Study on the role of MYCN in retinoblastoma by inhibiting p53 and activating wnt/ßcatenin/Fra-1 signaling pathway by reducing DKK3.

Retinoblastoma (RB) is a pediatric malignancy, typically diagnosed at birth or during early childhood. The pathogenesis of RB is marked by the amplification of the Basic Helix-Loop-Helix (BHLH) Transcription Factor MYCN, which serves as a transcriptional regulator capable of binding to Dickkopf 3 (DKK3). However, the precise role of DKK3 in the malignant progression of RB cells caused by MYCN remains elusive. In the present study, the expression of MYCN was either overexpressed or interfered in RB cells. Subsequently, the expression level of DKK3 was assessed through quantitative real-time polymerase chain reaction and western blot analysis. Cell proliferation was evaluated using the Cell Counting Kit-8 assay and 5-ethynyl-2'-deoxyuridine staining, while cell cycle progression and apoptosis were analyzed by flow cytometry and western blot analysis, respectively. Additionally, the expression of proteins involved in the Wnt/ß-catenin/Fra-1/p53 signaling pathway was evaluated via western blot analysis. To gain further insights, Wnt agonists and the P53 inhibitor PFT-α were introduced into exploration. The current investigation revealed a negative correlation between the expression levels of MYCN and DKK3 in RB cells. Additionally, DKK3 overexpression inhibited cell proliferation, promoted cell apoptosis, and arrested cell cycle in RB cells with high expression of MYCN. Moreover, enhanced DKK3 expression inhibited proliferation, promoted cell cycle arrest and apoptosis of RB cells by modulating the wnt/ßcatenin/Fra-1/p53 signaling pathway. Furthermore, in vivo experiments revealed that overexpression of DKK3 inhibits the growth of RB tumors. Collectively, our findings elucidate that MYCN stimulates the Wnt/ß-catenin/Fra-1 pathway by suppressing DKK3 expression, ultimately suppressing p53 activity and contributing to malignant progression of RB.

Refractive status and optical components in premature infants with and without retinopathy of prematurity: A 4- to 5-year cohort study.

This study was aimed to investigate the characteristics of refractive parameters in premature infants and children aged 3-8 years with mild retinopathy of prematurity (ROP) and to explore the effects of premature delivery and mild ROP on the development of refractive status and ocular optical components. Premature infants who underwent ocular fundus oculi screening in our hospital between January 2009 and February 2011 were included and divided into the ROP group and the non-ROP group. Full-term infants were the controls. The results of the annual ocular examination conducted between 2014 and 2018 were analysed, and the refractive status, optical components, and developmental trends were compared among the three groups. The total follow-up time was 4-5 years. The prevalence of myopia and astigmatism was high in the ROP group (P < 0.05). In the non-ROP group, the prevalence of myopia was also higher than that in the control group. The prevalence of myopia increased with age in the ROP and non-ROP groups, while the prevalence of astigmatism remained unchanged. In the ROP group, the corneal refractive power was the largest, the lens was the thickest and the ocular axis was the shortest; in the control group, the corneal refractive power was the smallest, the lens was the thinnest, and the ocular axis was the longest. These parameters in the non-ROP group were between those in the two groups mentioned above (P < 0.05). The corneal refractive power was relatively stable at 3-8 years old in the three groups. The change in lens thickness was small in both the ROP group and the non-ROP group (P = 0.75, P = 0.06), and the lens became thinner in the control group (P < 0.001). The length of the ocular axis increased in the three groups. Preterm infants are more likely to develop myopia than full-term infants, and children with ROP are more likely to develop both myopia and astigmatism. Thicker lenses were the main cause of the high prevalence of myopia in premature infants with or without ROP.

Multivariate analysis of the effect of Chalazia on astigmatism in children.

