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Worldwide, the incidence rate of myopia is maintained in a high level. Especially, the morbidity is rising continuously among children and adolescents. The progression of myopia affects visual acuity, vision related quality of life and productivity. Moreover, high myopia and its related ocular complications also aggravate the family and social burden. Therefore, the mechanism of myopia, related complications and methods of myopia prevention and control need further exploration. International Myopia Institute(IMI)published the second-edition white papers in April 2021. These white papers included reflections on the implications for clinical practice, the impact of myopia, the risk factors of myopia, the relationship among accommodation and binocular vision with myopia, pathologic myopia, prevention of myopia and digest. Comparing to the first edition, more than thousands of articles and conference abstracts were considered in white papers II, highlighting the latest research and progress related to myopia prevention and control. This article briefly summarizes and interprets the contents of the above white papers, including overview of myopia, impact of myopia, risk factors in myopia, ocular changes in the progress of myopia, and myopia prevention and control, hoping to provide advice for the clinical and scientific research work relating to myopia prevention and control.
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AIM: To analyse the prevalence and risk factors of dry eye among children aged 7-14 years in myopia prevention and control clinic.METHODS:A total of 222 children aged 7-14 years in myopia prevention and control clinic from December 2021 to February 2022 were included. General data of included children were collected, assessing the prevalence of dry eye by the ocular surface disease index(OSDI)scale and Keratograph 5M, and analyzing risk factors for dry eye occurrence by Logistic regression model.RESULTS:The prevalence of dry eye in children in myopia prevention and control clinic was 27.9%. Logistic Regression analysis showed that, allergic conjunctivitis(OR=2.31, 95%CI=1.12-4.78, P=0.02), refractive error(OR=5.57, 95%CI=2.40-12.94, P<0.01), use time of electronic >2h per day(OR=2.74, 95%CI=1.11-6.78, P=0.03), time of playing games >2h per day(OR=2.33, 95%CI=1.12-4.84, P=0.02), outdoor activity time ≤2h per day(OR=4.28, 95%CI=2.02-9.07, P<0.01)and sleep duration <8h per day(OR=3.23, 95%CI=1.44-7.27, P=0.01)were risk factors for dry eye among the children.CONCLUSIONS:The prevalence of dry eye among children in myopia prevention and control clinic should be paid high attention. Therefore, improving behavior habits and controlling the use time of visual display terminal products to prevent and slow down the occurrence of dry eye in children.
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AIM: To determine the students' satisfaction with the three teaching modes in the contact lens course and provide suggestions to improve teaching quality.METHODS: We conducted a survey at Tianjin Medical University in June 2021 using the Students' Evaluations of Educational Quality(SEEQ)questionnaire. We used descriptive statistics to analyze SEEQ items and the One-way ANOVA was used to determine differences in scores among the three modes.RESULTS: Among the 221 valid responses collected, 87(39.4%)respondents were males and 134(60.6%)were females. The total scores were 151.46(12.45), 148.71(13.14), and 147.97(14.56)for offline, online, and blended teaching, respectively, with no significant difference(F=1.10, P=0.33). Students had a longer interaction time with the teacher in offline teaching than in online and blended teaching(P=0.03). The three different teaching modes have no significant difference among genders or academic performance(P=0.33, P=0.91, respectively). Furthermore, 18.1% of students suggested that the amount of experiment time should be increased.CONCLUSION: Students were satisfied with all three teaching modes. However, they had more interaction time with teachers in traditional offline teaching compared with online and blended teaching. More time is needed to increase teachers' online teaching ability.
