The data related signs of ocular fundus associated with COVID-19 published in this journal collected from December 2022, while the pandemic of COVID-19 was in a clustering occurrence. The signs of ocular fundus including acute macular neuroretinopathy (AMN), cotton wool spots or Purtscher-like retinopathy, central retinal vein occlusion (CRVO) and macular edema of unknown etiology. The different lesions can be concurrent existence in some cases is one of the clinical characteristics of COVID-19, other characteristics including both eye involved, predominated affected more women, aged from 13 to 56 years. AMN was mentioned recently in most papers on COVID-19, it has been known as deep capillary ischemia. Cotton wool spots is sign infarct in superficial capillary. Retina dots indicated retinal infarct in the outer plexiform layer. CRVO was demonstrated that the blood clot blocks the flow of blood at the level of the lamina cribro, optic disc edema with macular subretinal fluid showed the retina tissue as well as optic head affected. Eye is part of the body, lesions of ocular fundus are identical with body system. Several study proposed different hypothesis for these alterations in acute phase of COVID-19: direct viral endothelial injury, activation of the immune response by a cytokine storm leading to a procoagulant state or transient hypercoagulability. Retina lesions demonstrated a vasculature impairment in several layers of retina and edema in retina and optic disk. We should monitor in the acute phase of COVID-19 the prothrombotic markers and the treatment should consider anti-virus and preventing thrombosis formation.
Retinal vein occlusion (RVO) is a closely related disease of ophthalmology and systemic diseases. The Expert consensus on clinical diagnosis and treatment path of retinal vein occlusion in China (consensus) emphasizes that etiological diagnosis and treatment should be paid primary attention to, and etiological exploration should be placed in an important position in the diagnosis and treatment path. In addition to etiological treatment, the consensus emphasizes that clinical attention should be paid to the management of anterior segment neovascularization, neovascular glaucoma and macular edema. Especially for patients with short course of central retinal vein occlusion, the occurrence of 100-day glaucoma should be vigilant, and active anti-vascular endothelial growth factor (VEGF) drugs, laser photocoagulation and intraocular pressure treatment should be taken. For the treatment of macular edema, the consensus points out that anti-VEGF drugs and intraocular glucocorticoid sustained-release agents are effective, but the latter should be used cautiously to avoid problems such as high intraocular pressure glaucoma and accelerated cataract formation. For deficient RVO, the consensus defines its concept, defines the time point of treatment when combined with macular edema, and clarifies the applicable conditions of laser therapy.
Evidence-based guidelines for diagnosis and treatment of diabetic retinopathy in China (2022) is based on evidences in recent clinical trials and a system of Grading of Recommendations, Assessment, Development and Evaluation of evidence quality and strength of recommendations. The main key points around why the diabetic macular edema (DME) changes the classification, what thresholds for initiating anti-vascular endothelial growth factor (VEGF) drug therapy; eyes with center-involved DME (CI-DME) and good vision for clinical significant macular edema still treated by focal laser even with good vision, the clinical pathway for CI-DME changes first-line treatment from laser to anti-VEGF, loading dose of anti-VEGF for CI-DME in non-proliferative diabetic retinopathy (DR) from 3 injections up to 4-5 injections is recommended; severe non-proliferative DR and proliferative DR with vision impairment but without hemorrhages and retinal traction could be considered first treatment of anti-VEGF comparing to initiate pan-retinal photocoagulation (PRP) (weakly recommended), PRP is still gold-standard for progressive non-perfusion area of retina. With the rapid development of DR evaluation devices such as optical coherence tomography, wide-angle optical coherence tomography angiography and wide-angle fluorescein fundus angiography, imaging biomarkers have been provided for the degree of DR lesion, treatment response and prognosis. It is believed that the clinical practice will be promoted a new height by the 2022 edition of Chinese DR guideline.
Prevention and treatment of infants and young children can avoid blindness, effectively reduce the incidence of children's blindness and vision loss. Eye diseases causing blindness in infants and young children mainly include retinopathy of prematurity, retinoblastoma, familial exudative retinopathy, persistent embryonic blood vessels, vitreous hemorrhage, congenital cataract, etc. Most of them are preventable and controllable, however, many diseases have strict requirements for the effective treatment time window. The basic form and path to carry out the prevention and control of blinding eye diseases in infants and young children are building a prevention and control system with a combination of multi-party medical forces, referral to pediatric eye disease institutions with relevant technical resources for further diagnosis and treatment, so as to achieve early detection, standardized treatment and visual training.
Retinal vein occlusion (RVO) is the second visual threatening retinal disorders followed by diabetic retinopathy in the elderly. In the past decades, increasing knowledge of the natural history, aetiology and risk factors, medical management investigation, together with the support of high level evidence-based medical evidence and the results of real-world clinical trials play key roles in guiding the clinical practice. However, without understanding the pathogenesis and pathogeny of the disease, it is difficult to implement a comprehensive, precise and personalized treatment strategy for the RVO patients. It is of significance in the clinic to discuss the pathological process of RVO, analyze the etiological characteristics of the disease, reveal the clinical outcomes, which aim to facility the optimal treatment and follow-up procedure for the patients.
