超声造影在眼部占位疾病诊断的应用

目的研究超声造影在眼部占位疾病诊断中的应用价值。设计回顾性病例系列。研究对象常规超声检查不能确定诊断的表现为眼部占位性疾病的患者306例（309眼）。方法将超声造影剂Sono Vue2．4ml经肘静脉弹丸式推注后行眼部超声造影检查。观察眼部正常组织及病变内的造影剂随时间的灌注变化情况,实时录像记录供脱机分析使用。主要指标造影剂在眼部病变内的填充情况（开始充盈时间、持续时间等）,造影剂充盈的形态特点和强化是否均匀等。结果306例（309眼）患者的眼部正常组织内均可观察到造影剂填充,病变内有260例（263眼）（84．97％）显示造影剂填充,填充方式为“团状”完全强化、“抱球状”向心强化、不均匀强化等。46例（46眼）（15．03％）病变内无造影剂填充。强化病例诊断为占位性病变者257例（260眼）（98．85％）,诊断为炎症者3例（3眼）（1．15％）。无造影剂填充的病例均诊断为出血。结论超声造影对于眼部占位疾病的诊断可提供重要的鉴别诊断信息,为更准确地诊断眼部占位病变提供帮助。     

超声诊断视网膜下出血五例

报告用美国CILCO公司生产的SONOMETRICS TM OCUSCAN400型眼用实时超声扫描仪诊断视网膜下出血5例。共同病史为突然视力下降，眼底后极部有青灰色的隆起病灶，易误诊为脉络膜恶性黑色素瘤。超声检查有独特的表现，将A-扫描的波形和B-扫描的图像结合起来，能够鉴别诊断，排除眼内肿瘤，防止延误诊断。尤其合并玻璃体出血时，超声检查是很重要的检查方法。 （中华眼底病杂志，1994，10：97-98）     

泪腺炎型炎性假瘤的超声诊断及临床应用价值

目的探讨彩色多普勒超声检查在诊断泪腺炎型炎性假瘤中的应用价值。方法应用彩色多普勒超声对泪腺炎型炎性假瘤11例（11只眼）进行超声观察。结果发现彩色多普勒超声检查能够更清晰的显示正常人泪腺，对泪腺炎型炎性假瘤患者具有一定声像图特点。结论应用彩色多普勒超声检查诊断泪腺炎型炎性假瘤是一种简便、有效的辅助检查方法。     

超声造影剂时间-强度曲线在眼内肿瘤诊断及鉴别诊断的应用

目的 观察超声造影剂在眼内肿瘤内的时间强度曲线特征.方法 临床诊断的眼内肿瘤236例238只眼纳入研究.所有患者均行常规眼科检查及二维超声、彩色多普勒超声、超声造影检查.其中,脉络膜黑色素瘤166例166只眼;脉络膜转移癌16例18只眼;脉络膜血管瘤52例52只眼;视网膜血管瘤2例2只眼.记录超声造影的全过程,以Dicom格式输出图像,应用德国Tomteck公司的Sonoliver软件对输出的图像进行处理,绘制肿瘤内造影剂的时间-强度曲线.结果 所有患眼肿瘤病灶完全被造影剂填充,部分患眼可见自周边向中心的向心性填充.脉络膜黑色素瘤和脉络膜转移癌的时间强度曲线特征基本一致;脉络膜血管瘤和视网膜血管瘤的时间-强度曲线基本相同.所有肿瘤在充盈期的表现均为快速充盈型;但在肿瘤的消退期,前者表现为病变内的造影剂消退早于对照组织,后者表现为病灶内造影剂消退与对照组织同步或略晚于对照组织.脉络膜黑色素瘤166只眼中,完全符合上述变化特点者138只眼,占83.1％;基本符合上述变化特点者28只眼,占16.9％.脉络膜转移癌、脉络膜血管瘤和视网膜血管瘤均完全符合上述变化特点,占100.0％.结论 常见眼内恶性肿瘤的时间-强度曲线的特点为快进快出型;常见血管性良性肿瘤的时间-强度曲线的特点为快进慢出型.     

