The improvement of diagnostic levels for fundus diseases depend on the advancements of fundus imaging technology.Different fundus imaging technologies allow doctors to inspect ocular fundus from different aspects such as morphological or functional changes of retina.As a basic fundus examination method,optical coherence tomography provides high-resolution and cross-sectional retinal images coupled with non-invasive advantages.Fully understanding of the advantages and disadvantages of each fundus imaging technique,appropriate choosing one or combining several imaging techniques,and optimizing diagnostic procedures for each fundus disease are crucial steps to improve our diagnostic.levels of ocular fundus diseases.

There are many research reports about surgical treatments for central retinal vein occlusion (CRVO) up to date, such as radial optic neurotomy, vitrectomy combined with internal limiting membrane removal or not, t-PA retinal venous thrombelysis, oph-thalmic artery thrombolysis and so on. However, the most of the therapeutic methods are controversial, the action mechanism of some therapies are still not clear, and their complications should be taken attendtion seriously. So in the future it is necessary to conduct multiple centre prospective randomized controlled trials for evaluating the role of different surgical therapies for CRVO. (Ophthalmol CHN, 2009, 18: 217-220)

Advantages and disadvantages of morphologic and functional examinations for macular disease were reviewed. These examinations included optical coherence tomography(OCT), Heidelberg retina tomograph(HRT), and multifocal electroretinography (mfERG), etc. It is very important to improve ability of diagnosis and management of macular disease by choosing examination logically and integrating morphologic examination with functional examination on the basis of disease.

Mitomycin-C eyedrops were administered for the prevention of pterygium recurrence after surgical excision.37 primary and 16 recurrent pterygia were postoperatively instil- led 0.2mg/ml or 0.4mg/ml mitomycin-C eyedrops,and 24 primary and 4 recurrent pterygia were given placebo instead to serve as controls.During a follow-up of 3 to 8 months,one(1.89%)of the 53 eyes treated with mitomycin recurred 3 months after the operation while 3 eyes(10.7%)of the 28 controls recurred,the difference being very significant.The authors opinted that mitomy- cin-C eyedrops of low concentration was safe and effective for the prevention of postop- erative pterygium recurrence.

Being a part of the microcirculatoty system,retinal microvasculature may have similar morphology change as cardio-and cerebro-microvasculature under the pathological conditions.Although no study has proved that there exists causal relationship between retinal microvasculature change and cardiovascular diseases (CVD) , realizing their connection is extremely vital for ophthalmologists to evaluate the status of the systemic microcirculation, predict the occurrence of CVD, and proceed primary prevention by visible information of retinal microvascular alteration.In addition,for the patients suffering from retinal vascular occlusion,especially those with undiagnosed systemic diseases like CVD,ignoring systemic examinations may delay proper treatment and lead to the consequences of ill health.In conclusion, ophthalmologists should recognize the association of retinal microvasculature changes with systemic vascular diseases and provide useful information for primary prevention and early diagnosis and treatment of systemic vascular diseases.

