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Objective:To evaluate the feasibility of measurement and characteristics of intraocular lens (IOL) tilt using the swept-source optical coherence tomography (SS-OCT) biometer (IOLMaster 700) and to explore its potentially relevant parameters.Methods:A cross-sectional study was conducted.Two hundred and forty-two eyes (119 right eyes, 123 left eyes) of 185 patients after phacoemulsification and IOL implantation were included in Beijing Tongren Hospital from July to September 2018.The IOL position, angle κ, angle α, corneal curvature, anterior chamber depth (ACD), pupil diameter (PD), and axial length (AL) were obtained by IOLMaster 700, and the IOL tilt direction and magnitude were calculated.The within-subject standard deviation and intraclass correlation coefficient were used to evaluate the repeatability of three IOL tilt measurements.Binocular symmetry of IOL tilt and the correlation between IOL tilt and different influencing factors were evaluated by Pearson linear correlation analysis or Spearman rank correlation analysis.Influencing factors for IOL tilt were assessed by multiple linear regression analysis.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Beijing Tongren Hospital, Capital Medical University (No.TRECKY2018-049). Patients were informed of the purpose and methods of this study and signed the written informed consent.Results:The repeatability of IOL tilt measurements was excellent with a within-subject standard deviation of 5.16° for IOL tilt direction and 0.13° for IOL tilt magnitude.IOL tilt was mirror symmetric in both eyes.The IOL tilt direction in right eyes ranged from -89.60° to 87.53° with a mean of (18.85±29.65)°, and the tilt magnitude ranged from 1.32° to 7.05° with a mean of (4.16±1.26)°.The IOL tilt direction in left eyes ranged from -84.30° to 89.44° with a mean of (21.17±32.38)°, and the tilt magnitude ranged from 0.58° to 7.40° with a mean of (3.80±1.31)°.There were moderate and weak positive correlations of IOL tilt direction and tilt magnitude between both eyes ( r=0.473, P<0.001; r=0.335, P=0.011). IOL tilt magnitude was weakly positively correlated with angle α and IOL diopter ( rs=0.272, P=0.003; r=0.285, P=0.002), and was weakly negatively correlated with ACD, PD and AL ( r=-0.303, P=0.001; r=-0.233, P=0.011; rs=-0.331, P<0.001). In backward stepwise regression analysis, the regression equation of IOL tilt magnitude, angle α, ACD, PD, AL and IOL diopter in multiple linear regression analysis was as follows: IOL tilt magnitude=10.503+ 1.456×angle α-0.532×ACD-0.196×AL ( R2=0.400; F=8.588, P<0.001). Conclusions:The SS-OCT biometer can be an effective method to assess IOL tilt.IOL tilt is mirror symmetric between the right eyes and left eyes.
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Objective:To analyze the ultrasonographic features of adenoma of the nonpigmented ciliary epithelium (ANPCE).Methods:A retrospective series of case studies. From January 2014 to October 2021, 31 patients (31 eyes) with ANPCE (ANPCE group) were diagnosed in the eye center of Beijing Tongren Eye Center of Beijing Tongren Hospital, Capital Medical University, and 17 patients (17 eyes) with ciliary body melanoma (control group) diagnosed at the same time were selected as the control group. There was no significant difference in age ( t=-0.564) and sex composition ratio ( χ 2=0.182) between the two groups ( P=0.576, 0.670). All patients underwent ultrasound biomicroscopy to obtain the measurement parameters: tumor height, maximum basal diameter, maximum diameter, ratio of maximum diameter to basal diameter and ratio of maximum diameter to height; tumor location, shape, internal echogenicity intensity, echogenicity uniformity, degree of sound attenuation, invasion of iris, anterior displacement of the iris, lens subluxation were observed. The measurement parameters and observation indexes of the two groups were compared by independent sample t-test and χ 2 test. Receiver operating characteristic (ROC) curve was drawn, area under the ROC curve (AUC) was determined, and parameter indicators with differential diagnosis value were screened. Results:The maximum diameter, height, maximum basal diameter, ratio of the maximum diameter to the maximum basal diameter, and the ratio of the maximum diameter to the height of the tumors in the ANPCE group and the control group were 5.64±0.98 mm, 4.24±0.59 mm, 3.66±0.71 mm, 1.58±0.34, 1.34±0.19 and 7.82±2.03 mm, 4.47±2.44 mm, 7.02±1.96 mm, 1.13±0.16, 2.09±1.06. The maximum diameter, the maximum