A small-molecule activation mechanism that directly opens the KCNQ2 channel.

Pharmacological activation of voltage-gated ion channels by ligands serves as the basis for therapy and mainly involves a classic gating mechanism that augments the native voltage-dependent open probability. Through structure-based virtual screening, we identified a new scaffold compound, Ebio1, serving as a potent and subtype-selective activator for the voltage-gated potassium channel KCNQ2 and featuring a new activation mechanism. Single-channel patch-clamp, cryogenic-electron microscopy and molecular dynamic simulations, along with chemical derivatives, reveal that Ebio1 engages the KCNQ2 activation by generating an extended channel gate with a larger conductance at the saturating voltage (+50 mV). This mechanism is different from the previously observed activation mechanism of ligands on voltage-gated ion channels. Ebio1 caused S6 helices from residues S303 and F305 to perform a twist-to-open movement, which was sufficient to open the KCNQ2 gate. Overall, our findings provide mechanistic insights into the activation of KCNQ2 channel by Ebio1 and lend support for KCNQ-related drug development.

Automatic identification of myopic maculopathy related imaging features in optic disc region via machine learning methods.

BACKGROUND: Myopic maculopathy (MM) is the most serious and irreversible complication of pathologic myopia, which is a major cause of visual impairment and blindness. Clinic proposed limited number of factors related to MM. To explore additional features strongly related with MM from optic disc region, we employ a machine learning based radiomics analysis method, which could explore and quantify more hidden or imperceptible MM-related features to the naked eyes and contribute to a more comprehensive understanding of MM and therefore may assist to distinguish the high-risk population in an early stage. METHODS: A total of 457 eyes (313 patients) were enrolled and were divided into severe MM group and without severe MM group. Radiomics analysis was applied to depict features significantly correlated with severe MM from optic disc region. Receiver Operating Characteristic were used to evaluate these features' performance of classifying severe MM. RESULTS: Eight new MM-related image features were discovered from the optic disc region, which described the shapes, textural patterns and intensity distributions of optic disc region. Compared with clinically reported MM-related features, these newly discovered features exhibited better abilities on severe MM classification. And the mean values of most features were markedly changed between patients with peripapillary diffuse chorioretinal atrophy (PDCA) and macular diffuse chorioretinal atrophy (MDCA). CONCLUSIONS: Machine learning and radiomics method are useful tools for mining more MM-related features from the optic disc region, by which complex or even hidden MM-related features can be discovered and decoded. In this paper, eight new MM-related image features were found, which would be useful for further quantitative study of MM-progression. As a nontrivial byproduct, marked changes between PDCA and MDCA was discovered by both new image features and clinic features.

Morphological differences between two types of Bruch's membrane defects in pathologic myopia.

PURPOSE: To investigate morphological differences between two types of Bruch's membrane (BM) defects-patchy atrophy (PA) and CNV-related macular atrophy (CNV-MA) METHODS: Eyes presenting with PA or CNV-MA were included. Scleral thickness (ST), choroidal thickness (CT), and scleral morphological characteristics were obtained by swept-source optical coherence tomography (SS-OCT). Fundus photographs were performed to measure the size of PA and CNV-MA lesions. RESULTS: Among a total of 167 eyes evaluated, 106 eyes had PA and 61 eyes had CNV-MA. In addition, dome-shaped macula (DSM) was identified in 20 (18.87%) and 10 (16.39%) eyes among PA and CNV-MA, respectively. The eyes of CNV-MA without DSM showed a thicker subfoveal ST (278.61 ± 56.17 vs 231.58 ± 66.09 mm, P < 0.001), a thinner subfoveal CT, and a higher rate of scleral perforating vessels (70.6% vs 50.0%, P = 0.021) when compared with those of PA without DSM. The size of PA/CNV-MA lesions was associated with CT in eyes without DSM. However, it was only associated with bulge height in eyes with DSM (r = 0.5, P = 0.013). CONCLUSIONS: The eyes with CNV-MA had a thicker sclera than those with PA, which add another evidence to indicate the absence of the progressive relationship between two types of BM defects. The enlargement of lesions in BM defects between eyes with and without DSM may be caused by different mechanical forces. SS-OCT, which focuses on scleral and choroid morphology, may be necessary for more accurate classification of pathologic myopia.

