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Objective:To conduct a systematic review of clinical manifestations, treatment, and associated genotyping of Sorsby fundus dystrophy (SFD).Methods:An evidence-based medicine study. Sorsby fundus dystrophy, anti-vascular endothelial growth factor therapy, choroidal neovascularization, macular neovascularization, and TIMP3 gene were hereby used as search terms. Relevant literature was searched in CNKI, Wanfang, PubMed of the National Library of Medicine, and Embase of the Netherlands. The time span for literature searching ranged from the establishment of the database to April 2022, and two reviewers independently screened the literature and extracted relevant data, with duplicates, incomplete or irrelevant articles, and review articles excluded. SPSS26.0 software was used for analysis. The 95% confidence interval ( CI) was used as an estimate of the effect size. The clinical manifestations, treatment and related pathogenic genes of SFD were counted and recorded. Results:According to the search strategy, 157 pieces of literature were initially retrieved, and 49 eyes of 35 patients from 16 articles were finally included for analysis, among which, 17 patients were male, 13 patients were female, and 5 patients were unknown gender; 16 involved left eyes, 19 involved right eyes, and 14 involved unidentified eyes. The age of the disease onset was 42.33±2.19 years (28-59) years old. There were 19 cases with a positive family history, and the total positive rate was 54.3% (19/35, 95% CI 36%-72%). There were 31 cases of gene mutation, all of which were TIMP3. In the included literature, there were 2 and 2 cases with no mutation and unreported loci, respectively, with a total positive rate of 93.9% (31/33, 95% CI 85%-100%). Among the 31 cases with gene mutation, 22, 4, 1, and 4 cases were in the UK, Germany, Switzerland, and Chinese, respectively, and the detection rates were all 100% (22/22, 4/4, 1/1, 4/4). The clinical manifestations of SFD were mainly yellow-white deposits in the fundus and choroidal neovascularization (CNV) in the macula, thereby leading to a decrease in central vision, followed by the expansion of the deposits to the periphery, the further development of CNV, and a severe decline in vision caused by peripheral retinal and choroidal atrophy. The treatment methods for SFD include photodymatic therapy, anti-VEGF drugs, glucocorticoids, vitamin A, etc., among which, anti-VEGF drugs were considered the first-line treatment, and the combined treatment was provided with a better prognosis than a single treatment. Conclusions:Variations in the TIMP3 gene cause SFD, the fundus characteristic manifestations of which, are yellowish-white deposits and CNV, which develop from the center to the periphery, thus resulting in progressive decline of visual acuity. Current studies have shown that combined therapy presents a better prognosis than monotherapy.
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At present, the contents and class hours of contact lens course cannot meet the teaching and clinical requirements. Therefore, the curriculum of contact lens on practical operation was optimized, the number of practice hours was increased, and various models for practice course were applied, including problem-based learning, community practice course, and practice enhancement course, to improve students' learning interest and initiative. A variety of evaluation models were used to help teachers understand the performances of their students and make adjustments in the process of teaching and evaluation, so as to improve students' score of practical test, help them better master the practical skills and enter clinical practice without difficulties. The feedback scores of teachers in clinical practice have also been improved compared with the former ones.
ABSTRACT
At present, the contents and class hours of contact lens course cannot meet the teaching and clinical requirements. Therefore, the curriculum of contact lens on practical operation was optimized, the number of practice hours was increased, and various models for practice course were applied, including problem-based learning, community practice course, and practice enhancement course, to improve students' learning interest and initiative. A variety of evaluation models were used to help teachers understand the performances of their students and make adjustments in the process of teaching and evaluation, so as to improve students' score of practical test , help them better master the practical skills and enter clinical practice without difficulties. The feedback scores of teachers in clinical practice have also been improved compared with the former ones.
ABSTRACT
The aim of this study was to investigate the feasibility of anterior segment optical coherence tomography to assess the anterior segment morphology of hyperopia in school-aged children. 320 eyes of 160 school-aged children, 6-12 years of age, were examined with anterior segment optical coherence tomography and were divided into four groups according to the cycloplegic spherical equivalence of refractive error. The mentioned four groups were: emmetropia group, low hyperopia group, moderate hyperopia group and high hyperopia group. The measurements of central corneal thickness, anterior chamber depth, angle opening distance, trabecular iris space area and scleral angle were compared in pairs among objects in the four groups. The results showed that high hyperopia and moderate hyperopia had shallower anterior chamber depth and narrower anterior chamber angle compared to those in emmetropia group. The study also showed that anterior segment optical coherence tomography as a non-contact technology could become a new technology for accessing the anterior segment morphology of hyperopia in school-aged children.
