Intelligent diagnosis of retinal vein occlusion based on color fundus photographs

AIM:To develop an artificial intelligence(AI)diagnosis model based on deep learning(DL)algorithm to diagnose different types of retinal vein occlusion(RVO)by recognizing color fundus photographs(CFPs).METHODS:Totally 914 CFPs of healthy people and patients with RVO were collected as experimental data sets,and used to train,verify and test the diagnostic model of RVO.All the images were divided into four categories[normal,central retinal vein occlusion(CRVO),branch retinal vein occlusion(BRVO),and macular retinal vein occlusion(MRVO)]by three fundus disease experts.Swin Transformer was used to build the RVO diagnosis model,and different types of RVO diagnosis experiments were conducted.The model’s performance was compared to that of the experts.RESULTS:The accuracy of the model in the diagnosis of normal,CRVO,BRVO,and MRVO reached 1.000,0.978,0.957,and 0.978;the specificity reached 1.000,0.986,0.982,and 0.976;the sensitivity reached 1.000,0.955,0.917,and 1.000;the F1-Sore reached 1.000,0.9550.943,and 0.887 respectively.In addition,the area under curve of normal,CRVO,BRVO,and MRVO diagnosed by the diagnostic model were 1.000,0.900,0.959 and 0.970,respectively.The diagnostic results were highly consistent with those of fundus disease experts,and the diagnostic performance was superior.CONCLUSION:The diagnostic model developed in this study can well diagnose different types of RVO,effectively relieve the work pressure of clinicians,and provide help for the follow-up clinical diagnosis and treatment of RVO patients.

The optimal atropine concentration for myopia control in Chinese children: a systematic review and network Metaanalysis

AIM:To figure out whether various atropine dosages may slow the progression of myopia in Chinese kids and teenagers and to determine the optimal atropine concentration for effectively slowing the progression of myopia.METHODS:A systematic search was conducted across the Cochrane Library,PubMed,Web of Science,EMBASE,CNKI,CBM,VIP,and Wanfang database,encompassing literature on slowing progression of myopia with varying atropine concentrations from database inception to January 17,2024.Data extraction and quality assessment were performed,and a network Meta-analysis was executed using Stata version 14.0 Software.Results were visually represented through graphs.RESULTS:Fourteen papers comprising 2475 cases were included;five different concentrations of atropine solution were used.The network Meta-analysis,along with the surface under the cumulative ranking curve(SUCRA),showed that 1%atropine(100%)>0.05%atropine(74.9%)>0.025%atropine(51.6%)>0.02%atropine(47.9%)>0.01%atropine(25.6%)>control in refraction change and 1%atropine(98.7%)>0.05%atropine(70.4%)>0.02%atropine(61.4%)>0.025%atropine(42%)>0.01%atropine(27.4%)>control in axial length(AL)change.CONCLUSION:In Chinese children and teenagers,the five various concentrations of atropine can reduce the progression of myopia.Although the network Meta-analysis showed that 1%atropine is the best one for controlling refraction and AL change,there is a high incidence of adverse effects with the use of 1%atropine.Therefore,we suggest that 0.05%atropine is optimal for Chinese children to slow myopia progression.

RDH12-associated retinal degeneration caused by a homozygous pathogenic variant of 146C>T and literature review

