Objective To propose a new evaluation system and evaluate the application value of diabetic retinopathy ( DR) intelligence assisted diagnostic technology based on fundus photography. Methods By using the diagnostic test method,an evaluation system of DR intelligent diagnostic technology based on fundus photography was established. The fundus photographs of 331 diabetic patients (662 eyes) with DR screening were collected in the First Affiliated Hospital of Huzhou University from January 2017 to October 2018. The results of experts ' diagnosis and intelligence assisted diagnosis were compared and evaluated. The evaluation system includes primary evaluation, intermediate evaluation and advanced evaluation. The primary evaluation is the consistency of non-DR ( NDR) in all diabetic patients receiving DR-assisted diagnostic techniques;the intermediate evaluation is the diagnosis consistency of DR lesion degree in patients diagnosed with DR (grade 1-4);the advanced evaluation is the diagnosis consistency of DR classification ( grade 0 -4 ) in all diabetic patients receiving DR-assisted diagnostic techniques. The intermediate evaluation includes two evaluation methods. The main evaluation indicators include sensitivity,specificity and Kappa value. Results Based on experts ' diagnosis, NDR accounted for 22. 7％;mild non-proliferative DR (NPDR),moderate NPDR,and severe NPDR accounted for 19. 9％,18. 7％ and 25. 7％,respectively;proliferative DR( PDR) accounted for 13. 0％. Based on intelligence diagnostic system,NDR accounted for 25. 8％;mild NPDR, moderate NPDR and severe NPDR accounted for 19. 7％,19. 3％ and 22. 8％,respectively;proliferative DR( PDR) accounted for 12. 4％. Based on evaluation system in the paper,the sensitivity,specificity and Kappa value in primary evaluation were 91. 4％, 84. 7％ and 0. 72;the sensitivity, specificity and Kappa value in intermediate evaluation method one were 88. 4％,91. 1％ and 0. 79;the sensitivity, specificity and Kappa value in intermediate evaluation method two were 80. 5％,93. 3％ and 0. 75;the Kappa value in advanced evaluation was 0. 62. Conclusions The evaluation system can be applied to the evaluation of DR intelligent diagnostic technology,and the evaluation result can be used as the basis for the selection of DR intelligent diagnosis application scene.

Anti-vascular dndothelial growth factor (VEGF) drugs have open up a new treatment channel for ocular neovascular diseases.A lots of clinical data has proved that anti VEGF drugs are effective and safe.But we should also notice that long-term and excessive usage of anti-VEGF drugs brings some new problems and complications,and even affect the normal ocular physiological process of the angiogenesis and retinal blood flow.So,it is necessary to pay attention to the problems and potential risks of excessive usage of anti VEGF therapies for ocular neovascular disease.

Background Retinal vein occlusion (RVO) is a common vasculoretinopathy in ophthalmology.No an effective treating way is confirmed so far,and some new approach is in exploration.Objective The present study aims to investigate the safety and feasibility of injection of tissue plasminogen activator into optic nerve for the treatment of RVO using flash visual evoked potential (F-VEP) and flash electroretinogram(F-ERG).Methods The recording electrodes for F-VEP were implanted into the skull of rabbits to investigate the safety and feasibility of injection of tPA into the optic nerve.25μg of tPA or 12.5μg tPA (0.1 mL) was injected in pars plane via the center of optical disc respectively in different groups (6 eyes in each group),and 0.1 mL of BSS was injected at the same method in control group.Other 6 eyes were as normal control group.Slit lamp biomicroscope,indirect ophthalmoscope,F-VEP and F-ERG examinations were performed in 1 day,3,4,14 and 28 days after injection.All experiments were conducted in accordance with the Association for Research in Vision and Ophthalmology statement on the use of animals in ophthalmic and Vision Research.Results No obvious evidence of optic nerve or retinal toxicity or damage was found by the examination of ophthalmoscope,F-VEP,and F-ERG after injection of tPA.No significantly differences were found in the mean latency of P_1 wave of F-VEP (P=0.411),the mean amplitude of P_1 wave of F-VEP (P=0.065),the mean latency and amplitude of ERG a-waves (P=0.627,P=0.725) as well as the mean latency and amplitude of ERG b-waves (P=0.257,P=0.096) among 25 μg of tPA group,12.5 μg tPA group,BSS group and control group.Conclusion The injection of tPA into optic nerve is a safe and simple procedure.This therapy may is a potential approach to the treatment of RVO.