Cytomegalovirus (CMV) retinitis (CMVR) is a common opportunistic infection of the eye after allogeneic hematopoietic stem cell transplantation in patients with hematological diseases. It often occurs within 3 months after the operation, with CMV activation and high blood CMV peaks. It often occurs on patients with long-term CMV viremia, human leukocyte antigen incompatible transplantation, unrelated donor transplantation, haploid transplantation, childhood hematopoietic stem cell transplantation, delayed lymphocyte engraftment, acute and chronic graft-versus-host disease after surgery. The visual prognosis of patients is related to the area of CMVR lesions on the retina, the number of quadrants involved, whether the macula is involved, and the CMV load of the vitreous body is involved, and it is not related to whether the Epstein-Barr virus infection is combined with blood and vitreous humor. The incidence of CMVR is increasing year by year. It is helpful that paying attention to systemic risk factors and epidemiology can provide more effective guidance for ophthalmologists during diagnosis and treatment, help patients improve the prognosis of vision, and reduce or even avoid the occurrence of blindness caused by CMVR.
By using the different light stimuli, the flash ERG of 32 cases of central retinal vein occlusion(CRVO) (13 of ischemic type,19 of non-ischemic type) during acute phase were examined. The results showed that the a-wave and b-wave latency of CRVO elongated,while the b-wave amplitude of ischemie type decreased and that of non-ischemic type varied in different stimulus: decreased,increased or normal.Therefore,b-wave amplitude and b/a ratio,and selection of suitable ERG condition of stimulus are thought to be important in differetiating ischemic from non-ischemic CRVO. (Chin J Ocul Fundus Dis,1994,10:7-10）
Diabetic retinopathy is one of the microvascular complications of diabetes and a major cause of blindness in adults. Early screening is an effective way to reduce blindness caused by diabetic retinopathy. The diabetic retinopathy is one of the chronic retinal diseases highlighted in the “14th Five-Year” National Eye Health Plan (2021-2025). The establishment of effective and practical community screening model is a powerful guarantee to complete early screening. It is of great significance to standardize screening methods, screening personnel duties, equipment allocation, referral conditions and screening sustainability. Chinese fundus disease and related field experts developed the consensus through a serious, comprehensive, and complete discussion, to provide more reference for establishing a suitable community screening model of diabetic retinopathy and increasing the screening rate of diabetic retinopathy.
With the recent domestic adoption of novel formulations such as high-dose anti-vascular endothelial growth factor agents and gene therapy drugs, sterile intraocular inflammation (SIOI) following intravitreal injection has gradually come into public awareness and garnered widespread attention. Concurrently, multiple ophthalmic medications with established clinical histories, including prophylactic antibiotics (e.g., vancomycin) and corticosteroids (e.g., triamcinolone acetonide), have also been reported to induce SIOI. To enhance Chinese ophthalmologists’ understanding of SIOI and standardize its diagnostic and therapeutic protocols, the Fundus Disease Group of Ophthalmological Society of Chinese Medical Association, Fundus Disease Group of Ophthalmologist Branch of Chinese Medical Doctor Association, adhering to evidence-based medicine principles and integrating international guidelines and consensus documents with China’s socio-economic context, have spearheaded the development of the Expert consensus for the diagnosis and treatment of sterile intraocular inflammation after intraocular drug delivery (2025) through rigorous consensus-building processes. This consensus systematically presents diagnosis and treatment recommendations with Chinese characteristics, addressing seven key clinical issues such as the epidemiological features, clinical manifestations, identification of high-risk factors, perioperative management, and prognosis evaluation of SIOI. It focuses on constructing a hierarchical intervention system based on the severity of the disease. An in-depth understanding of the core content of this consensus can, on the one hand, help avoid diagnostic and therapeutic deviations caused by insufficient understanding, and on the other hand, assist in establishing a standardized SIOI management process, thereby effectively reducing the risk of visual impairment and optimizing the visual prognosis of patients. The introduction of this consensus marks the further improvement of the quality management system for intraocular injection therapy in our country and holds significant guiding importance for enhancing the diagnostic and therapeutic level of retinal diseases.
Retinal vein occlusion (RVO) is one of the most important retinal vascular diseases in China that leads to severe loss of vision. In recent years, the emergence of various emerging imaging technologies and new drugs has not only deepened our understanding of the natural course of this disease, but also significantly changed the traditional treatment mode of retinal laser photocoagulation as the gold standard, thereby significantly improved the visual prognosis. However, currently in various regions and levels of hospitals in China, the diagnosis and treatment of RVO still rely mainly on their own experience. The awareness and knowledge of RVO among ophthalmologists in various regions still need to be improved. A standardized clinical diagnosis and treatment pathway is needed in order to meet the needs of most RVO patients. Led by the Fundus Disease Group of the Ophthalmology Branch of the Chinese Medical Association and the Fundus Disease Professional Committee of the Ophthalmology Branch of the Chinese Medical Association, based on the existing evidence-based evidence at home and abroad, and following the principles of consensus formulation, Expert consensus on clinical diagnosis and treatment path of retinal vein occlusion in China has been compiled. The consensus systematically and comprehensively elaborated a standardized diagnosis and treatment pathway for RVO. Interpreting the key points in this consensus is helpful to highlight the core ideas, and improve the utilization of this consensus by ophthalmologists from all levels of hospitals.