老视前期近视患者准分子激光原位角膜磨镶术后AC／A值的变化研究

目的 观察老视前期近视患者准分子激光原位角膜磨镶术(LASIK)术后调节性集合(AC)与调节(A)比值的变化.方法 对接受LASIK手术治疗的老视前期近视患者25例(50只眼),按术前屈光矫正方式分为戴框架眼镜组11例和角膜接触镜组14例,采用Von Grade法测量各组术前戴镜和术后裸眼1个月及3个月远距、近距水平隐斜,根据公式得到计算性AC/A值并进行统计学分析.结果 老视前期近视患者戴框架眼镜组术后1、3个月计算性AC/A值明显低于术前戴镜AC/A值(P<0.05),而术后6个月计算性AC/A值与术前比较无统计学差异(P>0.05).角膜接触镜组术后1个月AC/A值明显低于术前戴镜AC/A值(P<0.05),3个月和6个月AC/A值与术前比较均无统计学差异(P>0.05).结论 老视前期近视患者LASIK术后早期AC/A值较术前先减小,以后逐渐上升,至术后6个月时逐渐恢复至术前水平.LASIK手术对老视前期近视患者计算性AC/A值无明显不良影响.     

高度近视LASIK后早期AC/A值的变化研究

目的 观察高度近视患者准分子激光原位角膜磨镶术(laser in situ keratomileusis,LASIK)术后早期调节性集合(accommodative convergence,AC)与调节(accommodation,A)比值的变化.方法 用LASIK治疗高度近视患者38例76眼,按术前屈光矫正方式分为归为框架眼镜组17例和角膜接触镜组21例,采用VonGraefe法测量各组术前戴镜和术后裸眼1月及3月远距、近距水平隐斜,根据公式得到计算性AC/A值并进行统计学分析.结果 框架眼镜组术后1个月计算性AC/A值明显低于术前戴镜AC/A值(P<0.05),而术后3月计算性AC/A值与术前比较无统计学意义(P>0.05).角膜接触镜组术后1月和3月AC/A值与术前比较均无统计学意义(P>0.05).结论 配戴框架眼镜的高度近视患者LASIK术后早期AC/A值较配戴角膜接触镜明显减小,3月后逐渐恢复至术前水平.LASIK手术对高度近视患者计算性AC/A值无明显不良影响.     

斜视矫正手术治疗内隐斜引起的肌性视力疲劳疗效分析

目的：观察手术矫正对内隐斜引起的肌性视力疲劳的治疗效果。
　　方法：对21例42眼内隐斜视引起肌性视力疲劳的患者进行屈光、隐斜、融合功能检查后进行手术矫正内隐斜。
　　结果：术后1wk,患者的临床症状得到明显改善,如头痛、复视、眼胀等症状消失。术后1a随访仍未见临床症状复发。检查患者术前、术后1 wk、术后1 a的远距内隐斜量分别为20.3△±6.3△、-3.1△±1.4△、0.7△±1.6△,近距内隐斜量分别为10.5△±3.1△、-1.3△±0.6△、1.5△±0.8△;术前与术后相比较,差异具有统计学意义(P<0.01)。患者术前、术后1 wk与术后1 a的远、近距负向融合力比较,差异无统计学意义(P>0.05)。
　　结论：斜视矫正手术能明显缓解内隐斜引起的肌性视力疲劳症状,不影响患者的融合力。     

