Comparison of OCT and OCTA manifestations among untreated PCV, neovascular AMD, and CSC in Chinese population

AIM: To compare the qualitative and quantitative features among untreated polypoidal choroidal vasculopathy(PCV), neovascular age-related macular degeneration(nv-AMD) and central serous chorioretinopathy(CSC) using optical coherence tomography(OCT) and OCT angiography(OCTA).METHODS: This retrospective study included 16 eyes with thin-choroid PCV, 18 eyes with thick-choroid PCV, 16 eyes with nv-AMD and 17 eyes with CSC, respectively. The indicators were obtained by OCT and OCTA.RESULTS: Sub-foveal choroidal thickness(SFCT) in CSC was thicker compared to other groups(all P<0.05). SFCT in nv-AMD was thicker compared to thin-choroid PCV, but thinner compared with thick-choroid PCV(both P<0.05). As the ratio of thickness of Haller's layer to thickness of SFCT, which of thin-choroid PCV was significantly higher than CSC(P<0.001). Likewise, thick-choroid PCV had significantly higher ratio than nv-AMD(P=0.016) or CSC(P<0.001). There were differences among them in pigment epithelium detachment(PED). The whole-superficial retinal vessel density(RVD), deep RVD and choroidal capillary vessel density(CCVD) in CSC were significantly higher compared to other three groups, respectively(all P<0.05). The whole CCVD in nv-AMD was higher compared to thick-choroid PCV(P=0.032). Cross-sectional local angiographic form was 87.50%, 83.33%, 0 and 35.29% in thin-choroid PCV, thickchoroid PCV, nv-AMD and CSC, respectively. Cross-sectional diffuse angiographic form was 12.50%, 16.67%, 100% and 5.88% in thin-choroid PCV, thick-choroid PCV, nv-AMD and CSC, respectively.CONCLUSION: Combination of OCT and OCTA can effectively observe the significant alterations existed in PCV, CSC and nv-AMD, and there are distinctive differences among them. The pathogenesis is not exactly the same between PCV and nv-AMD, or PCV and CSC.     

眼睑阴虱1例报告及图片样本

本文报道了1例由阴虱引起的耐药性双侧睑结膜炎病例.在参考了一系列裂隙灯和光学显微镜下照片的基础上,我们描述了寄生虫的结构特点.这有助于精确鉴定和准确诊断该病.     

Exploratory study of non-invasive, high-resolution functional macular imaging in subjects with diabetic retinopathy

AIM:To evaluate a high-resolution functional imaging device that yields quantitative data regarding macular blood flow and capillary network features in eyes with diabetic retinopathy(DR).METHODS:Prospective,cross-sectional comparative case-series in which blood flow velocities(BFVs)and noninvasive capillary perfusion maps(nCPMs)in macular vessels were measured in patients with DR and in healthy controls using the Retinal Functional Imager(RFI)device.RESULTS:A total of 27 eyes of 21 subjects were studied[9 eyes nonproliferative diabetic retinopathy(NPDR),9 eyes proliferative diabetic retinopathy(PDR)and 9 controls].All diabetic patients were type 2.All patients with NPDR and 5 eyes with PDR also had diabetic macular edema(DME).The NPDR group included eyes with severe(n=3)and moderate NPDR(n=6),and were symptomatic.A significant decrease in venular BFVs was observed in the macular region of PDR eyes when compared to controls(2.61±0.6 mm/s and 2.92±0.72 mm/s in PDR and controls,respectively,P=0.019)as well as PDR eyes with DME compared to NPDR eyes(2.36±0.51 mm/s and 2.94±1.09 mm/s in PDR with DME and NPDR,respectively,P=0.01).CONCLUSION:The RFI,a non-invasive imaging tool,provides high-resolution functional imaging of the retinal microvasculature and quantitative measurement of BFVs in visually impaired DR patients.The isolated diminish venular BFVs in PDR eyes compared to healthy eyes and PDR eyes with DME in comparison to NPDR eyes may indicate the possibility of more retinal vein compromise than suspected in advanced DR.     

