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The blood‐retinal barrier (BRB), homeostasis, neuronal integrity, and metabolic processes are all directly influenced by Müller cells, the most important retinal glial cells. We isolated primary Müller cells from Sprague–Dawley (SD) neonatal rats and treated them with glucose at varying doses. CCK‐8 was used to quantify cellular viability, and a TUNEL assay was performed to detect cell apoptosis. ELISA, immunofluorescence, and western blotting were used to assess cAMP/PKA/CREB signaling, Kir4.1, AQP4, GFAP, and VEGF levels, respectively. H&E staining was used to examine histopathological alterations in diabetic retinopathy (DR)‐affected retinal tissue in rats. As glucose concentration increases, gliosis of Müller cells became apparent, as evidenced by a decline in cell activity, an increase in apoptosis, downregulation of Kir4.1 level, and overexpression of GFAP, AQP4, and VEGF. Treatments with low, intermediate, and high glucose levels led to aberrant activation of cAMP/PKA/CREB signaling. Interestingly, blocking cAMP and PKA reduced high glucose‐induced Müller cell damage and gliosis by a significant amount. Further in vivo results suggested that cAMP or PKA inhibition significantly improved edema, bleeding, and retinal disorders. Our findings showed that high glucose exacerbated Müller cell damage and gliosis via a mechanism involving cAMP/PKA/CREB signaling. [ABSTRACT FROM AUTHOR]

Aim: To identify the differential methylation sites (DMS) and their according genes associated with diabetic retinopathy (DR) development in type 1 diabetes (T1DM) children., Methods: This study consists of two surveys. A total of 40 T1DM children was included in the first survey. Because no participant has DR, retina thinning was used as a surrogate indicator for DR. The lowest 25% participants with the thinnest macular retinal thickness were included into the case group, and the others were controls. The DNA methylation status was assessed by the Illumina methylation 850K array BeadChip assay, and compared between the case and control groups. Four DMS with a potential role in diabetes were identified. The second survey included 27 T1DM children, among which four had DR. The methylation patterns of the four DMS identified by 850K were compared between participants with and without DR by pyrosequencing., Results: In the first survey, the 850K array revealed 751 sites significantly and differentially methylated in the case group comparing with the controls (|Δβ|>0.1 and Adj. P <0.05), and 328 of these were identified with a significance of Adj. P <0.01. Among these, 319 CpG sites were hypermethylated and 432 were hypomethylated in the case group relative to the controls. Pyrosequencing revealed that the transcription elongation regulator 1 like ( TCERG1L , cg07684215) gene was hypermethylated in the four T1DM children with DR ( P =0.018), which was consistent with the result from the first survey. The methylation status of the other three DMS (cg26389052, cg25192647, and cg05413694) showed no difference (all P >0.05) between participants with and without DR., Conclusion: The hypermethylation of the TCERG1L gene is a risk factor for DR development in Chinese children with T1DM., Competing Interests: Conflicts of Interest: Qian Y, None; Xiao Y, None; Lin QR, None; Xiang ZY, None; Cui LP, None; Sun JQ, None; Li SC, None; Qin XR, None; Zou HD, None; Yang CH, None; Jin PY, None., (International Journal of Ophthalmology Press.)

