Purpose: To observe the changes in the retinal and choroidal vessels in patients with central retinal artery occlusion (CRAO) and their correlation with visual acuity via optical coherence tomography angiography (OCTA). Methods: This was a retrospective case analysis.Sixty-two eyes with clinically confirmed acute CRAO (symptom onset ≤ 7 days) were included in the study. All examined eyes underwent best-corrected visual acuity (BCVA), slit lamp microscopy, indirect ophthalmoscopy, fundus color photography, OCTA and fundus fluorescence angiography (FFA) examinations. The results of the OCTA-B scan and FFA examination were recorded, and the type of CRAO was divided into three groups: incomplete type, subcomplete type and complete type. The software built into the OCTA system used to measure the superficial and deep retinal vessel density, outer retinal blood flow area, retinal thickness and choroidal blood flow area. BCVA statistics were converted to the logarithm of the minimum angle of resolution (logMAR). Contralateral healthy eyes were used as the control group.Spearman’s correlation analysis was used to determine the correlations between retinal blood vessel density, retinal thickness, and choroidal blood flow area and visual acuity.Results: In whole-image analysis, compared with the control group, the incomplete-type group showed significantly decreased blood vessel density of the superficial and deep retina (t=-0.028, 0.058; p=0.014, 0.000 < 0.05), significantly increased outer retinal flow areas (t=2.42, p=0.031 < 0.05), and no significant changes in the choriocapillaris flow area and retinal thickness (t=0.315, 1.535, p=0.17, 0.136 > 0.05). For the subcomplete type, the superficial retinal vessel density, retinal thickness and outer retina flow area were not significantly different from those of the control group (t=-0.427, 1.216, 1.117, p=0.485, 0.244, 0.286 > 0.05), but the deep retinal vessel density and choriocapillaris flow area were (t=0.098, -2.362, p=0.031, 0.036 < 0.05). The superficial retinal vessel density was not significantly different between the complete-type group and its control group (t=-0.255, p=0.899 > 0.05), but the deep retinal vessel density, retinal thickness, outer retinal flow area and choriocapillaris flow area were (t=-5.618, 27.06, 4.68, -13.05, p=0.005, 0.000, 0.018, 0.001 < 0.05). The logMAR BCVA of the incomplete-type group was significantly lower than that of both the subcomplete-type and complete-type groups (F=15.524, p=0.000 < 0.05). The vessel density of the superficial central fovea of the incomplete-type group was significantly lower than that of both the subcomplete-type and complete-type groups, and that of the subcomplete-type group was significantly lower than that of the complete-type group. The nasal vessel density near the superficial central fovea of both the incomplete-type and subcomplete-type groups were significantly lower than that of the complete-type group (F=7.807, 7.437, p=0.001, 0.001 < 0.05). The choroidal blood flow area of the complete-type group was significantly lower than that of the incomplete type group (F=8.025, p=0.018 < 0.05). Spearman’s correlation analysis showed that the logMAR BCVA was positively correlated with the vessel density of the superficial central fovea and the nasal vessel density near the superficial central fovea (r=0.279, 0.326, p=0.031, 0.013 < 0.05) but was not significantly correlated with the choroidal blood flow area (r=-0.157, p=0.257 > 0.05). Conclusions: OCTA observation of choroidal blood flow area and retinal vessel density is helpful for determining the type of CRAO and evaluating retinal ischemia and visual impairment in CRAO eyes. The vessel density of the superficial central fovea and nasal vessel density near the superficial central fovea may be reliable markers of visual impairment in CRAO.