BACKGROUND: Chalazion may affect visual acuity. This study aimed to evaluate refractive status of chalazia and effect of different sites, sizes, and numbers of chalazion on astigmatism. METHODS: Three hundred ninety-eight patients aged 0.5-6 years were divided into the chalazion group (491 eyes) and the control group (305 eyes). Chalazia were classified according to the site, size, and number. Refractive status was analyzed through the comparison of incidence, type, mean value and vector analysis. RESULTS: The incidence, type, refractive mean and of astigmatism in the chalazion group were higher than those in the control group, and the difference was statistically significant (P < 0.05). For comparison of the incidence, the middle-upper eyelid (50%) was highest, followed by 41.77% in the medial-upper eyelid, both higher than that in the control group (P < 0.05). In medium (54.55%) and large groups (54.76%) were higher than that in the control group (27.21%) (P < 0.05). In multiple chalazia, the astigmatism incidence for chalazion with two masses was highest (56%), much higher than that in the control group (P < 0.05). However, this difference was not significant in chalazion with ≥3 masses (P > 0.05). For comparison of the refractive mean,the medial-upper eyelid, middle-upper eyelid and medial-lower eyelid were higher than the control group (P < 0.05) (P < 0.05). The 3-5 mm and >5 mm group were higher than those in the control group and <3 mm group(P < 0.05), and the>5 mm group was larger than the 3-5 mm group，suggesting that the risk of astigmatism was higher when the size of masses > 5 mm. Astigmatism vector analysis can intuitively show the differences between groups, the results are the same as refractive astigmatism. CONCLUSION: Chalazia in children can easily lead to astigmatism, especially AR and OBL. Chalazia in the middle-upper eyelid, size ≥3 mm, and multiple chalazia (especially two masses) are risk factors of astigmatism. Invasive treatment should be performed promptly if conservative treatment cannot avoid further harm to the visual acuity due to astigmatism.

Thygeson's superficial punctate keratitis (TSPK): a paediatric case report and review of the literature.

BACKGROUND: Thygeson's superficial punctate keratitis (TSPK) is reportedly a rare disease with an insidious onset, numerous remissions and exacerbations, and a long duration. The corneal lesions are elevated, whitish-grey in colour, and granular in the intraepithelium. A few reported cases of TSPK exist, and paediatric experience is limited. Due to the unknown aetiology and controversial treatment strategies for TSPK, we performed a literature review to summarize the criteria for the diagnosis, treatment and prognosis of TSPK to provide a basis for the treatment of TSPK in paediatric patients. CASE PRESENTATION: The clinical course of a boy with TSPK who repeatedly presented with episodes of tearing, photophobia and foreign body sensation in both eyes is described. Irritation was uncontrollable with antiviral and antibiotic medications, and it was managed by corticosteroids. No recurrence was reported at the 1-year follow-up after corticosteroid replacement and tapering. CONCLUSIONS: The clinical features, treatment and prognosis between adult and paediatric TSPK patients have many similarities. The diagnosis of TSPK in children is more difficult, leading to missed diagnosis. TSPK needs to be carefully differentiated from other types of keratitis, especially intraepithelial secondary and other infectious ocular surface diseases.

Refractive status and optical components of premature babies with or without retinopathy of prematurity at 7 years old.

