Background: This study aimed to explore the best screening measure of myopia and its associated optimal referral criteria for children aged between 6 and 16.Methods: After informed consent of cycloplegia was obtained, a total of 6,321 children aged between 6 and 16 from 53 primary or junior middle schools in Jiading District of Shanghai were included in our populationbased study. Receiver operating characteristic (ROC) curve was performed to determine the best cutoff points, sensitivities and specifi cities of diff erent screening tests, including uncorrected visual acuity (UCVA), noncycloplegic autorefraction (NCAR) and the combination of these two tests.Results: There was significant difference in prevalence of myopia between boys and girls (χ2 =6.358, P=0.012). Compared with children of low age, the prevalence of older children was significantly higher (χ2 =1,386.404, P<0.001). For the combination of UCVA and NCAR, the best cutoff point was UCVA less than or equal to 0.2 logarithm of minimum angle of resolution (MAR) (20/30) and NCAR spherical equivalent refraction (SER) less than or equal to ?0.75 diopters (D), with associated sensitivity and specifi city of 75.0% and 85.0%, respectively, which were higher than those of UCVA and NCAR alone. After stratified by age, the best cutoff points were varied among children. The accuracy for children aged between 9 and 12 was higher than that for other ages.Conclusions: The best screening measure of myopia was the combination of UCVA and NCAR. The optimal referral criteria of myopia for children should be age-determined.
Background: This study aimed to explore the best screening measure of myopia and its associated optimal referral criteria for children aged between 6 and 16.Methods: After informed consent of cycloplegia was obtained, a total of 6,321 children aged between 6 and 16 from 53 primary or junior middle schools in Jiading District of Shanghai were included in our populationbased study. Receiver operating characteristic (ROC) curve was performed to determine the best cutoff points, sensitivities and specifi cities of diff erent screening tests, including uncorrected visual acuity (UCVA), noncycloplegic autorefraction (NCAR) and the combination of these two tests.Results: There was significant difference in prevalence of myopia between boys and girls (χ2 =6.358, P=0.012). Compared with children of low age, the prevalence of older children was significantly higher (χ2 =1,386.404, P<0.001). For the combination of UCVA and NCAR, the best cutoff point was UCVA less than or equal to 0.2 logarithm of minimum angle of resolution (MAR) (20/30) and NCAR spherical equivalent refraction (SER) less than or equal to ?0.75 diopters (D), with associated sensitivity and specifi city of 75.0% and 85.0%, respectively, which were higher than those of UCVA and NCAR alone. After stratified by age, the best cutoff points were varied among children. The accuracy for children aged between 9 and 12 was higher than that for other ages.Conclusions: The best screening measure of myopia was the combination of UCVA and NCAR. The optimal referral criteria of myopia for children should be age-determined.
Background: Different visual acuity chart can be targeted to evaluate the visual function of patients with different eye diseases. We conducted a comparative analysis of the digital logarithm of the minimum angle of resolution (LogMAR) vision chart and the standard logarithmic vision chart for the measurement of visual acuity after retinal detachment surgery.Methods: We used the digital LogMAR vision chart and the standard logarithmic vision chart to measure the visual acuity of 100 patients (100 eyes) who underwent retinal detachment surgery at our hospital using the LogMAR recording method and compared the differences between the mean measurements obtained by both methods for all patients and for different age groups.Results: When all of the patients were analyzed, the mean visual acuity differed between the digital LogMAR vision chart and the standard logarithmic vision chart by –0.07 LogMAR units. No significant difference was observed in the mean visual acuity between the two vision charts in the 10-20 year and 21-40 year age groups (P>0.05), while a significant difference was observed in post-operative mean visual acuity between the two vision charts for patients aged 41-65 years (P<0.05).Conclusions: Both the digital LogMAR vision chart and the standard vision chart were effective and reliable for the measurement of visual acuity. The visual acuity measured by the standard vision chart was higher than that measured by the digital LogMAR vision chart. We recommend using the digital LogMAR vision chart as the preferred chart for measuring visual acuity after retinal detachment surgery.
