青光眼是全世界范围内不容忽视的致盲性眼病,其起病隐匿,视功能损害进展迅速,晚期预后不理想。长期发展且未行治疗的青光眼患者视神经呈进行性损害,引起视力急剧下降、视野不可逆性缺损,严重降低患者的生活质量。为了适应逐渐恶化的视功能,患者注视行为发生明显变化,由此在日常活动中引起步态行为随之改变,意外事故频繁发生。故目前对于青光眼的研究引起国内外广泛重视,虚拟现实技术(virtual reality,VR)作为青光眼早期诊断及康复治疗的新手段已被现代医学所尝试。本文具体阐述了青光眼的视觉损害与注视行为及运动行为间的联系,并总结了目前国内外关于VR诊断青光眼及作为康复治疗的相关研究。
Glaucoma is a blinding eye disease that cannot be ignored worldwide. Its onset is insidious, visual impairment is progressing rapidly, and the late prognosis is not ideal. Long-term untreated glaucoma patients show progressive damage to the optic nerve, causing a sharp decline in vision, irreversible visual field defects, and severely reducing the quality of life of the patients. In order to adapt to the gradual deterioration of visual function, the patient’s gaze behavior changes significantly, which causes the gait behavior to change in daily activities, and accidents occur frequently. Therefore, the current research on glaucoma has attracted wide attention in the nation and abroad,and virtual reality (VR) technology has been tried in modern medicine as a new method for early diagnosis and rehabilitation of glaucoma. This article specifically elaborates the relationship between the visual impairment of glaucoma and the gaze behavior and movement behavior, and summarizes the current domestic and foreign research on the diagnosis of glaucoma and the rehabilitation of VR technology.
目的:了解儿童罹患青光眼的疾病类型、特点,更好地做到早期发现早期治疗。方法:收集北京同仁医院2014—2019年度834例0~18周岁住院接受抗青光眼手术的患者,回顾性分析患者的人群特点与疾病构成特点。结果:834例患者中,原发青光眼397例(47.6%),继发青光眼429例(51.4%)。另有8例无法明确诊断青光眼类型。原发青光眼中以原发先天性青光眼最常见,继发青光眼中以白内障术后继发青光眼为主,两种类型的青光眼占总患者数的50%。结论:儿童罹患青光眼的疾病种类繁多,其中原发先天青光眼与白内障术后继发青光眼最常见,重视婴幼儿先天青光眼的筛查,监测儿童白内障术后眼压有助于早期发现青光眼,并给予治疗,延缓儿童青光眼患者视功能的损害。
Objective: To understand the types and characteristics of glaucoma in pediatric inpatients to achieve early detection and treatment. Methods: A total of 834 patients aged 0–18 years who underwent anti-glaucoma surgery in Beijing Tongren Hospital from 2014 to 2019 were collected and their population characteristics and disease composition characteristics were retrospectively analyzed. Results: In all of the 834 cases, there were 397 patients (47.6%) with primary glaucoma and 429 (51.4%) with secondary glaucoma. The type of glaucoma could not be definitively diagnosed in 8 cases. Primary infant glaucoma and secondary glaucoma following cataract surgery accounted for above 50%. Conclusion: The causes of pediatric inpatients with glaucoma are various. Screening of primary infant glaucoma should be taken seriously and monitoring intraocular pressure after cataract surgery is also important. Early detection and treatment can prevent further visual loss of pediatric patients with glaucoma.
