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Aim: To observe changes in the best-corrected visual acuity (BCVA), central macular thickness (CMT), and central choroidal thickness (CCT) of patients with macular edema (ME) secondary to ischemic retinal vein occlusion (iRVO) following intravitreal Conbercept injection., Methods: This retrospective study included 33 eyes from 33 patients who received intravitreal injections of Conbercept for ME secondary to iRVO. Treatments were performed on a 3+ pro re nata (3+PRN) basis. All of the patients were examined by fundus fluorescein angiography and spectral domain optical coherence tomography at the first visit. Laser photocoagulation was performed in the nonperfusion area of the retina of all eyes after the first injection. BCVA, CMT, and CCT were observed before and after 6mo of treatment. The number of injections necessary to achieve improved vision was also noted., Results: Following Conbercept treatment, the mean BCVA significantly improved from 0.81±0.39 at baseline to 0.41±0.25 and 0.43±0.29 logMAR in the third and sixth months, respectively (both P =0.000). The CMT of the patients at baseline was 556.75±98.57 µm; 304.78±68.53 and 306.85±76.77 µm 3 and 6mo after treatment, respectively (both P =0.000 vs baseline). The CCTs of the patients at baseline, 3 and 6mo after treatment were 304.63±57.83, 271.31±45.53, and 272.29±39.93 µm, respectively ( P =0.026 and 0.035 vs baseline). No severe adverse event relevant to the therapy was noted, and the average number of injections delivered was 3.35., Conclusion: Intravitreal Conbercept injection combined with laser photocoagulation appears to be a safe and effective treatment for ME secondary to iRVO in the short-term., (International Journal of Ophthalmology Press.)

Aim: To determine the differences of amino acid (AA) levels in experimental autoimmune uveoretinitis (EAU)., Methods: AA analysis of the plasma samples in EAU rats induced by interphotoreceptor retinoid-binding protein emulsion were performed with high performance liquid chromatography (HPLC) and phenylisothiocyanate (PITC) pre-column derivation methods were performed. Using partial least squares discriminant analysis (PLS-DA), the potential biomarkers were identified in EAU rat plasma, and the metabolic pathways related to EAU were further analyzed., Results: The method results showed that linear ( r ≥0.9957), intra-day reproducible [relative standard deviation (RSD)=0.04%-1.33%], inter-day reproducible (RSD=0.06%-2.07%), repeatability (RSD=0.03%-0.89%), stability (RSD=0.05%-2.48%) and recovery (RSD=1.98%-4.39%), with detection limits of 0.853-11.4 ng/mL. The metabolic profile in EAU rats was different from that in the control groups five AAs concentrations were increased and nine AAs were reduced. Moreover, five metabolic pathways were related to the development of EAU., Conclusion: The developed method is a simple, rapid and convenient for determination of AAs in EAU rat plasma, and these findings will provide a comprehensive insight on the metabolic profiling of the pathological changes in EAU.

