论著

基于简易设备和算法的瞳孔动、静态信息提取

Extraction of dynamic and static information of the pupil based on simple equipment and algorithms

:601-608
 
目的:设计一套瞳孔动、静态信息提取方案,尝试初步建立正常人群瞳孔动、静态信息数据库。法:于2023年1月—7月,从中山大学眼科中心眼科门诊招募无眼部疾病、全身疾病的参与者。使用工业级红外相机搭配850 nm红外光源录制参与者瞳孔区域20 s视频,提取瞳孔横径数据并输出为txt文件。使用R语言分析数据,构建瞳孔舒缩过程中的波峰、波谷拟合线,并估算瞳孔舒缩频率。结果:共收集32位参与者的瞳孔动态数据,右眼数据纳入主要结果的分析。参与者年龄范围为7~61岁,男性占50%,等效球镜度范围为-5.630~+5.00 D。测量过程中的瞳孔横径平均值与年龄呈负相关,与等效球镜度、性别无关。在20 s的记录中,瞳孔舒缩次数为(15±7)次。基于波峰与波谷拟合线的趋势,瞳孔舒缩动态分为3种类型:舒缩扩张型、舒缩稳定型和舒缩缩小型。舒缩稳定型进一步分为稳定扩张型、稳定恒定型和稳定缩小型3个亚型,其中25人为舒缩缩小型。双眼的过滤后波峰、波谷拟合线的斜率和截距与过滤前比较差异无统计学意义(P>0.05)。结论:低成本、简易的设备配以算法可以便捷、快速地提取瞳孔动、静态信息。
Objective: To design a method for extracting dynamic and static information of the pupil and to establish a database of pupil dynamic and static information in a healthy population. Methods: From January to July 2023, subjects without any ocular or systemic diseases were recruited from the ophthalmology outpatient department. An industrial-grade infrared camera, paired with an 850nm infrared light source, was used to record 20-second videos of the pupil area of each subject. Horizontal pupil diameter data was extracted and saved as txt files. The data was analyzed using R software to construct fitted lines of peaks and troughs during the pupil constriction and dilation process, and the frequency of pupil contraction and dilation was estimated. Results: Pupil dynamic data was collected from 32 subjects with an age range of 7 to 61 years, of whom 50% were male. The spherical equivalent range was from +5.00 D to -5.625 D. The average number of pupil contractions and dilations within the 20-second recordings was (15 ± 7) cycles. Based on the trend of fitted lines for peaks and troughs, pupil dynamic types were categorized into three types: dilation type, stable type, and contraction type. The stable type was further divided into stable dilation, stable constant, and stable contraction subtypes. 25 subjects exhibiting the constriction type. A paired t-test showed no significant difference in the slope and intercept of the fitted lines for peaks and troughs between both eyes. Conclusion: Low-cost and simple equipment combined with algorithms can efficiently and quickly extract dynamic and static pupil information.
临床病例讨论

新发双侧强直性瞳孔1例

Newly bilateral tonic pupil: A case report

:116-119
 

强直性瞳孔在临床工作中较为少见,容易被误诊,典型的强直性瞳孔为单侧,随着病程的进展,逐渐转变为双侧。新发双侧强直性瞳孔更是极为罕见,应当引起重视。其典型的临床表现包括瞳孔散大、瞳孔运动迟钝、节段性瞳孔麻痹、无其他眼部器质性病变。依据病因可以分为继发于急性眼内肌麻痹、合并有全身疾病以及特发性三类。目前治疗方面多以病因治疗为主。

Tonic pupil is rare in clinical work and likely to be misdiagnosed. The typical tonic pupil is unilateral, which gradually turns to bilateral with the progress of disease. Newly bilateral tonic pupil is extremely rare, which captivates widespread attention. Typical clinical manifestations include dilated pupils, slow pupil movement, segmental pupillary palsy, and no other ocular diseases. On this basis, the causes can be divided into three categories, including secondary to acute intraocular myoparalysis, complicated with systemic disease and idiopathic type. At present, etiological treatment is the main treatment.

