Low vision is a serious visual impairment. Due to low vision status, patients often face varying degrees of difficulties in their daily lives, studies, and work. Low vision rehabilitation refers to the use of visual rehabilitation, rehabilitation training, and other methods to help patients maximize their ability to maintain independence and improve their quality of life. This study provides a certain reference basis for clinical low vision rehabilitation work by summarizing the epidemiological status and rehabilitation status of low vision both domestically and internationally.
Objective: To evaluate the effectiveness of music therapy on the anxiety level and physiological response of patients undergoing ophthalmic surgery.
Methods: Relevant randomized controlled trials that compared the combined effect of music therapy for patients undergoing ophthalmic surgery were included. Four English databases and three Chinese databases were searched from inception to Jan. 2022. Two reviewers independently performed data extraction and risk of bias assessments. The Cochrane Collaboration tool was used to assess the risk of bias. Meta-analysis was performed using Review Manager 5.3. The outcomes were overall anxiety, blood pressure, heart rate and pain.
Results: Atotal of 11 trials with 1,469 participants were included in the meta-analysis. Compared to standard care, music therapy had a good effect on reducing the anxiety levels of patients undergoing ophthalmic surgery (p<0.05). The results also suggested that music therapy produced a signifcant improvement in blood pressure (p<0.05) and heart rate (p<0.05). The visual analogue scale (VAS) showed that music therapy signifcantly reduced pain compared to standard care (p<0.05).
Conclusions: This meta-analysis provided evidence that music therapy has an obvious efect on relieving anxiety levels, while it is also more effective in alleviating pain and improving physiological responses than standard care alone. Our fndings may provide accurate evidence-based guidance for the clinical implementation of music therapy. In the future, more high-quality studies are required for verifying these results.
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: Patients with dacryocystitis should be treated for their infection by endoscopic dacryocystorhinostomy (EN-DCR) before any intraocular surgery. However, there is no unified standard for the specific time interval between the two surgeries. This study aimed to determine the appropriate interval for intraocular surgery in patients with previous EN-DCR for chronic dacryocystitis.
Methods: The medical files of all patients who underwent intraocular surgery after EN-DCR surgery in our hospital from 2016 to 2019 were reviewed. The EN-DCR data of patients undergoing intraocular surgery at different time intervals and the incidence of endophthalmitis after intraocular surgery were compared.
Results: A total of 116 patients (92 females and 24 males, mean age 64.06±7.78 years) underwent EN-DCR and intraocular surgery met the inclusion criteria. The interval between EN-DCR and intraocular surgery varied from 5–475 days. The number of patients undergoing cataract surgery after EN-DCR is the largest (75, 64.7%). All patients (100%) who had previously undergone EN-DCR did not develop endophthalmitis infection after intraocular surgery at a follow-up of 12 months.
Conclusions: For patients with dacryocystitis who have undergone EN-DCR surgery, there is no time limit when choosing the timing of intraocular surgery. For patients requiring intraocular surgery, operation can be arranged as soon as possible to solve their problems as long as the patients had patency on lacrimal passage irrigation and no secretions.
Retrobulbar block refers to the injection of local anesthetics into the muscle cone behind the eyeball, blocking the ciliary, oculomotor, and ciliary ganglion nerves, to provide pain relief, restrict eye movement, and reduce intraocular pressure. Modern retrobulbar block is the "gold standard" for eyeball immobilization and anesthesia in intraocular surgeries, and it is the one of the most commonly used methods for ocular regional block. Although the complications related to this method are rare, the complications will threaten the vision and even life. Th is expert consensus introduces the application scope of retrobulbar block, and systematically describes functional neuroanatomy of eye sensation and movements, safety and procedures of retrobulbar block, local anesthetics, contraindications and complications of the block, which can provide the reference for clinical application of this method.
Background: The “flipped classroom” is a learner-centered approach that centers on delivering videos,podcasts or slide-based material to learners prior to a lecture or class session. The class session is then dedicated to discussion, analysis, and problem-solving activities. The aim of this study was to investigate whether the flipped classroom could be adapted to medical (ophthalmology) students learning about ocular trauma and to assess the impact of the flipped classroom on those students’ performance and attitudes.
Methods: Questionnaires (using a 4-point scale) were distributed to 93 fifth-year medical students at Sun Yat-sen University, and the data showed that the majority of students preferred the flipped classroom approach to the traditional lecture method.
Results: The results of pre- and post-test scores were 14.35±3.404 and 20.37±4.356, which showed a significant improvement in students’ performance after the flipped classroom was introduced (P<0.05).
Conclusions: Student response to the flipped classroom strategy was largely positive, indicating that the strategy received a high level of approval in an ophthalmology clerkship course taken by medical students in China.
Backgrounds: To assess changes in anterior segment biometry during accommodation using a swept source anterior segment optical coherence tomography (SS-OCT).
Methods: One hundred-forty participants were consecutively recruited in the current study. Each participant underwent SS-OCT scanning at 0 and -3 diopter (D) accommodative stress after refractive compensation, and ocular parameters including anterior chamber depth (ACD), anterior and posterior lens curvature, lens thickness (LT) and lens diameter were recorded. Anterior segment length (ASL) was defined as ACD plus LT. Lens central point (LCP) was defined as ACD plus half of the LT. The accommodative response was calculated as changes in total optical power during accommodation.