Background: Different visual acuity chart can be targeted to evaluate the visual function of patients with different eye diseases. We conducted a comparative analysis of the digital logarithm of the minimum angle of resolution (LogMAR) vision chart and the standard logarithmic vision chart for the measurement of visual acuity after retinal detachment surgery.Methods: We used the digital LogMAR vision chart and the standard logarithmic vision chart to measure the visual acuity of 100 patients (100 eyes) who underwent retinal detachment surgery at our hospital using the LogMAR recording method and compared the differences between the mean measurements obtained by both methods for all patients and for different age groups.Results: When all of the patients were analyzed, the mean visual acuity differed between the digital LogMAR vision chart and the standard logarithmic vision chart by –0.07 LogMAR units. No significant difference was observed in the mean visual acuity between the two vision charts in the 10-20 year and 21-40 year age groups (P>0.05), while a significant difference was observed in post-operative mean visual acuity between the two vision charts for patients aged 41-65 years (P<0.05).Conclusions: Both the digital LogMAR vision chart and the standard vision chart were effective and reliable for the measurement of visual acuity. The visual acuity measured by the standard vision chart was higher than that measured by the digital LogMAR vision chart. We recommend using the digital LogMAR vision chart as the preferred chart for measuring visual acuity after retinal detachment surgery.
叶黄素类物质为膳食类胡萝卜素,主要存在于视网膜组织中,为黄斑色素发挥抗氧化活性和蓝光滤过作用。近年来,有研究证实,叶黄素类物质可降低色差,提高视力及对比敏感度等功能,并对于年龄相关性黄斑变性、视网膜光损伤等疾病具有防治作用。
Xanthophylls is a kind of dietary carotenoid, which is mainly located in retina, and plays an important role in antioxidant and blue light ffltration. Lutein, zeaxanthin and meso-zeaxanthin can enhance visual performance by decreasing chromatic aberration and enhancing contrast sensitivity, and they can also prevent age-related macular degeneration and retinal light-induced injury.
目的:评估低视力青少年使用电子助视器对其阅读速度的影响。
方法:在泉州市盲校筛查 10 名使用光学助视器有阅读能力的低视力青少年学生进行屈光矫正和常规外眼、内眼检查,分别测量其使用各种光学助视器及电子助视器阅读5号字卡的阅读速度。
结果:10 名低视力青少年学生在使用光学助视器后阅读速度为 (18.50±6.54) 字/分,使用电子助视器后阅读速度为 (34.36±5.06) 字/分,两组比较差异有统计学意义 (P < 0.05)。低视力青少年的近视力与阅读速度无关 (P > 0.05)。
结论:使用电子助视器较光学助视器可以明显提高低视力青少年的阅读速度,不同病因所致的低视力青少年其近视力与阅读速度无关。
Purpose: To evaluate the reading speed of adolescents with different causes of low vision using electronic visual aids.
Methods: The screening of 10 young students from Quanzhou Blind School who could read Chinese N5 print by different optical aids. After refractive correction and ophthalmic examination, the reading speeds with Chinese N5 print were measured using various optical and electronic visual aids.
Results: The reading speed of (34.36 ± 5.06) words/min by electronic visual aids performed faster than the reading speed of (18.50 ± 6.54) words/min by optical visual aids in 10 young students with low vision (P < 0.05). The reading speed of young people with low vision due to different causes had no direct linear correlation with their near visual acuity (P > 0.05).
Conclusion: The electronic visual aids could more significantly improve the reading speed of young people with low vision than the optical visual aids did. The reading speed of young people with low vision due to different causes was not related to their near visual acuity.
该文报道一例30岁的男性患者因“双眼自幼视力不佳,强光下视物模糊加重4年余”就诊,经过眼部检查评估,诊断为双眼瞳孔残膜、双眼屈光不正。患者接受一期双眼瞳孔残膜切除、二期双眼行有晶状体眼后房型环曲面人工晶状体(toric implantable collamer lens,TICL)植入手术,术后视力恢复良好。文章回顾了该例患者的诊治过程,为临床屈光不正同时伴有瞳孔残膜患者的诊治提供参考。
A 30-year-old male patient presented at our institution with a history of poor vision in both eyes since childhood, exacerbated by blurriness under bright light for over four years. Following a comprehensive ophthalmic examination, the patient was diagnosed with bilateral pupillary membrane remnants and refractive errors. The patient underwent a two-stage surgical intervention, starting with the removal of the pupillary membrane remnants, followed by the implantation of toric implantable collamer lenses (TICL) in the posterior chamber of the lensless eyes. Postoperative outcomes were favorable, with significant improvement in visual acuity. This article reviews the therapeutic journey of the patient, offering insights into the diagnosis and management of individuals with concurrent refractive anomalies and pupillary membrane remnants, thereby contributing to the clinical discourse on the subject.
