Background Choroidal neovascularization (CNV) is a major cause of visual loss in many fundus diseases.Fundus angiography (FA) is essential for the diagnosis,location and treatment of CNV.However, FA is an invasive examination method.Split spectrum amplitude decorrelation angiography (SSADA) OCT can quickly and clearly provide vascular signals.However, whether SSADA-OCT is feasible in the evaluation of CNV remains unclear.Objective This study was to detect and quantify CNV using OCT angiography.Methods Thirteen patients with unilateral CNV were included in Beijing Tongren Eye Center from June 2014 to August 2014.All affected eyes of the subjects were scanned with a high-speed frequency domain OCT.The SSADA-OCT images were obtained by scanning of macula covered 6 mm×6 mm area.The CNV area and grey scale were computed from the en face OCT images of retinal layer and choroidal layer.This study followed the Helsinki Declaration and was approved by the Ethics Committee of Beijing Tongren Hospital,and written informed consent was obtain from each patient prior to any medical examination.Results SSADA-OCT angiogram revealed CNV area and location confirmed by fluorescein angiography,and the CNV blood flow information of internal limiting membrane,inner plexiform layer,retinal pigment epithelium,and choroid was exhibited by OCT angiography.All CNVs with different causes showed the well defined and hyperreflected signal in macular region.The average CNV area was (0.15 ±0.09)mm2 , and the average grey scale of CNV was 75.40±32.35 in the affected eyes,and that in the contralateral eyes was 26.99±22.87 in the 300 μm area,showing significant elevation in gray scale in the affected eyes compared with the contralateral eyes (t =6.946, P＜0.001).Conclusions OCT angiography is a noninvasive observation technique of retinal and choroidal blood flow.It can provide quantitative information and detailed images of CNV.

Background Cystoid macular edema (CME) is caused by many fundus diseases.The noninvasive clinical diagnosis methods for CME are conventional color fundus photography up to now.However,these images can not display the CME range well.Confocal scanning laser ophthalmoscope (cSLO) based retinal imaging can provide clear picture with high contrast.However,whether cSLO imaging is feasible in the quantitative assessment of CME remains unclear.Objective This study was to image the boundary of CME and assess the quantification of CME image from cSLO imaging technology.Methods A series case-observational study was designed.This study protocal was approved by Ethic Committee of Beijing Tongren Hospital.cSLO based retinal imaging technology was carried out on consecutive 24 eyes of 24 patients with clinically diagnosed and OCT confirmed CME in Beijing Tongren Eye Center from August to December 2015 under the informed consent of each individual.The radial scan range was 45°× 45 ° and the line scan level was 49 at macula area.The pseudocolar image,green light reflective image (532 nm) and infrared reflective image (785 nm) were collected.The imaging was analyzed by EasyScan software (version 1.2.2).Fundus color photography and SD-OCT were carried out in each patient.The images were graded by specialists according to the SD-OCT cross sectional results.Results The primary causes of CME included epiretinal membrane (10 eyes),branch retinal vein occlusion (BRVO) (6 eyes),central retinal vein occlusion (CRVO) (4 eyes),diabetic retinopathy (DR) (3 eyes) and CRVO with BRVO (1 eye).A CME image was exhibited on the fundus color photogram with the obscure boundary;while the clear range of CME was displayed by the cSLO imaging.The mean score of CME from pseudocolar image,green light reflective image and infrared reflective image was 3.21±0.78,2.67±0.96 and 2.54±0.83,respectively,which was significantly higher than 1.33±0.82 from the fundus color photography (all at P＜0.01).Conclusions In CME patients,the imaging quality from cSLO-based retinal imaging technology is better than that from traditional fundus color photography.Combined with SD-OCT sectional scan analysis,cSLO-based retinal imaging technology may offer a method to observe and record more fundus details for CME diagnosis.

