视网膜视力计预测白内障术后视力的临床研究

目的研究手持式视网膜视力计(retinometer)评估白内障患者术后视力恢复的准确程度。方法运用手持式视网膜视力计对105例121眼白内障进行测量,记录术前和术后两次测量结果,同时记录术前和术后最佳矫正视力,并运用统计学方法分析术前视网膜视力和术后矫正视力的符合情况。结果具有一、二级硬度晶状体核的患者两者的一致性较好,其差异无统计学意义(P>0.05)。而随着晶状体浑浊程度的加重两者之间的一致性下降(P<0.001)。结论手持式视网膜视力仪判断屈光间质浑浊者的视网膜功能有一定的帮助,但是对于屈光间质浑浊严重者,单用此种测量方法来推断其视网膜的功能还不够精确,尚须结合临床上的其他功能检查。     

钝挫伤晶状体脱位合并视网膜脱离的玻璃体手术

目的　分析和总结眼球钝挫伤晶状体脱位或半脱位合并视网膜脱离的临床特点和处理。方法　对２８ 例２９ 眼钝挫伤有晶状体脱位半脱位合并孔源或牵引视网膜脱离的病例进行临床回顾，主要为一般流行病学资料临床特征与处理方法。结果　这类疾病多有明显屈光间质混浊，眼内病变复杂，玻璃体切割术治疗视网膜脱离成功率８０％ ，大部病例视功能改善或稳定。结论　玻璃体切割术可清除混浊之屈光介质，明确眼内病变。同时有效处理眼内病变，是治疗钝挫伤晶状体脱位合并视网膜脱离的主要方法。视功能的改善取决于眼内组织的受损范围与程度。     

视网膜视力测定在眼科的应用

视网膜视力测定是随着激光技术和人眼空间调制传递函数的深入研究而产生的新方法,它能反映屈光间质混浊情况下的视网膜功能.本文对视网膜视力仪进行了分类并阐述了其工作原理及使用方法,介绍了视网膜视力测定在白内障术前、视网膜病变、玻璃体疾病、角膜病变、弱视及屈光不正等病例中的应用,比较了不同视网膜视力仪在各类病变中的应用价值及其优缺点.     

多波长氪激光治疗增殖期糖尿病视网膜病变的临床观察

目的 观察多波长氪激光治疗增殖期糖尿病视网膜病变的疗效。方法 对52例74眼患有增殖期糖尿病视网膜病变伴有屈光间质混浊或轻度玻璃体积血的病例，进行了全视网膜光凝治疗。结果 术前、术后视力的差异无显著性。全视网膜光凝治疗后视盘和视网膜的新生血管部分消退。结论 多波长氪激光以不同波长为特点，对伴有屈光间质混浊或轻度玻璃体积血的增殖期糖尿病视网膜病变，进行全视网膜光凝术是有效的治疗方法，可使新生血管消退，有效地阻止了增殖期糖尿病视网膜病变的发展，防止再出血的发生。     

视网膜视力测定在眼科的应用

视网膜视力测定是随着激光技术和人眼空间调制传递函数的深入研究而产生的新方法,它能反映屈光间质混浊情况下的视网膜功能。本文对视网膜视力仪进行了分类并阐述了其工作原理及使用方法,介绍了视网膜视力测定在白内障术前、视网膜病变、玻璃体疾病、角膜病变、弱视及屈光不正等病例中的应用,比较了不同视网膜视力仪在各类病变中的应用价值及其优缺点。     

屈光间质混浊的视网膜脱离超声诊断评估

本文回顾了１７８例屈光间质混浊的视网膜脱离超声诊断。不同病种，诊断准确率不同。对于角膜混浊、晶体混浊而无玻璃体严重混浊的病例，仅行Ａ超检查即能明确视网膜是否脱离。非外伤性玻璃体混浊，可先行Ａ超检查，当Ａ超不能明确诊断时再加用Ｂ超检查。外伤性玻璃体混浊，尤其是伴眼内异物或爆炸伤者，应同时行Ａ及Ｂ超检查，结合临床表现才能正确判断视网膜是否脱离，本文还显示，病程长也影响超声诊断的准确性。     