Analysis of association between common variants of uncoupling proteins genes and diabetic retinopathy in a Chinese population.

BACKGROUND: The aim of this study was to explore the association between diabetic retinopathy (DR) and the variants of uncoupling proteins (UCPs) genes in a Chinese population of type 2 diabetes, in total and in patients of different glycemic status separately. METHODS: This case-control study included a total of 3107 participants from two datasets, among which 662 were DR patients (21.31%). Eighteen tag single nucleotide polymorphisms (SNPs) of UCP1, UCP2, and UCP3 were selected as genetic markers. TaqMan probes, Sequenom MassARRAY MALDI-TOF mass spectrometry platform and Affymetrix Genome-Wide Human SNP Array were used for genotyping. Online SHEsis software was used for association analysis. Bonferroni correction was used for multiple comparisons correction. RESULTS: Three SNPs of UCP1: rs7688743 (A allele, OR = 1.192, p = 0.013), rs3811787 (T allele, OR = 0.863, p = 0.023), and rs10011540 (G allele, OR = 1.368, p = 0.004) showed association with DR after the adjustment of glucose, but only rs10011540 was marginally significantly associated with DR when Bonferroni correction was strictly applied (padj = 0.048). In patients with uncontrolled glucose, rs7688743 (A allele, p = 0.012, OR = 1.309), rs10011540 (G allele, p = 0.033, OR = 1.432), and rs3811787 (T allele, p = 0.022, OR = 0.811) were associated with DR, while in participants with well controlled glucose, the rs2734827 of UCP3 was associated with DR (A allele, p = 0.017, OR = 0.532). Rs3811787 of UCP1 showed a protective effect to sight threatening DR (T allele, p = 0.007, OR = 0.490), and the association existed after the adjustment for environmental factors and the correction. In patients with uncontrolled glucose, the rs3811787 of UCP1 (T allele, p = 0.017, OR = 0.467) and the rs591758 of UCP3 (C allele, p = 0.026, OR = 0.103) were associated with STDR. While in those with well controlled glucose, only the rs7688743 of UCP1 showed a protective effect (A allele, p = 0.024, OR = 0.049). None of the associations remain significant when Bonferroni correction was strictly applied (all p < 0.05). CONCLUSIONS: The rs10011540 and rs3811787 of the UCP1 gene was marginally significantly associated with DR in Chinese type 2 diabetes patients. There might be different mechanisms of DR development in patients with different glycemic status.

Peripheral anterior chamber depth and screening techniques for primary angle closure disease in community elderly Chinese.

BACKGROUND: To investigate the distribution of peripheral anterior chamber depth (ACD) and the relationship between peripheral ACD and gonioscopy compared to other ocular parameters for primary angle closure disease (PACD) screening. We performed a population-based survey in Pudong New District of Shanghai, China, in 2011. METHODS: Cross-sectional study. Adults 50 and older were enrolled from a population-based study using cluster random sampling in Pudong New District, Shanghai. Remote ocular screening was performed with digital anterior eye structure photography. Van Herrick measurements were used to evaluate the peripheral ACD, the depth of the peripheral anterior chamber, and corneal thickness (CT), and the ACD to CT ratio was calculated. Subjects with peripheral ACD less than 0.5 CT were made follow-up appointments for clinical examination with gonioscopy. Receiver operating characteristic curves (ROC) were generated to show the performance of different tests in screening for primary angle closure disease (PACD). RESULTS: Two thousand five hundred twenty-eight adults participated in the study with 91 patients diagnosed with PACD. Two thousand four hundred sixty-three subjects had valid data in the right eye available for analysis. The mean peripheral ACD values for men and women were significantly different: 1.04 ± 0.46 (range 0.11-2.93) CT and 0.87 ± 0.41 (range 0.12-2.96) CT respectively (t = - 4.18; P<0.0001). Multivariate logistic regression analysis reveals that peripheral ACD declined by 0.31 CT (P < 0.0001) per diopter of SE and was 0.19 CT (P < 0.0001) shallower in women than in men (r2 = 0.1304, P < 0.0001). Peripheral ACD performed best in screening for PACD. CONCLUSIONS: Peripheral ACD measurement is recommended for PACD screening in community elderly Chinese.