Aim: To compare the efficacy and safety of combination of ranibizumab with photodynamic therapy (PDT) vs ranibizumab monotherapy in the treatment of age-related macular degeneration (AMD)., Methods: The Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, Pubmed, and Embase were searched. There were no language or data restrictions in the search for trials. Only randomized controlled trials (RCTs) were included. Methodological quality of the literatures was evaluated according to the Jadad Score. RevMan 5.2.6 software was used to do the meta-analysis., Results: Seven studies were included in our systematic review, among which four of them were included in quantitative analysis. The result shows that the ranibizumab monotherapy group had a better mean best corrected visual acuity (BCVA) change vs baseline at month 12 compared with that of the combination treatment group, and the statistical difference was significant (WMD, -2.61; 95% CI, -5.08 to -0.13; P=0.04). However, after the removal of one study, the difference between the two groups showed no significant difference (WMD, -2.29; 95% CI, -4.81 to 0.23; P=0.07). Meanwhile, no significant central retinal thickness (CRT) reduction was found in the combination treatment group and the ranibizumab monotherapy group at 12 months follow-up. Nevertheless, the combination group tended to have a greater reduction in CRT (WMD, -4.13µm; 95%CI, -25.88 to 17.63, P=0.71). The proportion of patients gaining more than 3 lines at month 12 in the ranibizumab group was higher than in the combination group and there was a significant difference (RR, 0.72; 95% CI, 0.54 to 0.95; P=0.02). Whereas there was no significant difference for the proportion of patients gaining more than 0 line at month 12 between the two groups (RR, 0.93; 95% CI, 0.76 to 1.15; P=0.52). The general tendency shows a reduction in ranibizumab retreatment number in the combination treatment group compared with the ranibizumab monotherapy group. As major adverse events, the differences in the number of eye pain, endophthalmitis, hypertension and arterial thromboembolic events were not significant between the two groups, and the incidence of serious adverse events in the two groups was very low., Conclusion: For the maintenance of vision, the comparison of the combination of ranibizumab with PDT vs ranibizumab monotherapy shows no apparent difference. Compared with the combination of ranibizumab and PDT, patients treated with ranibizumab monothearpy may gain more visual acuity (VA) improvement. The combination treatment group had a tendency to reduce the number of ranibizumab retreatment. Both the two treatment strategies were well tolerated.

Objectives: To explore the effects of exogenous interleukin (IL)-2 and IL-23 on differentiation of IRBP 1-20-specific T cells originated from C57BL/6 mouse with experimental autoimmune uveitis (EAU) and to investigate the difference in pathogenicity., Methods: Experimental study. Thirty C57BL/6 mice were immunized subcutaneously with 200 µl emulsion containing 200 µg interphotoreceptor retinoid-binding protein (IRBP) 1-20 and 0.8 mg mycobacterium tuberculosis in complete Freund's adjuvant, distributed over six spots at the tail base and on the flank. On postimmunization Day 13, spleens and draining lymph nodes were removed from mice, and a part of spleens, as the control group, was reserved for examining the expression of IFN-γ mRNA and IL-17 mRNA by RT-PCR. T cells were isolated from the rest of spleens and lymph nodes by passage through a nylon wool column, and then T cells were stimulated for 48 hours with IRBP 1-20 in the presence of antigen-presenting cell and mouse recombinant cytokine IL-2 or IL-23. The IRBP 1-20-specific T cells were separated by Ficoll gradient centrifugation, the expressions of IFN-γ mRNA and IL-17 mRNA were assessed by RT-PCR, and IFN-γ and IL-17 in T cells supernatant were detected using a commercial ELISA kit. The T cells were cultured for another 48 hours, and then the proportions of IL-17(+)γδ(+)T cells were analyzed by flow cytometry. EAU models were built in 30 C57BL/6 mice, T cells from which were randomly divided into two groups according to the methods mentioned above: IL-2 group and IL-23 group. Transfer EAU models were built in other 6 mice and divided into two groups, IL-2 group and IL-23 group, by intraperitoneal injection of 3.5×10(6) IRBP-special-T cells from IL-2 group or IL-23 group respectively. Clinical changes were observed by indirect ophthalmoscopy on postimmunization day 3, 7, 14. For histopathological evaluation, whole eyes were collected on postimmunization day 21. Rank sum test, one-way ANOVA and paired t test were used to analyze the results. A comparison of pathogenicity was made between Th1 and Th17 through clinical observation and histopathological evaluation of B6 mouse., Results: Rosette formation was found among T cells on poststimulation day 2. There was a statistical difference in the expression of IFN-γ mRNA between the IL-2 group and normal group or IL-23 group (0.26 ± 0.02 vs. 0.12 ± 0.05 or 0.10 ± 0.00) (F = 80.51, P = 0.003); however, the expression of IFN-γ in the IL-2 group [(13 124.67 ± 107.73) µg/L] was higher than that of the IL-23 group [(3953.67 ± 117.34) µg/L] (t = 169.61, P = 0.000); and the expression of IL-17 mRNA in the IL-2 group [(588.67 ± 77.43) µg/L] was lower than that of the IL-23 group [(5038.33 ± 88.00) µg/L] (t = -361.71, P = 0.000). Flow cytometer showed that the concentration of IL-17 in the IL-2 group [(3.23 ± 0.28)%] was significantly lower than that in the IL-23 group [(9.93 ± 0.55)%] (t = -33.18, P = 0.001). There was a significant difference in the proportion of IL-17(+)γδ(+)T cells between the IL-23 group and IL-2 group (9.93 ± 0.55 vs. 3.23 ± 0.28) (t = -33.18, P = 0.001). Inflammatory response could not be detected in either group three days after injection of IRBP 1-20-specific T cells. Both groups of mice had the most severe inflammatory response on the 14 th day, of which that of the IL-23 group was significantly more severe., Conclusions: IL-23 facilitates IRBP 1-20-specific T cells to differentiate into Th17, whereas IL-2 inhibits this process and induces these cells to differentiate towards Th1. Further studies showed that the pathogenicity of Th17 cells was significantly higher than that of Th1 cells.