Subject(s)
Child , Humans , Anterior Chamber , Pathology , Eye Diseases, Hereditary , Diagnosis , Hyperopia , Diagnosis , Tomography, Optical CoherenceABSTRACT
Higher order aberrations (HOAs) were measured in 54 anisometropic amblyopic children using the ZY-WAVE II aberrometer. The results were compared in normal fellow and amblyoic eyes which were determined by the corrected visual acuity. Between the normal eyes and anisometropic amblyopic eyes, no statistically significant difference were found in mean root square of total HOAs, total coma (TC), total spherical aberration (TSA), and the 5th root mean square (RMS5). There was no correlation among best corrected visual acuity (BCVA), HOAs, TC, TSA, and RMS5. There was some positively correlation between the degree of anisometropia and TC. HOAs increase with the increasing of the degree of anisometropic amblyopia. Lower order aberrations are the main refractive factors leading to amblyopia, and HOAs is related to anisometropia amblyopia. The study helps us understand the mechanism of amblyopia and make the further study.
Subject(s)
Adolescent , Child , Female , Humans , Male , Aberrometry , Amblyopia , Diagnosis , Corneal Wavefront Aberration , Refraction, Ocular , Physiology , Visual Acuity , PhysiologyABSTRACT
In order to understand the roles of the other subunits, we investigated expression of the NMDA receptor subunits (NR2A and NR2B) in visual cortex of normal and anisometropic amblyopia kittens with different ages in the present study. We examined the expressions of NR2A and NR2B in the visual cortex of the kittens by immunohistochemistry with polyclonal anti-NR2A antibody and anti-NR2B antibody, respectively. Using immunohisto-chemical Streptavidin Perosidase (SP) method, we observed the dynamic changes of NR2A and NR2B with microscope and computer-assisted image analyses. We found that NR2A and NR2B remained low expression after the peak of the critical period of kitten visual development; compared with normal group of the same age, NR2A expresses low. However, the difference is not significant for NR2B before maturation period of visual development. NR2B rises after the maturation period of visual development. According to this, the component of NR2A and NR2B can be affected by anisometropia. This research suggests that the difference of NR2A and NR2B expressions may affect the formation of amblyopia.
Subject(s)
Animals , Cats , Female , Male , Amblyopia , Metabolism , Receptors, N-Methyl-D-Aspartate , Genetics , Metabolism , Vision, Ocular , Physiology , Visual Cortex , MetabolismABSTRACT
This experimental study sought to determine the repeatability of a Video Keratography System specially designed for animals with small eyes. From day 5, ten newly hatched White Leghorn chicks were reared with monocular hyperopic defocus using -5.0D (n = 3), -10.0D (n = 3), -15.0D(n = 4) spherical PMMA lenses on their right eyes; the left eyes served as controls. Two sets of corneal topographical measurements, each set separated by about 5 minutes apart, were collected from both eyes of each animal at the end of 2-wk treatment period (i. e., 19 days of age). Each set of measurements consisted of five consecutive readings of corneal astigmatism. Bland-Altman plots were used to evaluate the repeatability of 3, 4 or all 5 readings from each set of data. When all 5 consecutive readings were used, the mean difference (95% limits of agreement) for the right treated and left untreated eyes were, respectively, -0.09D (-0.81, 0.64) and -0.02D (-0.86, 0.82). There was a tendency that lesser readings from each set of data produced greater difference between the two sets of measurements, although the differences (-0.19D) were not clinically significant. The Video Keratography System specially designed for animals with small eyes produced repeatable measurements for both treated and untreated eyes in chickens. Further studies are needed to validate other biometric features associated with corneal changes during normal and abnormal eye growth.
Subject(s)
Animals , Astigmatism , Diagnosis , Chickens , Cornea , Corneal Topography , Equipment DesignABSTRACT
Purpose To investigate the association between the macular volume and thickness,as assessed by optical coherence tomography(OCT),with refraction state and axial length(AL)in children.Methods A total of 100 normal children whose right eyes were randomly selected were divided into five groups due to their refraction,comprising hyperopia,emmetropia,low myopia,moderate myopia,high myopia.The AL of the eyes was measured by IOL master measuring machine.Then the macular volume and thickness were measured bv OCT.Results Children with high myopia have smaller macular volume and thinner parafoveal retinal thickness(especially out-ring macular).The minimum thickness and average thickness of the fovea were not significantly different among the five groups.The macular volume ,total average macular thickness and quadrant-specific macular thickness(except the nasal inner quadrants)were positively associated with refraction and negatively associated with AL,while there were no correlation between minimum foveal thickness,the average foveal thickness and refraction or AL.Conclusions In Chinese children,increasing axial length was associated with reduced maeular volume and thickness(except the foveal region and the nasal inner quadrant).