The significance of meibomian gland changes in asymptomatic children

Purpose

To evaluate meibomian gland morphology and function in children without ocular discomfort.

Retrospective Analysis of Patients with Fungal Keratitis in a Hospital in Wenzhou

Objective: To analyze the etiology, drug sensitivity, laboratory examinations and treatment of patients with fungal keratitis in a hospital in Wenzhou, thus providing evidence for the diagnosis and prognosis of fungal keratitis. Methods: This was a retrospective case. Data from 258 patients (258 eyes) who were diagnosed with fungal keratitis at the Eye Hospital,Wenzhou Medical University, from January 2017 to December 2019 were collected. Patients were divided into different groups: Males and females, older and younger patients, farmers and non-farmers, plant injuries and non-plant injuries, fusarium and non-fusarium infections. The respective operation rates were calculated for gender, age, occupation, pathogenic factors and pathogenic bacteria. χ2 analysis was performed for the difference in operation rates in each group. Further, the positive detection rate of the pathogenic examination method was compared and analyzed, and the drug sensitivity of the main pathogenic bacteria was also included. Results: September to November was the highest incidence period for fungal keratitis, accounting for 48.1% for the entire year. Most of the patients (60.5%)were farmers. Plant injury was the leading pathogenic factor while fusarium was the main pathogen accounting for 34.5% and 45.3%, respectively. The positive rate of fungal culture was 68.6%, which was higher than the smear test (χ2 =4.522, P=0.033). Of the 258 patients with fungal keratitis, 44(17.0%) underwent surgery. Further analysis revealed that elderly (≥65 years) patients (χ2 =5.293, P=0.036), plant injury patients (χ2 =11.386, P=0.001), and fusarium infection patients (χ2 =3.939, P=0.044) had a higher probability of surgery. Additionally, the geometric mean values of the minimum inhibitory concentrations (MIC) of fusarium to amphotericin B, itraconazole and voriconazole were 4.283, 17.290 and 1.105 μg/ml, respectively; those of aspergillus were 3.389, 2.661 and 0.125 μg/ml, respectively; those of alternaria were 0.604, 0.531 and 0.258 μg/ml, respectively; and those of candida were 0.317, 0.552 and 0.047 μg/ml. Conclusions: Fusarium is the main pathogen of fungal keratitis in Wenzhou, and plant injury is the main pathogenic factor. Elderly patients, plant injuries, and fungal keratitis caused by fusarium infections are more serious and are more likely to require surgical treatment.     

温州某医院258例真菌性角膜炎诊疗分析

目的：通过分析温州地区真菌性角膜炎患者的病原学、药敏、实验室检查及治疗方式等,进一步为 真菌性角膜炎的诊疗及预后评估提供依据。方法：回顾性研究。收集2017年1月至2019年12月在温 州医科大学附属眼视光医院拟诊为真菌性角膜炎患者共258例（258眼）,将患者分别按性别、年龄、 职业、致病因素、致病菌属分为男性组和女性组,老年组（≥65岁）和非老年组（<65岁）,农民组和非 农民组,植物伤组和非植物伤组,镰刀菌属组和非镰刀菌属组,分别统计各组的手术率。采用χ2检 验对各因素与手术率之间的关系进行分析比较,同时对病原学检查的阳性检出率做比较,并统计主 要致病菌的药敏情况。结果：9─11月份是真菌性角膜炎的高发期,占全年的48.1%,其中农民（60.5%） 为主要的患病人群。植物伤（34.5%）为首要致病因素。镰刀菌属（45.3%）是主要的致病菌。真菌培 养的阳性率为68.6%,高于涂片检查的43.0%（χ2 =4.522,P=0.033）。镰刀菌属对两性霉素B、伊曲康 唑、伏立康唑的最小抑菌浓度值的几何均数分别为4.283、17.290、1.105 μg/ml;曲霉菌属分别为3.389、 2.661、0.125 μg/ml;链格孢属分别为0.604、0.531、0.258 μg/ml;假丝酵母菌属分别为0.317、0.552、 0.047 μg/ml。258例真菌性角膜炎患者中,44例（17.0%）接受了手术治疗,进一步分析发现老年患者 （χ2 =5.293,P=0.036）,植物伤患者（χ2 =11.386,P=0.001）,镰刀菌属感染患者（χ2 =3.939,P=0.044）的 手术概率较高。结论：镰刀菌属是温州地区真菌性角膜炎的主要致病菌,而植物伤为首要致病因素。 老年患者、植物伤以及镰刀菌属感染导致的真菌性角膜炎较严重,需要手术治疗的概率更高。     