AIM:To describe the clinical,electrophysiological,and genetic features of an unusual case with an RDH12 homozygous pathogenic variant and reviewed the characteristics of the patients reported with the same variant.METHODS:The patient underwent a complete ophthalmologic examination including best-corrected visual acuity,anterior segment and dilated fundus,visual field,spectral-domain optical coherence tomography(OCT)and electroretinogram(ERG).The retinal disease panel genes were sequenced through chip capture high-throughput sequencing and Sanger sequencing was used to confirm the result.Then we reviewed the characteristics of the patients reported with the same variant.RESULTS:A 30-year male presented with severe early retinal degeneration who complained night blindness,decreased visual acuity,vitreous floaters and amaurosis fugax.The best corrected vision was 0.04 OD and 0.12 OS,respectively.The fundus photo and OCT showed bilateral macular atrophy but larger areas of macular atrophy in the left eye.Autofluorescence shows bilateral symmetrical hypo-autofluorescence.ERG revealed that the amplitudes of a-and b-wave were severely decreased.Multifocal ERG showed decreased amplitudes in the local macular area.A homozygous missense variant c.146C>T(chr14:68191267)was found.The clinical characteristics of a total of 13 patients reported with the same pathologic variant varied.CONCLUSION:An unusual patient with a homozygous pathogenic variant in the c.146C>T of RDH12 which causes late-onset and asymmetric retinal degeneration are reported.The clinical manifestations of the patient with multimodal retinal imaging and functional examinations have enriched our understanding of this disease.

Role of hsa_circ_0007482 in pterygium development: insights into proliferation, apoptosis, and clinical correlations

AIM:To investigate the impact of hsa_circ_0007482 on the proliferation and apoptosis of human pterygium fibroblasts(HPFs)and its correlation with the severity grades of pterygium.METHODS:Pterygium and normal conjunctival tissues were collected from the superior area of the same patient’s eye(n=33).The correlation between pterygium severity and hsa_circ_0007482 expression using quantitative reversetranscription polymerase chain reaction(RT-qPCR)were analyzed.Three distinct siRNA sequences targeting hsa_circ_0007482,along with a negative control sequence,were transfected into HPFs.Cell proliferation was assessed using the cell counting kit-8.Expression levels of Ki67,proliferating cell nuclear antigen(PCNA),Cyclin D1,Bax,B-cell lymphoma-2(Bcl-2),and Caspase-3 were measured via RT-qPCR.Immunofluorescence staining was employed to detect Ki67 and vimentin expressions.Apoptosis was evaluated using flow cytometry.RESULTS:Hsa_circ_0007482 expression was significantly higher in pterygium tissues compared to normal conjunctival tissues(P<0.001).Positive correlations were observed between hsa_circ_0007482 expression and pterygium severity,thickness,and vascular density.Knockdown of hsa_circ_0007482 inhibited cell proliferation,reducing the mRNA expression of Ki67,PCNA,and Cyclin D1 in HPFs.Hsa_circ_0007482 knockdown induced apoptosis,increasing mRNA expression levels of Bax and Caspase-3,while decreasing Bcl-2 expression in HPFs.Additionally,hsa_circ_0007482 knockdown attenuated vimentin expression in HPFs.CONCLUSION:The downregulation of hsa_circ_0007482 effectively hampers cell proliferation and triggers apoptosis in HPFs.There are discernible positive correlations detected between the expression of hsa_circ_0007482 and the severity of pterygium.

Relative peripheral refraction in school children with different refractive errors using a novel multispectral refraction topographer

