Silicone oil is a stable intraocular tamponade widely used in various vitreoretinal surgeries. However, it can migrate into the anterior chamber for various reasons, leading to complications such as pupillary block glaucoma, corneal endothelial decompensation, and keratopathy. The inferior peripheral iridectomy (later referred to as the Ando iridectomy) can allow the aqueous humor from the posterior segment to drain into the anterior chamber, and this drainage exerts pressure on the silicone oil, pushing it back into the vitreous cavity, thereby effectively addressing the complications. The application of the Ando iridectomy has expanded from aphakic eyes to phakic eyes and pseudophakic eyes in recent years, each with specific indications. The diameter of the Ando iridectomy should be ≥ 2 mm. The incision for the Ando iridectomy should be made at the 6 o'clock position at the iris root, at the lower edge of the silicone oil droplet in the anterior chamber, or in the inferior aqueous humor zone. Postoperatively, the Ando iridectomy may close due to inflammation or blood cell blockage. In such cases, it can be reopened using laser photocoagulation, surgical peripheral iridectomy, or needle puncture to restore its functionality. Currently, there is no standardized protocol for the application of the Ando iridectomy in vitreoretinal surgeries, and this warrants further research.

Vitreoretinal interface is consisted of posterior vitreous cortex, retina internal limiting membrane, and extracellular matrix between them. Basement membrane-like complex is formed in the interface. The interface in children is of much difference with that in adult. The adhesion of it is much tight in children. The posterior edge of vitreous base is closed to ora serrata. The retina internal limiting membrane is thin. But with age, the posterior margin of vitreous base extends posteriorly, internal limiting membrane thickens and its elasticity decreases, the adhesion in vitreoretinal interface weakens, and posterior vitreous detachment develops. To recognize fully the interface in children is of much importance for understanding the pathophysiology and treatment strategy of pediatric vitreoretinal diseases.

Visual electrophysiological examination has strict standards and quantitative methods for stimulating light, which involves the concepts of photopic and scotopic vision of human eyes.Photopic vision is a visual perceptual activity mainly involving cones in a bright environment, while scotopic vision is a visual perceptual activity mainly involving rod cells in a dark environment.Even if the rated power of the light source is the same, the brightness (luminous flux) perceived by human eyes is different for different spectral light sources in the same or different visual environments.To enable ophthalmologists and clinical visual electrophysiological examination technicians to accurately understand the setting mechanism and recording results of stimulating light in the international standard of visual electrophysiology, this paper introduced the basic concepts such as the concept of human eye photopic and scotopic vision, the measurement and expression of brightness in different visual environments, and the luminous flux of light sources under photopic and scotopic vision in detail, and interpreted the application of the concept of photopic and scotopic vision in clinical visual electrophysiology.

Objective:To evaluate whether there are changes in cone cells in patients with pre-clinical hydroxychloroquine (HCQ) retinopathy using an adaptive optics (AO) retinal camera.Methods:A retrospective case-control study. From May 2020 to July 2020, 46 patients who were treated in Department of Rheumatism and Immunology, Hainan Hospital of PLA General Hospital with rheumatic immune diseases were included. All patients had a history of HCQ use and no obvious abnormality was found in fundus examination; 105 healthy people with similar demographic characteristics without a history of hydroxychloroquine were recruited as the control group were included. All subjects received the routine ophthalmological examination including best corrected visual auity (BCVA), spectral-domain optical coherence tomography (SD-OCT), Fundus autofluorescence (FAF), visual field, endoscopy of the cornea, and the measurement of axial length (AL). The BCVA was performed with the Snellen visual acuity chart, and the result was converted to logarithmic minimum angle of resolution (logMAR) visual acuity for statistic. Among the 46 cases, 6 cases were males and 40 cases were females. Age was (42.02±13.81) years old; logMAR BCVA was 0.063±0.015; AL was (23.95±0.726) mm. Visual field, macular SD-OCT, FAF examination showed no abnormality. The average cumulative dose of HCQ was 522.60 (6-1 728) g. rtx1 AO retinal camera was used to collect fundus images of subjects in four quadrants above the retina, nasal side, lower side and temporal side with 3°centrifugation from the fovea in both eyes. The cone density, cone spacing, cone arrangement regularity and the proportion of the nearest cones with 6 (nn=6) were measured in the four quadrants. The density of cone cells between the left and right eyes in case group and control group were compared by paired t test. The density and spacing of cone cells in each quadrant were compared by t test of two independent samples. Results:Compared with the control group, the cone cell density in the four quadrants of the left eye and the nasal, superior and inferior sides of the right eye in the case group was significantly decreased, and the difference was statistically significant ( t=4.247, 2.107, 4.884, 2.254, 2.643, 4.445, 4.116; P<0.05). The cone spacing in the nasal and temporal sides of the left eye of the patients in the case group was significantly larger than that in the control eye, with statistical significance ( t=2.750, 3.318; P<0.05). Compared with the control group, the regulatign of cone cell arrangement in the left temporal side of the right and left eye in the case group were significantly reduced, the difference was statistically significant ( P=0.002, 0.011). The proportion of nn=6 in the inferior and temporal sides of the right eye decreased significantly in the case group, and the difference was statistically significant ( P=0.006, 0.032). Conclusion:AO retinal imaging can detect the changes of cone cells in the early clinical stage of HCQ retinopathy.

