE as compared with controls,so both circumpapillary thickness parameters measured by OCT can be considered as a new non-invasive quantitative index for the detection and research of ODE.

Objective To evaluate the efficacy and safety of intravitreal injection of conbercept for diabetic macular edema (DME) and the changes of ellipsoid zone (EZ).Methods A retrospective study was conducted in 14 patients (16 eyes) and the clinical data were reviewed and analyzed.All the patients were administrated with conbercept intravitreally,and rechecked 1 month,2 months,3 months after injection including the best corrected visual acuity (BCVA) and optical coherence tomography (OCT).Then a comparison was performed in logMAR BCVA,central foveal thickness (CFT) and macular volume before treatment and 1 month,2 months and 3 months after conbercept injection,as well as the cross-sectional length of incomplete portion in EZ before treatment and 3 months after injection.Results The value of logMAR BCVA before treatment and 1 month,2 months and 3 months after conbercept injection was 0.79 ± 0.08,0.65 ± 0.07,0.56 ± 0.06 and 0.52 ± 0.06,respectively;the average CFT before treatment and 1 month,2 months and 3 months after treatment was (536.44 ±35.87) μm,(385.63 ± 22.60) μm,(336.13 ± 21.91) μm and (292.38 ± 22.54) μm accordingly;the macular volume before treatment and 1 month,2 months and 3 months after treatment was (11.27 ± 0.37) mm3,(10.21 ± 0.22) mm3,(9.69 ± 0.17) mm3 and (9.30 ±0.20) mm3,respectively,with statistically significance in palrwise comparison.Moreover,the cross-sectional length of disrupted EZ before treatment and 3 months after injection was (3116.69 ± 385.55) μm and (1784.88 ± 362.39) μm respectively,and there was statistically significant difference (P ＜ 0.05).Conclusion Intravitreal injection of conbercept to treat DME can alleviate macular edema and restore the disrupted ellipsoid zone.

Objective To explore the influence of E.coli K5 polysaccharide on retinal neovascularization in mice of diabetic retinopathy.Methods E.coli K5 strain was cultivated by fermentation and the supernatant was used to prepare K5 polysaccharide for analyze its purity by high performance liquid chromatography (HPLC).Moreover,male ICR mice were divided into normal group,model group and K5 polysaccharide treatment group (treatment group for short).The mice in the normal group were healthy and left untreated,while the mice in the model group and treatment group were administrated with streptozotocin to establish diabetic model,and the treatment group received K5 polysaccharide 4 weeks after the successful modeling.Then the eyeball tissues in the three groups were collected 8 weeks after modeling for HE staining and ADPase staining,and real-time PCR and Western blot were used to detect the expression of vascular endothelial growth factor (VEGF) and matrix metalloproteinase-2 (MMP-2) in eyeball tissues.Results HPLC resuits showed that the purity of K5 polysaccharide exceeded 95％.HE staining and ADPase staining suggested that a few of new vessels were observed,and the number of vessels in the model group was significantly higher than those in the normal group,while the treatment group was significantly lower than the model group (P ＜ 0.05).Real-time and Western blot showed that the expression of VEGF and MMP-2 mRNA and protein in the model group were significantly higher than those in the normal group,while the treatment group was significantly lower than the model group (P ＜ 0.05).Conclusion E.coli K5 polysaccharide can inhibit the retinal neovascularization generation in mice with diabetic retinopathy,and the mechanism of its action may be associated with the suppressed expression of VEGF and MMP-2.

Objective To observe the effects of curcumin (Cur) on vasculogenic mimicry (VM) and PI3K pathway in choroid melanoma cell line OCM-1 in vitro 3-dimentional culture.Methods Three-dimensional culture of OCM-1 cells was performed for the observation of VM formation and the influence of concentration gradient (0μmol · L-1,10 μmol · L-1,20 μmol · L-1,30 μmol · L-1,40 μmol · L-1) Cur on VM,and immunohis to chemistry staining was used to detect the expression of PI3K and EphA2 in OCM-1 cell line.Results Cur could markedly inhibit the formation of VM in choroid melanoma cell line OCM-1 in vitro 3-dimensional culture with a dose-dependent manner.Cur suppressed EphA2 and PI3K expression in a concentration-dependent manner,and the difference between groups with 0 μmol · L-1 Cur group was significant statistically (all P =0.000),but there was no significant difference between 30 μmol · L-1and40 μmol · L-1 group (EphA2,P=0.300;PI3K,P=0.188).Conclusion Cur can significantly inhibit VM formation in choroid melanoma cell line OCM-1,of which the mechanism may be related to the downregulation expression of EphA2 and PI3K,thus inhibiting PI3K signaling pathway.

Objective To investigate the protective effect of curcumin (Cur) on mice cornea against ultraviolet A (UVA)-induced damage.Methods Together 30 C57BL/6 mice were randomly divided into 3 groups (10 mice in each group):UVA irradiation group (UVA group),UVA irradiation with curcumin treatment group (UVA + Cur group) and control group.Mice in the UVA group was exposed to UVA for 24 h,with the wavelength of 320-400 nm and the irradiation intensity of 0.05 W · cm-2.In UVA + Cur group,mice were given 30 mg · kg-1 curcumin intraperitoneally 3 days before irradiation and lasted until 48 h after irradiation.And the control group was left untreated.Then corneal opacity was evaluated and scored through slit-lamp biomicroscopy.After irradiation for 48 h,corneal tissue was collected for the detection of the expression of NF-κB by electrophoretic mobility shift assay.Results After irradiation for 48 h,the score of corneal opacity in the UVA group (3.10 ± 0.74) was higher than that of the control group (0) and UVA + Cur group (0.35 ± 0.24) (P ＜ 0.05).The expression of NF-κB in cornea was detectable at a low level in the control group (1.25 ± 0.13),but was remarkably increased in UVA group (3.98 ± 0.58) and suppressed by curcumin in UVA +Cur group (1.58 ± 0.34) (P ＜ 0.05).There was no significant difference in corneal opacity score and NF-κB expression between control and UVA + Cur group (P ＞ 0.05),but there was significant difference between control and UVA group and UVA + Cur and UVA group (all P ＜ 0.05).Conclusion Curcumin can protect cornea against UVA-induced damage via inhibiting NF-κB activation.

With the continuous increase in the incidence of diabetes mellitus in the world,the ocular complications are getting more and more attention.Diabetes mellitus can cause several complications,including diabetic retinopathy and diabetic cataract,as well as changes in the structure and micro-environment of ocular surface,which can further affect the composition and quality of tear fluid,even the stability of tear film.This review will provide a brief overview of ocular surface changes caused by diabetes mellitus,relevant detection methods and affecting factors.