Aim: To explore the photopic pupil size behavior in myopic children undergoing overnight orthokeratology (ortho-k) over 1-year period and its effects on the axial elongation., Methods: A total of 202 Chinese myopic children were enrolled in this prospective clinical trial. Ninety-five subjects in ortho-k group and eighty-eight subjects in spectacle group completed the 1-year study. Axial length (AL) was measured before enrollment and every 6mo after the start of ortho-k. The photopic pupil diameter (PPD) was determined using the Pentacam AXL and measured in an examination room with lighting of 300-310 Lx. Stepwise multiple linear regression analysis was used to identify variables contribution to axial elongation., Results: Compared with spectacle group, the average 1-year axial elongation was significantly slower in the ortho-k group (0.25±0.27 vs 0.44±0.23 mm, P <0.0001). In ortho-k group, PPDs significantly decreased from 4.21±0.62 mm to 3.94±0.53 mm after 1mo of lens wear ( P =0.001, Bonferroni correction) and the change lasts for 3-month visit. No significantly change during the other follow-up visits was found ( P >0.05, Bonferroni correction). The 4.81 mm PPD may be a possible cutoff point in the ortho-k group. Subjects with PPD below or equal to 4.81 mm tended to have smaller axial elongation compared to subjects with PPD above 4.81 mm after 1-year period ( t =-3.09, P =0.003). In ortho-k group, univariate analyses indicated that those with older age, greater degree of myopia, longer AL, smaller baseline PPD (PPD baseline ) experienced a smaller change in AL. In multivariate analyses, older age, greater AL and smaller PPD baseline were associated with smaller increases in AL. In spectacle group, PPD tended to be stable ( P >0.05, Bonferroni correction) and did not affect axial growth., Conclusion: PPDs experience significantly decreases at 1-month and 3-month ortho-k treatment. Children with smaller PPD tend to experience slower axial elongation and may benefit more from ortho-k., (International Journal of Ophthalmology Press.)

Aim: To investigate the prevalence of diabetic retinopathy (DR) in residents of Shanghai and analyze the risk factors of DR., Methods: This study involved 7233 patients with diabetes in 2016. The demographic data of the participants were collected using a questionnaire survey. Physical examination, laboratory tests, and ophthalmological examinations were conducted. Two professional ophthalmologists diagnosed and graded DR by fundus examination and then combined the results with fundus images. The unconditional multivariate Logistic regression analysis was used to determine the risk factors., Results: In total, 6978 patients with type 2 diabetes in Shanghai with a mean age of 68.33±8.40y were recruited, including 2975 males (42.6%) and 4003 females (57.4%). Overall, 1184 patients were diagnosed with DR, with a prevalence rate of 16.97%. Regression analysis showed that duration of diabetes (OR 1.061, 95%CI 1.049-1.073), high systolic blood pressure (SBP; OR 1.071, 95%CI 1.037-1.106), increased glycosylated hemoglobin level (OR 1.234, 95%CI 1.162-1.311), high blood glucose level (OR 1.061, 95%CI 1.023-1.099), increased neutrophil-to-lymphocyte ratio (NLR; OR 1.132, 95%CI 1.053-1.217) and mean platelet volume (MPV; OR 1.077, 95%CI 1.016-1.142) were risk factors of DR. Conversely, hematocrit (HCT; OR 0.971, 95%CI 0.954-0.988) and mean corpuscular volume (MCV; OR 0.980, 95%CI 0.965-0.994) were protective factors., Conclusion: The prevalence rate of DR in Shanghai is 16.97%. The duration of diabetes, high SBP, increased glycosylated hemoglobin, NLR, and MPV were determined as risk factors of DR., (International Journal of Ophthalmology Press.)

Aim: To explore the distribution pattern of macular choroidal thickness (ChT) and its association with age as well as refractive status in Chinese preschoolers., Methods: School-based, cross-sectional study. A total of 550 healthy preschool children aged 3 to 6 years old from 6 kindergartens were enrolled. Comprehensive ocular examinations, including measurement of visual acuity, axial length, intraocular pressure and slit-lamp examination before cycloplegia, as well as refraction measurement and swept-source optical coherence tomography (SS-OCT) examination after cycloplegia, were performed. The macular ChT in each sector of the ETDRS grid was measured by the built-in software of SS-OCT., Results: The mean central ChT of the participants was 312±59 µm. The mean axial length and spherical equivalent refraction were 22.36±0.72 mm and 1.51±0.83 D, respectively. Axial length increased with age ( P <0.001), while the spherical equivalent refraction was similar among different age groups. Similarly, no significant difference was observed in ChT in all sectors among different age groups (all P >0.05). The central ChT of 3-4, 5 and 6 years old children was 314±59 µm, 312±60 µm and 312±59 µm, respectively ( P =0.920). No difference was observed in ChT in most of the sectors between genders. No statistical significant difference was observed among different refractive groups (all P >0.05), though the ChT of each sector seemed to be smaller in myopic children. Axial length and weight were the independent factors of central ChT. Children with longer axial length ( β =-21.184, P <0.001) and smaller weight ( β =1.502, P =0.041) tended to have thinner choroid., Conclusion: In preschool children, the ChT remains relatively stable with age, while a negative association between ChT and axial length existed. This will be helpful to elucidate the characteristics of ChT during the early refractive development.

