非侵入式眼表综合分析仪评估近视青少年干眼和睑板腺功能障碍

目的 通过问卷调查和临床检查分析青少年近视患者干眼和眼表状况.方法 选取248例(496眼)7～18岁近视青少年患者为研究对象,进行眼表疾病指数(ocular surface disease index,OSDI)问卷调查,裂隙灯下行眼前节检查,格瓦拉-眼表综合分析仪Keratograph 5M检查眼表.根据OSDI干眼分级标准将患者分为干眼组(47例94眼)和正常组(201例402眼),分别对两组的眼表和睑板腺状况进行评估与比较.结果 近视儿童干眼发病率为18.95％.干眼组泪河高度为(0.23±0.03)mm,正常组为(0.22±0.03) mm,两组泪河高度均在正常范围内(泪河高度＞0.20 mm).干眼组和正常组的OSD1值分别为(27.02±14.35)分、(7.29±3.36)分,角膜荧光素染色评分分别为(3.51±1.67)分、(1.23±2.32)分,这两项指标在干眼组均明显高于正常组(P ＜0.001),NIBUT小于正常组(P ＜0.001).干眼组中睑板腺开口状况评分、睑板腺脂质分泌物性状评分、睑板腺缺失评分均明显高于正常组(均为P＜0.0001),纳入的248例近视青少年的睑板腺参数与角膜荧光素染色评分有正相关性(P＜0.0001),与非侵入性泪膜破裂时间有负相关性(P＜0.05),但与泪河高度无相关性(P＞0.05),OSDI值与非侵入性泪膜破裂时间呈负相关(rs=-0.982,P=0.000),与睑板腺的缺失评分呈正相关(rs=0.838,P =0.000).结论 睑板腺功能障碍是近视青少年人群干眼的重要病因之一,Keratograph 5M非侵入式眼表综合分析仪可无创性客观评价近视青少年患者眼表的情况.     

2型糖尿病患者干眼相关指标分析

目的 观察2型糖尿病患者的眼表情况,探讨可能引起糖尿病患者干眼的影响因素。方法 纳入2型糖尿病患者110例110眼、正常受试者46例46眼。所有受试者均进行OSDI主观评分、Keratogragh 5M检查。所有糖尿病患者记录病程、糖化血红蛋白(HbA1c),并行眼底镜及OCT检查评估眼底病变情况,根据有无糖尿病视网膜病变、有无黄斑水肿、HbA1c水平、糖尿病病程长短分组,分析不同分组条件下非侵入性泪膜破裂时间(NI-BUTav)、睑板腺缺失评分、眼红指数、泪河高度及OSDI评分的改变情况。结果 与正常受试者相比,糖尿病患者NI-BUTav降低,OSDI评分、睑板腺缺失评分升高,差异均有统计学意义(均为P<0.05)。HbA1c≥7%的糖尿病患者OSDI评分高于HbA1c<7%的糖尿病患者,差异有统计学意义(P=0.04)。有黄斑水肿的糖尿病患者的OSDI评分、眼红指数均大于无黄斑水肿的患者,差异均有统计学意义(均为P<0.05)。糖尿病病程≥10年的患者泪河高度较病程<10年者显著降低,差异有统计学意义(P=0.00)。结论 2型糖尿病患者泪膜质量下降,干眼的...     