目的:评估与原发性慢性青光眼患者生活质量最具相关性的视觉指标。方法:回顾性病例系列研究。收集2010年3月至2010年8月就诊于首都医科大学附属北京同仁医院且符合入选及排除标准的原发性慢性闭角型青光眼和原发性开角型青光眼患者131例262只眼。采用Humphrey Field AnalyzerII 750i型视野分析仪对入选患者分别进行单眼Central 24-2程序和Esterman双眼视野检查程序(Esterman Binocular Visual Field Test,EBVFT)各两次检查,以保证所得数据的可靠性。使用LogMAR视力表检查并记录受试者日常单眼生活视力和日常双眼生活视力、非接触式眼压计测量眼压、直接眼底镜检查视神经的杯盘比。记录病史及目前所使用抗青光眼药物,角膜及晶状体状态。应用视功能相关生活质量量表-25(25-Item National Eye Institute Visual Function Questionnaire,VFQ-25)对患者进行生活质量评估,并将双眼日常生活视力、较好眼生活视力、较差眼视野MD(mean defect)值、较好眼视野MD值、(Esterman Visual Field Test,EVFT)效用值和VFQ-25得分进行相关性分析。结果:共有131例受试者符合入选条件。在患者生存质量的统计中,自我评价视力、近距离活动、远距离活动、社会功能、依赖程度、色觉、视野这7项得分较好,即受试者完成该7项的能力较高。VFQ-25总分与EBVFT效用值成正相关(r=0.24998,P=0.004<0.05),与双眼日常生活视力成负相关(r=?0.37778,P<0.0001),与较差眼视野MD值成正相关(r=0.22917,P=0.0187<0.05),与较好眼生活视力、较好眼视野、较差眼生活视力无明显相关关系。结论:原发性慢性青光眼患者双眼视觉(双眼视野和双眼日常生活视力)和VFQ-25有良好的相关性,可用于评估慢性青光眼患者的生活质量。
Objective: To assess the correlation between the Esterman binocular visual field (EBVF) and the visual function quality of life (VFQ) in primary chronic glaucoma patients. Methods: It is a retrospective case series study.One hundred and thirty-one patients, that is to say, two hundreds and sixty-two eyes, with primary chronic glaucoma satisfying the methodological criteria were recruited for this study, who were chosen from Beijing Tongren Hospital, Capital Medical University from March 2010 to August 2010. The Humphrey Field Analyzer Model II 750i (Humphrey Instruments, Zeiss Company) was used to perform an Esterman binocular visual field test (EBVFT) and bilateral monocular full-threshold central visual field testing using the 24-2 SITA Standard program. Visual acuities were examined by logarithm of the minimum angle of resolution (logMAR) scale. Intraocular pressure and cup-disc ratio were also recorded. The history with glaucoma and anti-glaucoma drugs, and the state of the cornea and crystalline lens were also remarked. All interviews were administered face to face by the same experienced interviewer, by using the 25-Item National Eye Institute Visual Function Questionnaire (VFQ-25). Agreement between the scores from these tests and the VFQ-25 was evaluated. Results: A total of 131 patients were recruited. In the statistics of the quality of life, seven domain scores of the VFQ-25 (self-assessment vision, color vision, near action, distant action, social function, mental health and peripheral vision) were better than the others, which meant the ability of completing the seven domain was higher. Substantial agreement was found between the composite score of the VFQ-25 and the Esterman test (r=0.24998, P=0.004<0.05), strong negative correlation was found between the composite score of the VFQ-25 and the binocular visual acuity of daily life (r=?0.37778, P<0.0001), and positive correlation was found between the composite score of the VFQ-25 and the MD of the worse eye (r=0.22917, P=0.0187<0.05).Conclusion: In this sample of clinic-based patients with primary chronic glaucoma, the efficiency score of the binocular visual field tests correlated well with the composite score of the VFQ-25. Binocular visual function can be well used in evaluating the quality of life of the glaucoma patients.