Results: Compared to non-accommodative status, ACD (2.952±0.402 vs. 2.904±0.382 mm, P<0.001), anterior (10.771±1.801 vs. 10.086±1.571 mm, P<0.001) and posterior lens curvature (5.894±0.435 vs. 5.767±0.420 mm, P<0.001), lens diameter (9.829±0.338 vs. 9.695±0.358 mm, P<0.001) and LCP (4.925±0.274 vs. 4.900±0.259 mm, P=0.010) tended to decreased and LT thickened (9.829±0.338 vs. 9.695±0.358 mm, P<0.001), while ASL (6.903±0.279 vs. 6.898±0.268 mm, P=0.568) did not change significantly during accommodation. Younger age (β=0.029, 95% CI: 0.020 to 0.038, P<0.001) and larger anterior lens curvature (β= -0.071, 95% CI: -0.138 to -0.003, P=0.040) were associated with accommodation induced greater steeping amplitude of anterior lens curvature. The optical eye power at 0 and -3 D accommodative stress was 62.486±2.284 and 63.274±2.290 D, respectively (P<0.001). Age was an independent factor of accommodative response (β= -0.027, 95% CI: -0.038 to -0.016, P<0.001).
Conclusions: During -3 D accommodative stress, the anterior and posterior lens curvature steepened, followed by thickened LT, fronted LCP and shallowed ACD. The accommodative response of -3 D stimulus is age-dependent.
Background: Surgically induced astigmatism (SIA) and corneal high-order aberrations (HOAs) are the two main causes of poor visual quality after cataract surgery. Changes in the parameters of corneal HOAs after cataract surgery and their effects on and relationships with changes in corneal curvature have not yet been reported. This study aimed to explore changes in anterior, posterior and total corneal curvature, astigmatism and HOAs after microincision cataract surgery.
Methods: Sixty-one age-related cataract patients (61 eyes) were included in this prospective study. The total, anterior and posterior corneal astigmatism and corneal HOAs were analyzed by anterior segment optical coherence tomography (AS-OCT) and iTrace before, one day, one week and three months after 2.2 mm temporal microincision coaxial phacoemulsification to evaluate the changes in anterior, posterior and total corneal curvature, astigmatism and corneal HOAs.
Results: The mean J0 and J45 values of anterior, posterior and total corneal curvature obtained by AS-OCT showed no statistically significant difference between preoperatively and any postoperative follow-up. SIA occurred on the anterior, posterior and total corneal surfaces and showed no statistically significant difference at any postoperative follow-up. No significant changes in 3rd-order oblique trefoil, vertical coma or 4th-order spherical aberrations were observed after surgery except for a significant increase in horizontal coma at postoperative day 1 (POD1).
Conclusions: There were no significant changes in corneal curvature after 2.2 mm temporal microincision coaxial phacoemulsification, and the corneal HOAs were not changed significantly except for the increase in horizontal coma at POD1, which may be one of the main reasons of poor visual quality at POD1 in some cataract patients who have good uncorrected or corrected distance vision.
Objective To explore the factors of macular edema after por-ogenous retinal detachment and its influence on visual vision. Methods A total of 180 (180 eyes) patients with rhegogenous retinal detachment admitted to our hospital from January 2021 to March 2023 were selected. 180 patients were classified without macular oedema (142 eyes) or (38 eyes) based on the optical coherence tomography (OCT) 1 month after surgery. Electronic medical records was collected for clinical data, and underwent ophthalmic examination for mean visual field defect (MD), intraocular pressure (IOP), axial length (AL), anterior chamber depth (ACD), central corneal thickness (CCT), and observed maximum systolic flow velocity (PSV), peak end diastolic flow velocity (EDV), and mean flow rate (MV). Structural equation models were constructed to analyze the effects of the occurrence of macular edema after pore-derived retinal detachment, and stratified regression was used to analyze the BCVA expression levels of different pathological features. Results After treatment, the serum total bilirubin (TB) content and peripheral neutrophil, lymphocyte ratio (NLR), best corrected visual acuity (BCVA) between the two groups (P <0.05). Diabetes mellitus, ocular artery systolic maximum flow velocity (OA-PSV), peak ocular artery end-diastolic flow velocity (OA-EDV), ophthalmic artery mean flow velocity (OA-MV), central retinal artery systolic maximum flow velocity (CRA-PSV), peak central retinal artery end-diastolic flow velocity (CRA-EDV), mean central retinal artery velocity (CRA-MV), maximum posterior ciliary artery systolic flow velocity (SPCA-PSV), and posterior ciliary short artery end-diastolic flow velocity (SPCA-EDV) are all macula Independent risk factors for oedema (P <0.05). The structural equation model was constructed. The various indicators of the model were good, and the convergent validity and combined reliability of the model were good. The nerve fiber layer, ganglion cell layer, inner tuxform layer, inner core layer and outer tuxform layer were all affected (P <0.05). Conclusion Elevations of diabetes mellitus, OA-PSV, OA-EDV, OA-MV, CRA-PSV, CRA-EDV, CRA-MV, SPCA-PSV, and SPCA-EDV are risk factors for postoperative macular edema in patients with pore-origin retinal detachment, which should be noted in clinical studies.