Thinner Average Choroidal Thickness Is a Risk Factor for the Onset of Diabetic Retinopathy.

PURPOSE: To analyze the relationships between choroidal thickness (CT) and diabetes mellitus (DM), diabetic retinopathy (DR), and DR severity in community residents diagnosed with type 2 DM, and to explore whether CT can improve the discriminatory ability of other risk factors to predict the incidence of DR. METHODS: A total of 1,250 type 2 DM residents and 1,027 healthy controls in Xinjing community of Shanghai participated a cross-sectional survey of eye diseases in 2016. CT was measured using swept-source optical coherence tomography. DR was classified according to the 2002 international clinical classification of DR. A total of 537 subjects with type 2 DM without DR at the 2016 survey were followed up in 2018 to investigate the 2-year incidence of DR. Receiver operating characteristic curve analysis was used to test the accuracy of different indicators in predicting the onset of DR. RESULTS: The central CT of the control, no DR, mild non-proliferative DR (NPDR), moderate NPDR, severe NPDR, and PDR groups were 223.40, 216.22, 213.57, 211.91, 178.47, and 168.15 µm, respectively (p for trend <0.001), and the average CT (ACT) were 197.83, 186.94, 182.03, 178.00, 156.91, and 136.72 µm respectively (p for trend <0.001). Body mass index (BMI), DM duration, fasting blood glucose, glycosylated hemoglobin (HbA1C), and ACT were risk factors for 2-year DR incidence. For the onset of DR, as predicted by ACT, after tenfold cross validation the average area under the curve was 0.55 (p = 0.048). Addition of ACT did not improve the discriminatory ability of DM duration, BMI, glucose and HbA1C on the incidence of DR (Z = 0.48; p = 0.63). CONCLUSIONS: As the severity of DR increased, the CT of community type 2 DM patients showed a significant downward trend compared with the healthy controls. Thinner ACT was found to be a risk factor for DR incidence, but it did not improve the discriminatory ability of other risk factors to predict the incidence of DR.

Two-Year Incidence and Associated Factors of Dry Eye Among Residents in Shanghai Communities With Type 2 Diabetes Mellitus.

OBJECTIVE: To evaluate the 2-year incidence and associated factors of dry eye (DE) among community residents with type 2 diabetes mellitus (DM). METHODS: For confirmed type 2 DM residents in the Xinjing community of Shanghai in China, 2 surveys on DE and related factors were performed in 2016 and 2018. The survey content included general information, subjective symptom questionnaires, tear-film break-up time test, Schirmer I test, corneal fluorescence staining (FL), slit-lamp examination, and examination of blood and urine samples. Symptoms of depression were evaluated using the Center for Epidemiologic Studies Depression (CES-D) scale. Dry eye was diagnosed based on the diagnostic standards developed by the Asia Dry Eye Society in 2016. RESULTS: The 2-year incidence of DE among 460 type 2 DM residents was 33.7% (95% confidence interval [CI]=29.6%-38.3%). The incidence of DE significantly increased with increasing age (P<0.01). The incidence among women (35.7%) was not statistically significant compared with that of men (31.0%). In the multivariate logistic regression model, age (odds ratio [OR]=1.03, 95% CI=1.01-1.06, P=0.04), corneal sensitivity (OR=0.97, 95% CI=0.94-0.99, P=0.03), and depressive symptom score (OR=1.04, 95% CI = 1.00-1.08, P=0.04) were associated factors for the incidence of DE. In the CES-D scale, two items, "I felt that everything I did was an effort" and "I felt sad," were significantly correlated with DE onset. CONCLUSION: The incidence of DE among community residents with type 2 DM was high. Screening for DE among DM residents, especially residents with advanced age, corneal hypoesthesia, and depression, should be strengthened.

Ocular surface health in Shanghai University students: a cross-sectional study.