basal diameter, and the ratio of the maximum diameter to the height of the tumor in the ANPCE group were all smaller than those of the control group, and the ratio of the maximum diameter to the maximum basal diameter was greater than that of the control group, and the differences were statistically significant ( t=-4.159,-6.808, -2.924, 6.257; P<0.05). The tumors in the ANPCE group were mainly spherical (87.1%, 27/31), with no significant acoustic attenuation (77.4%, 24/31), less invading the root iris (77.4%, 24/31), and the tumors were mostly located in the ciliary body coronal (74.2%, 23/31); tumors in the control group were mainly hemispherical (47.1%, 8/17) or spherical (47.1%, 8/17), with significant sound attenuation (76.5%, 13/17), most of the tumors invaded the iris (70.6%, 12/17), and the tumors were mostly located from the pars plana to the coronal (76.5%, 13/17). There were statistically significant differences in the position, shape, sound attenuation degree, and whether it invaded the iris between the two groups of eyes ( χ 2=15.132, 19.767, 13.118, 10.581; P<0.05). The results of ROC curve analysis showed that the ratio of the largest diameter to the largest base diameter, the degree of sound attenuation and the AUC of whether the iris was violated were higher, which were 0.881, 0.769, and 0.740, respectively. Conclusions:Ultrasound biomicroscopy is helpful in the diagnosis and differential diagnosis of ANPCE and ciliary body melanoma. The ratio of maximum diameter to maximum basal diameter, the degree of sound attenuation and whether it invades the root iris are important parameters to distinguish the two tumors.
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Objective:To discuss the characteristics of ultrasound diagnosis of optic disc capillary hemangioma.Methods:The study analyzed retrospectively 7 cases of optic disc capillary hemangioma diagnosed in the Beijing Tongren Hospital from 2015 to 2018. The size, morphology, internal echo, and secondary changes of the lesion were analyzed during ultrasound examination.Color Doppler flow imaging was used to check the blood flow in the lesion.Results:Pre-optic disc occupying lesions could be detected in the ultrasound images of the 7 cases. Lesion size: average base diameters (5.39±1.90)mm×(4.79±1.28)mm, average height (3.61±1.37)mm. Lesion morphology: 5 cases were round, and 2 cases were irregular. Echo within the lesion: 3 cases had medium echo inside the lesion, and 4 cases had high echo inside the lesion. Internal echo characteristics: 5 cases had uniform echo, and 2 cases had uneven echo. Secondary changes: 6 cases had secondary retinal detachment and vitreous opacity, and 1 cases was accompanied by retinal hemangioma in other parts. In all cases, blood flow signals could be detected inside the space-occupying lesions, which were in the form of branches, stripes or spots, and the blood flow spectrum showed a parallel spectrum of arteries and veins.Conclusions:Ultrasound examination of optic disc capillary hemangioma has certain characteristics, which can provide a valuable follow-up basis for clinical diagnosis.
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OBJECTIVE@#To detect variant of the CD40L gene and infection of Jamestown Canyon virus (JCV) in a 7-year-and-9-month-old boy with co-commitment progressive multifocal leukoencephalopathy (PML) and X-linked hyper IgM syndrome (XHIGM).@*METHODS@#Peripheral blood samples of the child and his parents were collected for the extraction of genomic DNA. The 5 exons and exon/intronic boundaries of the CD40L gene were subjected to PCR amplification and sequencing. Suspected variants were analyzed by using bioinformatic software. The JCV gene was amplified from genomic DNA by nested PCR and sequenced.@*RESULTS@#The child was found to harbor a hemizygous c.506 A>C (p.Y169S) missense variant in exon 5 of the CD40L gene. The variant may affect the TNFH domain of the CD40L protein and result in structural instability and loss of hydrophobic interaction between CD40L and CD40. As predicted by PolyPhen2 and SIFT software, the variant was probably damaging (score = 1.00) and deleterious (score= -8.868). His mother was found to be a heterozygous carrier, while the same variant was not found in his father. Gel electrophoresis of the nested PCR product revealed presence of target JCV band, which was confirmed to be 99% identical with the JCV gene by sequencing.@*CONCLUSION@#The patient was diagnosed with co-commitment XHIGM and PML based on the testing of the CD40L gene and JCV infection.