Aim: To investigate the Chinese version of the Low Vision Quality of Life Questionnaire (CLVQOL) as an instrument for obtaining clinically important changes after cataract surgery., Methods: Patients underwent cataract surgery in Shanghai General Hospital, Shanghai Jiao Tong University, who fit the inclusion criteria were recruited. Two CLVQOLs were administered, including a preoperative CLVQOL and a CLVQOL at the end of the 3mo follow-up period, and were completed using face-to-face interviews or phone interviews conducted by trained investigators. The minimal clinically important difference (MCID) was calculated using an anchor-based method and a distribution method. In addition, the responsiveness of the questionnaire was measured., Results: A total of 155 residents were enrolled. The average visual acuity (VA) preoperatively was 0.08 (SD=0.05), and it increased to 0.47 (SD=0.28) at the end of follow-up. Statistically significant positive changes in the CLVQOL scores indicated significant improvement of vision related quality of life after cataract surgery. With the larger value between the two results as the final value, the MCID values of the CLVQOL (scores of the four scales as well as the total score) were 8.94, 2.61, 4.34, 3.10 and 17.63, respectively. The CLVQOL has both good internal and external responsiveness., Conclusion: CLVQOL scores are appropriate instruments for obtaining clinically important changes after cataract surgery. This study is an effective exploration for establishing cataract surgery efficacy standards, which helps clinical and scientific research workers in ophthalmology to gain a more in-depth understanding when using CLVQOL.

Objective: To explore the cataract surgical rate (CSR) of Shanghai from 2006 to 2012 and examine its influencing factors., Methods: As of 2003, a cataract surgery registration form had been filled by physicians after every cataract surgery in Shanghai. The local eye disease prevention team then entered the relevant information into the Shanghai Cataract Operations Database. Based upon this database, CSR of Shanghai was calculated. And the number of cataract surgeries was compared between Shanghai urban and suburban districts as well as among different medical institutions., Results: The overall CSR in Shanghai increased from 1741 in 2006 to 2313 in 2012. In 2012, CSR in urban districts reached 6013 while it stood at 460 and 584 in inner and outer suburb districts respectively. The number of hospitals performing cataract surgery in urban districts was much more than that in suburbs. And the average number of cataract surgeries per hospital per year in suburbs was only one third of that (748 cases) in urban areas. The number of cataract surgeries at in private hospitals increased rapidly during the past 7 years. The number of 1921 cases was nearly twice as many as that at tertiary hospitals in 2012. Phacoemulsification surgery was the most popular surgical choice for cataract removal, accounting for 98.40% of total cataract surgeries in 2012., Conclusion: Until 2012, CSR in Shanghai dropped below the target of World Health Organization (WHO). A low level of CSR in suburbs is a major influencing factor for the overall level of CSR in Shanghai.