BACKGROUND: This study aimed to investigate the refractive status and optical components of premature babies with or without retinopathy of prematurity (ROP) at 7 years old and to explore the influence of prematurity and ROP on the refractive status and optical components. METHODS: From January 2009 to February 2011, premature babies receiving fundus photographic screening (FPS) were recruited and divided into non-ROP group and ROP group. Full-term babies matched in age were recruited as controls. Auto-refractometer was employed to detect the corneal refractive power, corneal radius (CR) of curvature and corneal astigmatism, A-scan ultrasonography was performed to detect the anterior chamber depth (ACD), lens thickness (LT), vitreous thickness (VITR) and ocular axial length (AL), and retinoscopy was done following cycloplegia with 1% cyclopentolate in these babies at 7 years old. These parameters were compared among groups, and the correlations of gestational age and birth weight with the refractive status and optical components were further evaluated. RESULTS: Of 126 subjects, a total of 252 eyes were evaluated in this study, including 50 eyes of 25 subjects in ROP group (pre-threshold stage 1-3), 110 eyes of 55 subjects in non-ROP group and 92 eyes of 46 subjects in control group. The incidence of myopia was the highest in ROP group (9/50, 18%), followed by non-ROP group (11/110; 10%) and control group (6/92; 6.52%). The incidence of hyperopia was the highest in control group (21/92; 22.83%), followed by ROP group (8/50; 16%) and non-ROP group (10/110; 9.09%). The incidence of astigmatism was the highest in ROP group (18/50; 36%), followed by non-ROP group (25/110; 22.73%) and control group (12/92; 13.04%). The corneal astigmatism (-1.58, -1.11, -0.86 DC, P<0.01) and the mean degree of astigmatism (1.38, 1.17, 0.64 DC, P<0.05) in ROP group and non-ROP group were significantly higher than those in control group. The corneal refractive power in ROP group was more potent as compared to non-ROP group and control group (43.98, 43.16, 42.99 D, P<0.05); the corneal curvature in ROP group was significantly higher than that in non-ROP group and control group (7.87, 7.71, 7.67 mm, P<0.05); the ocular AL in ROP group and non-ROP group was significantly shorter than that in control group (2.41, 22.47, 22.78 mm, P<0.05). The LT in ROP group and non-ROP group was markedly thicker than that in control group (4.48, 4.45, 4.37 mm, P>0.05); the ACD in ROP group and non-ROP group was markedly deeper than in control group (3.16, 3.12, 3.21 mm, P>0.05). The gestational age was negatively related to corneal astigmatism (r=-0.208, P=0.013) and astigmatism (r=-0.226, P=0.004), but positively associated with ocular AL (r=0.252, P=0.005). The birth weight was negatively associated with corneal astigmatism (r=-0.30, P<0.001), astigmatism (r=-0.267, P=0.001), corneal refractive power (r=-0.255, P=0.001) and corneal curvature (r=0.242, P=0.001), but positively to ocular AL (r=0.243, P=0.001) and spherical equivalent refraction (SER) (r=0.151, P=0.028). CONCLUSIONS: (I) Premature babies with or without ROP are susceptible to myopia and astigmatism; (II) low birth weight, prematurity and ROP synergistically influence the development of refractive status and optical components, resulting in myopia and astigmatism; (III) premature babies with or without ROP have increased corneal curvature and LT, which are related to the higher incidence of myopia and astigmatism.

Association between allergic conjunctivitis and provisional tic disorder in children.

BACKGROUND: Allergic diseases are associated with a higher risk of Tourette's syndrome (TS). Provisional tic disorder (PTD) and eye blinking are often reported as the initial symptoms both in TS and in allergic conjunctivitis (AC). OBJECTIVE: To investigate the association between AC and PTD in children of 4-10 years of age in southwest China. METHODS: This case-control study was carried out at the Children's Hospital of Chongqing Medical University between January 2016 and June 2017. Age- and gender-matched children without PTD were included as the control group. Intraocular pressure was measured by non-contact tonometry, tear film break-up time by slit-lamp examination, and allergens by skin prick test (SPT). Multivariable logistic regression analysis was applied to adjust for the simultaneous effects of AC, dry eye, and allergic history in children with PTD. RESULTS: The frequency of AC was higher in the PTD group (74.3%, 52/70) than in the control group (17.1%, 12/70) (P < 0.001). The frequencies of positive SPT were found to be higher in the PTD group (80.0%, 56/70) than in the control group (20.0%, 14/70). AC, dry eye, and history of allergic rhinitis were significantly associated with PTD. CONCLUSION: The frequencies of AC are high in children with PTD. AC and dry eye may be both associated with PTD in children.