AIM:To compare relative peripheral refraction(RPR)in Chinese school children with different refractive errors using multispectral refraction topography(MRT).METHODS:A total of 713 eyes of primary school children[172 emmetropia(E),429 low myopia(LM),80 moderate myopia(MM),and 32 low hypermetropia(LH)]aged 10 to 13y were analyzed.RPRs were measured using MRT without mydriasis.MRT results showed RPR at 0-15°(RPR 0-15),15°-30°(RPR 15-30),and 30°-45°(RPR 30-45)annular in the inferior(RPR-I),superior(RPR-S),nasal(RPR-N),and temporal(RPR-T)quadrants.Spherical equivalent(SE)was detected and calculated using an autorefractor.RESULTS:There were significant differences of RPR 15-30 between groups MM[0.02(-0.12;0.18)]and LH[-0.13(-0.36;0.12)](P<0.05),MM and E[-0.06(-0.20;0.10)](P<0.05),and LM[-0.02(-0.15;0.15)]and E(P<0.05).There were also significant differences of RPR 30-45 between groups MM[0.45(0.18;0.74)]and E[0.29(-0.09;0.67)](P<0.05),and LM[0.44(0.14;0.76)]and E(P<0.001).RPR values increased from the hyperopic to medium myopic group in each annular.There were significant differences of RPR-S between groups MM[-0.02(-0.60;0.30)]and E[-0.44(-0.89;-0.04)](P<0.001),and LM[-0.28(-0.71;0.12)]and E(P<0.05).There were also significant differences of RPR-T between groups MM[0.37(0.21;0.78)]and LH[0.14(-0.52;0.50)](P<0.05),LM[0.41(0.06;0.84)]and LH(P<0.05),and LM and E[0.29(-0.10;0.68),P<0.05].A Spearman’s correlation analysis showed a negative correlation between RPR and SE in the 15°-30°(P=0.005),30°-45°(P<0.05)annular(P=0.002),superior(P<0.001),and temporal(P=0.001)quadrants.CONCLUSION:Without pupil dilation,values for RPR 15-30,30-45,RPR-S,and T shows significant differences between myopic eyes and emmetropia,and the differences are negatively correlated with SE.

New recessive compound heterozygous variants of RP1L1 in RP1L1 maculopathy

AIM:To identify a maculopathy patient caused by new recessive compound heterozygous variants in RP1L1.METHODS:Comprehensive retinal morphological and functional examinations were evaluated for the patient with RP1L1 maculopathy.Targeted sequence capture array technique was used to screen potential pathologic variants.Polymerase chain reaction and Sanger sequencing were used to confirm the screening results.RESULTS:Fundus examination showed round macular lesions appeared in both eyes.Optical coherence tomography showed that the inner segment/outer segment continuity was disorganized and disruptive in the left eye,but it was uneven and slightly elevated in the right eye.Fundus autofluorescence showed patchy hyper-autofluorescence in the macula.Visual field examination indicates central defects in both eyes.Electroretinogram(ERG)and multifocal ERG showed no obvious abnormalities.Fundus fluorescein angiography in the macula showed obviously irregular hyper-fluorescence in the right eye and slightly hyper-fluorescence in the left eye.We found that the proband carried a missense variant(c.1972C>T)and a deletion variant(c.4717_4718del)of RP1L1,which were originated from the parents and formed compound heterozygous variants.Both variants are likely pathogenic according to the ACMG criteria.Multimodal imaging,ERG and detailed medical history are important diagnostic tools for differentiating between acquired and inherited retinal disorders.CONCLUSION:A maculopathy case with detailed retinal phenotype and new recessive compound heterozygous variants of RP1L1 is identified in a Chinese family,which expands the understanding of phenotype and genotype in RP1L1 maculopathy.

HCSP-Net:A Novel Model of Age-Related Macular Degeneration Classification Based on Color Fundus Photography

Age-related macular degeneration(AMD)ranks third among the most common causes of blindness.As the most conventional and direct method for identifying AMD,color fundus photography has become prominent owing to its consistency,ease of use,and good quality in extensive clinical practice.In this study,a convolutional neural network(CSPDarknet53)was combined with a transformer to construct a new hybrid model,HCSP-Net.This hybrid model was employed to tri-classify color fundus photography into the normal macula(NM),dry macular degeneration(DMD),and wet macular degeneration(WMD)based on clinical classification manifestations,thus identifying and resolving AMD as early as possible with color fundus photography.To further enhance the performance of this model,grouped convolution was introduced in this study without significantly increasing the number of parameters.HCSP-Net was validated using an independent test set.The average precision of HCSPNet in the diagnosis of AMD was 99.2%,the recall rate was 98.2%,the F1-Score was 98.7%,the PPV(positive predictive value)was 99.2%,and the NPV(negative predictive value)was 99.6%.Moreover,a knowledge distillation approach was also adopted to develop a lightweight student network(SCSP-Net).The experimental results revealed a noteworthy enhancement in the accuracy of SCSP-Net,rising from 94%to 97%,while remarkably reducing the parameter count to a quarter of HCSP-Net.This attribute positions SCSP-Net as a highly suitable candidate for the deployment of resource-constrained devices,which may provide ophthalmologists with an efficient tool for diagnosing AMD.