Objective: To detect the correlation of retinal sensitivity, visual acuity and central macular thickness in patients with different types of diabetic macular edema (DME), macular function were evaluated by measuring the sensitivity, fixation pattern of the macular was examined by fundus-related microperimetry, then analyzed and compared the results with best-corrected visual acuity (BCVA) and foveal retinal thickness measured by optical coherence tomography (OCT)., Methods: A retrospective case-series study. In a prospective, observational case series study, 52 consecutive patients (83 eyes) with diabetic macular edema were included.Sex, age,BMI, education, type of DM, duration, treatment, laboratory examinations, history of cardiovascular disease, hypertension, hyperlipidemia, diabetic nephropathy, and cigarette use were documented.Logarithm of the minimum angle of resolution (logMAR) BCVA was evaluated using the international vision test chart.Foveal thickness was measured by OCT. Mean retinal sensitivities, fixation stability and position was investigated with microperimetry. Variables related with BCVA, foveal thickness and mean retinal sensitivities were analyzed in different types of DME patients using one-way ANOVA or Kruskal-Wallis test. As for fixation, Fisher exact test was chosen. Pearson Correlation analysis was performed to evaluate the association between these variables. Spearman correlation analysis was used for ordinal data. The correlation between retinal sensitivities and all the variables examined were analyzed under multiple regression analysis., Results: Eighty-three eyes were included in this study. Forty-seven eyes (56.63%) were graded as focal DME, 20 eyes (24.10%) as diffuse DME, 5 eyes (6.02%) as ischemic DME and 11 eyes (13.25%) as proliferative DME. Comparison between different types of DME patients showed statistically significant difference in mean logMAR BCVA (F = 12.737, P < 0.01) , mean OCT foveal thickness (H = 31.504, P < 0.01) , mean central retinal sensitivities (F = 14.760, P < 0.01) , and patterns of fixation, which were also statistically correlated (χ(2)= 23.47, 21.01; P < 0.01). It was a positive correlation between OCT foveal thickness and logMAR BCVA in patients with focal, diffuse and ischemic DME (r = 0.56, -0.62; P < 0.01) , but not with proliferative DME (r = 0.43, P = 0.19) .While central retinal sensitivities were also negative correlation between OCT foveal thickness and logMAR BCVA (r = -0.62, -0.68; P < 0.01) . Multiple regression analysis showed that central retinal sensitivity was inversely correlated with LogMAR and retinal thickness (t = -5.52, -4.24; P < 0.01)., Conclusions: There are statistically significant difference in macular morphology and vision function between different types of DME patients. The progression of DME are expressed gradually from focal, diffuse to ischemic type. DME could be fully evaluated by measuring macular sensitivity, fixation pattern with microperimetry as well as macular thickness measurement with OCT and visual acuity determination comprehensively.

Vision check is the first step of mass screening works of most blinding diseases. In recent China, the primary childhood vision check is mainly conducted by hygiene teachers in educational institutions, following the Chinese traditional poor vision classification system, which is based on uncorrected distance visual acuity. However, this classification system does not meet childhood vision developmental mechanism, and may lead to massive unnecessary repetitive screening, diagnosis and treatment of corrected ametropia. In some Chinese communities and villages, the vision check is still based on uncorrected distance visual acuity during eye diseases mass screening procedures in adults. The critical point of preschool children vision impairment screening is then suggested to follow novel Chinese amblyopia diagnostic criteria. Combination of uncorrected, presenting and corrected visual acuity indexes may be used for children' vision check. Collaboration of children health care workers, pediatric ophthalmologists and optometrists in children eye diseases screening projects should be realized as soon as possible. In the adult population, presenting vision is suggested to be used in vision impairment screening works, and appropriate vision check scheme should be adopted in specific eye diseases screening works.