BACKGROUND: Our study aimed to investigate the ocular surface health of Shanghai University students. METHODS: This is a cross-sectional study carried out among freshmen and sophomores on the main campus of Shanghai University. Questionnaires including the widely-used ocular surface disease index (OSDI) and the Zung Self-rating Anxiety Scale (SAS) were completed first, and then ocular examinations were conducted regarding height & weight, blood pressure and heart rate, optometry, intraocular pressure exam, vision and subjective refraction, Aladdin, Macular pigment density measurement, tear test, anterior segment examination, fundus photography, ophthalmologist check, TOPCON OCT check, and Collin's fundus blood test. RESULTS: Totally 901 students were involved in our five-day study. The prevalence of myopia was 92% (the spherical equivalent refraction (SER) < - 0.50 D), and that of high myopia was 23% (SER < - 6.0D). The prevalence of dry eye disease (DED) was 10%. The corneal epithelial loss rate (corneal fluorescein staining > 1) was 10%, and corneal sensation decline rate (≤ 30 mm) was 12%. 4.5% of subjects (n = 40) had moderate or severe anxiety, 78% were mild and a small portion (17.5%) didn't have anxiety at all. No statistical significant association was found between anxiety with DED, fluorescein staining or with corneal sensation (all p > 0.05). However, subjects with DED had more symptoms of anxiety. Results also showed that students who kept eye strain for a long time were more inclined to have DED (12.5%: 6.9%, p = 0.0407, 95% CI); those who watched mobile phones and/or computers for over eight hours daily were more vulnerable to DED and fluorescein staining than others (14.1%: 8.6%, p = 0.0129; 13.0%: 8.3%, p = 0.0233, 95% CI). CONCLUSIONS: Keeping eye strain or near work for a long time is associated with DED, while students with DED tend to encounter anxiety symptoms. The prevalence of myopia in Chinese university students is still high. We consider it necessary to provide education to university students about the good eye-using habits, and to diagnose anxiety for student patients with DED.

Prevalence and clinical characteristics of dry eye disease in community-based type 2 diabetic patients: the Beixinjing eye study.

BACKGROUND: This study was performed to evaluate the prevalence and clinical characteristics of dry eye disease (DED) in community-based type 2 diabetic patients and to identify the associated factors related with DED. METHODS: A total of 1360 type 2 diabetic patients in the Beixinjing community were randomly selected. All participants were given a questionnaire that assessed basic information and subjective symptoms.DED was diagnosed using the revised Japanese DED diagnostic criteria. All subjects underwent a routine ophthalmic examination, corneal sensitivity test, tear film break-up time(BUT) test, Schirmer I test, fluorescein and lissamine green staining(FL) and fundus photography. Diabetic retinopathy (DR) was graded according to the International severity scale of diabetic retinopathy and diabetic macular edema. RESULTS: Of the 1360 subjects, 238 (17.5%) were diagnosed with DED. There was a significant association between the presence of DED and higher blood glucose (P < 0.001, OR1.240) as well as higher levels of glycosylated hemoglobin HbA1c (P < 0.001, OR1.108). Corneal sensitivity was negatively correlated with the prevalence of DED (P = 0.02, OR0.973). CONCLUSIONS: The prevalence of DED in this community-based study was 17.5%, which was lower than that observed in hospital-based studies. Diabetic patients with poor metabolic control were more likely to present with DED. A dry eye examination should be added to the routine screening of diabetes.

General analysis of factors influencing cataract surgery practice in Shanghai residents.

BACKGROUND: It was reported that lack of knowledge, less confidence of medical services, commute difficulties, and poor economic conditions would be the main barriers for cataract surgery practice. The influencing factors could have changed in cities with high developing speed. Shanghai is one of the biggest cities in China and the world. The purpose of the study was to explore the factors influencing cataract surgery practice in Shanghai. METHODS: This was a population-based, cross-sectional study. A total of 2342 cataract patients older than 50 years old with cataract-induced visual impairment or who had undergone cataract surgery were recruited from rural and urban areas of Shanghai. Participants accepted a face-to-face structured questionnaire. Data were collected on patient demographics, education, work, income, health insurance, awareness about cataracts disease, treatment and related medical resources and deration policy, transportation and degree of satisfaction with hospitals. RESULTS: There were 417 patients who had received cataract surgery, 404 of them supplied complete information in the questionnaire. More female subjects (64.6%) than male subjects (35.4%) accepted cataract surgery among the 404 patients. Of the patients with cataract history, 36.4% of surgery patients were equal or older than 80. More people with urban medical insurance received surgery (p = 0.036). Patients who received surgery were more satisfied with local medical service (p = 0.032). In urban area, Lower income and difficulties with commutes were related to a higher rate of surgery. CONCLUSIONS: Cataract patients with the following features were more inclined to receive surgery: female, old age, better awareness. In urban areas low income and difficult commutes did not represent barriers for cataract surgery, probably because of appropriate cataract surgery promotion policies recent years in Shanghai. In rural areas, better healthcare reimbursement policies would likely lead to a higher uptake of cataract surgery. Further cohort studies with more controls could supply stronger evidence for our viewpoint.

