摘要 目的 探究原发性急性闭角型青光眼与脉络膜厚度、眼轴长度及前房深度的相关性。方法 随机选取2020年3月-2022年3月在我院进行诊治的80例（109眼）原发性急性闭角型青光眼患者（急性组）作为研究对象进行回顾性分析研究，选取同时期在本院进行检查的正常房角眼受检者17例（47眼）作为对照组。采用频域光学相干断层扫描增强技术检测脉络膜厚度相关指标。采用人工晶体光学生物测量仪检测眼轴长度变化。采用超声生物显微镜检测前房深度变化。Pearson相关性检验分析脉络膜厚度、眼轴长度及前房深度间的相关关系。结果 与对照组对比，急性组患者受检眼球中心凹颞侧2500μm（T2.5）、眼球中心凹鼻颞侧2500μm（N2.5）及黄斑中心凹下脉络膜厚度（SFCT）水平均明显降低（P<0.05）。与对照组对比，急性组患者眼轴长度、前房深度及前房深度/眼轴长度水平均明显降低（P<0.05）。经Pearson相关性检验，T2.5、SF脉络膜厚度、N2.5、眼轴长度、前房深度及前房深度/眼轴长度间均存在显著正相关（P<0.05）。结论 原发性急性闭角型青光眼患者具有脉络膜薄、眼轴长度短、前房深度浅的特点，且脉络膜厚度与眼轴长度、前房深度具有明显正相关关系。
Cystoid macular edema (CME) is a rare complication of nab-paclitaxel.. In our article, it is reported a case of a 60-year old woman who had undergone nab-paclitaxel chemotherapy for 7 weeks after a radical surgery for breast cancer.During the treatment, she reported vision declined, and was diagnosed as CME caused by nab-paclitaxel through ophthalmic examinations. The nab-paclitaxel was immediately discontinued after the diagnosis, and the patient was treated with oral acetazolamide instead. In the follow up visit, after stopping nab-paclitaxel for 20 months, CME was found to disappear basically, and the corrected visual acuity was restored to 1.0 in patient's both eyes. his case is CME caused by chemotherapy drugs. Its mechanism may be related to toxic effects of paclitaxel to Müller cells and the retinal pigment epithelial layer. Notably, its typical feature is that there is no obvious fluorescence leakage could be observed on fundus fluorescein angiography. In the article, the course and development of this case is reviewed, and the clinical characteristics and diagnosis and treatment of nab-paclitaxel induced CME cases reported in other literature are also summarized. At the same time, the potential the potential pathogenesis of nab-paclitaxel-induced CME is discussed, to provide reference to ophthalmologists for early diagnosis and treatment for this disease.
Intraocular lens opacity is a relatively rare complication after cataract surgery. Many patients seek medical service serveral months or years after surgery, due to unexplained visual impairment or blurred vision. A case is reported in this article that a 73-year-old female patient who was implanted the same type of hydrophilic acrylate intraocular lens in both eyes during the same period. After 6 years of surgery, the right intraocular lens was completely cloudy, while the left intraocular lens remained completely transparent. Significant differences were found in two eyes clinical symptoms,optical coherence tomography (OCT), and ultrasound biomicroscopy (UBM) examination results. After surgical treatment, the vision of eye with intraocular lens opacity has recovered satisfactorily. In the article, the detailed record of the patient's preoperative relevant information, surgical treatment, and examination results of removing the intraocular lens were stated. The analysis and discussion results were also indicated to provide reference on the diagnosis and treatment of this type of patient for experts and colleagues.
Purpose To establish and validate a universal artificial intelligence (AI) platform for collaborative management of cataracts involving multilevel clinical scenarios and explored an AI-based medical referral pattern to improve collaborative efficiency and resource coverage. Methods The training and validation datasets were derived from the Chinese Medical Alliance for Artificial Intelligence, covering multilevel healthcare facilities and capture modes. The datasets were labelled using a three step strategy: (1) capture mode recognition; (2) cataract diagnosis as a normal lens, cataract or a postoperative eye and (3) detection of referable cataracts with respect to aetiology and severity. Moreover, we integrated the cataract AI agent with a real-world multilevel referral pattern involving self-monitoring at home, primary healthcare and specialised hospital services. Results The universal AI platform and multilevel collaborative pattern showed robust diagnostic performance in three-step tasks: (1) capture mode recognition (area under the curve (AUC) 99.28%–99.71%), (2) cataract diagnosis (normal lens, cataract or postoperative eye with AUCs of 99.82%, 99.96% and 99.93% for mydriatic-slit lamp mode and AUCs >99% for other capture modes) and (3) detection of referable cataracts (AUCs >91% in all tests). In the real-world tertiary referral pattern, the agent suggested 30.3% of people be ’referred’, substantially increasing the ophthalmologist-to-population service ratio by 10.2-fold compared with the traditional pattern. Conclusions The universal AI platform and multilevel collaborative pattern showed robust diagnostic performance and effective service for cataracts. The context of our AI-based medical referral pattern will be extended to other common disease conditions and resource-intensive situations.