Objective: To investigate the prevalence of blindness and low vision and the leading causes of blindness in residents aged≥60 years in Dachang Blocks of Baoshan District, Shanghai, China., Methods: A cross-sectional study was carried out by Shanghai Eye Disease Prevention & Treatment Center and the Center for Disease Control and Prevention in Baoshan District of Shanghai from October to December in 2009. Randomly cluster sampling was used to identify the adults aged≥60 years who had lived in Dachang Blocks of Baoshan District, Shanghai for more than 10 years. Presenting visual acuity (PVA) and best-corrected visual acuity (BCVA) based on autorefraction and subjective refraction were measured separately in each eye. External eye, anterior segment and ocular fundus were examined by the ophthalmologist using slit lamp-microscopes direct ophthalmoscopy and non-mydriatic digital camera. And the leading causes of visual impairment were assured. The Chi square test was used between the groups of rate comparison., Results: Of 5199 enumerated subjects≥60 years of age, 87.42% (4545/5199) were examined. All subjects were urban population who were originally changed from the rural population in nearly 10 years. In this population, with best-corrected visual acuity, 30 persons were diagnosed as blindness, 145 persons were diagnosed as low vision. The prevalence of blindness and low vision were 0.67%, 3.19%, respectively. Low vision was associated with female gender. It was statistically significant difference (χ2=4.88, P<0.05). The leading causes of blindness were cataract, macular degeneration, ocular absence or atrophy, glaucoma, and diabetic retinopathy or corneal diseases. With presenting visual acuity, 39 persons were diagnosed as blindness, 401 persons were diagnosed as low vision. The prevalence of blindness and low vision were 0.86%, 8.82%, respectively. Blindness and low vision were associated with older age. The prevalence of blindness and low vision increased rapidly in aged 75 years or older people. The leading causes of blindness were cataract, uncorrected refractive error, macular degeneration, ocular absence or atrophy, glaucoma. Low vision was associated with female gender. It had statistically significant difference (χ2=13.345, P<0.01)., Conclusions: In rapidly urbanized and aging community of Shanghai, cataract, uncorrected refractive error, macular degeneration were the leading causes of blindness with presenting visual acuity. The prevalence of low vision in females was higher than that of males which had statistically significant difference. These kinds of residents needed more targeted eye health education and services.

Objective: To assess the standardization of meta-analyses reports on eye diseases published in Chinese journals in recent ten years., Methods: Meta-analyses manuscripts on eye diseases published in Chinese-language journals from January 2000 to September 2010 were retrieved through the following databases: Wanfang Data, VIP Information, CNKI and Chinese Bio-medicine Database, along with manual database search. The manuscripts translated from foreign-language meta-analyses reports or repetitive publications were excluded. All enrolled manuscripts were then analyzed item by item according to the checklist of QUOROM statement and MOOSE guidelines., Results: 50 manuscripts were finally enrolled into the present quality appraisal study, including 32 meta-analyses manuscripts of randomized control trail (RCT) studies and the other 18 meta-analyses manuscripts of observational studies. Out of the 32 manuscripts evaluated with QUOROM statement, only 8 (25.0%) manuscripts included flow chat describing the process of selection, 18 (56.3%) manuscripts included sensitivity analyses and 9 (28.1%) included bias evaluation part. Out of the 18 manuscripts evaluated with MOOSE guidelines, only 6 (33.3%) included comprehensive relative literatures search strategy, 4 (22.2%) included sensitivity analyses and 8 (44.4%) included bias evaluation section., Conclusion: The standardization of meta-analyses reports on eye diseases published in Chinese journals needs to be improved.

The present paper concerns on some distinct shortcomings of recent eye diseases related meta-analysis manuscripts in Chinese literatures, then discusses the following important-aspects in meta-analysis procedures: addressing the purpose properly, providing a precise title, collecting relative literatures comprehensively, assessing the quality of enrolled studies systematically, evaluating the result of test for heterogeneity correctly, choosing the outcome indicators and effect indexes accurately, analyzing sensitivity, and correlating the statistical and clinical significance of the results in an objective manner, et al. The reporting format is suggested to follow the MOOSE guidelines and QUOROM statement.