屈光间质混浊的视网膜脱离超声诊断评估

本文回顾了１７８例屈光间质混浊的视网膜脱离超声诊断。不同病种，诊断准确率不同。对于角膜混浊、晶体混浊而无玻璃体严重混浊的病例，仅行Ａ超检查即能明确视网膜是否脱离。非外伤性玻璃体混浊，可先行Ａ超检查，当Ａ超不能明确诊断时再加用Ｂ超检查。外伤性玻璃体混浊，尤其是伴眼内异物或爆炸伤者，应同时行Ａ及Ｂ超检查，结合临床表现才能正确判断视网膜是否脱离，本文还显示，病程长也影响超声诊断的准确性。     

丹参单体、三氟拉嗪防治兔眼增生性玻璃体视网膜病变的实验研究

目的 评价丹参单体和三氟拉嗪对实验性兔增生性玻璃体视网膜病变( proliferative vitreoretinopathy,PVR)的防治作用.方法 有色兔81只随机分为6组:A至C组为药物防治组,E至G组为药物毒性观察组；从A至C组、E至G组中兔另一非实验眼分别选对照组:D组和H组.A至D组眼内注入视网膜色素上皮(retinal pigment epithelial,RPE)细胞后分别注入三氟拉嗪、丹参单体、三氟拉嗪加丹参单体混合液、磷酸盐缓冲液；E至H组注入磷酸盐缓冲液后分别注入三氟拉嗪、丹参单体、三氟拉嗪加丹参单体混合液、磷酸盐缓冲液.通过间接检眼镜观察A至D组玻璃体混浊、视网膜脱离情况,通过间接检眼镜、光学显微镜观察E至H组视网膜病理学改变.结果 给药后1d,A组发生Ⅱ级玻璃体混浊8眼,B组Ⅱ级玻璃体混浊6眼,C组Ⅱ级玻璃体混浊7眼,D组Ⅱ、Ⅲ级玻璃体混浊各10眼,3个实验组与D组相比差异均有显著统计学意义(均为P=0.00).给药后3d,A组Ⅱ级玻璃体混浊3眼,B组及C组未见发生Ⅱ级及以上玻璃体混浊,D组Ⅱ级玻璃体混浊10眼、Ⅲ级玻璃体混浊6眼,3个实验组与D组相比差异也均有统计学意义(均为P=0.00).给药后5d,A组、B组及C组均未见发生Ⅱ级及以上玻璃体混浊,D组Ⅱ级玻璃体混浊8眼,3个实验组与D组相比差异均有统计学意义(均为P ＜0.05).给药后5d,D组Ⅱ级PVR 8眼、Ⅲ级PVR 2眼,3个实验组无PVR发生,差异均有统计学意义(均为P＜0.05).给药后7d,D组Ⅱ级PVR 14眼、Ⅲ级PVR6眼,各实验组无PVR发生,差异也均有统计学意义(均为P＜0.05).给药后14 d,A组Ⅱ级PVR 3眼,B及C组各有Ⅱ级PVR2眼,D组Ⅱ级PVR2眼、Ⅲ级PVR 16眼、Ⅳ级PVR2眼；3个实验组与D组相比差异均有统计学意义(均为P=0.00).给药后21 d,D组Ⅲ级PVR 12眼、Ⅳ级PVR 8眼；3个实验组PVR发生情况无变化,3个实验组与D组比较差异均有统计学意义(均为P=0.00).给药后28 d,D组Ⅳ级PVR 14眼、Ⅲ级PVR 6眼,3个实验组PVR发生情况无变化,所有实验组与D组比较,差异也均有统计学意义(均为P =0.00).E至H组在整个观察期内未见毒性病理学改变.结论 三氟拉嗪、丹参单体、三氟拉嗪与丹参单体联合可有效预防实验性PVR.     

