高度近视黄斑病变的对比敏感度

为研究高度近视黄斑病变的形觉功能损害特点,对高度近视黄斑病变１０３眼和高度近视非黄斑病变５０眼作对比敏感度（ＣＳＦ）检查,结果非黄斑病变组高频段下降,中频段峰值“左移”,黄斑病变组全频段明显下降,两组比较有非常显著性差异;两组矫正视力相同（０．６）和屈光度相同（１２Ｄ）的ＣＳＦ显示,黄斑病变者ＣＳＦ明显低于非黄斑病变者,两组比较有显著性差异;黄斑病变的四组ＣＳＦ从高到低依次为：毛细血管拱环缺损、漆裂样纹、新生血管和出血、Ｆｕｃｈｓ斑和萎缩斑,四组比较,漆裂样纹与新生血管和出血无统计学意义,其余各组有非常显著性差异。认为高度近视黄斑病变的对比敏感度较之非黄斑病变者损害更明显,受损的规律是由高频向中频、低频扩展,受损的程度与黄斑病变的进行密切相关。     

频域光学相干断层成像技术监测玻璃体切割术对糖尿病黄斑部病变的影响

目的 评价频域光学相干断层成像技术(SD-OCT)在观察玻璃体切割术对糖尿病视网膜病变患者黄斑部视网膜病变影响中的应用价值。 方法 选取2013年7月至2014年10月我院收治的85例糖尿病视网膜病变患者接受单侧玻璃体切割术, 同时选取16例(22眼)正常志愿者作为对照组。常规进行闭合式玻璃体切割术,并在新生血管处根据具体情况补充光凝。术后1天、2周、1个月、2个月,利用SD-OCT进行黄斑部扫描,并用分析软件进行九分区的自动分析,记录各区视网膜厚度数据和黄斑区视网膜平均厚度。 结果 正常对照组黄斑部视网膜厚度平均为(310.71±30.87)μm,黄斑中心凹 (259.36±18.14)μm。患者术后1天黄斑部视网膜厚度平均为(426.72±41.49)μm,黄斑中心凹平均为(427.86±247.16)μm,均显著高于正常对照组。术后2周厚度平均减少42.48 μm(9.96%),术后1个月平均减少73.13 μm(17.37%),治疗后2个月平均减少111.51 μm (26.06%),差异均有统计学意义(P<0.05)。治疗前后视力差异无统计学意义(P>0.05)。 结论 SD-OCT能直观地了解术后黄斑区视网膜病变的转归情况,可以作为黄斑水肿诊断和长期随访的有效检查手段。玻璃体切割术治疗糖尿病视网膜病变,可降低黄斑区视网膜厚度。     

Saccade control without a fovea

Prior research has suggested that two types of fast eye movements (FEMs) can be distinguished behaviorally. Foveating saccades respond to salient peripheral targets by directing the target image to the fovea. Non-foveating saccades include other FEMs such as nystagmus quick phase, saccades without visual stimuli and visually-directed saccades that direct target images to eccentric retina. Foveating saccades have a shorter initiation latency and are faster than non-foveating saccades. Following adaptation to central scotoma, patients tend to use preferred retinal loci for fixation (PRL). If PRL acquire the foveal characteristic of a retino-motor center then visually guided saccades would acquire the properties of foveating saccades. Using an objectively-calibrated 2-dimensional search coil, we measured saccades in response to salient, unpredictable targets. The saccades of normal observers were compared to the saccades of patients with long-standing macular scotomas. Although the saccades of patients consistently directed images to PRL, the saccades still had the latency and dynamic characteristics of non-foveating saccades. Moreover, the non-foveating saccades of patients were found to be less accurate than foveating saccades, showing a range effect (larger saccades undershoot with greater error than do smaller saccades). Apparently, patients with macular scotoma suppress rather than adapt a foveating saccade mechanism.     

频域光学相干断层扫描黄斑光损伤表现的特点

目的 探讨频域光学相干断层扫描（fourier-domain optical coherence tomography,FD-OCT）应用于光损伤黄斑病变所表现出的特点及重要性.方法 回顾性研究.对光损伤黄斑病变7例（11只眼）进行FD-OCT检查.包括阳光导致视网膜病变2只眼,电弧光导致视网膜病变6只眼,激光损伤导致视网膜病变3只眼.所有患者均行散瞳眼底检查照相,部分患者行多焦视网膜电图检查.结果 所有患眼均有黄斑区病理改变.视力0.04 ～1.0.FD-OCT显示在视锥细胞内外节层局限性缺失7只眼,视网膜层间低反射暗腔3只眼,黄斑孔1只眼.揭示了光损伤黄斑病变缺损区域不仅存在于视细胞层,还存在于视细胞外节与色素上皮绒毛的连接处.激光损伤的黄斑病变可以表现为多种形态.结论 FD-OCT能够在不同类型光损伤黄斑病变患眼中显示出显著的形态学改变,FD-OCT更能发现视细胞外节与色素上皮绒毛连接处的特征性改变,提高了诊治效率.     

