Lamellar macular hole associated preretinal hyperplasia membrane (LHEP) is considered to be the repair process of retinal tissue damage after the formation of lamellar macular hole (LMH). LMH with LHEP usually shows a non-progressive and stable state, but after long-term clinical follow-up, a few LMH develop to full-thickness macular hole (FTMH). It has been found that in the months or years before the formation of LMH, the contractile epiretinal membrane (ERM) and / or partially detached posterior vitreous body, or Cystoid macular edema (CME), lead to traction deformation of the macular fovea, and the central fovea results in structural destruction of the fovea or the formation of FTMH after traction stretching or cystic edema. The central concave configuration of LMH can be reconstructed spontaneously after transient attacks of CME and small FTMH. Therefore, traction ERM or incomplete posterior vitreous detachment in the formation of degenerative LMH may initially cause interlamellar damage of the retina, followed by the formation of LHEP,LHEP to help LMH maintain a long-term stable state. Whether vitreoretinal surgery is beneficial to both traction and degenerative subtypes is controversial. Some studies reported that visual acuity improved after treatment for both subtypes, while others described poor surgical results for degenerative LMH. The analysis of the visual and anatomical results of flat part vitrectomy for degenerative and tractive LMHs shows that the postoperative visual results are similar. This finding has important clinical significance and can prove that surgical treatment can also be performed in degenerative subtypes. However, the incidence of FTMH after degenerative LMH is still higher than that of traction LMH. Therefore, before surgical treatment of LMH, we should evaluate the type of LMH, evaluate the status of LHEP and traction ERM and vitreous body combined with OCT follow-up results, judge the stability of LMH, and carry out surgical intervention at an appropriate time, which may lead to better visual acuity.

Abstract: Visual function training is a non-surgical, personalized, and systematic physical therapy for visual impairments and visually related neurological abnormalities. This article reports a 7-year-old male patient with visual impairment who experienced reading difficulties, blurred vision, and blurred vision for more than 2 months. The final diagnosis was visual dysfunction, and the patient underwent continuous visual function training for three months. Currently, the patient's clinical symptoms have disappeared.

Abstract: Visual function training is a non-surgical, personalized, and systematic physical therapy for visual impairments and visually related neurological abnormalities. This article reports a 7-year-old male patient with visual impairment who experienced reading difficulties, blurred vision, and blurred vision for more than 2 months. The final diagnosis was visual dysfunction, and the patient underwent continuous visual function training for three months. Currently, the patient's clinical symptoms have disappeared.

Aims: To analyze the characteristics and trends of non-tumor-related eye removal in Southern China from 2009 to 2018. Methods: Inpatient data from Zhongshan Ophthalmic Center were examined to identify trends and characteristics of non-tumorous enucleation/evisceration. The Chi-square test assessed differences in age, gender, and etiology, while linear regression analyzed the significance of trends from 2009 to 2018 across subgroups. The nonquadratic Mann-Kendall test evaluated the trends in etiology and types of ocular injuries. Results: A total of 1824 patients (mean age 28 years, SD 19.2) underwent non-tumor-related eye removal during the study period. The majority were male (73.1%), with ocular trauma (72.3%) and corneal perforation (7.7%) being the leading causes. Work-related injuries accounted for 30.5% of ocular trauma, showing a moderate increase over the decade. However, no statistically significant trends were observed in the etiology or specific causes of ocular trauma. Conclusions: The rates of non-tumorous eye removal remained stable from 2009 to 2018. Ocular trauma was the predominant non-tumorous cause of enucleation or evisceration in Southern China. Translational Relevance: The findings highlight the need for preventive measures against work-related injuries leading to enucleation and the importance of rigorous childcare to mitigate the risk of eye removal due to trauma.

Aims: To establish and evaluate predictive models for glaucoma-related adverse events (GRAEs) following secondary intraocular lens (IOL) implantation in paediatric eyes. Methods：205 children (356 aphakic eyes) receiving secondary IOL implantation at Zhongshan Ophthalmic Center with a 3-year follow-up were enrolled. Cox proportional hazard model was used to identify predictors of GRAEs and developed nomograms. Model performance was evaluated with time-dependent receiver operating characteristic (ROC) curves, decision curve analysis, Kaplan-Meier curves and validated internally through C-statistics and calibration plot of the bootstrap samples. Results: Older age at secondary IOL implantation (HR=1.5, 95% CI: 1.03 to 2.19), transient intraocular hypertension (HR=9.06, 95% CI: 2.97 to 27.67) and ciliary sulcus implantation (HR=14.55, 95% CI: 2.11 to 100.57) were identified as risk factors for GRAEs (all p<0.05). Two nomograms were established. At postoperatively 1, 2 and 3 years, model 1 achieved area under the ROC curves (AUCs) of 0.747 (95% CI: 0.776 to 0.935), 0.765 (95% CI: 0.804 to 0.936) and 0.748 (95% CI: 0.736 to 0.918), and the AUCs of model 2 were 0.881 (95% CI: 0.836 to 0.926), 0.895 (95% CI: 0.852 to 0.938) and 0.848 (95% CI: 0.752 to 0.945). Both models demonstrated fine clinical net benefit and performance in the interval validation. The Kaplan-Meier curves showing two distinct risk groups were well discriminated and robust in both models. An online risk calculator was constructed. Conclusion: Two nomograms could sensitively and accurately identify children at high risk of GRAEs after secondary IOL implantation to help early identification and timely intervention.

