Objective: To analyze computed tomography (CT) manifestations of space-occupying lesions of the orbital bone and their relationship with histopathology. Methods: The clinical data of 15 patients with orbital bone occupying lesions confirmed by clinical manifestations , imaging features and pathological symptoms features were retrospectively collected, and their CT examination, histopathological sections and other clinical manifestations were analyzed. Results: Among the 15 patients, 4 cases were pathologically diagnosed with osteoma, 3 cases of intraosseous hemangioma, 2 cases of osteoid osteoma and 2 cases of ossifying fibroma, 3 cases of eosinophilic granuloma and 1 case of Ewing’s sarcoma. Osteoma was composed of mature lamellar bones, which corresponded to a high-density osteoid nodular protuberance on CT. The pathological features of intraosseous hemangioma were mainly malformed blood vessels between bone trabeculae and typical “fence” and “honeycomb” features on CT. Osteoid osteoma was mainly composed of bone-like tissue and connective tissue, mainly showing round high-density shadow, typical low-density “tumor nest” shadow in the center, and hypertrophic bone density shadow in the periphery. Ossifying fibroma was composed of proliferative fibrous tissue and bone-like tissue. CT showed that the surface of the tumor was often surrounded by bone shell, and the lesions were mostly round or oval. Eosinophilic granuloma was mainly composed of a large number of Langerhans cells, which corresponded to the soft tissue mass on CT and could be accompanied by osteolytic destruction. Ewing’s sarcoma was mainly composed of poorly differentiated small round cells, and CT manifestations were worm-eaten bone destruction with soft tissue lesions between destroyed bone tissues. Conclusion: Various lesions occurring in the orbital bone have their own special pathological composition. Different pathological components show corresponding imaging features on CT.
Objective: To evaluate the clinicopathological features of ocular metastatic clear-cell renal cell carcinoma.Methods: Data of 5 patients (5 eyes) with ocular metastatic clear-cell renal cell carcinoma treated and diagnosed at Eye & ENT Hospital of Fudan University from January 2010 to December 2020 were retrospectively analyzed for medical history, clinical features, imaging examinations, pathomorphological features, immunophenotypes and survival outcomes. Results: There were 3 males of choroidal metastatic clear-cell renal cell carcinoma with age from 51 to 62 years old. They all presented with shadow before the eye and reduced visual acuity of the right eye for 1 to 6 months. On examination the visual acuity was hand movement in front of the affected eye. Fundus examination showed a subretinal elevated mass with retinal detachment. B-scan ultrasound demonstrated an intraocular mass with medium internal reflectivity suspected of choroidal melanoma. Case 2 reported a history of clear-cell renal cell carcinoma treated with a left nephrectomy 2 years ago and developed lung metastasis 1 year ago. Three patients all underwent enucleation and prosthesis implantation. Histopathological and immunohistochemical examinations showed intraocular malignant tumor suggestive of clear-cell renal cell carcinoma which needed further examinations to confirm the primary tumor. Postoperative computed tomography scan of the abdomen for case 1 revealed a mass of the left kidney highly suggestive of a renal cell carcinoma. The computed tomography scan of the chest revealed multiple lesions suggestive of lung metastasis. Postoperative PET-CT scan of case 3 revealed a mass of the left kidney which was confirmed to be clear-cell renal cell carcinoma histopathologically. There were 2 patients of orbital metastatic clear-cell renal cell carcinoma. One 56-year-old female patient (Case 4) presented with swelling, redness and proptosis of the right eye for 2 months. Two months ago, her right kidney was resected for the diagnosis of clear-cell renal cell carcinoma. PEC-CT revealed metastasis to the right orbit with bone destruction. Another 65-year-old male patient (Case 5) presented with palpable mass of the left eyebrow for 3 years. He had left nephrectomy for renal cell carcinoma 7 years earlier and metastasis to the lung later. Histopathology of all 5 cases demonstrated uniform cells with clear or granular cytoplasm in solid and glandular arrangement surrounded by a rich vascular network. Immunohistochemical positivity for the biomarkers CK, Vimentin, CD10 and PAX-8 confirmed the diagnosis of metastatic clear-cell renal cell carcinoma.Conclusion: Clear-cell renal cell carcinoma can metastasize to the choroid or orbit. It should be differentiated from the other ocular primary and metastatic tumors with clear-cell appearance histopathologically.