Lens Power, Axial Length-to-Corneal Radius Ratio, and Association with Diabetic Retinopathy in the Adult Population with Type 2 Diabetes.

PURPOSE: To calculate crystalline lens power and to determine the relationship between ocular biometry and diabetic retinopathy (DR) in an adult population with type 2 diabetes mellitus (T2DM). DESIGN: Cross-sectional, population-based study. PARTICIPANTS: Patients with T2DM from the Beixinjing community, Changning district, Shanghai. METHODS: Random clustering sampling was used to identify adults with T2DM in the Beixinjing community. Spherical equivalent (SE) was determined by subjective refraction that achieved the best corrected vision. Axial length (AL), corneal power (CP), and anterior chamber depth (ACD) were measured using the IOLMaster. Diabetic retinopathy and diabetic macular edema (DME) were assessed according to the international DR classification. MAIN OUTCOME MEASURES: The crystalline lens power was calculated using the Bennett-Rabbetts formula. The AL-to-corneal radius ratio (AL/CR ratio) was defined as the axial length divided by the mean corneal radius of curvature. RESULTS: A total of 4011 eyes of 2057 subjects with T2DM were included in the analysis. In multivariate logistic models adjusting for age, sex, duration of diabetes, glycosylated hemoglobin A1c, serum creatinine, body mass index, systolic blood pressure, and cataract, after categorizing values into quartiles, there were trend associations between lens power and any DR (P = 0.01), between AL/CR ratio and any DR (P = 0.02), and between AL and any DR (P = 0.03), between lens power and moderate DR (P = 0.02), and between AL and moderate DR (P = 0.02); eyes with higher AL/CR ratio were less likely to have any DR (odds ratio [OR], 0.43; 95% confidence interval [CI], 0.24-0.78; P = 0.01 per 1 increase) and moderate DR (OR, 0.44; 95% CI, 0.21-0.93; P = 0.03 per 1 increase), eyes with longer AL were less likely to have any DR (OR, 0.88; 95% CI, 0.81-0.95; P = 0.002 per millimeter increase) or moderate DR (OR, 0.89; 95% CI, 0.80-0.98; P = 0.02 per millimeter increase), and eyes with higher SE were more likely to have any DR (OR, 1.08; 95% CI, 1.03-1.13; P = 0.003 per diopter increase). CONCLUSIONS: In persons with T2DM, lens power, AL/CR ratio, and AL were associated with the presence of any DR and moderate DR. These findings suggested that globe elongation plays a major role in protective effects against DR, with contributions from lens power and other refractive components.

CHOROIDAL THICKNESS IN HEALTHY CHINESE CHILDREN AGED 6 to 12: The Shanghai Children Eye Study.

PURPOSE: To explore the characteristics of choroidal thickness (ChT) in Chinese children. METHODS: A total of 144 healthy children, aged 6 years to 12 years old, were enrolled in the study. The ChT of subfovea and peripheral locations 0.5, 1.5, and 2.5 mm away from the fovea were evaluated by enhanced depth imaging optical coherence tomography. The association between subfoveal ChT and systemic, as well as ocular factors, including age, sex, height, weight, body mass index, axial length, refractive error, intraocular pressure, preterm history, and the refractive status of parents were studied. RESULTS: The mean subfoveal ChT was 302 ± 63 µm. In the nasal, superior, and inferior areas, the ChT of locations closer to the fovea was thicker than those farther away from the fovea (all P < 0.05); however, ChT was not significantly different among different locations in the temporal area (P = 0.16). The ChT of the nasal quadrant was significantly thinner than that of other areas (P < 0.01). Subfoveal ChT decreased with age, axial length, preterm history, and increased with height. Sex was not statistically associated with subfoveal ChT. CONCLUSION: In Chinese children, the ChT is thinnest in the nasal quadrant and thicker in central regions than in peripheral areas. The subfoveal ChT independently decreases with age, axial length, preterm history, and increases with height.

