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Yang Y, Chen C, Chen Z, Zeng L, Xue F, Zhou J. Redistribution of Epithelium and Stroma and Their Relationship With Corneal Curvature After 1-Month Cessation of Overnight Orthokeratology. Eye Contact Lens 2024; 50:249-254. [PMID: 38687606 DOI: 10.1097/icl.0000000000001085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2024] [Indexed: 05/02/2024]
Abstract
OBJECTIVES To investigate the changes in the thickness of epithelium and stroma and their relationship with corneal curvature following the cessation of overnight orthokeratology for a period of 1 month. METHODS This prospective study consecutively included 20 juveniles (20 right eyes) who had undergone overnight orthokeratology for a minimum of one year and were willing to discontinue the treatment. The study measured and compared epithelial and corneal curvature using optical coherence tomography and Medmont topographer at the first day of cessation and 1 month after cessation. In addition, changes in uncorrected visual acuity and refractive error before and after the cessation of the treatment were analyzed. RESULTS The study found a significant increase in the thickness of the epithelium in the central 2-mm area after the cessation of the treatment (t = -4.807, P <0.001). Moreover, the stroma in the paracentral area (2-5 mm) and peripheral area (5-6 mm) showed a general thinning trend ( P =0.016, P =0.016). Regarding the correlation analysis, the change in central epithelial thickness (ΔCET) was significantly correlated with the change in paracentral corneal curvature (ΔPCCC) (r=0.610, P =0.007) and the change in peripheral corneal curvature (ΔPCC) (r=0.597, P =0.009). Similarly, the change in central stromal thickness (ΔCST) was significantly correlated with the change in central corneal curvature (ΔCCC) (r=0.500, P =0.035), ΔPCCC (r=0.700, P =0.001), and ΔPCC (r=0.635, P =0.005). CONCLUSIONS The study found that the corneal remodeling induced by orthokeratology was reversible after the cessation of the treatment. Specifically, changes in the epithelium were found to be more prominent in the central area, while changes in the stroma were more pronounced in the paracentral and peripheral areas. In addition, the study established a significant correlation between central corneal remodeling and changes in curvature.
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Affiliation(s)
- Ying Yang
- Department of Ophthalmology (Y.Y.), Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, People's Republic of China; and Department of Ophthalmology (C.C., Z.C., L.Z., F.X., J.Z.), Eye & ENT Hospital, Fudan University, NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai Research Centre of Ophthalmology and Optometry, Shanghai, People's Republic of China
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Abtahi MA, Beheshtnejad AH, Latifi G, Akbari-Kamrani M, Ghafarian S, Masoomi A, Sonbolastan SA, Jahanbani-Ardakani H, Atighechian M, Banan L, Nouri H, Abtahi SH. Corneal Epithelial Thickness Mapping: A Major Review. J Ophthalmol 2024; 2024:6674747. [PMID: 38205099 PMCID: PMC10776199 DOI: 10.1155/2024/6674747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 06/27/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024] Open
Abstract
The corneal epithelium (CE) is the outermost layer of the cornea with constant turnover, relative stability, remarkable plasticity, and compensatory properties to mask alterations in the underlying stroma. The advent of quantitative imaging modalities capable of producing epithelial thickness mapping (ETM) has made it possible to characterize better the different patterns of epithelial remodeling. In this comprehensive synthesis, we reviewed all available data on ETM with different methods, including very high-frequency ultrasound (VHF-US) and spectral-domain optical coherence tomography (SD-OCT) in normal individuals, corneal or systemic diseases, and corneal surgical scenarios. We excluded OCT studies that manually measured the corneal epithelial thickness (CET) (e.g., by digital calipers) or the CE (e.g., by confocal scanning or handheld pachymeters). A comparison of different CET measuring technologies and devices capable of producing thickness maps is provided. Normative data on CET and the possible effects of gender, aging, diurnal changes, refraction, and intraocular pressure are discussed. We also reviewed ETM data in several corneal disorders, including keratoconus, corneal dystrophies, recurrent epithelial erosion, herpes keratitis, keratoplasty, bullous keratopathy, carcinoma in situ, pterygium, and limbal stem cell deficiency. The available data on the potential role of ETM in indicating refractive surgeries, planning the procedure, and assessing postoperative changes are reviewed. Alterations in ETM in systemic and ocular conditions such as eyelid abnormalities and dry eye disease and the effects of contact lenses, topical medications, and cataract surgery on the ETM profile are discussed.
