Background: The purpose of this study is to study the effect of repeated intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF) drugs on vitreomacular interface.Methods: Neovascular age-related macular degeneration patients who received intravitreal injection of anti-VEGF drugs were included. Eyes with severe vitreous opacity, uveitis, complicated cataract surgery and previous vitrectomy were excluded. vitreomacular interface, best corrected visual acuity (BCVA) and central retinal thickness (CRT) assessment was performed once a month for at least 3 months. The nature and time of the change event are recorded.Results: Total 87 eyes were evaluated. Vitreomacular interface change event occurred in 9 eyes. Pre-existing vitreomacular interface abnormality (VMIA) was a risk factor for the VMI change (P=0.033, OR=16.518, 95% CI: 1.258 to 216.939). The interface event occurred in the first 3 months of treatment. the final BCVA of eyes with vitreomacular interface unchanged was significantly higher than that at baseline (P=0.001), and the final CRT was also significantly lower than that at baseline (P<0.001 and P=0.001). The final CRT of eyes with vitreomacular interface changed was significantly lower than that at baseline (P=0.015), however, there was no statistical significance in BCVA (P=0.468).Conclusions: Intravitreal injection of anti-VEGF drugs has a certain probability to cause changes in vitreomacular interface, and the risk is higher in eyes with pre-existing vitreomacular interface abnormality. The effect of intravitreal injections on vitreomacular interface was concentrated in the first three injections, and subsequent increases in the number of injections did not significantly increase the risk of vitreomacular interface abnormality. Ophthalmologists should increase attention to the vitreomacular interface in the early stages of anti-VEGF therapy and counsel patients accordingly.

Introduction Previous studies have reported a high prevalence of visual defects in children with special needs. However, routine ocular examinations for these children in rural areas of China are lacking. This study aimed to evaluate the status of visual impairment (VI) in children at special education schools in rural China. Methods A total of 316 students from two special schools in Zunyi city, Guizhou province, were enrolled. Full ophthalmic examinations were performed, and gene-sequencing services were offered to potential patients. Results The mean age of the 316 participants was 12.27±3.49 years, and 75 showed abnormal ophthalmic manifestations on slit-lamp examination. Visual acuity (VA) was assessed in 232 eyes, and the mean VA (logarithm of the minimum angle of resolution, logMAR) was 0.27±0.34. Whole-exome sequencing (WES) identified 19 mutations in these children, which might explain their visual complaints. Children with Down syndrome had a significantly higher prevalence of ocular disorders than those without. Conclusion VI is common among children at special education schools in rural areas; however, routine screening and effective interventions have not been consistently implemented. Efforts should be made to address this issue in these already disadvantaged children.