目的:探讨正常眼压性青光眼(normal tension glaucoma,NTG)患者睡眠体位与其双眼不对称损害的关系。方法:纳入2014年1月至2018年9月在温州青光眼进展研究(Wenzhou Glaucoma Progression Study,WGPS)项目中的NTG患者。眼部主要检查有视野和光学相干断层扫描(optical coherence tomography,OCT)。睡眠体位数据通过基线睡眠体位问卷获得。根据侧卧位睡眠偏好,将NTG患者眼部参数分为卧位高侧眼和卧位低侧眼进行讨论;根据双眼不对称损害,将患者眼部参数分为较好眼和较差眼讨论。双眼不对称损害定义为双眼视野平均偏差(mean deviation,MD)差值>6 dB或杯盘比差值>0.2。结果:共纳入158例NTG患者,最长随访时间为48个月,其中122例(77.22%)患者存在睡眠偏好;存在睡眠偏好的患者中,83例(68.03%)患者存在侧卧位偏好;存在侧卧位偏好的患者中,大多数患者偏好右侧卧位[右vs左:59 (71.1%) vs 24 (28.9%),P<0.001]。对存在侧卧位偏好的患者进行分析,发现卧位高侧眼与卧位低侧眼眼部参数之间,差异无统计学意义(P>0.05);卧位低侧眼的视野进展速率[视野指数(visual field index,VFI)、MD]慢于卧位高侧眼(0.48%±1.66%/年 vs ?0.45%±3.07%/年;0.54±0.96 dB/年 vs 0.2±1.15 dB/年),差异无统计学意义(P=0.086,P=0.308)。对同时存在侧卧位偏好及双眼不对称损害的患者进行分析,发现卧位高侧眼与卧位低侧眼的眼部参数之间,差异无统计学意义(P>0.05);卧位低侧较好眼的个数及占比高于卧位低侧较坏眼[23 (57.5%) vs 17(42.5%)],但差异无统计学意义(P=0.132);卧位低侧眼的视野进展速率(VFI、MD)也慢于卧位高侧眼(1.19%±1.65%/年 vs ?0.86%±3.65%/年;0.71±1.13 dB/年 vs0.13 dB/年),但差异无统计学意义(P=0.064,P=0.419)。结论:存在睡眠体位偏好的NTG患者中,约68%存在侧卧位偏好;存在侧卧位偏好的患者中,约70%偏好右侧卧位。但本研究并未发现睡眠体位与青光眼患者双眼不对称损害及其疾病进展存在相关性。
Objective: To investigate the association between lateral decubitus position (LDP) and asymmetric loss in normal tension glaucoma (NTG) patients. Methods: NTG patients were enrolled from Wenzhou Glaucoma Progression Study (WGPS) in Jan. 2014 to Sep. 2018. The main eye examinations included visual field test and optical coherence tomography (OCT). A questionnaire to determine the preferred sleeping position was administered to each patient in the baseline. According to the LDP, the eye parameters were divided into non-dependent eyes(higher lateral eyes) and dependent eyes (lower lateral position eyes) for discussion. According to the asymmetric damage, the ocular parameters of the patients were divided into the better eyes and the worse eyes for analysis.Asymmetric loss was defined as a difference in mean deviation (MD) between the 2 eyes of at least 6 dB or disc/cup >0.2. Results: One hundred and twenty-two patients (77.22%) had sleep preferences among the 158 NTG patients who was finally recruited and the longest follow up time was 48 months. Among the patients with sleep preference, 83 patients (68.03%) preferred the lateral decubitus position. Patients who had the lateral decubitus position mostly preferred the right lateral position [59 (71.1%) vs 24 (28.9%), P<0.001]. For patients who had the lateral decubitus position, the ocular parameters between the dependent eyes and the non-dependent eyes had no statistical difference(P>0.05); the rate of visual field progression in the dependent eyes was slower than that in non-dependent eyes, but there was no statistical difference between the two groups (0.48%±1.66%/year vs ?0.45%±3.07%/year; 0.54±0.96 dB/year vs 0.2±1.15 dB/year; P=0.086, P=0.308, respectively). For patients who had the lateral decubitus position and asymmetric damage, the ocular parameters between the dependent eyes and the non-dependent eyes had also no statistical difference (P>0.05); the number and ratio of the dependent-better eye and the dependent-worse eye were 48 and 41, respectively [23 (57.5%) vs 17 (42.5%), P=0.132]; the rate of visual field progression in the dependent eyes was also lower than that in non-dependent eyes, but there was no statistical difference between the two groups (1.19%±1.65%/year vs ?0.86%±3.65%/year; 0.71±1.13 dB/year vs 0.13 dB/year; P=0.064, P=0.419 respectively). Conclusion: About 68% of NTG patients with sleep preferences preferred the lateral decubitus position; and about 70% of patients with the lateral decubitus position preferred the right side sleeping. However, this study did not find a correlation between lateral decubitus position and asymmetric visual field loss.
