2016年 · 第52卷第03期

The academic report in this issue focuses on advances in ocular surface diseases. The responsible editorial committee responsible for the planning, composition and review of the key contents of this issue is Professor Shi Weiyun.

Uveitis is a common eye disease worldwide, with many causes and types. The classification methods include etiology classification, anatomical location classification, clinicopathological characteristics classification, disease course classification, etc. According to the anatomical position, uveitis can be classified into four categories: anterior uveitis, intermediate uveitis, posterior uveitis and panuveitis. Anterior uveitis is the most common type of uveitis, accounting for approximately 50% of the total number of patients. According to the course of the disease, uveitis can be divided into three types: acute, chronic and recurrent. Natural course of acute anterior uveitis<3 months, natural course of chronic anterior uveitis>3 months^[1]。

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The patient was a 17-year-old female. Due to the finding of yellow-white papules on both eyelids for more than 5 years, which increased progressively without obvious discomfort, I went to Beijing Tongren Hospital on May 2, 2014. Eye condition: visual acuity in both eyes 1.0, beaded yellow-white translucent papules at the root of eyelashes in both eyes (Figure 1), without eyelash loss, no flushing on the skin of both eyelids, no scales attached, no conjunctiva congestion, transparent cornea, and no abnormalities in the remaining eye signs. Follow-up medical history: The patient developed normally, had no nervous system obstacles, had hoarseness 1 year after birth, and the skin was easily injured by slight external force, which was difficult to heal. After healing, atrophic scars were left, and flaky atrophic scars were visible on the skin of the face, back, upper arm and buttocks. The parents are not intimate married and have no similar disease. Laboratory tests: blood, urine routine, liver and kidney function, blood lipids and blood sugar were all in the normal range; Chest X-ray and electrocardiogram showed no abnormalities. Otolaryngologic consultation to diagnose chronic inflammation of the vocal cords. Dermatology consultation, back skin scar was taken for pathological examination, periodic acid Schiff staining (PAS) staining was strong positive, and red transparent substance was thickened (Figure 2)。 Diagnosis: lipoid proteinosis. Treatment: Ophthalmology does not intervene temporarily, close follow-up, and there is no effective treatment in the whole body.

A 76-year-old male patient was admitted to the Department of Ophthalmology of Yantai Yuhuangding Hospital affiliated to Qingdao University School of Medicine on August 28, 2013 with rhegmatogenous retinal detachment in his right eye and high myopia in both eyes due to 5-day occlusion in his right eye. He had been highly myopic in both eyes for more than 50 years, and his left eye was blind for 12 years due to retinal detachment. Ophthalmological examination: right eye visual acuity several fingers in front of the eye, left eye no light sensation, mild vitreous opacity, horseshoe-shaped hole about 1 PD after the equator in the superior temporal quadrant of the right fundus, temporal and inferior retina detachment, involving the macula. The patient completed the preoperative examination and underwent right eye vitrectomy on August 30, 2013. During the operation, 2.5 ml of 2% lidocaine and 0.75% ropivacaine mixture were drawn with a disposable No. 5 retrobulbar injection needle (Shandong Kaili Medical Devices Co., Ltd.) and performed retrobulbar block anesthesia. The patient had no abnormal reaction. When the surgeon adjusted the microscope to the surgical field, it was found that the cornea was transparent and the intraocular pressure was not high, but the fundus showed diffuse red reflection. It was suspected that the ball wall damaged the vitreous body and was fresh, so the surgical process was immediately accelerated. Under the intraocular light guide illumination, the whole posterior pole anterior retinal vitreous body was fresh bleeding. After clearing the accumulated blood, it was found that the left eye papilla was oblique ball wall lacerated below the nose, which was about 3 PD long. The morphology and movement of retinal blood vessels were normal, and no abnormalities such as macular edema were found. The surgical process was smooth, and the corrected visual acuity of the right eye was 0.15 when discharged. The patient successfully performed silicone oil removal combined with phacoemulsification and intraocular lens implantation in the right eye on 19 December 2013. The postoperative naked eye visual acuity was 0.15, and no abnormalities were found after 3 months postoperative review (Figure 1）。

The patient was a 49-year-old male. He went to the Department of Ophthalmology of Beijing Tongren Hospital because of dry eyes. Eye examination: both eyelid margins are normal, conjunctiva is not congested, and tear river is narrow; The cornea of the left eye is small round and turbid, with negative staining. It is a white ring composed of small dot-like white particles under the corneal epithelium. Scattered white particles of different sizes can also be seen in the white ring (Quintessence Picture 1）。 The cornea of the right eye is transparent. Clinical diagnosis: Left eye Coats corneal white ring.

