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Neuro-Ophthalmology in China

Zhang, Xiaojun MD, PhD

Section Editor(s): Digre, Kathleen B. MD

Journal of Neuro-Ophthalmology: March 2015 - Volume 35 - Issue 1 - p e4–e7
doi: 10.1097/WNO.0000000000000215
Worldwide Neuro-Ophthalmology

Department of Neurology, Beijing Tongren Hospital, Capital Medical University, Beijing, China

One of the earliest Chinese neuro-ophthalmic publications appeared in the Chinese Medical Journal in 1932 and dealt with optic disc abnormalities. It was authored by Dr. Wenbing Lin (Fig. 1), a graduate of Harvard Medical School who returned to Shanghai in 1926. In subsequent years, articles dealing with retrobulbar optic neuritis were published by ophthalmologists in Shanghai and Chengdu. In 1949, Dr. Yuanxiu Lao (Fig. 2) spent 1-year training in neuro-ophthalmology and visual field testing at the University of Pennsylvania with Francis H. Adler, MD and Harold G. Scheie, MD. She returned to China in 1950 and started the first neuro-ophthalmology service at Peking Union Medical College Hospital. In 1957, she published Clinical Perimetry, the first Chinese textbook dealing with evaluation of visual fields. In 1958, the first Chinese neuro-ophthalmology textbook entitled Clinical Neuro-ophthalmology was published. It was coauthored by a senior neurosurgeon Zhesheng Han, and ophthalmologist, Xiaohui Zheng.

Advances in our subspecialty slowed in 1966 with the start of the cultural revolution and lasted 10 years. In 1979, Dr. Mi Yan (Fig. 3) did a retinal fellowship at Scheie Eye Institute, University of Pennsylvania followed by a neuro-ophthalmology fellowship at Wilmer Eye Institute, John Hopkins Hospital in Baltimore. Dr. Yan returned to China and established the first neuro-ophthalmology clinic at West China School of Medicine University in Chengdu, Sichuan. He also introduced neuro-ophthalmology to more ophthalmologists at the annual National Training Course of Ocular Fundus Disease which began in 1988. Ten years later, Dr. Yan was instrumental in creating a neuro-ophthalmology section in the Chinese Journal of Ocular Fundus Disease. In addition, articles dealing with optic neuritis, Leber hereditary optic neuropathy, and other neuro-ophthalmic disorders began to appear in the English literature. During this period, textbooks were published in Chinese including Clinical Practical Neuro-Ophthalmology coauthored by senior ophthalmologist, Dr. Yi Tong from Fujian Medical University and Japanese ophthalmologist, Tadashi Fujino, and Neuro-ophthalmology authored by a senior neurologist, Chunhe Zhai from Shanghai.

In the past decade, many Chinese ophthalmologists and neurologists received training abroad, and neuro-ophthalmology in China has experienced rapid growth (Table 1). Xinzu Gu, after finishing his training in Doheny Eye Institute in Los Angeles, established a neuro-ophthalmology service in Zhongshan Eye Center in Guangzhou in 2002, with a research interest in pupillary disorders. Xiaojun Zhang completed a neuro-ophthalmology fellowship at the Emory Eye Center in Atlanta and returned to Beijing in 2005. Dr. Zhang set up the first multidisciplinary neuro-ophthalmology center with both an outpatient clinic and a 40-bed inpatient unit at Beijing Tongren Hospital. Master and PhD degree programs in neuro-ophthalmology were created in the Department of Neurology of Beijing Tongren Hospital, Capital Medical University, and now there are 12 graduates who work in different teaching hospitals in China.

Currently, there are 9 university hospitals that have neuro-ophthalmology clinics, mostly based on ophthalmology departments (Table 2). Neuro-ophthalmologists in these hospitals usually combine their practices with other subspecialties, such as retina, strabismus, cataract, electrophysiology, or neurological subspecialties. Neuro-ophthalmology services outside of these university hospitals are provided by general ophthalmologists.

Currently, neuro-ophthalmology is not a mandatory part of residency training in either ophthalmology or neurology, and there are no neuro-ophthalmology fellowship training programs. This has led to creation of short-term training courses in neuro-ophthalmology. In 2003, first national neuro-ophthalmology training course was hosted by Dr. Xinzu Gu. Dr. Yong Zhong from Peking Union Medical Hospital and Dr. Shi hui Wei from the People's Liberty Army General Hospital also annually run national training courses. In April 2011, a 2-day intensive training course named Chinese National Key Neuro-ophthalmologist Training Course was held and attracted over 100 attendees. The content was prepared by Jonathan Trobe, and the conference was led by Xiaojun Zhang and Shi hui Wei. This has become the only national annual neuro-ophthalmology training course in China. In addition, many neuro-ophthalmologists have lectured in China including Neil Miller, Joseph Rizzo, Peter Savino, Andrew Lee, Valerie Biousse, Agnes Wong, Gondon Plant, Satoshi Kashii, and May-Yung Yen. Bradley Farris has been giving his training course on optic nerve sheath fenestration in Chengdu annually for over 10 years. Table 3 shows the major neuro-ophthalmology research programs in China. Although most studies are published in the Chinese literature, Chinese neuro-ophthalmologists now are presenting their research findings at international meetings and more publications are appearing in English language journals.

The Chinese Ophthalmology Society (COS) annual meeting is held in each fall. Since 2007, there has been a neuro-ophthalmology session at this meeting. In 2012, the COS approved creation of the Chinese Neuro-ophthalmology Society (CNOS). This was followed by a joint conference of the inaugural CNOS meeting and the 2nd National Key Neuro-ophthalmologist Training Course. Held in Beijing, with over 400 attendees, invited lecturers included Satoshiii Kashii (Aichi, Japan), An-Guor Wang (Taipei, Taiwan), Patrick Yu-Wai-Man (Newcastle, United Kingdom), Ian Morgan (Canberra, Australia), and David and Sheila Crewther (Melbourne, Australia). The most recent CNOS annual meeting was held this June in Suzhou, Zhejiang, combining Jonathan Trobe's Training course and The Cross-Strait Neuro-ophthalmology symposium. The 8th annual meeting of the Asian Neuro-Ophthalmology Society will be held in October 2015 in Beijing.

Clearly, momentum in neuro-ophthalmology in China is increasing. With access to worldwide communication, help from colleagues and friends, enthusiasm and effort of a younger generation, neuro-ophthalmology in China will develop even more rapidly in the years to come.

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Appreciation of assistance from Professor Jian Tang, Eye Center of West China Medical School; Professor Yong Zhong, Department of Ophthalmology, Peking Union Medical College Hospital; Professor Wen bin Wei, Eye Center, Beijing Tongren Hospital, Capital Medical University; and Professor Shi hui Wei, Department of Ophthalmology, Chinese People's Liberty Army General Hospital.

© 2015 by North American Neuro-Ophthalmology Society