Exploration of peripapillary vessel density in highly myopic eyes with peripapillary intrachoroidal cavitation and its relationship with ocular parameters using optical coherence tomography angiography.

IMPORTANCE: Identifying changes of peripapillary vessel density in highly myopic eyes with peripapillary intrachoroidal cavitation by optical coherence tomography angiography. BACKGROUND: To investigate peripapillary vessel density and its relationship with other ocular parameters in highly myopic eyes with peripapillary intrachoroidal cavitation. DESIGN: Hospital-based, cross-sectional study. PARTICIPANTS: Thirty-five highly myopic eyes with peripapillary intrachoroidal cavitation, 46 highly myopic eyes without peripapillary intrachoroidal cavitation and 36 normal eyes were included in this study. METHODS: All participants underwent optical coherence tomography angiography to image the retinal vasculature in the peripapillary areas, including the radial peripapillary capillaries and optic nerve head layer. Correlations between vessel density and ocular metrics were analysed. MAIN OUTCOME MEASURES: Peripapillary vessel density. RESULTS: In highly myopic eyes, vessel density was significantly lower in eyes with peripapillary intrachoroidal cavitation than in those without in peripapillary (P = 0.014, P = 0.037), inferotemporal (P < 0.001, P < 0.001) and superotemporal (P = 0.014, P = 0.009) areas. In the radial peripapillary capillaries layer, vessel density was negatively correlated with peripapillary atrophy area (P = 0.012) and myopic maculopathy (P = 0.002), and in the optic nerve head layer, it was negatively associated with a diagnosis of peripapillary intrachoroidal cavitation (P = 0.012) and myopic maculopathy (P < 0.001). In addition, it was positively correlated with retinal nerve fibre layer thickness in both layers (P < 0.001). CONCLUSIONS AND RELEVANCE: Highly myopic eyes with peripapillary intrachoroidal cavitation had lower peripapillary vessel densities, especially in the temporal area, than those without.

[Prevalence and risk factors of mild vision loss in patients with type 2 diabetes in Beixinjing Community of Shanghai].

OBJECTIVE: To investigate the prevalence and risk factors of mild vision loss in adult patients with type 2 diabetes in Beixinjing Community, Shanghai, China. METHODS: A population-based, cross-sectional survey among 2 216 Chinese Han adult patients with type 2 diabetes was conducted from October 2014 to January 2015.Random cluster sampling was used to enroll diabetic patients based on the local Chronic Diseases Prevention and Control System data.The survey was preceded by a pilot study in which operational methods were refined and quality assurance evaluation was carried out.Eligible participants underwent a comprehensive eye examination, including the best corrected visual acuity (BCVA) test using the logarithm of the minimum angle resolution charts.Mild vision loss was defined as BCVA <20/32 to ≥20/63 following the International Council of Ophthalmology (ICO) 2002 definitions.The primary causes of visual impairment and blindness were determined.The prevalence and causes of monocular and binocular mild vision loss were investigated.Logistic regression analysis was used to determine the related risk factors of binocular mild vision loss. RESULTS: Among 2 582 patients, 2 216 were examined, and the response rate was 85.8%.Monocular mild vision loss was found in 591 patients with a prevalence rate of 26.7%.Binocular mild vision loss was detected in 650 patients, with a prevalence rate of 29.3%.Totally 1 891 eyes were confirmed as mild vision loss.Diabetic retinopathy (27.3%, 517/1 891) were the second leading cause of mild vision loss, after cataract (31.3%, 591/1 891). Binocular mild vision loss of unknown reasons happened in 201 persons.Old age, female gender, lower educational level, higher glycosylated hemoglobin A1c level and longer duration of diabetes were associated with the prevalence of total binocular mild vision loss and binocular mild vision loss of unknown reasons. CONCLUSION: The prevalence of mild vision loss is higher among adult patients with type 2 diabetes in Beixinjing Community.Intensive glucose control is recommended to prevent and slow mild vision loss in Chinese Han patients with type 2 diabetes.

Prevalence and risk factors of primary open-angle glaucoma in a city of Eastern China: a population-based study in Pudong New District, Shanghai.