Background Glaucoma is characterized by loss of retinal ganglion cells (RGCs) followed by visual field defects.Spectral domain OCT(SD-OCT) enabled more precise and quantitative assessments of macular ganglion cell complex (GCC) thickness.Objective This study was to evaluate the diagnostic ability of GCC thickness in identifying primary open angle glaucoma (POAG).Methods A prospective study was performed.Seventy POAG patients and 30 healthy volunteers were enrolled in Beijing Tongren Hospital from November 2015 to April 2016.Macular GCC thickness and peripapillary retinal nerve fiber layer (RNFL) thickness were measured with RTVue SD-OCT,and Humphrey perimetry was performed on the eyes.The patients were assigned to the early stage POAG group,advanced POAG group and later stage POAG group based on the mean defect (MD) of visual field.The average,superior,inferior GCC and RNFL,focal loss volume (FLV),and global loss volume (GLV) were measured and compared among the groups.The correlations between GCC thickness or RNFL thickness with MD were evaluated in the POAG eyes.The discrimination capabilities of GCC thickness or RNFL thickness were assessed and compared by using areas under the receiver operating characteristic (ROC) curves (AUC).Results Compared with the normal control group,the average,superior,inferior GCC thickness and RNFL values were evidently reduced,the FLV and GLV were significantly increased in the early stage POAG group,advanced POAG group and later stage POAG group (all at P＜0.001).Compared with the early stage POAG group,the average GCC and RNFL thickness values were significantly reduced,and GLV was increased in the advanced POAG group and later stage POAG group (all at P＜0.05).In the later stage POAG group,superior RNFL was thinner than that in the early stage POAG group (P =0.003).The superior GCC value were lower in the later stage POAG group than that in the early stage POAG group and advanced POAG group (all at P＜0.001).Compared with the early stage POAG group,the inferior GCC and RNFL thicknesses were decreased and the FLV was increased in the advanced POAG group and the later stage POAG group (all at P≤0.01).Linear positive correlations were found between average GCC,superior GCC,inferior GCC,average RNFL,superior RNFL or inferior RNFL and MD (r =0.624,0.583,0.601,0.571,0.447,0.537,all at P＜0.001),and the positive correlations were also seen between average GCC and average RNFL,between superior GCC and superior RNFL or between inferior GCC and inferior RNFL (r =0.648,0.630,0.602,all at P＜0.001).The AUCs were 0.965,0.979,0.924,0.985,0.980,0.990,0.979 and 0.992 in the average GCC,superior GCC,inferior GCC,FLV,GLV,average RNFL,superior RNFL and inferior RNFL,with the largest AUCs in the FLV and inferior RNFL thickness.No significant difference was found in the AUC between FLV and inferior RNFL thickness (P＞0.05).Conclusions Inferior GCC is more susceptible to glaucomatous damage.FLV and GLV from GCC pattern parameters are sensitive indicators for diagnosis of POAG.GCC thickness could be a valid structural parameter for detecting glaucoma and can be used as a marker in glaucoma assessment.

Background Recently,the study on the cause of optic nerve damage induced by glaucoma is of concern in ophthalmology.Some research showed that the immune system is associated with glaucoma-induced optic neuropathy.Acute ischemia-reperfusion is an ideal model of studying optic neuropathy.ObjectiveThe present study investigates the effect of T and B lymphocyte deficiency on the retinal neurocytes of mice with acute intraocular hypertension.Methods Sixteen SPF CB-17/Icr.Cg-Prkdc~(scid)Lyst~(bg)/CrlVR mice 6-8 week-old (severe combined immunodeficiency mouse,SCID) were used in this study and 16 age-matched SPF wild type (C57BL/6) mice served as controls.The ischemia-reperfusion injury models were induced in the right eyes of 10 SCID mice and 10 C57BL/6 mice through intra-anterior chamber infusion of balanced saline solution for 45minutes to increase the intraocular pressure to 104mmHg,and the left eyes served as model controls.The other 6 SCID mice and 6 C57BL/6 mice served as normal control group.10g/L (2μL) of FlouroGold was injected into the brains of the mice for the labeling of surviving retinal ganglion cells 21 days after ischemia-reperfusion.The thickness of retinal inner nuclear layer was measured by H&E staining under the fluorescent microscope 21 days after ischemic insult.The use of the animals followed the Standard of Association for Research in Vision and Ophthalmology.Results In normal control mice,the morphology of retinal ganglion cells (RGCs) and retinal structure were similar between SCID mice and C57BL/6 mice.The differences in the numbers of RGCs and retinal thickness were insignificant between the two types of mice(P＞0.05).In the experimental mice,the surviving RGCs were strikingly increased in SCID mice (91%±5%) compared with C57BL/6 mice(78%±5%)(P=0.003).The thickness of the retinal inner nuclear layer was obviously thinner in the model eyes (22.44±1.70μm) compared to model control eyes (31.06±3.75μm) in C57BL/6 mice(P=0.004),but no statistically significant difference was found between the model eyes and model control eyes in SCID mice (33.52±2.13μm vs 34.06±3.00μm) 21 days after ischemia-reperfusion injury(P＞0.05).Conclusion T and B lymphocytes deficient mice show a better tolerance to acute intraocular hypertension than the wild type C57BL/6 mice.