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Adulto , Criança , Feminino , Humanos , Masculino , Ligante de CD40/genética , Éxons/genética , Síndrome de Imunodeficiência com Hiper-IgM Tipo 1/genética , Leucoencefalopatia Multifocal Progressiva/genética , Mutação de Sentido Incorreto , Reação em Cadeia da PolimeraseRESUMO
Objective:To investigate the ultrasonic features, contrast-enhanced ultrasound findings and long-term follow-up results of melanocytoma of the optic disc(MCOD).Methods:The data of 35 patients (35 eyes, 35 lesions) diagnosed with MCOD in Beijing Tongren Ophthalmic Center, Beijing Tongren Hospital from September 2012 to October 2020 were retrospectively analyzed. The B-mode ultrasonography and color Doppler flow imaging (CDFI) were performed on them. The size, morphology, internal echo and secondary changes of the lesions were analyzed. Contrast-enhanced ultrasound was performed on 13 patients. At the same time, 9 patients were followed up for long-term observation.Results:Six lesions (17.1%) showed hemispherical high echo, and 29 lesions (82.9%) showed limited uplift high echo. The largest base diameter of the lesions was (4.0±0.8)mm, average height was(1.9±0.4)mm. Internal echo characteristics: 8 lesions (22.9%) showed uniform echo and 27 lesions (77.1%) showed uneven echo.Lesion boundary: 35 lesions (100%) showed clear lesion boundary. Fifheen lesions (42.9%) showed secondary vitreous opacity. CDFI: blood flow signals could be detected inside the lesions in 19 lesions(54.3%), and not in 16 lesions(45.7%). Contrast-enhanced ultrasound showed 11 of the 13 lesions (84.6%) were completely filled with contrast agent.Conclusions:MCOD has certain ultrasonographic characteristics, which can provide a reliable basis for clinical diagnosis and differential diagnosis. There is no significant change in tumor size after long-term follow-up.
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Objective:To analyze the perfusion characteristics of choroidal metastasis using contrast-enhanced ultrasound, and compare with choroidal hemangioma.Methods:This was a retrospective study.From January 2016 to February 2018 in Beijing Tongren Hospital, a total of 21 eyes from 21 patients who were clinically diagnosed as choroidal metastasis were included as the choroidal metastasis group and 46 eyes from 46 patients who were diagnosed as choroidal hemangioma during the same period were included as the choroidal hemangioma group. All patients underwent contrast-enhanced ultrasound examination, and Sonoliver was used to obtain the data on quantitative parameters of the tumor and the adjacent normal orbital tissues, including maximum of intensity (IMAX), rise time (RT), time to peak (TTP), and mean transit time (mTT). The quantitative parameters between choroidal metastasis and normal orbital tissues were compared. And the quantitative parameters between choroidal metastasis and choroidal hemangioma were compared. The receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic performance.Results:The IMAX of choroidal metastasis was significantly higher than that of normal orbital tissues, while RT, TTP and mTT were significantly shorter than these of normal orbital tissues (all P<0.01). The IMAX of choroidal metastasis was lower than that of choroidal hemangioma, and RT, TTP and mTT were shorter than choroidal hemangioma (all P<0.01). The ROC curve analysis showed that area under curves of the IMAX, RT, TTP and mTT were 0.775 (95% CI=0.666-0.884), 0.970 (95% CI=0.896-0.996), 0.729 (95% CI=0.607-0.831) and 0.992 (95% CI=0.931-1.000) respectively. The sensitivities were 71.7%, 95.7%, 76.1% and 95.7%, and the specificities were 85.7%, 90.5%, 66.7% and 95.2%, respectively. Conclusions:Contrast-enhanced ultrasound can reflect the differences in perfusion characteristics between choroidal metastasis and choroidal hemangioma. RT and mTT are useful parameters in differential diagnosis between the two types of tumors.