Factors affecting meibomian gland area loss in symptomatic adults

AIM:To characterize the distribution of meibomian gland(MG)area loss(MGL)and its relationship with demographic characteristics,mites,and symptoms.METHODS:This retrospective observational study included patients who visited the Dry Eye Clinic of Shenzhen Eye Hospital between June 2020 and August 2021.General patient characteristics,ocular symptoms,Demodex test results of the eyelid edges,and the results of a comprehensive ocular surface analysis were collected.MGL was analyzed using Image J software.RESULTS:This study enrolled 1204 outpatients aged 20-80(40.70±13.44)y,including 357 males(29.65%)and 847 females(70.35%).The patients were classified into mild(n=155;12.87%),moderate(n=795;66.03%),severe(n=206;17.11%),and extremely severe(n=48;3.99%)MGL groups.MGL was significantly larger in female than in male(P=0.006).The degree of MGL also significantly differed in age(P<0.001)and the more numbers of mites with severity(P<0.001).Multivariate disordered multinomial logistic regression analysis identified that female sex,older age,secretory symptoms,and a large number of mites were risk factors for MGL(P<0.05).CONCLUSION:Patients with MGL are more likely to be older,female,more numbers of mites,and increased secretion.

Bibliometric analysis of hotspots and trends of global myopia research

AIM:To gain insights into the global research hotspots and trends of myopia.METHODS:Articles were downloaded from January 1,2013 to December 31,2022 from the Science Core Database website and were mainly statistically analyzed by bibliometrics software.RESULTS:A total of 444 institutions in 87 countries published 4124 articles.Between 2013 and 2022,China had the highest number of publications(n=1865)and the highest H-index(61).Sun Yat-sen University had the highest number of publications(n=229)and the highest H-index(33).Ophthalmology is the main category in related journals.Citations from 2020 to 2022 highlight keywords of options and reference,child health(pediatrics),myopic traction mechanism,public health,and machine learning,which represent research frontiers.CONCLUSION:Myopia has become a hot research field.China and Chinese institutions have the strongest academic influence in the field from 2013 to 2022.The main driver of myopic research is still medical or ophthalmologists.This study highlights the importance of public health in addressing the global rise in myopia,especially its impact on children’s health.At present,a unified theoretical system is still needed.Accurate surgical and therapeutic solutions must be proposed for people with different characteristics to manage and intervene refractive errors.In addition,the benefits of artificial intelligence(AI)models are also reflected in disease monitoring and prediction.

Intelligent diagnostic model for pterygium by combining attention mechanism and MobileNetV2

AIM:To evaluate the application of an intelligent diagnostic model for pterygium.METHODS:For intelligent diagnosis of pterygium,the attention mechanisms—SENet,ECANet,CBAM,and Self-Attention—were fused with the lightweight MobileNetV2 model structure to construct a tri-classification model.The study used 1220 images of three types of anterior ocular segments of the pterygium provided by the Eye Hospital of Nanjing Medical University.Conventional classification models—VGG16,ResNet50,MobileNetV2,and EfficientNetB7—were trained on the same dataset for comparison.To evaluate model performance in terms of accuracy,Kappa value,test time,sensitivity,specificity,the area under curve(AUC),and visual heat map,470 test images of the anterior segment of the pterygium were used.RESULTS:The accuracy of the MobileNetV2+Self-Attention model with 281 MB in model size was 92.77%,and the Kappa value of the model was 88.92%.The testing time using the model was 9ms/image in the server and 138ms/image in the local computer.The sensitivity,specificity,and AUC for the diagnosis of pterygium using normal anterior segment images were 99.47%,100%,and 100%,respectively;using anterior segment images in the observation period were 88.30%,95.32%,and 96.70%,respectively;and using the anterior segment images in the surgery period were 88.18%,94.44%,and 97.30%,respectively.CONCLUSION:The developed model is lightweight and can be used not only for detection but also for assessing the severity of pterygium.