Long noncoding RNA SNHG7 inhibits high glucose-induced human retinal endothelial cells angiogenesis by regulating miR-543/SIRT1 axis.

Diabetic retinopathy (DR) is the serious complication of type 2 diabetes mellitus, which could lead to visual impairment. Growing evidence have revealed the involvement of long non-coding RNAs (lncRNAs) in the pathogenesis of DR. Thus, this study was performed to investigate the role of lncRNA SNHG7 (small nucleolar RNA host gene 7) in high glucose (HG)-induced proliferation, migration, and angiogenesis of human retinal endothelial cells (hRECs). We discovered that SNHG7 was decreased in hRECs under HG stimuli. Although SNHG7 had no influence on cell viability, migration and angiogenesis under condition, overexpression of SNHG7 inhibited the HG-induced cell proliferation, migration and angiogenesis, as well as vascular endothelial growth factor (VEGF) expression in HG condition. In terms of mechanism, we found that SNHG7 directly inhibited miR-543, which targeted the 3'-UTR of Silent information regulator T1 (SIRT1) mRNA and subsequently downregulated the VEGF expression in hRECs. Ultimately, upregulation of miR-543 or inhibition of SIRT1 both abrogated the effect of SNHG7 on HG-induced angiogenesis. Collectively, our results suggested that SNHG7 is a potential molecular target for attenuating HG-induced angiogenesis in the DR through regulation of the miR-543-mediated SIRT1/VEGF pathway.

The antitumor function of arctigenin in human retinoblastoma cells is mediated by jagged­1.

Retinoblastoma is an intraocular malignant tumor that may severely affect vision and represents a life­threatening disease in children. Arctigenin (ATG) is an active compound that exhibits numerous pharmacological activities, which is isolated from the seeds of greater burdock (Arctium lappa Linnaeus), a plant used in traditional Chinese herbal medicine. The present study aimed to investigate the effects of ATG on cancer progression by analyzing the retinoblastoma cell line Y79. ATG exhibited a significant inhibitory effect on the viability of Y79 cells in a dose­dependent manner. Furthermore, treatment with ATG promoted apoptosis, and increased the protein expression levels of B­cell lymphoma 2 (BCL­2)­associated X protein and decreased the protein expression levels of BCL­2. Cell migration was suppressed following treatment with ATG, as assessed by Transwell migration assay. Furthermore, the protein expression levels of jagged­1 (JAG1) were decreased, and various factors involved in the Notch signaling pathway, including the Notch intracellular domain (NICD), transcription factor HES (HES)5 and HES1 were downregulated following treatment with ATG. The decreased expression levels of JAG1 were restored in response to JAG1 overexpression, alongside increases in the protein expression levels of NICD, HES5 and HES1. Furthermore, overexpression of JAG1 partly restored the cell viability and migration suppressed following treatment with ATG. In addition, ATG­induced apoptosis was reduced by JAG1 overexpression. Collectively, the present results suggested that ATG may serve as an antitumor compound by suppressing the proliferation and migration of retinoblastoma cells, inducing apoptosis, downregulating the protein expression levels of JAG1, and decreasing the activity of the Notch signaling pathway.

Lacrimal passage irrigation in children with Stevens-Johnson syndrome or toxic epidermal necrolysis: a five-year retrospective study.

BACKGROUND: To identity the effect of lacrimal system irrigation in the acute stage in children with Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN). METHODS: A retrospective review of 39 patients with SJS or TEN from 2012 to 2017 was analyzed. Patients were divided into two subgroups according to whether they received irrigation in the acute stage. The irrigation group included 21 inpatients and the control group included 18 inpatients. The χ2 test was used to compare clinical findings and data in both groups. RESULTS: The rate of lacrimal system obstructions in the chronic stage of SJS or TEN in the irrigation group was significantly lower than in the control group (p < 0.01). A significant difference was also found between the epiphora rates in patients with SJS or TEN in the chronic stage in the two groups (p = 0.047). One of 15 patients with mild dry eyes or without dry eyes in the irrigation group had epiphora, and it affected five of 12 in the control group. The difference between the two groups was significant (p = 0.03). Epiphora in the two patients in the control group was long-term, owing to the disappearance of puncta marks. CONCLUSIONS: Lacrimal system irrigation with dexamethasone drops in the acute stage was a simple way to lessen lacrimal system obstructions and epiphora in patients with SJS or TEN. It should be considered a conventional ocular treatment for SJS or TEN.