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Objective To observe the application value with color Doppler flow imaging (CDFI) in the detection ofmacular diseases in senile cataract.Methods A cross-sectional descriptive study.From December 1 to December 30,2017,720 senile cataract patients (1380 eyes) diagnosed in Beijing Tongren Eye Center were included in this study.There were 330 males (629 eyes) and 390 females (751 eyes),with the mean age of 70.35 ± 19.05 years.There were 716 right eyes and 664 left eyes,with the visual acuity 0.05-0.8.The fundus of all the patients can be observed.All patients were examined by OCT using Cirrus HD-Model 5000 produced by German Carl Zeiss company and CDFI using MyLab90 color Doppler ultrasound system produced by ESAOTE S.P.A.Comparing the detection rate of macular lesions between the two methods by using X2 test.Using statistical methods to evaluate diagnostic tests,a crosstabulation was made to compare the consistency of frequency-domain OCT and CDFI in the diagnosis of macular lesions.Logistic regression analysis of correlation between detection of CDFI macular lesions and central foveal thickness (CFT),average thickness (AT),with or without macular anterior membrane,retinal folds,retinal cystoid edema,hard exudation,macular hole or lamellar macular hole,superficial detachment of neuroepithelium,detachment of pigment epithelium,vitreous macular traction.Results Two hundreds and thirty-nine eyes (17.3％) showed macular disease by OCT,and 161 eyes (11.7％) showed the abnormal echo in the macular region by CDFI.The detection rate of the macular disease between two methods were statistically significant (χ2=851.661,P＜ 0.001),however,the consistency was well (r=0.766,P=0.000).Logistic analysis showed that the detection rate of macular lesions was related to retinal folds,cysts in retina and CFT (r=1.396,1.041,0.12;P＜0.01).Conclusion CDFI can effectively detect macular lesions that affect the visual prognosis of senile cataract patients.
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Objective:To compare the agreement of biometric parameters measured by a new swept-source optical coherence tomography IOLMaster 700 and a new Scheimpflug imaging combined with partial coherence interferometry biometer Pentacam AXL in cataractous eyes.Methods:A cross-sectional study was performed.A total of 146 eyes from 76 cataract patients were enrolled in Beijing Tongren Eye Center from 2 to 11 in January 2018, including 69 eyes in 36 males and 77 eyes in 40 females, the age ranged from 35 to 88 years, the mean age was (64.52±11.36) years.Axial length (AL), mean keratometry (Km), anterior chamber depth (ACD), central corneal thickness (CCT) and white-to-white (WTW) were measured with IOLMaster 700 and Pentacam AXL, respectively.The differences and correlations of the biometry parameters between the two devices were assessed.Bland-Altman method was used to evaluate the agreement of these parameters between the two devices and the 95% limits of agreement was calculated.This study adhered to the tenets of the Declaration of Helsinki and was approved by an Ethics Committee of Beijing Tongren Hospital (TRECKY2018-049).Results:The mean values of the AL measured by IOLMaster 700 and Pentacam AXL were (24.03±1.72)mm and (23.98±1.73)mm, Km were (44.04±1.71)D and (43.88±1.72)D, ACD were (3.24±0.47)mm and (3.28±0.47)mm, WTW were (11.82±0.51)mm and (11.49±0.49)mm, respectively.Compared with the values in Pentacam AXL, the AL, Km and WTW were larger while ACD was smaller in IOLMaster 700 with significant differences ( t=18.06, 8.94, 23.83, -15.36, all at P<0.01). The mean CCT values from the IOLMaster 700 and Pentacam AXL were (534.18±30.12)μm and (533.42±28.71)μm, respectively, with no significant difference ( t=1.04, P=0.30). The AL, Km, ACD, CCT and WTW from IOLMaster 700 were highly correlated with those from Pentacam AXL ( r=0.999, 0.992, 0.998, 0.956, 0.942; all at P<0.01). The Bland Altman analysis showed that the 95% limits of agreement of AL, Km, ACD, CCT and WTW were-0.02-0.11 mm, -0.27-0.59 D, -0.10-0.02 mm, -16.5-18.1 μm and 0.00-0.67 mm. Conclusions:IOLMaster 700 and Pentacam AXL have good agreements and narrow 95% limits of agreement in the measurements of AL, ACD, CCT, which can be clinically interchangeable.The 95% limits of agreement of WTW and Km are out of the clinically acceptable range, so the WTW and Km measured by the two devices are not interchangeable.
