Editorial
Original Article

Subjective refractions determined by Dyop® and LogMAR chart as fixation targets

Subjective refractions determined by Dyop® and LogMAR chart as fixation targets

:-
 
Background: Dyop® is a dynamic optotype with a rotating and segmented visual stimulus. It can be used for visual acuity and refractive error measurement. The objective of the study was to compare refractive error
measurement using the Dyop® acuity and LogMAR E charts.
Methods: Fifty subjects aged 18 or above with aided visual acuity better than 6/12 were recruited. Refractive error was measured by subjective refraction methods using the Dyop® acuity chart and LogMAR E charts and the duration of measurement compared. Thibo’s notation was used to represent the refractive error obtained for analysis.
Results: There was no significant difference in terms of spherical equivalent (M) (P=0.96) or J0 (P=0.78) and J45 (P=0.51) components measured using the Dyop® acuity and LogMAR E charts. However, subjective refraction measurement was significantly faster using the Dyop® acuity chart (t=4.46, P<0.05), with an average measurement time of 419.90±91.17 versus 452.04±74.71 seconds using the LogMAR E chart.
Conclusions: Accuracy of refractive error measurement using a Dyop® chart was comparable with use of a LogMAR E chart. The dynamic optotype Dyop® could be considered as an alternative fixation target to be used in subjective refraction.
Background: Dyop® is a dynamic optotype with a rotating and segmented visual stimulus. It can be used for visual acuity and refractive error measurement. The objective of the study was to compare refractive error
measurement using the Dyop® acuity and LogMAR E charts.
Methods: Fifty subjects aged 18 or above with aided visual acuity better than 6/12 were recruited. Refractive error was measured by subjective refraction methods using the Dyop® acuity chart and LogMAR E charts and the duration of measurement compared. Thibo’s notation was used to represent the refractive error obtained for analysis.
Results: There was no significant difference in terms of spherical equivalent (M) (P=0.96) or J0 (P=0.78) and J45 (P=0.51) components measured using the Dyop® acuity and LogMAR E charts. However, subjective refraction measurement was significantly faster using the Dyop® acuity chart (t=4.46, P<0.05), with an average measurement time of 419.90±91.17 versus 452.04±74.71 seconds using the LogMAR E chart.
Conclusions: Accuracy of refractive error measurement using a Dyop® chart was comparable with use of a LogMAR E chart. The dynamic optotype Dyop® could be considered as an alternative fixation target to be used in subjective refraction.
综述

Ahmed青光眼引流阀植入术后处理引流盘纤维包裹的研究进展

Research progress on the treatment of fiber wrapping of drainage tray after Ahmed glaucoma drainage valve operation

:63-68
 
Ahmed青光眼引流阀植入术作为难治性青光眼的主要治疗方案,能很大程度控制眼压,且疗效和预后均优于常规滤过性手术。但是远期引流盘周围被纤维包裹后会阻塞房水流出,引起术后高眼压,导致手术失败。因此,解决引流盘纤维包裹能很大程度地提高青光眼阀植入术后远期成功率,这也是目前的研究热点。目前临床上主要采用术前预防及术后二次操作对纤维包裹进行干预,但长期效果欠佳。本文就青光眼引流阀纤维包裹发生的组织病理学及分子机制、临床目前解决方案、前沿研究进展以及对Ahmed青光眼阀门的材料改造的探索进行综述。
Ahmed glaucoma valve implantation, as the main treatment option for refractory glaucoma, can control intraocular pressure (IOP) to a large extent. And its efficacy and prognosis are superior to those of conventional filtration surgery. IOP is well-controlled in the early postoperative stages. However, long-term fibrosis of encapsulated bleb inhibits fluid exchange and causes elevated IOP, leading to surgical failure. Therefore, treating fibrosis of encapsulated bleb can improve the long-term success rate after glaucoma valve implantation, which is also a research hotspot. Currently, the main clinical interventions are preoperative prophylaxis and postoperative secondary operations for fiber wrapping, but its long-term efficacy is not satisfactory. This article reviews the occurrence, histopathology and molecular mechanism of fibrous encapsulation, treatment in a clinical setting, cutting-edge research progress, and exploration on material modification of Ahmed glaucoma valve.
技术交流