ObjectiveTo compare the clinical effects of conventional versus laparoscopic surgery in adults with congenital bile duct dilatation. MethodsA retrospective analysis was performed on the clinical data of 37 patients with congenital bile duct dilation who were treated in our hospital from February 2011 to February 2013. All the 37 cases underwent bile duct cyst resection and common hepatic duct-jejunal Roux-en-Y anastomosis; 20 of them (study group) underwent laparoscopic surgery, while the other 17 cases (control group) underwent open surgery. The mean operative time, mean intraoperative blood loss, mean length of hospital stay after surgery, mean time to first flatus after surgery, and postoperative complications were compared between the two groups. Comparison of continuous data between the two groups was made by t test, while comparison of categorical data was made by chi-square test. ResultsCompared with the control group, the study group had a significantly longer operative time (P＜0.05) but significantly less mean intraoperative blood loss, mean length of hospital stay after surgery, and mean time to first flatus after surgery (P＜0.05). The incidence of postoperative complications showed no significant difference between the two groups (P＞0.05). ConclusionCompared with conventional surgery, laparoscopic bile duct cyst resection and common hepatic duct-jejunal Roux-en-Y anastomosis is less invasive and safer and leads to faster recovery in adults with congenital bile duct dilation, and it is worthy of clinical application.

Objective To evaluate the correlation between antiphospholipid (APLA) antibodies and retinal vein occlusion (RVO).Methods A computerized search was conducted in the Pubmed,Chinese Biological Medicine Database,China National Knowledge Infrastructure,VIP database,Wanfang Database combined with manually searching of literature reference proceedings.The search time was ranged from establishment of each database to August 1st,2012.After the data extraction,quality of RCT was assessed.The meta analysis was performed by Stata 11.0.Results In total,12 case-control studies (1324subjects) that fulfilled the eligibility criteria were included in the meta-analysis involving 505 patients in RVO group and 819 subjects in control group.The odds ratio (OR) and 95％ confidence interval (CI) of APLA,anticardiolipin antibodies (ACA),lupus coagulation inhibitor and RVO were 5.01 and 3.33-7.53,4.38 and 2.38 8.05,1.72 and 0.73-4.04,respectively.The OR and 95％ CI of APLA,ACA and central RVO were 4.80 and 2.59-8.88,6.02 and 2.06-17.63,respectively.The OR and 95％ CI of APLA,ACA,lupus coagulation inhibitor and branch RVO were 4.22 and 1.67-10.63,3.69 and 1.32-10.32,2.07 and 0.79-5.41,respectively.Conclusions APLA may increase the rick of RVO,especially ACA has a prediction function to RVO.It is necessary to screening for APLA in RVO patients.

OBJECTIVE: To evaluate the efficacy and safety of acupuncture for optic atrophy. METHODS: All the randomized controlled trials (RCTs) on optic atrophy treatment with acupuncture were included after retrieving the PubMed, Embase, Cochrane Library, CBM, CNKI, VIP, Wanfang database from their establishment to November 2012. The bibliographies of the included studies were retrieved as well. The quality of RCTs meeting the inclusion criteria was evaluated and the data were extracted. Meta-analyses were performed with Stata 11.2 software. RESULTS: Thirteen RCTs involving 1180 eyes were included. Meta-analyses showed that the effect of acupuncture or combined with medicine was superior to medicine alone in terms of total effectiveness [OR=3.281, 95% CI ( 2.517, 4.278)], visual acuity [3.287, 95% CI (2.193, 4.925)], and visual field [3.215, 95% CI (1.580, 6.543)]. The visual sensitivity and P-VEP test showed the similar results. CONCLUSION Acupuncture is superior to medicine in terms of improved visual acuity, visual field and P-VEP. However, large samples, and high-quality studies are needed for stronger evidence.
Acupuncture Therapy ; Adolescent ; Adult ; Child ; Female ; Humans ; Male ; Middle Aged ; Optic Atrophy ; therapy ; Randomized Controlled Trials as Topic ; Treatment Outcome ; Visual Acuity ; Visual Fields ; Young Adult

As a new rising edge discipline,neuro-ophthalmology is a subject of extensive radia-tion,with low awareness and poor efficiency. Specialists of General Hospital of PLA summarized a practi-cable series of teaching ideas and methods including teaching thoughts,strategies and methods. Combi-nation of traditional theory and practice with the use of modern means and platforms were introduced and satisfactory results were achieved.

Objective To investigate the application of optical coherence tomography (OCT) in traumatic macular disease.MethodsOCT examination was carried out and analyzed in 56 eyes of 56 cases with traumatic macular disease.ResultsThe OCT examination showed that there were 23 cases of whole macular hole, 3 cases of lamellar macular hole, 3 cases of epi-macular membrane, 8 cases of macular hemorrhage, 5 cases of serous neuroretinal detachment, 4 cases of hemorrhagic retinal pigment epithelium detachment, 4 cases of macular edema and 6 eyes of macular neuroretinal thinning.ConclusionOCT plays an important role in diagnosis, monitoring and investigation of pathogenic mechanisms for traumatic macular disease.

Objective To explore the use of Ultrasonic Biomicroscopy(UBM)for peri-operative examination of traumatic cyclodialysis.MethodsUBM was used in 33 eyes of 33 cases who were diagnosed as traumatic cyclodialysis.The morphologic characters were observed peri-operatively.ResultsCiliary detachment of 360° was verified in the 33 eyes with cyclodialysis of more than 2 clock hours.1 month after cyclopexy,the space of ciliary detachment disappeared or diminished and all reattached 3 months after operation.ConclusionUBM is safe and effective for checking traumatic cyclodialysis.