目的：开发一款可自动校准测试距离的智能手机视力检测APP(WHOeye的iOS版本)，并评估其实用性。方法： WHOeyes在经过验证的视力检测APP “V@home”的基础上新增自动距离校准(automatic distance calibration, ADC)功能。研究招募了3组不同年龄(≤20岁、20~40岁、>40岁)的中国受试者，分别使用糖尿病视网膜病变早期治疗研究(Early Treatment Diabetic Retinopathy Study, ETDRS)视力表和WHOeyes进行远距离和近距离的视力检测。ADC功能用于确定WHOeyes的测试距离。红外测距仪用于确定ETDRS的测试距离以及WHOeyes的实际测试距离。通过问卷调查评估用户满意度。结果：WHOeyes ADC确定的实际测试距离在3个年龄组中均与预期测试距离总体上表现出良好的一致性(P > 0.50)。在远距离和近距离视力检测方面，WHOeyes的准确性与ETDRS相当。WHOeyes与ETDRS之间的平均视力差异范围为–0.084 ~ 0.012 logMAR，各组的二次加权卡帕系数(quadratic weighted kappa, QWK)均大于0.75。WHOeyes在近距离和远距离视力检测中的重测信度高，平均差异范围为–0.040 ~ 0.004 logMAR，QWK均大于0.85。问卷调查显示WHOeyes具有较好的用户体验和接受度。结论：与金标准ETDRS视力表方法相比，WHOeyes测试距离较为准确，可以提供准确的远距离和近距离视力测量结果。
Background: To develop and assess usability of a smartphone-based visual acuity (VA) test with an automatic distance calibration (ADC) function, the iOS version of WHOeyes. Methods: The WHOeyes was an upgraded version with a distinct feature of ADC of an existing validated VA testing APP called V@home. Three groups of Chinese participants with different ages (≤20, 20-40, >40 years) were recruited for distance and near VA testing using both an Early Treatment Diabetic Retinopathy Study (ETDRS) chart and the WHOeyes. The ADC function would determine the testing distance. Infrared rangefinder was used to determine the testing distance for the ETDRS, and actual testing distance for the WHOeyes. A questionnaire-based interview was administered to assess satisfaction. Results: The actual testing distance determined by the WHOeyes ADC showed an overall good agreement with the desired testing distance in all three age groups (p > 0.50). Regarding the distance and near VA testing, the accuracy of WHOeyes was equivalent to ETDRS. The mean difference between the WHOeyes and ETDRS ranged from -0.084 to 0.012 logMAR, and the quadratic weighted kappa (QWK) values were greater than 0.75 across all groups. The test-retest reliability of WHOeyes was high for both near and distance VA, with a mean difference ranging from -0.040 to 0.004 logMAR and QWK all greater than 0.85. The questionnaire revealed an excellent user experience and acceptance of WHOeyes. Conclusion: WHOeyes could provide accurate measurement of the testing distance as well as the distance and near VA when compared to the gold standard ETDRS chart.
