Purpose:Evaluation of the changes of corneal biomechanics with the new generation of Corvis ?ST in the early stage of juvenile myopia of orthokeratology and the correlation with Corneal volumes in different regions（CV3mm、CV5mm、CV7mm and CV10mm） before and after orthokeratology . Methods:A prospective case study method was adopted to include 71 juvenile myopia patients (137 eyes) who were first fitted with orthokeratology in Foshan No.2 People's Hospital from January to August 2021.Follow-up data before and after orthokeratology at 1 week, 1 month and 3 months.BIOP, DA2ratio, IR, ARTh, SP-A1, CBI and SSI were measured by the new generation of Corvis? ST. The Pentacam anterior segment analysis system was used to measure corneal volumes in different regions.Repeated measurement ANOVA and LSD-T test were used to analyze the differences of corneal biomechanical parameters and Corneal volumes in different regions before and after orthokeratology;Spearman correlation analysis and partial least squares regression analysis (PLSLR) explored the relationship between corneal biomechanics and Corneal volumes in different regions before and after orthokeratology . Results:The ARTh and bIOP of teenagers using orthokeratology decreased significantly with the extension of wearing time (F =153.109、13.481,p < 0.05).IR and CBI were significantly increased with the extension of wearing time (F =25.312、31.480,p < 0.05).SSI decreased in the first week after using orthokeratology (p < 0.05), maintained for one month, and increased in the third month after using orthokeratology;DARatio only increased at 1 month after using orthokeratology (p < 0.05), but there was no significant change at 1 week and 3 months after using orthokeratology (p > 0.05).There was no significant difference between SP-A1 before and after orthokeratology (p > 0.05).There were significant changes in CV3mm, CV7mm and CV10mm before and 1 week, 1 month and 3 months after orthokeratology, and the differences were statistically significant (F =4.500、6.732、5.015,P＜0.05). CV3mm decreased with the extension of wearing time, and was stable after 1 month; CV7mm increased at 1 week and 1 month, and began to decrease 3 months after orthokeratology; CV10mm increased with the prolongation of wearing time. There was no significant difference in CV5mm (F =1.197,P > 0. 05). Correlation analysis showed that DARatio, IR and CBI were negatively correlated with CV3mm, CV5mm and CV7mm before and after orthokeratology（P＜0.05）, while ARTh and SP-A1 were positively correlated with CV3mm, CV5mm and CV7mm（P＜0.05）. There was no significant correlation between bIOP, SSI and corneal volume（P＞0.05）. Conclusion:The corneal biomechanics in the early stage of orthokeratology in teenagers changed after orthokeratology, and then a new stable period was gradually formed with the wearing time. There seems to be no significant corneal biomechanical changes affecting corneal safety after orthokeratology in a short period of time, and Short-term orthokeratology is relatively safe.Corneal volume before and after orthokeratology can characterize the changes of corneal biomechanics before and after orthokeratology, and further predict the safety of orthokeratology.
Objective: Day surgery mode has sharply shortened the preoperative waiting time of patients. However, this mode also made rough interactions between patients with vision loss and nursing staff during the preoperative visit. Moreover, patients might experience negative mood. The aim of this study was to describe the preoperative experiences and identify related stressful factors among patients who were waiting for vitreo-retinal day surgery. Methods: An interpretive qualitative approach guided this study. Semi-structured, face-to-face, in-depth interviews were carried out with patients from August 2021 to October 2021. Inductive content analysis and research software were used to analyze the data. Results: Elven patients agreed to join the interviews. The ages ranged from 19- to 70- year-old. The waiting time before hospitalization ranged from 7 to 90 days. Three main categories emerged from patients’ complaints: day surgery procedures, worries about eye conditions and supports. Conclusion: The findings highlighted the importance of preoperative care services. It was suggested that accurate preoperative information and effective supports are beneficial for improving the quality of preoperative care service.
Diabetic retinopathy (Diabetic retinopathy DR) is a chronic condition associated with persistent hyperglycemia. Progressive, potentially vision-damaging microvascular disease of the retina. It is present in both type 1 and type 2 diabetics and is one of the major causes of vision loss and blindness in the working population. At the same time, the improvement of social and economic level leads to higher requirements for people's quality of life, and diets high in sugar and carbohydrate are popular, providing space for the development of diabetes epidemic. At present, Asia has become the global center of diabetes epidemic. In view of the increasing number of diabetes patients, the proportion of DR Patients is also gradually increasing. Based on the unique insights on the etiology and pathogenesis of traditional Chinese medicine and the pathophysiological mechanism of Western medicine, this paper summarizes the traditional Chinese medicine principles and remedies with clinical efficacy, the external treatment with traditional Chinese medicine characteristics and the new treatment methods of Western medicine. It is found that the combination of traditional Chinese and western medicine is more effective in the treatment of DR, which provides certain reference significance for the treatment of diabetic retinopathy.
Thyroid-associated ophthalmopathy is an organ specific autoimmune disease that is caused by the joint participation and synergistic effect of multiple factors. Currently, its pathogenesis has not been fully revealed, and clinical treatment is mainly symptomatic. Therefore, studying the risk factors that affect the onset of the disease is of great significance for scientific management, reducing the incidence and recurrence rate of the disease, and exploring the possible mechanisms of its occurrence and development.
Objective To investigate the imaging features, diagnosis, treatment and prognosis of idiopathic retinal pigment epithelial detachment (IRPED).Methods Four patients (8 eyes) with IRPED diagnosed by indirect ophthalmoscope, fundus photography, FFA, ICGA, OCT and OCTA in our hospital since 2015 were retrospectively analyzed. The long-term follow-up period was more than 1.5 to 8 years. The clinical and imaging features of the disease were summarized. Among them, 5 eyes did not receive any special treatment, and 2 eyes of 2 patients were injected with conbercept 2 to 3 times each. One eye was treated surgically because of macular hole. The changes of subretinal pigment epithelial fluid and visual acuity were observed. Results On OCT, 8 eyes showed a semicircle-shaped arch bridge, varying in size, sharp edge or a small area of pigment epithelial detachment, low arc, and wavy shape. The fluid dark area and the reflected light band of deep choroidal tissue were observed below it. In one patient ,a small amount of hyperreflective substance was deposited and a small amount of fluid accumulated under the neuroepithelial layer. After long-term follow-up, the number and size of lesions in 2 patients had slight development. However, there was no significant change in visual acuity. Two patients were treated with anti-VEGF injection for 2 to 3 times, and one patient had no change in PED morphology and visual acuity after 3 years. In one case, PED recovered spontaneously 2 years after the termination of treatment, with no change in visual acuity. The visual acuity and metamorphopsia were slight or unchanged in all patients. Fundus examination showed single or multiple semicircular retinal pigment epithelial bulging in the posterior pole. The characteristics of fluorescence angiography showed prompt filling in the early stage. A large amount of fluorescence continued to accumulate in the late stage, forming a strong fluorescence pool, with no change in morphology and scope. However, no abnormal fluorescence leakage point was found in the whole process.Conclusion IRPED is a rare clinical disease with unknown etiology. The disease is very stable, the visual impairment is relatively mild, anti-VEGF therapy is ineffective, there is no other effective treatment at present. The disease may be self-limited. However, it should be noted that Central serous chorioretinopathy (CSCR) and Age-related macular degeneration AMD), Polypoidal choroidal vasculopathy (PCV), and Koyanagi-Harada disease (VKH) may lead to retinal pigment epithelium detachment.