Early visual function outcomes of topography-guided FS-LASIK and SMILE in treatment of myopia and myopic astigmatism

AIM: To compare the quality outcomes of vision at early phase after topography-guided femtosecond laser-assisted in situ keratomileusis(FS-LASIK-CV) and small incision lenticule extraction(SMILE) in treatment of myopia and myopic astigmatism.METHODS: Retrospective comparative analysis of 49 patients that underwent FS-LASIK(n=23) or SMILE(n=26) procedure for myopia and myopic astigmatism between April and September in 2019. Pre-and postoperative uncorrected visual acuity(UCVA), spherical equivalent refraction(SEQ), cylindrical refraction, contrast sensitivity function(CSF), and corneal higher-order aberrations(HOAs) were evaluated. Independent t-test was used for inter-group comparison, while repeated measures ANOVA was used to analyze changes at different time points. RESULTS: In both groups, 100% of the eyes obtained a UCVA of 20/20 or better at 1 wk, 1, and 3 mo postoperatively. At 1 d and 3 mo postoperatively, UCVA was better in FS-LASIKCV group than in SMILE group. At 1 wk postoperatively, SEQ was lower in SMILE group than in FS-LASIK-CV group(P=0.006). At 3 mo postoperatively, the SEQ reached target refraction in both groups. The residual astigmatism was reduced in both groups without intergroup difference(P>0.05). At 3 mo postoperatively, the spherical aberration and coma under 6 mm pupil size were higher than preoperative levels in both groups(P<0.05). However, the increase in the corneal HOAs in the FS-LASIK-CV group was less than the SMILE group(P<0.05). At 3 mo postoperatively, the log CS were better than preoperative levels under scotopic conditions without glare and scotopic conditions with glare in both groups(P<0.05). At 1 and 3 mo postoperatively, under scotopic conditions without glare and scotopic conditions with glare, FS-LASIK-CV group showed more improvement in log CS at two spatial frequencies(12.0 c/d and 18.0 c/d;P<0.05).CONCLUSION: Both FS-LASIK-CV and SMILE demonstrate to be safe, effective, and predictable in treatment of myopia and myopic astigmatism. Early postoperative improvement in UCVA and CSF at high spatial frequency under scotopic conditions were better after FS-LASIK-CV than SMILE.     

Comparison of early changes in ocular surface markers and tear inflammatory mediators after femtosecond lenticule extraction and FS-LASIK

AIM:To compare the short-term impacts of femtosecond lenticule extraction(FLEx)and femtosecond laser-assisted laser in situ keratomileusis(FS-LASIK)on ocular surface measures and tear inflammatory mediators.METHODS:This prospective comparative nonrandomized clinical study comprised 75 eyes(75 patients).Totally 20 male and 15 female patients(age 21.62±3.25 y)with 35 eyes underwent FLEx,and 26 male and 14 female patients(age 20.18±3.59 y)with 40 eyes underwent FS-LASIK.Central corneal sensitivity,noninvasive tear breakup time,corneal fluorescein staining,Schirmer I test,tear meniscus height,and ocular surface disease index were evaluated in all patients.Tear concentrations of nerve growth factor(NGF),interleukin-1α(IL-1α),transforming growth factor-β1(TGF-β1),tumor necrosis factor-α(TNF-α),interferon-γ(IFN-γ),and matrix metalloproteinase-9(MMP-9)were assessed by multiplex antibody microarray.All measurements were performed preoperatively,and 1 d,1 wk,and 1 mo postoperatively.RESULTS:Patients who underwent FLEx exhibited a more moderate reduction in central corneal sensation and less corneal fluorescein staining than those in the FS-LASIK group 1 wk after the procedure(P<0.01).NGF was significantly higher 1 d and 1 wk after surgery in the FS-LASIK group than in the FLEx group(P<0.01).By contrast,compared to those in the FLEx group,higher postoperative values and slower recovery of tear TGF-β1,IL-1α,and TNF-αconcentrations were observed in the FS-LASIK group(P<0.01).Tear concentrations of NGF,TGF-β1,TNF-α,and IL-1αwere correlated with ocular surface changes after FLEx or FS-LASIK surgery.CONCLUSION:There is less early ocular surface disruption and a reduced inflammatory response after FLEx than after FS-LASIK.NGF,TGF-β1,TNF-α,and IL-1αmay contribute to the process of ocular surface recovery.     