Diabetic retinopathy identification based on multi-sourcefree domain adaptation

AIM:To address the challenges of data labeling difficulties,data privacy,and necessary large amount of labeled data for deep learning methods in diabetic retinopathy(DR)identification,the aim of this study is to develop a source-free domain adaptation(SFDA)method for efficient and effective DR identification from unlabeled data.METHODS:A multi-SFDA method was proposed for DR identification.This method integrates multiple source models,which are trained from the same source domain,to generate synthetic pseudo labels for the unlabeled target domain.Besides,a softmax-consistence minimization term is utilized to minimize the intra-class distances between the source and target domains and maximize the inter-class distances.Validation is performed using three color fundus photograph datasets(APTOS2019,DDR,and EyePACS).RESULTS:The proposed model was evaluated and provided promising results with respectively 0.8917 and 0.9795 F1-scores on referable and normal/abnormal DR identification tasks.It demonstrated effective DR identification through minimizing intra-class distances and maximizing inter-class distances between source and target domains.CONCLUSION:The multi-SFDA method provides an effective approach to overcome the challenges in DR identification.The method not only addresses difficulties in data labeling and privacy issues,but also reduces the need for large amounts of labeled data required by deep learning methods,making it a practical tool for early detection and preservation of vision in diabetic patients.

Artificial intelligence applications in ophthalmic optical coherence tomography:a 12-year bibliometric analysis

AIM:To explore the current application and research frontiers of global ophthalmic optical coherence tomography(OCT)imaging artificial intelligence(AI)research.METHODS:The citation data were downloaded from the Web of Science Core Collection database(WoSCC)to evaluate the articles in application of AI in ophthalmic OCT published from January 1,2012 to December 31,2023.This information was analyzed using CiteSpace 6.2.R2 Advanced software,and high-impact articles were analyzed.RESULTS:In general,877 articles from 65 countries were studied and analyzed,of which 261 were published by the United States and 252 by China.The centrality of the United States is 0.33,the H index is 38,and the H index of two institutions in England reaches 20.Ophthalmology,computer science,and AI are the main disciplines involved.

Novel MIP gene mutation causes autosomal-dominant congenital cataract

●AIM:To identify disease-causative mutations in families with congenital cataract.●METHODS:Two Chinese families with autosomaldominant congenital cataract(ADCC)were recruited and underwent comprehensive eye examinations.Gene panel next-generation sequencing of common pathogenic genes of congenital cataract was performed in the proband of each family.Sanger sequencing was used to valid the candidate gene mutations and sequence the other family members for co-segregation analysis.The effect of sequence changes on protein structure and function was predicted through bioinformatics analysis.Major intrinsic protein(MIP)-wildtype and MIP-G29R plasmids were constructed and microinjected into zebrafish single-cell stage embryos.Zebrafish embryonic lens phenotypes were screened using confocal microscopy.●RESULTS:A novel heterozygous mutation(c.85G>A;p.G29R)in the MIP gene was identified in the proband of one family.A known heterozygous mutation(c.97C>T;p.R33C;rs864309693)in MIP was found in the proband of another family.In-silico prediction indicated that the novel mutation might affect the MIP protein function.Zebrafish embryonic lens was uniformly transparent in both wild-type PCS2+MIP and mutant PCS2+MIP.●CONCLUSION:Two missense mutations in the MIP gene in Chinese cataract families are identified,and one of which is novel.These findings expand the genetic spectrum of MIP mutations associated with cataracts.The functional studies suggest that the novel MIP mutation might not be a gain-of-function but a loss-of-function mutation.