Inadvertent macular burns and consecutive psychological depression secondary to Alexandrite laser epilation: A case report

Unwanted hair is an important aesthetic problem in many cultures. Laser epilation devices have become commonly available at the present time. Nowadays, laser hair removal is widely practiced as a cosmetic procedure, however, some ocular complications may occur. The retina is the most vulnerable to laser-related injury which can lead to serious visual impairment. Laser epilation can cause serious complications and medical costs if not performed carefully and appropriately. The use of laser hair removal devices by unskilled aestheticians who is untrained and do not have the proper protective equipment at the beauty centers, can cause serious ophthalmological and psychological disorders and thus substantial labour productivity loss and economic loss. Therefore, the protective eyewear must be used by both the aesthetician and the patient during the procedure of laser epilation. In this way, we can improve the safety of both patients and aestheticians and at the same time ensure their healths. I reported the case of a 49-year-old female with a unilateral maculopathy responsible for an acute visual field defect and consecutive psychological depression secondary to Alexandrite laser epilation. This report is important to raise the awareness of ophthalmology and dermatology society and public about risks of their misuse.     

2型糖尿病黄斑病变的相关因素分析

目的:研究2型糖尿病患者中糖尿病性黄斑病变的相关因素.方法:对83例2型糖尿病患者的黄斑病变与血压、病程、糖化血红蛋白、总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、载脂蛋白A1、载脂蛋白B.、血尿素氮和血肌酐进行Logistic回归分析.结果:在83例糖尿病病人中,有黄斑病变患者35例.在16例增殖型糖尿病视网膜病变病人中,有黄斑病变病人数12例,较非增殖型糖尿病视网膜病变的病人多(P＜0.01).Logistic回归分析发现糖尿病性黄斑病变与血浆总胆固醇(β=-3.13,P＜0.05)、低密度脂蛋白胆固醇(β=4.077,P＜0.05)和神经病变(β=-2.655,P＜0.05)呈显著相关,与糖尿病的严重程度(国内分期)呈显著相关(β=2.423,P＜0.01).结论:糖尿病性黄斑病变与脂代谢紊乱、神经病变和与糖尿病视网膜病变的严重程度密切相关.提示严格控制血糖、血脂等相关危险因素,对预防和控制黄斑病变有重要意义.     

Quantifying fixation in patients with Stargardt disease

Fixational eye movements in 60 eyes of 30 patients with ABCA4-associated Stargardt disease were recorded by a Scanning Laser Ophthalmoscope (SLO). The results were quantified by two new fixation quality measures expressing the eccentricity of the preferred retinal locus (PRL) non-parametrically, and fixation stability by a dynamic index. 46 eyes (77%) fixated eccentrically; in 32 eyes (70% of the eccentrically fixating eyes) the PRL was located above the central retinal lesion. PRL eccentricity correlated positively with logMAR visual acuity (r=.72; p<.0001) and negatively with fixation stability (r=-.58; p<.0001). Multiple PRL were found only in three eyes.     

X-linked Juvenile Retinoschisis in Females and Response to Carbonic Anhydrase Inhibitors: Case Report and Review of the Literature

A 63 year old woman was referred to the retina clinic after her vision failed to improve in her left eye after cataract surgery. X-linked retinoschisis was diagnosed in the patient after her retina exam revealed an area of retinoschisis and a foveal cyst.The OCT confirmed the macular cyst and the ERG showed loss of B waves.The florescein angiogram showed no significant perifoveal leakage. Her foveal cyst resolved after treatment with carbonic anhydrase inhibitors.The patient’s son was examined and his ophthalmologic exam,ERG and imaging findings were consistent with X-linked retinoschisis. However, his bilateral foveal cysts did not respond to treatment with carbonic anhydrase inhibitors. X-linked retinoschisis is a very rare disease in women due to its X-linked recessive inheritance and the foveal cysts associated with it can respond to carbonic anhydrase inhibitors.