眼黄斑囊样水肿(cystoid macular edema,CME)是白蛋白结合型紫杉醇的罕见并发症。该文报告了一例60岁女性患者，在右侧乳腺癌根治术后进行为期7周的白蛋白结合型紫杉醇化学治疗，治疗过程中出现双眼视力下降，经眼科检查诊断为由白蛋白结合型紫杉醇引起的双眼CME。确诊后即刻停用白蛋白结合型紫杉醇，并采用口服乙酰唑胺治疗。经随访，患者停药20个月时双眼CME基本消失，同时双眼矫正视力恢复至1.0。该病例为化学治疗药物引起的CME，机制可能与紫杉烷类药物对Müller细胞和视网膜色素上皮层产生毒性作用有关。值得注意的是，其典型的特征表现为荧光素眼底血管造影未见明显的荧光渗漏。文章回顾了该病例的病程发展，并对其他文献中报道的白蛋白结合型紫杉醇诱导的CME病例的临床特点及诊疗进行了总结。同时，对白蛋白结合型紫杉醇诱导CME的潜在发病机制进行了讨论，旨在为眼科医生提供早期诊断和治疗此类疾病的思路。
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.
人工晶状体混浊是白内障术后较为少见的并发症，患者多于手术后数月或数年因不明原因视力下降或视朦就诊。本文报道一例73岁女性患者，在同一时期双眼先后植入同一型号亲水性丙烯酸酯人工晶状体，术后6年右眼人工晶状体完全混浊，而左眼人工晶状体仍为完全透明状态。两眼的临床眼部体征、眼前节光学相干断层成像(optic coherence tomography,OCT)、超声生物显微镜检查(ultrasound biomicroscopy,UBM)等检查结果均有明显差异，人工晶状体混浊眼通过手术治疗后视力恢复满意。文章详细记录了该例患者术前的相关资料、手术治疗以及手术取出人工晶状体的检查结果，并进行了分析讨论，供专家同行参阅，为该类患者的诊疗提供参考。
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.
Terson综合征又称蛛网膜下腔出血合并玻璃体积血综合征，是一种较为罕见的眼科疾病。患者多因颅内出血而存在意识障碍，沟通困难，极易漏诊，错过最佳治疗时机。该文报道了一例30岁男性患者，因弥漫蛛网膜下腔出血，突发昏迷，于发病1个月后出现双眼视物模糊，最终确诊为双眼Terson综合征，并行双眼玻璃体切割术及右眼视网膜前膜剥膜术治疗。术后54 d，患者左眼视力由指数/5 cm恢复至矫正视力0.3。术后19 d，患者右眼视力由手动/20 cm恢复至矫正视力0.12。
Terson syndrome, which is also defned as subarachnoid hemorrhage combined with vitreous hemorrhage syndrome, is a relatively rareeye disease. Due to intracranial hemorrhage, patients with this disease usually experience consciousness disorders and communication difculties, so that it is easy to to miss the diagnosis and the optimal time for treatment. This article reports a case of a 30-year-old male patient with sudden coma due to diffuse subarachnoid hemorrhage. He felt blurred in both eyes 1 month afer the onset, and was diagnosed as binocular terson syndrome ultimately. He underwent bilateral vitrectomy and anterior retinal membrane detachment surgery in the right eye. Te patient visual acuity was restored from fnger count/5cm to 0.3 corrected visual acuity in the lef eye when 54 days afer surgery, and his visual acuity was from manual/20 cm to 0.12 corrected visual acuity in the right eye when 19 days afer surgery.
Background: To compare two swept-source optical coherence tomography (SS-OCT) biometers,IOLMaster 700 and ANTERION.Methods: This is a retrospective study. Biometric measurements of cataract patients performed between March and July 2021 in the Department of Ophthalmology, United Christian Hospital, Hong Kong, were reviewed. Patients scheduled for cataract surgery were measured with both SS-OCT devices on the same day.The following biometry parameters were compared: keratometry (K), total keratometry (TK), axial length (AL), central corneal thickness (CCT), anterior chamber depth (ACD), lens thickness (LT), white-to-white (WTW) and the predicted intraocular lens (IOL) power to achieve emmetropia. To assess the agreement between the devices, Bland-Altman analysis with 95% limits of agreement (LoA) were used.Results: In total, 92 eyes of 47 subjects were measured with both devices. There were statistically significant differences between the two biometers for most measurements (P<0.05) except for flat K, AL and IOL power when using the right eyes for analysis. For the left eyes, there were statistically significant differences in the measurements from the two biometers in all parameters except for flat and steep K. The ANTERION did not obtain ACD, AL and LT in 2 (2.17%), 1 (1.09%) and 5 cases (5.43%) respectively.Conclusions: The two biometers showed a clinically acceptable agreement in most parameters. Comparisons showed significant differences in most parameters but not clinically relevant except for the TK and WTW, and these two parameters should not be used interchangeably between the devices.