Development and research status of intelligent ophthalmology in China

This paper analyzes the current status,technological developments,academic exchange platforms,and future challenges and solutions in the field of intelligent ophthalmology(IO)in China.In terms of technology,significant progress has been made in various areas,including diabetic retinopathy,fundus image analysis,quality assessment of medical artificial intelligence products,clinical research methods,technical evaluation,and industry standards.Researchers continually enhance the safety and standardization of IO technology by formulating a series of clinical application guidelines and standards.The establishment of domestic and international academic exchange platforms provides extensive collaboration opportunities for professionals in various fields,and various academic journals serve as publication platforms for IO research.However,challenges such as technological innovation,data privacy and security,lagging regulations,and talent shortages still pose obstacles to future development.To address these issues,future efforts should focus on strengthening technological research and development,regulatory framework construction,talent cultivation,and increasing patient awareness and acceptance of new technologies.By comprehensively addressing these challenges,IO in China is poised to further lead the industry’s development on a global scale,bringing more innovation and convenience to the field of ophthalmic healthcare.

Guidelines on clinical research evaluation of artificial intelligence in ophthalmology(2023)

With the upsurge of artificial intelligence(AI)technology in the medical field,its application in ophthalmology has become a cutting-edge research field.Notably,machine learning techniques have shown remarkable achievements in diagnosing,intervening,and predicting ophthalmic diseases.To meet the requirements of clinical research and fit the actual progress of clinical diagnosis and treatment of ophthalmic AI,the Ophthalmic Imaging and Intelligent Medicine Branch and the Intelligent Medicine Committee of Chinese Medicine Education Association organized experts to integrate recent evaluation reports of clinical AI research at home and abroad and formed a guideline on clinical research evaluation of AI in ophthalmology after several rounds of discussion and modification.The main content includes the background and method of developing this guideline,an introduction to international guidelines on the clinical research evaluation of AI,and the evaluation methods of clinical ophthalmic AI models.This guideline introduces general evaluation methods of clinical ophthalmic AI research,evaluation methods of clinical ophthalmic AI models,and commonly-used indices and formulae for clinical ophthalmic AI model evaluation in detail,and amply elaborates the evaluation methods of clinical ophthalmic AI trials.This guideline aims to provide guidance and norms for clinical researchers of ophthalmic AI,promote the development of regularization and standardization,and further improve the overall level of clinical ophthalmic AI research evaluations.

Research on classification method of high myopic maculopathy based on retinal fundus images and optimized ALFA-Mix active learning algorithm

AIM:To conduct a classification study of high myopic maculopathy(HMM)using limited datasets,including tessellated fundus,diffuse chorioretinal atrophy,patchy chorioretinal atrophy,and macular atrophy,and minimize annotation costs,and to optimize the ALFA-Mix active learning algorithm and apply it to HMM classification.METHODS:The optimized ALFA-Mix algorithm(ALFAMix+)was compared with five algorithms,including ALFA-Mix.Four models,including Res Net18,were established.Each algorithm was combined with four models for experiments on the HMM dataset.Each experiment consisted of 20 active learning rounds,with 100 images selected per round.The algorithm was evaluated by comparing the number of rounds in which ALFA-Mix+outperformed other algorithms.Finally,this study employed six models,including Efficient Former,to classify HMM.The best-performing model among these models was selected as the baseline model and combined with the ALFA-Mix+algorithm to achieve satisfactor y classification results with a small dataset.RESULTS:ALFA-Mix+outperforms other algorithms with an average superiority of 16.6,14.75,16.8,and 16.7 rounds in terms of accuracy,sensitivity,specificity,and Kappa value,respectively.This study conducted experiments on classifying HMM using several advanced deep learning models with a complete training set of 4252 images.The Efficient Former achieved the best results with an accuracy,sensitivity,specificity,and Kappa value of 0.8821,0.8334,0.9693,and 0.8339,respectively.Therefore,by combining ALFA-Mix+with Efficient Former,this study achieved results with an accuracy,sensitivity,specificity,and Kappa value of 0.8964,0.8643,0.9721,and 0.8537,respectively.CONCLUSION:The ALFA-Mix+algorithm reduces the required samples without compromising accuracy.Compared to other algorithms,ALFA-Mix+outperforms in more rounds of experiments.It effectively selects valuable samples compared to other algorithms.In HMM classification,combining ALFA-Mix+with Efficient Former enhances model performance,further demonstrating the effectiveness of ALFA-Mix+.