糖尿病周围神经病变患者干眼的临床特征分析

目的:探讨糖尿病周围神经病变(DPN)患者泪膜功能的改变及干眼症状特征。方法:病例对照研究。选取存在泪膜异常的2型糖尿病(T2DM)患者59例59眼,以是否存在DPN分为T2DM组31例31眼和DPN组28例28眼,另选择符合泪膜异常标准且无糖尿病的患者33例33眼作为无T2DM组。对三组患者进行眼表疾病指数(OSDI)量表评分、泪膜破裂时间(BUT)、角结膜荧光素钠染色(FL)评分、泪液分泌试验(SchirmerⅠ)、红外线睑板腺照相。结果:各组间BUT结果有差异(F=9.43,P<0.01),无T2DM组、T2DM组和DPN组两两比较均有差异(P<0.05);各组间SchirmerⅠ及FL阳性率比较无差异(P>0.05);各组间睑板腺缺失评分有差异(χ2=8.433,P<0.05),T2DM组与无T2DM组比较无差异(P>0.05),DPN组与无T2DM组、T2DM组比较均有差异(P<0.05);各组间OSDI量表评分比较有差异(P<0.05),两两比较,T2DM组与无T2DM组比较无差异(P>0.05),DPN组与无T2DM组、T2DM组比较均有差异(P<0.05)。结论:合并DPN的T2DM患者较不伴发DPN的T2DM患者及无T2DM患者BUT更短、睑板腺缺失更重,但干眼症状更不明显,应密切关注和随访DPN患者的眼表异常。     

眼表综合分析仪评价干眼患者相关指标的临床分析

目的 评价眼表综合分析仪在干眼患者中的应用价值。方法 横断面研究。选择70例（135眼）干眼患者作为研究对象。检查指标包括眼表疾病指数（OSDI）评分、泪液分泌试验（SⅠT）、睑板腺分泌物性质检查,以及利用眼表综合分析仪系统--Keratograph 5M进行泪河高度测量、泪膜破裂时间（BUT）测定以及睑板腺检查。Keratograph 5M与传统检查方法之间的相关性、干眼患者睑板腺状况评分与OSDI评分及BUT的相关性用Pearson相关及线性回归进行分析,Keratograph 5M分析眼表状况的重测信度用组内相关系数评价。结果 70例（135眼）患者OSDI评分为（15.8±3.4）分,SⅠT为（6.0±7.7）mm,泪河高度为（0.27±0.13）mm,BUT为（7.9±5.5）s。睑板腺分泌物评分为（3.3±1.4）分,睑板腺缺失面积评分为（3.4±1.6）分。测得的BUT时间越短,SⅠT越短（r=0.474,P＜0.01）;泪河高度越低,SⅠT越短（r=0.432,P＜0.01）。睑板腺分泌物评分、睑板腺照相评分与OSDI评分呈正相关（r=0.673、0.752,P<0.05）,与BUT呈负相关（r=-0.638、-0.603,P<0.05）。眼表综合分析仪的检查结果具有较好的重测信度（ICC值在0.84~0.89之间）。结论 眼表综合分析仪能够直观地评价干眼患者眼表状况,是一种非接触性、无创、可重复性强的快速检查手段,具有实际临床应用价值。     

眼表综合分析仪在儿童早期前睑缘炎临床分析中的应用

目的利用眼表综合分析仪对儿童早期前睑缘炎患者的眼表情况进行观察,分析其临床特点。方法描述性研究。选取2015年7月至2016年5月就诊于山西省眼科医院门诊,经裂隙灯显微镜检查确诊为早期前睑缘炎的儿童患者40例（80眼）,年龄4~14岁。对患儿睑缘炎体征进行评分,利用眼表综合分析仪检查其泪膜破裂时间（BUT）、泪河高度,并进行眼表充血、睑板腺缺失及角膜荧光素钠染色评分,对所得数据进行Spearman秩相关分析。结果80眼中,58眼（72%）BUT缩短;50眼（62%）泪河高度下降;15眼（19%）发生角膜上皮点状缺损;25眼（31%）睑板腺缺失范围＞1/3。睑缘炎体征评分与BUT、泪河高度、角膜荧光染色评分及睑板腺缺失评分不相关;睑板腺缺失评分与BUT呈负相关（r=-0.253,P=0.024）,与角膜荧光染色评分呈正相关（r=0.563,P＜0.001）。结论儿童早期前睑缘炎患者泪膜稳定性下降,同时合并睑板腺缺失的患者易继发干眼。     

