The retinal vessel changes are the primary and major features of retinal vascular diseases.The retinal vessel is part of systemic vessels with its own characteristics to sustain normal retinal function.These basic characteristics are important to the correct understanding and proper treatment of retinal vascular diseases.Always keep in mind that the retinal vessels is one part of the systemic vascular system,thus retinal vascular diseases may have systemic etiology,and systemic drug administration may have a profound effects to the whole body.However retinal vascular system also has its own structural and functional characteristics,thus retinal vascular diseases are also different from the systemic diseases.Finally the main function of retinal vascular network is to maintain the neuro-retinal function,thus we should balance the vision protection and treatments against abnormal retinal blood vessels.Over-treatments may damage the retinal vision.

The importance of software version in the medical device software supervision does not cause enough attention at present. First of all, the effect of software version in the medical device software supervision is discussed, and then the necessity of software version in the medical device software supervision is analyzed based on the discussion of the misunderstanding of software version. Finally the concrete suggestions on software version naming rules, software version supervision for the software in medical devices, and software version supervision scheme are proposed.
Equipment and Supplies ; Software

Objective: The FDA regulation requirements for medical device software are relatively mature and systematic, and the research on the FDA regulation thinking of medical device software helps to promote the regulation work of the medical device software in our country. Methods:Based on the comparison of the 1998 edition and 2005 edition FDA software submission guidance, the trend of the FDA regulation requirements for medical device software was analyzed, and then its regulation thinking was discussed according to other current effective software-related guidance. Results:FDA integrally improves the submission requirements for all medical device software, especially for the minor Level of Concern software, and simplifies the requirements for design specification, verification and validation, but strengthens the requirements for traceability analysis and revision history. Conclusion: The regulation work of the medical device software in our country needs to fully consider the particularity of the medical device software, strengthen the audit of software quality management system, implement the software traceability analysis, and determine the regulation requirements for software change.

Corticosteroids are widely used to treat ocular fundus diseases such as inflammatory disease,macular edema and choroidal neovascularization.To increase local drug concentration and reduce systemic side effects,corticosteroids are often delivered by periocular or intravitreal iniection.However there are still more and more clinical complications with the expanded scope of application of these drugs.In order to achieve the best risk-benefit ratio,fully understanding the pharmacological characteristics,indications,contraindications and complications of corticosteroid is critical for clinicians to prescribe this drug to their patients.

Objective To evaluate the clinical effect of transpupillary thermotherapy (TTT) on circumscribed choroidal hemangioma (CCH). Methods The clinical data of 12 eyes of 12 patients with CCH treated with TTT were retrospectively analysed. Infrared diode laser Iridex, oculight SLX was used in TTT at 810 nm and power between 220 and 1 000 mW with a beam diameter of 1.2 or 2 0 or 3 0 mm, with 1 to 2 minutes of exposure time. The visual acuity , subretinal fluid , complication ,thickness and hyperfluorescence of CCH were observed pre and postoperatively in the treated eyes. The average period of follow up was 10 months (6 16 months). Results Among the 8 eyes with peripheral retinal detachment in 12 cases of CCH the peripheral subretinal fluid was completely absorbed in 6 eyes, and partially absorbed in 2 eyes after TTT treatment. In 8 patients undergone ultrasonography, the mean value of tumor thickness went down by 21.75 % in 7 eyes. The resultant visual acuity after treatment was improved in 3 eyes, maintained no change in 7 eyes and reduced in 2 eye. The fundus fluorescein angiography in 10 eyes revealed a significant decrease of the leakage in tumor. Postoperative complication of TTT in the 12 eyes included retinal hemorrhage (5 eyes) and retinal fold (1 eye). Conclusion TTT is an effective treatment for CCH.

Objective To evaluated the effect of transpupillary thermotherapy (TTT) on age related macular degeneration (AMD). Methods Sixty two cases (62 eyes) of exudative AMD were managed with TTT. Before treatment, 58 cases underwent fundus fluorescein angiography(FFA),42 cases underwent simultaneous indocyanine green angiography (ICGA), and 56 cases underwent optic coherence tomography (OCT).TTT was delivered using a 810 nm diode laser with variable spot sizes 0.5 3.0 mm and power range 60 40 mW,60 seconds duration. Sixty two cases were followed up for 1 10 months with 4 8 months average. Results The visual acuities of last visit were compared with those before the treatment. The visual acuity was unchanged in 43 cases (69.3%), improved in 15 cases (24.2%), and declined in 4 cases (6.5%). OCT was re done in 51 cases and compared with OCT images before TTT treatment. The height of macular edema was unchanged in 29 cases (56.9%), decreased in 18 cases (35.3%), and increased in 4 cases (7.8%). The amelioration of visual acuity was compatible with that of macular configuration in the majority of cases (74.5%). Only in 13 cases (25.5%) the amelioration of visual acuity lagged behind that of macular configuration. The re treatment was performed in 18 cases (29.1%), probably due to insufficiency of laser power. No side effect was found. Conclusion TTT makes most of the cases of exudative AMD retaining or improving their visual acuity. The employment is secured. Further exploration is needed in order to obtain the parameters of the laser treatment.

