Gonioscopy is an important examination for the etiology, diagnosis, treatment and prognosis of glaucoma, which is known as the gold standard for a long time. But with the improve of the technology, the new equipment has been more and more popular in ophthalmologists especially glaucoma ophthalmologists, and in some even dependent on them excessively, and played down the role of gonioscopy. In order to solve this problem, in this paper, we summarize the history of gonioscope, using methods, matters needing attention and the importance for clinical work again, in order to cause the attention of ophthalmic clinicians.

To discuss the relationship among high molecular weight adiponectin (HMW-ADP), tumor necrosis factor(TNF)-α and vascular endothelial growth factor(VEGF) with diabetic retinopathy(DR).

150 cases with type 2 diabetes mellitus from January to December 2014 were selected as study objects, 50 cases with NDR, 50 cases with NPDR and 50 cases with PDR. 50 cases for physical examination were selected as control group. Compared with the gender, history of hypertension and diabetes family history of χ²test. The clinical data such as HMW-ADP, TNF-α, VEGF, biochemical indexes and body mass index were all expressed by mean and standard deviation (±s), and compared by single factor analysis of variance. The effects of HMW-ADP, TNF-α, VEGF and other factors on NPDR and PDR were analyzed by multiple Logistic regression. The correlation of HMW-ADP, TNF-α and VEGF with DR was analyzed by Pearson correlation.

The age of the NPDR group and the PDR group were larger than that of the NDR group and the control group (F=5.329, P<0.05). The history of hypertension in group NDR, group NPDR and group PDR were significantly higher than that of control group (χ²=20.215, P<0.05). The patients in group PDR had the longest course, followed by group NPDR, and the group NDR was the shortest (F=96.434, P<0.05). Fasting blood glucose in patients in group NDR, group NPDR and group PDR were significantly higher than that of control group (F=12.510, P<0.05). The fasting insulin levels in group PDR were the highest, followed by group NPDR and group NDR, and lowest in the control group (F=25.305, P<0.05). The content of triglyceride (TG) in patients in group NDR, group NPDR and group PDR were significantly higher than that of control group (F=16.419, P<0.05). The content of high-density lipoprotein cholesterol (HDL-C) was significantly lower than that of the control group (F=4.259, P<0.05). The creatinine of group NPDR and group PDR was significantly higher than that of control group (F=47.158, P<0.05). The difference between the two groups was statistically significant. The level of HMW-ADP in the NPDR group and the PDR group were significantly lower than that in the control group and the NDR group, and the NDR group was significantly lower than that of the control group, the difference between the two groups was statistically significant (F=362.480, P<0.05). The levels of TNF-α and VEGF in group PDR were the highest, followed by NPDR group; NDR group and control group were lowest, the difference between the two groups were statistically significant (F=239.200, 641.970; P<0.05). Multivariate analysis showed that age, duration of disease, TNF-α and VEGF were independent risk factors for NPDR (χ²=7.621, 18.331, 5.532, 5.618; P<0.05), and they were also independent risk factors for PDR (χ²=6.962, 11.542, 5.615, 5.331; P<0.05). HDL-C and HMW-ADP were protective factors for NPDR (χ²=6.694, 10.671; P<0.05), and they were also protective factors for PDR (χ²=5.674, 7.671; P<0.05). The levels of HMW-ADP in patients with DR were negatively correlated with TNF-α and VEGF (r=-0.328, -0.810; P<0.05).

In patients with DR, the level of HMW-ADP decreases, and the levels of TNF-α and VEGF increase; Multivariate analysis shows that HMW-ADP is protective factor, and TNF-α and VEGF are risk factor; HMW-ADP is negatively correlated with TNF-α and VEGF.

To investigate the changes of serum Vaspin levels in patients with type 2 diabetic retinopathy (DR) and to analyze its correlation with glucose metabolism and insulin sensitivity. To further investigate the role of Vaspin in the development of type 2 DR.