Refractive state and optical compositions of preterm children with and without retinopathy of prematurity in the first 6 years of life.

This study aimed to investigate the refractive state and optical compositions of preterm children with and without mild retinopathy of prematurity (ROP) and explore the influence of prematurity and mild ROP on the development of refractive state and optical compositions.Preterm children who received fundus screening were recruited, and divided into ROP group and non-ROP group. Term children matched in age were also recruited as controls. Several correspondence indicators were measured before and after ciliary muscle paralysis with 1% cyclopentanone.A total of 250 eyes from 126 patients were included for analysis. The incidence of myopia was the highest in ROP group. The incidence of hyperopia was the highest in control group. The incidence of astigmatism was the highest in ROP group. The corneal astigmatism and mean astigmatism in ROP group and non-ROP group were significantly higher than in control group. Corneal refraction in ROP was markedly higher than in non-ROP group and control group; corneal curvature in ROP group increased significantly as compared with non-ROP group and control group (P < .05). The axial eye length in ROP group and non-ROP group reduced significantly as compared with control group (P < .05). Gestational age had negative relationships with corneal astigmatism (P = .019) and astigmatism (P = .001) and positive relationship with axial eye length (P = .005). Birth weight had negative relationships with corneal astigmatism (P = .001), astigmatism (P < .001), corneal refraction (P = .001), and corneal curvature (P = .001) and positive relationships with axial eye length (P = .001) and spherical equivalent refraction (P = .039). The incidence of myopia increased and that of hyperopia reduced in children over age. In children aged 3 to 4 years, the anterior chamber depth, lens thickness, vitreous thickness, and axial eye length significantly increased as compared with those aged 5 years (P < .05); the vitreous thickness and axial eye length in children aged 5 years increased significantly as compared with those aged 6 years (P < .05).This study shows that preterm children with and without mild ROP are more likely to develop myopia and astigmatism, and low birth weight, prematurity, and ROP may simultaneously affect the development of optical compositions, leading to myopia and astigmatism.

The protective efficacy and safety of bandage contact lenses in children aged 5 to 11 after frontalis muscle flap suspension for congenital blepharoptosis: A single-center randomized controlled trial.

BACKGROUND: Postoperative complications, lagophthalmos and exposure keratopathy sometimes occur after surgery for congenital blepharoptosis. Bandage contact lenses (BCL) can help prevent some ocular surface disorders. The study aims to evaluate the efficacy and safety of BCL for protection of the ocular surface in children aged 5 to 11 years after frontalis muscle flap suspension for congenital blepharoptosis. METHODS: We conducted a prospective randomized clinical study of 30 eyes of 30 patients with congenital blepharoptosis consecutively enrolled at the Ophthalmology Ward of the Children's Hospital of Chongqing Medical University, China from September 1, 2016, to February 30, 2017. After frontalis muscle flap suspension surgery, patients were randomly assigned to undergo BCL application (BCL group, 15 eyes) or no BCL application (control group, 15 eyes). All patients were treated with bramycin 0.3% and polyvinyl alcohol drops after surgery. The primary outcomes were dry eye assessed by tear film break time (TFBUT), fluoresce in corneal staining (FCS) on slit-lamp on days 1, 3, and 15 postoperatively, and lower tear meniscus height (LTMH) on optical coherence tomography on days 1 and 15 postoperatively. Secondary outcomes were pairwise correlation of TFBUT, FCS and LTMH. RESULTS: In the BCL group, abnormal TFBUT and FCS were only found in 2 patients (13.33%) on postoperative day 15. In the control group, the incidence of dry eye assessed by TFBUT was 67.00% (10/15 eyes) on day 1, 73.33% (11/15 eyes) on day 3, and 53.33% (8/15 eyes) on day 15 (P < .001). LTMH were significantly higher in the BCL group than the control group postoperatively (P < .001). Significant positive correlations were found between LTMH and TFBUT pre-operation and on days 1 and 15 post-operation. For LTMH and FCSS (R = -0.815, P < .001), and TFBUT and FCS (R = -0.837, P < .001), the Pearson coefficient was negative on postoperative day 1, but not correlated on day 15. CONCLUSIONS: Silicone hydrogel BCL were safe and efficacious for protective use in children after frontalis muscle flap suspension for congenital blepharoptosis.

