DTI analysis on white matter changes in children with ametropic amblyopia / 眼科新进展

Objective To evaluate white matter nerve fiber changes of children with binocular ametropic amblyopia by applying the technology of diffusion tensor imaging and the whole brain analysis method of deterministic tractography,and analyze its correlation with visual acuity.Methods Fourteen binocular ametropic amblyopia children was collected from the Second Xiangya Hospital of Central South University as study subject of experimental group,14 cases of normal sight children as the control group.All children were scanned by MRI system,conventional MRI examination,3DTlWI scan were made,then echo-planar sequence scanning was used to obtain diffusion tensor imaging.Quantitative analysis was made to all diffusion tensor imaging using deterministic tractography.Using the experimental group tracts with statistic changes of FA value,volume and tract count as the region of interest(ROI),the correlation analysis with vision for each ROI was performed.Results Isoametropic amblyopia children demonstrated low FA values in the right ventral and dorsal pathway,right optic radiation and corpus callosum compared to control group.There was low volume of fibers in the bilateral ventral and dorsal pathway,the left optic radiation and body of corpus callosum compared to control group.The tract count of right dorsal pathway had reduced compared to control group.Among FA value,tract count and volume,FA value had the maximum regression coefficient with visual acuity,the regression coefficient of tract count and volume was small.The relative correlation coefficient of FA value at right optic radiation,right ventral pathway and body of corpus callosum with vision acuity were 0.486,0.534 and 0.456,respectively,the right ventral pathway had the maximum correlation with visual acuity.Conclusion Isoametropic amblyopia patients shows abnormal structure on bilateral optic radiation,bilateral ventral and dorsal pathway and body of corpus cailosum,these may cause the capability loss of object recognition and spatial position recognition.The FA value of right ventral pathway has the maximum influence on visual acuity.

Application of Icare rebound tonometer in children after congenital cataract surgery / 中南大学学报(医学版)

OBJECTIVE@#To compare the difference in intraocular pressure (IOP) readings as well as the tolerability between Icare rebound tonometer (Icare RBT) and Goldmann applanation tonometer (GAT), and to evaluate the application of Icare RBT in monitoring the intraocular pressure in children after congenital cataract surgery.@*METHODS@#The IOP was measured with the Icare RBT and GAT respectively in 150 children (262 eyes) after congenital cataract surgery by two experienced ophthalmologists. Correlation and Bland-Altman analysis were used to assess the agreement in IOP readings between the two instruments. The influence of the central corneal thickness (CCT) adjusted for age on IOP readings was analyzed by linear regression analysis. The tolerance of the patients to Icare RBT and GAT measurement were surveyed.@*RESULTS@#The mean age was (44.82 ± 11.56) months in 150 children, including 81 boys and 69 girls. The mean IOP readings by the Icare RBT and GAT were (16.08 ± 5.72) mmHg and (14.17 ± 5.05) mmHg, respectively. The mean difference between the Icare RBT and GAT was (1.91 ± 2.04) mmHg, which was significantly correlated with CCT (r=0.409, P<0.001). The IOP readings by Icare RBT was significantly correlated with that measured by GAT(r= 0.936, P<0.001). The 95% confidence interval of the difference between the two instruments was ?2.10 to 5.91 mmHg. The Icare RBT examination was well tolerated by the children compared to the GAT examination.@*CONCLUSION@#The Icare RBT is easy to use and well tolerated by the children after congenital cataract surgery. Compared to GAT, the value measured by the IOPs trends to be overestimated. The difference in readings between the 2 tonometers will magnify with the increase in CCT.

Pattern visual evoked potentials in normal-vision eyes of post-therapy amblyopia / 中南大学学报(医学版)

