眼挫伤后视力损害患者视觉诱发电位分析

目的:探讨视觉诱发电位(VEP)在评价挫伤后视力损害中的价值。方法:对74例挫伤性视力损害患者进行图形翻转刺激VEP测定,并与自体健侧眼和正常对照组进行比较。结果:74例患者中,单眼挫伤57例,双眼挫伤17例,共91眼受伤,受伤眼均有不同程度视力损害。VEP检查结果:91 眼中波形不典型者5眼(6％);P100波幅下降异常者54眼(59％);P100潜伏期延长者23眼(25％)。其中单纯潜伏期延长12眼(13％);单纯波幅下降异常43眼(47％);潜伏期延长伴波幅下降者11眼 (12％),总异常66眼,异常率为73％。所有挫伤后视力损害者,与自体健侧服和正常对照组比较,P100 潜伏期延长和波幅降低,差异均有显著意义(P<0．01)。结论:VEP为挫伤性视力损害的视功能评价、临床早期诊断、预后评估以及伤残鉴定提供了重要的客观依据。     

眼外伤性视神经挫伤患者的早期视觉诱发电位分析

目的 :探讨视觉诱发电位 (VEP)在眼外伤性视神经挫伤中的应用价值。方法 :对 6 8例临床诊断为外伤性视神经挫伤的患者进行VEP测定 ,并与自体健侧眼或正常对照组进行对照。结果 :6 8例患者中单眼挫伤者 6 2例 ,双眼挫伤者 6例 ,共 74眼 ,VEP检查结果均有不同程度的异常。其中有 2例 3眼VEP波幅明显降低 (4 % ) ,单纯波幅异常降低者 5 0例 5 3眼 (71% ) ,波幅降低伴有峰潜伏期延长者 16例 18眼 (2 5 % )。所有外伤性视神经挫伤与自体健侧眼和正常对照比较 ,P10 0波幅差异有显著意义 (P <0 0 1) ,而P10 0峰潜伏期仅有 16例稍有延长 ,与正常值比较无明显差异 (P >0 0 5 )。结论 :VEP对眼球钝挫伤后视神经损伤的检出有较高的敏感性 ,因此对于眼外伤性视神经挫伤中的早期诊断 ,疗效观察 ,预后评估有着重要价值     

眼挫伤所引发的眼底损害临床分析

目的通过试验，探究眼挫伤所引发的眼底损害的临床特点。方法选取100例眼挫伤患者，分析他们的眼底血流变化及眼底损害类型和临床特征。结果105只发生挫伤的眼中，眼底损害的类型不尽相同，其中视网膜震荡者有70只眼(66.7%)，视网膜出血者有23只眼(21.8%)，发生脉络膜破裂者有6只眼(5.7%)，发生黄斑裂孔者有3只眼(2.9%)，发生视神经损伤者有3只眼(2.9%)。结论眼挫伤所引发的眼底损害临床分型较多，其中所占比例较大的是视网膜震荡和视网膜出血，临床上治疗眼挫伤时要注意其眼底损害，考虑常见类型，做出正确的判断和及时的处理。     

前庭诱发肌源电位对眩晕定位诊断的价值探讨

目的:通过良性阵发性位置性眩晕(BPPV)患者前庭诱发肌源电位(VEMP),包括颈性VEMP和眼性VEMP的特性研究,以探讨其对眩晕定位诊断的价值.方法:对67例对照组和33例BP-PV患者分别进行颈性VEMP、眼性VEMP检测,分析比较两组之间各项检测数据的差异.结果:①病例组患耳的颈性VEMP、眼性VEMP异常率分别达到33％和36％;②病例组与对照组的颈性VEMP各波潜伏期比较差异有显著意义,但峰-峰波幅比较差异无显著意义.病例组与对照组眼性VEMP各波潜伏期和峰-峰波幅比较差异有显著意义.结论:VEMP可以作为(BPPV)耳石器功能异常变化的客观量化评估指标,并对眩晕的定位诊断提供一定帮助.     