云南省多民族人群白内障术后干眼发病因素分析

目的　通过收集云南省不同民族人群行白内障超声乳化+人工晶状体植入术(Phaco+IOL)术后的干眼数据,分析各民族及云南省各地区干眼发病特点及影响因素。方法　采用多阶段分层抽样的方法,在云南省不同少数民族聚集地面对面调查9740人(18 908眼),将既往有Phaco+IOL手术史并符合干眼诊断标准的227眼设为Phaco组,分别随机抽取既往无手术史符合干眼诊断的227眼为干眼组、健康眼227眼为正常组。对3组受试者泪河高度、泪膜破裂时间(BUT)、睑板腺开口堵塞、上睑板腺缺失面积及临床症状评分（OSDI评分）依次进行统计学分析,分析Phaco+IOL术后干眼的特点以及危险因素。结果　调查对象未手术眼（18 020眼）中干眼发生率21.98%,其中哈尼族最高,为14.65%;苗族最低,为2.80%。Phaco组患者术后干眼发生率为25.56%,其中拉祜族最高,为20.26%;景颇族最低,为0.88%。与干眼组和正常组受试者相比,Phaco组患者年龄大、睑板腺开口阻塞率高、上睑板腺缺失面积>1/2者占比高、泪河高度低、BUT短及OSDI评分高,差异均有统计学意义（均为P<0.05）。结论　云南省多民族白内障患者Phaco+IOL术后,普洱市拉祜族患者干眼发生率最高、德宏州景颇族最低;患者年龄大、睑板腺开口阻塞及上睑板腺缺失面积>1/2均是干眼发生的危险因素。     

年龄相关性白内障患者睑板腺与眼表状况分析

背景 睑板腺是位于上下睑板内一种特殊分化的皮脂腺,其形态学和功能学的严重改变与多种眼表疾病有关,研究睑板腺形态学和功能变化与干眼的关系具有重要的临床意义. 目的 观察年龄相关性白内障患者的睑板腺形态、结构及功能变化,探讨衰老与睑板腺功能障碍(MGD)及眼表健康状态的关系.方法 采用系列病例观察研究方法,选取2016年3-9月在山西省眼科医院就诊的45岁以上年龄相关性白内障患者93例93眼作为研究对象,按照年龄将患者分为45～ 59岁组和≥60岁组;按照睑板腺缺失范围将受检眼分为睑板腺缺失范围≥1/3组和睑板腺缺失范围＜1/3组.采用裂隙灯显微镜检查眼表组织、睑缘形态、睑板腺开口形态和睑脂性状;采用眼表疾病指数(OSDI)量表问卷对眼表症状进行调查和评分;采用眼表综合分析仪测定受检眼泪膜破裂时间(BUT)、泪河高度、睑板腺缺失、结膜充血及角膜荧光素染色情况.结果 93例受检者均无干眼主观症状,OSDI问卷评分均＜12分.裂隙灯显微镜检查受检眼均未发现睑缘及皮肤黏膜交界线的形态学变化,无睑板腺开口、睑脂排出及睑脂性状的异常.眼表综合分析仪检查发现,42眼BUT缩短,占45.16％;52眼泪河高度下降,占55.91％;58眼睑板腺缺失范围≥1/3,占62.27％.45 ～59岁组受检眼睑板腺缺失评分为1.65±0.79,≥60岁组为1.86±0.72,差异无统计学意义(t=1.301,P=0.197).但相关分析示年龄与睑板腺缺失评分呈弱正相关(r5=0.323,P=0.002),与BUT及泪河高度均无明显相关性(r=0.154,P=0.141;r =-0.024,P=0.821);睑板腺缺失评分与BUT呈负相关(r3=-0.251,P=0.015),睑板腺缺失范围≥1/3组BUT异常的发生眼数明显多于缺失范围＜1/3组,差异有统计学意义(P=0.018). 结论 中老年人随着年龄的增长,睑板腺缺失逐渐加重;睑板腺缺失范围较大者发生泪膜不稳定的风险增加;早期MGD患者体征先于症状出现,临床工作中应重视无症状的MGD患者.     