Seclected the clinical data of 150 patients with type 2 diabetes mellitus diagnosed in the Department of Ophthalmology of Linyi Central Hospital of Shandong from January 2014 to December 2016. The patients were divided into non DR (NDR) group, non proliferative group DR (NPDR) group and proliferative type DR (PDR) group, with 50 cases in each group. Another 50 healthy subjects were chosen as control group at the same time. All patients underwent routine ophthalmologic examination. Age, type 2 diabetes, height, weight, and body mass index (BMI) were recorded. Determination of subjects serum fasting blood glucose (FBG), fasting insulin (FINS), glycosylated hemoglobin (HbA1c), cholesterol (TC), triglyceride (TG), high density lipoprotein (HDLC) and low density lipoprotein (LDLC). Enzyme linked immunosorbent assay (ELISA) was used for the determination of Vaspin. The age, height, weight, BMI and serum indexes of the subjects were tested by normal distribution, and expressed by mean±standard(±s)deviation. The mean between groups were compared by single factor analysis of variance. When the difference was statistically significant, they were further compared with each other. The correlation between serum markers and stages was analyzed by univariate correlation analysis, and the multivariate correlation analysis was performed after adjusting for gender, age, and BMI.

Three DR groups subject age height, weight and BMI were compared, there were no significant differences (F=0.509, 0.343, 0.348, 0.357; P>0.05); the 3 groups of subjects was compared, the difference was statistically significant (F=2.397, P<0.05). Three DR groups and control group by comparing the subjects of each serum level, using single factor variance analysis, the differences were statistically significant (F=5.66, 5.57, 7.90, 5.06, 6.87, 9.19, 7.27, 4.89, 8.56; P<0.05); compared with the control group, significantly decreased the serum levels of Vaspin in three DR groups. The difference of serum TG levels between the 3 groups was not statistically significant (F=2.19, P>0.05). By single factor analysis correlation, DR stage were significantly correlated with each serum level (r=0.962, 0.861, 0.862, 0.662, 0.613, -0.965, -0.678, -0.853; P<0.05). Adjusted for gender, age and BMI factors, multivariate analysis, DR stage were significantly correlated with HbA1c, FBG, FINS, LDLC and HOMA-IR levels (r=0.467, 0.598, 0.658, 0.357, 0.377; P<0.05), and the decline was significantly correlated with serum Vaspin, HOMA-IS and HDLC (r=-0.612, -0.472, -0.367; P<0.05). Was significantly related to DR stage group Vaspin and HDLC, HOMA-IS (r=0.801, 0.715; P<0.05), and negatively correlated with HOMA-IR (r=0.690, P<0.05).

tudies have shown that the serum levels of Vaspin in diabetic retinopathy patients are significantly lower, which can affect the sensitivity of insulin, and is closely related to abnormal lipid metabolism. The decrease of serum Vaspin level is a risk factor in the pathogenesis of DR, and Vaspin plays an important role in the pathogenesis of DR.

System evaluation about the clinical efficacyof combining traditional Chinese and western medicine for epidemic keratoconjunctivitispublished at home and abroad by the method of Meta analysis, and provide reference for clinicaltreatment of EKC.

Through the collection of PubMed, MEDLINE, China retrieval CNKI, Wanfang database, VIP database and China biomedical literature database of Chinese medicine combined with western medicine in the treatment of EKC related Chinese and English literature. According to the inclusion and exclusion criteria, the literature was extracted, and the data of the study were extracted. The combination of Chinese medicine and Western medicine was used as the treatment group, and Western medicine treatment as the control group. According to the requirement of the Meta analysis to evaluate the quality of the literature retrieved, and use the RevMan5.3 for researching according to the Meta analysis, evaluation of the clinical curative effect of EKC. The revised Jadad quality scoring method was used to evaluate the included literature. The chi square test was used to test the heterogeneity of the study. If the P>0.05 indicated the homogeneity was better, the fixed effect model was used; otherwise, the random effect model was used to calculate the combined effect. The total effective rate was expressed by relative risk (OR) and 95% confidence interval.

7 trials including 520 patients were included. There were 553 eyes in the treatment group and 469 eyes in the control group. 7 articles are the combination of traditional Chinese and Western medicine treatment group and the control group, the total effective rate of treating EKC, after heterogeneity test, the difference was statistically significant (I²=15%, P>0.05), suggesting good homogeneity, so we use the fixed effect model of Meta analysis. The results showed that the difference between the two groups was statistically significant(OR=9.00, 95% confidence interval: 4.53~17.89, Z=6.27, P<0.05). It shows that the combination of traditional Chinese medicine and Western medicine is better than western medicine in the treatment of traditional Chinese medicine and Western medicine.

The overall effective rate of combining traditional Chinese and western medicine for EKC is significantly superior to control group.