马方综合征 (Marfan syndrome, MFS) 是一种由原纤维蛋白-1(fibrillin-1,FBN-1)突变引起的全身性遗传性疾病，FBN-1基因突变与MFS相关表型的联系相关，目前已报道的MFS常见的眼部表现包括角膜扁平、长眼轴、晶状体异位以及视网膜病变等异常，这些眼部异常将对MFS患者的视力产生影响，如角膜异常可影响角膜高阶像差的异常，可能导致近视或散光等屈光状态异常，从而影响视觉质量，损害视力清晰度。此外，MFS的眼底血管病变，也可能导致MFS患者的视力丧失，研究发现，MFS视网膜血管及脉络膜血管的密度较正常人减少，并与最佳矫正视力相关，由于光感受器的代谢与营养供应与视网膜及脉络膜血管息息相关，血管异常可能与视力损失相关。由于MFS患者存在视力损害的风险，其早期诊断和治疗尤为重要，因此，了解MFS眼部病变的特点及其对视力的影响，对制定针对MFS眼病的治疗方案具有重要的意义。另外，由于MFS眼部异常与FBN1基因突变相关，其基因突变类型多样，致病机制复杂，总结MFS眼部特点对其发病机制的继续探索有一定的指导作用，因此，文章拟就MFS患者眼部生物学参数特点及其对视力的影响这一领域国内外的相关研究进展进行综述。
Marfan syndrome (MFS) is a systemic hereditary disease caused by fibrillin-1 (FBN-1) mutations. FBN-1 gene mutations are associated with MFS-related phenotypes. Common ocular manifestations of MFS reported so far include corneal flattening, long axial length, ectopia lentis, and retinal abnormalities. These ocular abnormalities will affect the vision of MFS patients. For example, corneal abnormalities can affect abnormalities in corneal higher-order aberrations, which may lead to abnormal refractive states such as myopia or astigmatism, thereby affecting visual quality and compromising visual acuity. In addition, retinal vascular abnormalities may also lead to vision loss in MFS patients. Studies have found that the density of retinal and choroidal blood vessels in MFS patients is lower than that in normal individuals and is associated with best corrected visual acuity. Given the close relationship between the metabolism and nutrient supply of photoreceptors and retinal and choroidal vasculature, vascular abnormalities may be linked to visual impairment. Since MFS patients are at risk of visual impairment, early diagnosis and treatment are particularly important. Therefore, understanding the characteristics of ocular manifestations in MFS and their impact on vision is crucial for devising effective treatment strategies for MFS-related ocular conditions. Additionally, as ocular abnormalities in MFS are linked to mutations in the FBN1 gene, which exhibit diverse mutation types and complex pathogenic mechanisms, summarizing the ocular features of MFS can provide valuable insights for further exploration into its pathogenesis. Therefore, this article aims to review the progress of domestic and international research on the ocular biological parameters of MFS patients and their impact on vision.
目的：探讨蛋白A免疫吸附联合糖皮质激素治疗对MOG抗体相关视神经炎（MOG antibody-associated optic neuritis， MOG-ON）患者的临床疗效及安全性。方法：回顾性分析2022年6月—2024年12月在广东三九脑科医院神经内科确诊并接受蛋白A免疫吸附联合糖皮质激素治疗的7例MOG-ON患者。所有患者均接受蛋白A免疫吸附治疗（隔天1次，共5次为1个疗程）并同期联合糖皮质激素治疗。评估治疗前及治疗后3个月、6个月的视力变化、扩展伤残状态量表（expanded disability status scale，EDSS）评分变化及MOG抗体滴度变化，并记录不良反应。结果：治疗后6个月，6/7患者视力较治疗前改善，其中4/7视力改善显著。左眼LogMAR视力值从治疗前的0.20(0.14，0.70)改善至0.10(0.10，0.42)，右眼LogMAR视力值从0.30(0.19，0.47)改善至0.18(0.10，0.21)，EDSS视力评分从2.86±1.68降至1.43±1.51（P < 0.05）。治疗前血清MOG抗体滴度几何平均数为1:52.0（几何标准差GSD = 3.7），治疗后3个月降至1:8.8（GSD = 1.9）（P = 0.027），治疗后6个月降至1:13.0（GSD = 4.1）（P = 0.027）。7例患者共接受35次免疫吸附治疗，未观察到严重不良反应，仅有轻微可控的不良事件。结论：蛋白A免疫吸附联合糖皮质激素治疗能够有效降低血液中MOG抗体水平，改善MOG-ON患者的视力。
Objective: To investigate the clinical efficacy and safety of protein A immunoadsorption combined with glucocorticoid therapy in patients with myelin oligodendrocyte glycoprotein antibody-associated optic neuritis（MOG-ON）. Methods: A retrospective analysis was conducted on 7 patients with MOG-ON who were diagnosed and treated with protein A immunoadsorption combined with glucocorticoid therapy at the Department of Neurology，Guangdong Sanjiu Brain Hospital from June 2022 to December 2024. All patients underwent protein A immunoadsorption therapy （once every other day, with 5 sessions constituting one course） in conjunction with concurrent steroid therapy. Visual acuity changes, EDSS score changes, and MOG antibody titer changes were assessed before treatment, as well as at 3 and 6 months after treatment. Additionally, adverse events were meticulously recorded. Results: At the 6 months post-treatment mark, 6 patients （85.7%） demonstrated an improvement in visual acuity compared to their baseline levels, with 4 patients （57.1%） achieving a significant improvement. The median LogMAR visual acuity values in the left eye improved from 0.20(0.14,0.70) to 0.10(0.10,0.42), and in the right eye, they improved from 0.30(0.19,0.47) to 0.18(0.10,0.21). MeanWhile, the EDSS visual score decreased from 2.86±1.68 to 1.43±1.51（P < 0.05）. The geometric mean serum MOG antibody titer declined from 1:52.0（GSD = 3.7） before treatment to 1:8.8（GSD = 1.9） at 3 months after treatment（P = 0.027）, and further decreased to 1:13.0（GSD = 4.1） at 6 months after treatment（P = 0.027）. A total of 35 immunoadsorption sessions were administered to the 7 patients, and no serious adverse reactions were observed; only minor and manageable adverse events occurred. Conclusion: Protein A immunoadsorption combined with glucocorticoid therapy can effectively lower serum MOG antibody levels and enhance visual outcomes in patients with MOG-ON.