季节性过敏性结膜炎对糖尿病患者眼表影响的临床研究

目的探讨季节性过敏性结膜炎(SAC)对糖尿病患者眼表的影响。 方法选取2019年2月至2019年8月于南京大学医院眼科就诊的糖尿病患者80例(160只眼)。其中,男性49例,女性31例;年龄41~76岁,平均年龄(58.5±8.2)岁。SAC发作期的糖尿病患者40例(80只眼)为观察组;糖尿病常规眼科体检者40例(80只眼)为对照组。观察并记录患者发作时与病情缓解后的眼表疾病指数(OSDI)、泪液分泌量(SⅠt)、泪河线高度(TMH)、泪膜破裂时间(BUT)、角膜荧光素染色(FL)及睑板腺综合评分,并以均数±标准差表示。观察组与对照组患者发作期和缓解期眼表各相关参数的比较,采用单因素方差分析;各参数的相关性,采用Spearman非参数检验。 结果两组患者性别的比较,差异无统计学意义(χ²＝0.891,P>0.05);两组患者年龄、糖尿病病程、空腹血糖、糖化血红蛋白、最佳矫正视力及眼压的比较,差异无统计学意义(t＝0.925,1.218,0.787,1.014,0.962, 1.231;P>0.05)。观察组发作期患者的OSDI、BUT、FL及睑板腺综合评分分别为(44.79±17.26)、(5.47±2.30)s、(1.45±1.13)及(3.75±2.20),对照组分别为(28.49±9.18)、(10.39±3.66)s、(0.98±0.80)及(2.83±1.95),差异有统计学意义(F＝36.387、14.015、4.293,6.011;P<0.05)。与对照组相比,观察组发作期糖尿病患者的OSDI、FL及睑板腺综合评分增高,但BUT缩短。两组患者OSDI、FL、睑板腺综合评分及BUT的比较,差异均有统计学意义(t＝9.386,8.230,5.795,-6.016;P<0.05)。经治疗缓解后,各项相关参数有所改善,OSDI和睑板腺综合评分仍高于对照组,BUT低于对照组。观察组缓解期患者的OSDI、睑板腺综合评分及BUT分别为(35.89±10.76)、(1.10±0.84)及(8.40±3.72)s,差异有统计学意义(t＝4.587,3.840,-6.233;P<0.05)。两组患者SⅠt和TMH的比较,差异无统计学意义(F＝2.185,1.214;P>0.05)。观察组发作期糖尿病患者的OSDI与SⅠt、TMH及BUT呈负相关。经Spearman相关分析,其相关性有统计学意义(r＝-0.652,-0.640,-0.343;P<0.05)。OSDI与FL和睑板腺综合评分呈正相关。经Spearman相关分析,其相关性有统计学意义(r＝0.679,0.817;P<0.05)。SⅠt与TMH呈正相关。经Spearman相关分析,其相关性有统计学意义(r＝0.745,P<0.05)。BUT与FL和睑板腺综合评分呈负相关。经Spearman相关分析,其相关性有统计学意义(r＝-0.521,-0.559;P<0.05)。观察组SAC缓解期糖尿病患者的OSDI与TMH和BUT呈负相关。经Spearman相关分析,其相关性有统计学意义(r＝-0.321,-0.398;P<0.05)。OSDI与睑板腺综合评分呈正相关。经Spearman相关分析,其相关性有统计学意义(r＝0.272,P<0.05)。SⅠt与TMH呈正相关。经Spearman相关分析,其相关性有统计学意义(r＝0.799,P<0.05)。BUT与FL和睑板腺综合评分呈负相关。经Spearman相关分析,其相关性有统计学意义(r＝-0.697,-0.602;P<0.05)。 结论SAC对糖尿病患者眼表的OSDI、FL、BUT及睑板腺综合评分均有影响,但对SⅠt及TMH的影响不大;SAC缓解期患者眼表的OSDI、BUT及睑板腺综合评分恢复较慢;OSDI与SⅠt、TMH、BUT、FL及睑板腺综合评分等眼表相关参数有着良好的一致性。     