Changes in corneal biomechanics and intraocular pressure following Femto-LASIK using Goldman applanation tonometry and ocular response analyzer

AIM:To compare intraocular pressure(IOP)measurements before and after laser in situ keratomileusis(LASIK)with a femtosecond laser for flap creation using ocular response analyzer(ORA)and Goldmann applanation tonometry,and to identify factors that may influence the preoperative and postoperative IOP.METHODS:A prospective study conducted on myopic patients who underwent LASIK using a femtosecond laser for flap fashioning.Enrolled patients were evaluated preoperatively,6 wk and 3 mo postoperatively for manifest refraction(MR),keratometric(K)readings and central corneal thickness(CCT)using a scheimpflug-based topography.Corneal resistance factor(CRF),corneal hysteresis(CH),Goldmann correlated IOP(IOPg)and corneal compensated IOP(IOPcc)were measured using ORA besides IOP assessment by Goldman applanation tonometry(GAT).RESULTS:There was a statistically significant decrease in measures of IOPg by 3.35±0.83 mm Hg,followed by GAT which decreased by 2.2±0.44 mm Hg,and the least affected by operation was IOPcc which decreased only by 0.87±0.1 mm Hg after 6 wk.After 3 mo follow up there was a statistically significant decrease in IOPcc which decreased only by 0.76±0.4 mm Hg,followed by IOP GAT by 1.6±0.5 mm Hg,and the most affected by operation was IOPg which decreased by 2.3±0.3 mm Hg.Correspondingly,there was a statistically significant decrease in CH and CRF after 6 wk and 3 mo.At 3 mo,the preoperative MR and preoperative GAT were prominent significant predictors of the postoperative GAT changes.The prediction equation was subsumed.CONCLUSION:IOP measurements and corneal biomechanical factors reduce significantly after LASIK with a femtosecond laser for flap creation.The IOPcc values are less influenced by changes in corneal properties than IOPg and GAT,indicating that IOPcc may provide the most reliable measurement of IOP after this procedure.     

Laser therapy versus intravitreal injection of anti-VEGF agents in monotherapy of ROP:a Meta-analysis

AIM:To compare the efficacy and safety between laser therapy and anti-vascular endothelial growth factor(VEGF)agents intravitreal injection monotherapy in type-1 retinopathy of prematurity(ROP)and aggressive posterior retinopathy of prematurity(APROP).METHODS:A systematic literature search was performed in PubMed,Cochrane Library,and Embase for original comparable studies.We included studies that compare laser therapy and intravitreal injections of anti-VEGF agents monotherapy in ROP regardless of languages and publication types.RESULTS:Complication incidence was significantly higher in laser therapy group(OR:0.38;95%CI:0.19-0.75;P=0.005).Spherical equivalent(SE)was higher in laser therapy[weighted mean difference(WMD):2.40,95%CI:0.88-3.93;P=0.002].The time between treatment and retreatment was longer in laser therapy group(WMD:8.45,95%CI:5.35-11.55;P<0.00001).Recurrence incidence(OR:0.97;95%CI:0.45-2.09;P=0.93)and retreatment incidence(OR:1.24;95%CI:0.56-2.73;P=0.59)were similar in two approaches.Subgroup analysis between type-1 ROP and APROP was not significant except SE reported in the included studies(P<0.0001).CONCLUSION:This Meta-analysis outcome indicates anti-VEGF agents are as effective as laser treatment,and safer than laser in type-1 ROP and APROP.The degree of myopia in APROP is higher than type-1 ROP.More randomized controlled trials in large sample size should be conducted in the future.     