Effects of microRNA-29a on retinopathy of prematurity by targeting AGT in a mouse model.

BACKGROUND: This study aimed to explore the effects of microRNA-29a (miR-29a) on retinopathy of prematurity (ROP) by targeting angiotensinogen (AGT) expression in a mouse model. METHODS: Ninety-six C57BL/6J mice were selected and divided into the normal control group (n = 12) and the oxygen-induced retinopathy (OIR) group (n = 84). All the mice in the OIR group were assigned to the following seven groups (12 mice in each group): the blank, miR-29a mimics, miR-29a inhibitors, empty plasmid, miR-29a mimics + si-AGT, miR-29a inhibitors + si-AGT and si-AGT groups. ADPase histochemical staining was conducted to detect the morphology of retinal neovascularization. H&E staining was performed to quantify retinal neovascularization. The qRT-PCR assay was applied to detect the expression levels of miR-29a and the AGT mRNA. Western blotting was used to detect the protein expressions of AGT, vascular endothelial growth factor (VEGF), hepatocyte growth factor (HGF), angiotensin (ANG) and angiotensin II (AngII). RESULTS: Compared with the normal control group, miR-29a expression decreased, while the AGT mRNA expression and the protein expression levels of AGT, VEGF, HGF, ANG and AngII increased, and retinal vascular density and neovascularization also increased in the OIR group. In the OIR group, compared with the blank, empty plasmid, miR-29a inhibitors and miR-29a inhibitors + si-AGT groups, miR-29a expression increased, while the AGT mRNA expression and protein expression levels of AGT, VEGF, HGF, ANG and AngII decreased, and retinal vascular density and neovascularization also decreased in the miR-29a mimics, miR-29a mimics + si-AGT and si-AGT groups. CONCLUSION: MiR-29a could inhibit retinal neovascularization to prevent the development and progression of ROP by down-regulating AGT.

High incidence of dry eye in young children with allergic conjunctivitis in Southwest China.

PURPOSE: To identify the prevalence of dry eye in pediatric population with allergic conjunctivitis in Southwest China. METHODS: A single-centre, prospective, case-control study conducted between May 2015 and December 2015 included 40 children, 3-6 years of age, with seasonal allergic conjunctivitis (SAC) or perennial allergic conjunctivitis (PAC) and 40 age- and gender-matched children undergoing medical healthy examination without history of allergy or dry eye as a control. A dry eye score system (DESS) was administered to both groups. Slit-lamp examinations including tear film break-up time (TFBUT) and fluorescent corneal staining (FCS) were performed. Correlation analyses were performed to evaluate associations between measures of dry eye and signs and symptoms of AC. RESULTS: The prevalence of dry eye was 97.5% (78/80 eyes) in cases and 27.50% (22/80 eyes) in controls. Mean DESS score was 4.75 ± 2.22 in the case group and 0.80 ± 1.22 in the control group (p < 0.001). Symptoms of dry eye in the case group were mild (<6). Mean tear film break-up time was 6.54 ± 1.48 seconds in the case group and 10.04 ± 1.79 seconds in the control group (p < 0.001). Mean FCS scores were 0.79 ± 1.34 and 0.21 ± 0.57, respectively (p = 0.001). The DESS score and TFBUT were both associated with the duration of allergic conjunctivitis. CONCLUSION: The incidence of dry eye assessed by TFBUT was higher in young children with SAC and PAC than in controls. However, subjective symptoms of dry eye (DESS) were inconsistent with objective signs, indicating that close attention should be paid to the evaluation and treatment of dry eye in pediatric population with AC.