Objective: To design the community-based tele-screening system for diabetic retinopathy and evaluate the feasibility of it., Methods: Cross-sectional study. The tele-screening system was based on non-mydriatic digital eye fundus camara photography and computer network technology. 109 type 2 diabetes mellitus residents were randomly selected for system evaluation, which included: (1) The consistency of the far visual acuity examined by an ophthalmologist and a trained inspector, evaluated by paired t-sample test; the consistency of diagnosis of diabetic retinopathy by tele-screening system and traditional screening method by ophthalmoscope, slit-lamp bimicroscope combined with non-contact lens after pupil dilation, evaluated by kappa value and intraclass coefficient correlation. (2) The proper compression ratio of the fundus photographs transferring through the internet, evaluated by intraclass coefficient correlation. (3) The working time for the tele-screening on the residents, comparing with the traditional screening method., Results: The visual acuities of the 218 eyes in 109 residents examined by an ophthalmologist were < 0.05 in 13 eyes, between 0.05 and 0.3 in 61 eyes, > or = 0.3 in 144 eyes. No significant difference was found between the vision acuity given by different examiner (t = -0.572, P = 0.568). 52 eyes were diagnosed as DR by traditional screening method, while 51 eyes were diagnosed as DR by the tele-screening method, so in DR diagnosis, high consistency were found with kappa value as 0.885, 95%CI 0.807 to 0.963, and in DR degree diagnosis with ICC value as 0.91, 95%CI 0.85 to 0.94. The most compression ratio of fundus photographs was as low as 15% (526 x 350). It took 5 to 7 minutes for the tele-screening system to examining and giving diagnosis of a diabetes mellitus resident, a little bit sooner than traditional screening method., Conclusions: This community-based tele-screening system can meet the requirements of mass screening for diabetic retinopathy.

Objective: To investigate the prevalence rate of blindness and low vision and the leading cause of blindness in residents aged > or = 60 years in Beixinjing blocks, Shanghai., Methods: A cross-sectional study was carried out by Shanghai First People's Hospital, affiliated Shanghai Jiaotong University and Shanghai Beixinjing Community hospital from November 2007 to April 2008. Randomly cluster sampling method was used, and all the individuals aged > or = 60 years in 8 communities from Beixinjing blocks, Shanghai was enrolled in this study. The pinhole visual acuity and presenting visual acuity were measured separately in each eye. External eye, anterior segment and ocular fundus were examined by the ophthalmologist using slit lamp-microscopes, direct ophthalmoscopy and non-mydriatic digital camara. Assigned ophthalmologic doctors assured the leading blind causes of every blind person. The survey was preceded by a pilot study where operational methods were refined and quality assurance evaluation was carried out., Results: 3851 individuals were examined, and the response rate was 92.73%. According to WHO diagnostic criteria: 29 persons were diagnosed as blindness, 11 male (37.93%) and 18 female (62.07%). 104 persons were diagnosed as low vision, 37 male (35.58%) and 67 female (64.42%). The prevalence rates of blindness and low vision were 0.75% and 2.70%. The leading causes of blindness were macular degeneration, cataract, corneal diseases, and retinal detachment. According to presenting vision diagnostic criteria: 61 persons were diagnosed as severe binocular blindness, 20 male (32.79%) and 41 female (67.21%). 66 persons were diagnosed as slight binocular blindness, 27 male (40.91%) and 39 female (59.09%). 276 persons were diagnosed as monocular blindness, 120 male (43.48%) and 156 female (56.52%). The prevalence of severe binocular blindness, slight binocular blindness and monocular blindness was 1.58%, 1.71% and 7.17%, respectively. The leading causes of blindness were macular degeneration, cataract, ametropia and corneal diseases., Conclusion: The leading cause of blindness was macular degeneration. The prevalence of degenerative retinopathy in this area is on the rise.

The present paper concerns on some shortcoming of the planning and conducting steps in recent Chinese vision-related quality of life (VRQoL) studies, addresses the main application of VRQoL, introduces two instruments, these are questionnaire and utility value for VRQoL evaluation, the standard strategies for introducing or self-making questionnaire, and the principals of the conducting work.