BACKGROUND: The aim of the present study was to investigate the prevalence and characteristics of primary open-angle glaucoma among the urban population of Pudong New District, Shanghai. METHODS: Three residents' committees were randomly selected from Pudong New District, and residents aged 50 and older were screened for primary open-angle glaucoma (POAG) from March to April 2011. In remote screening, the tests on visual acuity, refraction, intraocular pressure (IOP), and the photographs of anterior segment and fundus were used to identify POAG suspect. The suspected subjects were then reexamined with the tests on IOP, gonioscopy, Humphrey visual field test, and retinal nerve fiber layer (RNFL) thickness by optical coherence tomography (OCT). POAG was diagnosed according to the criteria defined by International Society for Geographic and Epidemiological Ophthalmology (ISGEO). Finally, POAG risk factors were evaluated using logistic regression analysis. RESULTS: A total of 2528 citizens out of 3,146 eligible residents (80.36 %) participated in this study. Among the citizens, 72 were diagnosed to have POAG, giving the crude prevalence rate of 2.85 % (95 % CI:2.20 %-3.50 %) in general and age- and gender-adjusted prevalence rate of 2.8 % (95 % CI: 2.78 %-2.83 %). Among the 72 POAG patients, only 22 cases had IOP exceeding 21 mmHg while other 50 cases had IOP of 21 mmHg or less; nine cases had one eye blind (12.5 %). Intriguingly, only eight cases (11.11 %) had been diagnosed with POAG before this screening. CONCLUSIONS: More efforts are required for early screening and education on POAG in communities, especially in a POAG high-risk population.

[Investigation and strategy research of eye disease prevention resources in community health service centers in Shanghai].

OBJECTIVE: To investigate the status of eye disease prevention resources in community health service centers, to understand the distribution of ophthalmology service resources in each community, and to understand the main problems existing in the work of blindness prevention and treatment in Shanghai, so as to strengthen the prevention of blindness and improve the primary eye care level. METHODS: Using the survey method, we carried out the investigation of disease control and prevention resources in all community health service centers to obtain the data of eye disease prevention and treatment resources. Using the descriptive statistics, we described the distribution of resources of eye disease prevention and treatment in different districts. RESULTS: There were 244 communities in 17 districts and counties in Shanghai, of which 236 (96.72%) communities participated in the survey and completed the questionnaires. Forty-nine (20.8%) communities had independent outpatient departments of ophthalmology, 96 (40.7%) had departments of ophthalmology and otorhinolaryngology, 33 (14%) had ophthalmology doctor visits from secondary or tertiary medical institutions, and 87 (36.9%) had no outpatient department of ophthalmology. There were 82 oculists, 129 general or otorhinolaryngology doctors treating eye disease, 9 ophthalmic nurses, and 1 optometrist. There were 36 specialized personnel for public health of eye protection and 217 part-time personnel. Moreover, there were a total of 1 103 pieces of ophthalmic equipment in all communities with the use rate of 91%. CONCLUSIONS: Uneven ophthalmology resources and eye care professional ability in community health service centers, lack of technical and public health personnel for prevention of eye disease, backward eye disease screening equipment, and inadequate investment in prevention and treatment of eye disease are major problems. More government supports for prevention and treatment of eye disease in communities and continuous improvement in three-level blindness prevention network systems and information construction are needed.

Prevalence and causes of visual impairment and rate of wearing spectacles in schools for children of migrant workers in Shanghai, China.