本文报告两例单眼无痛性视力下降病例。病例1为47岁男性，表现为右眼亚急性视力下降，伴视盘水肿及黄斑区星芒状渗出，血清汉塞巴尔通体（Bartonella henselae）IgG抗体阳性（滴度1:256），结合猫接触史及跳蚤叮咬史，诊断为猫抓病相关视神经视网膜炎。经口服多西环素联合球周注射曲安奈德治疗后，视力显著恢复至1.0。病例2为33岁男性，表现为右眼急性视野缺损伴轻度视力下降，视盘水肿伴出血及棉绒斑。血清学检查示汉塞巴尔通体IgG阳性（滴度1:256）及梅毒螺旋体抗体阳性（TPPA+, TRUST+）。初始经验性抗猫抓病（多西环素+利福平）及抗梅毒（苄星青霉素）治疗无效，视力持续下降。随访1个月时光学相干断层扫描（OCT）显示视盘周围视网膜色素上皮（RPE）局灶性钉状突起，符合梅毒眼部特征性改变，结合患者抗汉塞巴尔通体治疗反应不佳，最终修正诊断为梅毒性视神经病变。继续抗梅毒治疗后视力稳定于0.63，但遗留视神经萎缩。两例病例提示感染性视神经病变的诊断需综合病史、临床表现、辅助检查、治疗反应及特征性体征进行鉴别，尤其需审慎解读汉塞巴尔通体抗体血清学阳性结果。
This paper reports two cases of unilateral painless vision loss. Case 1 involved a 47-year-old male presenting with subacute vision loss in the right eye, accompanied by optic disc edema and macular stellate exudates. Serological testing revealed positive IgG antibodies against Bartonella henselae (titer 1:256). Combined with a history of cat contact and flea bites, a diagnosis of cat scratch disease-associated optic neuroretinitis was made. After treatment with oral doxycycline combined with periocular triamcinolone acetonide injection, the patient's vision significantly improved to 1.0. Case 2 involved a 33-year-old male presenting with acute visual field defect in the right eye accompanied by mild vision loss, optic disc edema with hemorrhage, and cotton-wool spots. Serological tests showed positive IgG antibodies against Bartonella henselae (titer 1:256) and positive antibodies against Treponema pallidum (TPPA+, TRUST+). Initial empirical treatment for cat scratch disease (doxycycline + rifampicin) and syphilis (benzathine penicillin) was ineffective, with continued vision decline. Optical coherence tomography (OCT) at the one-month follow-up revealed focal spiculated protrusions of the retinal pigment epithelium (RPE) around the optic disc, consistent with characteristic ocular changes of syphilis. Considering the patient's poor response to anti-Bartonella henselae treatment, the diagnosis was revised to syphlitic optic neuropathy. After continued anti-syphilis treatment, the patient's vision stabilized at 0.63, but optic atrophy persisted. These two cases suggest that the diagnosis of infectious optic neuropathy requires comprehensive differentiation based on medical history, clinical manifestations, auxiliary examinations, treatment responses, and characteristic signs, with particular caution in interpreting positive serological results for Bartonella henselae antibodies.
