[A summary of ocular fundus diseases in China over the past 70 years].

After 70 years of development, China has become a global leader in the academic research and clinical practice of fundus diseases. The dramatic progress is mainly attributable to the relentless efforts of generations of fundus ophthalmologists. We are moving forward to incorporate new technologies such as AI and big data into the treatment of fundus diseases. The summary is intended to commemorate the past masters and to inspire the young ophthalmologists. We would like to send congratulations on the 70th anniversary of Chinese Journal of Ophthalmology with this article. (Chin J Ophthalmol, 2020, 56:241-245).

Retinoscopio de estría de Copeland / Copeland streak retinoscope

No disponible

Photic maculopathy: A review of the literature (I). / Maculopatía fótica: revisión de la literatura (I).

The human retina, as transducer of light energy, is especially exposed to light toxicity. Solar maculopathy has been the only form of photic maculopathy for millennia, often secondary to the observation of an eclipse. During the last century, technological advances have led to the appearance of new forms of photic maculopathy, related to the exposure to new forms of artificial light, such as welding devices and lasers. In recent years, the general use of laser pointers has led to an upturn in interest in this pathology. The aim of this review is to offer an integrated view of the different types of photic maculopathy. Due to the extension of this topic, the review is presented divided into two parts. In this first part solar maculopathy and welding arc maculopathy are presented.

Light damage to the retina: an historical approach.

A brief review of retinal light damage is presented. Thermal damage requires a local rise in temperature of at least 10 °C, causing an instant denaturation of proteins. The primary absorber is melanin. Photochemical damage occurs at body temperature and involves cellular damage by reactive forms of oxygen. The photosensitizers are photoproducts of the visual pigments. First indications that non-thermal damage might exist, in particular in the case of eclipse blindness, was presented by Vos in 1962. Attribution thereof to photochemical action was presented in 1966 by Noell et al who also measured the first action spectrum, in rat. It turned out to be identical to the absorption spectrum of rhodopsin. However, in 1976 and 1982 Ham et al found a quite different spectrum in monkeys, peaking at short wavelengths. The latter spectrum, but not the former, was confirmed since in numerous publications with animal models including rat. In ophthalmological practice a 'sunburn' was at first the only complaint caused by light damage. To avoid this, patients with dilated pupils should always be advised to wear sunglasses. Since the invention of the laser accidents have been reported, the most recent development is youth playfully pointing a strong laser pen in their eyes with marked consequences. The operation microscope and endoilluminators should always be used as brief as possible to avoid photochemical damage. Arguments for implant lenses that block not only the UV but also part of the visible spectrum seem too weak to justify extra costs.

The entoptic view of the retinal vessels.

The first time the retinal vessels were seen in man in vivo was reported in 1819 by Purkinje as an entoptic view. This was understood to show the shadow of the vessels, an interpretation objected to in 1834 by Brewster. Müller in 1855 (Über die entoptische wahrnehmung der netzhautgefässe, insbesondere als beweismittel für die lichtperception durch die nach hinten gelegenen netzhautelemente, Stahel, Würzburg) used the phenomenon to deduce the location of the photoreceptive layer of the retina, and his conclusion is accepted as true today. Because the phenomenon has some characteristics of an afterimage, it touches on the question of what is subjective and what is objective physical reality. It was recently used clinically to measure potential visual acuity and in the diagnoses of diabetic retinopathy and macular degeneration.

An eye chart for Edgar Degas.

The French Impressionist painter Edgar Degas had progressive visual loss from a type of maculopathy during the last 40 years of his life. The effects of this visual failure are evident in a comparison of early and later pastels, which shows a loss of precision in outlining, shading, and detail over the years. A remarkable oil painting, Scene from the Steeplechase: The Fallen Jockey, provides on one canvas an historical record of his visual struggles. It was begun in 1866 and reworked in 1880 and 1897, during which his visual acuity fell from near normal to 20/200. Computer simulations show Degas' own view of this painting at each of these times and demonstrate how his style changed: details became rougher and larger in correspondence with his failing acuity. The painting is an eye chart of his career.

Krypton red laser photocoagulation of the ocular fundus. 1982.

The theoretical rationale, the histopathologic evidence, and the preliminary clinical studies related to krypton red laser (KRL) photocoagulation of the ocular fundus are reviewed. The authors report on their experience with currently available laser systems using this wavelength (647.1 nm) for photocoagulation of retinal vascular proliferative diseases and chorioretinal diseases associated with exudative manifestations. A histopathologic and clinical comparison of argon blue-green laser (ABGL), the pure argon green laser (AGL), and the krypton yellow laser (KYL), with reference to photocoagulation treatment of the ocular fundus is also discussed.

Solar retinopathy: a photobiologic and geophysical analysis. 1989.

A series of young adult patients developed solar retinopathy during sun exposure over a two-day period in a particular region of the United States during March of 1986. Evaluation of the photobiological and geophysical parameters involved in solar retinitis are presented. A multifactorial pathogenesis is proposed. Of interest, a possible increase in terrestrial ultra-violet B radiation secondary to a localized relatively low ozone column during the days involved may have contributed to the retinal damage. Recommendations for protection from solar retinitis are noted.

Unilateral acute idiopathic maculopathy. 1991.

This is a report of nine patients who experienced sudden, severe, unilateral central vision loss following a flulike illness. Each patient had an exudative detachment of the macula. All patients experienced a spontaneous resolution of the acute macular manifestations with near-complete recovery of vision. A characteristic "bull's-eye" appearance in the macula persisted. The acute manifestations of the disorder did not recur in any of the patients during the period of follow-up. The constellation of findings was suggestive of an inflammatory disease of the retinal pigment epithelium, but a specific causative agent could not be identified. The acute clinical and angiographic features, the natural course, and the residual pigment epithelial derangement were not consistent with any previously described disorder.