Artificial intelligence assisted pterygium diagnosis:current status and perspectives

Pterygium is a prevalent ocular disease that can cause discomfort and vision impairment.Early and accurate diagnosis is essential for effective management.Recently,artificial intelligence(AI)has shown promising potential in assisting clinicians with pterygium diagnosis.This paper provides an overview of AI-assisted pterygium diagnosis,including the AI techniques used such as machine learning,deep learning,and computer vision.Furthermore,recent studies that have evaluated the diagnostic performance of AI-based systems for pterygium detection,classification and segmentation were summarized.The advantages and limitations of AI-assisted pterygium diagnosis and discuss potential future developments in this field were also analyzed.The review aims to provide insights into the current state-of-the-art of AI and its potential applications in pterygium diagnosis,which may facilitate the development of more efficient and accurate diagnostic tools for this common ocular disease.

Improving myopia awareness via school-based myopia prevention health education among Chinese students

AIM:To investigate the myopia awareness level,knowledge,attitude,and skills at baseline and to implement and evaluate the efficacy of myopia prevention health education among Chinese students.METHODS:A total of 1000 middle school students from 2 middle schools were invited to participate in the study,and myopia prevention health education was conducted.The students were assessed at baseline,followed by a survey.The efficacy of health education was evaluated using the self-comparison method pre-and post-health education.RESULTS:The study included 957 and 850 pre-and post-health education par ticipants,respectively.The baseline knowledge of all respondents on myopic symptoms(87.5%),myopia is a risk of eyes(72.9%),myopia prevention(91.3%),myopia increases with age(86.7%),performing periodic eye examinations(92.8%),and one first,one foot,and one inch(84.8%)significantly increased after health education(P<0.001 for all).However,the percentage of students who still did not think it necessary to take breaks after 30-40min of continuous near work was 27.0%.The opinion that“myopia can be cured”was still present in 38.3%.CONCLUSION:Implementing school-based myopia prevention health education improves knowledge,attitudes,and skills regarding myopia among Chinese middle school students.

Role of 7-methylxanthine in myopia prevention and control: a mini-review

·Myopia is becoming increasingly common. By 2050 around 10% of the world’s population is expected to be highly myopic(<-5 diopters) and therefore particularly at risk of suffering from sight-threatening complications. Currently used myopia control treatments, such as multifocal soft contact lenses or spectacle lenses, orthokeratology, and atropine eyedrops, either do not completely arrest myopia progression or are associated with significant ocular and possibly systemic side effects. A new candidate for pharmaceutical control of myopia progression and excessive eye elongation, the non-selective adenosine antagonist 7-methylxanthine(7-MX), appears to be nontoxic and effective in reducing myopia progression and axial eye growth in experimental and clinical studies. The latest findings regarding 7-MX for myopia control and evaluate its potential as a supplement to existing treatment options were reviewed.

Role of the ultra-wide-field imaging system in the diagnosis of pigmented paravenous chorioretinal atrophy

Dear Editor,P igmented paravenous chorioretinal atrophy(PPCRA), which was first described by Hewiston-Brown in 1937, is a rare pigmentary retinopathy affecting the retina and choroid;most patients mainly manifest symmetrical retinal choroid in both eyes, except for a small number of patients with monocular manifestations[1].