80例外伤性视神经病变患者内镜下经蝶筛径路视神经管减压术的护理体会

Nursing experience of 80 patients with traumatic optic neuropathy undergoing endoscopic trans-ethmosphenoid optic canal decompression

:870-875
 
目的:探讨外伤性视神经病变(traumatic optic neuropathy,TON)患者内镜下经蝶筛径路视神经管减压术(endoscopic trans-ethmosphenoid optic canal decompression,ETOCD)的整体护理。方法:选取中山大学中山眼科中心2020年1月至2021年3月收治的80例TON患者,回顾总结患者 ETOCD期间的护理措施及手术疗效。结果:所有患者经过综合护理后均顺利完成手术,未发生感染,出血、疼痛情况经治疗和护理后均改善,68.8%患者术后视力有提高。结论:针对TON患者ETOCD的特点,采取个体化的整体护理具有重要意义,有利于帮助患者顺利完成手术,降低并发症的发生率,促进患者康复。
Objective: To investigate the holistic nursing care of patients with traumatic optic neuropathy undergoing endoscopic trans-ethmosphenoid optic canal decompression (ETOCD). Methods: A total of 80 patients with traumatic optic neuropathy admitted to Zhongshan Ophthalmology Center of Sun Yat-sen University from Jan 2020 to Mar 2021 were selected as the subjects, and the nursing measures and surgical effect during ETOCD were reviewed and summarized. Results: All 80 surgical patients successfully completed the operation after comprehensive nursing without infection. The bleeding and pain were improved after treatment and nursing, and 68.8% patients presented with vision improvement. Conclusion: According to the characteristics of ETOCD in patients with traumatic optic neuropathy, it is of great significance to take individualized overall care, which is beneficial to help patients successfully complete the operation, reduce the incidence of complications, and promote the recovery of the patient’s healthy.
论著

载脂蛋白A1及其模拟肽在眼科疾病中的研究新进展

Advances of apolipoprotein A1 and its mimetic peptide in ophthalmic diseases

:154-159
 
近年来,脂质代谢紊乱与眼科疾病关系密切。体外研究和临床前模型显示,高密度脂蛋白(high density lipoprotein,HDL)及其主要蛋白成分载脂蛋白A1(apolipoprotein A1,apoA1)对内皮细胞具有抗氧化、抗炎和抗凋亡作用,对血管具有强大的保护作用。ApoA1模拟肽能够模拟apoA1功能,且分子质量更小,前景非常乐观。而动物实验及人体试验均证实了模拟肽D-4F口服使用的安全性及有效性,因此目前研究最为广泛。目前来说,对于apoA1及其模拟肽在眼科疾病的研究中属于萌芽阶段。本文总结了apoA1及其模拟肽的结构,及其在眼科疾病如视光学、角膜病、玻璃体视网膜疾病中的研究进展,为apoA1及其模拟肽在眼科的进一步研究及开发利用提供参考。
The recent researches indicate that the disorder of lipid metabolism is closely related to ophthalmic diseases. In vitro studies and preclinical studies have shown that high density lipoprotein (HDL) and its main structural protein apolipoprotein A1 (apoA1) have superior efficacy in blood vessel protection, with antioxidant, anti-inflammatory and antiapoptotic effects on endothelial cells. Prospect of the ApoA1 mimetic peptide is very optimistic as it can mimic the function of apoA1, and its molecular weight is smaller. The safety and efficacy of oral use of mimetic peptide D-4F have been confirmed in both animal experiments and clinic trials. Thus, it had been extensively studied. In this paper, we reviewed the structure of apoA1 and its mimetic peptide, as well as their researches related to ophthalmic diseases, such as optometry, corneal diseases and vitreoretinal diseases, so as to provide reference to further researches in apoA1 and its mimetic peptide in the field of ophthalmic diseases.
论著