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Objective To describe the ultrasonographic features of intraocular lymphoma . Methods It was a retrospective analysis of 19 patients ( 26 eyes ) with intraocular lymphoma at the department of ophthalmology ,Beijing Tongren Hospital from January 2015 to December 2017 . T he diagnosis was established by tissue biopsy in 4 patients with diagnostic vitrectomy and 8 with enucleation ,and other 7 cases were clinically diagnosed followed by pathological examination of central nervous system lymphoma . T he ultrasonographic features of all patients were analyzed . Results Of the 19 patients ( 26 eyes ) with intraocular lymphoma ,12 cases ( 19 eyes) of vitreoretinal lymphoma accounted for 63 .2% ,of which 7 cases were bilateral eyes ,and 7 cases ( 7 eyes ) of uveal lymphoma accounted for 36 .8% ,all of w hich were monocular . Ultrasonography of vitreoretinal lymphoma included vitreous opacity , posterior vitreous detachment ,partial retinal detachment ,irregular hypoechoic lesions under the retina ,and CDFI detected blood flow signals in the lesion . T here were two different types of ultrasound findings in uveal lymphoma . Five cases ( 5 eyes ) showed diffuse thickening of the uveal membrane with low echo , and irregular hypoechoic mass around the optic nerve and the ball wall ,in w hich CDFI detected abundant blood flow signals . Ultrasound biological microscope examination showed that the iris‐ciliary body thickened and the internal echo decreased . T his ultrasound finding accounted for 71 .4% of uveal lymphoma . T wo cases ( 2 eyes) showed a solitary ciliary‐choroid choroidal hypoechoic mass ,combined with retinal detachment and blood flow signals with CDFI ,accounting for 28 .6% of uveal lymphoma . Conclusions T he ultrasonography of intraocular lymphoma is various . T he ultrasound findings of vitreoretinal lymphoma are not specific , w hile the diffuse thickened uvea and retrobulbar hypoechoic lesions encircled optic nerve and eye wall suggest the possibility of uveal lymphoma .
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Objective To compare the agreement of axial length (AL),anterior chamber depth (ACD) and keratometry measured by IOLMaster 500 with IOLMaster 700 in cataract eyes with high myopia.Methods A cross-sectional study was performed.One hundred and fifty-two eyes of 87 cataract patients with high myopia were included from September to October 2017 in Beijing Tongren Hospital.The best corrected visual acuity (BCVA) was 0.05-1.0,and the refraction power was-6.25--21.00 D,with an average power of (-13.625 ± 7.375) D.A L,ACD and keratometry (Kf,Ks) were measured by IOLMaster 700 and IOLMaster 500 respectively for all the eyes.The eyes were assigned to AL＞26-≤28 mm group,AL＞28-＜30 mm group and AL≥30 mm according to the results of IOLMaster 500.The measured differences between two devices were assessed using paired samples t-test,and the measured consistency of the two devices was evaluated using Bland-Altman agreement analysis.This study protocol was approved by Ethics Committee of Beijing Tongren Hospital and complied with Declaration of Helsinki.Results There were no significant differences in the AL and Kf measured by the two devices in all the three groups (all at P＞0.05).Both ACD and Ks values measured by IOLMaster 700 were lower than those by IOLMaster 500 (both at P＜0.05),which were clinically acceptable.The percentage beyond 95％ agreement limit between IOLMaster 700 and IOLMaster 500 were 4.10％,2.17％ and 3.03％ for AL differences and 4.10％,4.34％ 和 3.03％ for Kf difference in the three groups.Significant differences were found in ACD and Ks between IOLMaster 700 and IOLMaster 500 at a clinically acceptable level (both at P＜0.05),and Bland-Altamn agreement analysis showed that the percentage beyond 95％ agreement limit between IOLMaster 700 and IOLMaster 500 were 4.10％,4.34％ and 3.03％ for both ACD and Ks differences in the three groups.Conclusions There is a good agreement in AL,ACD,Kf and Ks measured by IOLMaster 700 with IOLMaster 500 and is clinically interchangeable in cataract eyes with high myopia.However,IOLMaster 700 is better because it can provide the OCT image of macula.
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Objective To explore the diagnostic value of ultrasonic elastography in choroidal melanoma. Methods A total of 96 cases (97 eyes) of choroidal melanoma were included in present study from June 2016 to June 2017 in Eye Center of Beijing Tongren Hospital, Capital Medical University. The control group consisted of 18 patients with choroidal hemangioma (18 eyes). All eyes were examined by color Doppler ultrasound and ultrasonic elastosonography. The strain ratio of the tumor and surrounding normal tissue was calculated for each case. By comparing the strain ratio between choroidal melanoma and choroidal hemangioma, the diagnostic value of ultrasound elastography in choroidal melanoma was investigated. Results The strain ratios of the two groups were 39.51±15.79 for choroidal melanoma and 13.15±10.40 for choroidal hemangioma. The independent sample t-test was performed between the two sets of data. The difference of the strain ratio between choroidal melanoma and choroidal hemangioma was statistically significant (t=6.802, P<0.001). Conclusions The stiffness of ocular malignant tumor (choroidal melanoma) is significantly higher than that in intraocular benign tumor (choroidal hemangioma). Ultrasonic elastography can be used as an important examination for the diagnosis and differential diagnosis of choroidal melanoma.