532激光联合曲安奈德治疗糖尿病视网膜病变的临床观察

目的评价倍频532激光联合曲安奈德治疗伴有黄斑水肿的糖尿病视网膜病变的疗效。方法对52例87眼伴有弥漫性黄斑水肿的糖尿病视网膜病变患者采用532激光进行黄斑格栅样光凝联合全视网膜光凝，同时球后注射曲安奈德20mg，1～3次，间隔1周，分析患者视力、黄斑水肿及并发症情况。结果激光治疗后随访6～18个月，87眼中51（59％）眼视力稳定，视力提高者30（35％）眼，视力下降者6（7％）眼；眼底荧光血管造影检查，光凝后水肿完全消退者50（57％）眼，部分消退者32（37％）眼，不变者5（6％）眼，晶状体混浊加重者5眼，4只眼眼压升高。结论532倍频激光联合曲安奈德治疗糖尿病视网膜病变有助于黄斑水肿消退，提高视力。     

视觉诱发电位对眼挫伤患者的应用价值

目的:探讨视觉诱发电化(VEP)对眼挫伤视神经损伤的诊断、预后评估和出具鉴定意见的价值。方法:对55例眼挫伤患者(单眼挫伤53例,双眼挫伤2例)进行VEP检查,单眼损伤者以自体健侧眼为对照。视力≥0.1者行图形模式刺激视觉诱发电位(P-VEP)检查为A组;视力<0.1者行闪光视觉诱发电位(F-VEP)检查为B组。结果:55例中VEP正常16例(占29%),异常39例(占71%)。异常者中单纯P100波幅下降9例(占23%),单纯P100波潜伏期延长12例(占31%),P100波潜伏期延长伴波幅下降16例(占41%),P100波形完全消失2例(占5%)。所有眼挫伤后视力损害者与自体健侧眼作对比,A、B组间VEP P100波潜伏期延长和波幅降低,差异均有非常显著意义(P<0.01)。结论:VEP为挫伤性视力损害的视功能评价、临床早期诊断、预后评估以及伤残鉴定提供了重要的客观依据。     

2型糖尿病视网膜病变的视网膜光敏感度研究

目的　探讨 2型糖尿病并视网膜病变患者的视网膜光敏感度改变及其原因分析 .方法　采用国产APS -6 0 0 0B型全自动视野分析仪 ,分别对 80例 16 0眼 2型糖尿病并视网膜病变患者和对照组 80例 16 0眼进行 0°～ 90°视野视网膜光敏感度的定量检测并进行对比 .结果　糖尿病组的视网膜平均光敏感度有不同程度的下降 (p <0 .0 5 ) .结论　 2型糖尿病并视网膜病变患者的视网膜光敏感度是降低的 ,提示有光感受器的功能障碍     

2型糖尿病视网膜病变的视网膜光敏感度研究

目的探讨2型糖尿病并视网膜病变患者的视网膜光敏感度改变及其原因分析.方法采用国产APS-6000B型全自动视野分析仪,分别对80例160眼 2型糖尿病并视网膜病变患者和对照组80例160眼进行0°～90°视野视网膜光敏感度的定量检测并进行对比.结果糖尿病组的视网膜平均光敏感度有不同程度的下降(p<0.05).结论 2型糖尿病并视网膜病变患者的视网膜光敏感度是降低的,提示有光感受器的功能障碍.     

原发性开角型青光眼术后筛板血流改变及其临床意义

研究原发性开角型青光眼术后的血流改变情况 ,探讨其机理。方法25例(40眼)经临床证实为原发性开角型青光眼并接受小梁切除术的患者用HRF共焦激光多普勒眼底视网膜血流仪行筛板血流检查。根据术前视野损害程度分组 ,其中早期组15例(15眼) ,中晚期组25例(25眼)。SPSS统计软件分析两组血流速度改变情况。结果术后血流速度改变与青光眼所处的阶段有关。在早期组血流速度无明显改善 ,而中晚期组血流速度明显改善 ,并且与术后眼压下降的幅度有关(P<0.05)。结论中晚期青光眼术后血流改善明显 ,与眼压下降幅度有关 ,预示着中晚期青光眼患者存在筛板血管自身调节异常     

