The clinical characteristic analysis of idiopathic hypotony maculopathy in a series of 18 patients / 中华眼底病杂志

Objective To summarize the clinical features in idiopathic hypotony maculopathy.Methods A retrospective case series study.Eighteen eyes of 18 patients who were diagnosed with idiopathic hypotony maculopathy were enrolled in the Second Affiliated Hospital of Wenzhou Medical University from August 2012 to December 2017.There were 8 males (8 eyes) and 10 females (10 eyes).All patients underwent examinations including BCVA,optometry,slit lamp microscope,fundus color photography,UBM,B-mode ultrasound,OCT,FFA and axial length (AL).BCVA was recorded with logMAR acuity.The results of affected eyes and contralateral healthy eyes were compared.Paired t test was performed to compare the intraocular pressure (IOP),diopter and AL of the affected eyes and contralateral healthy eyes.Results Among 18 eyes,there were 6 eyes with logMAR BCVA＜ 1.0,10 eyes with logMAR BCVA 1.0-2.0,2 eyes with light perception.The average diopter was +2.32± 1.78 D.The average IOP was 5.18± 1.38 mmHg (1 mmHg=0.133 kPa).The average AL was 20.92± 1.61 mm.The differences of IOP (t=21.6,P＜ 0.000),diopter (t=5.9,P=0.002) and AL (t=9.13,P＜0.000) between the affected eyes and contralateral healthy eyes were significant.The inflammatory reaction in the anterior segment was observed in 13 eyes (72.22％).In the posterior segment,all the eyes were documented with chorioretinal folds,optic disc swelling and retinal phlebectasia were also demonstrated in 14 eyes,while with macular uplift in 7 eyes.In the UBM and gonioscope examination,the angle chamber was open in all patients with ciliary body cyst in 6 eyes,while no ciliary body detachment was detected.All eyes had been examined with B-scan ultrasound and found the increasing thickness of eye ball in all eyes,and nodular changes in the optic papilla in 5 eyes.The chorioretinal folds were further confirmed by OCT with the appearance of the gear shape,much more obviously in the chomid than that in retina.In the FFA,fluorescein leakage was found around the optic disc in 13 eyes at the late stage,while there was no obvious abnormal leakage in the macular or poster part of retina.Conclusions Idiopathic hypotony maculopathy could present with various clinical manifestations.The choroiretinal folds is typical clinical sign.

Clinical analysis of 12 posterior scleritis patients with an initial symptom of affected optic nerve / 中华眼底病杂志

Objective To summarize the clinical features and visual outcome of posterior scleritis presented with symptoms involving affected optic nerve.Methods Retrospective case series study.Twelve eyes of 12 female patients with posterior scleritis were included in this study.The average age was 35.2± 14.31 years old.The patients got diagnosed with an average of 24.75 ± 22.91 days.Ocular pain was complained in all patients,and blurred vision in 11 patients.The best corrected visual acuity (BCVA),intraocular pressure (IOP),slit lamp microscope examination,B-scan ultrasound,optical coherence tomography (OCT),fundus photography,fundus fluorescein angiography (FFA) and ocular wall thickness measurement were performed in all patients.Nine eyes received visual field examination.All patients received systemic corticosteroid and steroidal eye drops for 3 months.Clinical features and outcome were retrospectively studied.Results Before treatment,the BCVA was from ＜0.1 to ＞0.8.There were 3 eyes with scleral hyperemia,3 eyes with anterior chamber flares,12 eyes with papilledema and different degrees of retinal vein dilatation,3 eyes with star-shaped macular exudates and 2 eyes with macular retinal pigment epithelium detachment.B-scan ultrasound demonstrated that the ocular walls were thickening in all eyes with typical T-sign,and the average thickness was 2.76± 0.68 mm.OCT demonstrated optic disc swelling,and the macular retinal detachment in 2 eyes.In the FFA examination,the fluorescein leakage of the disc was enhanced with time.In the Humphrey test,the value of mean deviation (MD) was 12.56± 5.73 dB and pattern standard deviation (PSD) was 8.15±4.23 dB in 9 eyes before the treatment.After treatment for 3 months,the symptoms were attenuated and the visual acuity was obviously improved with BCVA＞0.1 in all eyes.Scleral hyperemia and anterior chamber flares were only found in 1 eye.The optic disc edema gradually faded away.The ocular wall thickness in the poster part of the eyeball decreased,and the T-sign disappeared in all eyes,the average thickness was 1.53±0.41 mm.Compared with parameters before the treatment,the difference was statistically significant (t=0.003 5,P＜0.05).OCT demonstrated the recovery of the macular retinal detachment.There was no abnormal leakage evidenced in FFA in the optic disc and macular.After treatment,the value of MD and PSD was 5.19±4.82 dB and (4.33 ±3.76) dB,respectively.The difference of MD value between before and after the treatment was significant (t=0.026,P＜0.05).Conclusions Posterior scleritis with an initial symptom of optic nerve was tend to affect middle-aged patients,with clinical manifestations of anterior segment signs in some patients and optic disc swelling with retinal vein dilatation in all patients.B ultrasound examination showed typical T sign.Systemic corticosteroid treatment always obtained remission of the ocular inflammatory activity,and could achieve favorable visual outcome.