二极管激光治疗糖尿病视网膜病变的临床观察

目的；探讨二级管激光光凝治疗伴有—定程度屈光间质混浊的糖尿病视网膜病变患者的疗效。方法：用二级管激光光凝治疗36例40眼屈光间质混浊、不能用氩激光治疗的糖尿病视网膜病变患者．治疗前作视力、眼底和眼底荧光血管造影检查及照彩色眼底傀。随访以上项目8~14 月(平均11个月)． 结果：29眼(约73%)视力提高或维持不变，在34眼增殖性糖尿病性视网膜病变中25眼(约74%)新生血管部分或全部退行。 结论：二级管激光光凝对伴有一定程度屈光间质混浊的糖尿病视网膜病变疗效较为满意． （中华眼底病杂志，1996，12：111-113）     

全周边视网膜及睫状体冷凝治疗新生血管性青光眼12例

目的：探讨因某种原因不能行全视网膜光凝治疗的新生血管性青光眼进行全周边视网膜睫状体冷凝治疗的效果。方法：对失明的屈光间质混浊或小瞳孔不能行全视网膜光凝治疗的新生血管性青光眼12例12眼进行全周边视网膜及睫状体冷凝术,根据病史长短及高眼压程度不同选择不同数量的冷凝点,每点冷凝30～40s。结果：所有病例眼压均得到控制症状缓解,虹膜新生血管消失,眼球萎缩2例。结论：对于屈光间质混浊等无法进行全视网膜光凝治疗的新生血管性青光眼,尤其是已丧失视功能全周边视网膜及睫状体冷凝是一种有效的治疗方法。     

Habitual vs optimal distance visual acuity

PURPOSE: The maintenance of a good level of vision is desirable for developmental and social reasons; it is also a requirement that should not be overlooked in the clinical research environment. This study set out to quantify and analyse any difference between 'habitual' (pre-sight test) and 'optimal' (post-refraction) distance visual acuity in an optometric population. It is intended that the outcome of this work will inform not only clinicians but also those undertaking vision research. METHODS: Binocular logMAR visual acuity was determined at 6 m before and after optometric intervention in patients attending optometric practice for a routine sight test. Cases were recorded seriatim but restricted to the 'core' refraction range representative of typical optometric practice; three further exemption criteria included subject illiteracy, the necessity for a non-standard test distance and contact lens wear. Over a 12-month period, two-thirds of patients examined satisfied the study inclusion criteria; it is the clinical data of these 1288 individuals that are described and analysed here. RESULTS: These data provide a quantitative demonstration that an optometric intervention will most likely improve the habitual distance visual acuity of subjects, irrespective of gender, age group, time interval since last test, refractive status and whether or not the subject is a habitual spectacle wearer. The improvement found was typically within one logMAR chart line (<5 letters), being greatest in spectacle-wearing teenagers and in individuals beyond retirement age (increasing to eight letters in elderly habitual non-spectacle wearers); also in non-wearers who left an interval of 2 years or more between sight tests. CONCLUSIONS: Clinical and laboratory-based investigators are advised that a current and optimal refractive correction should be worn by subjects of all ages enrolled in vision-related studies. Refractive defocus may introduce or exaggerate test outcome variability.     

噪声视力表在儿童视力检查中的可重复性分析

目的探讨噪声视力表对儿童视力检查的可重复性及其相关影响因素。方法在门诊首诊患儿中,随机选择无理解障碍及除屈光不正外无其他器质性眼病儿童200例,使用噪声视力表进行噪声视力重复检查。采用配对t检验进行统计学分析。结果两次视力测量之间差异的均数为O.03行,（P=0.515）;两次视力测量结果按性别分组无明显差异（P=1.0,P=0.262）;按年龄分组亦无明显差异（P=0.159,P=0.786）;按屈光不正分组,其中近视组两次视力测量结果有明显差异（P=0.010）。近视儿童视力检查一致性较差,而正视及远视儿童的视力检查一致性较好（P=0.133,P=0.083）。结论结果提示噪声视力表适合儿童视力检查,建议推广使用。     