Objective: To investigate the impact of capsular tension ring (CTR) implantation on the choice of new generation intraocular lens (IOL) calculation formulas (Barrett Universal II, Hill-RBF 2.0, EVO, Kane, and Pearl DGS) in patients with high myopia and cataracts. Methods: This is a prospective case-control study that observed patients with an axial length (AL)≥27.00mm who underwent cataract surgery with AR40E IOL implantation at the Shaanxi Eye Hospital between December 2020 and September 2021. The eyes were randomly assigned to the CTR implantation group (group A) and the non-CTR implantation group (group B). Before surgery, the necessary IOL power was calculated using the Barrett Universal II formula based on measurements of ocular parameters with the IOL-Master 700. The actual refractive error and the predicted error (PE) and absolute error (AE) of the five formulas were recorded and compared at 1 week, 1 month, and 3 months postoperatively. A1 (27.00mm ≤ AL ≤ 30.00mm) and A2 (AL > 30.00mm) were used to divide group A, and B1 (27.00mm ≤ AL ≤ 30.00mm) and B2 (AL > 30.00mm) were used to divide group B. The effects of CTR implantation on the accuracy of formula prediction in different AL ranges were analyzed. Results: 63 patients (89 eyes) were included, with a mean age of 55.93 ± 10.17 years (range: 35years~82 years) and a preoperative axial length of 30.30 ± 2.18 mm (range: 27.05mm~35.75mm). There was no significant difference in the postoperative refractive outcome over time between group A, A1, and A2 (P > 0.05), while there was a statistically significant difference in group B, B1, and B2 between 1 week and 1 month, and between 1 week and 3 months postoperatively (P < 0.05). There was no significant difference in the AE values among the five formulas in groups A, B, A1, A2, B1, and B2 (H = 9.27, P = 0.06, H = 7.09, P = 0.13, H = 2.44, P = 0.66, H = 8.56, P = 0.07, H = 4.16, P = 0.39, H = 8.72, P = 0.07). The implantation of CTR resulted in myopic or hyperopic in all formulas, but there was no statistically significant difference (P > 0.05). Conclusion: After 1 week of surgery, the refraction of the CTR group tended to stabilize, while in the non-implantation group, the refraction tended to stabilize after one month. CTR implantation had no effect on the accuracy and selection of the five formula predictions. The five IOL calculation formulas can be normally selected for cataract patients with AL ≥ 27.00mm.
Objective: To analyze the clinical characteristics and therapeutic effect of 46 patients with bilateral retinoblastoma(RB). Methods: The clinical data of 46 patients with bilateral retinoblastoma who received intravenous chemotherapy combined with transpupillary thermotherapy (TTT) or enucleation from December 2008 to December 2019 in our department were analyzed retrospectively. The eye salvage rate, enucleation rate, visual acuity, and chemotherapy side effects were evaluated. Results: The 46 enrolled patients were 27 males and 19 females, at an average age of (13.21±11.13) months at the first visit. Among them, 10 received chemotherapy, 11 received chemotherapy combined with TTT, 17 received chemotherapy combined with TTT and enucleation,and 2 received chemotherapy combined with freezing, 6 received chemotherapy combined with freezing and enucleation. After treatment, 58 eyes were salvaged, with a total salvage rate of 73.1% (57/78), and the eyes that preserved vision account for 64.1% (50/78). The eye salvage rate in each stage were 100.0% for stage A and B, 86.7% for stage C, and 94.1% for stage D, 35.7% for stage E. Twenty-four eyes were enucleated, with a total enucleation rate of 26.1% (24/92), and among 35 eyes at stage E, 21 eyes were enucleated, accounting for 60.0%(21/35). The average time of chemotherapy was 4.1±1.9 and the myelosuppressive effects of chemotherapy include leucopenia, thrombocytopenia and hemoglobinopenia. During the mean follow-up time of (35.4±23.8) months, 7 (15.2%) patients died, and 39 (84.8%) cases survived. The 5-year cumulative survival rate was 80.2%. Conclusion: Intravenous chemotherapy combined with local treatment has a good overall effect and plays an important role in the treatment of bilateral retinoblastoma. Intravenous chemotherapy leads to myelosuppression, and the myelosuppression gradually recovered after stopping intravenous chemotherapy.
Retinal Arterial Macroaneurysms (RAM) are retinal vascular diseases that commonly occur in the elderly. Most of them are unilateral. Bilateral RAM with Diabetic Retinopathy (DR) are rare. So far, no similar case has been reported at home and abroad. This article mainly describes a case report of a patient with bilateral RAM and DR, and discusses the relationship between RAM and DR, in order to provide reference for clinical ophthalmologists.