B型超声在急性玻璃体后脱离的诊断应用

目的探讨B型超声在急性玻璃体后脱离（PVD）的诊断价值。方法应用B型超声诊断技术对434例（434只眼）急性PVD患者进行检查、分析,根据PVD的声像图特点分为完全性和不完全性PVD。结果完全性PVD 289只眼（占66.59%）,而不完全性PVD 145只眼（占33.41%）,其中有28只眼合并少量玻璃体出血,仔细寻找发现裂孔19只眼,给予裂孔周边视网膜光凝,术后随访6个月无复发。结论 B型超声检查可以准确地诊断急性PVD,在玻璃体视网膜疾病的病程和预后中起重要的作用。     

超声生物显微镜在原发性虹膜睫状体囊肿诊断中的应用

超声生物显微镜（UBM）是一种新型超声诊断仪，能够无创伤地显示眼前节的结构和病变，对于虹膜后面的虹膜睫状体囊肿具有一定的诊断意义。我们就应用UBM检查出的682眼虹膜睫状体囊肿病例进行回顾性分析。     

眼科B型超声检查在诊断玻璃体后脱离中的应用

目的:探讨眼科B型超声检查在诊断玻璃体后脱离(posterior vitreous detachment,PVD)中的应用价值。方法:选取2011-09/2012-09来我院进行治疗的PVD患者305例506眼,应用B型超声进行检查和分析。结果:选取506眼中共计179眼(35.4%)为不完全PVD,327眼(64.6%)为完全PVD。其中有61眼(12.1%)出现少量玻璃体出血,经检查26眼(5.1%)为视网膜裂孔,裂孔周边激光光凝治疗后痊愈。结论:眼科B型超声检查可以准确诊断PVD,同时具有无创和快捷等特点,值得在临床上推广。     

几种眼科疾病的超声诊断

几种眼科疾病的超声诊断浙江省温岭市第一医院戴华朝Ｂ超在眼科疾病的诊断中已广泛采用，高频探头更能清晰地显示晶状体、玻璃体，视网膜的结构，而且不受屈光间质混浊的影响，为临床眼科提供了有效的无创伤性的诊断价值。本人将８９例９７眼超声检查分析如下：资料和方法...     

眼眶肿瘤术前超声造影的影像学研究

目的 探讨超声造影在眼眶肿瘤诊断和治疗中的应用价值.方法 收集我院2010年3月至2011年9月收治的各类眼眶肿瘤(包括眼内肿瘤)38例(38眼).其中眼眶海绵状血管瘤7例;皮样囊肿及粘液囊肿7例;泪腺多形性腺瘤5例;泪腺腺样囊性癌2例;恶性淋巴瘤4例;脉络膜恶性黑色素瘤6例;脉络膜血管瘤4例;炎性假瘤1例;视网膜下出血2例.全部病例术前行二维超声、超声造影、计算机断层摄影(CT)、磁共振成像(MRI)检查,检查结果结合临床治疗以及手术后病理检查结果进行分析.结果 几种眼眶内肿瘤(包括眼内肿瘤)在超声造影中均有特征性显像,与CT和MRI检查比较,在诊断符合率上存在差异(P＜0.05),超声造影在眼眶肿瘤的术前诊断上更具有优越性.结论 超声造影对于眼眶内肿瘤的术前诊断可以提供重要的鉴别诊断信息,结合CT、MRI的检查,可以更准确地完成眼眶肿瘤的定性诊断.     

开展小儿视网膜疾病影像检查，提高小儿视网膜疾病诊断治疗水平

随着眼底影像检查设备技术的进步以及应用水平的提高，视频检眼镜、眼底照相、荧光素眼底血管造影、光相干断层扫描以及眼部超声等眼底病影像检查手段逐步应用于小儿视网膜疾病的检查、诊断、治疗过程中。这些实时、精确、可重复的检查手段所提供的小儿眼底检查信息，不仅有助于更好地理解和观察小儿视网膜发育，揭示小儿特有的视网膜疾病的发病机制和病程进展，监测治疗效果和预后，而且使众多既往不能早期发现和诊断的小儿视网膜疾病的早期诊断成为可能。通过多学科专业合作，使这些小儿视网膜疾病影像检查过程更简便、安全，检查结果更加全面、客观，则将进一步扩大影像检查在小儿视网膜疾病诊断治疗过程中的应用，提高小儿视网膜疾病的诊断治疗水平。     

智能手机图像采集在眼科住院医师规范化培训教学实践中的应用

目的：探讨智能手机自带的图像及视频采集功能配合裂隙灯检查在眼科住院医师规范化培训教学中的应用。

方法：利用手机支架将智能手机与裂隙灯显微镜一侧目镜相连接,通过调节裂隙灯光带配合前置镜、三面镜、房角镜的使用获取清晰图片或动态视频,然后在教学活动中使用无线局域网络连接、微信等软件,将影像资料传输给眼科规范化培训医师进行学习与交流,考核评价教学效果。