2046名小学生非散瞳状态下屈光状态分析

Analysis of Refractive status without cycloplegia in 2046 pupils

:16-18
 
目的:分析非散瞳状态下的小学生眼屈光状态。
方法:采用横断面调查设计,对城区小学生2046人 (4092眼) 进行电脑自动验光,数据采用 SPSS10.0 软件行统计分析。
结果在4092眼中 ,正视眼1309眼 (32.0%),远视眼170眼 (4.2%),近视眼2613眼 (63.8%)。 其中低度近视2102眼 (51.4%),中度近视464眼 (11.3%),高度近视47眼 (1.1%)。 其中,男生1348眼近视 (61.2%),女生1265眼近视 (67%)。6个年级中正视眼比例逐渐下降 , 1年级正视眼占 45.5%、6年级正视眼占19.2%。平均屈光度 (-1.32±1.60) D,小学六个年级屈光度比较差异有统计学意义 (P < 0.01),其中女生的平均近视程度较男生重,男女屈光度比较差异有统计学意义 (P < 0.01)。小学6年间近视的进展为 -1.0 D,平均 -0.2 D/y。
结论:我国小学生近视情况严重 ,应予以重视 ,加强早期干预 。
Purpose: To observe the eyes' refractive status without cycloplegia in 2046 pupils.
MethodsThe cross-sectional study was conducted in 2046 pupils of 4092 eyes in Xi‘an city primary schools. The objective ophthalmic examinations were done on all participants, which included non-cycloplegic objective refraction, visual acuity, ocular pressure, fundus evaluation by special trained ophthalmologists and nurses. The special designed inventory scale was filled in and input special computer program, then the data were statistically analyzed with SPSS10.0.
ResultsIn the primary school of 2046 pupils of 4092 eyes,  the detective rate of emmetropia was 32.0% of 1309 eyes, hypermetropia was 4.2% of 170 eyes, myopia was 63.8% of 2613 eyes, low myopia was 51.4% of 2102 eyes, moderate myopia was 11.3% of 464 eyes, and high myopia was 1.1% of 47 eyes in total. In both eyes, the detective rate was  61.2% of 1348 eyes in 2204 boys,  67% of 1265 in 1888 girls. Among 6 grades , the constituent ratio of moderate and high myopia groups were significantly increased with the age,s growing, including emmetropia 45.5% of 343 eyes out of 754 in 1st grade and 19.2% of 122 eyes out of 634 in 6th grade. The average refractive error of spherical equivalent refraction was (-1.32±1.60) D. Among 6 grades, the 1st grade, was (0.82±1.42) D , and the 6th grade’s was (-1.82±1.68) D, there were significant differences among 6 grades (P < 0.01). There was a significant difference between girls and boys (P < 0.01).  The average myopizing rate was -0.2 D per year, -1.0 D in the total of the progression in 6 years.
Conclusion: Poor condition of myopizing was showed in Chinese pupils. It should be taking seriously and making early intervention. 

单眼挫伤瞳孔对光反射与视功能改变的相关研究

Correlation Analysis of Pupil Light Reflex and Visual Functions after Unilater al Ocular Contusion