Background The studies on intravitreal ranibizumab for diabetic macular edema (DME) primarily focuses on the absolute change of central retinal thickness, while the affection of the relative change of central retinal thickness (RCRT) or relative change of central retinal thickening (RCRTing) on visual prognosis has not been elucidated completely.Objective This study aimed to evaluate the effect of RCRT and RCRTing in assessing visual prognosis in DME patients following intravitreal injection of ranibizumab.Methods A self-controlled observational study was designed.Thirty eyes of thirty patients with clinically significant DME (CSDME) were recruited in Beijing 401 Hospital of China Nuclear Industry from November 2013 to October 2014.Ranibizumab of 0.05 ml (10 mg/ml) was intravitreally injected by 30G syringe needle at 3.5 mm posterior corneal limbus.Best corrected visual acuity (BCVA) far 2.5 meters away modified ETDRs visual chart was examined before injection and 3 and 6 months after injection,and the BCVA difference value between before injection and 6 months after injection was calculated as the absolusion BCVA (ABCVA).Spectral domian optical coherence tomography (SD-OCT) system was employed to measure the central retinal thickness (CRT) and to calculate the RCRT and RCRTing value.The correlations of RCRT or RCRTing with ABCVA was analyzed.Results The LogMAR values were (0.66±0.20) ,(0.40±0.25) BCVA and (0.37±0.25) before injection and 3,6 months after injection respectively in the CSDME patients,with a significant difference among them (F =36.79,P＜0.05).The values were obviously improved 3 and 6 months after injection compared with before injection (both at P＜0.05).The mean ABCVA (LogMar) of the patients was (0.30±0.21).The CRT 3,6 ,pmyjd sgyrt omkrvyopm values were (508.63±130.44), (331.07±71.84) and (311.77±64.47)μm before injection and respectively in the CSDME patients, showing a significant difference among them (F=49.78,P＜0.05).The CRT values were evidently reduced 3 and 6 months after injection in comparison with before injection (both at P＜0.05) ,and the mean ACRT value was (196.87±140.59) μm.The ABCVA values were (0.13±0.13),(0.44±0.14),(0.07±0.09) and (0.41±0.15) LogMAR in the RCRT＜35％ group,RCRT≥ 35％ group,RCRTing＜69％ group and RCRTing ≥ 69％ group, respectively.Significant differences were found in ABCVA between the RCRT＜35％ group and RCRT≥35％ group (t=-6.27,-8.65,both at P＜0.05).RCRT and RCRTing showed the positive correlations with ABCVA in the CSDME patients (r =0.86,0.79, P ＜ 0.05).Conclusions RCRT and RCRTing can identify well the optimal responders to intravitreal ranibizumab and predict BCVA improvement after treatment.RCRT has better association with ABCVA than RCRTing.RCRTing may be preferable when retinal thickening is more severe.

Scleral buckling surgery is a main surgical method for rhegmatogenous retinal detachment, and it is the basic skill of retinal surgeons. As a kind of classic treatment, retinal surgeons must recognize and understand the essence and connotation of scleral buckling surgery, master and apply skillfully, improve the success rate of rhegmatogenous retinal detachment, and use the minimum amount of surgical combination to achieve anatomical retinal reattachment and restore visual function as much as possible.

Objective:To analyze the reasons for the failure of scleral buckling (SB) in the treatment of rhegmatogenous retinal detachment, and observe the efficacy and safety of re-buckling.Methods:This was a retrospective non-comparative clinical research. From July 2014 to June 2020, patients with first-time SB failure who visited the Beijing Tongren Hospital were included in this study. There were 42 patients, including 30 males and 12 females, with the average age of 29.40±16.13 years, and they were all monocular. The retinal detachment range <1, 1-2 and > 2 quadrants were 9, 22 and 11 eyes, respectively. The macula was involved in 38 eyes. The average logarithm of the minimum angle of resolution (logMAR) best corrected visual acuity (BCVA) was 0.99±0.57. Forty eyes and 2 eyes were performed 1 and 2 SB, and all the retina were not reattached. All patients were under general anesthesia, according to the conditions during the operation, re-freeze and located the holes under indirect ophthalmoscope. And selected the new external pressure material or retained the old one in combination with the other operations to reattaced the retina. The average follow-up time was 31.93±18.97 months. The reasons for the failure of the first surgery based on the records of this surgery were analyzed. The visual acuity changes, the rate of retinal reattachment and the occurrence of complications were observed. The visual changes were compared by paired t test. Results:The top three reasons for the failure were: 16 case of the displacement of the compression spine (38.10%); 9 cases of missing the retinal holes and 9 case of improper selection of compression substances (account for 21.43%, respectively); 6 cases of insufficient height of compression spine (14.29%). All of retina were reattached (100%, 42/42). The average logMAR BCVA was 0.52±0.40. The difference of logMAR BCVA between before and after surgery was statistically significant ( t=6.106, P=0.000). There were a slight increase in intraocular pressure in 8 eyes, the average intraocular pressure was 25.00±2.61 mmHg (1 mmHg=0.133 kPa). No serious complications occurred after surgery. Conclusions:The position deviation of the compression spine, the missed hole during the operation, the improper selection of external compression material, and the insufficient height of the compression spine are the main reasons for the failure of SB. After adjusting the reasons for the failure, there is still a higher rate of retinal reattachment.