雷珠单抗联合光凝治疗糖尿病视网膜病变黄斑水肿

目的观察玻璃体腔注射雷珠单抗联合氪激光光凝治疗糖尿病视网膜病变黄斑水肿(DME)的临床疗效。方法筛选出2013年1月至2014年11月我院收治的符合纳入标准的DME患者25例(单纯激光组15例,24只眼;玻璃体腔注药术联合激光组10例,13只眼),对照组给予单纯氪激光(510 nm红激光、483 nm黄激光)格栅样或大"C"字形光凝术,观察组在氪激光光凝后给予玻璃体腔注射雷珠单抗。随访期末采用国际标准视力表检查患者治疗前后视力,使用光学相干断层扫描仪(OCT)检查患者治疗前后黄斑区视网膜厚度变化情况。结果治疗前2组患者视力比较,差异无统计学意义(P0.05);与治疗前视力相比,治疗后2组患者视力均显著提高(P0.05);治疗后视力组间比较,观察组视力好于对照组(P0.05)。观察组和对照组治疗前黄斑区视网膜厚度分别为(510.75±61.06)μm、(487.47±43.41)μm,2组间差异无统计学意义(P0.05);治疗后黄斑区视网膜厚度分别为(253.41±39.12)μm、(358.81±43.24)μm,较治疗前均降低(P0.05)。治疗后黄斑区视网膜厚度组间比较,观察组视力均好于对照组(P0.05)。结论单纯氪激光光凝与玻璃体腔注射雷珠单抗联合氪激光光凝对DME均有疗效。但玻璃体腔注射雷珠单抗联合氪激光光凝相对于单纯氪激光光凝,其治疗DME的术后视力恢复更显著,黄斑水肿吸收效果更明显。     

Time will tell: Object categorization and emotional engagement during processing of degraded natural scenes

The aim of the present study was to examine the relationship between object categorization in natural scenes and the engagement of cortico‐limbic appetitive and defensive systems (emotional engagement) by manipulating both the bottom‐up information and the top‐down context. Concerning the bottom‐up information, we manipulated the computational load by scrambling the phase of the spatial frequency spectrum, and asked participants to classify natural scenes as containing an animal or a person. The role of the top‐down context was assessed by comparing an incremental condition, in which pictures were progressively revealed, to a condition in which no probabilistic relationship existed between each stimulus and the following one. In two experiments, the categorization and response to emotional and neutral scenes were similarly modulated by the computational load. The Late Positive Potential (LPP) was affected by the emotional content of the scenes, and by categorization accuracy. When the phase of the spatial frequency spectrum was scrambled by a large amount (>58%), chance categorization resulted, and affective LPP modulation was eliminated. With less degraded scenes, categorization accuracy was higher (.82 in Experiment 1, .86 in Experiment 2) and affective modulation of the LPP was observed at a late window (>800 ms), indicating that it is possible to delay the time of engagement of the motivational systems which are responsible for the LPP affective modulation. The present data strongly support the view that semantic analysis of visual scenes, operationalized here as object categorization, is a necessary condition for emotional engagement at the electrocortical level (LPP).     

