Myopia prevention and control has risen to the national strategic level in China. Optic neuropathy caused by high myopia can damage visual function, but it is often ignored in clinical practice Optical coherence tomography (OCT) characterized by non-invasiveness, high resolution, rapid, and repeatable quantifying the thickness of each layer in the retina has emerged as a powerful tool for evaluating high myopia related optic neuropathy. Due to the changes in and near the optic disc in high myopia, errors often occur in the quantification of the thickness of the optic nerve fiber layer. In recent years, researchers have gradually focused on the study of the thickness of ganglion cell complex (GCC), but the regularity of its changes in high myopia is not yet unified. This article reviews the measurement specifications, diagnostic values, and change rules of GCC in the macular region of high myopia in recent years, in order to improve the attention and research level of ophthalmologists on high myopia optic neuropathy.
Marfan syndrome (MFS) is a common systemic disease associated with lens heterotopia, and about 50%~80% of Marfan patients have lens heterotopia. This article reports a case of a 21-year-old male patient who suffered from bilateral lens subluxation and concurrent cataract due to MFS, who underwent cataract extraction and IOL implantation with CTR suspension fixation was performed to preserve low-grade myopia after surger y. No complications such as increased intraocular pressure, intraocular lens severely displacement and capsular bag shrinkage were found during follow-up.
Crystalline lens dislocation is a commonly encountered clinical condition that remains challenging in the realm of lens surgery. Inspired by prior studies, the authors originally proposed a technique involving implantable polypropylene capsular hooks after demonstrating their feasibility and safety. After six years of clinical application and follow-up, the technique has shown capable of helping preserve the complete lens capsule to a maximally viable extent and achieve intracapsular implantation of an intraocular lens with high efficacy. At the same time, the authors have also improved the technique’s design and operational method. This paper comprehensively disseminates lessons learned on the principle, design, feasibility, indications, and procedural details of the implantable polypropylene capsular hook technique.
Objective: To investigate the efficacy and safety of phacoemulsification combined with supra-capsular and scleral-fixated intraocular lens (IOL) implantation in the treatment of microspherophakia (MSP). Methods: by retrospective analysis, 37 MSP patients (37 eyes) who were treated in our hospital from January 2019 to June 2020 were randomly divided into two groups, including 20 MSP patients (20 eyes) who treated by SCSF-IOL and 17 MSP patients (17 eyes) who treated by transscleral-fixated modified capsular tension ring and in-the-bag intraocular lens implantation (MCTR-IOL). The best corrected vision and complications were observed. Results: the best corrected vision was significantly improved in both groups (P < 0.001), but there was no remarkable difference between the two groups (P = 0.326). The IOL tilt was also comparable (P = 0.216). Prophylactic Nd: YAG laser posterior capsulotomy was performed from 1 week to 1 month after the SCSF-IOL procedure. In the SCSF-IOL group, two eyes (10.00%) needed repeated laser treatment, and one eye (5.00%) had a decentered capsule opening. Posterior capsular opacification was the most common complication (6, 35.29%) in the MCTR group. No IOL dislocation, secondary glaucoma, or retinal detachment was observed during follow-up. Conclusions: SCSF-IOL is a simple and viable surgical option for managing MSP and is comparable with the MCTR-IOL. Nd: YAG laser posterior capsulotomy is a necessary mean to prevent residual capsule complications after the SCSF-IOL procedure.
The eye is composed of refractive system and visual nervous system. It is one of the most important sensory organs of the human body. The abnormal development or function of eye tissues may cause various degrees of visual impairment. At present, the pathophysiological mechanism and treatment of eye diseases are mainly explored through animal experiments and in-vitro cell culture. However, they are of certain limitations. The in-vitro cell culture cannot fully reflect the morphological, structural and biochemical characteristics of organs, whereas the animal models are heterogeneous of species and genetic background. In recent years, with the continuous development of in-vitro three-dimensional structure organoids and organ microfluidic organ-on-a-chip technology derived from primary tissues, embryonic stem cells and induced pluripotent stem cells, organ cloning models more similar to in vivo organs in terms of the structure and function have been constructed. These models can provide more sensitive, quantitative and large-scale phenotypic analysis, and can be better applied to the research of eye development, physiological structure, disease mechanism, personalized medical diagnosis and treatment. At present, microfluidic organ-on-a-chip and organoids technologies have shown great application potential in the structural development and disease models’ construction of cornea, lens, lacrimal gland and retina.