Objective: To assess the safety, efficacy, predictability, stability, and changes in cylindrical degree and axis after iris recognize-guided LASIK with the Zyoptix 4.01 System for the correction of myopic astigmatism., Methods: The present study was a prospective, nonrandomized, self-controlled trial. Iris recognize-guided LASIK with the Zyoptix 4.01 System (Bausch & Lomb) was performed in 97 patients (183 eyes) with myopic astigmatism in a 6-month trial. Patients were divided into 3 group according to the pre-operative cylindrical degree: Group 1, -0.50 to -1.00D, 79 eyes; Group 2, -1.25 to -2.00D, 70 eyes; Group 3, 2.00 to 4.00D, 34 eyes. They were also grouped by preoperative astigmatism axis: Group A, with the rule (WTR) astigmatism, 126 eyes; Group B, against the rule (ATR), 34 eyes; Group C, oblique axis astigmatism, 23 eyes. After a Hansatome microkeratome cut, iris recognized wavefront-based excimer ablation (Zyoptix 100) was performed. The degree and axis of astigmatism pre-operative and at various times post-operatively (1 day, 1 month, 3 month and 6 months) were analyzed and compared., Results: At 6 month post-operatively, uncorrected visual acuity (VA) was 1.0 or better in 92.3% of the eyes, and 0.5 or better in all eyes. No eye lost > or = 1 lines of best spectacle-corrected VA (BSCVA) at 6 month post-operatively; 60 eyes gained 1 line of BSCVA, and 22 eyes gained 2 lines. The cylindrical degree of astigmatism decreased from (-1.54 +/- 0.65) D of pre-operation to (-0.26 +/- 0.25) D (6 month, post-operatively), the difference between these two groups was statistically significant. The uncorrected VA (UCVA) and the degree of astigmatism returned to normal in the first week and tended to be stable after 1 month. Six months after the operation, WTR astigmatism decreased from106 eyes (per-operation) to 45 eyes (post-operation). ATR astigmatism decreased from 43 eyes (per-operation) to 31 eyes (post-operation). Oblique astigmatism increased from 34 to 38 eyes. Sixty-nine eyes became non-astigmatism 6 months after the operation., Conclusion: Iris recognize-guided LASIK using Zyoptix is an effective and safe procedure for the treatment of myopic astigmatism.