儿童间歇性外斜视术后早期双眼视功能恢复及影响因素

目的：探讨间歇性外斜视儿童眼位成功矫正后早期的双眼视功能恢复情况及其影响因素。方法：前 瞻性临床研究。收集2019年7月至2020年7月期间于温州医科大学附属眼视光医院的间歇性外斜视 术后1个月眼位矫正成功的患者177例,年龄7~14（9.97±2.16）岁。采用配对t检验、Pearson相关性 检验和多元线性回归分析评估术后1个月的眼位和双眼视功能参数,及其与术前临床特征之间的相 关性。结果：患者术后1个月斜视角均符合正位标准,与术前斜视角有显著差异（远距：-2.80 △±3.96 △ vs.-33.67 △±9.17 △,t=-41.83,P<0.001;近距：-4.05 △±4.68 △vs.-38.50 △±9.09 △,t=-44.27,P<0.001）。 远距（2.59±0.38 vs.2.80±0.25,t=7.30, P<0.001）和近距（2.19±0.36 vs.2.36±0.44,t=5.68,P<0.001） 立体视较术前获得明显改善,分别有16.4%和22.0%患者获得远距和近距正常的立体视功能。术后 远距知觉性融像功能较术前获得明显改善（χ2=8.08,P=0.004）,而近距结果与术前比较无差异明显统 计学意义。术后1个月时的远距和近距立体视功能与术前年龄、屈光参差度、远距和近距立体视功 能呈显著正相关（远距：r=0.15,P=0.043;r=0.19,P=0.012;r=0.28,P<0.001;r=0.22,P=0.004;近距： r=0.23,P=0.002;r=0.34,P<0.001;r=0.15,P=0.043;r=0.49,P<0.001）。结论：间歇性外斜视儿童眼 位成功矫正后,术后早期立体视和知觉性融像功能较术前明显改善。术后立体视功能状态与手术年 龄、屈光参差量、术前立体视功能有一定的相关性。     

LASIK对近视患者调节和隐斜的影响

目的　探讨LASIK手术对近视患者调节和隐斜的影响。方法　对LASIK手术的近视患者 60人在术前和术后一个月进行调节力和看近隐斜度的测定 ,并进行对比分析。结果　术前调节力平均值为 6 77D± 1 41D ,术后调节力平均值为 7 3 9D± 1 2 5D。统计学分析二者之间的差异有非常显著性意义 (t =6 887,P <0 0 1)。术前裸眼隐斜度的平均值为 -10 18± 5 0 7Δ。术前戴矫正镜片隐斜度的平均值为 -1 99± 6 49Δ ;术后裸眼隐斜度的平均值为 -4 92± 4 46Δ。统计学分析 ,术前裸眼与戴矫正镜片隐斜度平均值之间的差异有非常显著性意义 (t =11 898,P <0 0 1) ;术前裸眼与术后裸眼隐斜度平均值之间的差异有非常显著性意义 (t =11 10 1,P <0 0 1) ;术后裸眼与术前戴矫正镜片隐斜度平均值之间的差异有非常显著性意义 (t =3 0 45 ,P <0 0 1)。结论　LASIK手术后近视患者的调节力有一定增加。矫正眼镜和LASIK手术可以减少近视患者看近外隐斜。较长期的影响尚有待于观察。     

儿童间歇性外斜视术后早期双眼视功能恢复及影响因素

目的: 探讨间歇性外斜视儿童眼位成功矫正后早期的双眼视功能恢复情况及其影响因素。方法: 前瞻性临床研究。收集2019年7月至2020年7月期间于温州医科大学附属眼视光医院的间歇性外斜视术后1个月眼位矫正成功的患者177例, 年龄7～14(9.97±2.16)岁。采用配对t检验、Pearson相关性检验和多元线性回归分析评估术后1个月的眼位和双眼视功能参数, 及其与术前临床特征之间的相关性。结果: 患者术后1个月斜视角均符合正位标准, 与术前斜视角有显著差异(远距:-2.80△±3.96△vs.-33.67△±9.17△, t=-41.83, P<0.001;近距:-4.05△±4.68△vs.-38.50△±9.09△, t=-44.27, P<0.001)。远距(2.59±0.38vs.2.80±0.25, t=7.30,P<0.001)和近距(2.19±0.36vs.2.36±0.44, t=5.68, P<0.001)立体视较术前获得明显改善, 分别有16.4%和22.0%患者获得远距和近距正常的立体视功能。术后远距知觉性融像功能较术前获得明显改善(χ2=...     