目的:应用彩色多普勒超声造影检查测定不同类型原发性青光眼患者的视神经血液供应情况,探讨血流变化与青光眼的关系。方法:选取2012年1 2月至2014年3月在哈尔滨医科大学附属第二医院眼科经临床确诊的原发性闭角型青光眼(primary angle closure glaucoma,PACG)患者16例(20只眼)和原发性开角型青光眼(primary open angle glaucoma,POAG)患者8例(10只眼),分别设为PACG组和POAG组;同时,选取1 0例1 0只正常眼设为对照组。所有受试者分别行彩色多普勒及超声造影检查,观察眼动脉(ophthalmic artery,OA)、视网膜中央动脉(central retinal artery,CRA)、睫后短动脉(short posterior ciliary artery,SPCA)的血流动力学指标,包括收缩期最大血流速度(peak systolic velocity,PSV)、舒张末期血流峰值速度(diastolic peak velocity,EDV)、血流阻力指数(resistance index,RI)、造影剂到达时间(arrival time,AT)及消退时间(departure time,DT)等指标,并对结果进行统计学分析。结果:超声造影测定POAG组的眼动脉造影剂AT较正常对照组延长(P=0.035),PACG组及POAG组的眼动脉造影剂DT均较正常对照组延长(P=0.010);彩色多普勒测定PACG组及POAG组的OA和SPCA,以及POAG组的CRA的PSV、EDV均较正常对照组减低(P=0.003);同时,PACG组及POAG组的OA以及POAG组的CRA的RI较正常对照组增高(P<0.001)。结论:彩色多普勒及超声造影可以检测青光眼患者的眼部血供明显低于正常人群,为临床诊治青光眼及评价眼部疾病患者的眼部血供状态提供了一种新的技术手段。
Objective: This study used Doppler imaging and contrast-enhanced ultrasound to measure ocular haemodynamic of patients with primary angle-closure glaucoma (PACG) and primary open-angle glaucoma (POAG), to investigate the association between the blood flow changes and glaucoma. Methods: Doppler imaging and contrast-enhanced ultrasound were performed on 16 PACG patients (20 eyes, PACG group), 8 POAG patients(10 eyes, POAG group) who were diagnosed in the Department of Ophthalmology, the Second Affiliated Hospital of Harbin Medical University from Dec. 2012 to Mar. 2014. The normal eyes from 10 persons were selected as control group. The flow velocity of ophthalmic artery, central retinal artery, and posterior ciliary artery were observed, including the peak systolic velocity, diastolic peak velocity, resistance index, and the arrival time and departure time of the ultrasound microbubbles (SonoVue). Results: Compared to control group, the arrival timeof the ultrasound microbubbles (SonoVue) of ophthalmic artery of patients with POAG increased (P=0.035),and the departure time of ophthalmic artery of patients with PACG and POAG increased (P=0.010). Both peak systolic velocity and diastolic peak velocity of the ophthalmic artery and short posterior ciliary artery of patients with PACG and POAG and the central retinal artery of patients with POAG decreased (P=0.003). Meanwhile, the resistance index of ophthalmic artery of patients with PACG and POAG and the central retinal artery of patients with POAG were higher than those in the control group (P<0.001). Conclusion: The flow velocity of ocular vascular was worse than that of normal group respectively. This study provides a new technology for the diagnosis of glaucoma and the evaluation of the flow velocity of ocular vascular.