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.
目的: 探讨 ETDRS 对数视力表对儿童视力检查的可重复性及其影响的相关因素。方法: 在流行病学调查的过程中, 随机使用 ETDRS 对数视力表, 为 250 位裸眼视力低于 0.5 和 98 位视力正常儿童进行裸眼视力重复检查。
结果: 两次视力测量之间差异的均数为0.004log±0.07; Kappa 分析结果具有很好的一致性(k = 0.71) ; 性别与视力检查一致性无明显相关(P = 0.845) ; 年龄与视力检查一致性有显著相关性(P = 0.019) , 年龄越小视力检查一致性越差; 屈光不正与视力检查一致性也有显著相关性(P = 0.000) , 近视度数在- 1.00D～- 5.00D 之间的儿童视力检查一致性相对差, 而正视眼的视力检查一致性较好。结论: 结果提示 ETDRS 对数视力表适合儿童视力检查, 建议推广使用。
Purpose: To evaluate repeatability of the ETDRS log MAR visual acuity measurementin children and the relative influence factors.Methods: The children (n = 348) with visual acuity less than 0.5 ( equal to 0.3 logunit) in either eye,or one tenth in children with normal visual acuity were chosen todo repeatable uncorrected VA measurement with Bland-Altman analysis and Kappa analysis using ETDRS acuity chart.Results: The mean difference of visual acuity was 0.004log±0.07. There was a significant repeatability (k = 0.71) between two visual acuity examination. There were significant consistent results both on male and female patients (P = 0.845) . A significant relationship was found between age and VA repeatability(P = 0.019) . The VA repeatability could also be influenced by refractive error (P = 0.000) . The acuity measurement in children with emmetropia (k = 0.82) had a higher repeatability than in the children with myopia (k = 0.66) .Conclusions: The ETDRS visual acuity chart can provide a repeatable measure of visual acuity in children. It is recommended for clinic examination of children.
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：比较不同受检者在相同近视屈光欠矫下使用C字视力表和E字视力表所测得的视力差别及探讨导致这种差别的原因。方法：选取不同年龄段250名受检者，在完全矫正屈光度[最正之最佳视力(maximum plus to maximum visual acuity，MPMVA)]情况下附加相应的球镜造成相应的近视度数后比较使用2种不同的视力表测出的视力值变化情况。同时根据2种视力表的设计原理及视力表的不同记录法探讨造成数值不同的可能原因。结果：同一附加度情况下分别用C字视力表组和E字视力表组行方差分析，不同年龄组间差异无统计学意义(P>0.05)。相同附加度情况下同一受检者使用C字视力表组和E字视力表组行t检验，两者差异具有统计学意义(t=?15.798，P<0.05)，C字视力表测得视力平均值小于E字视力表测得视力平均值。结论：受检者使用C字视力表比E字视力表检测视力结果更加优异；C字视力表和E字视力表的视标形状及开口方向不同是2种视力表检测结果差异的主要原因。
Objective: To compare the difference of visual acuity measured by C-chart and E-chart in the same myopic refractive undercorrection and to explore the causes of the difference. Methods: Two hundred and fifty subjects of different ages were selected to compare the changes of visual acuity measured by two different visual meters after adding corresponding spherical lenses to the maximum plus to maximum visual acuity (MPMVA) corrected diopter. At the same time, according to the design principle of the two kinds of visual acuity meters and the different recording methods of visual acuity tables, the possible reasons for the different values were discussed.Results: There was no significant difference between different age groups (P>0.05). Under the same degree of additionality, the visual acuity of the same subjects was tested by t-test with C visual acuity chart and E visual acuity chart. The difference was statistically significant (t=?15.798, P<0.05). The average visual acuity of C visual acuity table was smaller than that of E visual acuity table. Conclusion: The visual acuity of myopic patients tested by C visual acuity chart is better than by E visual acuity chart. The main reason for the difference between C visual chart and E visual chart was the different shape and opening direction of visual icons.