Purpose: To observe the changes in the retinal and choroidal vessels in patients with central retinal artery occlusion (CRAO) and their correlation with visual acuity via optical coherence tomography angiography (OCTA). Methods: This was a retrospective case analysis.Sixty-two eyes with clinically confirmed acute CRAO (symptom onset ≤ 7 days) were included in the study. All examined eyes underwent best-corrected visual acuity (BCVA), slit lamp microscopy, indirect ophthalmoscopy, fundus color photography, OCTA and fundus fluorescence angiography (FFA) examinations. The results of the OCTA-B scan and FFA examination were recorded, and the type of CRAO was divided into three groups: incomplete type, subcomplete type and complete type. The software built into the OCTA system used to measure the superficial and deep retinal vessel density, outer retinal blood flow area, retinal thickness and choroidal blood flow area. BCVA statistics were converted to the logarithm of the minimum angle of resolution (logMAR). Contralateral healthy eyes were used as the control group.Spearman’s correlation analysis was used to determine the correlations between retinal blood vessel density, retinal thickness, and choroidal blood flow area and visual acuity.Results: In whole-image analysis, compared with the control group, the incomplete-type group showed significantly decreased blood vessel density of the superficial and deep retina (t=-0.028, 0.058; p=0.014, 0.000 < 0.05), significantly increased outer retinal flow areas (t=2.42, p=0.031 < 0.05), and no significant changes in the choriocapillaris flow area and retinal thickness (t=0.315, 1.535, p=0.17, 0.136 > 0.05). For the subcomplete type, the superficial retinal vessel density, retinal thickness and outer retina flow area were not significantly different from those of the control group (t=-0.427, 1.216, 1.117, p=0.485, 0.244, 0.286 > 0.05), but the deep retinal vessel density and choriocapillaris flow area were (t=0.098, -2.362, p=0.031, 0.036 < 0.05). The superficial retinal vessel density was not significantly different between the complete-type group and its control group (t=-0.255, p=0.899 > 0.05), but the deep retinal vessel density, retinal thickness, outer retinal flow area and choriocapillaris flow area were (t=-5.618, 27.06, 4.68, -13.05, p=0.005, 0.000, 0.018, 0.001 < 0.05). The logMAR BCVA of the incomplete-type group was significantly lower than that of both the subcomplete-type and complete-type groups (F=15.524, p=0.000 < 0.05). The vessel density of the superficial central fovea of the incomplete-type group was significantly lower than that of both the subcomplete-type and complete-type groups, and that of the subcomplete-type group was significantly lower than that of the complete-type group. The nasal vessel density near the superficial central fovea of both the incomplete-type and subcomplete-type groups were significantly lower than that of the complete-type group (F=7.807, 7.437, p=0.001, 0.001 < 0.05). The choroidal blood flow area of the complete-type group was significantly lower than that of the incomplete type group (F=8.025, p=0.018 < 0.05). Spearman’s correlation analysis showed that the logMAR BCVA was positively correlated with the vessel density of the superficial central fovea and the nasal vessel density near the superficial central fovea (r=0.279, 0.326, p=0.031, 0.013 < 0.05) but was not significantly correlated with the choroidal blood flow area (r=-0.157, p=0.257 > 0.05). Conclusions: OCTA observation of choroidal blood flow area and retinal vessel density is helpful for determining the type of CRAO and evaluating retinal ischemia and visual impairment in CRAO eyes. The vessel density of the superficial central fovea and nasal vessel density near the superficial central fovea may be reliable markers of visual impairment in CRAO.