The sound and the fury: Late positive potential is sensitive to sound affect

Emotion is an emergent construct of multiple distinct neural processes. EEG is uniquely sensitive to real‐time neural computations, and thus is a promising tool to study the construction of emotion. This series of studies aimed to probe the mechanistic contribution of the late positive potential (LPP) to multimodal emotion perception. Experiment 1 revealed that LPP amplitudes for visual images, sounds, and visual images paired with sounds were larger for negatively rated stimuli than for neutrally rated stimuli. Experiment 2 manipulated this audiovisual enhancement by altering the valence pairings with congruent (e.g., positive audio + positive visual) or conflicting emotional pairs (e.g., positive audio + negative visual). Negative visual stimuli evoked larger early LPP amplitudes than positive visual stimuli, regardless of sound pairing. However, time frequency analyses revealed significant midfrontal theta‐band power differences for conflicting over congruent stimuli pairs, suggesting very early (∼500 ms) realization of thematic fidelity violations. Interestingly, late LPP modulations were reflective of the opposite pattern of congruency, whereby congruent over conflicting pairs had larger LPP amplitudes. Together, these findings suggest that enhanced parietal activity for affective valence is modality independent and sensitive to complex affective processes. Furthermore, these findings suggest that altered neural activities for affective visual stimuli are enhanced by concurrent affective sounds, paving the way toward an understanding of the construction of multimodal affective experience.     

Small vessel involvement in Takayasu's arteritis

ObjectivesTo describe the small retinal and systemic vessel involvement in Takayasu's arteritis.MethodsWe described 3 patients with Takayasu's arteritis and small retinal vessel occlusion seen in our department between 2004 and 2011. We performed an extensive literature review and provided a global analysis of small retinal vessel involvement in Takayasu arteritis (i.e., total number of patients analyzed = 9).ResultsSeven patients had small retinal artery occlusion, and two had venous involvement. Four cases were inaugural of the disease (44.4%). Takayasu's arteritis was extended (Type V) in the majority of patients presenting with small retinal vessel occlusion (5/9, 55.6%), and 8/9 reported cases (88.9%) presented with involvement of the supra-aortic branches. Immunosuppressive regimen allowed an improvement in 5/9 patients and stabilization in 1/9, but the situation worsened in 3/9 patients. The visual outcome was severe, and 3/9 patients (33.3%) experienced irreversible blindness.ConclusionOcclusion of small retinal vessels is a rare and severe microcirculatory complication in Takayasu's arteritis, as well as necrotizing cutaneous vasculitis or myocarditis. Small retinal vessel involvement can be inaugural of the disease and seriously impact the visual prognosis in TA patients.     

超声检查在闭合性腹外伤诊断中的价值

目的 探讨超声检查在诊断闭合性腹外伤中的应用价值。方法 回顾性分析2013年1月~2018年1月在我院经超声检查后手术证实或CT证实的106例闭合性腹外伤患者的声像图表现。结果 106例闭合性腹外伤中95例超声探查到腹腔游离液体,均经手术证实为腹腔脏器挫裂,其中脾挫裂65例,包括延迟性脾挫裂12例,占脾挫裂18.46%。7例误诊,其中肝挫裂伤1例,复合挫裂伤3例,小肠挫裂伤3例。超声诊断与手术符合率为92.63%。11例超声未探及游离液体,均经手术或CT证实为腹腔脏器挫伤或血肿。结论 超声检查对腹腔游离液体检出在闭合性腹外伤的诊断中发挥着重要的作用。     

Two cases of lichen planus pigmentosus presenting with a linear pattern

We report two cases of lichen planus pigmentosus (LPP) that developed in a unilateral linear pattern. The patients presented with unilateral linear brown macules on the extremities. Skin biopsy showed orthokeratosis, basal hydropic degeneration with scarce lymphohistiocytic infiltrates, and numerous melanophages in both patients. These patients, to the best of our knowledge, are the first cases of LPP presenting with a linear pattern. LPP should be considered in the differential diagnosis of linear hyperpigmented skin lesions.     

Macular and retinal dysfunction of unknown origin in adults with normal fundi: evidence for an autoimmune pathophysiology