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Affiliation(s)
| | | | - Golshan Latifi
- Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Sadegh Ghafarian
- Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Masoomi
- Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | | | - Laleh Banan
- Sunshine Coast University Hospital, Brisbane, Queensland, Australia
| | - Hosein Nouri
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed-Hossein Abtahi
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Meng Z, Chen S, Zhe N, Cao T, Li Z, Zhang Y, Wei R. Short-term Changes in Epithelial and Optical Redistribution Induced by Different Orthokeratology Designs. Eye Contact Lens 2023; 49:528-534. [PMID: 37902624 PMCID: PMC10659253 DOI: 10.1097/icl.0000000000001045] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2023] [Indexed: 10/31/2023]
Abstract
OBJECTIVES This study aimed to investigate corneal epithelial and topographic changes caused by two commercial myopia orthokeratology (ortho-k) designs. METHODS Twenty-six subjects fitted with vision shape treatment (VST) lenses and 30 subjects fitted with corneal reshaping therapy (CRT) lenses were reviewed 1 day, 1 week, and 1 month after lens initiation. A spectral-domain optical coherence tomography system was used to create epithelial maps that were in turn used to determine the average epithelial thickness of each zone and the diameter of treatment zone. By measuring the topographic tangential differential map, the treatment zone diameter and the power and width of the high convex zone (HCZ) were obtained. All epithelial thicknesses and topographic corneal variations recorded were analyzed. RESULTS At the central zone, the epithelial thickness changes (△ET) decreased significantly after 1 day of ortho-k in two groups. At 2- to 9-mm peripheral zone, ortho-k increased △ET until 1 week in the VST group, whereas it kept increasing in the CRT group after 1 week. At 1 month, the central △ET is -9.51±2.38 mm in the VST group, which was comparable to -8.72±3.43 mm in the CRT group. The nasal HCZ power and the △ET of nasal and inferior nasal were significantly larger in the CRT group. A positive correlation was found between the HCZ power and △ET generated by VST-type lenses inferiorly and temporally. For the CRT group, a positive correlation was found between inferior HCZ power and △ET. CONCLUSIONS At the early stage of ortho-k, epithelial thickness and topography change quickly and simultaneously. Epithelial changes were in line with corneal topography reshaping. Epithelial and optical remodelling were affected by different lens types.