The patient was a 72-year-old male. Because the tumor on the nasal side of his right eye grew for 72 years and increased for 1 month, he went to Tianjin Eye Hospital. Since childhood, the patient has seen a black mass the size of a sesame seed in the canthus of his right eye, and has no symptoms such as red eyes, eye pain and vision loss, and has not been diagnosed and treated. 20 years of previous history of hypertension and 6 years after left carotid stenting. General physical examination: No obvious abnormalities were found. Eye examination: visual acuity was 0.3 for the right eye and 0.1 for the left eye; IOP was 12 mmHg (1 mmHg =0.133 kPa) in the right eye and 13 mmHg in the left eye; The eyeballs of both eyes can move freely in all directions; The appearance of the right eye is normal, and the eyelid is not red or swollen; There was no congestion in the conjunctiva, and a round-like mass with a diameter of about 7 mm was seen in the medial canthus conjunctiva, protruding about 5 mm from the surface of the conjunctiva. It was purple-black, soft in texture, clearly defined, with a small amount of bleeding when touched, and the mobility was acceptable (Essence Picture 1A), a black round lesion of approximately 3 mm in diameter was visible at the edge of the upper tarsal plate, and the surrounding conjunctiva was pigmented (Quintessence Picture 1B), a black strip can be seen under the conjunctiva of the inferior fornix, which is connected to the nasal tumor, and the surrounding conjunctiva is pigmented; There is no yellowing stain in the sclera, transparent cornea, normal anterior chamber depth, no aqueous humor flash, clear iris texture, round pupil, about 3 mm in diameter, sensitive to light, opacity of the lens, and invisibility of the vitreous body and fundus. There were no abnormalities in the appearance and anterior segment of the left eye. The lens was opaque, and the vitreous body and fundus of the eye were not clear. He was admitted to the hospital for resection of the right preorbital mass and conjunctival sac plasty. Immunohistochemical examination of resected tissues: S-100 (+ +), melanoma-associated antigen HMB45 (+ +), Ki-67>10% (Quintessence Picture 2）。 Postoperative histopathological diagnosis: conjunctival melanoma of right eye (malignant transformation of conjunctival nevus)

The patient was a 38-year-old male. Because of the decrease of visual acuity in both eyes for more than 15 years, he went to Huaibei Aier Eye Hospital. Eye examination: visual acuity in both eyes was 30 cm manual; The conjunctiva of the right eye is ciliary congested, the conjunctival epithelium is slightly dry, the corneal epithelium is rough, covered with gray-white scab-like membrane, and pannus can be seen around it; Trichiasis in the left eye, dry conjunctiva in the lateral canthus and below, loss of mucosal morphology and function, completely cutaneous, conjunctival blood vessels still visible in the medial canthus, corneal epithelium loss of transparency, cutaneous, granular appearance, invisible structure in both eyes (Quintessence Picture 1）。 Clinical diagnosis: extremely severe keratoconjunctivitis sicca in both eyes.

With the arrival of the new century, China's national strength has obviously enhanced, and the ophthalmology business has also been flourishing. During this period, the work of the Ophthalmology Society of the Chinese Medical Association (Chinese Ophthalmology Society) has achieved unprecedented rapid development, the scale of the National Ophthalmology Congress has been continuously expanded, and the academic and professional level and internationalization degree have been significantly improved. Domestic conferences of ophthalmology are often held in conjunction with international conferences of ophthalmology. It was also during this period that the Chinese Ophthalmology Society solved the problem of joining major international ophthalmology organizations, and the international status of China's ophthalmology has been significantly improved.