Wedge resection of the tarsal plate combined with the modified Hotz procedure for correction of involutional lower eyelid entropion

Objectives

To investigate the outcomes for correction of involutional lower eyelid entropion by wedge resection of the tarsus combined with the modified Hotz procedure.

Optical coherence tomography angiography in neuro-ophthalmology: Current clinical role and future perspectives

Optical coherence tomography angiography (OCTA) is a noninvasive, depth-resolved imaging tool for the appraisement of retinal vascular changes. Since its introduction, the understanding of diabetic retinopathy, age-related macular degeneration, central serous retinopathy, and other diseases has been enriched on many fronts. Its dyeless imaging property maps retinal as well as deeper choroidal vasculature in quick succession with good reproducibility. Hence, it can play an important role in the diagnosis and management of optic nerve–related diseases as well. A detailed literature review for its role in nonarteritic anterior ischemic optic neuropathy, papilledema, optic disc drusen, papillitis, hereditary optic neuropathies, central nervous system diseases, and others highlights its role. The whole spectrum of neuro-ophthalmological diseases shows consistent peripapillary and macular capillary changes with structural and functional correlation. The superficial and deeper retinal and choroidal vasculatures are affected depending on the nature of the disease process. Hence, OCTA positions itself as a useful, noninvasive tool in the armamentarium of a neuro-ophthalmologist in future; however, there are several limitations of the OCTA with respect to its technical abilities in challenging neuro-ophthalmic cases. Therefore, future research should be directed to enhance the technical capabilities of OCTA and to determine the more precise role of it in the prognosis of neuro-ophthalmic diseases.     

角膜及眼表疾病研究中存在的问题及建议

我国在角膜及眼表疾病研究领域形成了自己的特色和优势，但在某些方面与国际学术水平相比仍有差距，本文就当前研究中应该重视的若干问题提出建议。加强感染性角膜病的流行病学和药物敏感性筛选研究，面向基层普及感染性角膜炎的正确治疗观念。重视眼表重建手术的临床和基础研究，提高对常见眼表疾病的诊断和治疗水平。加强具有原创性的基础研究，力求在生物组织工程、基因诊断和治疗、新型药物研制等方面取得进展，为角膜病专业学科水平的可持续发展提供强大动力。     

先天性泪囊炎治疗中的问题

目的分析先天性泪囊炎冲洗和探通中出现问题的原因，总结教训，以提高治疗成功率和安全性。方法回顾500例（694眼）先天性泪囊炎冲洗和探通治疗过程中的细节，对失败的原因进行探讨，并对因此引起的投诉和纠纷进行分析。结果694眼的治愈率为99．28％。结论1个月以内的新生儿不主张探通，除非有并发症。给2—6个月婴儿探通，首选6号针头，遇阻换5号。3个月婴儿是最佳探通时机。治疗前检查器械质量，稳妥抱头，准确轻柔操作，是避免先天性泪囊炎治疗失败和意外的因素。在细菌培养结果指导下合理使用抗生素，避免小儿禁忌品种，保障用药安全。     

如何发挥眼保健在心脑血管疾病防治中的作用?