Effects of persistent viewing of 3 D TV on human visual function

目的:研究持续观看3D电视对视功能的影响,以及探索不同视功能参数之间的关系.方法:本研究录入19位受试者,每位受试者观看90分钟的2 D电视或90分钟的3 D电视,两部电视观看间隔时间为一周,顺序随机.每次观看电视前及观看后15 min内都做相关视功能检查,检查包括以下四种视功能参数:调节功能(调节反应、调节微波动、调节灵敏度、正相对调节、负相对调节、AC/A),融像性聚散功能(远距负融像性聚散功能、远距正融像性聚散功能、近距负融像性聚散功能、近距正融像性聚散功能),隐斜量(远距隐斜量、近距隐斜量),立体视.结果:无论是与观看前的基础值比较,还是与观看2D电视后的数据比较,观看3D电视后近距离调节反应增加,汇聚减少,远距隐斜量向外隐斜改变(P<0.05).结论:持续观看3D电视会对人们的视功能有一定影响,主要是打破了调节和聚散系统的平衡.厂家和公众应该引起重视,将调节功能、融像性聚散功能、隐斜量等参数作为评估3D电视安全性的指标.     

肌性视力疲劳的手术治疗效果分析

目的 观察手术矫正外隐斜引起的肌性视力疲劳的治疗效果.方法 对27例外隐斜导致肌性视力疲劳的患者进行屈光、隐斜、融合功能检查后进行手术矫正外隐斜视.结果 术后1月,患者的临床症状得到明显改善,视物不清、复视、眼胀、头痛、恶心等症状消失,阅读持续时间较术前明显延长.术后1年随访仍未见临床症状复发者.检查患者术前、术后1月、术后1年的远距外隐斜量分别为(21.6±7.4)Δ、(1.8±0.6)Δ、(2.0±0.4)Δ,近距外隐斜量分别为(20.5±8.7)Δ、(2.3±0.8)Δ、(2.4±0.9)Δ;术前与术后各阶段相比较,差异具有统计学意义(P ＜0.01),而术后各阶段相比,差异无统计学意义(P＞0.05).患者术前、术后各阶段的远、近距正向融合功能比较,差异无统计学意义(P＞0.05).结论 外隐斜视矫正手术能明显缓解外隐斜引起的肌性视力疲劳症状,不影响患者的融合功能.     

近视患者准分子激光原位角膜磨镶术后调节性集合与调节比值的变化

目的　探讨近视患者准分子激光原位角膜磨镶术 (laserinsitukeratomileusis,LASIK)后调节性集合 (accommodativeconvergence ,AC)与调节 (accommodation ,A)比值的变化及其影响因素。方法使用同视机测定 135例不同程度近视患者LASIK术前裸眼、术前配戴框架眼镜 (戴镜 )及术后裸眼的AC/A值 ,并进行统计学比较和分析。结果　全部患者术前裸眼、术前戴镜及术后裸眼的AC/A值分别为 ( 0 72 4± 0 5 87) △/D、( 2 75 4± 1 5 6 5 ) △/D及 ( 1 6 18± 1 0 2 7) △/D ,两两比较差异均有非常显著意义 (P <0 0 0 1)。不同程度近视患者术前裸眼AC/A值比较差异有显著意义 (P <0 0 1) ,术前戴镜和术后裸眼AC/A值比较差异均无显著意义 (P >0 0 5 )。LASIK术后裸眼AC/A值与术前戴镜AC/A值和屈光度数呈正相关 (P <0 0 0 5 ) ,与患者年龄和眼轴长度呈负相关 (P <0 0 0 2 )。术后裸眼AC/A值 (Y)与患者年龄 (X1)、眼轴长度 (X2 )及术前戴镜AC/A值 (X3)建立多元回归方程为Y =4 0 80 0 - 0 0 318X1- 0 0 971X2 +0 32 5 0X3(P <0 0 0 1)。结论　近视患者AC/A值LASIK术后裸眼高于术前裸眼 ,低于术前戴镜 ;LASIK术后AC/A值受术前戴镜AC/A值、患者年龄及眼轴长度的影响。     

准分子激光原位角膜磨镶术后调节性集合与调节比率变化

目的:探讨准分子激光原位角膜磨镶术(laserin situ keratomileusis,LASIK)后近视患者调节性集合与调节比率(accommodative convergence per unit of accommodation,AC/A)变化。方法:Von Graefe法测定患者近距水平隐斜,给予+1.00D近附加后再次测量,结果之差为梯度性AC/A比率,测量患者LASIK手术前、手术后1wk;1,3,6mo的AC/A比率,结果进行统计学分析。结果:术前戴镜AC/A比率为(2.98±0.80)△/D,手术后1wk;1,3,6mo的AC/A比率分别为(2.02±0.57)△/D,(2.43±0.63)△/D,(2.87±0.65)△/D,(2.91±0.68)△/D,手术后1wk;1mo时AC/A比率较手术前显著降低(P<0.01)。手术后3,6mo AC/A比率较手术前无差异。结论:LASIK术后1wk;1mo,AC/A比率较术前降低,术后3mo升至术前水平并稳定。     