2型糖尿病干眼患者与正常干眼患者睑板腺及泪膜脂质层特征比较

目的 观察不同病程的2型糖尿病干眼患者与正常干眼患者睑板腺结构及泪膜脂质层厚度变化,探讨糖尿病患者干眼的发病特点,进一步指导临床治疗.方法 经泪膜破裂时间(BUT)测定和眼表疾病指数(OSDI)量表确诊的糖尿病干眼患者130例(130眼,糖尿病组)及正常干眼患者46例(46眼,正常对照组),其中糖尿病组以病程为界再分为...     

睑板腺功能障碍患者白内障术后眼表状况

目的：分析睑板腺功能障碍患者白内障手术后眼表状况的改变。方法：前瞻性研究。收集2015年1月至2017年1月期间就诊于上海市浦东医院眼科并接受白内障超声乳化摘除术联合人工晶状体植入术的睑板腺功能障碍患者67例（83眼）,评价术前及术后1、2、3个月的眼表症状指数评分（OSDI）、裂隙灯显微镜下睑缘形态评分、角膜荧光素染色评分（CFS）、泪膜破裂时间（BUT）、基础泪液分泌试验（SⅠT）以及光学相关断层扫描技术计算下泪河高度（TMH）、下泪河深度（TMD）和下泪河面积（TMA）。采用重复测量的方差分析进行统计学处理。结果：术后1、2、3个月的OSDI较术前显著恶化（F=1193.031,P<0.001）,BUT显著下降（F=21.042,P<0.001）;而睑缘形态评分、CFS、TMH、TMD、TMA和SⅠT在术后没有显著改变。结论：睑板腺功能障碍患者白内障术后在不伴有明显器质性改变的情况下就可能出现眼表症状的进一步加重。     

Assessment of Functional Vision Score and Vision-Specific Quality of Life in Individuals With Retinitis Pigmentosa

Purpose

To determine the relationship between the American Medical Association''s (AMA) functional vision score (FVS) and vision-specific quality of life in retinitis pigmentosa (RP) patients using the National Eye Institute''s Visual Functioning Questionnaire (NEI-VFQ 25).

Methods

One hundred eight patients with RP participated in the study. We measured best-corrected visual acuity, conducted Goldmann perimetry, and collected the self-reported NEI-VFQ 25. The FVS was calculated using the functional field score (FFS) and the functional acuity score (FAS). The correlations of the VFQ composite scores to the FVS, FFS, and FAS were determined using correlation and regression analyses.

Results

FVS was highly correlated to the BCVA (r=0.69, p<0.001), the FFS (r=0.86, p<0.001) and the FAS (r=0.73, p<0.001). Significant correlations of the VFQ composite score to the BCVA (r=0.60, p<0.001), FFS (r=0.44, p<0.001), FAS (r=0.60, p<0.001), FVS (r=0.58, p<0.001) were also found. However, the correlation strengths of BCVA, FVS, FAS, and FFS to NEI-FVQ were not different.

Conclusions

In RP patients, the vision-specific quality of life was correlated with the AMA guidelines'' FVS, FFS, and FAS. Their correlation degrees to NEI-FVQ were not different. This result suggests that vision-specific quality of life can be explained by both visual acuity and visual field in RP patients.     