Objective To compare the therapeutic effects of 577 nm laser and 532 nm laser panretinal photocoagulation (PRP) in the treatment of non-proliferative diabetic retinopathy (NPDR).Methods This is a prospective controlled study.A total of 23 patients (41 eyes) with clinically diagnosed severe NPDR were randomly divided into two groups including 577 nm group (11 patients,20 eyes) and the 532 nm group (12 patients,21 eyes).577 nm group and 532 nm group received 3-4 times PRP with single-point mode.The laser energy and the number of laser spots were compared,and the laser energy density was calculated.Before treatment and 1 day,1,3,6 and 12 months after treatment,the changes of best corrected visual acuity (BCVA),average threshold sensitivity,a/b-wave amplitude of flash ERG (F-ERG) in the 30°-60° visual field,and fundus fluorescein angiography (FFA) were compared between two groups.Results The response rate was 85.0％ and 23.8％,respectively in the 577 nm and 532 nm group,the difference was statistically significant (x2 =15.43,P ＜ 0.05).Compare to the pre-treatment measurement,the average threshold sensitivity,a/b wave amplitude of F-ERG and the 30°-60°visual field were reduced at 1 day after treatment both in the 577 nm and 532 nm group,the difference were statistically significant (F =8.68,7.57,4.52;P＜0.05).The average threshold sensitivity (t=2.41,3.48,1.23),a/b wave amplitude (a wave:t=5.82,4.45,7.83;b wave:t=5.40,3.23,4.67) of F-ERG were different between 577 nm and 532 nm group at 3,6 and 12 months after treatment (P＜0.05).There was no retinal neovascularization and non-perfusion region in two groups at 6 months after treatment.The average laser power were (436.25 ±54.65) and (446.43 ± 35.61) mW,number of laser spots were (1952.95 ± 299.09) and (2119.05 ± 302.69) spots,energy density were (7.60±1.30) and (7.60±3.00) mW× ms/μm2 in the 577 nm group and 532 nm group,respectively.There was no difference in average laser power (t=1.35),number of laser spots (t=2.85) and energy density (t=1.99) between two groups (P＞0.05).Conclusion Compared with the 532 nm laser,577 nm laser treatment has better visual outcomes for NPDR patients.

Objective To discuss the diagnostic value of soluble scavenger receptor(sCD163)for the patients of malignant tumor associated with fever in early infection .Methods Collect 102 cases of patients confirmed with malignant tumor in this hospi-tal since January to December 2014 ,all the patients were examined with blood culture .102 patients were divided into two groups ac-cording to the results of blood culture :infection group (60 cases) and uninfected group (42 cases) .ELISA ,electrochemical lumines-cence and immune transmission turbidimetric methods were used to detect the levels of sCD163 ,PCT and CRP in serum ,to compare the differences in the above indicators between two groups .The receiver-operating characteristic curve (ROC curve) was applied to evaluate the application value of sCD163 in diagnosing of malignant tumor associated with fever in early infection .Results The lev-el of sCD163 ,PCT and CRP had statistically difference in two groups(P< 0 .05) ;the critical values of sCD163 、PCT and CRP were 110 .80 ng/mL ,0 .45 ng/mL ,15 .60 mg/L respectively which can suggest the patients with malignant tumor complicated with fever in early infection .The area under the curve were 0 .894 ,0 .835 ,0 .743 respectively ,among that sCD163 area was the largest ;The corresponding sensitivity were 88 .9% ,77 .9% and 88 .0% ;specificity were 77 .0% ,74 .0% and 50 .0% respectively .Conclusion Compared with PCT ,CRP ,sCD163 has more value for diagnosing the patients of malignant tumor associated with fever in early in-fection .