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.

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)

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 discuss the diagnosis characteristics and clinical value of posterior vitreous detachment (PVD) by color Doppler flow imaging(CDFI). Methods One thousand and two cases were examed by CDFI for the diagnosis standard and property of PVD. Results Typical acoustic properties of PVD: the B scan may show a very fluid thick line. There were two types complete PVD and part PVD based on the vitreous separated from the optic nerve. Kinetic echography typically showed a very fluid, undulating after movement of the completely PVD. Part PVD had more than one dot with attachments to the retina and less mobile than complete PVD. There was not blood flow signal on the PVD by CDFI. Conclusions Ultrasonography for PVD not only exactitudes,but also provides foundation for clinic.

Objective To analyse the detection of The Heidelberg Retina Tomograph Ⅱ (HRT-II ) for macular diseases. Design Retrospective observational case series. Participants 110 patients(201 eyes). Methods Fifty-two normal eyes, 74 eyes with macular edema, 23 eyes with macular hole, 31 eyes with macular premembrane and 21 eyes with choroidal neovascularization were examined with macular edema module(MEM) of HRT-Ⅱ. Main Outcome Measures Edema index (E value), signal width value (W value) and features of reflectance pictures. Results In normal eyes, E value and W value of some areas in macula were partly associated with age(r=0.207-0.359). E value and W value in macular diseases were significantly different from normal eyes (P=0.000). HRT-II could display macular edema cysts, configuration and size of macular holes, extension of macular premembrane and its relationship with retina and druen or subretinal neovascularization in age-related degeneration. Conclusion The reflectance pictures of HRT-Ⅱ have characteristic appearances in different macular diseases, and the measurements of E value and W value altered in pathologic stage of macular diseases. Especially E value of central zone can reflect changes of retinal thickness and light reflectance in macula, and it is obviously different in macular edema.