Objective:To evaluate the clinical significance of pattern visual evoked potential (P-VEP) parameters on amblyopic patients with normal-vision atfer pleoptic therapy. Methods:We investigated 60 amblyopic children (8-12 years old) who gained normal-vision atfer pleoptic therapy. hTese patients were assigned to a unilateral amblyopia group (40 patients)and a bilateral amblyopia group (20 patients). Another 20 healthy children served as a control group. All patients underwent a full initial ophthalmologic and orthoptic evaluation. P-VEP test was performed in all. Amplitude and latencies were analyzed and compared among groups. The latencies of P100 waves in the amblyopic eyes were used to generate a multiple linear regression formula from sex, ifrst treatment age, baseline visual acuity, and cycloplegic refraction. Results:hTere was no signiifcant difference in the mean levels of best-corrected visual acuity among groups (P>0.05). A signiifcant prolongation of the latency and a decrease of amplitude of P100 waves were observed in the unilateral amblyopia group and the bilateral amblyopia group compared with the healthy control group (P<0.05). Amplitude and latencies of the fellow eyes in the unilateral amblyopia group were abnormal compared with the healthy control group (P<0.05). Multiple linear regression analysis revealed that the latencies of P100 waves were signiifcantly correlated with the ifrst treatment age, baseline visual acuity, and cycloplegic refraction (R2=0.52, P<0.05). Conclusion:Deifcits exist in the fellow eyes and in normal-vision eyes atfer pleoptic therapy. hTe delayed P100 latency is affected by the ifrst treatment age, baseline visual acuity, and cycloplegic refraction. Traditional amblyopic therapy may be not enough for vision function recovery.

Diagnosis and management of lipogranuloma of the eyelids from nasal endoscopic surgery / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To enhance the safety of nasal endoscopic surgery and decrease its complications of eyes.@*METHOD@#Three patients of chronic rhinosinusitis and nasal polyposis with lipogranulomas of the eyelids after nasal endoscopic surgery and nasal packing of petrolatum gauze were reported and analyzed, and their treatment results were presented during the last 2 years.@*RESULT@#The medial orbital wall injury occurred in all three patients during endoscopic sinus surgery. The patients developed an ipsilateral periocular swelling, eyelid hematoma and palpebral conjunctival edema during 2 to 3 hours after surgery. Nasal packs petrolatum gauze were removed 10-24 hours after surgery. The patients were discharged from hospital when periorbital swelling and eyelid ecchymoma disappeared, and nasal cavity obstruction was improved 6 to 8 days after surgery. The swelling and nodular mass of ipsilateral eyelids (one in left upper eyelid and two in right lower eyelid) were found 12-15 days after surgery, and their eye movement and eyesight were normal. Antibiotic and corticosteroid were administered for 3 4 weeks with only improvement in eyelid swelling. These masses of eyelids were completely excised through palpebral margin 1-6 months after surgery. The histopathological examination of the surgical specimens showed lipogranuloma. No recurrence and symptom of the eyes had been observed during 4-18 months follow up.@*CONCLUSION@#The lipogranuloma of the eyelid is a rare and late complication after nasal endoscopic surgery and nasal packing with vaspetrolatum gauze. The medial orbital wall injury and bleeding during surgery, and vaseline of nasal packing permeated into the eyelid are the direct causes of this complication. The application of petrolatum gauze should be avoided when the medial orbital wall trauma is identified. The complete excision of granulomas is a best effective therapy.

Magnetic resonance imaging and ultrasonography in 6 cases of spontaneous ocular hemorrhage / 眼科

Objective To improve the accuracy with magnetic resonance imaging (MRI) diagnosis of spontaneous intraocular hemorrhage. Design Retrospective case series. Participants 6 patients with spontaneous intraocular hemorrhage. Methods The image findings were retrospectively analyzed in 6 patients confirmed by surgery with or without pathology. All of them were examined with ultrasonography and 5 cases with color ultrasonography. MRI was performed in 6 cases,and enhanced MRI in 5 cases. Main Outcome Measures Configuration,signal intense,characteristics of enhancement signal and ultrasonograph. Results 1 case was crescent shape on MRI of spontaneous intraocular hemorrhage,2 cases were lenticular shape,3 cases were hump shape. 2 cases showed high signal intensity on T1WI,and low signal on T2WI. 2 cases showed high signal on both T1 and T2WI. 2 cases showed low signal on T1WI,and high signal intensity on T2WI. 2 cases presented a ring with hypointensity on T2WI. No enhancement was revealed within the lesions in 5 cases. Liner enhancement was showed in 2 cases; ring enhancement was showed in 1 case. 2 cases were corrected diagnosed by MRI,2 cases were misdiagnosed as melanoma,and 2 cases were misdiagnosed as tumor concomitant hemorrhage,and all cases were diagnosed as tumor with ultrasonography. With color Doppler imaging 4 cases were correctly diagnosed as hemorrhage based on without blood-flow signal,and 1 case was diagnosed as tumor. Conclusions The MRI signal characteristic of spontaneous ocular hemorrhage is variable,and the main feature is no enhancement within the lesion. MRI combined with ultrasonography can make the diagnosis more correctly.