Effects of a new dexamethasone-delivery system (Surodex) on experimental intraocular inflammation models

Background To investigate the effects of a new biodegradable dexamethasone drug delivery system, Surodex, in two experimental intraocular inflammation models; endotoxin-induced uveitis (EIU) and experimental autoimmune uveoretinitis (EAU).Methods Surodex was inserted into the right anterior chambers (ACs) of rats. In the EIU experiment, protein concentration, cell infiltration, and myeloperoxidase (MPO) activity in the aqueous humor were measured 24 h after injection. Eyes were evaluated histopathologically. In the EAU experiment, firstly, Surodex was administered at various days after immunization. Then, Surodex was administered on day 9 and eyes were evaluated histopathologically. Intraocular cytokine levels (IFN- and IL-4) were investigated.Results In the EIU experiments, eyes with Surodex exhibited significantly reduced inflammation compared with contralateral controls. Protein concentrations, cell infiltrations, as well as MPO activity were reduced. In the EAU experiments, all rats with Surodex given on days 0 or 7 showed no or significantly reduced inflammation in both eyes. Rats treated on day 12 developed reduced inflammation only in the treated eyes. IFN- levels were significantly lower in the eyes with Surodex, whereas IL-4 was not detectable.Conclusions This new, biodegradable corticosteroid drug-delivery system is highly effective in suppressing intraocular inflammation, and should be a useful tool to manage uveitis in humans.     

眼眶骨折综合评分刍议

目的 探讨用综合评分方法评价眼眶骨折的损伤程度.方法 回顾5年来眼眶骨折120例,结合国内外眼眶骨折手术指征及疗效评价方法总结出一套评价方法.根据眼眶骨折的临床特点,选择具有代表性,确定性好,有一定区别性且相互独立的4项评价指标,即眶壁骨折类型、眶内容、眼肌嵌顿及眶缘骨折错位,分别以四级评分进行量化打分,然后累加综合评分,并行统计学处理.结果 各项指标综合评分后各级别的分值发生率行正态性检验,均符合正态分布,具有统计学意义.各级别分值行两两比较,均具有显著性差异.用该评价方法综合评分,6分以上作为手术指征,术后疗效好.结论 眼眶骨折综合评分方法量化了眼眶骨折整体的损伤程度,为眼眶骨折临床治疗、预后评价的参考依据,并便于学术交流.     

Weighing of risk factors for penetrating keratoplasty graft failure: application of Risk Score System

AIM: To analyze the relationship between the score obtained in the Risk Score System (RSS) proposed by Hicks et al with penetrating keratoplasty (PKP) graft failure at 1y postoperatively and among each factor in the RSS with the risk of PKP graft failure using univariate and multivariate analysis. METHODS: The retrospective cohort study had 152 PKPs from 152 patients. Eighteen cases were excluded from our study due to primary failure (10 cases), incomplete medical notes (5 cases) and follow-up less than 1y (3 cases). We included 134 PKPs from 134 patients stratified by preoperative risk score. Spearman coefficient was calculated for the relationship between the score obtained and risk of failure at 1y. Univariate and multivariate analysis were calculated for the impact of every single risk factor included in the RSS over graft failure at 1y. RESULTS: Spearman coefficient showed statistically significant correlation between the score in the RSS and graft failure (P<0.05). Multivariate logistic regression analysis showed no statistically significant relationship (P>0.05) between diagnosis and lens status with graft failure. The relationship between the other risk factors studied and graft failure was significant (P<0.05), although the results for previous grafts and graft failure was unreliable. None of our patients had previous blood transfusion, thus, it had no impact. CONCLUSION: After the application of multivariate analysis techniques, some risk factors do not show the expected impact over graft failure at 1y.     