Objective: To investigate the prevalence and relative factors of conjunctivochalasis among people over 60 years old in Caoyangxincun community of Shanghai., Methods: A cross-sectional study based on local residents in this community was carried out from September 2008 to October 2008. Cluster sampling was used in randomly selecting individuals aged > or = 60 years. Slit-lamp ophthalmoscope was used for eye examination and diagnosis. The survey was preceded by a pilot study where operational methods were refined and quality assurance evaluation was carried out. A database was set using SPSS 10.0 software, Chi-square test was used for data analysis., Results: 2110 residents took part in this study, with the response rate 94.85%. 930 cases (1762 eyes) were confirmed as conjunctivochalasis, so the prevalence rate is 44.08%. The prevalence of conjunctivochalasis was increasing with age (chi(2) = 10.44, P < 0.01). 556 cases (943 eyes) were confirmed as degree I, 246 cases (647 eyes) as degree II, 120 cases (162 eyes) as degree III and the rest 8 cases (10 eyes) as degree IV. Several symptoms, such as blurred vision, asthenopia and eye pain were more frequent in patient group than in the normal ones (chi(2) value was 15.44, 20.54 and 19.74, respectively, P < 0.01). In the disease eyes, the conjunctiva usually piled up on the nasal and temporal side (944 eyes, 53.58%), the location of inferior lid margin was usually above corneal limbus (2589 eyes, 61.35%) and inferior lid margin entropion and introversion were always found (7.04% and 6.63%). Abnormal lacrimal river was found in 87.23% of the diseased eyes, more than the non-conjunctivochalasis eyes (chi(2) = 1615.81, P < 0.01)., Conclusions: Conjunctivochalasis is a common eye disease in aged population, with obvious signs and symptoms of ocular surface and lacrimal river impairment. In the local residents, most patients were classified as minimal or moderate degree. The location of inferior lid margin and the tension of inferior lid may be related factor of conjunctivochalasis.

Objective: To investigate the prevalence of dry eye in populations equal or over 20 years old in Jiangning District, Shanghai, China., Methods: This was a cross-sectional study. From September 2008 to January 2009, 6 small districts including 21,102 people of Jiangning District were randomly selected as survey venues by Department of Ophthalmology in First People's Hospital affiliated to Shanghai Jiaotong University. Then, 1266 people as the selected residents were enrolled, which was figured out through the random cluster sampling procedure. Every participant completed dry eye questionnaire, the ocular surface disease index (OSDI), and a series of examination including slit-lamp microscope, tear-film break-up time (BUT) , Schirmer I test, and fluorescein staining of the cornea (F1). The diagnosis of dry eye was referred to the well-accepted domestic diagnostic criteria The SPSS11. 0 software was used to analyze the database, t . test, chi2 test, one-way-ANOVA and Logistic regression were used for analysis., Results: One thousand and eighty five residents finally took part in this study, and the inclusion ratio was 85.70%. Three hundred and twenty six individuals, including 101 men and 225 women, were diagnosed as dry eye, and the prevalence rate was 30.05%. The prevalence of dry eye in the female (33.78%) was higher than that of the male (24.11%) (chi2 = 11.46, P < 0.01). The prevalence of dry eye in people over 50 years old was higher than that under 50 years (chi2 = 94.50, P < 0.01). The figure of Schirmer I test and BUT decreased in elder people, at the same time the scores of Fl and MGD increased. Meanwhile, the score of OSDI in dry eye patients was significantly higher than that in non-dry eye individuals. The relative risk factors of dry eye were gender, age, wearing contact lens, long-time using of eye solutions, taking anti-allergy drugs., Conclusions: The prevalence of dry eye in female is higher than that in the male. And the prevalence of dry eye increases following the aging process. Relative risk factors of dry eye are gender, age, wearing contact lens, long-time using of eye solutions, taking anti-allergy drugs.

Nowadays, the number of ophthalmic population-based epidemiology survey is increasing in China But some distinct shortcomings of the planning and conducting steps, such as wrong concept of the relationship between statistic correlation and risk factor, unnecessary large sample size, inappropriate sampling method, informal design of questionnaire, no pilot study, improper field study, incorrect data input and sort, no quality control, etc., are presented in some surveys, resulting in the poor reliability. Valuable epidemiology results could be obtained only after elucidation of these problems and using a standard design.