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Affiliation(s)
- Ziqi Meng
- Tianjin Key Laboratory of Retinal Functions and Diseases (Z.M., R.W.), Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China; Eye Hospital and School of Ophthalmology and Optometry (Z.M., S.C., N.Z., Z.L., Y.Z.), Wenzhou Medical University, Wenzhou, China; National Clinical Research Center for Ocular Diseases, Wenzhou, China; Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China; and Mailman School of Public Health (T.C.), Columbia University Irving Medical Center, New York, NY
| | - Siping Chen
- Tianjin Key Laboratory of Retinal Functions and Diseases (Z.M., R.W.), Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China; Eye Hospital and School of Ophthalmology and Optometry (Z.M., S.C., N.Z., Z.L., Y.Z.), Wenzhou Medical University, Wenzhou, China; National Clinical Research Center for Ocular Diseases, Wenzhou, China; Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China; and Mailman School of Public Health (T.C.), Columbia University Irving Medical Center, New York, NY
| | - Nan Zhe
- Tianjin Key Laboratory of Retinal Functions and Diseases (Z.M., R.W.), Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China; Eye Hospital and School of Ophthalmology and Optometry (Z.M., S.C., N.Z., Z.L., Y.Z.), Wenzhou Medical University, Wenzhou, China; National Clinical Research Center for Ocular Diseases, Wenzhou, China; Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China; and Mailman School of Public Health (T.C.), Columbia University Irving Medical Center, New York, NY
| | - Tongxin Cao
- Tianjin Key Laboratory of Retinal Functions and Diseases (Z.M., R.W.), Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China; Eye Hospital and School of Ophthalmology and Optometry (Z.M., S.C., N.Z., Z.L., Y.Z.), Wenzhou Medical University, Wenzhou, China; National Clinical Research Center for Ocular Diseases, Wenzhou, China; Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China; and Mailman School of Public Health (T.C.), Columbia University Irving Medical Center, New York, NY
| | - Zhangliang Li
- Tianjin Key Laboratory of Retinal Functions and Diseases (Z.M., R.W.), Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China; Eye Hospital and School of Ophthalmology and Optometry (Z.M., S.C., N.Z., Z.L., Y.Z.), Wenzhou Medical University, Wenzhou, China; National Clinical Research Center for Ocular Diseases, Wenzhou, China; Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China; and Mailman School of Public Health (T.C.), Columbia University Irving Medical Center, New York, NY
| | - Yunjie Zhang
- Tianjin Key Laboratory of Retinal Functions and Diseases (Z.M., R.W.), Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China; Eye Hospital and School of Ophthalmology and Optometry (Z.M., S.C., N.Z., Z.L., Y.Z.), Wenzhou Medical University, Wenzhou, China; National Clinical Research Center for Ocular Diseases, Wenzhou, China; Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China; and Mailman School of Public Health (T.C.), Columbia University Irving Medical Center, New York, NY
| | - Ruihua Wei
- Tianjin Key Laboratory of Retinal Functions and Diseases (Z.M., R.W.), Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China; Eye Hospital and School of Ophthalmology and Optometry (Z.M., S.C., N.Z., Z.L., Y.Z.), Wenzhou Medical University, Wenzhou, China; National Clinical Research Center for Ocular Diseases, Wenzhou, China; Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China; and Mailman School of Public Health (T.C.), Columbia University Irving Medical Center, New York, NY
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Modeling and Prediction of the Immediate and Short-Term Effect of Myopic Orthokeratology. Eye Contact Lens 2023; 49:77-82. [PMID: 36694311 DOI: 10.1097/icl.0000000000000962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2022] [Indexed: 01/26/2023]
Abstract
PURPOSE To characterize the clinical changes occurring in the initial phase of the orthokeratology (OK) treatment for myopia correction, developing a model of prediction of the refractive changes in such phase. METHODS Prospective study enrolling 64 eyes of 32 patients (range, 20-40 years) undergoing myopic OK treatment with the reverse geometry contact lens CRT (Paragon Vision Science). Changes in uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA), refraction, corneal topography, ocular aberrations, and corneal epithelial thickness were evaluated during the first hour of OK lens wear and after 1 week of OK treatment. Multiple linear regression analysis was used to obtain a model to predict the short-term refractive effect of OK. RESULTS The UCVA improved at each visit, reaching normal visual acuity values after a week (P<0.001) of OK treatment, which was consistent with the significant spherical equivalent (SE) reduction and central flattening (P<0.001). Multiple linear regression analysis revealed that one night change in refraction (ΔR×1N) could be predicted according to the following expression (P<0.001, R2=0.686): ΔR×1N=1.042+0.028×Age+1.014×BCET (baseline central epithelium thickness)-0.752×BKm (baseline mean keratometry)-1.405×BSE (baseline SE)+1.032×ΔR×1 h (change in SE after 1 hr of OK lens use). Similarly, a statistically relevant linear relationship was obtained for predicting the refractive change after 1 week (ΔR×1W) of OK use (P<0.001, R2=0.928): ΔR×1W=3.470-1.046×BSE-1.552×BBCVA (baseline BCVA)-0.391×BKm+0.450×ΔR×1 h. CONCLUSIONS The immediate and short-term refractive effects of myopic OK with the reverse geometry contact lens CRT can be predicted with enough accuracy from baseline and first trial visits data.
