Objective To observe the abnormal expression of transthyretin in serum and vitreous of high myopia patients. Methods 116 patients (50 males and 66 females) with high myopia, diagnosed by retinoscopic reflex, slit-lamp microscope, indirect ophthalmoscope and Iol-Master, were enrolled. The patients had an average age of (49.7plusmn;12.3) years and average diopter of (-10plusmn;4.2) D. The control group had 86 healthy individuals (42 males and 44 females) with an average age of (48.5plusmn;10.5) years. According to the findings of indirect ophthalmoscope and optical coherence tomography (OCT) examination, the patients were classified as foveal detachment, macular hole, choroidal neovascularization, epimacular membrane, retinal scar and no significant pathological changes. 2 ml peripheral blood samples were taken from all the subjects. The vitreous samples of high myopia patients with foveal detachment and macular hole (20 patients, 20 eyes) were collected before pars plana vitrectomy. LTQ-MASS was performed on 16 serum samples of patients and 16 control serum samples. Western blot and enzyme linked immunosorbent assay (ELISA) were used to detect serum transthyretin expression in high myopia groups（n=100）and control group (n=80). Vitreous samples (n=20) and corresponding serum samples were further analyzed by ELISA. Meanwhile, the relationship between visual acuity after surgery and transthyretin expression level in vitreous were analyzed. Results LTQ-MASS detected 4 proteins differentially expressed in the serum of patients and control group, transthyretin was the most significantly increased protein in high myopia patients. Western blot validated that serum transthyretin of high myopia group was much higher than that of the control group (t=3.68, P＜0.05). High myopia patients with macular hole and macular detachment had much higher serum and vitreous transthyretin than that of control group (F=9.28，P＜0.01). Patients with higher vitreous transthyretin had better postoperative visual acuity. Conclusions The transthyretin level increases significantly in serum and vitreous of high myopia patients, and it correlated with ocular pathologies and visual outcomes.
Objective To observe the microperimetry performance of macular function in pathologic myopia patients. Methods The clinical data of 90 patients (142 eyes) with pathologic myopia were retrospectively analyzed. All patients were asked in details about history, and take examinations of best corrected visual acuity (BCVA), refractive dioptre, eye axis, fluorescent fundus angiography (FFA), indirect ophthalmoscopy and optical coherence tomography (OCT). According to the test results, patients were divided into non-pathological macular group (20 patients, 24 eyes) and pathological macular group (70 patients, 118 eyes). Retinal imaging and macular microperimetry were measure by MP-1 Microperimeter.The mean retinal sensitivities (MS) and fixation stability in the central 10deg;, fixation rate and fixation position in the central 2deg; and 4deg;were determined.Results The MS of pathological and non-pathological macular group were(16.39plusmn;2.12), (10.80plusmn;4.53) dB respectively, the difference was statistically significant(F=15.044,t=-9.314;P=0.000). Among 24 eyes of non-pathological macular group, fixation was stable in 19 eyes (79.17%), relative unstable in five eyes (20.83%); among 118 eyes of pathological macular group, fixation was stable in 45 eyes (38.14%), relative unstable in 52 eyes (44.07%), unstable in 21 eyes (17.79%), the difference was statistically significant(chi;2=13.56, P=0.000). The differences of 2 deg;and 4 deg;fixation rate between those two groups are statistically significant (F=5.773, 13.230; t=-4.110,-5.465;P=0.000) . Among 24 eyes of non-pathological macular group, center fixation occurred in 23 eyes (95.83%), weak center fixation occurred in one eye (4.17%); among 118 eyes of pathological macular group, fixation center occurred in 81 eyes (68.64%), weak center fixation occurred in 16 eyes (13.56%)，eccentric fixation occurred in 21 eyes (17.80%), the difference was statistically significant (F=9.618,t=-5.773；P=0.000).Conclusion Pathological myopia patients with pathological macular changes have decreased retinal sensitivity, decreased fixation stability and eccentric fixation points.
Objective To observe the macular structure changes and its relationship with visual function in patients with idiopathic macular hole (IMH). Methods Forty-seven patients (47 eyes) with IMH who underwent pars plana vitrectomy were enrolled in this study. All patients were examined including bestcorrected visual acuity (BCVA), slit-lamp microscopy, indirect ophthalmoscopy, B-scan ultrasonography, optical coherence tomography (OCT) and MP-1. All the patients underwent a standard three-port pars plana vitrectomy. The BCVA, mean light sensitivity (MS) in macular area, macular hole diameter, the photoreceptor inner and outer segment (IS/OS) junction defect, external limiting membrane (ELM) defect were observed on the 1st, 3rd and 6th months after surgery, and then the relationship of IS/OS junction defect, ELM defect, sensitive and BCVA were analyzed. Results The 1st, 3rd and 6th months after surgery, the logarithm of minimal angle of resolution (logMAR) BCVA (t=16.4, 35.7, 20.7; P＜0.05) and MS （t=－13.8, －17.9, －2.5; P＜0.05） were improved significantly; the macular hole diameter （t=7.7, 7.7, 7.7;P＜0.05）, IS/OS junction defect （t=24.1, 19.3, 27.4; P＜0.05） and ELM （t=20.5, 6.7, 15. 8; P＜0.05） defect were decreased significantly. Preoperative IS/OS junction defect and ELM defect were both related to sensitive （r=-0.55, -0.53; P＜0.05）, but uncorrelated with BCVA （r=0.13, 0.13; P＞0.05）. IS/OS junction defect and ELM defect 1st, 3rd and 6th months after surgery were both related to MS and BCVA （P＜0.05）. Conclusions The logMAR BCVA and MS increases, while IS/OS junction and defect ELM defect decreases after surgery in IMH patients. IS/OS junction defect and ELM defect after surgery were both related to sensitive and BCVA.