The training of qualified ophthalmologists is important to help our country prevent eye diseases and visual impairment more effectively and to provide quality eye care services to the people according to their needs. This article focuses on comparing the details of the standardized ophthalmology residency training system in the Mainland and Hong Kong, and analyzing the similarities and differences in ophthalmology education in the Mainland and Hong Kong. The comparison of ophthalmology education between the Mainland and Hong Kong will help us to improve the ophthalmology residency education and training system in the Mainland in the light of our own actual situation. Relevant reference information is provided for medical educators.

【Abstract】 Objective To analyze the application and testing of clinical diagnosis and treatment involving non-surgical routine test items in a tertiary ophthalmology specialty hospital in the south of China in the past five years, and to provide a basis for ophthalmologists to understand the overview of test-assisted diagnosis, laboratory project management in specialty hospitals, and the development of new projects. Methods From the hospital laboratory information management system, 22,453 blood samples (a total of 94,081 test items) of 12,866 patients attending Sun Yat-sen University Zhongshan Ophthalmology Center during the period from January 1, 2018, to December 31, 2022, were exported from the relevant test records. The departments and specialists applying for testing were classified into 10 subspecialties according to the recommendations of the Chinese Medical Association Ophthalmology Branch, and the information on diseases and test items was statistically analyzed and described in the form of text, bar graphs and line graphs. Results A total of 12,866 patients applied for blood testing during the five-year, including 6,356 male patients (49.4%) and 6,510 female patients (50.6%). Based on the first ophthalmic specialty classification, the top three ophthalmic diseases were oculoplastic/ophthalmic oncology diseases in 5214 cases (40.5%), fundus diseases in 3487 cases (27.1%), and keratoconus diseases in 1711 cases (13.3%). The volume of specimens requested for testing increased from 3,163 in 2018 to 5,903 in 2022, with a general upward trend. Analyzing the application samples from specialists, oculoplastic/orbital disease specialists had the largest number of application slips, with 6,751 (30.1%), of which autoimmune disease testing accounted for the largest proportion of 49.1%, and thyroid disease-related testing accounted for 41.9%; ocular immunity specialists applied for 4,214 tests (18.8%), with autoimmune disease testing accounting for 55.7% of the total and 32.5% for infectious item testing; fundus specialists applied for a total of 3,629 tests (16.2%), with autoimmune disease testing and infectious item testing accounting for 47.8% and 39.6%, respectively; and cornea specialists applied for 1,436 tests, with the proportion of allergic disease testing accounting for 41.2%. Based on the fact that one application form can test multiple items at the same time, oculoplastic/orbital specialists applied for the most testing items with 33,513 items, thyroid disease testing accounted for 65.0%, keratoconus specialists applied for 16,482 items, and allergic disease testing accounted for 83.4%, and fundus specialists and ocular immunity specialists applied for 8,794 items and 8,047 items, respectively, and all of them were dominated by autoimmune disease testing, which accounted for 42.5% and 40.4% respectively. Conclusion The number of applications for clinical diagnosis and treatment involving non-surgical routine tests in ophthalmology specialty hospitals has increased year by year, with the number of applications for each subspecialty being significantly uneven, and the composition of the items being influenced by the disease characteristics of the subspecialty. Specialized hospitals should strengthen the publicity and management of non-surgical routine testing items.