Clinical Assessment of 20G and 23G Vitrectomy for Treatment of Posterior Segment Intraocular Foreign Bodies / 中山大学学报(医学科学版)

[Objective] To analyze the clinical curative effect of 20G and 23G vitrectomy for posterior segment intraocular foreign bodies,to explore the differences of their efficacy and safety.[Methods] This was a retrospective case study.Select 71 patients (71 eyes) who suffered from posterior segment intraocular foreign bodies and underwent different ways of vitrectomy,according to the way of vitrectomy,the patients were enrolled into 20G vitrectomy group (20G group,37 patients,37 eyes) and 23G vitrectomy group (23G group,34 patients,34 eyes).All patients were given wound suture,and patients complicated traumatic cataract should underwent cataract surgery;then were given 20G/23G vitrectomy and extraction of intraction foreign bodies,and (or) be given retinal laser photocoagulation,cryocoagulation,and endotamponade during the procedure.Extraction of intraction foreign bodies and the location of retinal,surgical time,postoperative inflammation and stimulus syndrome,length of hospital stay,the best corrected acuity (BCVA) and other complications after surgery were registered.Minimum follow-up was 6 months.[Results] The rate of extraction of intraction foreign bodies and early retinal reattachment rate were 100％ of the two groups.Comparing the complications after surgery between the two groups,the differences had no statistical significance (all P ＞ 0.05) except the incidence of postoperative ocular hypotenison.The significant difference was found in the comparison of surgical time,average hospitalizcd days,postoperative inflammation score and stimulus syndrome between the two groups,and there were significant differences when the vision distribution before and after surgery in two groups were self-compared (P ＜ 0.05).At lastest follow up,the differences had no statistical significance when comparing the cases of unplanned surgical reoperation,the location of retinal and the vision distribution between the two groups (P ＞ 0.05).[Conclusion] 20G and 23G vitrectomy are both safely and effectively performed in patients with posterior segment intraocular foreign bodies,the efficacy and safety of them are comparable.There is higher incidence of postoperative ocular hypotension in 23G group,and it has an ascendant than 20G group in shorter surgical time and length of hospital stay,lighter postoperative inflamnation and stimulus syndrome.

Clinical Efficacy of Integrated Traditional Chinese and Western Medicines in the Treatment of Patients with Ocular Herpes Zoster / 中国药师

Objective:To observe the clinical curative effect of integrated traditional Chinese and western medicine in the treat-ment of patients with ocular herpes zoster. Methods:Seventy patients with ocular herpes zoster in our hospital were selected during De-cember 2011 to December 2013. According to random number table,the patients were divided into two groups. The patients in the con-trol group were treated with ganciclovir 5. 0 mg·kg-1 ·h-1 , ivd, qd and ganciclovir ophthalmic gel, qid. The patients in the observa-tion group were treated with Banlangen granules and acupuncture additionally. The clinical efficacy, the time of blistering, pain and crusting and adverse reactions in the two groups were observed and compared. Results:After the treatment, the effective rate of the ob-servation group was 94. 29% , while that of the control group was 77. 14% (P0. 05). Conclusion:The clinical efficacy of integrated traditional Chinese and western medicine in the treatment of ocular herpes zoster is obviously better than that of western medicine treat-ment alone with fewer adverse reactions and shorter time of blistering, pain and crusting.