霜样树枝状视网膜血管炎是一种少见的急性视网膜血管炎,多发生于健康青少年,病因不明,可能与病毒感染有关,糖皮质激素治疗有效,预后良好;也可继发于感染性疾病和全身疾病,预后较差。该文回顾了一例继发于异基因造血干细胞移植后的霜样树枝状视网膜血管炎,治疗后病情缓解,预后良好。
Frosted branch angiitis (FBA) is a rare acute retinal vasculitis which often occurs in healthy adolescents. The etiology of FBA is unknown, but its occurrence may be related to viral infection, glucocorticoid therapy is effective and has a good prognosis. FBA may also be secondary to infectious and systemic diseaseswith poor prognosis. In this paper, we reviewed a case of FBA secondary to allogeneic hematopoietic stem cell transplantation, which was relieved after treatment and had a good prognosis.
遗传在儿童和青少年的眼耳功能障碍发病机制中起着重要作用。由于眼耳有共同的神经内、外胚层起源,具有相似的基因网络,所以当共同的基因发生致病性变异时会导致眼耳双重感觉丧失。有超过70多种病因与聋盲有关,常见的伴有听力异常并累及视神经和视网膜的综合征型眼遗传病,包括CHARGE综合征、Usher综合征、Stickler综合征、Alport综合征、Wolfram综合征、Waardenburg综合征等。其他如染色体和胚胎的异常也会出现导致眼耳发育障碍,如Down综合征、Dandy-Walker综合征等。一些已知的眼遗传病致病基因变异也可导致听力异常,如OPA1基因。由于遗传异质性,眼耳综合征的临床诊断往往很困难,尤其是对婴幼儿。了解遗传综合征中眼耳相关临床特征,有利于早期发现和正确诊断;而当综合征中眼部表型不典型,可以通过耳部等其他系统表型协助诊断。同时,明确诊断对终生视觉和听觉功能的监测,以及与优生遗传咨询均有重要意义。
Heredity plays an important role in the pathogenesis of eye and ear dysfunction in children and adolescents. Because of common neural endodermal and ectodermal origins, the eyes and ears have the similar networks of genes Therefore, when pathogenic mutations occur in common genes, it can lead to loss of double sensation in the eyes and ears. There are more than 70 etiologies associated with the deafblindness, including CHARGE, Usher, Down, Stickler, Alport, Wolfram and Waardenbur syndromes, which are the most common syndromic ophthalmic genetic diseases with hearing and optic nerve/retinal abnormalities. Other abnormalities such as chromosomal and embryonic abnormalities can also lead to hearing and vision impairment, like Down and Dandy Walker syndromes. Some known genetic variants in ocular genetic diseases can also lead to hearing loss, such as OPA1 gene. Due to genetic heterogeneity, the clinical diagnosis of ocular and ear syndrome is often difficult, especially for infants and young children. With understanding the clinical features of eyes and ears in genetic syndrome,is conducive to early detection and accurate diagnosis, and when the ocular phenotype in the syndrome is atypical, it can be assisted by other systematic phenotypes such as the ear. At the same time, clear diagnosis is important for lifelong monitoring of visual and auditory function, as well as for eugenic genetic counseling.