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Post-Ortho-K Corneal Epithelium Changes in Myopic Eyes. DISEASE MARKERS 2022; 2022:3361172. [PMID: 35677633 PMCID: PMC9168212 DOI: 10.1155/2022/3361172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 05/08/2022] [Indexed: 11/18/2022]
Abstract
The study is aimed at evaluating corneal epithelial thickness changes associated with overnight orthokeratology (ortho-K). In this retrospective study, epithelial thickness was measured using optical coherence tomography (OCT) before and after 1 day, 1 week, 1 month, and 3 months ortho-K nightly lens wear. Compared with pre-orthokeratology measurements, central (2 mm) corneal epithelium thickness was significantly reduced at 1 day, 1 week, 1 month, and 3 months with ortho-K (P < 0.05). Paracentral (2 mm~5 mm annular ring) epithelial thickness was also significantly reduced at superior temporal, inferior temporal, temporal, and inferior locations after ortho-K (P < 0.05), while midperipheral (5 mm~6 mm annular ring) epithelial thickness was greater post- than pre-ortho-K at superior, superior temporal, inferior temporal, inferior, and inferior nasal locations (P < 0.05). In other zones, superior, superior nasal, nasal, and inferior nasal in paracentral annular ring and temporal and superior nasal in midperipheral ring, epithelial thickness underwent no significant change. Ortho-K lens wear caused the central corneal epitheliums to thin. The temporal half zones become thinner in paracentral zones and thicker in midperipheral zones.
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Comparison of Epithelial Thickness Mapping in Normal Corneas with Different Types of Astigmatism. Optom Vis Sci 2022; 99:443-448. [DOI: 10.1097/opx.0000000000001886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Wu J, Fang W, Xu H, Liu X, Zhao D, Rong Q. The Biomechanical Response of the Cornea in Orthokeratology. Front Bioeng Biotechnol 2021; 9:743745. [PMID: 34708026 PMCID: PMC8542762 DOI: 10.3389/fbioe.2021.743745] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 09/06/2021] [Indexed: 11/13/2022] Open
Abstract
Orthokeratology has been widely used to control myopia, but the mechanism is still unknown. To further investigate the underlying mechanism of corneal reshaping using orthokeratology lenses via the finite element method, numerical models with different corneal curvatures, corneal thicknesses, and myopia reduction degrees had been developed and validated to simulate the corneal response and quantify the changes in maximum stress in the central and peripheral corneal areas during orthokeratology. The influence of the factors on corneal response had been analyzed by using median quantile regression. A partial eta squared value in analysis of variance models was established to compare the effect size of these factors. The results showed central and peripheral corneal stress responses changed significantly with increased myopia reduction, corneal curvature, and corneal thickness. The target myopia reduction had the greatest effect on the central corneal stress value (partial eta square = 0.9382), followed by corneal curvature (partial eta square = 0.5650) and corneal thickness (partial eta square = 0.1975). The corneal curvature had the greatest effect on the peripheral corneal stress value (partial eta square = 0.5220), followed by myopia reduction (partial eta square = 0.2375) and corneal thickness (partial eta square = 0.1972). In summary, the biomechanical response of the cornea varies significantly with the change in corneal conditions and lens designs. Therefore, the orthokeratology lens design and the lens fitting process should be taken into consideration in clinical practice, especially for patients with high myopia and steep corneas.