眼外伤的流行病学分析及眼外伤评分的临床应用

目的:分析眼外伤的流行病学特点,根据美国眼外伤协会制定的眼外伤评分(OTS)标准,对眼外伤进行国际标准化分级,以对眼外伤的严重程度及预后提供客观准确的信息,指导我们准确而快速地制定出更为合理的诊断和治疗方案。方法:统计251例252眼眼外伤患者的基本情况(性别、年龄、眼别、受伤时间、受伤类型、致伤物及并发症等),对眼外伤患者伤眼进行OTS评分(对就诊初视力、是否有眼球破裂、眼内炎、是否为穿孔伤、是否伴发视网膜脱离、是否合并相对传入性瞳孔阻滞等进行评估),根据OTS评分数据表推算出最终视力的概率;对比本组患者的终视力概率与OTS评分表的终视力概率。对不同级别眼外伤患者的评分进行比较。结果:本研究计算出的终视力概率与由美国眼外伤协会提供的OTS评分表计算出的终视力(无光感、光感/手动、0.005~0.095,0.1~0.4,≥0.5)的概率相比,没有统计学差异(P>0.05)。终视力与初视力呈明显正相关(r=0.772,P=0.000)。OTS-1级的终视力是0.5者的例数为0,OTS-5级的终视力为无光感的例数也为0。结论:对眼外伤患者进行OTS评分可以很好地为眼科医生对伤情初判及快速制定出治疗方案提供较好的帮助。     

数字化训练系统对集合不足型视疲劳的疗效观察

目的 观察数字化训练系统对集合功能不足型视疲劳的疗效。方法 18位集合不足型视疲劳患者随机分2组,分别采用数字化训练系统和笔尖训练法进行12周的视觉训练,训练前后均进行CISS集合不足型视疲劳问卷评分并检测辐辏近点和正融像辐辏功能。比较两种方法对集合功能不足性视疲劳的治疗效果。结果 两种训练方法对治疗集合不足性视疲劳后辐辏近点均明显变近,正融像辐辏能力均明显加强,数字化训练法治疗效果较笔尖训练法效果更为明显。数字化训练组CISS评分视疲劳症状明显改善,而笔尖训练组症状改善不明显。结论 不论主观评价还是集合功能检测,数字化训练的治疗集合不足性视疲劳均较笔尖训练法更有效。     

Microperimetry and spectral domain optical coherence tomography in myelinated retinal nerve fibers

AIM: To complete the data of ocular trauma in central China, as a well-known tertiary referral center for ocular trauma, we documented the epidemiological characteristics and visual outcomes of patients hospitalized for ocular trauma in this region. METHODS: A retrospective study of patients hospitalized for ocular trauma in central China from 2006 to 2011 was performed. RESULTS: This study included 5964 eyes of 5799 patients. The average age was 35.5±21.8y with a male-to-female ratio of 2.8:1. The most common age was 45-59y age group. Most patients were farmers and workers (51.9%). The most common injuries were firework related (24.5%), road traffic related (24.2%), and work related (15.0%). Among the most common causative agents were firecrackers (24.5%), followed by metal/knife/scissors (21.4%). Most injuries occurred in January (14.2%), February (27.0%), and August (10.0%). There were 8.5% patients with ocular injuries combined with other injuries. The incidence of open ocular injuries (4585 eyes, 76.9%) was higher than closed ocular injuries (939 eyes, 15.7%). The incidences of chemical and thermal ocular injuries were 1.2% and 0.6%. Ocular trauma score (OTS) predicted final visual acuity at non light perception (NLP), 20/200-20/50 and 20/40 with a sensitivity of 100%, and light perception (LP)/hand motion (HM) and 1/200-19/200 with a specificity of 100%. CONCLUSIONS: This study provides recent epidemiological data of patients hospitalized for ocular trauma in central China. Some factors influencing the visual outcome include time interval between injury and visit to the clinic, wound location, open or closed globe injury, initial visual acuity, and OTS.     