【Abstract】 Objective To analyze the application and testing of clinical diagnosis and treatment involving non-surgical routine test items in a tertiary ophthalmology specialty hospital in the south of China in the past five years, and to provide a basis for ophthalmologists to understand the overview of test-assisted diagnosis, laboratory project management in specialty hospitals, and the development of new projects. Methods From the hospital laboratory information management system, 22,453 blood samples (a total of 94,081 test items) of 12,866 patients attending Sun Yat-sen University Zhongshan Ophthalmology Center during the period from January 1, 2018, to December 31, 2022, were exported from the relevant test records. The departments and specialists applying for testing were classified into 10 subspecialties according to the recommendations of the Chinese Medical Association Ophthalmology Branch, and the information on diseases and test items was statistically analyzed and described in the form of text, bar graphs and line graphs. Results A total of 12,866 patients applied for blood testing during the five-year, including 6,356 male patients (49.4%) and 6,510 female patients (50.6%). Based on the first ophthalmic specialty classification, the top three ophthalmic diseases were oculoplastic/ophthalmic oncology diseases in 5214 cases (40.5%), fundus diseases in 3487 cases (27.1%), and keratoconus diseases in 1711 cases (13.3%). The volume of specimens requested for testing increased from 3,163 in 2018 to 5,903 in 2022, with a general upward trend. Analyzing the application samples from specialists, oculoplastic/orbital disease specialists had the largest number of application slips, with 6,751 (30.1%), of which autoimmune disease testing accounted for the largest proportion of 49.1%, and thyroid disease-related testing accounted for 41.9%; ocular immunity specialists applied for 4,214 tests (18.8%), with autoimmune disease testing accounting for 55.7% of the total and 32.5% for infectious item testing; fundus specialists applied for a total of 3,629 tests (16.2%), with autoimmune disease testing and infectious item testing accounting for 47.8% and 39.6%, respectively; and cornea specialists applied for 1,436 tests, with the proportion of allergic disease testing accounting for 41.2%. Based on the fact that one application form can test multiple items at the same time, oculoplastic/orbital specialists applied for the most testing items with 33,513 items, thyroid disease testing accounted for 65.0%, keratoconus specialists applied for 16,482 items, and allergic disease testing accounted for 83.4%, and fundus specialists and ocular immunity specialists applied for 8,794 items and 8,047 items, respectively, and all of them were dominated by autoimmune disease testing, which accounted for 42.5% and 40.4% respectively. Conclusion The number of applications for clinical diagnosis and treatment involving non-surgical routine tests in ophthalmology specialty hospitals has increased year by year, with the number of applications for each subspecialty being significantly uneven, and the composition of the items being influenced by the disease characteristics of the subspecialty. Specialized hospitals should strengthen the publicity and management of non-surgical routine testing items.

Objective: To explore the application of Optical Coherence Tomography Angiography (OCTA) in non proliferative diabetic retinopathy (NPDR) in Kashi area. Methods: Thirty two patients with non proliferative diabetes and 50 normal controls were selected from the ophthalmology department of our hospital. OCTA data of the areas of the Superficial Retinal Vascular Plexus (SVP), the Deep Retinal Vascular Plexus (DVP) and the Deep Capillary Free Zone (FAZ) were obtained from the two groups. Results: In the NPDR group, there were 11 males (34.375%) and 21 females (65.625%), with an average age of 58 ± 9.89 years, an average age of 13.39 ± 7.2 years of diabetes, an average glycosylated hemoglobin value of 9.48 ± 2.28 mmol/L, and an optimal corrected visual acuity (BCVA) of 0.54 ± 0.3. There are 50 cases in the normal control group, with 21 males (42%) and 29 females (58%). The best corrected visual acuity (BCVA) is 0.97 ± 0.12. The SVP blood flow density (%) in the NPDR group was (21.65 ± 5.38), while the normal control group was (26.36 ± 6.23). The DVP blood flow density (%) in the NPDR group was (19.12 ± 4.3), while the normal control group was (27.51 ± 2.95). The FAZ area (mm2) in the NPDR group was (0.51 ± 0.15), while the normal control group was (0.41 ± 0.14). Compared with the normal control group, the SVP blood flow density and DVP blood flow density in the NPDR group were significantly reduced, while the FAZ area was significantly increased, And it has statistical significance (P=0.001, P=0.000, P=0.003, respectively). Conclusion: OCTA is helpful for the diagnosis of non proliferative diabetes patients in Kashi area, and may be able to detect the retinal blood flow changes of diabetes retinopathy earlier.

A 5 years old girl complained of “right eye exotropia and poor vision of the right eye for 4 years” visited to the Department of Ophthalmology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine on November 15, 2023. The child had a full-term vaginal delivery, and there was no abnormality in her personal and family history. Eye examination showed normal palpebral fissures in both eyes and no obvious ptosis. Both eyes had clear corneas, normal anterior chamber depth, and clear lenses. The pupil of the right eye was approximately 6mm dilated and unresponsive to direct light reflection, and the pupil of the left eye was approximately 2.5mm and sensitive to direct light reflection. Fundus examination showed clear optic disc border in both eyes and no obvious abnormality in retina. The visual acuity of both eyes was 0.3 in the right eye and 0.7 in the left eye. The cycloplegic refraction of compound tobicamide eye drops was +1.25D=0.3 in the right eye and +1.25D=0.7 in the left eye. The intraocular pressure was normal in both eyes. Eye movement examination showed a normal eyelid position, dilated pupil, weakened response to light, and the exotropia was increased lasted for about 2 minutes of the right eye in paralysis stage. While during the spasm period, the eyelid position of the right eye was normal, and the eye position of the right eye gradually changed from exotropia to esotropia. The pupil of the right eye was constricted and the response to light weakened for about 15s (Video 1). Brain and orbit enhanced magnetic resonance imaging showed no abnormal lesions. We diagnosed “periodic oculomotor nerve palsy and right amblyopia in the right eye.”