Objective: To describe the clinical and histopathological features of ciliary body tumors. Methods: A total of 19 patients with ciliary body tumors who were collected in Tianjin Eye Hospital from June 2008 to June 2018,and confirmed by surgical treatment and histopathological examation.The clinical symptoms, eye signs, imageological examination, treatment strategies, histopathological examination and prognosis were analyzed. SPSS 21.0 software was used to statistically describe the age and follow-up time. Results: Of the 19 patients, 13 cases were male and 6 cases were female. 9 cases involved with the right eye and the other 10 involved with the left eye. The mean age was 13~65 (50.8±3.5) years old. B-mode ultrasound revealed round or irregular tumors in the ciliary body, with clear boundaries and uniform internal echo. Color Doppler ultrasonography showed no blood flow signal in 8 tumors, whereas found a small amount of blood flow signal in other 11 tumors. All 19 patients underwent ultrasound biomicroscopy, which showed that the ciliary body was thickened and the tumors were mostly medium-intensity echoes with clear boundaries. Among them, 13 patients had uneven internal echoes, and 6 patients had uniform internal echoes. All patients underwent CT examination. Among them 9 tumors were found round shape, 4 tumors were single flat mounds, 3 tumors were multiple mounds, and 3 tumors were irregular shape. 13 cases with homogeneous high tumor density and 6 cases with medium density. The CT value was between 55 and 108HU. In MRI examination, the patients with ciliary body melanoma showed moderate high signal on T1WI and low signal on T2WI. The pathological diagnosis of ciliary body melanocytoma showed high-signal intensity on T1WI and low-signal intensity on T2WI. Nonpigmented epithelium adenoma of ciliary body showed moderately high signal intensity on T1WI and moderate signal on T2WI.Patients with ciliary body leiomyoma showed moderate signal intensity on T1WI and moderate signal intensity on T2WI. Among the 19 patients, 14 patients underwent eyeball enucleation combined with artificial eye platform implantation surgery and 5 patients underwent local resection of tumors with vitreoretinal surgery and secondary implantation of anterior chamber intraocular lenses. Among the 19 cases with ciliary body tumors, 11 cases (57.9%) were ciliary body melanoma, 3 cases (15.8%) were ciliary body melanocytoma, 3 cases (15.8%) were non-pigmented epithelial adenoma，one case were ciliary body leiomyoma (5.3%), and one case of recurrent conjunctival squamous cell carcinoma invading the ciliary body (5.3%). A regular telephone follow-up and the outpatient clinical system was performed. During the follow-up period,14 patients underwent the eyeball enucleation did not occur orbital metastasis,and without other complications.No recurrences occurred in five patients who underwent local tumor resection during the follow-up period, and their visual acuity was 0.05-0.2. Conclusions: Ciliary body tumors are rare and histopathological classifications are complicated. The differentiation between benign and malignant tumors is often difficult. The identification is based on clinical signs and imageological examination, but the final diagnosis is based on the histopathological characteristics.
Dry eye (dryeyedisease,DED) affects hundreds of millions of people around the world, which is characterized by the increase of inflammatory cytokines and chemokines and the destruction of tear film homeostasis on the eye surface. With the further study of the pathogenesis of dry eyes, more and more attention has been paid to the role of PRG4 and its derivatives in lubricating the ocular surface and regulating inflammation in dry eyes. Proteoglycan 4 (Proteoglycan4,PRG4) is a mucin-like glycoprotein on the eye surface and is well known as a lubricant that contributes to the integrity of the tear film on the eye surface. Therefore, it is of great significance to study the treatment and prevention of PRG4 in dry eyes. The purpose of this article is to review the literature on the treatment of dry eyes with PRG4 and to provide reference for the clinical treatment of dry eyes. In this paper, the research status of PRG4 in dry eyes in recent years is reviewed.
OBJECTIVE To observe the cleaning effect of multiplexed phacoemulsification tips. METHODS Through experimental exploration, a set of standard cleaning procedures for multiplexed phacoemulsification needles was established. According to the amount of lumen cleaning water (60ml-30ml-15ml-10ml-5ml-0ml (control group)), they were divided into 6 groups, each with 6 needles. All groups were cleaned according to the standard cleaning process, and after cleaning, the cleaning quality was detected by visual inspection of the blowing cavity of the pressure air gun and ATP fluorescence detector. RESULTS The phacoemulsification tips cleaned according to the standard process are 100% qualified by visual inspection and ATP detection methods. The volume of lumen cleaning water is not less than 5ml. CONCLUSION The standard cleaning procedure can be used for the cleaning of multiplexed phacoemulsification tips, and the minimum flushing water volume is 5ml.