Refractive status and optical components of premature babies with or without retinopathy of prematurity at 3-4 years old.

PURPOSE: To investigate the refractive status and optical components of premature babies with or without retinopathy of prematurity (ROP) at 3-4 years old, and to explore the influence of prematurity and ROP on the refractive status and optical components. METHODS: Premature babies receiving fundus examination were recruited into ROP group and non-ROP group, with age-matched full-term babies as controls. RESULTS: The incidence of myopia was the highest in ROP (3/59, 5.08%). The incidence of astigmatism was significantly different between ROP (37.29%, 22/59) and controls (17.86%, 15/84). The corneal refractive power in ROP and non-ROP was more potent compared with controls (P<0.05); corneal curvature was steeper (P<0.05); lens thickness was thinner (P<0.05); ocular axial length was shorter P<0.05). The gestational age was negatively related to corneal astigmatism and astigmatism, positively associated with vitreous thickness and axial length. The birth-weight was negatively associated with corneal astigmatism, astigmatism and corneal refractive power, positively related to corneal radius of curvature, vitreous thickness and ocular axial length. CONCLUSION: Premature babies with or without ROP are susceptible to myopia and astigmatism. ROP, prematurity and low birth-weight synergistically influence the development of refractive status and optical components, of which the prematurity and low birth-weight are more important.

Incidence of retinopathy of prematurity in southwestern China and analysis of risk factors.

BACKGROUND: The aim of this study was to screen for retinopathy of prematurity (ROP) in southwestern China and understand the prevalence and risk factors of ROP, which may provide evidence useful in the prevention and treatment of ROP. MATERIAL/METHODS: 1864 preterm infants (gestational age of <37 weeks and birth weight of ≤2500 g) underwent ROP screening from January 2009 to November 2012 in Southwest China. The medical information of infants during perinatal period was reviewed, and risk factors of ROP were determined. A total of 1614 infants were recruited for final analysis. RESULTS: Incidence of ROP was 12.8%. The first, second, third, and fourth stage of ROP was found in 64.6%, 29.6%, 3.4%, and 0.5% of infants, respectively. No fifth stage of ROP was observed. In addition, 7.7% of infants required surgical intervention. In our Department of Neonatology, the incidence of ROP was 20.0%, which was significantly higher than in non-hospitalized patients (9.9%). The incidence of ROP remained unchanged over the years. Independent risk factors of ROP included low birth weight (p=0.049), low gestational age (p=0.008), days of oxygen supplementation (p=0.008), and myocardial injury after birth (p=0.001). CONCLUSIONS: The prevalence of ROP in preterm infants is relatively high in Southwest China, and low birth weight, low gestational age, days of oxygen supplementation, and myocardial injury after birth are independent risk factors for ROP.

Prevalence of low serum vitamin a levels in young children with chalazia in southwest china.