眼底视网膜检查为非侵入性、直接观察系统性微血管改变的唯一途径，国外多项流行病调查及队列研究证实，视网膜微血管改变及其视网膜病变为预测心脑血管疾病的发生、发展、治疗效果及预后提供了重要的临床指标。对社区人群采用数码眼底照相的筛查模式，不仅能对可预防盲的眼病（青光眼、糖尿病视网膜病变）进行筛查，而且结合高血压、高血糖、高血脂，检测视网膜微血管改变，对心脑血管疾病进行预测。此筛查模式费用低、效率高，受到社区医院欢迎，具有推广前景。     

Comment on survival analysis following early surgical success in intermittent exotropia surgery

Comment and Response     

Comment on “Evaluation of hyperreflective foci as a prognostic factor of visual outcome in retinal vein occlusion”

Comment and Response     

2010年西安市城乡中小学生视力调查情况分析

目的：了解西安市中小学生视力低下状况,为开展视力低下防治工作提供科学依据。

方法：采取分层随机整群抽样法,抽取3 869名学生7 738眼进行视力检查。按照视力低下诊断标准,将所有观察对象分为正常、轻度、中度、重度视力低下,所有数据均用EpiData 3.1建立数据库及SPSS 18.0进行统计分析。

结果：西安市中小学生视力低下率为54.9%,以重度视力低下为主,随着年龄及年级的增长视力低下率明显呈上升趋势,女生视力低下率明显高于男生(χ²=63.19,P<0.01)。城市学生视力低下率显著高于农村学生(χ²=547.53,P<0.01)。

结论：西安市中小学生视力低下率较高,应及早采取有效措施以预防中小学生视力低下,降低和控制视力低下的发病率。     

超声乳化人工晶状体植入联合小梁切除术治疗青光眼合并白内障的疗效观察

目的观察超声乳化人工晶状体植入联合小梁切除术治疗青光眼合并白内障的临床疗效。方法回顾性分析我院2005年6月至2009年12月青光眼合并白内障患者32例(32眼),均采用超声乳化人工晶状体植入联合小梁切除术治疗,观察患者术后1d、1周、1个月及6个月的眼压、视力情况,另外记录视野、滤过泡及并发症情况。结果患者术后1d、1周、1个月及6个月的平均眼压分别为(19.2±1.6)mmHg(1kPa=7.5mmHg)、(18.4±1.4)mmHg、(15.6±0.8)mmHg、(15.0±0.7)mm-Hg,与术前(23.2±1.1)mmHg比较,差异均有统计学意义(均为P<0.05)。术前平均视力为0.12±0.08,术后1d、1周、1个月及6个月分别为0.26±0.09、0.28±0.09、0.32±0.12、0.45±0.18;术后视力较术前明显提高,差异均有统计学意义(均为P<0.05)。术前、术后平均视野缺损值与平均模式标准差值差异均无统计学意义(均为P>0.05)。术后形成功能型滤过泡22眼,非功能型10眼。术中出现晶状体后囊膜破裂2眼,均未出现玻璃体脱出等其他并发症。结论超声乳化人工晶状体植入联合小梁切除术治疗青光眼合并白内障既可降低眼压、改善视力,又能减少患者的经济负担,且成功率较高,并发症少。     

原发性闭角型青光眼定义和分类的困惑与思考

我们阐述了对国际地域和流行病学眼科学会(international society of geographical and epidemiological ophthalmology,ISGEO)提出的原发性闭角型青光眼分类及相关定义的困惑和思考,指出青光眼定义标准的不统一是导致困惑的根本原因,并对如何定义青光眼进行了初步探讨。     

Hemiretinal stimuli elicit different amplitudes in the pattern electroretinogram

Pattern electroretinograms were elicited in 13 normal eyes by half-field checkerboard stimulation of nasal-temporal and upper-lower retinal areas. With nasal-temporal visual half-field stimulation the p-q component amplitude of the nasal hemiretina was significantly larger than that of the temporal hemiretina. With upper-lower visual half-field stimulation the amplitude was significantly larger for the upper than for the lower hemiretina. No significant differences were found with respect to the component latency. Finding the p-q amplitude of the pattern electroretinogram to be closely related to the distribution of nerve cells in the innermost retinal layer supports the conclusion that the pattern response is generated in the more proximal retinal layers including the retinal ganglion cells.