目的:测量黄斑区视网膜神经节细胞层和内界膜-视网膜色素上皮层厚度,分析其与新发缺血性脑卒中的相关性。方法:采用前瞻性研究,选择2021年12月至2022年3月在潍坊医学院附属医院体检的健康者30例(60眼)为对照组(A组);选择同期收治且年龄匹配的新发缺血性脑卒中患者30例(60眼)为卒中组(B组)。比较两组黄斑区神经节细胞层(ganglion cell layer,GCL)和内界膜-视网膜色素上皮层(inner limiting membrane-Retinal pigment epithelium,ILM-RPE)厚度及平均GCL厚度/ILM-RPE平均容积厚度(GCL/ILM-RPE厚度比)。结果:共纳入120只眼,A、B组分别60只眼。A组的平均GCL为(83.5±4.7)μm,B组的平均GCL厚度为(78.7±10.5)μm,组间比较差异有统计学意义(P<0.001)。A组的GCL最小厚度为(80.4±4.4)μm,B组的GCL最小厚度为(70.7±16.3)μm,组间比较差异有统计学意义(P<0.001)。A组的ILM-RPE中心子区厚度为(247.5±19.8)μm,B组的ILM-RPE中心子区厚度为(241.6±36.3)μm,组间比较差异无统计学意义(P=0.393)。A组的ILM-RPE平均容积厚度为278.4±9.8μm,B组的ILM-RPE平均容积厚度为(278.5±15.3)μm,组间比较差异无统计学意义(P=0.448)。A组的GCL/ILM-RPE厚度比为0.300 3±0.012 2,B组的GCL/ILM-RPE厚度比为0.286 2±0.028 6,组间比较差异有统计学意义(P<0.001)。结论:缺血性脑卒中影响GCL厚度和GCL/ILM-RPE厚度比, GCL厚度和GCL/ILM-RPE厚度比与新发缺血性脑卒中可能有关。
Objective: To measure the thickness of retinal ganglion cell layer and inner limiting membrane-retinal pigment epithelium layer in the macular region, and analyze its correlation with new-onset ischemic stroke. Methods: By using a prospective study, 30 healthy subjects (60 eyes) who underwent physical examination in Affiliated Hospital of Weifang Medical University from December 2021 to March 2022 were selected as the control group (Group A). Thirty age-matched patients with new-onset ischemic stroke admitted at the same time (60 eyes) were selected as the stroke group (Group B). The ganglioncelllayer (GCL) and innerlimitingmembrane-Retinalpigmentepithelium (ILM-RPE) were compared between the two groups. It included the thickness and mean GCL thickness/Mean Volume thickness of ILM-RPE (GCL/ILM-RPE thickness ratio). Results: A total of 120 eyes were included, with 60 eyes in group A and B. The average GCL thickness in group A was (83.5±4.7) μm, and the average GCL thickness in group B was (78.7±10.5) μm,and the difference between groups was statistically significant (P<0.001). The minimum thickness of GCL in group A was (80.4±4.4) μm, and the minimum thickness of GCL in group B was (70.7±16.3) μm, showing statistical significance(P<0.001). The thickness of the central subregion of ILM-RPE in group A was (247.5±19.8) μm, and the thickness of the central subregion of ILM-RPE in group B was (241.6±36.3) μm, and the difference was not statistically significant between two groups (P=0.393). The mean volumetric thickness of ILM-RPE in group A was (278.4±9.8) μm, and the mean volumetric thickness of ILM-RPE in group B was (278.5±15.3) μm, and the difference was not statistically significant (P=0.448). The GCL/ILM-RPE thickness ratio of group A was (0.300 3±0.012 2), and that of group B was (0.286 2±0.028 6), showing a statistical difference between groups (P<0.001). Conclusion: Ischemic stroke affects the GCL thickness and the thickness ratio of GCL/ILM-RPE, which may be related to new-onset ischemic stroke.