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Objective To explore the value of conventional ultrasound, color Doppler ultrasound and contrast-enhanced ultrasound (CEUS) in the diagnosis of sub-retinal hemorrhage. Methods A total of 26 patients with sub-retinal hemorrhage were examined by conventional ultrasound, color Doppler ultrasound and CEUS. The results of medical history, ultrasound, color Doppler ultrasound and CEUS were recorded and analyzed.And the difference of the detection rate between the three methods was analyzed by χ2test. Results The mean fundus diameter of the sub-retinal hemorrhage was (5.31±2.21) mm, and the mean height was (1.97±0.98) mm. In twenty-two eyes (84.6%) the lesions were located in the posterior pole of the ocular wall, while in two eyes (7.7%) the lesions were located in the equator and peripheral of the ocular wall. Seven eyes (26.9%) had dome-shaped mass, ten eyes (38.5%) had flat-shaped mass, and nine eyes (34.9%) had irregular-shaped mass. The echogenecity of the lesions was homogeneous in twelve eyes (46.2%), and heterogeneous in fourteen eyes (53.8%). The lesions showed clear margin in seventeen eyes (65.4%). Blood flow signals can be detected in twenty-three eyes (88.5%). The surface of the lesions was filled by contrast-medium in all cases. The detection rate of sub-retinal hemorrhage with color Doppler and contrast-enhanced ultrasound was higher than that of conventional ultrasound, and the difference was statistically significant. Conclusion Color Doppler ultrasonography and CEUS can provide a powerful basis for the clinical diagnosis of sub-retinal hemorrhage, while CEUS has higher application value.
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Objective To evaluate the value of color Doppler ultrasonography in the diagnosis of retinoblastoma (RB). Methods One hundred and eighty-two patients (199 eyes) with RB confirmed by pathology from June 2012 to June 2016 in Beijing Tongren Hospital were included in this study. The two-dimensional gray-scale image and color Doppler imaging ultrasound features were observed. The variance analysis was used to compare the width and height of different morphologies. Comparison the detection rate of the two methods by χ2test.Results The ultrasonography of RB was characterized by substantial masses of the eyeball, which could be hemispherical, spherical, irregular, filled with vitreous cavity, or diffuse along the retina. The results of variance analysis showed statistical difference in three shapes (F= 29.134, 24.474, P<0.001),LSD-t test showed difference between hemisphere and spherical,spherical and irregular shape, hemispherical and irregular shape. The t values of basal width were 2.457,-2.333 and-6.205, respectively and all P < 0.05 respectively. The t value of height were 3.917,-6.711 and-7.244, respectively and all P < 0.05.All lesions were uneven echo. Calcification and localized low echo area within the mass was observed in 93.47% (186/199) and 52.76% (105/199) eyes respectively. 46.73% (93/199) retinal detachment and 31.16% (62/199) vitreous opacity is present. Colorful blood flow signals extended from the central retinal vessels could be seen inside the masses of 98.49% (196/199) eyes. Two-dimensional image and color Doppler imaging ultrasound were consistent with the pathological diagnosis in 96.5% (192/199) and 99.5% (198/199) RB cases, respectively.The difference was statistically significant (χ2=4.167, P=0.031). Conclusions Retinoblastoma has characteristic ultrasound manifestations. Color Doppler ultrasonography is a valuable clinical tool in the diagnosis of RB.
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Objective To investigate the characteristic of the B-mode ultrasonography and the color Doppler flow imaging diagnosis for intraocular cysticercosis.Methods Eleven eyes of 1 1 patients diagnosed of intraocular cysticercosis clinically and confirmed by operation and pathology were retrospectively studied. Their B-mode ultrasonography and color Doppler flow imaging were analyzed.Surgery diagosis was also reviewed.Results Among 1 1 eyes of 1 1 patients,intravitreal cysticercus presented in 7 cases (7 eyes),and 4 cases (4 eyes)diagnosed of subretinal cysticercus.Intraocular cysticercosis showed a round or oval vesicle-like echogenic mass in the vitreous body or under the retina,and the high-level echo spot in it was the scolex. Some dot and stripe echo and retinal detachment also appeared in the vitreous cavity with vitreous inflammation.The blood flow signal was detected in retinal detachment with color Doppler flow imaging. Conclusions Ultrasonography is extremely useful in the diagnosis of intraocular cysticercosis and the findings can be pathognomonic.