Changes in Bruch's membrane in experimental hypercholesteremia in rats

PURPOSE: We investigated the effect of high cholesterol diet for the aging changes in Bruch's membrane of rats. METHODS: After feeding a 4% cholesterol diet for 15 weeks to three young rats 3 months old and four aged rats 23 months old, we observed the morphological changes of Bruch's membrane by electron microscopy, and made a comparison with rats fed an ordinary diet. RESULTS: In one young rat fed a high-cholesterol diet, the endothelial basement membrane of the choriocapillaris formed multiple folds separated from the plasma membrane of the endothelium and showed lamellar thickening and crack in some areas. The elastic fiber layer in Bruch's membrane disappeared partly and some new microfibrils appeared. In one aged rat fed a high-cholesterol diet, the endothelial basement membrane of the choriocapillaris showed more lamellar thickening with lumps in some parts. Compared with rats fed an ordinary diet, rats fed a high-cholesterol diet showed thickening of the basement membrane and the changes were more severe. CONCLUSIONS: Our data indicated that high-cholesterol diet might promote age-related changes of Bruch's membrane.     

Advances in imaging in oculoplastics

Color Doppler imaging, computed tomography (CT) and magnetic resonance (MR) imaging are the most precious imaging tools for the clinician in the field of oculoplastics. Orbital and facial vasculature, with its dynamic changes and flow velocities seen in orbital varices, carotid-cavernous fistulas, and dural cavernous arteriovenous malformations, is best detected by Color Doppler imaging. Computed tomography remains the dominant imaging modality in the evaluation of orbital trauma. Helical CT axial scanning with multiplanar reconstruction and three-dimensional CT imaging are most helpful in assessing iatrogenic, traumatogenic, and teratogenic orbital abnormalities. Despite its poor histologic specificity, MR imaging provides superior soft tissue contrast, and contrast-enhanced MR imaging has an established role regarding soft tissue tumor infiltration. The greatest value of MR studies in the evaluation of orbital and palpebral tumors is that it has the capacity to show the precise relation between lesions and adjacent structures before the clinician contemplates a surgical approach. Finally, contrast-enhanced MR imaging proved to be a valuable vascularization indicator based upon the extent of relative enhancement within porous orbital implant in anophthalmic socket.     

Follow-up studies in pattern VECP in demyelinating diseases in children

Spectral sensitivity functions and the transient decrease of sensitivity to short wavelengths after the offset of yellow light (transient tritanopia) were measured by increment threshold techniques in patients suffering from hereditary macular degenerations. Color vision defects were determined by arrangement tests and the anomaloscope. Central areolar choroidal dystrophy was found to produce a mild protan defect and to reduce foveal spectral sensitivity throughout the visible spectrum by a factor of 100; it also abolishes transient tritanopia. Electroretinogram (ERG) was normal, electrooculogram (EOG) subnormal. Stargardt's disease, despite numerous fluorescent macular spots, does not abolish transient tritanopia nor does it reduce spectral sensitivity, although scotopic matches were performed on the Nagel anomaloscope. Only in severe, advanced cases was transient tritanopia reduced and spectral sensitivity found to follow the absorption spectrum of rods. Routine ERGs and EOGs were normal. Vitelliform macular degeneration, despite the ophthalmoscopically pronounced dystrophic macula, produced only very small changes in spectral sensitivity and transient tritanopia, although a widened matching range on the Nagel anomaloscope and electrophysiological abnormalities were found. Apparently damage of the retinal circuit which connects long and short wavelength-sensitive cones, caused by hereditary conditions, is different from that caused by retinotoxic drugs.     