双眼先天性无虹膜一例

患儿,男,10岁.自幼双眼视力差,畏光.于2008年3月15日就诊.患儿为足月顺产,父母非近亲结婚,家族中无遗传病史.全身检查:一般情况好,智力及发育无异常.眼部检查:视力右眼0.3,矫正0.8(-3.75DS/ 2.50DC×170°);左眼0.2,矫正0.7(-4.25DS/ 2.75DC×10°);双眼眼位正常,各方向运动自如.     

圆锥角膜中细胞凋亡及Fas-L蛋白的表达

目的 探讨凋亡与圆锥角膜发病的关系及凋亡相关蛋白Fas-L的表达.方法 对20例圆锥角膜及5例正常角膜用原位末端标记法(TUNEL)检测凋亡,用免疫组织化学SP法检测Fas-L蛋白的表达;透射电镜观察凋亡细胞的形态学变化.结果 TUNEL染色示圆锥角膜组中上皮层、基质层及内皮层中细胞凋亡与正常角膜组比较差异均有统计学意义(P＜0.05);免疫组织化学示圆锥角膜组与正常角膜组基质层间Fas-L表达比较差异有统计学意义(P＜0.05);透射电镜可见圆锥角膜中存在凋亡特征的细胞.结论 圆锥角膜中存在凋亡,Fas-L蛋白的表达存在异常,Fas-FasL系统可能在圆锥角膜细胞凋亡中发挥了重要作用.     

散光视标检查与散光轴位关系的定量推导

目的 定量推导散光视标检查与散光轴位之间的关系.方法 根据光学和数学的原理,从点光源成像入手,逐步定量地推导被检者对散光视标的辨认结果和散光轴位之间的关系.结果 被检者看到的最清晰散光视标的时钟钟点数乘以30°,即为被检者的散光轴位.或者被检者看到的最不清晰的散光视标的时钟钟点数加上3乘以30°,亦为被检者的散光轴位.结论 被检者对散光视标辨认结果和散光轴位之间关系的定量推导有助于正确的理解和临床应用.     

Relationship between intraocular pressure and parameters of obesity in ocular hypertension

AIM:To evaluate the correlation between intraocular pressure(IOP)and various obesity-related health factors in patients with ocular hypertension in Korea.METHODS:A total of 40850 subjects underwent age,sex,body weight,and height assessments and automated multiphasic tests,including non-contact tonometry,automated perimetry,fundus photography,systolic/diastolic blood pressure measurement,and evaluation of obesity-related health parameters such as obesity index,body mass index(BMI),a body shape index(ABSI),and waist-to-height ratio(WtHR).Subjects were divided into ocular hypertension group and normal IOP group according to IOP after matching of age and sex.RESULTS:Of 40850 participants,1515(3.7%)had ocular hypertension,and 1515 with normal IOP were selected as controls using propensity score matching.The mean IOP of control group was 15.3±2.3 mm Hg,compared with 23.3±1.6 mm Hg in ocular hypertension group.Height,obesity index,BMI,and WtHR in the ocular hypertension group were significantly higher than in the normal IOP group(P<0.001,P<0.001,P=0.009,P=0.002).IOP of ocular hypertension was positively correlated with obesity index(P=0.027)and BMI(P=0.016),whereas IOP of control was positively correlated with blood pressure(P<0.001,P=0.002),obesity index(P<0.001),BMI(P<0.001),and WHtR(P=0.002).Systolic blood pressure(β=0.022,P<0.001)and body weight(β=0.016,P=0.02)were precursors of IOP in normal subjects,but sex(male;β=-0.231,P=0.008)and obesity index(β=-0.007,P=0.017)were precursors of ocular hypertension according to multiple regression analysis.CONCLUSION:Among various obesity-related health parameters,obesity index is the best indicator for further increase in IOP in ocular hypertension group.     