Background Neuromyelitis optica,term of Devic's disease,is characterized by the symptoms of both optic neuritis and myelitis.In clinic,misdiagnosis rate of neuromyelitis is too high to ignore because of the unsynchronous exsist of both optic neuritis and myelitis.Objective This study aims to analyze the clinical characteristics of Devic's disease in order to reduce the misdiagnosis rate.Methods Thirty six patients diagnosed as Devic's disease in General Hospital of PLA from January 2000 through October 2008 were included in this study.The clinical data including sex,age,initial events,clinical signs of optic neuritis and myelitis,misdiagnosis status were analyzed.Results The 21 patients showed the initial events of eye and were diagnosed as neurititis.In all of the 36 patient,the ratio of the patients was from 30 to 50 years.The prevalence of atrophy of optical nerve within 1-3 months was 72.7% and that of above 3 months was 91.4% in these patients.The incidence rate was obviously increased in 1-3 months course group (χ~2=7.59,P=0.009) and ＞3 months course group(χ~2= 20.29,P＜0.001) in comparison with ＜1 month course group.Two patients without clinical signs were determined the diagnosis by visual evoked potential.In 22 patients received magnetic resonance imaging of spinal cord,the lesions of 14 patients located in cervical cord and that of 9 patients was in thoracic cord and only 1 patient in lumbar cord.Conclusion Devic's disease is more common in female patients with the age between 30-50 years.Most patients visit ophtalmologist firstly due to initial events of eye.Occurrence of optic atrophy is associated with disease course.MRI suggest that the lesions of spinal cord are often in cervical cord and thoracic cord.

ObjectiveTo investigate the correlation between the surgical effect and clinical factors in retinal detachments with macular hole patients.Methods71 patients were picked up from the rhegmatogenous retinal detachment (RRD) database in our hospital. All patients were well informed with clinical data and followed up. Logistic regression statistical analysis was performed to analyze correlation between the effect of operation and clinical factors.ResultsAll patients obtained successful retinal replacement and macular hole closure, but retinal detachment was relapsed in 10 patients from 3 days to 3 years after operation. Effect of retinal replacement was related with proliferative vitreoretinopathy (PVR) grade and course (P<0.05), while eyesight improvement was related with PVR grade, age and course (P<0.05).ConclusionAge, PVR grade and course affect the surgical effect.

Objective To investigate the effect of retinectomy 360? for severe ocular rupture and evaluate the related factors associated with prognosis. Methods We retrospectively analyzed 28 consecutive patients (28 eyes), 18 men and 10 women, with severe ocular rupture admitted to the Chinese PLA General Hospital between January 1999 and October 2002. The patient′s ages ragned from 16 to 58 years, mean 29 years. According to the internation standardized classification of ocular trauma, the injuries located in zone Ⅰ in 5 eyes, zone Ⅰ-Ⅱ in 8 eyes,zone Ⅱ in 3 eyes, zone Ⅱ-Ⅲ in 5 eyes, zone Ⅲ in 7 eyes, zone Ⅱ in 3 eyes, zone Ⅱ-Ⅲ in 5 eyes and zone Ⅲ in 7 eyes. The presenting visual acuity was in grade 4 (0. 02 to light perception) in 19 eyes, and grade 5 in 9 eyes. In 28 patients, 13 had the total absence of iris and lens, 10 had iris deletion more than 1/2, and 15 had lens opacity or rupture. Ultrasound biomicroscopy and B-scan revealed ciliochoroidal detachment in 17 eyes. The B-scan revealed vitreous hemorrhage and retinal detachment in all paitents. The intraocular pressure was from 5 to 11 mm Hg in all patients. The therappeutic operative procedures which were performed by one surgeon in all of the affected eyes included standard 3-port pars plana vitrectomy with scleral encircling buckle, endophotocoagulation and tamponading with silicone oil in all patients; lensectomy in 15 eyes; 360? retinotomy and retinectomy at anterior equator in 16 patients, and posterior equator in 12 eyes. Results During the operation, all patients were confirmed with vitreous hemorrhage and retinal detachment, including hemorrhagic ciliary body detachment in 9 eyes, suprachoroidal hemorrhage in 12 eyes, retinal twisting like morning glory in 11 eyes, and retinal incarceration in 17 eyes. Postoperative follow-up In 26 eyes who were followed up postoperatively from 6 months to 46 months, retinal reattachment was found in 20 patients (76. 9%) in whom the retina of 3 was reattached after revitrectomy and the silicone oil of 8 was removed at the fourth month after operation. In 20 eyes with reattached retina, 14 (70. 0%) had corrected visual acuity of 0. 02 or more, including 7 (35. 0%) had 0. 05 or more, 3 had 0. 1 or more, and 1 had the best visual acuity of 0. 3. Conclusion Retinectomy may improve the prognosis of severe ocular rupture and save the visual function of some patients.