因不同的眼部和神经性疾病,导致视觉功能严重受损,为低视力患者日常活动(如阅读及驾驶)及生活质量、心理健康带来严重的影响。人们对外界信息的感知主要来源于视觉,除威胁生命的重大疾病外,对人感官影响最大的损害当属视觉损伤。且随着人口日益老龄化,该问题日趋加重,低视力已成为目前全球范围内一个严重的公共卫生问题。目前,低视力康复发展面临着临床和科研的巨大挑战,要研发出一种能有效改善视觉功能,同时能兼顾多种功能的视障辅助技术,这需要医学、生物学、工程学、微电子学、计算机学等多学科的共同发展和相互合作。低视力康复通过为患者提供适宜的视障辅助技术,最大化利用患者的残余视力及视觉功能,改善与低视力相关的功能限制,有效改善其独立性和整体生活质量,使其独立生活、工作并融入社会成为可能。该文对经典的助视器、人工视觉(视觉假体/视觉感官替代设备)、经颅刺激及视觉生物反馈训练等视障辅助技术在低视力康复中的应用进展进行综述。
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.People's perception of external information mainly comes from vision. Expect for the life-threatening major diseases,visual damage has the greatest impact on people's senses. With the ageing of the population, the problem is getting worse, and low vision has become a serious public health problem in the world. Currently the development of low vision rehabilitation is facing a huge challenge in clinical and scientific research, to develop a visual impairment assistance technology that can effectively improve visual function while balancing multiple functions. It requires the joint development and cooperation of multiple disciplines such as medicine, biology, engineering, microelectronics, and computer science. Low vision rehabilitation provides patients with appropriate visual impairment assistance technology,maximizing the use of residual vision and visual function of patients, improving the functional limitations associated with low vision, effectively improving 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 on visual impaired assistive technologies such as classic visual aids, artificial vision (visual prostheses/visual sensory replacement devices), transcranial stimulation and visual biofeedback training in low vision rehabilitation.
目的:探索白内障术眼低视力的原因。方法:对2011年10月至2013年3月在汕头国际眼科中心行白内障手术,术前无法窥清眼底,术后1周最佳矫正视力<0.3的患者进行视力、最佳矫正视力、眼压测量、裂隙灯检查、眼底镜检查、眼底照相及光学相干断层扫描(optical coherence tomography,OCT),若未发现任何视网膜器质性病变,再进行视觉诱发电位检查及视野检查。由2位医生对检查结果进行分析,对不同的眼底病变做出诊断,统计分析白内障术眼低视力的原因。结果:共纳入行白内障手术患者5 608例,术后1周最佳矫正视力<0.3的患者共49例(共49眼),其中男20例,女29例,右眼31只,左眼18只,年龄(69.11±12.05)岁。白内障术后低视力比例为0.87%。其中高度近视性脉络膜视网膜病变12例(24.5%),椭圆体带连续性破坏10例(20.4%),糖尿病性视网膜病变8例(16.3%),黄斑孔5例(10.2%),老年性黄斑变性4例(8.1%),黄斑前膜3例(6.1%),黄斑区视网膜厚度变薄1例(2.0%),视网膜色素变性1例(2.0%),视网膜劈裂症1例(2.0%),视网膜分支动脉阻塞1例(2.0%),白塞氏病1例(2.0%),缺血性视神经病变1例(2.0%),视网膜前膜1例(2.0%)。结论:在本组白内障术眼低视力的患者中,高度近视性脉络膜视网膜病变占主要部分,为24.5%,其次分别为椭圆体带连续性破坏、糖尿病性视网膜病变、黄斑孔、老年性黄斑变性和黄斑前膜。利用OCT可发现影响白内障术后视力的细微视网膜结构变化,对于白内障术前眼底可见的患者常规行OCT有利于判断手术预后,便于医患沟通,提高手术满意度。
Objective: To explore the causes of low vision after cataract surgery. Methods: Patients who underwent cataract surgery at Joint Shantou International Eye Center of Shantou University and the Chinese university of Hong Kong ( JSIEC) from October 2011 to March 2013, whose fundus status could not be seen before surgery, and the best corrected visual acuity <0.3 in the first week after surgery, underwent a series of detailed ocular examinations, including visual acuity, best corrected visual acuity, intraocular pressure, slit-lamp examination, fundus examination, fundus photography and optical coherence tomography. If no organic lesions of the retina were found, then visual evoked potential examination and visual field examination were performed. Two doctors analyzed the examination results of the examination, made the diagnosis of different fundus diseases, and statistically analyzed the causes of low vision after cataract surgery. Results: A total of 5 608 cataract surgeries were performed in our hospital from October 2011 to March 2013. A total of 49 patients (49 eyes) with best corrected visual acuity worse than 0.3 within postoperative 1 week 20 male and 29 female, 31 right eyes and 18 left eyes, aged (69.11±12.05) years on average. The proportion of low vision after cataract surgery was 0.87%. 12 cases (24.5%) of high myopic chorioretinopathy, 10 cases (20.4%) of ellipsoidal band defect, 8 cases (16.3%) of diabetic retinopathy, 5 cases (10.2%) of macular holes, 4 cases (8.1%) of age-related macular degeneration, 3 cases (6.1%) of macular epiretinal membrane, 1 case (2.0%) of thinning macular retinal thickness, 1 case (2.0%) of retinitis pigmentosa, 1 case of retinoschisis (2.0%), 1 case of branch retinal artery occlusion (2.0%), 1 case of Behcet’s disease (2.0%), and 1 case of ischemic optic neuropathy (2.0%), 1 case of epiretinal membrane (2.0%). Conclusion: Among patients with low vision after cataract surgery, high myopic chorioretinopathy accounts for 24.5%, followed by ellipsoidal band defect, diabetic retinopathy, macular hole, age-related macular degeneration, and macular epiretinal membrane. The use of optical coherence tomography can detect subtle microscopic retinal structural changes that affect vision after cataract surgery. For patients with visible fundus before cataract surgery, routine optical coherence tomography contributes to evaluating the prognosis of the operation, facilitating doctorpatient communication, and improving the degree of surgical satisfaction.