结果：智能手机图像采集功能配合裂隙灯检查所获得的照片及动态视频能够清晰地显示眼部组织及病变特点; 影像资料的快捷传输可以让更多的学生同时受到教育,及时互相交流; 与传统裂隙灯检查教学方式相比很大程度上提高了规培生的学习兴趣、学习参与度及学习效率。

结论：手机支架购买方便,简单易得,高像素的智能手机普及广泛,成像质量完全可以满足临床教学需要且丰富了临床教学资源; 智能手机图像采集功能配合裂隙灯检查在眼科住院医师规范化培训教学实践中值得推广。     

充分利用临床实践中的影像资料进行眼科解剖教学

在眼科学解剖学教学中,充分利用临床实践中的影像资料如手术录像、眼科影像学检查资料进行讲解,可以使学生对眼的解剖有更生动形象、全面的理解,提高学生学习兴趣,优化教学质量。（眼科, 2015, 24： 354-355）     

智能手机照相技术在眼科学中的应用探索

使用图像来记录疾病在现代眼科学实践中越来越普遍，传统的眼科学仪器可以提供高质量的图像，但是设备笨重和高昂的价格限制了其应用范围。近年来，广泛使用的智能手机可以很容易地捕捉高质量的图像和视频。实践证明，在适配器的帮助下，用智能手机捕捉眼前节和眼后节图像成为可能。研究表明，无论是传统的眼科设备还是基于智能手机的照相系统，图像均具有良好的一致性。基于智能手机的角膜内皮检查和荧光素眼底血管造影将手机照相功能应用到眼科学更多领域。本文将对智能手机照相技术在眼科学中的应用进行综述。     

Skiaskopie Multimediales Lernprogramm auf CD

INTRODUCTION: Retinoscopy is a classical method to determine the refraction of the eye by observing the dynamics of reflexes and varying the experimental parameters until a specific reflex (neutralisation point) is observed. Until now photographs and geometrical drawings of the different ray tracings have been commonly used to visualise the pathways. We intend to use new media such as video and CD to offer the students a better understanding of retinoscopy. METHODS: With the aid of appropriate experimental devices, retinoscopal reflexes of artificial and human eyes are recorded on video. The video sequences are converted in computer files and together with computer animations of the geometrical ray tracings, text files and audio sequences, they are stored in a suitable CBT-programme. RESULTS: The systematically prepared computer compatible contents offer a modern individually controllable method to perform the instruction programme by multimedia. The CBT-program and the specific files are stored on CDs or can be distributed on the internet. A collection of retinoscopy records of patients, some with extraordinary reflex phenomena is also available. DISCUSSION: Video and animation procedures are more suitable for matching the dynamic phenomena on retinoscopy than photographs or drawings as they offer a more direct basis for understanding of the sometimes difficult processes of retinoscopy. The collection of recorded reflexes also offers the direct visualised experience of particular patient findings such as the appearance in context of implanted spherical and aspherical intraocular lenses or the irregularities of the optic system of eyes with keratokonus.     

Advantage of three dimensional animated teaching over traditional surgical videos for teaching ophthalmic surgery: a randomised study

BACKGROUND/AIM: Owing to the complex topographical aspects of ophthalmic surgery, teaching with conventional surgical videos has led to a poor understanding among medical students. A novel multimedia three dimensional (3D) computer animated program, called "Ophthalmic Operation Vienna" has been developed, where surgical videos are accompanied by 3D animated sequences of all surgical steps for five operations. The aim of the study was to assess the effect of 3D animations on the understanding of cataract and glaucoma surgery among medical students. METHOD: Set in the Medical University of Vienna, Department of Ophthalmology, 172 students were randomised into two groups: a 3D group (n=90), that saw the 3D animations and video sequences, and a control group (n=82), that saw only the surgical videos. The narrated text was identical for both groups. After the presentation, students were questioned and tested using multiple choice questions. RESULTS: Students in the 3D group found the interactive multimedia teaching methods to be a valuable supplement to the conventional surgical videos. The 3D group outperformed the control group not only in topographical understanding by 16% (p<0.0001), but also in theoretical understanding by 7% (p<0.003). Women in the 3D group gained most by 19% over the control group (p<0.0001). CONCLUSIONS: The use of 3D animations lead to a better understanding of difficult surgical topics among medical students, especially for female users. Gender related benefits of using multimedia should be further explored.     

