REVIEW AND COMMENTARY

Who needs myopia control?

Yan-Xian Chen, Chi-Mei Liao, Zachary Tan, Ming-Guang He

Myopia has become a major visual disorder among school-aged children in East Asia. Improved risk assessment for myopia onset and progression in children is critical in clinical decision-making. Besides traditional prediction models, individualized prediction using machine learning and data based on age-specific refraction is promising. Although emerging treatments for myopia are promising and some have been incorporated into clinical practice, identifying populations who require and benefit from intervention remains the most important initial step for clinical practice. Further, more real-world data are required to identify optimal myopia treatment strategies for individuals, prior to wide population-level adoption. Lastly, further study is required to investigate new treatments that may have improved efficacy and fewer side effects for children who would otherwise respond poorly to currently available options.

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谁需要控制近视？

近视已成为东亚学龄儿童的主要视力障碍。改善儿童近视发病和进展的风险评估在临床决策中至关重要。除了传统预测模型外，利用机器学习和基于年龄特异性屈光数据进行的个性化预测颇有前景。虽然新兴的近视治疗方法很有前途且有些已被纳入临床实践，但确定需要干预并从中获益的人群仍是临床实践中最重要的初始步骤。此外，在应用于更广泛的人群之前，需要更多的真实数据来确定个人最佳近视治疗策略。最后，还需要进一步的研究来调查新的治疗方法，这些新的治疗方法可能会提高疗效，减少副作用，否则这些儿童可能会对目前治疗方案反应不佳。

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CLINICAL RESEARCH

Five-year results of refractive outcomes and vision-related quality of life after SMILE for the correction of high myopia

Min Lang, Kai-Wei Cao, Ting Liu, Ying Zhu, Jian Ye

This study evaluates the long-term visual, refractive outcomes and vision-related quality of life of thirty patients (60 eyes) with high myopia who underwent small incision lenticule extraction (SMILE) more than 5y. At 5-year follow up, the efficacy index and safety index of SMILE were 1.09±0.18 and 1.19±0.12, respectively. Five years postoperatively, 73% eyes obtained a visual acuity of 20/20 or better, 95% eyes were within ±1.00 D of attempted correction and the participants showed a significantly higher total score (90.14) of CHI-NEI-VFQ-25 than those who wore corrective spectacles (81.43). Correcting high myopia with SMILE is safe, effective, and predictable in the long-term.

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高度近视SMILE矫正术后屈光度和视觉相关生活质量的五年随访

该研究评估了30例（60眼）接受SMILE手术超过5年的高度近视患者术后视力、屈光结果和视力相关生活质量。经5年随访，SMILE的疗效指数为1.09±0.18，安全性指数为1.19±0.12。术后5年，73%的术眼获得20/20或更好的视力，95%的术眼屈光度在预期1.00 D内，且CHI-NEI-VFQ-25的总分(90.14)明显高于佩戴框架眼镜者(81.43)。SMILE矫正高度近视经长期随访是安全、有效和可预测的方法。

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CLINICAL RESEARCH

One-step viscoelastic agent technique for ICL V4c implantation for myopia

Hua-Mao Miao, Feng Zhao, Ling-Ling Niu, Jing Zhao, Xiao-Ying Wang, Xing-Tao Zhou

This study investigated the safety and efficacy of using a one-step viscoelastic agent technique for ICL V4c implantation for myopia correction. No significant difference was found in corrected distance visual acuity, corneal endothelial cell density, the coefficient of variation in cell size, and the percentage of hexagonal cells postoperatively and the IOP was decreased. The results showed the one-step viscoelastic agent technique for ICL V4c implantation is safe and effective for myopia correction and causes little disturbance to the cornea.

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一步粘弹剂技术在ICL V4c植入治疗近视的应用

该研究探索一步粘弹剂技术植入ICL V4c矫正近视的安全性和有效性。术后矫正视力、角膜内皮细胞密度、细胞变异系数和六角形细胞百分比无显著差异，眼压下降。一步粘弹剂技术植入ICL V4c矫正近视安全有效，对角膜的干扰较小。

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INVESTIGATION

Socio-economic disparity in visual impairment from cataract

Zhi Fang, Xin-Yi Chen, Li-Xia Lou, Ke Yao

This is a study to investigate the association of visual impairment of cataract with human development index (HDI) using Years Lived with Disability (YLDs). In present study, the author found that age-standardized YLD rates caused by cataract declined since 1990. Cataract burden of visual impairment was inversely associated with national socioeconomic development and was more concentrated in countries with low HDI, especially among the blind. The study is helpful to decision maker and highlight the need to provide more cataract services and cataract surgery coverage for developing countries.

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白内障致视力损害的社会经济因素差异

该研究采用伤残损失生命年（YLDs）调查白内障致视力损害与人类发展指数（HDI）之间的关系。在该研究中，作者发现自1990年以来，白内障引起的年龄标准化YLD发生率下降。白内障致视力损害的负担与国家社会经济发展呈负相关，并且更集中于HDI较低的国家，尤其是致盲负担。该研究将对决策者有所帮助，并强调需要为发展中国家提供更多的白内障服务和提高白内障手术覆盖率。

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INVESTIGATION

A single nucleotide polymorphism in the IL1RL1 gene is associated with Behcet’s disease in a Chinese Han population

Xin-Shu Liu, Zi-Yan Wu, Si Chen, Chan Zhao, Fei Gao, Ming-Hang Pei, Shan-Shan Jia, Yong-Zhe Li, Pei-Zeng Yang, Mei-Fen Zhang

Behcet’s disease (BD) is defined as a kind of chronic recurrent systemic vasculitis. The etiology of BD remains poorly understood. Several studies have displayed a significant change in IL-33 and/or ST2 levels in the peripheral circulation and/or at inflammatory sites, but few studies have been conducted to explore the genetic predisposition of IL33/IL1RL1 to BD. Totally 8 single nucleotide polymorphisms in the candidate gene region were genotyped in 783 BD patients and 701 healthy controls. The results indicate that the frequency of rs12712142 in IL1RL1 variant allele A was significantly lower in BD patients than that in controls; the genotype distribution and additive and dominant genetic model analyses also indicated a strong association between rs12712142 and BD patients. This study clearly demonstrates the A variant in IL1RL1 rs12712142 is correlated with a decreased risk of BD in the Chinese Han population, which may suggest a protective role of the IL1RL1 gene in the pathogenesis of BD.

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IL1RL1基因的单核苷酸多态性与白塞病在中国汉族群体的患病相关性

白塞病（BD）被定义为一种慢性复发性多系统受累的血管炎性疾病。BD的病原学仍然不明确。一些研究显示BD患者外周血循环和/或炎症部位的IL-33和/或ST2水平有显著变化，但很少有研究探讨IL33/IL1RL1对BD的遗传易感性。该研究收集共783名BD患者和701名健康对照者的候选基因区域，对所有候选基因区域的8个单核苷酸多态性进行了基因分型。结果显示，BD患者IL1RL1基因rs12712142位点等位基因A变异频率明显低于对照组；基因型分布以及相加模型和显性模型分析也表明rs12712142与BD患者之间存在很强的关联。研究显示IL1RL1基因rs12712142位点等位基因A变异与中国汉族群体BD发病风险降低有关，提示IL1RL1基因在BD的发病机制中发挥了保护作用。

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