Predictors of angle widening after laser iridotomy in Chinese patients with primary angle-closure suspect using ultrasound biomicroscopy

AIM:To assess the predictive value of baseline parameters of ultrasound biomicroscopy(UBM) for angle widening after prophylactic laser peripheral iridotomy(LPI) in patients with primary angle-closure suspect(PACS).METHODS:Angle-opening distance(AOD),trabecular iris angle(TIA),iris thickness,trabecular-ciliary process angle,and trabecular-ciliary process distance were measured using UBM performed before and two weeks after LPI.Iris convexity(IC),iris insertion,angulation,and ciliary body(CB) size and position were graded.Uni-and multivariate regression analyses were used to determine factors predicting the change in AOD(ΔAOD500,calculated as an angle width change before and after LPI) in all quadrants and in subgroup quadrants based on IC.RESULTS:In 94 eyes of 94 patients with PACS,LPI led to angle widening with increases in AOD500 and TIA(P<0.01).Multivariable regression analysis showed that IC(P<0.001),CB position(P=0.007) and iris insertion(P=0.049) were significantly predictive for ΔAOD500.All quadrants were categorized into extreme IC(27.8%),moderate IC(62.3%),and absent IC(9.9%) subgroups.The AOD500 increased by 220% and no other predictive factor was found in the extreme IC quadrants.The AOD500 increased by 55%,and baseline iris angulation was predictive for smaller changes in ΔAOD500 in the moderate IC quadrants.CONCLUSION:In PACS patients,quadrants with greater iris bowing predict substantial angle widening after LPI.Quadrants with a flatter iris,anteriorly positioned CB,and basal iris insertion are associated with less angle widening after LPI.Quadrants with iris angulation as well as a flatter iris configuration predict a smaller angle change after LPI.     

Clinical outcomes of transepithelial photorefractive keratectomy versus femtosecond laser assisted keratomileusis for correction of high myopia in South Egyptian population

AIM: To evaluate the safety and efficacy of transepithelial photorefractive keratectomy(t-PRK) with adjuvant mitomycin C(MMC) versus femtosecond laser assisted keratomileusis(Femto-LASIK) in correction of high myopia.METHODS: Prospective randomized comparative study including 156 eyes of 156 patients with high myopia and a spherical equivalent refraction(SER) <-6.00 D. They were divided randomly into two groups: Group A included 72 eyes treated with t-PRK with adjuvant MMC and Group B included 84 eyes treated with Femto-LASIK. Visual acuity, SER, corneal topography, pachymetry and keratometry were assessed for 12 mo postoperatively.RESULTS: The preoperative mean SER was-8.86±1.81 and-9.25±1.70 D in t-PRK MMC group and Femto-LASIK respectively(P=0.99) which improved to-0.65±0.43 D and-0.69±0.50 D at 12 mo follow up. Mean SER remained stable during the 12 mo of follow-up, with no statistically significant difference between the two groups(P=0.64). In t-PRK MMC group, only six eyes needed retreatment after six months of follow up. And two eyes showed haze(one reversible haze grade 2, while the other had dense irreversible haze grade 4).CONCLUSION: t-PRK MMC provides safe and satisfactory visual outcomes and acceptable risk as Femto-LASIK in patients with high myopia.     

沙眼防治的研究进展

沙眼是一种由沙眼衣原体感染所致的传染性角结膜炎,是世界上导致传染性盲目的主要原因.沙眼在发展中国家,如在亚非贫穷偏僻的地区、中东、拉丁美洲和澳洲的一些地区仍有很高的发病率.世界卫生组织估计全球大约有8 400万人感染沙眼,有800万人因为沙眼而致视觉损害,约590万人因此失明或者有严重的视力下降.WHO已经建立了辨认和命名沙眼的简化分级系统(TF、TI、TS、TT、CO),并针对沙眼的临床特征,提出了有效的控制沙眼的4个要素即"SAFE"战略.包括:S(Surgery),即手术矫正沙眼性倒睫;A(Antibiotics),即抗生素治疗活动性沙眼感染人群;F(Facial Cleanliness),即面部清洁眼部;E(Environmental improvements),改善环境,通过改进水的供应、卫生和居住环境以预防沙眼.近来证实,单剂口服阿奇霉素可有效地治疗沙眼,特别是群体发放阿奇霉素,对于社区水平特别是儿童沙眼的防治具有重要意义.WHO还推荐新的双板层睑板翻转术,以有效地矫正沙眼性倒睫,国家卫生部"十一五"防盲规划已将其列入推广计划.     