Objective To cpmpare the assessment of retinal and choroidal disease using confocal scanning laser ophthalmoscope (cSLO) imaging and color fundus camera.Methods Sixty-seven patients (90 eyes) with fundus diseases were included in this study.There were 35 males (51 eyes) and 32 female (39 eyes),mean age was 51.32 years.All subjects underwent fundus imaging using cSLO technology and traditional color fundus camera,positive numbers of every retinal pathological change were calculated and compared.Spectral domain-optical coherence tomography (SD-OCT) was also done to compare the accordance rate between two modes of fundus imaging (cSLO technology and traditional color fundus camera) and SD-OCT in choroidal changes.Results The positive numbers of retinal microaneurysm (x2 =4.157,P＜ 0.05) and epiretinal membrane (x2 =5.428,P ＜ 0.05) using cSLO fundus imaging were significantly higher than traditional color fundus camera,while the positive numbers of cotton wool spots (x2 =0.523),retinal hemorrhage (x2 =0.117),hard exudates (x2 =0.325) and macular hole (x2 =0.070)were no significant different (P＞ 0.05).The SD-OCT accordance rate of choroidal pathological changes using cSLO technology was higher than traditional color fundus camera (x2 =9.143,P=0.007).Conclusion In retinal and choroidal diseases,the imaging quality of cSLO fundus imaging technology is better than the traditional color fundus camera technology.

Objective:To investigate the change regularity and influencing factors of subfoveal choroidal thickness (SFCT) with age among adults.Methods:A cross-sectional study was adopted.A total of 281 Chinese adults, aged between 21 and 90, were selected from working staff and retired staff of an institution who underwent routine physical examinations from June to October 2016 in Beijing Tongren Hospital.One eye of each subject was included in the study according to the random number table method.The subjects were divided into different age groups including 21-30 years group, 31-40 years group, 41-50 years group, 51-60 years group, 61-70 years group, 71-80 years group and 81-90 years group.The SFCT was measured at the fovea and at 500 μm, 1 000 μm and 2 000 μm nasal (N) and temporal (T) to fovea by high definition-optical coherence tomography.Multiple linear regression equation was used to analyze the influence of ages, gender, intraocular pressure (IOP), spherical equivalent (SE) and retinal thickness on SFCT.This study followed the Declaration of Helsinki and was approved by the Ethics Committee of Beijing Tongren Hospital, Capital Medical University (No.TRECKY2016-012). Written informed consent was obtained from each patient prior to any examination.Results:Mean SFCT of eligible 229 subjects (229 eyes) was (218.73±79.69)μm.Choroid became thinner gradually towards nasal and temporal part.There were significant differences in SFCT, N2 000, N1 000, N500, T500, T1 000 and T2 000 among all age groups ( F=27.05, 22.85, 25.38, 29.11, 32.55, 29.22, 28.70, all at P<0.01). Choroidal thicknesses of all locations showed age-related linear decrease with a steep drop after 50 years old ( R2ranged 0.35-0.47, all at P<0.01). SFCT was associated with SE (β=-10.07, P<0.01) and age (β=-2.43, P<0.01) but not related with gender (β=-19.69, P=0.057), foveal thickness (β=0.02, P=0.897) or IOP (β=-0.86, P=0.466). Conclusions:SFCT shows an age related linear decrease with a steep decline after 50 years old, which was associated with aging and higher SE in myopia, but not related with gender, foveal thickness or IOP within the normal range.

Objective To explore the effect of FORUM data management system on the efficiency of ophthalmology chinic.Methods Outpatients′data were collected from October 2015 to March 2016 in glaucoma clinic in Beijing Tongren Hospital affiliated to Capital Medical University. Eight outpatient clinics after the application of FORUM data management system ( Janaury 1st 2016) were allocated to observation group, while 8 outpatient clinics before the application of new system were regarded as control group. The number of outpatients and ophthalmic examinations were compared between two groups.Results After the application of FORUM data management system, the average number of outpatients (27.88±6.53) in one clinic day was significantly higher than the number before(20.00±7.78)(P<0.05);the average number of ophthalmic examinations (31.00±9.23) was also higher than the number before application of new management system ( 15. 75 ± 7. 05 ) ( P<0. 05 ) . Similarly, the number of ophthalmic examination per patient was significantly different before and after the application of FORUM data management system ( P<0. 05 ) . Conclusions The application of FORUM data management system can remarkably enhance the working efficiency of ophthalmology clinic and can help medical staff manage the patients more easily.