Application of artificial intelligence in ocular imaging diagnosis北大核心CSCD

In ophthalmic clinical, a variety of image-related techniques are used to analyze the patient's condition, help the diagnosis and guide the prognosis.The artificial intelligence is based on computer intelligence science, which has great advantages in image recognition and gradually become a hot point in ophthalmic image examination diagnosis.At present, the application of artificial intelligence technology in ophthalmic image diagnosis is mainly focused on fundus photography and optical coherence tomography.In the diagnosis of diabetic retinopathy, age-related macular degeneration, glaucoma and other diseases, the artificial intelligence has high specificity and high sensitivity.With the development of intelligent technology, the application of artificial intelligence in the ophthalmic image examination diagnosis will be more and more in-depth and extensive. Copyright © 2018 by the Chinese Medical Association.     

Tuebingen Education System (TES)--An interactive case demonstration software

BACKGROUND: Presentations based on slides, videos and/or computer presentations are usually sequentially structured, resulting in an inflexible order of the demonstrated information and examination results. However, in (medical) education such a system only inadequately reflects the real physician-patient situation. MATERIALS UND METHODS: The software solution presented here is based on the widespread computer programme Microsoft PowerPoint(R) (PPT) which offers an opportunity to present information via text boxes, figures, illustrations, video sequences and/or audio files in an user-friendly way. However, PPT's capabilities of simulating realistic decision processes (e. g. by "interactive keys" and "hyperlinks") are still restricted as far as adapting the order of the information/slides to the individual demand is concerned. The Tuebingen Education System (TES) uses an additional user interface based on Visual Basic. By means of this, every examination result or information can be chosen via five additional pull-up menus in an arbitrary order. Furthermore, the pathway - i. e. the examinations used to arrive at a diagnosis - as well as the costs incurred are documented in parallel and are finally compared to the costs incurred using an optimum pathway. RESULTS: TES has been used routinely in the education of the students and residents of the University Eye Hospital Tuebingen for three (half-)terms. Meanwhile, an adapted version of TES is used to educate students in the department of paediatric surgery. TES was judged in extensive evaluations of both subjects very positively. CONCLUSIONS: TES is an easy to use tool suitable for lecturers and students, a further step towards realistic, practice-oriented and interactive education.     

Video recording in ophthalmic surgery

Video recording in ophthalmic surgery has immense potential to drive quality improvement in patient care, ophthalmology training, and research. Not only do surgical videos permit introspective and critical analyses of surgical technique, they also allow for objective assessment, allow for more informative audits, and are an invaluable medium for surgical education. Unfortunately, medical-grade video recording equipment is often costly. Various novel methods of video recording that utilize commercially available products offer adequate alternatives. Certain ethical and legal issues also need to be considered before the commencement of video recording in the operating room to protect both the patient and surgeon. We review the current applications and methods of video recording in ophthalmic surgery described in the literature, as well as the potential ethical and legal issues surrounding video recording.     

Bridging analog and digital video in the surgical setting

Editing surgical videos requires a basic understanding of key technical issues, especially when transforming from analog to digital media. These issues include an understanding of compression-decompression (eg, MPEGs), generation quality loss, video formats, and compression ratios. We introduce basic terminology and concepts related to analog and digital video, emphasizing the process of converting analog video to digital files. The choice of hardware, software, and formats is discussed, including advantages and drawbacks. Last, we provide an inexpensive hardware-software solution.     

后巩膜炎眼科影像学特征

目的：分析总结描述后巩膜炎的眼科影像学特征。 方法：在我院2008-10/2013-06期间确诊的后巩膜炎患者16例21眼的临床资料进行回顾性分析,分析B超、眼底彩色照相、眼底荧光血管造影、CT结果,对后巩膜炎眼科影像学特征进行综合评价与分析。 结果：所有患者均行B超检查,B超表现分为弥漫型和结节型两种,弥漫型表现为巩膜弥漫增厚,其后有筋膜囊水肿性低回声暗区与视神经相连,形成典型的“T”形征;结节型表现为巩膜结节型回声增强,内部结构较规则。 FFA表现为动脉早期见斑驳状相对弱荧光,动静脉期出现多发针尖样强荧光,逐渐变大融合;晚期荧光素渗漏至视网膜下组织;视盘有不同程度的强荧光,边界欠清或不清。 CT结果表现为眼球球壁增厚。 结论：后巩膜炎好发于中青年女性患者,其眼科影像学的表现多变,以B超表现较有特异性;选择合理的眼科影像学检查手段,并结合临床表现,能够准确诊断后巩膜炎,避免漏诊和误诊现象的发生。