两种干涉条纹视力计对白内障患者术后视力预测的对照研究

目的通过国产干涉条纹视力计与Heine干涉条纹视力计在预测白内障患者术后视力中的应用对比,探讨国产干涉条纹视力计预测白内障患者术后视力的准确性、实用性、可行性。方法将71例(92眼)白内障患者平均分成2组,术后的视功能情况分别用国产干涉条纹视力计与Heine干涉条纹视力计2种方法进行预测,结果与患眼术后最佳矫正视力进行相关性分析对比。结果国产干涉条纹视力计预测的准确率为81.0%(预测视力与术后视力相差2行以内者认为准确),平均预测视力(4.695)与平均术后最佳矫正视力(4.771)比相差不到1行。Heine干涉条纹视力计预测的准确率为43·9%,平均预测视力(4.481)与平均术后最佳矫正视力(4.771)比相差约3行。结论比起Heine干涉条纹视力计,国产干涉条纹视力计检查更能合理的反映视觉功能,对白内障术后视力具有较好的预测性。     

灯箱视力表与Freiburg电子视力表应用对比研究

目的 比较灯箱视力表与Freiburg电子视力表结果的一致性与可重复性,评价Freiburg电子视力表的临床应用价值。设计 诊断性技术评价。研究对象 空军杭州航空医学鉴定训练中心的工作人员86例,平均年龄（26.3±2.1）岁。方法 所有入选者均随机由2位固定检查者分别使用灯箱视力表和Freiburg电子视力表进行检查,两种视力表检查的顺序随机决定。所有检查均在同一房间内完成,房间内亮度小于3 lux。检查距离均为3 m。对不同视力表间与检查者间测量重复性采用配对t检验比较结果的差别并计算相关系数r值。主要指标 使用两种视力表获得的logMAR视力。结果 在检查者一,用灯箱视力表查,被检者logMAR视力为0.19±0.23,Freiburg电子视力表0.20±0.15,两者差值为-0.011±0.141,差异无统计学意义（t=-0.741, P=0.461）,但有显著相关性（r=0.808,P=0.000）。在检查者二,用灯箱视力表查,被检者logMAR视力为0.32±0.25,Freiburg电子视力表为0.20±0.15,两者差值为-0.118±0.151,差异有统计学意义（t=7.191, P=0.000）及显著相关性（r=0.810,P=0.000）。均用灯箱视力表,检查者一、二的差异有统计学意义（F=11.872,P=0.001）,两者显著相关（r=0.938,P=0.000）。而均用Freiburg电子视力表,检查者一、二的差异无统计学意义（F=0.019,P=0.890）,两者显著相关（r=0.986,P=0.000）。结论 Freiburg电子视力表受检查者因素的影响小于灯箱视力表,其在不同测量者间的可重复性优于灯箱视力表。（眼科, 2013, 22: 117-120）     

灯箱视力表与电脑视力表临床应用对比研究

目的:通过与灯箱视力表的对比研究了解电脑视力表的临床使用价值。方法:选取初三学生63例(126眼)同时用灯箱和电脑视力表进行远用视力检测,对视力检测值进行配对检验。结果:两种视力表检测值的t检验等于1.2671,P>0.20,两种视力表的检测在统计学上无显著性差异。结论:电脑视力表和灯箱视力表在临床上具有相同的应用价值,可以推广和普及。     

Habitual visual acuity in a large urban cohort of Western India and factors influencing poor habitual vision