Retinal nerve fiber layer thickness and retinal vascular caliber alterations in coal miners in northern China: a community-based observational study

AIM:To evaluate retinal nerve fiber layer thickness and retinal vascular caliber alterations in coal mine workers.METHODS:The community-based observational crosssectional study included 4004 participants of a subpopulation of the Kailuan Study.All the study participants underwent structured interviews with a standardized questionnaire,fundus photography and spectral-domain optical coherence tomography(OCT)examinations performed by trained doctors.RESULTS:The retinal nerve fiber layer thickness was significantly higher(P=0.006)and the central macular thickness was lower in coal miners(n=659,51.0±7.8 y)as compared to the control(working above the ground;n=477,51.8±7.5 y;P=0.032).Additionally,the downhole workers showed a significantly thicker retinal artery(P=0.012)and vein diameters(P<0.001).In multivariable regression,a thicker retinal nerve fiber layer was associated with a higher cumulative silica dust exposure(P=0.005)after adjusting for younger age and larger spherical equivalent.In a reverse pattern,a higher cumulative silica dust exposure(P=0.004)was significantly associated with a thicker retinal nerve fiber layer after adjusting for age,high-density lipoproteins and uric acid.Wider retinal vein diameters were associated with higher cumulative silica dust exposure(P=0.036)after adjusting for younger age and larger spherical equivalent.CONCLUSION:The retinal vessels diameters and retinal nerve fiber layer thickness are significantly thicker in long term of coal mining.The results of our study indicate that underground working environment may lead to retinal vessel dilation and inflammation.Thus,ocular examination might be needed within coal miners in order to monitor the occupational eye health as well as the incidence and progression of eye diseases.     

Clinical characteristics of progressive nonarteritic anterior ischemic optic neuropathy

AIM:To study whether patients with progressive nonarteritic anterior ischemic optic neuropathy(NAION)present earlier than patients with stable NAION and to describe their clinical characteristics and visual outcome.METHODS:This was a retrospective chart review.All patients with NAION seen during the acute stage from January 2012 to December 2018 were reviewed.Patients were included if they had documented disc edema and follow up of at least 3 mo.Patients with progressive NAION were identified if they worsened in 2 out of 3 parameters:visual acuity≥3 Snellen lines;Color vision≥4 Ishihara plates;the visual field defect involved a new quadrant.The clinical characteristics,time from symptom onset to presentation,systemic risk factors and visual outcome were compared to patients with stable NAION.RESULTS:Totally 122 NAION cases met the inclusion criteria.Mean age was 58.1 y(range 22-74),70%were men.Twenty cases(16.4%)had progressive NAION.Patients with progressive NAION did not differ from stable NAION in their demographics,systemic risk factors or in their initial visual deficit.At last follow up,median visual acuity was 1.0 log MAR(IQR 0.64-1.55)in patients with progressive NAION,vs 0.18(IQR 0.1-0.63)in stable NAION(P<0.001).Median color vision testing was 0 plates correct(IQR 0-2.5%)vs 92%plates correct(IQR 50%-100%)in the stable NAION group(P<0.001).Patients with progressive NAION differed in the time from symptom onset to presentation(median 2 d vs 5 d,P=0.011).CONCLUSION:We find no identifiable risk factors associated with progressive NAION.Progressors arrive earlier for ophthalmological evaluation.     