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Background Choroidal hemangioma is a common benign intraocular tumor.Typical choroidal hemangioma is comparably easy to diagnose,but untypical one might be misdiagnosed as malignant tumor.Contrastenhanced ultrasound (CEUS) has been used to diagnose multiple neoplasm for the past few years.However,the application of CEUSin ophthalmology is less.Objective This study was to investigate the CEUS characteristics of choroidal hemangioma.Methods Fifty-eight eyes of 58 patients who were diagnosed as choroidal hemangioma were included in Beijing Tongren Hospital during July 2010 to December 2012.CEUS was performed on the patients to check the manifestations of choroidal hemangioma.A time-intensity analysis was employed to quantitatively analyzed and compared the maximum intensity (MI),rising time (RT),time to peak (TTP),and mean transit time (mTT) between the choroidal hemangioma and normal orbital tissue and the parameters were contrasted using Wilcoxon signed-rank test.Results CEUS showed that choroidal hemangioma was gradually enhanced by the contrast after intravenous injection of sulphur hexafluoride microbubbles with a high-reference signal in choroidal hemangioma,and the fading procedure was slower in choroidal hemangioma than that of normal orbital tissue.MI,RT,TTP,and mTT were294.20％ (217.35％,373.25％),21.30 (17.35,23.35) s,25.00 (21.68,27.48) s and 59.30 (51.08,78.35) s in the choroidal hemangioma,which were significantly higher than 100.00％ (100.00％,100.00％),17.75 (15.00,20.30) s,22.40 (18.35,24.63) s and 47.25 (40.90,57.23) s in the normal orbital tissue (Z =-6.608,-4.998,-4.650,-4.332,all at P＜0.001).Conclusions Choroidal hemangioma has its own CEUS manifestation characteristics.CEUS is helpful to the differential diagnosis of choroidal hemangioma.
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Objective To evaluate the clinical effects of percutaneous kyphoplasty ( PKP ) for osteoporosis vertebral compression fractures . Methods From January 2011 to June 2013, 65 patients underwent PKP .The evaluation was based on the visual analogue scale (VAS), vertebral height, and Cobb’s angle recorded at 3 days and 6 moths postoperatively.The duration of follow-up after operation was 6-12 months. Results The PKP operation was successfully completed in all the 65 cases.The VAS reduced from 6.62 ±0.63 before operation to 3.22 ±1.20 at 3 days (P =0.000) and 2.12 ±1.15 (P =0.000) at 6 months postoperatively.The vertebral height was increased from (15.26 ±1.19) mm before operation to (18.14 ±1.29) mm at 3 days (P=0.000) and (17.65 ±1.37) mm (P=0.000) at 6 months postoperatively.The Cobb’s angle was decreased from 16.25°±2.66° before operation to 6.34°±1.68°at 3 days (P=0.000) and 7.13°±1.82°(P=0.000) at 6 months postoperatively. Conclusion Percutaneous kyphoplasty can relieve pain and improve the functions .
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Objective To observe the time-intensity curve characteristics of contrast agents in intraocular tumor.Methods A total of 236 patients (238 eyes) with intraocular tumor were enrolled in this study.All the patients received regular ophthalmologic examination,two dimensional ultrasound,color doppler ultrasonography and contrast-enhanced ultrasonography.There were 166 patients (166 eyes) with choroidal melanoma,16 patients (18 eyes) with choroidal metastatic carcinoma,52 patients (52 eyes) with choroidal hemangioma,two patients (two eyes) with retinal hemangioma.The whole process of contrast-enhanced ultrasound were recorded, and exported as t images of Dicom format.These images were processed by Sonoliver software (Tomteck Company, Germany) to drawn the time-intensity curve of contrast agents in the intraocular tumors.Results All intraocular lesions were completely filled with contrast agent,concentric filling from the periphery to the center can be documented in some cases.The time-intensity curve of choroidal hemangioma and retinal hemangioma were basically the same.The time-intensity curve of choroidal melanoma and choroidal metastatic carcinoma were also basically the same.In the filling phase,all tumors were rapid filling type.In the regression phase,contrast agent subsided earlier than in control tissue within the melanoma or metastatic carcinoma lesions,but subsided synchronous or slightly faster than in control tissue within the choroidal hemangioma and retinal hemangioma lesions.Among 166 eyes with choroidal melanoma,138 eyes (83.1％) were in full compliance with the above changes,28 eyes (16.9％) were largely in line with these changes.All the eyes (100.0％) with choroidal metastatic carcinoma,choroidal hemangioma and retinal hemangioma were in full compliance with the above changes.Conclusion Time-intensity curve is quickly filling and fast regression for malignant intraocular tumors,but is quickly filling and slow regression for benign intraocular tumors.