Objective: To investigate the clinical, imaging and pathological features of orbital extranodal marginal zone B cell lymphoma of mucosa-associated lymphoid tissue (MALT), so as to reduce misdiagnosis and improve survival rate.Methods: The clinical, imaging and histopathological data of 71 patients with orbital extranodal marginal zone B cell lymphoma of MALT who were treated in Zhongshan Ophthalmic Center, Sun Yat-sen University from Jan.2020 to Dec. 2020 were retrospectively analyzed. Results: There were 38 males and 33 females in the 71 patients.There were 31 cases located on the left orbit, 34 cases on the right orbit, and 6 cases were bilateral; there were 67 primary cases and 4 relapsed cases. The age ranged from 23 to 84 years old. The disease course ranged from 3 months to 15 years. The main clinical manifestations included ocular masses and limited eyeball movement.Magnetic resonance imaging showed a “cast-like” soft tissue shadow of uniform density, and no intraocular invasion is observed. Histopathological examination showed that the tumor was composed of small to medium sized lymphocyte-like cells. Tumor cells exhibited diffuse or lamellar growth, with small to medium-sized irregular nuclei, and the nucleoli were inconspicuous. Some of the lymphocyte-like cells showed mononuclear lymphoma cells changes, and plasmacytoid differentiation was observed in 9 cases, in which kappa and lambda expressions were asymmetric.Conclusion: The clinical manifestations of orbital extranodal marginal zone B cell lymphoma of MALT are various, and imaging examination has certain characteristics, which can assist preoperative diagnosis.Pathological examination can be used for accurate diagnosis and classification after operation, based on which appropriate treatment plan can be made and curative effect can be improved.
Objective: To explore the nursing effect of diversified high-quality nursing on self-efficacy and quality of life of one-eyed cataract patients. Methods: A total of 120 patients with monocular cataract treated in Zhongshan Ophthalmic Center Sun Yat-sen University from July 2021 to March 2022 were selected as the research objects, and diversified high-quality nursing was implemented. Questionnaire survey in quantitative survey was used to analyze the self-efficacy and quality of life of patients before and one week after surgery by using general self-efficacy scale and visual function quality of life scale. Results: One week after operation, the self-efficacy score of the patients increased from 19.61±5.58 to 30.15±5.58 (t=4.397,p=0). The quality of life score increased from 36.15±17.97 to 81.01±13.74 (t=15.36,p<0.001), and the difference was statistically significant. Conclusion: Diversified high-quality nursing can effectively improve the general self-efficacy of patients and improve the quality of life after surgery, and it is worth promoting and applying in clinical practice.
[Abstract] Objective To investigate the current situation and related influencing factors of visual fatigue among college students using the Visual Fatigue Survey Scale. Method In November 2022, a visual fatigue questionnaire survey was conducted among 1350 college students at Jinzhou Medical University. 1132 valid students were surveyed using the Visual Fatigue Survey Scale (Conlon Visual Inappropriate Scale, CISS Set Deficiency Syndrome Scale) and subjective symptoms. Differences, analysis of variance, logistic regression, and multiple linear regression were used to evaluate the risk factors and their correlations affecting visual fatigue. Result 1. 203 college students were diagnosed with visual fatigue through the Conlon Visual Insufficiency Scale survey, with an incidence rate of 17.93%. Analysis shows that subjective symptoms and factors related to visual fatigue are related to the presence of myopia, dry eyes, abnormal regulatory function, other chronic ocular surface abnormalities, smoking in the past two weeks, and average daily close work hours; Multivariate logistic regression analysis showed that abnormal regulatory function, myopia, other chronic ocular surface abnormalities, and smoking in the past two weeks were the main risk factors for visual fatigue (Chi Square, 20.6861, 10.8319, 9.6815, 6.4821, respectively). 2. A total of 308 college students were diagnosed with visual fatigue through the Collective Deficiency Syndrome Scale (CISS) survey, with an incidence rate of 27.20%. Analysis shows that the factors related to subjective symptoms and visual fatigue are related to whether myopia, dry eyes, other chronic ocular surface abnormalities, abnormal regulation function, eye movement function, other eye factors that may cause visual fatigue, as well as alcohol consumption in the past two weeks, and the time spent using electronic products at close range every day; Multivariate logistic regression analysis showed that abnormal regulatory function, myopia, dry eyes, and the presence of other eye factors that may cause visual fatigue were the main risk factors for visual fatigue (Chi Square, 20.6861, 10.8319, 9.6815, 6.4821, respectively). Conclusion Visual fatigue can seriously affect the learning and life of college students. Therefore, it is necessary to attract the high attention of college students and clinical doctors in avoiding behavioral factors that affect visual fatigue, improving their own awareness of eye health, and personalized prevention.