Infectious keratitis in Vietnam: etiology, organisms, and management at Vietnam National Eye Hospital

AIM:To report the etiologies,risk factors,treatments,and outcomes of infectious keratitis(IK)at a major Vietnamese eye hospital.METHODS:This is a retrospective review of all cases of IK at Vietnam National Eye Hospital(VNEH)in Hanoi,Vietnam.Medical histories,demographics,clinical features,microbiological results,and treatment outcomes were reviewed.RESULTS:IK was diagnosed in 1974 eyes of 1952 patients,with ocular trauma being the greatest risk factor for IK(34.2%),frequently resulting from an agriculturerelated injur y(53.3%).The mean duration between symptom onset and presentation to VNEH was 19.3±14.4 d,and 98.7%of patients had been treated with topical antibiotic and/or antifungal agents prior to evaluation at VNEH.Based on smear results of 1706 samples,the most common organisms identified were bacteria(n=1107,64.9%)and fungi(n=1092,64.0%),with identification of both bacteria and fungi in 614(36.0%)eyes.Fifty-five of 374 bacterial cultures(14.7%)and 426 of 838 fungal cultures(50.8%)were positive,with the most commonly cultured pathogens being Pseudomonas aeruginosa,Streptococcus pneumonia,Fusarium spp.,and Aspergillus spp.Corneal perforation and descemetocele developed in 391(19.8%)and 93(4.7%)eyes,respectively.Medical treatment was successful in resolving IK in 50.4%eyes,while 337(17.1%)eyes underwent penetrating or anterior lamellar keratoplasty.Evisceration was performed in 7.1%of eyes,most commonly in the setting of fungal keratitis.CONCLUSION:Ocular trauma is a major risk factor for IK in Vietnam,which is diagnosed in almost 400 patients each year at VNEH.Given this,and as approximately one quarter of the eyes that develop IK require corneal transplantation or evisceration,greater emphasis should be placed on the development of prevention and treatment programs for IK in Vietnam.     

医源性眼巩膜双穿孔伤一例

1 病例 患者女,汉族,63岁.右眼视物不清3年确诊老年性白内障于2006年8月5日人院,检查:全身检查无异常;右眼视力光感,光定位和色觉正常;前房正常深浅,瞳孔3 mm,对光反射存在,晶状体乳白色浑浊,眼压15.55 mmHg(1 mmHg=0.133 kPa).     

斜视对心理的影响

斜视不但影响患者的视功能、容貌,对患者的心理影响也是明显的.主要表现在斜视患者普遍存在抑郁、低自尊、社交焦虑和就业方面.另外,斜视患儿父母也因其孩子的影响而存在抑郁、紧张、焦虑.对年幼患儿斜视手术可以有效地改变他们的视功能,提高其适应社会的能力.对青少年和成年人斜视手术可改善其容貌,提高自尊水平,减少受到的社会歧视,减轻社交焦虑,更好的获得就业.     

Prevalence and risk factors of dry eye disease in young and middle-aged office employee:a Xi’an Study

AIM:To estimate the prevalence of and risk factors for dry eye disease(DED)in young and middle-aged office employee in Xi’an.METHODS:This cross-sectional study of the prevalence of and risk factors for DED investigated 486 young and middle-aged Chinese office employee in Xi’an.DED symptoms and potential risk factors were assessed using the ocular surface disease index combined with a risk factors questionnaire,and tear function was evaluated using the tear film break-up time and Schirmer’s test.Possible risk factors for DED were estimated by binary Logistic regression analysis.RESULTS:DED was diagnosed in 100 females and 96 males,giving a prevalence of 40.3%[95%confidence interval(CI)=36.0%-44.7%].The multivariate binary Logistic regression model indicated that the possible risk factors for DED were being female(OR=1.592,95%CI=1.034-2.451,P=0.035),being aged≥40 y(OR=1.593,95%CI=1.034-2.454,P=0.035),using a VDT daily for>6 h(OR=1.990,95%CI=1.334-2.971,P=0.001),the presence of central air conditioning(OR=1.548,95%CI=1.053-2.276,P=0.026),and self-reported dryness of the mouth and nose(OR=1.589,95%CI=1.071-2.357,P=0.021).CONCLUSION:There is a high prevalence of clinically diagnosed DED in young and middle-aged video displayterminal(VDT)users.Interventions against the modifiable risk factors should be taken to prevent the occurrence and development of DED in this population.