Objective: To retrieve and summarize the best evidence on standardized ocular medication management among open-angle glaucoma patients. Methods: With evidence-based nursing method, practical problemswere identified. According to the “6S” pyramid model of evidence resource, studies on standardized ocular medication management among open-angle glaucoma patients were retrieved, including clinical guidelines, best practice information booklet, systematic reviews, and expert consensus. Two evidence-based nursing researchers independently evaluated the quality of the included literature and summarized the evidence. Results: A total of 12 articles were ultimately enrolled, including 4 clinical guidelines, 3 evidence summaries and 5 systematic reviews. Finally, 3 aspects including 19 pieces of best evidence were summarized, which were Eye drop technical instruction, medication adherence management and related information provision. Conclusion: The best evidence for the medication management of open-angle glaucoma patients were summarized, which provide reference for clinical medical staffs to manage patients, so as to achieve the purpose of standardizing medication,controlling intraocular pressure and preventing disease progression.
Eye health is an important part of national health. Visual impairment, including blindness, seriously affects people’s physical health and quality of life, increases the burden on families and society, threatens social and economic production activities, and is a major public health and social problem related to people’s livelihood. Amblyopia,as one of the main visual disorders in early childhood, is the primary factor causing low vision in adolescents, which affects their academic and mental health and increases the risk of blindness. Therefore, it is urgent to do a good job in the prevention and rehabilitation of amblyopia. By summarizing existing studies, it is found that traditional treatment methods for amblyopia at home and abroad include occlusion therapy, refractive correction, and depressive therapy, while perceptual learning, visual function training, electronic video games, acupuncture and so on are gradually emerging in recent years and widely used in recent years. There are numerous studies on the impact of age on the rehabilitation of amblyopia. By sorting out the previous research results, this paper puts forward the countermeasures of establishing visual acuity files for children and adolescents, establishing the five- in-one rehabilitation treatment layout model, and combining clinical treatment for adolescent amblyopia, in order to provide reference and choice for the rehabilitation treatment of adolescent amblyopia, and promote the development of the eye health cause of adolescent amblyopia rehabilitation.
Objective: To explore the application and effects of supervised teaching clinic in standardized training of ophthalmology residents. Methods: A weekly supervised teaching clinic was set through reasonable scheduling and limiting the registration numbers. After 4 months of application, feedbacks were collected through questionnaire survey from both the teachers and residents. Clinical skills assessments were also taken to evaluate the teaching effect. Results: A total of 16 teachers and 8 residents participated in the supervised teaching clinic. The results of the questionnaire showed that 100% of the teachers and residents agreed with the teaching mode. The clinical skill assessment scores of the residents who participated in the teaching clinic were significantly higher than those of the control group (t=3.631, P<0.05). Conclusion: The application of supervised teaching clinic in standardized training of ophthalmology residents is feasible and can improve the clinical skills of the residents.
In recent years, artificial intelligence (AI) technology has been applied to analyze clinical big data and images and then make intelligent diagnosis, prediction and treatment decisions. It is gradually becoming an advanced technology to assist clinical and scientific research. Biobank is a platform for collecting clinical information and samples for scientific research, serving as a bridge between clinical and scientific research. It is also an integrated platform of clinical information and scientific research data. However, there are some challenges. First, clinical and laboratory information obtained is incomplete. Additionally, the information among different databases is asymmetric, which seriously impedes the information sharing among different Biobanks. In this article, the specific application scenarios of AI technology and blockchain in the construction of a Biobank were discussed, aiming to pinpoint the core direction of the information construction of an intelligent Biobank in the era of big data.
At present, there is an imbalance in the development of ophthalmology in China. There are huge differences in the level of ophthalmology related facilities, diagnosis and treatment technologies between big cities and rural, remote areas. New intelligent diagnosis and treatment models are still needed to solve the imbalance. Since the eye is the only organ that can directly observe the blood vessels and nerves of the human body, the eye can reflect the health status of other organs and diagnosis of eye diseases based on medical images of some ophthalmic examinations can be made as well as other characteristics. Therefore, the development of artificial intelligence in ophthalmology has unique advantages. In addition, artificial intelligence can improve the accuracy and efficiency of information transmission across time and space to a certain extent. The advantages of artificial intelligence in ophthalmology and telematics are helping to solve the imbalance in ophthalmology development. From the perspective of the application of ophthalmic artificial intelligence in telemedicine, this paper mainly analyzes and summarizes the development degree, advantages and existing problems of artificial intelligence in the telemedicine of ophthalmic diseases in China, and discusses the prospect of the application of ophthalmic artificial intelligence in telemedicine.