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BACKGROUND:Soft-tissue defect in plastic surgery is a major problem,and currently all of methods used for clinical treatment have certain shortcomings.OBJECTIVE:To investigate the research status of adipose tissue engineering,to analyze the current deficiencies in the application of the program,and to outlook its possible future in clinical application.METHODS:A computer-based online search was conducted jn Medline and CNK J with the key words of"adipose tissue engineering.mesenchymal stem cells,derived from adipose tissue"in both Chinese and English from January 1 991 to May 2009.The related articles about fat tissue and tissue-engineered building were included,but the duplicated studies were excluded.RESULTS AND CONCLUSION:A total of 342 documents were retrieved firstly.According to the inclusion criteria,33 articles were included in the final analysis During the exploration of treatment for soft-tissue defect,tissue engineering technology provided a new method by combining the seed cells amplifying in vitro with biomatedal to repair some tissue or organ defects,reconstruct physiological function,and finally to achieve the ultimate goal of non-damage repairment of organic defect and reconstruction of morphology,structure and function Nowadays there are several successful strategies of constructing adipose tissue in treatment for soft tissue defect,which will fill in the blanks in the repairment of adipose tissue defect.
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The pathophysiological mechanism of spinal cord injury is very complex.In order to find out the clinical treatment for spinal cord injury,the suitable design of a spinal cord injury experimental model is critically important to explore the mechanism in treatment the spinal cord injury,by which the transplantation of bone marrow mesenchymal stem cells could be conducted,Nowadays,several methods have already existed on the design of spinal cord injury experimental model,including contused model,tension model,compression model,cutting model or resorption model,and ischemia model,and the way of bone marrow mesenchymal stem cells transplantation,including call suspension stereotaxis injection,lumbar puncture cell suspension injection,and intravenous cell suspension injection.The possible mechanisms of bone marrow mesenchymal stem cells in treatment of spinal cord injury were as follows:① bone marrow mesenchymal stem cells could move to the damage department and differentiate into neural cell phenotype;② bone marrow mesenchymal stem cells could play the role of bridge-mediation;③ bone marrow mesenchymal stem cells could inhibit the apoptosis of the nerve cells after transplantation.Animal experiments proved that there are broad prospects of clinical application of bone marrow mesenchymal stem calls for the treatment of spinal cord injury.
RESUMO
Objective To investigate the effects of anti-adhesion treatment and high-strength suture technique on the treatment of extensor tendon rupture by animal experiments and clinical application.Methods Twenty-eight leg-born chickens were randomly divided into four groups(7 each).Double cross suture was applied in group A,while double cross suture combined with sodium hyaluronate spraying in group B,cross-finger-like micro-braided suture in group C,and cross-finger-like micro-braided suture combined with sodium hyaluronate spraying in group D.The animals were sacrificed 6 weeks after operation,morphological,histological and biomechanics were observed and compared among the groups.One hundred and sixteen patients were treated with the surgical method in group D(89 males,27 females,aged 20-55 with an average of 36 years;73 with extensor tendon rupture,38 with strain/chalasis,5 with firearm injuries;56 on back of hand,48 on central slip,12 on lateral fixing chorda;82 with one-stage operation,and 34 with second-stage operation),and then followed-up for 2-5 years to observe the therapeutic effects.Results The repaired tendons in group D was in good contour,most tendon cells arranged regularly in bunches.The maximum load was significantly higher in group D(70.9?5.7N) than in group A(48.4?5.7N),Group B(51.3?3.2N) and Group C(68.3?2.8N,P