Purpose:The aim of this study was to determine habitual visual acuity (HVA) in a large urban cohort in western India and identify factors associated with poor HVA.Methods:This was a prospective study conducted over 10 days in September 2018 to assess the HVA in individuals attending a 10-day festival in Western India. Participants who volunteered to undergo vision screening and also filled the questionnaire form pertaining to demographic information including their age, gender, address, income, and educational status were included in this study. HVA was recorded with the distance correction that the participants were wearing when they attended the screening. The study evaluated the prevalence of visual acuity 6/6 or <6/6, 6/12, and 6/18 and the factors associated with lower visual acuity.Results:Of the 6300 participants, 1660 (26.3%) were females. Majority of the participants were from urban background (6084, 96.6%) and were of younger age group (18–40 years––3786, 60.1%; 41–60 years––2187, 34.7%; >60 years––327, 5.2%). HVA was recorded as 6/6 both eyes in 4136 (65.6%), at least 6/12 both eyes in 5691 (90.3%), and at least 6/18 both eyes in 5974 (94.8%) individuals. Only 11 patients (0.17%) had VA worse than 6/60 with only 3 patients (0.003%) having bilateral VA <6/60. Older age, female sex, lower education status, and low annual income were significant risk factors for poor HVA.Conclusion:Poor education, lower income, female gender, and old age are significantly associated with poor HVA even in urban Western India despite relatively easy access to affordable eye care facilities.     

弱视患者远、近视力差异的临床观察

目的  了解弱视儿童近视力和远视力是否存在差异。设计 回顾性病例系列。研究对象 弱视儿童81例（139眼）。方法 对81例初次就诊的弱视患者进行屈光矫正,分别运用标准对数远视力表和标准对数近视力表进行矫正后远、近视力的测量及分析。对所有接受检查的弱视儿童分别按年龄、屈光度和病因进行分组统计分析。主要指标 近视力,远视力。结果 不同病因弱视患者的远近视力比较：屈光不正性弱视、屈光参差性弱视、斜视性弱视患者的平均近视力分别为0.48±0.27、0.47±0.28、0.45±0.30,平均远视力分别为0.46±0.22、0.40±0.20、0.43±0.30,各组的远近视力差异均无统计学意义（P均＞0.05）。不同年龄弱视患者的远近视力比较：3岁～≤5岁组、＞5岁～≤7岁组、＞7岁～12岁组的平均近视力分别为0.41±0.23、0.56±0.29、0.46±0.31,平均远视力分别为0.39±0.18、0.52±0.22、0.42±0.23,各年龄组患者的远近视力差异均无统计学意义（P均＞0.05）。不同屈光度弱视患者的远近视力比较：≤+4.00 D组和＞+4.00 D组平均近视力分别为0.45±0.26、0.48±0.28,平均远视力为0.40±0.30、0.46±0.21,两组屈光度患者的近视力与远视力平均值差异均无统计学意义（P均＞0.05）。结论 本研究结果显示,不同病因、不同年龄段、不同屈光度的弱视患者其远、近视力无明显差异。 （眼科,2013,22： 266-268）     

Methods of visual acuity determination with the spatial frequency sweep visual evoked potential

Purpose The spatial frequency sweep visual evoked potential (sVEP) is used to rapidly determine visual acuity in children or non-responsive patients. Two techniques have been used to separate signal from noise: (1) the 95% confidence interval for the signal amplitude (95% CI) or (2) the amplitude of a Fourier frequency adjacent to 2×the signal frequency (DFT). The purpose of this study is to determine if there is a significant difference in acuity estimates with these techniques.Methods Ten normal subjects (approximately 0.00logMAR acuity) and 11 patients with decreased visual acuity took part in this project. Stimulus production and data analysis were done with an Enfant 4010 (Neuroscientific Corp). Standard VEP recording techniques were employed. The stimulus was a horizontal-oriented, sine wave grating that swept up the spatial frequency spectrum (contrast 80%, temporal reversal rate 7.5Hz). Sweeps were repeated until the confidence intervals for the data were no longer decreasing. The Bailey LovielogMAR chart was used to determine visual acuity. A line was fit to the high spatial frequency data using either the 95% CI or the DFT as the noise estimate. By using these linear equations, acuity estimates were obtained at 0, 1, and 2V signal amplitudes.Results The average logMAR acuity for the subjects with normal acuity was –0.06±0.070 (SD). The sVEP acuity estimates were 0.08±0.098, 0.18±0.092, and 0.33±0.195 (0, 1, and 2V extrapolations) with the 95% CI used as noise and 0.07±0.100, 0.18±0.103, and 0.33±0.202 (0, 1, and 2V extrapolations) with the DFT used as noise. By using the average noise from the Fourier frequency as the extrapolation level, the acuity was 0.10±0.098logMAR. The averagelogMAR acuity for the subjects with decreased visual acuity was 0.67±0.306 (SD). The sVEP acuity estimates were 0.53±0.175, 0.66±0.171, and 0.88±0.295 (0, 1, and 2V extrapolations) with the 95% CI used as noise and 0.53±0.179, 0.65±0.176, and 0.86±0.268 (0, 1, and 2V extrapolations) with the DFT used as noise. By using the average noise from the Fourier frequency as the extrapolation level, the acuity was 0.57±0.186logMAR. No significant difference was found between the two acuity estimate techniques for all of the subjects (repeated measures ANOVA, p=0.16, F₂₀=2.131). The sVEP estimates of acuity to the 0V and noise levels were not significantly different from the logMAR acuity (paired t-test, all p values >0.05).Conclusions The results indicate that the sVEP acuity does not depend on the noise estimation technique. In agreement with prior studies, the sVEP acuity underestimates the logMAR acuity in normally sighted individuals by about an octave.     