Objective To evaluate the effect of transpupillary thermotherapy (TTT) on the treatment of intraocular tumors. Methods A total of 50 patients with intraocular tumors, including 37 choroidal hemangioma, 2 retinal capillary hemangioma, 5 choroidal osteoma, 4 choroidal melanoma, and 2 retinoblastoma (RB) underwent TTT and were followed up for 1～20 months. Results In 30 patients with choroidal hemangioma (average follow-up was 5.1 months), 29 (96.7%) had pigment scarring in different levels and the retinal detachemnts were partly or completely recovered; 1 had no obvious improvement. The visual acuity was unchanged in 24 (80.0%) patients, improved in 41 (13.3%) and declined in 2 (6.7%). In 2 patients with retinal capillary hemangioma, no effect was found. In 5 eyes (4 patients) with choroidal osteoma (average follow-up was 6 months), no change of the tumor was found in 1 and the atrophic spots were seen in 4; the visual acuity was unchanged in 3, improved in 1 and declined in 1. In 4 patients with choroidal melanoma (average follow-up was 8 months), the tumor was shrunken in 1, unchanged in 2, and enlarged in 1; the visual acuity was unchanged in 2 and declined in 2. In 2 patients with RB, RB was totally shrunken in 1 and partly shrunken in 1. Visual acuity of one child patient who was followed up for 20 months could not be examined, and was unchanged in another one who was followed up for 3 months. No severe complications were found in the patients during the treatment and the follow-up. Conclusions TTT is effective for the treatment of some intraocular tumors except retinal capillary hemangioma. It is a kind of potential treatment for intraocular tumors with few side-effect.

Objective To analyze the problems in the diagnosis of Coats disease and its main causes of misdiagnosis. Methods The clinical data of a group of patients with Coats diseases who had undergone indirect ophthalmoscopy, ocular fundus photography, fundus fluorescein angiography (FFA) and follow-up examination were retrospectively analyzed. The main causes of misdiagnosis were analyzed via reviewing the images of FFA and revising or confirming the initial diagnosis of Coats diseases according to the main features of abnormal dilation of retinal capillary vessels. Result In 68 patients (75 eyes), there were 45 cases whose initial diagnosis was Coats disease while the final diagnosis was not, in whom the final diagnosis was old retinal vein occlusion in 21, retinal vasculitis in 9, diabetic retinopathy in 3, old posterior uveitis in 3, congenital retinoschisis in 3, and proliferative vitreoretinopathy, familial exudative vitreoretinopathy, racemose hemangioma, old rhegmatogenous retinal detachment, macular epiretinal membrane, and idiopathic juxtafoveal telangiectasis in 1, respectively. There were 23 patients who was diagnosed as Coats disease in the final diagnosis but not the initial one. The initial diagnosis was old posterior uveitis in 6 patients, retinal vasculitis in 5, exudative age-related macular degeneration in 4, retinal main arterial tumor in 2, retinal angioma in 3, intraocular tumor in 2, and central serous chorioretinopathy in 1. Conclusions There are many problems in the clinical diagnosis of Coats disease. The main reason of misdiagnosis is that the clinicians can not comprehensively master the core of the definition of Coats disease and its clinical characters.

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[Objective] To evaluate the value of cardiac screening in the first trimester by using three-dimensional ultrasound with spatiotemporal image correlation (STIC) and to analyze the value of different views for cardiac assessment.[Methods] This study retrospectively reviewed the eighty-seven fetuses with congenital heart diseases which were diagnosed in our institution between January 4th 2013 and June 30th 2016.We compared the detection rate of prenatal ultrasound screening with STIC in the first trimester and the results of postnatal echocardiography or autopsy.In addition,the detection rates of the different planes,including four-chamber view (4CV),outlet of the left ventricle (OLV),outlet of the right ventricle (ORV) and three vessels-trachea view (3VT) were analyzed.[Results] Severe cardiac anomalies were identified in 62 fetuses (71.3％) and non-severe cardiac anomalies were identified in 25 fetuses (28.7％).Seventy-eight cases (89.7％,78/87) with congenital heart diseases could be detected by using three-dimensional ultrasound with STIC.The detection ratesfor 4CV,4CV+OLV,4CV+ORV,4CV+3VT,4CV+OLV+ORV and 4CV+OLV+ORV+3VT were 48.3％,64.4％,66.7％,79.3％,69.0％ and 89.7％ respectively.[Conclusions] Three-dimensional ultrasound with STIC could detect congenital heart disease in the first trinester.The four-chamber view plus outlet of the left ventricle,outlet of the right ventricle and three vessels-trachea view could increase the detection rates of congenital heart diseases.