To evaluate the effect and safety of femtosecond laser assisted LASIK (FS-LASIK) in the treatment of ultra-high myopia , and to evaluate the efficacy and safety of different times after the operation.

The clinical data of 106 patients (211 eyes) with ultra-high myopia who were followed up for more than 1 year, was conducted between January 2013 and January 2016 in Hospital of Shanxi Province. Among them, there were 50 males (100 eyes) and 56 females (111 eyes). Age from17 to 43, average (24.09±5.32) years old. Routine ophthalmologic examinations were performed before and after surgery at 1 month, 3 months, 6 months and 1 year. Routine visual acuity was performed before surgery, including uncorrected visual acuity (UCVA) and corrected visual acuity (BCVA). The visual acuity records were indicated by the logMAR. The range of refraction, including balloon, column, and equivalent spherical lenses were examined. Exclusion of anterior segment disease, using non-contact tonometer, using binocular indirect ophthalmoscope after mydriasis fundus examination, using phoropter, using corneal topography exam and corneal shape by AB ultrasound scanning and biological measurement of corneal thickness and axial length by slit lamp microscope examination. The cornea was cut by femtosecond laser system and excimer laser. UCVA, BCVA, safety index, effective index and diopter were examined at different time after operation. Validity index=postoperative UCVA/preoperative BCVA, safety index=postoperative BCVA/preoperative BCVA. The visual acuity, safety index, effective index and diopter before and after the operation were indicated by mean ± standard deviation(±s). The overall difference between the indexes at different time points before and after the operation was compared by single factor repeated measures analysis of variance, and the multiple comparisons in the group were checked by LSD-t test. The comparison of refraction regression at different time points after operation was performed by chi square test.

There were significant differences in UCVA at different time points before and after operation (F_time=2767.01, P<0.05). The UCVA at each time point after operation were higher than that of preoperative BCVA, and the visual acuity was stable at 3 months after operation. The safety index of patients at different time points after operation was compared, the difference was statistically significant(F_time=7.63, P<0.05). The safety index at each time point after operation was greater than 1, the optimum time was 3 months after operation, and decreased slightly after 6 months, then recovered. The validity index of patients at different time points after operation was compared, the differences were statistically significant(F_group=7.52, P<0.05). The validity index at each time point after operation was greater than 1, which was the best at 3 months after operation, and then stabilized. There were no significant differences in equivalent spherical lenses at different time points after surgery(F_time=1.34, P>0.05). There were significant differences in refractive regression at different time points (χ²=13.69, P<0.05).

FS-LASIK are effective in the treatment of ultra-high myopia. UCVA at each time point after 1 year was better than preoperative BCVA. With the increase of time, refractive regurgitation rate increased, after 1 year to reach 7.58%.

Retinoblastoma (RB) is the most common intraocular malignant tumor in infants. In recent years, the incidence of retinoblastoma has been on the rise. In China, the treatment of retinoblastoma is still mainly based on enucleation of eyeball, supplemented by chemotherapy, compared with the developed countries, there is still a big gap in eye reservation rate. Through in-depth study of the RB histopathologic high risk factors, and to explore the clinical features, clinical staging and auxiliary examination correlation, which can further guide treatment, strengthen individualized comprehensive treatment. It has important clinical value for improving the survival rate, eye retention rate and reducing the risk of metastatic risk of RB in children.

Third nerve palsy is a disease of abnormal eye movements, ptosis and pupillary damage caused by a variety of causes, and it is one of the most important causes of non concomitant strabismus. The clinical manifestations of Third paralysis ptosis, eye rotation, in turn, have limited pupil Kong Sanda and unresponsive to light or disappear. Common causes include cerebrovascular disease, head trauma, tumor, inflammation and endocrine and metabolic diseases. In this paper, the clinical features and treatment principles of Third nerve paralysis are reviewed from the aspects of anatomy, location, diagnosis, common cause and treatment of Third nerve.

Myopia is a common eye disease beyond the eye as the main symptoms of the disease, has become the main influence in our country and the whole world of adolescent health. There are many factors affecting the diopter of myopia, including the corneal system, the lens system and the axial length of the eye. In addition, because of the difference of eyeball structure and ocular biological parameters, these differences are closely related to the changes of refractive state. Therefore, in this paper the author analyzes the ocular biological parameters of various nationalities have been reported, in between the Han and other ethnic groups, differences in the rate of abnormal visual acuity, refractive parameters and biological parameters of the eye color vision abnormalities were reviewed.