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Affiliation(s)
- Jinfang Wu
- Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing, China
| | - Wenxuan Fang
- Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing, China
| | - Huiwen Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.,Medical Informatics Center, Peking University, Beijing, China
| | - Xiaode Liu
- Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing, China.,X Lab, the Second Academy of CASIC, Beijing, China
| | - Dongliang Zhao
- School of Chemical Biology and Biotechnology, Peking University Shenzhen Graduate School, Shenzhen, China
| | - Qiguo Rong
- Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing, China
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Vincent SJ, Cho P, Chan KY, Fadel D, Ghorbani-Mojarrad N, González-Méijome JM, Johnson L, Kang P, Michaud L, Simard P, Jones L. CLEAR - Orthokeratology. Cont Lens Anterior Eye 2021; 44:240-269. [DOI: 10.1016/j.clae.2021.02.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 02/01/2021] [Indexed: 12/25/2022]
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Kim WK, Ryu IH, Yoo J, Kim SW. Effect of Gender, Age, and Ocular and Growth-Related Factors on Corneal Epithelial and Stromal Thickness in Children. J Clin Med 2020; 9:jcm9123849. [PMID: 33260816 PMCID: PMC7760657 DOI: 10.3390/jcm9123849] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 11/24/2020] [Accepted: 11/25/2020] [Indexed: 01/01/2023] Open
Abstract
Data on corneal epithelial and stromal thickness in school-aged children in relation to gender, age, and ocular and growth parameters are limited. In this retrospective study, we analyzed corneal epithelial and stromal thickness measured with the RTVue system (Optovue, Inc., Fremont, CA, USA) in 122 male and 201 female Korean children (mean age 9.59 ± 2.18 years) with myopia. We used simple and multiple regression analysis to establish the relationships between gender, age, refractive status, axial length, anterior chamber depth (ACD), corneal refractive power, white-to-white corneal diameter (WTW), height, and body weight. Age, body weight, height, and central corneal thickness were positively associated with corneal epithelial thickness, whereas WTW was negatively associated. The multiple regression analysis showed corneal epithelial thickness was affected by sex, body weight, WTW, and central corneal thickness (CCT), while stromal thickness was influenced by age, sex, and WTW. Both corneal epithelial and stromal thickness were significantly greater in male than in female children and were affected by growth. Neither corneal epithelial nor stromal thickness were associated with the severity of myopia, corneal refractive power, or axial length.
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Affiliation(s)
- Wook Kyum Kim
- B & VIIT Eye Center, Seoul 06615, Korea; (W.K.K.); (I.H.R.)
| | - Ik Hee Ryu
- B & VIIT Eye Center, Seoul 06615, Korea; (W.K.K.); (I.H.R.)
| | - Jeongseo Yoo
- Department of Ophthalmology, Yonsei University Wonju College of Medicine, Wonju 26426, Gangwon-do, Korea;
| | - Sun Woong Kim
- Department of Ophthalmology, Yonsei University Wonju College of Medicine, Wonju 26426, Gangwon-do, Korea;
- Correspondence:
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Zhou J, Xue F, Zhou X, Naidu RK, Qian Y. Correction to: Thickness profiles of the corneal epithelium along the steep and flat meridians of astigmatic corneas after orthokeratology. BMC Ophthalmol 2020; 20:338. [PMID: 32811455 PMCID: PMC7433141 DOI: 10.1186/s12886-020-01607-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
An amendment to this paper has been published and can be accessed via the original article.
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Affiliation(s)
- Jiaqi Zhou
- Department of Ophthalmology, Eye and ENT Hospital, Fudan University; Key Laboratory of Myopia of The State Health Ministry, 200031, 83 Fenyang Road, Shanghai, People's Republic of China
| | - Feng Xue
- Department of Ophthalmology, Eye and ENT Hospital, Fudan University; Key Laboratory of Myopia of The State Health Ministry, 200031, 83 Fenyang Road, Shanghai, People's Republic of China
| | - Xingtao Zhou
- Department of Ophthalmology, Eye and ENT Hospital, Fudan University; Key Laboratory of Myopia of The State Health Ministry, 200031, 83 Fenyang Road, Shanghai, People's Republic of China
| | | | - Yishan Qian
- Department of Ophthalmology, Eye and ENT Hospital, Fudan University; Key Laboratory of Myopia of The State Health Ministry, 200031, 83 Fenyang Road, Shanghai, People's Republic of China.
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