Here we report the discovery of and phenotypic characterization of a retinal disorder of unknown origin in adults using clinical, electrophysiological and psychophysical techniques, and to seek the presence of circulating retinal autoantibodies in the sera of these patients. Sixteen patients were identified with progressive bilateral visual loss over a period of months. Ten of the patients were male, and the average age was 55.3 years (range from 43 to 76 years). Known causes such as carcinoma-associated retinopathy, acute zonal occult outer retinopathy and hereditary cone dystrophy appeared unlikely. Investigations included electrophysiology, fundus autofluorescence imaging and psychophysical tests. The sera of these patients were analyzed with indirect immunocytochemistry and Western immunoblot analysis on murine (BALB/c) retinal tissue for the presence of retinal autoantibodies. Bilateral visual loss and photophobia progressed over a period of months to years (average 28.7 months, range 3-67) and subsequently stabilized. No abnormality was observed by biomicroscopy, angiography or autofluorescence imaging. Electrophysiology indicated predominant cone-system dysfunction, either macular or generalized, and post-phototransduction involvement in 9 patients (56%). Photopic and scotopic visual fields and dark adaptation kinetics showed both cone and rod system involvement in all cases. Heterogeneous immunohistochemical staining patterns were seen with the sera of these patients as compared with controls. A majority of the affected patients (9/15) stained with an antinuclear pattern. The retinal autoantibodies from the sera of most patients reacted with the retinal proteins of molecular weight between 34 and 40 kDa. The aetiology of this distinctive retinal disorder therefore appears to be mediated through an autoimmune mechanism.     

基于眼电和稳态视觉诱发电位分析的目光跟踪方法

眼动跟踪技术作为人机交互手段和行为检测方法已广泛应用于心理学和认知科学领域的研究,基于稳态视觉诱发电位的脑-机接口也是一种备受关注的人机交互方法。本研究提出一种结合眼电和稳态视觉诱发电位同步分析的眼睛注视点位置跟踪方法,通过同步检测两种电生理信号:眼电信号(EOG)和脑电信号(EEG)来实现。主要的处理算法有:基于EOG的人机交互算法,包括基线去除、去噪声、角度变换、基准校正等;基于SSVEP的脑-机接口算法,通过典型相关分析法实现。由SSVEP判断出的目标对应的屏幕坐标可以作为眼动分析中基准校正的输入参数。实验结果表明:每0.5 sEOG-HCI可以对注视点位置进行一次识别;每2 sSSVEP-BCI可以对注视目标做一次判别;两者既可以独立运行,也可以协同工作,相比单一信号的人机交互方法,可以缩短判断时间和提高准确率。     

Differential Contributions of Blinks and Vertical Eye Movements as Artifacts in EEG Recording

Blinks and vertical eye movements were studied as artifacts of EEG recording. The electro-oculogram (EOG) and vertex vs joined mastoids EEG were recorded in 13 college-aged subjects. Subjects were asked to blink “normally, without excessive effort,” and move their eyes through vertical visual arcs of 5°, 10°, 20°, 30°, and 60°. The ratio EEG/EOG, the fraction of the EOG potential transmitting to the scalp EEG electrode as artifact, was calculated for potentials generated during both blinks and eye movement. Vertical eye movement scalp EEG artifact was a constant percentage of the vertical eye movement EOG across visual arcs of 10° to 60°. Mean percentage eye blink EEG artifact (9.3%) was significantly (p < .001) less than the mean percentage vertical eye movement artifact (13.9%). Thus, blink and vertical eye movement artifact fields are quantitatively different in terms of their transmission to the scalp (C_z) EEG electrode. Subtraction of a single subject specific percentage of the EOG from the EEG would correct for either artifact source, but different subtraction percentages must be used for each.     

See no evil: directing visual attention within unpleasant images modulates the electrocortical response

The late positive potential (LPP) is larger for emotional than neutral stimuli, and reflects increased attention to motivationally salient stimuli. Recent studies have shown that the LPP can also be modulated by stimulus meaning and task relevance. The present studies sought to determine whether the magnitude of the LPP can be manipulated by directing attention to more or less arousing aspects within an emotional stimulus. To this end, trials included a passive viewing and directed attention portion. In both Studies 1 and 2, unpleasant compared to neutral images were associated with an increased LPP during passive viewing; additionally, directing attention to non-arousing compared to highly arousing areas of unpleasant images resulted in a decreased LPP. Results are discussed in terms of the utility of using the LPP to understand emotion–cognition interactions, especially with regard to directed visual attention as an emotion regulation strategy.