Objective: To explore the prevention efficacy of auricular points plaster therapy on gastrointestinal reaction caused by fundus fluorescein angiography (FFA). Methods: We selected 583 patients who underwent fundus fluorescein angiography in the special examination department of our hospital from October 2019 to April 2020, and divided these patients into experimental group (n=298) and control group (n=285). The control group was given routine nursing measures before the examination. The experimental group was treated with auricular points plaster therapy on the basis routine nursing measures before the examination. The gastrointestinal reactions, degree of patient compliance and comfortableness during the examination were compared between the two groups. Results: The incidence of gastrointestinal reaction in the experimental group was lower than that of control group (P<0.05). The score of patient compliance degree was 2.87±0.35 in the experimental group and 2.96±0.19 in the control group, and there was a significant difference between the two groups (P<0.001). Degree of comfortableness was 3.93±0.70 in the experimental group and 3.91±0.56 in the control group. There was no significant difference between the two groups (P=0.122). Conclusion: Auricular points plaster therapy can reduce the incidence of gastrointestinal reaction caused by fundus fluorescein angiography, which is safe and reliable, easy to operate. In addition, the auricular points plaster therapy will not affect patient’s comfortness during examination, and will comply the patients to the examnination smoothly. is helpful for patients to complete the examination comfortably and safely
At present, the research on adult keratoconus has been extensive, while the research on pediatric keratoconus is few. The diagnosis and treatment of pediatric keratoconus are often based on the study of keratoconus in adults. Pediatric keratoconus is more aggressive than adult keratoconus, resulting in visual impairment that can follow throughout their lives and have a serious negative impact on their quality of life and educational development. In this paper, according to the treatment progress of pediatric keratoconus in recent years, the safety, effectiveness,and treatment timing of different treatment methods were summarized, in order to have a more comprehensive understanding of the treatment of pediatric keratoconus.
Objective: To explore the application effect of WeChat platform in continuous nursing care for patients with complicated cataract after implantable collamer lens (ICL) implantation. Methods: Thirteen patients (16 eyes) with complicated cataracts after ICL implantation were followed up and continued nursing on the WeChat platform, then the self-control of the patients’ satisfaction on nursing before and one month after surgery was observed. Results: A total of 13 patients’ operation (16 eyes) went well, and they had no postoperative complications. The visual acuity of the patients was improved after operation compared with that of before operation, and the nursing satisfaction score of patients after operation was higher than that of before operation; the difference was statistically significant (P<0.05). Conclusion: Using WeChat platform for follow-up and continuous nursing can improve patients' nursing satisfaction, which was an effective nursing method for patients with complicated cataract after ICL implantation.
Objective: To understand the clinical distribution characteristics of cataract surgery patients and provide reference for cataract prevention and treatment in primary hospitals. Methods: From January 2019 to December 2019, 892 cataract patients (1 008 eyes) were selected from the Department of Ophthalmology, Third Affiliated Hospital of Jinzhou Medical University. Medical records were collected, including patient’s name, gender, age, surgical eye, admission time and history of diabetes, preoperative vision, corneal endothelial cell density, eye axis, phacoscotasmus type and cataract etiology, surgery method, intraocular lens, intraoperative complications, intraocular pressure, visual acuity and eye recovery on the first day after operation. These data were statistically described and analyzed. Results: A total of 892 cataract patients (1 008 eyes) were included, including 357 males (401 eyes) and 535 females (607 eyes), with the average age of (71.17±10.28) years old. The 90.7% patients cause of disease was age-related cataract. Admission time of all patients was mainly in March–June and September– December. Cataract patients of different ages had their own ocular characteristics. There was a statistically significant difference between the type of cataract and age (P<0.05). Compared with the cortical patients and posterior subcapsular patients, nuclear cataract patients were older at admission. There was no significant difference in the type of cataract between the gender and the patients with diabetes or not (P>0.05). The most frequently selected surgical method for cataract patients was phacoemulsification and intraocular lens implantation, which has the advantages of less intraoperative complications and rapid postoperative recovery. Conclusion: We still have a long way to go in the prevention and treatment of cataract. Most of the operations were performed on age-related cataract patients, and most of them were older and had low vision when they were admitted to hospital, so the optimal timing of the operation was missed. Patients of different age groups and different types of cataract have different characteristics. Phacoemulsification is the first choice because of its own advantages.