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AIM: To investigate the influencing factors of disequilibrium refractive development in children aged 6-12 years old.METHODS: A total of 607 children with a mean age of 8.2±1.8 years old from two primary schools in Binhai New Area of Tianjin in December 2019 were selected by cluster sampling for optical biometry measurement(axial length and equivalent corneal power), cycloplegia refractive examination and questionnaire survey.RESULTS: The childrens'spherical equivalent was -0.11±1.63D, binocular spherical equivalent difference was -0.08±0.64D and absolute value of spherical equivalent difference was 0.41±0.49D. There were 56 children with anisometropia and 551 children without anisometropia. There was no difference in the absolute value of binocular corneal power difference between anisometropia and non-anisometropia group(0.30±0.34D vs 0.27±0.24D, P=0.430). But the absolute value of axial difference was significantly different(0.67±0.39mm vs 0.13±0.13mm, P=0.005). Multivariate linear regression analysis showed that weekly usage time of phones/computers, weekly close work hours, weekly visual fatigue times and habitual reading distance were the influencing factors of refractive imbalance development(the absolute value of binocular spherical equivalent difference). Habitual reading distance and handedness in writing are the influencing factors of the developmental bias of refractive imbalance(binocular spherical equivalent difference).CONCLUSION: Children aged 6-12 years old who spend more time on phones/computers, and have prolonged close work, more times of visual fatigue and close habitual reading distance may increase the degree of refractive imbalance. Children with right-handed handwriting and severe left or right head deviation have a deeper degree of myopia in the right eye than in the left eye.
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DNA methylation, as an important form of epigenetic modification, plays vital roles in the occurrence and development of diseases by regulating gene expression. In recent years, with the rapid development of DNA methylation research and the continuous updates of the detection method,it is reported that DNA methylation has become an important way to explore the pathogenesis of various diseases and new treatment methods.Many breakthroughs have been made in the basic research of DNA methylation in different ophthalmological diseases, including corneal epithelium repair, cell adhesion and abnormal matrix remodeling of conjunctival epithelium, ocular fibrosis and glaucoma, oxidative stress, inflammatory response and cell damage, the relationship between different DNA methylation levels and ocular tumors, etc. This review aims to provide a new idea for the pathogenesis, examination, diagnosis and prevention of different ocular diseases by summarizing the relevant studies on the regulatory mechanisms of DNA methylation in ophthalmological diseases.
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AIM:To investigate the correlation between corneal biomechanical parameters measured by the corneal visualization Scheimpflug Technology(Corvis ST)and corneal high-order aberrations(HOAs)in children with mild to moderate myopia.METHODS:A cross-sectional study. A total of 255 pediatric patients with myopia enrolled from April to July 2021 in Tianjin Medical University Eye Hospital were continuously collected, and all the right eyes were taken for analysis. Corneal biomechanical parameters were obtained from Corvis ST. Pentacam three-dimensional anterior segment analyzer was used to measure total corneal higher-order aberrations(RMSh), third order aberrations(RMS3)and fourth order aberrations(RMS4).RESULTS:RMS3 was positively correlated with the second applanation time(A2T)(r=0.175, P=0.009)and negatively correlated with the axis length(AL)(r=-0.155, P=0.014). RMS4 was negatively correlated with the highest concavity radius(HCR)(r=-0.165, P=0.009). RMSh was negatively correlated with HCR and AL(r=-0.152, P=0.037; r=-0.175, P=0.005).CONCLUSION:There is a correlation between corneal biomechanical parameters and HOAs in children with myopia. Cornea with higher stiffness and stronger deformation resistance has smaller RMS3, RMS4 and RMSh.