Objective: To investigate the prevalence of diabetic retinopathy (DR) and diabetic macular edema (DME) in Beixinjing District, and analyze the image characteristics of their Optical coherence tomography (OCT), so as to evaluate the correlation among DME and the grade of DR as well as posterior vitreous detachment (PVD)., Methods: In a prospective study, OCT was performed in 151 eyes of 100 type 2 diabetes patients with DR and 102 normal eyes as control subjects., Results: 795 cases were examined, and 215 of them were diagnosed to have DR. The average thickness of macular fovea was 195.56 microm in 151 eyes from 100 random sampling. 46 eyes had macular thickening. Three characteristics were found in the images of OCT in the patients with DME: sponge-like retinal swelling in 35 eyes (76.1%), macular cystoid edema in 8 eyes (17.4%), and serous retinal detachment in 3 eyes (6.5%). The statistical analysis showed that there was a positive correlation between the thickness of macular fovea and negative correlation with best-corrected visual acuity (r = 0.2869, P = 0.0004). There was statistic significance between the severity of DR and DME (P = 0.0003). But there was no statistic significance between DME and PVD., Conclusions: The prevalence of DME is 37.1% in this district. Three type images of OCT were demonstrated in DME. The macular thickness is correlated with the severity of DR regardless of PVD.

Objective: To develop and evaluate a Chinese language vision health related quality-of-life (VRQoL) questionnaire., Methods: The low vision quality of life questionnaire (LVQOL) was translated and adapted into the Chinese-version low vision quality of life questionnaire (CLVQOL). The systematic protocols were set as 3 forward translations, 2 committee reviews and 1 back-ward translation. The CLVQOL was performed in 100 randomly selected people with low vision (primary group) and 100 people with normal vision (control group). Ninety-four participants from the primary group completed the CLVQOL and repeated 2 weeks later (test-retest group). The results were compared with patient demographics and the internal consistency reliability, test-retest reliability, item-internal consistency, item-discrimination validity, construct validity and discrimination validity of the CLVQOL were calculated., Results: The review committee agreed that the CLVQOL replicated the meaning of the LVQOL and was sensitive to cultural adaptations. The Cronbach alpha coefficient and the split-half coefficient for the four scales and total CLVQOL scales were 0.75 to 0.97. The test-retest reliability as estimated by intraclass correlation coefficient was 0.69 to 0.95. Item-internal consistency was > 0.4 and item-discrimination validity was generally < 0.40. The varimax rotation factor analysis of the CLVQOL identified four principal factors. All of the scores of four subscales and the total score of CLVQOL of the primary group were lower than those of the control group, both in patients and local residents. CLVQOL scores were highly correlated with visual acuity., Conclusions: The CLVQOL is a culturally specific VRQOL measure instrument. CLVQOL can satisfy conventional psychometric criteria, can discriminate visually healthy populations from low vision patients and is valuable in the clinical practice and in the screening of the community populations.

Objective: To investigate the prevalence of age-related maculopathy (AMD) in Shanghai residents older than 50 years., Methods: 1023 individuals were examined in the years 2002 and 2003 for clinical and subjective signs of dry and exudative AMD. A interview concerning clinical symptoms of AMD as also a complete eye exam was performed. Non-mydriatic retinoscopy was done by use of a direct opthalmoscopy. Fundus photography was used to confirm and document the diagnosis. The diagnosis of both forms of AMD was made according to the criteria of the Sub-society of Fundus Disease, Chinese Ophthalmological Society., Results: 15.5% of the included population had AMD and 19 of them were exudative AMD. The prevalences of AMD in the age groups of 50-59, 60-69, 70-79 and more than 80 were identified as 5.7%, 13.5%, 20.2% and 23.5%, respectively (chi(2) = 27.97, P < 0.01). No statistical differences were found concerning atrophic and exudative AMD related to gender, education, daily focus time, smoking, alcohol consumption and systematic diseases. In the AMD patients, 5.1% and 36.2% of the eyes were identified as blind or with low vision. In exudative AMD patients, 23.3% and 63.3% of the eyes were identified as blind or with low vision. The visual acuity of eyes with exudative AMD was significantly lower than the visual acuity of atrophic AMD eyes. (chi(2) = 15.4, P < 0.01)., Conclusions: The prevalence of AMD is high, and increasing with aging. The AMD, especially the exudative AMD, leads to severe visual impairment.