Internal limiting membrane peeling with different dyes in the surgery of idiopathic macular hole: a systematic review of literature and network Meta-analysis

AIM: To evaluate the effect of internal limiting membrane(ILM) peeling with indocyanine green(ICG), brilliant blue G(BBG), triamcinolone acetonide(TA), trypan blue(TB), or without dye for the treatment of idiopathic macular hole(IMH). METHODS: A search was conducted using Pub Med, EMBASE, and CENTRAL(Cochrane Central Register of Controlled Trials) for related studies published before October 2018. RESULTS: A total of 29 studies and 2514 eyes were included in this network Meta-analysis. For IMH closure, the rank from the best to the worse treatment was: BBG, TB, TA, ICG, and no dye. There was a significant difference in postoperative IMH closure rate between BBG and no dye. The rank of the best to the worse treatment to improve visual acuity was: BBG, TB, no dye, TA, and ICG. The improvement rate of visual acuity after using BBG was significantly higher than ICG. The improvement rate of visual acuity was more favorable with TB than ICG, TA, and no dye. CONCLUSION: BBG can contribute to better anatomical and functional outcomes compared to other dyes for ILM peeling in patients with IMH. The results show that the best treatment of ILM peeling with dyes is BBG.

Measurements of the parapapillary atrophy area and other fundus morphological features in high myopia with or without posterior staphyloma and myopic traction maculopathy

AIM:To investigate the affecting factors of parapapillary gamma and delta zones and other fundus morphological features in high myopia.METHODS:Seventy high myopia patients were included in this retrospective observational study and 47 patients were female.Patients were divided into three groups:no posterior staphyloma(no PS),PS with myopic traction maculopathy(PS with MTM),and PS without MTM using 3-dimensional magnetic resonance imaging and optical coherence tomography.MTM patients were fur ther classified into three types[epiretinal membrane,macular hole,and macular retinoschisis(MRS)].Diameters of the gamma and delta zones were measured among other morphometric variables using fundus photographs.RESULTS:Of the 70 individuals(127 eyes),the mean age was 57.46±13.56y.In univariate analysis,morphological features changed most dramatically in PS with MTM patients,who had the largest gamma zone diameters,the largest disk-fovea distance(DFD)and disk-fovea angle,and the smallest angle kappa and vertical distance of temporal arterial arcade.However,their horizontal delta zone diameter was smaller than in the patients with PS yet without MTM.In multivariate analysis,with axial length(AL)and age adjusted,the horizontal diameter in the delta zone of the PS without MTM group was still significantly larger than in the PS with MTM group(P=0.024).Comparing the three subtypes of MTM patients,the diameters of the gamma zone and DFD in MRS group were the largest.CONCLUSION:The characteristics of the gamma and delta zones change inconsistently in different stages of high myopia.These changes may be associated with anatomical changes caused by local traction.Factors such as PS,AL and age play an important role.These findings may provide a hint about the pathogenesis of traction in high myopia.

Comparison of ocular parameters of two biometric measurement devices in highly myopic eyes

AIM: To compare the differences and agreement of ocular biometric parameters in highly myopic eyes obtained by optical biometric measurement instruments, the OA-2000 and IOLMaster 500. METHODS: Totally, 90 patients(90 eyes) were included. They were divided into high myopia group and control group. Ocular parameters, including axial length(AL), mean keratometry(Km), anterior chamber depth(ACD), and white to white(WTW), were obtained from the OA-2000 and IOLMaster 500. RESULTS: For the control group, we applied BlandAltman graphs to assess the 95% limits of agreement(LoA) for most parameters including AL, ACD, Km, and WTW(-0.24 to 0.29 mm,-0.22 to 0.45 mm,-0.39 to 0.31 D, and-0.90 to 0.86 mm, respectively). In high myopia patients, AL, ACD, Km values had wider 95% LoA(-0.34 to 0.32 mm,-0.36 to 0.34 mm,-0.57 to 0.47 D, respectively), except WTW(-0.80 to 0.68 mm). Differences were not statistically significant between these two instruments(P>0.05). CONCLUSION: Most parameters obtained by the OA-2000 and IOLMaster 500 are comparable, including the AL, ACD, and K values. Among them, the agreement of the high myopia patients is poor compared to the patients without high myopia.

Characteristics of chemical components in PM2.5 at a plateau city, South-west China

A sampling campaign including summer, autumn and winter of 2014 and spring of 2015 was accomplished to obtain the characteristic of chemical components in PM2.5 at three sites ofKunming, a plateau city in South-west China. Nine kinds of water-soluble inorganic ions （WSI）, organic and element carbon （OC and EC） in PM2.5 were analyzed by ion chromatography and thermal optical reflectance method, respectively. Results showed that the average concentrations of total WSI, OC and EC were 22.85±10.95 μg.m -3, 17.83±9.57 μg.m-3 and 5.114-4.29 μg.m-3, respectively. They totally accounted for 53.0% of PM2.5. Secondary organic and inorganic aerosols （SOA and SIA） were also assessed by the minimum ratio of OC/EC, nitrogen and sulfur oxidation ratios. The annual average concentrations of SOA and SIA totally accounted for 28.3% of the PM2.5 concentration. The low proportion suggested the primary emission was the main source of PM2.5 in Kunming. However, secondary pollution in the plateau city should also not be ignorable, due to the appropriate temperature and strong solar radiation, which can promote the atmospheric photochemical reactions.