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?AIM: To assess the consistency of refractive errors measured by two autorefractors in myopia screening of school-age Chinese children.?METHODS: Topcon RM- 8900 and Tianle RM - 9000 autorefractors were utilized to measure refractive errors under noncycloplegic condition in students aged 6 to 16 years old who were cluster sampled from four primary and secondary schools in Dongli district, Tianjin. Sperman correlation analysis and Bland-Altman method were used to evaluate the consistency of spherical diopters, cylindrical diopters and spherical equivalents measured by the two methods, and the axial difference distribution of astigmatism measured by the two methods was analyzed.?RESULTS:A total of 2276 eyes of 1138 subjects with a mean age of 10.49± 2.66 a were finally enrolled. Spearman correlation analysis showed that sphere ( r = 0.958, P<0.0001) , cylinder ( r= 0.769, P<0.0001 ) , and spherical equivalent ( r=0.962, P<0.0001) measured by Tianle RM-9000 were highly correlated with those measured by Topcon RM-8900, respectively. Bland-Altman analysis showed spherical diopters measured by Tianle RM-9000 were significantly more hyperopic ( P< 0.0001 ) with a mean difference of 0. 44 D ( SD: 0.37;95％ CI: -0.27, 1.16) while the maximum absolute value ( 1.13 D) of the difference within the 95％ CI was above the clinically acceptable range;however, no significant difference ( P=0.83) was found between cylindrical diopters measured by the two methods with a mean difference of -0.01 D ( SD: 0.31;95％ CI= -0.62, 0.61 ) while the maximum absolute value ( 0.62 D ) of the difference within the 95％CI was clinically acceptable. The proportion of the axial deviation within ± 20° was 84.6％( 1503/1777) in eyes with cylinder ≤-0.25D while that rose to 96.4％ ( 853/885) in eyes with cylinder ≤-0.75D.?CONCLUSION: Spherical diopters measured by Tianle RM-9000 have a significant hyperopia bias than those measured by Topcon RM-8900 while the consistency of cylindrical diopters and cylindrical axes is clinically acceptable.
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Myopia has become a common disease all over the world,affecting the public quality of life and endangering public health.Exploring the pathogenesis is helpful for the prevention and treatment for myopia.However,the pathogenesis of myopia is still not clear,which makes it a hotspot and nodus.From the 1970s,the research on myopic animal models has made great breakthrough.It has provided valuable evidences and hint for mechanism research from the perspective of molecular mechanism,signal pathway,drug intervention,etc.In this paper,the research progess on common myopic animal models and pathogenesis will be reviewed.
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Objective To investigate the effects of the eye drops containing deproteinized calf blood extract on the ocular surface and tear film at the early stage of orthokeratology treatment in myopic adolescents.Methods Together 59 myopia (118eyes) who received vision correction by orthokeratology lens between June 2016 and October 2016 were included in this study,and they were randomly assigned into two groups:the treatment group,29 patients (58 eyes) receiving the eye drops containing deproteinized calf blood extract to presumably promote the repair of corneal epithelium,and the control group,30 patients (60 eyes) without receiving such eye drops.For each subject,the surface regularity index (SRI) and objective scattering index (OSI)were recorded;lipid layer thickness (LLT) and tear film break-up time (BUT) were measured,and finally fluorescein stain of corneal epithelium and the ocular surface disease index (OSDI) questionnaire were performed before treatment and 1 week and 1 month after lens wearing.Results The treatment group showed significantly lower rate of corneal staining than the control group at 1 week (10.3％ vs.33.3％,all P ＜0.05) and 1 month after treatment (8.6％ vs.26.7％,all P ＜ 0.05).There was no significant difference in LLT at 1 week and 1 month after treatment and before treatment (all P ＞ 0.05).Both corneal curvature and BUT were decreased,while SRI,OSI,and OSDI score were increased significantly after 1-week lens wearing (all P ＜ 0.05),but there was no significant difference at 1 week and 1 month after lens wearing (all P ＞ 0.05).Moreover,there was no significant difference in corneal curvature,SRI,BUT,LLT,OSI,and OSDI score at different time points between the treatment group and the control group (all P ＞ 0.05).Conclusion Eye drops containing deproteinized calf blood extract can protect and repair the corneal epithelium at the early stage of orthokeratology treatment.