Objective: To evaluate the efficacy of 5-fluorouracil polyactic acid microsphere in prevention of proliferative vitreoretinopathy (PVR)., Methods: 5-fluorouracil polyactic acid microsphere or 5-fluorouracil were used to implant into rabbits vitreous cavity. 48 healthy rabbits were divided into 3 groups: rabbits in Group 1 received implantation of 5-fluorouracil polyactic acid microsphere; rabbits Group 2 served as polyactic acid microsphere control; rabbits in Group 3 received only 5-fluorouracil powder. Macrophages were injected into vitreous cavity of rabbit to induce PVR. 0.2 ml BSS containing 25 mg microsphere with 2.6 mg 5-fluorouracil was injected into vitreous cavity of two eyes in Group 1. 0.2 ml BSS containing 25 mg microsphere without medicine and 0.2 ml BSS containing 2.6 mg 5-fluorouracil were injected into rabbits vitreous cavity in Group 2 and 3 respectively, Drug content in aqueous humor was measured regularly. Release feature of 5-fluorouracil polyactic acid microsphere in vivo was observed. The efficacy of the inhibition of PVR was evaluated according to Ryan's grade of proliferative vitreoretinopathy., Results: The releasing time of 5-fluorouracil polyactic acid microsphere was much longer than 5-fluorouracil powder. Its half life T(1/2) was 379.05 h with low clearance rate. The attack rate of retinal detachment in Group 2 was 62.5% and 71.9% on the 21st and 28th day respectively. The attack rate of retinal detachment in Group 3 was 64.3% and 78.6% whereas that of Group 1 was 13.3% and 13.3% on the 21st and 28th day. There was statistical difference in retinal detachment rate in Group 1 and 2 or 3 (P < 0.01). No differences was found in retinal detachment ration in Group 2 and 3 (P > 0.05)., Conclusion: Implantation of 5-fluorouracil polyactic acid microsphere into vitreous cavity can effectively prevent proliferative vitreoretinopathy induced by macrophages in rabbit model.

Objective: To study the results of using multifocal intraocular lens (MIOL) for the treatment of cataract., Methods: After the small incision phacoemulsification, MIOL was inserted into the eye in 30 cases (36 eyes, test group); single-focal intraocular lens (SIOL) was inserted in 32 cases (40 eyes, control group). Visual acuity, focal depth, corneal astigmatism, contrast sensitivity, glare sensitivity, operative complications and untoward visual symptoms were observed. The follow-up period was 6.0 approximately 18.0 months., Results: Percentage of patients with uncorrected near visual acuity 0.5 or better accounted was 80.6% (29/36) in the test group and 25.0% (10/40) in the control group, there was a significantly statistical difference between these two groups 6 months postoperatively (P < 0.05). There was no significantly statistical difference between the corrected near and far visual acuity and uncorrected far visual acuity of these two groups (P > 0.05). In patients with +1.00 - -1.00 D accommodation power, the percentage of patients with visual acuity 0.5 or better was 97.2% (35/36) in the test group and 97.5% (39/40) in the control group, there was no significantly difference between these two groups (P > 0.05). In patients with -1.50 D and -2.50 - -3.50 D accommodation power, the percentage of patients with visual acuity 0.5 or better was 97.2% (35/36) and 88.9% (32/36) in the test group, respectively; which was significantly greater than those in the control group [0.0% (0/40) and 0.0% (0/40), respectively] (P < 0.05). In patients with visual acuity 0.5 or better, the depth of focus was 4.50 D in 86.11% cases of the test group and was 2.00 D in 97.5% cases of the control group. There was no statistically significant difference between the preoperative corneal stigmatism and corneal astigmatism 1 week, 1 month, 3 months and 6 months after the operation in both groups (P > 0.05). Low frequency contrast sensitivity and glare sensitivity (28.49 +/- 6.45 and 16.97 +/- 4.40, respectively) in the test group were significantly lower than those of the control group (36.20 +/- 7.45 and 24.05 +/- 6.08, respectively) (P < 0.05). There was no significantly statistical difference in medium and high frequency contrast sensitivity and glare sensitivity between these two groups (P > 0.05). Two eyes needed Nd:YAG laser posterior capsulotomy in both groups. Two patients (5.6%) with unilateral MIOL complained glare at night., Conclusion: MIOL implantation is a safe and effective method for the treatment of cataract. MIOL has a distinct advantage in providing a full-distance visual acuity.