PURPOSE: To detect risk factors that may be related to chalazia in children in southwest China. DESIGN: Prospective case-control study. METHODS: The case group, 88 children with chalazia, was divided into 2 subgroups. One had 48 children 6 months to 6 years of age (defined as young children), and the other had 40 children 7 to 12 years of age (defined as older children). The control group consisted of 40 young children and 32 older children. Clinical findings for patients were recorded. Serum was tested for concentrations of vitamin A, vitamin D3, and immunoglobulin E. RESULTS: World Health Organization definitions were used for vitamin A deficiency (< 0.7 µmol/L) and marginal vitamin A deficiency (0.7 to 1.05 µmol/L). The average level of serum vitamin A in the case group was significantly lower than that in the control group (P < .001). Analyses failed to find significant differences in vitamin D3 or immunoglobulin E levels between the case and control groups. The average vitamin A level in young children with multiple chalazia (0.65 ± 0.12 µmol/L) was low. Blepharitis was less prevalent than low serum vitamin A levels in the young child subgroup (odds ratios, 8.5 and 96.9, respectively), but higher than in older children (odds ratios, 17.5 and 9.0, respectively). CONCLUSIONS: Low serum vitamin A is associated with a chalazion in young children in southwest China, especially young children with multiple chalazia.

Prevalence of eye diseases and causes of visual impairment in school-aged children in Western China.

BACKGROUND: The present study investigated the prevalence of refractive error, visual impairment, and eye diseases in school-aged children in western China. METHODS: The survey was done in a representative county (Yongchuan District, Chongqing Municipality) of western China. Cluster random sampling was used to select children aged 6 to 15 years. We conducted door-to-door surveys and eye examinations including optometry, stereoscopic vision test, eye position and eye movement, slit lamp examination of the anterior segment, retinoscopy, and fundus examination after cycloplegia with 1% cyclopentolate. RESULTS: Among 3469 children, data were available for 3079 (88.76%). The prevalences of eye diseases were, in descending order, refractive error (20.69%; 637/3079), conjunctivitis (11.76%; 362/3079), amblyopia (1.88%; 58/3079), color vision defect (0.52%; 16/3079), keratitis (0.36%; 11/3079), strabismus (0.29%; 9/3079), cataract (0.23%; 7/3079), pathologic myopia (0.19%; 6/3079), and ocular trauma (0.13%; 4/3079). The prevalence of corneal leucoma, corneal staphyloma, optic neuropathy, macular degeneration, and myelinated nerve fibers was 0.03% (1/3079) for each. The prevalence of visual impairment was 7.70% (237/3079), and the major causes of visual impairment were uncorrected refractive error (86.08%; 204/237), amblyopia (9.70%; 23/237), pathologic myopia (1.27%; 3/237), congenital cataract (0.42%; 1/237), and others (2.11%; 5/237). CONCLUSIONS: Among school-aged children in a less developed area of western China, refractive error was the most prevalent eye disorder, and uncorrected refractive error was the main cause of visual impairment.

Refractive status and prevalence of refractive errors in suburban school-age children.

OBJECTIVE: This study investigated the distribution pattern of refractive status and prevalence of refractive errors in school-age children in Western China to determine the possible environmental factors. METHODS: A random sampling strategy in geographically defined clusters was used to identify children aged 6-15 years in Yongchuan, a socio-economically representative area in Western China. We carried out a door-to-door survey and actual eye examinations, including visual acuity measurements, stereopsis examination, anterior segment and eyeball movements, fundus examinations, and cycloplegic retinoscopy with 1% cyclopentolate. RESULTS: A total of 3469 children living in 2552 households were selected, and 3070 were examined. The distributions of refractive status were positively-skewed for 6-8-year-olds, and negatively-skewed for 9-12 and 13-15-year-olds. The prevalence of hyperopia (≥+2.00 D spherical equivalent [SE]), myopia (≤-0.50 D SE), and astigmatism (≥1.00 diopter of cylinder [DC]) were 3.26%, 13.75%, and 3.75%, respectively. As children's ages increased, the prevalence rate of hyperopia decreased (P<0.001) and that of myopia increased significantly (P<0.001). Children in academically challenging schools had a higher risk of myopia (P<0.001) and astigmatism (≥1.00DC, P =0.04) than those in regular schools. CONCLUSION: The distribution of refractive status changes gradually from positively-skewed to negatively-skewed distributions as age increases, with 9-year-old being the critical age for the changes. Environmental factors and study intensity influence the occurrence and development of myopia.