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Objective To investigate the efficacy of security and validity of posterior sclera reinforcement (PSR) for high myopic retinopathy (MR).Methods This study included 76 eyes in 41 patients with MR who underwent PSR and were followed up for two years.Preoperative and postoperative axial length,best-corrected visual acuity,the reattachment of retinoschisis and the complications were evaluated.Results The axial length was shortened 3 days,1 month,3 months and 6 months after operation compared with preoperation[(27.71 ± 1.60) mm,(28.11 ± 1.62) mm,(28.58 ± 1.80)mm and (29.01 ± 1.92) mm vs.(30.29 ± 2.01) mm],and the difference was statistically significant (all P =0.000).The axial length gradually increased to preoperative level at 1 year after surgery,and there was no significant difference in the postoperative 2-year and preoperative axial length (P =0.300).The best corrected visual acuity was improved 1 month after surgery,but the improvement had no significantly difference compared with the preoperative one (P =0.080).The best corrected visual acuity was improved at 3 months,6 months,1 year and 2 years postoperatively continuously,and the improvement had significantly difference compared with the preoperative ones (all P ＜0.05).In addition,there were 34 eyes with retinoschisis before surgery,and the retina was completely attached postoperatively in 27 eyes (79.41％),almost attachment was observed in 4 eyes (11.76％),and improvement was in 3 eyes (8.82％).No complications occurred during surgery.Conjunctival irritation,high intraocuiar pressure,orbital inflammation,diplopia and visual deformation and macular bleeding recurrence occurred postoperatively and all recovered in 3 months.Conclusion During 2-year follow-up,it is safe and effective for PSR to treat MR,which can control myopic progression effectively in patients with pathological myopia.
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AIM:To compare the efficiency of fibrin glue to suture technique in pterygium surgery performed with limbal autograft under different methods of anesthesia. METHODS: A prospective randomised clinical trial was carried out in 60 eyes of 55 patients operated for primary nasal pterygium, which were divided into two groups randomly: experimental group ( 30 eyes in 27 patients ) was under surface anesthesia ( oxybuprocaine ) and control group ( 30 eyes in 28 patients ) was under local anesthesia ( 20g/L lidocaine ). Autologous limbal graft taken from the superotemporal limbus was used to cover the sclera by a fibrin tissue adhesive after pterygium excision. Patients were followed up at least for 6mo. Time of operation, matching degree of graft and VAS score were mainly observed and recorded. RESULTS: In experimental group the average surgery time was shorter (P=0. 008) and matching degree of graft ( 93%) was better than control group ( 83%) , the differences had statistical significance(P CONCLUSION: The surface anesthesia is enough when using fibrin glue for graft fixation in pterygium surgery, which will shorten surgery time and get better matching degree of graft.
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Objective To estimate the prevalence of cataract and its surgical coverage rate together with the burden related to bilateral cataract-blindness,among adults aged 40 or above in Gongshan county of Yunnan province and to evaluate the current cataract status and the efficacy of local cataract prevention program.Methods Cluster sampling was used.The protocol consisted of personal interview,pilot study,visual acuity checking,measuring the intraocular pressure; slit lamp microscopy and the fundus of the eye examination etc.Cataract was graded clinically using the Lens Opacity Classification System (LOCS) ]Ⅲ.Bilateral cataract-blindness burden,bilateral cataractblindness burden and cataract surgical coverage rate were calculated respectively,using two different criteria.Odds ratios (OR) were compared among different groups regarding age,gender,education,ethnic group and altitude of living area.Results Among the 1236 eligible residents,1116 (90.3％)were enrolled in the present study.The prevalence of cataract was 23.8％ among adults aged 40 or order.When the bilateral best refractive vision ＜3/60 was defined as the blindness criterion,the bilateral cataract-blindness burden showed as 1.3％,and cataract blindness surgical coverage rate was 50.0％.When the bilateral presenting vision ＜ 6/60 was defined as the blindness criterion,the bilateral cataract-blindness burden was 25.0％,and cataract blindness surgical coverage rate was 12.9％.The cataract surgical coverage rates were much lower and the bilateral cataract-blindness burden much higher in women,illiterates,living in high altitude areas and those who were aged 70 or above.Conclusion Cataract blindness was a serious public health problem in aged individuals and illiteracy in the residents of the studied areas.Poor prevention programs on cataract called for urgent action to be taken.