同步监测青光眼患者24 h眼压与血压的意义

Significance of simultaneous monitoring of intraocular pressure and blood pressure for 24 hours in glaucoma

:160-166
 
青光眼是世界范围内致盲和引起视力损害的主要眼病,也是不可逆性致盲性眼病之一。眼压是青光眼发生发展的重要危险因素,但除眼压外,血压在青光眼进展引起的影响也不可忽视。眼灌注压是血压和眼压的差值,可调节视神经的血液供应。眼压、血压、灌注压在青光眼发生发展中有一定相关性。本文通过对眼压和血压在青光眼中的影响以及24 h眼压和血压监测在青光眼中的应用进行文献索引,分析青光眼24 h眼压和血压同步监测的意义。
Glaucoma is a major eye disease causing blindness and visual damage worldwide, and it is also one of the irreversible eye diseases causing blindness. Intraocular pressure (IOP) is an important risk factor for the development of glaucoma, and the influence of blood pressure (BP) on the progression of glaucoma also cannot be ignored. Eye perfusion pressure is the difference between blood pressure and intraocular pressure, regulating the blood supply to the optic nerves. IOP, BP and perfusion pressure are related to the occurrence and the progression of glaucoma. Literature review was performed related to the effects of IOP and BP on glaucoma, and the application of 24-hour IOP and BP monitoring in glaucoma, aiming to analyze the significance of simultaneous monitoring of IOP and BP for 24 hours.
论著

角膜后表面散光对散光型人工晶状体计算的重要性

Importance of calculation of posterior corneal astigmatism on Toric intraocular lens power

:167-175
 
随着白内障手术由复明性向屈光性转变,对角膜的散光矫正显得越来越重要。而角膜散光不仅仅应该关注角膜前表面的散光数据,更应该考虑角膜后表面的散光,否则对散光人工晶状体植入矫正角膜散光可能出现不同程度的术后屈光误差。角膜后表面散光均值约为0.37 D,且多数情况下会产生逆规散光的效果,因此在进行散光型人工晶状体计算时应考虑到这一特点,进一步防止术后欠矫或过矫的发生。
With the cataract surgery evolving from visual restoration surgery to refractive surgery, surgical correction of corneal astigmatism becomes more and more important. For Toric intraocular lens implantation, the surgeon should not only pay attention to the values in surface of anterior corneal astigmatism but also that in posterior corneal astigmatism. Otherwise, unwanted postoperative refractive errors may occur. The mean value of posterior corneal astigmatism was around 0.37 D. In most cases, the posterior corneal astigmatism produces against-the-rule effect. Therefore, the above-mentioned feature of posterior corneal astigmatism should be noticed to prevent the under-correction or over-correction effect of toric lens.
论著

耳穴压豆预防眼底荧光血管造影胃肠反应的效果观察

Efficacy of auricular points plaster therapy on preventing gastrointestinal reaction caused by fundus fluorescein angiography

:144-148
 
目的:探讨耳穴压豆疗法预防眼底荧光血管造影(fluorescence fundus angiography,FFA)胃肠反应的效果。方法:选取2019年10月至2020年4月在汕头大学·香港中文大学联合汕头国际眼科中心特殊检查科行眼底荧光素血管造影检查的患者583例,试验组298例,对照组285例。对照组在检查前予常规护理措施。试验组检查前在对照组的基础上实施耳穴压豆疗法。比较两组受检者在检查期间的胃肠道反应情况及配合度和舒适度的区别。结果:试验组胃肠道反应发生率低于对照组(P<0.05)。配合度得分试验组为(2.87±0.35)分,对照组为(2.96±0.19)分,两组差异有统计学意义(P<0.001)。舒适度得分试验组为(3.93±0.70)分,对照组为(3.91±0.56)分,两组差异无统计学意义(P=0.122)。结论:耳穴压豆疗法可以降低FFA检查胃肠道反应发生率,疗效安全可靠,操作简便易行,另外,耳穴压豆方法不会造成患者检查时舒适度下降,有助于患者顺利安全完成检查。
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.
论著