Background: To compare two swept-source optical coherence tomography (SS-OCT) biometers,IOLMaster 700 and ANTERION.Methods: This is a retrospective study. Biometric measurements of cataract patients performed between March and July 2021 in the Department of Ophthalmology, United Christian Hospital, Hong Kong, were reviewed. Patients scheduled for cataract surgery were measured with both SS-OCT devices on the same day.The following biometry parameters were compared: keratometry (K), total keratometry (TK), axial length (AL), central corneal thickness (CCT), anterior chamber depth (ACD), lens thickness (LT), white-to-white (WTW) and the predicted intraocular lens (IOL) power to achieve emmetropia. To assess the agreement between the devices, Bland-Altman analysis with 95% limits of agreement (LoA) were used.Results: In total, 92 eyes of 47 subjects were measured with both devices. There were statistically significant differences between the two biometers for most measurements (P<0.05) except for flat K, AL and IOL power when using the right eyes for analysis. For the left eyes, there were statistically significant differences in the measurements from the two biometers in all parameters except for flat and steep K. The ANTERION did not obtain ACD, AL and LT in 2 (2.17%), 1 (1.09%) and 5 cases (5.43%) respectively.Conclusions: The two biometers showed a clinically acceptable agreement in most parameters. Comparisons showed significant differences in most parameters but not clinically relevant except for the TK and WTW, and these two parameters should not be used interchangeably between the devices.
Background: A variety of experimental animal models are used in basic ophthalmological research to elucidate physiological mechanisms of vision and disease pathogenesis. The choice of animal model is based on the measurability of specific parameters or structures, the applicability of clinical measurement technologies, and the similarity to human eye function. Studies of eye pathology usually compare optical parameters between a healthy and altered state, so accurate baseline assessments are critical, but few reports have comprehensively examined the normal anatomical structures and physiological functions in these models.Methods: Three cynomolgus monkeys, six New Zealand rabbits, ten Sprague Dawley (SD) rats, and BALB/c mice were examined by fundus photography (FP), fundus fluorescein angiography (FFA), and optical coherence tomography (OCT).Results: Most retinal structures of cynomolgus monkey were anatomically similar to the corresponding human structures as revealed by FP, FFA, and OCT. New Zealand rabbits have large eyeballs, but they have large optic disc and myelinated retinal nerve fibers in their retinas, and the growth pattern of retinal vessels were also different to the human retinas. Unlike monkeys and rabbits, the retinal vessels of SD rats and BALB/c mice were widely distributed and clear. The OCT performance of them were similar with human beings except the macular.Conclusions: Monkey is a good model to study changes in retinal structure associated with fundus disease, rabbits are not suitable for studies on retinal vessel diseases and optic nerve diseases, and rats and mice are good models for retinal vascular diseases. These measures will help guide the choice of model and measurement technology and reduce the number of experimental animals required.
Background: A variety of experimental animal models are used in basic ophthalmological research to elucidate physiological mechanisms of vision and disease pathogenesis. The choice of animal model is based on the measurability of specific parameters or structures, the applicability of clinical measurement technologies, and the similarity to human eye function. Studies of eye pathology usually compare optical parameters between a healthy and altered state, so accurate baseline assessments are critical, but few reports have comprehensively examined the normal anatomical structures and physiological functions in these models.Methods: Three cynomolgus monkeys, six New Zealand rabbits, ten Sprague Dawley (SD) rats, and BALB/c mice were examined by fundus photography (FP), fundus fluorescein angiography (FFA), and optical coherence tomography (OCT).Results: Most retinal structures of cynomolgus monkey were anatomically similar to the corresponding human structures as revealed by FP, FFA, and OCT. New Zealand rabbits have large eyeballs, but they have large optic disc and myelinated retinal nerve fibers in their retinas, and the growth pattern of retinal vessels were also different to the human retinas. Unlike monkeys and rabbits, the retinal vessels of SD rats and BALB/c mice were widely distributed and clear. The OCT performance of them were similar with human beings except the macular.Conclusions: Monkey is a good model to study changes in retinal structure associated with fundus disease, rabbits are not suitable for studies on retinal vessel diseases and optic nerve diseases, and rats and mice are good models for retinal vascular diseases. These measures will help guide the choice of model and measurement technology and reduce the number of experimental animals required.