Objective To create a calibrated animal model of graded optic nerve injury (ONI) in rats, focusing on quantification of injury intensity, injury severity and the correlation between them. Methods A pair of cross-action forceps with pressure of 148.0 g was used to clip rat optic nerves for 3, 6, 30 and 60 seconds, or a pair of artery clips with constant pressure (32.4 g) used to clip rat optic nerves for 5, 10 and 15 seconds in order to create graded ONI animal models. Transcranial FluoroGold-labeled retinal ganglion cell (RGC) was used to observe the changes of RGC one month after injury, which then could be used to evaluate the injury severity. Ocular blood supply was evaluated by transcardiacly perfused Luxol Fast Blue post-injury. Results The graded ONI animal models were successfully created in rats without retinal ischemia post-trauma. The injury intensity could be well-defined by impulse or averaged impulse, while injury severity could be evaluated by the count of FluoroGold-labeled RGCs. The averaged impulse produced by artery clips clipping rat optic nerves for 15 seconds equalized with that produced by cross-action forceps for three seconds. The severer injury intensity begot less number of RGCs. The correlation between injury impulse and RGCs was fit for power function. Short time clipping of optic nerves could not lead to ischemic injury of the retina. Conclusions A calibrated graded ONI animal model is successfully created by clipping optic nerves with a pair of cross-action forceps. The model can be evaluated with RGCs count, impulse and averaged impulse, the latter two of which stand for injury intensity and injury severity, respectively.

Objectives:To establish animal model of anterior proliferative vitreoretinopathy (aPVR) with cultured homologous dermal fibroblasts of rabbit, and to provide evidence why hypotony was caused by aPVR. Methods:Animal models of aPVR were established with cultured homologous dermal fibroblasts on pigmented rabbits. Rabbits were sacrificed on the 14th, 28th and 56th day after the operation to prepare naked eyes and to receive histological examinations. Results:Naked eye examination showed that the peripheral retina was detached by dragging in the experimental group 28 and 56 days postoperatively. Microscopic examination showed atrophy or absence of the non-pigmented ciliary epithelium on the 28th and 56th postoperative day in the experimental group. Conclusions:The epiciliary membrane in aPVR dragged the ciliary body, made atrophy of non-pigmented epithelium, which perhaps was the main cause of hypotony.

Objectives:To investigate the effects of verapamil on serum induced proliferation of rabbit pigment epithelial(RPE) cells so as to search for simple and effective medicine on PVR. Methods:The rabbit RPE cells(passage 2 to 5) were cultured with various concentrations of verapamil in DMEM.The effects of verapamil on the cell cycle of RPE were analyzed with flow cytometry. Results:Verapamil significantly inhibited the serum induced proliferation of RPE cells, prevented RPE from G 1 phase transiting to S phase. Conclusions:Verapamil significantly inhibits RPE cell proliferation, and it may become a promising drug on PVR.

Objective To investigate the occurrence, progress and conversion of hypotony in anterior proliferative vitreoretinopathy (aPVR), and to provide knowledge about how to prevent and treat it. Methods Animal models of chronic hypotony by aPVR were made with cultured homologous dermal fibroblasts on pigmented rabbits. The intraocular pressure (IOP) and ultrasound biomicroscopy(UBM) examination were taken preoperatively and on days 7,14, 28 and 56 postoperatively. Rabbits were killed on days 14, 28 or 56 postoperatively, prepared for histology and ultrastructure examination. Results The average IOP of experimental group was lower than that of control group on days 7,14,28 and 56 significantly (P