Refractive error in children in a rural population in India

PURPOSE: To assess the prevalence of refractive error and related visual impairment in school-aged children in the rural population of the Mahabubnagar district in the southern Indian state of Andhra Pradesh. METHODS: Random selection of village-based clusters was used to identify a sample of children 7 to 15 years of age. From April 2000 through February 2001, children in the 25 selected clusters were enumerated in a door-to-door survey and examined at a rural eye center in the district. The examination included visual acuity measurements, ocular motility evaluation, retinoscopy and autorefraction under cycloplegia, and examination of the anterior segment, media, and fundus. Myopia was defined as spherical equivalent refractive error of at least -0.50 D and hyperopia as +2.00 D or more. Children with reduced vision and a sample of those with normal vision underwent independent replicate examinations for quality assurance in seven clusters. RESULTS: A total of 4414 children from 4876 households was enumerated, and 4074 (92.3%) were examined. The prevalence of uncorrected, baseline (presenting), and best corrected visual acuity of 20/40 or worse in the better eye was 2.7%, 2.6%, and 0.78%, respectively. Refractive error was the cause in 61% of eyes with vision impairment, amblyopia in 12%, other causes in 15%, and unexplained causes in the remaining 13%. A gradual shift toward less-positive values of refractive error occurred with increasing age in both boys and girls. Myopia in one or both eyes was present in 4.1% of the children. Myopia risk was associated with female gender and having a father with a higher level of schooling. Higher risk of myopia in children of older age was of borderline statistical significance (P = 0.069). Hyperopia in at least one eye was present in 0.8% of children, with no significant predictors. CONCLUSIONS: Refractive error was the main cause of visual impairment in children aged between 7 and 15 years in rural India. There was a benefit of spectacles in 70% of those who had visual acuity of 20/40 or worse in the better eye at baseline examination. Because visual impairment can have a significant impact on a child's life in terms of education and development, it is important that effective strategies be developed to eliminate this easily treated cause of visual impairment.     

Vitrectomy in traumatic cataracts and in the complications of surgery in congenital cataract in children

Vitrectomies were carried out in 35 children with traumatic cataracts and complications of surgery for cataracts, caused by injury to the posterior lenticular capsule and incorporation of its fragments to the vitreous. Complete removal of lenticular rudiments rapidly eliminated phacogenic iridocyclitis and improved visual acuity. Improvement of visual functions was attained in 66.6% cases; in 33.4% cases visual acuity did not change. Hemorrhages to the vitreous cavity occurred in 4 cases with pronounced iridocyclitis; therefore, a corneal approach is preferable for cases with pronounced iridocyclitis.     

Refractive error in children in an urban population in New Delhi

PURPOSE: To assess the prevalence of refractive error and related visual impairment in school-aged children in an urban population in New Delhi, India. METHODS: Random selection of geographically defined clusters was used to identify a sample of children 5 to 15 years of age. From December 2000 through March 2001, children in 22 selected clusters were enumerated through a door-to-door survey and examined at a local facility. The examination included visual acuity measurements, ocular motility evaluation, retinoscopy and autorefraction under cycloplegia, and examination of the anterior segment, media, and fundus. Myopia was defined as spherical equivalent refractive error of at least -0.50 D and hyperopia as +2.00 D or more. Children with reduced vision and a sample of those with normal vision underwent independent replicate examinations for quality assurance in four of the clusters. RESULTS: A total of 7008 children from 3426 households were enumerated, and 6447 (92.0%) examined. The prevalence of uncorrected, baseline (presenting), and best corrected visual acuity of 20/40 or worse in the better eye was 6.4%, 4.9%, and 0.81%, respectively. Refractive error was the cause in 81.7% of eyes with vision impairment, amblyopia in 4.4%, retinal disorders in 4.7%, other causes in 3.3%, and unexplained causes in the remaining 5.9%. There was an age-related shift in refractive error from hyperopia in young children (15.6% in 5-year-olds) toward myopia in older children (10.8% in 15-year-olds). Overall, hyperopia was present in 7.7% of children and myopia in 7.4%. Hyperopia was associated with female gender. Myopia was more common in children of fathers with higher levels of education. CONCLUSIONS: Reduced vision because of uncorrected refractive error is a major public health problem in urban school-aged children in India. Cost-effective strategies are needed to eliminate this easily treated cause of vision impairment.