目的: 探讨儿童双目视力筛查仪在先天性白内障中的应用。 方法: 本文为回顾性分析,选择 2017 年 7 月 至 2018 年 5 月在厦门市儿童医院眼科的 3 个月至 2 岁婴幼儿 336 例(672眼),均由2个固定的医生分别采用小瞳孔红光反射及儿童双目视力筛查仪检查,同时详细记录病史资料。所有患儿均给予裂隙灯检查、复方托品卡胺散瞳后行眼底检查,对眼底无法窥入的者必要时给予眼部B超检查或眼部MRI检查,以排除眼底病变。结果:依据2009年出版的第5版《Harley’s小儿眼科学》的先天性白内障临床分类方法,本组病例中先天性白内障的类型依次为皮质(核)白内障2 7例(35眼),其中胚胎核2例( 4眼),板层2 3例(29眼),核性2例( 2眼);囊膜性白内障1 9例(28眼),缝合性白内障2例( 4眼),极性白内障3例( 6眼),全白内障2例( 3眼)。儿童双目视力筛查仪筛查出先天性白内障的灵敏度为81.58%,特异度为79.87%,诊断符合率为80.06%;红光反射筛查的先天性白内障的灵敏度为51.32%,特异度为69.97%,诊断符合率为67.86%;两组结果比较均有统计学意义。儿童双目视力筛查仪对皮质(核)性白内障筛查率为97.14%,而红光反射的筛查率为37.14%,结果比较具有统计学意义。结论:儿童双目视力筛查仪在先天性白内障筛查中,具有低漏诊率和误诊率,较高的诊断一致性的优势,尤其对皮质(核)性白内障有高的检出率,将有利于在日常儿童眼保健的辅助筛查工作中,及早发现先天性白内障患儿。
Objective: To explore the application of children’s binocular vision screening instrument in screening congenital cataract. Methods: This was a retrospective analysis of 336 infants aged 3 months to 2 years (672 eyes) who were admitted to the Ophthalmology Department of Xiamen Children's Hospital from July 2017 to May 2018. They were examined by two fixed doctors with the pupil red light reflex and binocular vision screening instrument, and the medical history was recorded in details. All the children received slit lamp examination, compound tropicamide mydriasis and fundus examination. If necessary, the children who could not see fundus were given with B-ultrasonic examination or MRI examination. Results: According to the clinical classification of congenital cataracts published in the 5th edition of Harley’s pediatric ophthalmology in 2009, In this group, there were 27 cases (35 eyes) of congenital cataract, including 2 cases (4 eyes) of embryonic nucleus, 23 cases (29 eyes) of lamellar layer, 2 cases (2 eyes) of nuclear cataract, 19 cases (28 eyes) of capsular cataract, 2 cases (4 eyes) of suture cataract, 3 cases (6 eyes) of polar cataract and 2 cases (3 eyes) of total cataract. The sensitivity of children’s binocular vision screening instrument screening congenital cataract was 81.58%, the specificity was 79.87%, and the diagnostic coincidence rate was 80.06%; the sensitivity of red reflection screening congenital cataract was 51.32%, the specificity was 69.97%, and the diagnostic coincidence rate was 67.86%; the results of the two groups were statistically significant. The screening rate of children's binocular vision screening instrument for cortical (nuclear) cataract was 97.14%, while that of red reflex was 37.14%. The results were statistically significant. Conclusion: In the screening of congenital cataract, the binocular vision screening instrument for children has the advantages of low missed diagnosis rate, high misdiagnosis rate and high diagnostic consistency, especially for cortical (nuclear) cataract. It is helpful to find the congenital cataract early in the auxiliary screening of children’cares eye health