白内障手术患者的临床分布特点

Clinical distribution characteristics of patients admitted to hospital for surgical cataract treatment

:133-138
 
目的:了解白内障手术患者的临床分布特点,为基层医院白内障防治工作提供信息参考。方法:选取2019年1月至2019年12月在锦州医科大学附属第三医院眼科手术医治的白内障患者892例1 008眼。查阅相关病历资料,收集姓名、性别、年龄、手术眼别、入院时间、有无糖尿病史;术前视力、角膜内皮细胞密度、眼轴、晶状体混浊类型及白内障病因;手术方式、人工晶状体(intraocular lens,IOL)、术中并发症;术后第1天眼压、视力、眼部情况,进行统计学描述及分析。结果:入选892例1 008眼,其中男357例401眼,女535例607眼,年龄(71.17±10.28)岁,90.7%的患者病因为年龄相关性白内障。入院时间集中在3~6月和9~12月。不同年龄段白内障患者具有各自的眼部特征。白内障类型与年龄差异有统计学意义(P<0.05),相比皮质性、后囊膜下性,核性白内障患者入院年龄偏大。白内障类型与性别、有无糖尿病史差异无统计学意义(P>0.05)。白内障患者选择最多的手术方式是超声乳化吸除术联合IOL植入术,术中并发症少,术后恢复快。结论:白内障的防治工作任重道远。手术多为年龄相关性白内障患者,入院时多年龄偏大,视力偏低,错失了手术最佳时机。不同年龄段、不同类型白内障患者具有不同的特征。超声乳化吸除术因其优势成为患者首选手术方式。
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.
论著

玻璃膜疣主要成分胆固醇对人视网膜色素上皮细胞金属硫蛋白表达的影响

Effect of cholesterol exposure on the expression of metallothionein in human retinal pigment epithelial cells

:128-132
 
目的:研究玻璃膜疣主要成分胆固醇对人视网膜色素上皮细胞ARPE-19中金属硫蛋白表达的影响。方法:体外培养ARPE-19细胞,将细胞分为对照组和胆固醇处理组(2.5 mg/mL),取样时间为0,6,12,24,48,72 h。通过实时定量PCR检测hMT1a,hMT2a和hMT3在转录水平的表达,用蛋白质印迹法检测总金属硫蛋白的表达。结果:在转录水平上hMT1a,hMT2a和hMT3受到胆固醇影响mRNA表达上调,且hMT3上调倍数最大;总金属硫蛋白的蛋白表达随着胆固醇处理时间延长明显增多。结论:玻璃膜疣主要成分胆固醇可以上调人视网膜色素上皮细胞中金属硫蛋白的表达,提示金属硫蛋白表达可受到玻璃膜疣形成起始阶段的刺激,其检测是否能用于年龄相关性黄斑变性的早期发现及早期诊断还需深入探讨。
Objective: To study the effects of cholesterol, the main component of drusen, on the expression of metallothionein of ARPE-19 cells. Methods: The ARPE-19 cell line was cultured in vitro, and the cells were divided into a control group and a cholesterol treatment group (2.5 mg/mL). The treatment time was 0, 6, 12, 24, 48, 72 hours. Real-time quantitative PCR was used to detect the expression of hMT1a, hMT2a and hMT3 at the mRNA level, and Western blot was used to detect the expression at the protein level. Results: The mRNA expression of hMT1a, hMT2a and hMT3 were up-regulated by cholesterol and the protein expression of total MTs was increased with cholesterol treatment. Conclusion: Cholesterol, the main component of drusen, can up-regulate the expression of metallothionein in human retinal pigment epithelial cells, suggesting that the expression of metallothionine can be stimulated by the initial stage of drusen formation. However, whether its detection can be used for the early detection and early diagnosis of age-related macular degeneration or not still needs to be further explored.
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
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  • 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
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