目的:借助于人工智能(artificial intelligence,AI)眼底筛查远程接转诊系统,探索“患者-社区-医院”远程筛查模式,推进眼科分级诊疗和双向转诊实施,为地市级医疗机构开展眼底疾病人工智能筛查工作提供一定的经验借鉴。方法:通过AI辅助远程筛查基层医疗机构的4886例患者,完成眼科检查并经AI初判、人工复核形成眼底诊断结论。通过医联体和专科联盟模式,对基层医疗机构的4886例患者的AI诊断系统结果和上级医师审核结果进行对照分析,分析AI诊断系统在眼科常见病种筛查中的推广应用的可信度和可行性。结果:AI检出DR的灵敏度为94.70%,特异度96.06%;DME的灵敏度96.43%,特异度96.55%;AMD的灵敏度77.55%,特异度95.74%;同时,其在病理性近视、白内障、青光眼等常见病种眼底筛查中也有一定作用。结论:AI辅助远程筛查系统对于绝大多数眼底疾病有较高的敏感性和特异性,适用于眼底疾病的筛查工作,利于基层医院或社区医院对于眼底疾病的初步诊断,落实眼科分级诊疗,有借鉴推广意义。
Objective: With the help of artificial intelligence (AI) based fundus screening remote referral telemedicine system,it enables us to explore the remote screening mode of patient-community-hospital, and promote the two-way referral and ophthalmic graded diagnosis. This investigation provides certain practice experiences for prefecture-level medical institutions to carry out AI screening for fundus diseases. Methods: Ophthalmologic examination was performed on 4,886 patients in primary medical institutions through AI-aided remote screening, and the final fundus diagnosis conclusion was formed after AI preliminary judgment and manual review. Through the Medical Consortium and specialty alliance model, the results of the AI diagnosis system and the audit results of superior physicians for 4 886 patients in primary care institutions were compared and analyzed, and the credibility and feasibility of the AI diagnosis system application in the screening of common ophthalmic diseases were discussed. Results: The sensitivity and specificity of AI detection of diabetic retinopathy were 94.70% and 96.06%, respectively. In the diabetic macular edema classification, the sensitivity and specificity were 96.43% and 96.55%, respectively. In the age-related macular degeneration classification, the sensitivity and specificity were 77.55% and 95.74%, respectively. Meanwhile, it also plays a role in screening common fundus diseases such as pathological myopia, cataract and glaucoma. Conclusion: The AI-aided remote screening system has high sensitivity and specificity for most of fundus diseases, indicating it is promising for fundus diseases screening in primary medical institutions. It is conducive for primary hospitals or community hospitals to carry out the initial diagnosis of fundus diseases, as well as the implementation of graded diagnosis and treatment of ophthalmology, which has reference and promotion significance.
目的:足月新生儿行眼部筛查,对眼部疾病的发生情况与特征进行分析。方法:回顾性分析从2021年1月至2022年6月间就诊于温州医科大学附属第二医院&育英儿童医院的足月新生儿共4 594例,记录眼部筛查结果并分析。结果:新生儿眼部筛查总异常率约10.54%,眼底异常率约6.38%。眼前段常见病为新生儿泪囊炎、结膜炎、血管瘤、睑内翻、白内障等;眼底常见病为视网膜白色病灶、视网膜出血、家族性渗出性视网膜病变等。结论:广角婴幼儿眼底筛查仪可早期发现新生儿隐匿性的眼病,部分致盲性眼病需要早期给予治疗,今后需要建立和完善新生儿眼病筛查及随访机制。
Objective: To screen the eyes of term neonates and analyze the occurrence and characteristics of eye diseases. Methods: The eye screening results of 4 594 term neonates admitted to the Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University from January 2021 to June 2022 were recorded and retrospectively analyzed. Results: The total abnormal rate of neonatal eye screening was about 10.54%, among which the abnormal rate of fundus was about 6.38%. Common diseases of the anterior segment included neonatal dacryocystitis, conjunctivitis, hemangioma, entropion, cataract, et al. Common diseases of the posterior segment included retinal leukoplakia, retinal hemorrhage, familial exudative retinopathy, et al. Conclusions: The wide-angle infant fundus screening instrument could detect neonatal occult ophthalmopathy early. And some blinding ophthalmopathies might need early treatment. In the future, it is necessary to establish and improve the screeningand the follow-up mechanism system for the neonatal ophthalmopathy.