Purpose To establish and validate a universal artificial intelligence (AI) platform for collaborative management of cataracts involving multilevel clinical scenarios and explored an AI-based medical referral pattern to improve collaborative efficiency and resource coverage. Methods The training and validation datasets were derived from the Chinese Medical Alliance for Artificial Intelligence, covering multilevel healthcare facilities and capture modes. The datasets were labelled using a three step strategy: (1) capture mode recognition; (2) cataract diagnosis as a normal lens, cataract or a postoperative eye and (3) detection of referable cataracts with respect to aetiology and severity. Moreover, we integrated the cataract AI agent with a real-world multilevel referral pattern involving self-monitoring at home, primary healthcare and specialised hospital services. Results The universal AI platform and multilevel collaborative pattern showed robust diagnostic performance in three-step tasks: (1) capture mode recognition (area under the curve (AUC) 99.28%–99.71%), (2) cataract diagnosis (normal lens, cataract or postoperative eye with AUCs of 99.82%, 99.96% and 99.93% for mydriatic-slit lamp mode and AUCs >99% for other capture modes) and (3) detection of referable cataracts (AUCs >91% in all tests). In the real-world tertiary referral pattern, the agent suggested 30.3% of people be ’referred’, substantially increasing the ophthalmologist-to-population service ratio by 10.2-fold compared with the traditional pattern. Conclusions The universal AI platform and multilevel collaborative pattern showed robust diagnostic performance and effective service for cataracts. The context of our AI-based medical referral pattern will be extended to other common disease conditions and resource-intensive situations.
OBJECTIVE: To evaluate the effectiveness of timolol and carteolol in lowering intraocular pressure to prevent refractive regression after LASIK. METHODS: Meta-analysis of the data on postoperative naked-eye visual acuity, refraction, equivalent spherical lens degree, intraocular pressure, corneal curvature, corneal thickness, and diff value was performed using Reviews Manager 5.3. RESULTS: Thirteen papers with 1532 cases and 2443 eyes were included.Meta-analysis showed that compared with the control group, the test group had better naked-eye visual acuity (MD=-0.05, 95% CI (-0.06, -0.04)), smaller refractive error (MD=0.56, 95% CI (0.52, 0.60)), and lower equivalent spherical lens diopters (MD=0.24, and 95% CI (0.18, 0.29)), lower IOP (MD=-1.09, 95% CI: (-1.72, -0.45)), lower corneal curvature (MD=-0.22, 95% CI (-0.36, -0.09)), and no significant difference in corneal thickness (MD=-1.52, 95% CI (-5.78, 2.74)), the The diff value was smaller (MD=-10.47, 95% CI (-11.32, -9.62)). CONCLUSION: Loroidal IOP-lowering drugs are indeed efficacious in preventing refractive regression after LASIK.
Objective To systematically evaluate the risk factors of Pathologic myopia (PM). Methods Search Cochran Library, PubMed database, Embase database, Knownet database. The literature retrieval started and ended from the establishment of the database to September 2023. NOS evaluation method was used to evaluate the literature quality. After extracting valid data, Meta analysis was performed using Review manager 5.3 software. Results A total of 424 relevant English literatures were retrieved. 385 articles remained after Endnote software was removed. After reading the title and abstract, 308 literatures were excluded, 77 literatures were obtained in the preliminary screening, 71 literatures were excluded after reading the full text, and 6 literatures were finally included in the intensive re-screening, all of which were case-control studies. The results of sensitivity analysis on analysis models of changes such as age, Axis length (AL) and Choroidal thickness (CT) show that there is no substantial change in the above three analysis results, which indicates that the combined results of the above factors are basically reliable. The OR values of age, ocular axis and choroid thickness were (2.67[1.83, 3.90], 4.31[2.67, 7.10], 6.06[2.95, 12.43]), respectively. Gender was not a risk factor for PM (P> 0.05). Conclusion The results show that age, ocular axis and Choroidal thickness (CT) are risk factors for PM.
Patients with low vision are severely impaired in visual function due to different ocular and neurological disorders, which have a serious impact on their daily activities (such as reading and driving), quality of life and mental health. Low vision rehabilitation provides patients with appropriate visual impairment assistance technology, maximizes the use of residual vision and visual function of patients, solves the functional limitations associated with low vision, effectively improves their independence and overall quality of life, and makes it possible for them to live, work and integrate into the society independently. This article reviews the progress in the application of visual impairment AIDS in low vision rehabilitation, such as classic visual AIDS, artificial vision (visual prosthesis/visual sensory replacement equipment), transcranial stimulation and visual biofeedback training and so on.