BACKGROUND: To assess the prevalence of visual impairment and rate of wearing spectacles in schools for children of migrant workers in Shanghai, China. METHODS: Children from grade 1 to 5 in schools for children of migrant workers were randomly chosen for ocular examinations. All children were screened for uncorrected visual acuity and presenting visual acuity. After screening, the children whose uncorrected visual acuity was 20/40 or less received ocular motility evaluation, cycloplegic refraction/non-cycloplegic refraction, and external eye, anterior segment, media, and fundus examinations. RESULTS: A total of 9673 children were enumerated and 9512 (98.34%) participated in this study. The prevalence of uncorrected, presenting, and best-corrected visual acuity of 20/40 or worse in the better eye were 13.33%, 11.26%, and 0.63%, respectively. The rate of wearing spectacles of the children with visual impairment in one or both eyes was 15.50%. Of these, 26.05% were wearing spectacles with inaccurate prescriptions. Refractive error was a major cause of visual impairment, accounting for 89.48% of all the visual impairment causes. Other causes of visual impairment included amblyopia accounting for 10.12%; congenital cataract, 0.1%; congenital nystagmus, 0.1%; ocular prosthesis, 0.1%; macular degeneration, 0.05%; and opaque cornea, 0.05%. CONCLUSIONS: This is the first study of the prevalence and causes of visual impairment in schools for children of migrant workers in Shanghai, China. The visual impairment rate in schools for children of migrant workers in suburbs of Shanghai in the best eye before vision correction was lower than those of urban children in mainstream schools in Guangzhou in 2012, and higher than students in rural of Beijing in 1998 and in suburb of Chongqing in 2007. The refractive error was the principal cause of the visual impairment of the children of migrant workers. The rate of wearing spectacles was low and the percentage of inaccurate prescriptions, among those who wore spectacles, was high. Uncorrected refractive error was a significant cause of visual impairment in migrant children.

[Prevalence of primary glaucoma among adults aged 50 years or above population in Huamu community: a cross-sectional survey in Shanghai, 2011].

OBJECTIVE: To investigate the prevalence and characteristics of primary glaucoma in the population of Huamu community, Shanghai. METHODS: It was a population-based cross-section study.Using random cluster sampling method, 3 neighborhood committees were randomly selected from Huamu community. And this survey was carried out by screening in community combined with diagnosis in tertiary hospital from March to September 2011. Residents aged more than 50 years old were included in this study.Information was collected on the participants' presenting visual acuity with habitual correction and best corrected visual acuity, intraocular pressure (IOP) assessed with non-contact tonometer, ocular anterior segment examination results with slit lamp anterior segment photography, optic disc examination results with fundus photography. And all glaucoma suspects received IOP measurement, gonioscopy, visual field test, retinal nerve fiber layer thickness measurement in Shanghai Eye Disease Prevention and Treatment center.Glaucoma was diagnosed according to International Society for Geographic and Epidemiological Ophthalmology. Distributions of different types of primary glaucoma within different groups of gender and age were described, and prevalence rates of primary glaucoma between different groups were compared using chi-square test. RESULTS: Two thousands five hundreds and twenty-eight cases were examined and the respond rate was 80.36%. Prevalence of primary glaucoma was 3.09%, in which primary open angle glaucoma (POAG) and primary angle closure glaucoma (PACG) were 2.85% and 0.24%. The prevalence of POAG had upward trend with age. The blindness rate within one or both eyes caused by POAG and PACG was 12.5% and 3/6, and the blindness rate of POAG was lower compared with PACG. 88.89% of POAG in this investigation had not been previously diagnosed, and 100% of PACG had been previously diagnosed and received treatment. CONCLUSIONS: The prevalence of primary glaucoma in Huamu community is relatively high and the previous diagnostic and treatment rate of POAG are relatively low. Early screening and health education for primary glaucoma are important in blindness prevention work in the future.

[Effects of additives in blood collection tubes on testing the alcohol concentration in blood samples].

OBJECTIVE: To discuss blood collection tubes with different additives and their effects on the testing results of alcohol concentration in blood samples. METHODS: Blood samples from 10 volunteers were collected 2 hours after drinking with seven different types of disposable vacuum blood collection tubes, including ordinary tube without anticoagulant, coagulant tube, separating gel-coagulant tube, sodium citrate (1:4) tube, sodium citrate (1:9) tube, sodium citrate (9:1) tube and EDTA-K2 tube. The alcohol concentrations in these blood samples were analyzed by headspace gas chromatography. RESULTS: The concentration testing results of the same blood samples in different types of tubes were different from one to another. The sequence was as follows: separating gel-coagulant tube > coagulant tube > ordi- nary tube without anticoagulant > EDTA-K2 tube> sodium citrate (1:9) tube> sodium citrate (1:4) tube, whereas the results of the same blood sample in sodium citrate (1:9) tube and sodium citrate (9:1) tube showed no obvious difference. CONCLUSION: It is better to collect a suspicious drunk driver's blood sam- ple using a disposable vacuum blood collection tube, with the EDTA-K2 tube being preferred.