Objective To compare the awareness of glaucoma between high-educated and general people and provide theoretical evidences for the focus of health education.Methods A total of 340 people in one work unit who received health examinations in the Health Screening Center in Beijing Tongren Hospital from June 2016 to September 2016 were selected and investigated using a self-designed questionnaire for the awareness of glaucoma. According to the education background, all subjects were divided into the high-educated group (bachelor degree and above) and the general group (below bachelor degree). Chi-squared test was used to analyze and compare the awareness of glaucoma between two groups.Results The rates of considering themselves as knowing glaucoma in the high-educated group and general group were 6.79% and 6.75% respectively, with no significant difference between the two groups (χ2=0.001,P=0.988). The rate of correct knowledge of symptoms and treatment of glaucoma in the high-educated group was significantly lower than that in the general group, while the misunderstanding of symptoms and treatment glaucoma in the high-educated group was significantly better than that in the general group (allP<0.05). The media was the major source to acquire the knowledge in both groups. High-educated people wanted to get glaucoma knowledge through medical consultant (34.57%), while general people wanted to obtain glaucoma knowledge through media (45.40%). The difference was statistically significant between the two groups (P<0.01).Conclusions The awareness of glaucoma in both high-educated and general people are low. There are differences in the knowledge of symptoms, treatment and approach of achieving of glaucoma between high-educated and general people. Special emphasis in the health education for two groups of people is necessary to achieve more effectiveness.

Objective:To analyze the change of intraocular pressure of normal adults measured by non-contact tonometer with age and to provide theoretical basis for health education of intraocular pressure.Methods:A total of 330 employed workers and retired employees (330 eyes, right eye) from a work unit who underwent physical examination in Beijing Tongren Hospital were selected from June to September 2019. According to the age of each 10 years, they were divided into 7 groups, including 31 cases in 20 to 29 years old group, 38 cases in 30 to 39 years old group, 32 cases in 40 to 49 years old group, 54 cases in 50 to 59 years old group, 43 cases in 60 to 69 years old group, 60 cases in 70 to 79 years old group and 71 cases in 80 to 90 years old group. The intraocular pressure was measured using a non-contact tonometer. Analysis of variance was used to compare the differences in intraocular pressure between different age groups and the effect of age on intraocular pressure was analyzed.Results:The age of the 330 subjects in this study ranged from 20 to 90 years old, and the intraocular pressure value was (13.57±3.42) mmHg. There were statistically significant differences in intraocular pressure among age groups ( F=4.36, P<0.01) . The 7 groups were regrouped into 20 to 59 years old group (155 eyes) and 60 to 90 years old group (175 eyes) , and intraocular pressure was respectively (14.53±3.18) mmHg and (12.72±3.41) mmHg, and the differences between the two groups were statistically significant ( t=4.98, P<0.01) . Simple linear regression analysis showed that the intraocular pressure decreased by 0.04 mmHg/year with the increasing age (95% CI -0.06- -0.02) . Conclusions:In normal people aged from 20 to 90 years old, the intraocular pressure drops after the age of 60. Therefore, determination of the normal range of intraocular pressure needs to be adjusted according to age so as to promote early detection, early diagnosis and early treatment of glaucoma.

Objective:To analyze the detection of myopic anisometropia in children of low and high age groups in a Class Ⅲ Grade A hospital to provide a theoretical basis for health promotion and education of myopia.Methods:A total of 217 children with myopia who were treated in the Ophthalmology Myopia Clinic of Beijing Tongren Hospital, Capital Medical University were selected from October to December 2020. According to age, they were divided into the low-age group (5-9 years old, 127 cases) and the high-age group (10-14 years old, 90 cases). The difference of spherical equivalent (SE) between left and right eyes of subjects was recorded, and the SE difference greater than or equal to 1.00d was defined as anisometropia. Non-parametric test was used to compare the difference of SE between the two groups, χ 2 test was used to compare the difference of gender and anisometropia detection rate between the two groups and multiple linear regression was used to analyze effects of age, gender and ocular axis difference on SE difference. Results:The binocular SE difference was 0.25 (0.00-0.50) D in the low age group and 0.50 (0.22-0.75) D in the high age group, and the difference between the two groups was statistically significant ( Z=2.75, P=0.006). The detection rates of anisometropia in the low-age group and the high-age group were respectively 9.45% and 20.00%, and the difference between the two groups was statistically significant (χ 2=4.92, P=0.027). Age had a significant effect on the SE difference. With the increase of age, the SE difference of both eyes increased 0.04 D/year (95% CI: 0.007-0.080, P=0.020). The binocular axial difference has a significant effect on the SE difference. For every 1 mm increased in the axial difference, the SE difference increased by 0.03 D (95% CI: 0.004-0.060, P=0.024). Gender had no effect on binocular SE difference ( P=0.382) . Conclusions:With the increase of age, the refractive difference of both eyes increases significantly, especially the incidence of anisometropia over 10 years old is higher than that under 10 years old. It is suggested that more attention should be paid to the occurrence of anisometropia in ophthalmology clinic, and to promote the early detection, intervention and control of anisometropia in children and adolescents.