青光眼Humphrey视野检查结果计分评价

目的 研究视野缺损计分对青光眼视野缺损评价的有效性与可靠性.方法 对25例30只眼原发性开角型青光眼患者进行海德堡视网膜断层扫描仪(HRT-Ⅱ)视盘检测和Humphrey视野检查,研究HRT视盘参数、视野平均缺损(MD)和视野缺损计分(VFDS)间的关系和相关性.结果 VFDS与MD间呈明显正相关;二者都与HRT视盘参数有相关性,VFDS的相关系数大于MD的相关系数.结论 VFDS与视盘客观检查结果相符,比MD更能准确反映青光眼视野缺损.     

Acute and Chronic Ophthalmic Involvement,Severity, and Sequelae in Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis

PurposeTo study the ocular manifestations, its severity and sequelae in patients with Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN).MethodsProspective study of 44 consecutive patients (30 SJS and 14 TEN) presenting in the acute phase of the disease. Patients were evaluated by dermatologist as well as physician for systemic status, skin lesions and mucosal involvement. Detailed history taking, visual acuity, ophthalmic evaluation (lid margin, corneal, conjunctival changes, tear film and ocular surface). Ocular severity score (OSS) was assessed at baseline (acute) and at 6 months (chronic / OSS6), graded as mild, moderate and severe.ResultsMean age was 28.15 ± 15.78 years. Sixty-five eyes of 33 patients were included for final analysis. Thirty-eight patients (86.4%) had ocular manifestations. Drugs were the most common causative factor (95.4%). At base line mild, moderate, and severe OSS was seen in 43.1%, 44.6%, and 12.3% eyes. At 6 months mild, moderate, and severe OSS was seen in 44.6%, 7.7%, and 6.2% of eyes. There was a significant correlation between age of the patient and OSS at 6 months (p = 0.02). Younger age had higher chronic OSS. Patients with TEN had higher acute (p = 0.001) and chronic (p = 0.001) OSS than SJS. Three mucosal surface involvement associated with higher acute and chronic OSS (p = 0.001). No long-term ocular complications observed in 27 / 65 (41.5%) eyes. Acute OSS correlated significantly with chronic OSS, at 1 and 6 months (p = 0.001).ConclusionsGreater severity of the disease, more number of mucosal surfaces involved and shorter symptom lag correlated with more severe acute and chronic ocular manifestations. The severity of lid margin involvement and corneal involvement in acute stage were good predictors of severity of chronic ocular findings. Initial severity of ocular involvement correlated with severity of ocular sequelae.     

Characteristics and visual outcomes of patients hospitalized for ocular trauma in central China: 2006–2011

AIM

To complete the data of ocular trauma in central China, as a well-known tertiary referral center for ocular trauma, we documented the epidemiological characteristics and visual outcomes of patients hospitalized for ocular trauma in this region.

METHODS

A retrospective study of patients hospitalized for ocular trauma in central China from 2006 to 2011 was performed.

RESULTS

This study included 5964 eyes of 5799 patients. The average age was 35.5±21.8y with a male-to-female ratio of 2.8:1. The most common age was 45-59y age group. Most patients were farmers and workers (51.9%). The most common injuries were firework related (24.5%), road traffic related (24.2%), and work related (15.0%). Among the most common causative agents were firecrackers (24.5%), followed by metal/knife/scissors (21.4%). Most injuries occurred in January (14.2%), February (27.0%), and August (10.0%). There were 8.5% patients with ocular injuries combined with other injuries. The incidence of open ocular injuries (4585 eyes, 76.9%) was higher than closed ocular injuries (939 eyes, 15.7%). The incidences of chemical and thermal ocular injuries were 1.2% and 0.6%. Ocular trauma score (OTS) predicted final visual acuity at non light perception (NLP), 20/200-20/50 and 20/40 with a sensitivity of 100%, and light perception (LP)/hand motion (HM) and 1/200-19/200 with a specificity of 100%.

CONCLUSIONS

This study provides recent epidemiological data of patients hospitalized for ocular trauma in central China. Some factors influencing the visual outcome include time interval between injury and visit to the clinic, wound location, open or closed globe injury, initial visual acuity, and OTS.