:53-57
 
目的: 测量单眼挫伤患者瞳孔对光反射的改变, 分析瞳孔对光反射与眼挫伤后其他视功能评价方法的相关性。
方法: 使用红外线自动瞳孔仪分别检测 26 例单眼挫伤患者双眼瞳孔对光反射, 并行视力、视野、图形视觉诱发电位等视功能检查。检查的瞳孔对光反射参数包括瞳孔面积, 对光反应潜伏期、反应幅度。
结果: 眼挫伤患者健眼直接、间接反应幅度比与双眼视力差具有显著相关性(=- 0.648) ; 瞳孔对光反应幅度差、反应幅度比均与视野平均偏差具有显著相关性(=0.5 和 =- 0.535) ; 瞳孔对光反应幅度比与双眼视觉诱发电位振幅比具有显著相关性; 多重线性回归分析显示瞳孔对光反应幅度和 VEP 振幅结合可提高预测视力预后的可能性。
结论: 在瞳孔对光反射各参数中, 瞳孔对光反应幅度在反映眼挫伤后视功能改变方面优于其它参数, 眼挫伤患者瞳孔对光反应幅度与视力、视野、VEP 波幅具有中度相关性, 其与 VEP 联合应用可提高眼挫伤后准确预测视功能的可能性。
Subjects and objective: To measure the quantitative pupil light reflex after unilateral ocular contusion, analyze the correlation of pupil light reflex and other tests of visual function.
Methods: The pupil light reflex in 26 patients who suffered unilateral ocular contusion was tested by infrared video pupillography, psychophysical and electrophysiological tests including visual acuity, visual field, and visual evoked potentials were also tested. Pupil area, the latency and amplitude of pupil light reflex were recorded.
Results: The correlation of the ratio of pupil light reflex amplitude and the differences of visual acuity between 2 eyes in 26 contusion patients was statistically significant. The correlation coefficient r was - 0.648. There were significant correlation between amplitude of pupil light reflex and median defect of visual field. The correlation coefficients r were 0.5 and 0.535. The significant correlations were found in the ratio of amplitudes between pupil light reflex and visual evoked potentials. Multiple linear regression analysis showed combining pupil light reflex amplitude and visual evoked potential amplitude could elevate the possibility of predicting visual acuity.
Conclusion: Pupil light reflex amplitude measurement is superior to other pupil measurements for reflection of the changes of visual function after ocular contusion. The correlations of pupil light reflex amplitude and visual acuity, visual field, visual evoked potential are significant in the ocular contusion patient. Pupil light reflex combined with visual evoked potential could elevate the possibility of predicting visual function precisely after ocular contusion.
病例报告

双眼瞳孔残膜切除联合有晶状体眼后房型环曲面人工晶状体植入治疗先天性视力不佳一例

Bilateral pupil residual membrane resection combined with TICL implantation in the treatment of congenital poor vision: a case report

:770-774
 
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.
眼科护理

先天性瞳孔残膜围手术期的护理

Perioperative nursing of persistent pupillary membrane

:264-267
 
目的:探讨先天性瞳孔残膜围手术期的护理方法。方法:对13例(15眼)先天性瞳孔残膜患儿围手术期给予心理护理、安全护理、优先安排术前检查、术后严密观察病情变化、延续性护理并观察其效果。结果:13例(15眼)先天性瞳孔残膜的患儿手术均顺利完成,术后均无出现并发症,其中6例患者术后视力较术前视力有所提高,住院满意度为92.3%(12/13)。结论:对先天性瞳孔残膜患儿围手术期给予针对性的心理护理、安全护理、延续性护理是瞳孔残膜围手术期的有效护理方法。
Objective: To explore the perioperative nursing methods of persistent pupillary membrane. Methods: In the perioperative period, 13 cases (15 eyes) with persistent pupillary membrane were given preoperative nursing care, psychological nursing, careful observation of the change of condition, safety nursing, continuous nursing and observation of its effect. Results: A total of 13 cases (15 eyes) with persistent pupillary membrane were successfully operated, among which 6 cases had improved postoperative visual acuity compared with preoperative visual acuity, and no postoperative complications occurred. The satisfaction rate of hospitalization was 92.3% (12/13). Conclusion: It is an effective nursing method to give psychological nursing, safety nursing and continuous nursing to children with persistent pupillary membrane in perioperative period.
其他期刊
  • 眼科学报

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
    浏览
  • Eye Science

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
    浏览