Imaging and measuring system of the accommodation of eye based on the optical coherence tomography / 中国医疗器械杂志

<p><b>OBJECTIVE</b>To develop a spectral-domain optical coherence tomography (SD-OCT) system, for precisely imaging the accommodation of the anterior segment of the human eye.</p><p><b>METHODS</b>Design the SD-OCT system based on two Michelson interferometer by using the basic principal of weak coherent light interference and modular design of dual channel dual focus.</p><p><b>RESULTS</b>The system can provide simultaneous cross-sectional imaging of all the surfaces of the anterior segment of the eye including the cornea, anterior chamber, anterior and posterior surfaces of the crystalline lens. Thus, the dynamic change of modification of the curvatures can be calculated in real time.</p><p><b>CONCLUSIONS</b>The system was successfully tested in imaging accommodation, with high resolution and non contact. The preliminary results demonstrated the feasibility of this novel approach to measure the eye parameters.</p>

The changes of multifocal electroretinography in commotio retinae / 中华眼底病杂志

Objective To observe the changes of the multifocal electroretinograph (mf-ERG) in commotio retinae. Methods The affected eyes (traumatic group) and the fellow eyes (control group) of 31 patients with unilateral commotio retinae were examined by RETI scan 3.15 system. The responses of 61 retinal regions were recorded, and the average amplitude densities of the N 1 (the first negative) wave and P 1 (the first positive) wave in different regions of retinal were analyzed. Results The average amplitude densities of 1-4 rings in N 1 wave and 1-5 rings in P 1 wave were much lower in traumatic group than those in the control. Conclusions The average amplitude densities of N 1 wave and P 1 wave of mf-ERG in retinal affected regions decreases markedly in eyes with commotio retina; mf-ERG may provide the quantificational and orientational detection for the visual ability of the eyes with commotio retinae.

The changes of multifocal electroretinogram of the affected and fellow eyes of the patients with central serous chorioretinopathy / 中华眼底病杂志

ObjectiveTo evaluate the retinal function with central serous chorioretinopathy (CSC) and the fellow eyes (mf-ERG).MethodsTwenty patients (40 eyes) with unilateral CSC, diagnosed by fluorescein angiography, were examined on each eye of the patients by mf-ERG multifocal electroretinography. The patients aged from 31 to 53 (13 men, 7 women; mean age, 41 years), and the CSC eyes had visual acuities of 0.2 to 0.8. None of the patients had significant abnormality in the fellow eyes with visual acuities of 0.8 to 1.5. Twenty-four healthy people (29 normal eyes with visual acuities of 1.0 and more and without any retinal diseases) were studied simultaneously as the normal control. The stimulus matrix of 61 hexagonal elements were grouped into 5 concentric rings from the fovea outward to 30? of the degree of visual field. The first-order responses of mf-ERG were recorded. The first negative wave (N 1-wave) and positive wave (P-wave) of the mf-ERG were measured. Amplitude intensities and latechies for the two configurations were calculated and compared.ResultsCompared with the control eyes, the responses were not only depressed severely in P 1- and N 1-wave amplitude intensities in the ring 1~3 in the CSC eyes with CSC (P0.05). There were no significant differences in N 1- and P 1-wave latencies in 5 concentric rings among the control eyes, the fellow eyes or the CSC eyes.ConclusionsCSC is a kind of macular disease involving both eyes. It may cause the decrease of retinal function in macular area of CSC eyes and also influence the retinal function in macular area of the fellow eyes. mf-ERG is a sensitive way in examining visual function.