Comparison of Applicability of Different Visual Acuity Charts for Pediatric Outpatient Visual Tests

Purpose： To evaluate the applicability of different visual acuity charts for outpatient pediatric visual tests.
Methods： Fifty-three children （53 eyes） aged 4-8 years undergoing visual acuity tests as outpatients were randomly selected for this study. The best corrected visual acuity （BCVA） of the eye with better visual acuity was measured for each child using the digital LogMAR visual chart, the ETDRS visual chart, and a new standard logarithm visual chart; all measurements were repeated twice and the BCVA was recorded. Paired comparisons were made between the LogMAR visual acuity chart and ETDRS chart measurements or between the ETDRS chart and logarithm visual acuity chart measurements for statistical analysis of the differences in measurement of visual acuity. The results of different measurements by the same chart were compared to evaluate the consistency of the measurement results. Bland-Altman analysis was employed to evaluate the most suitable chart for outpatient measurement of visual acuity in children.
Results： Bland-Altman analysis revealed that the mean visual acuity measured was （0.447±0.017 LogMAR）by the digital LogMAR chart, （0.301±0.024 LogMAR） by the standard logarithm visual acuity chart, and （0.309±0.018 LogMAR） by the ETDRS visual acuity chart. The BCVA was significantly lower when measured by the LogMAR visual acuity chart than by the ETDRS chart （P〈0.01）. The BCVA was slightly higher when measured by the logarithm visual acuity chart than by the ETDRS chart, but the difference was not statistically sig nificant（P〉0.05）. The Bland-Altman plot showed that the highest consistency was obtained with the digital LogMAR chart, with a difference between two repeated measurements of 0.068 LogMAR, compared to 0.090 and 0.072 LogMAR for the logarithm and ETDRS visual acuity charts, respectively.
Conclusion： All three types of visual acuity charts are appli-cable for outpatient measurement of pediatric visual acuity. The ETDRS and logarithm visual acuity ch     

视觉噪声双视力表在弱视检查中的临床应用

目的 探讨视觉噪声双视力表在弱视视觉敏感度检测中的临床应用价值.方法 弱视门诊随机选择100例弱视患者作为弱视组,同时随机抽取100例屈光不正患者作为对照组,使用视觉噪声双视力表分别检测2组患者在有、无视觉噪声条件下视力.然后分别将2组中有、无视觉噪声条件下的视力求差后进行对比研究,以明确视觉噪声双视力表在弱视检查中的应用价值.结果 2组中所有患者在有视觉噪声下的视力均低于无视觉噪声条件下的视力,其中弱视组有、无视觉噪声条件下测得的视力相差(1.62±1.11)行,对照组的视力相差(0.97±0.61)行,2组之间差异有统计学意义(t=5.355,P<0.05).结论 视觉噪声双视力表能够提示弱视者的视觉噪声加工缺陷,借此将弱视者和其他视觉异常者区分开来;可作为常规枧力检查的有益补充,用于弱视的临床检测和诊断.