Vestibular dysfunction in patients with auditory neuropathy detected by vestibular evoked myogenic potentials

ObjectivesThis study aimed to determine vestibular involvement in patients with auditory neuropathy (AN) using ocular vestibular evoked myogenic potential (oVEMP), cervical vestibular evoked myogenic potential (cVEMP), caloric tests, video Head Impulse Tests (vHIT), and Suppression Head Impulse Paradigm (SHIMP) tests.MethodsTwenty-two patients with AN (study group) and 50 age-and-gender-matched healthy subjects (control group) were enrolled. All patients underwent air-conducted sound oVEMP and cVEMP tests. In the study group, 20 patients underwent a caloric test, 10 patients underwent a video Head Impulse Test (vHIT), and nine patients underwent the Suppression Head Impulse Paradigm (SHIMP) test.ResultsSignificant differences in VEMP abnormalities were found between the two groups. Most AN patients showed no VEMP response, while only a few patients showed VEMP responses with normal parameters. Some AN patients presented abnormal VEMP parameters, including thresholds, latencies, and amplitudes. The abnormal rate (including no response and abnormal parameters) was 91% in the cVEMP test and 86% in the oVEMP test. No significant difference was found between oVEMP and cVEMP abnormalities. AN patients exhibited a 70% abnormal rate in the caloric test. Most AN patients showed normal VOR gains. Most patients showed no overt corrective saccades in vHIT, and exhibited normal anticompensatory saccades in the SHIMP test.ConclusionMany AN patients experience vestibular dysfunction, which may be detected by using a vestibular functional test battery.SignificanceVEMP abnormalities might reflect the status and degree of vestibular involvement in AN.     

羊膜移植治疗重症眼烧伤的疗效

目的:探讨羊膜移植在治疗眼烧伤患者的临床疗效.方法:采用新鲜羊膜治疗眼烧伤患者31例,术后随访3～18月.结果:24例眼表基本稳定,视力不同程度提高;1例羊膜全部溶解,1例羊膜部分溶解,3例条状睑球粘连,眼球活动尚好,3例假性胬肉2例眼结膜表层重建,但角膜混浊、中央逐渐变薄,转院行角膜板层移植和角膜移植.结论:用羊膜修复眼结膜和角膜创面,可以达到重建眼表的目的,而且羊膜取材方便,在治疗上有明显优势.     

Ocular surface involvement in patients with rheumatoid arthritis: Relation with disease activity and duration

Aim of the workThe aim of the present work was to present the frequency of ocular surface manifestations in rheumatoid arthritis (RA) patients and to determine its correlation with disease activity and duration.Patients and methodsThis cross-sectional study included 70 RA patients. Disease activity score (DAS-28) was scored. All patients underwent complete ophthalmic evaluation including assessment of visual acuity. Ocular surface assessment by Rose Bengal (RB) stain, and Schirmer test (ST) was carried out.ResultsSeventy patients (137 eyes) were studied; 3 eyes were excluded due to previous eye surgery. Patients were 67 women and 3 men with a mean age of 47.96 ± 10.8 years, and disease duration 9.19 ± 6.26 years. The mean DAS28 was 4.1 ± 0.77. Rheumatoid factor was positive in 39 (55.7%). Mean best-corrected visual acuity was 0.47 ± 0.33, ST was 10.6 ± 6.1 mm/5 min and RB score was 6.8 ± 3.6. 70% had ocular manifestations in the form of dry eye (54.7%), pterygium (16.1%), posterior blepharitis (5.8%), scleritis (1.3%), corneal thinning (13.9%), filamentary keratitis (8.7%) and maculopathy (11.7%). There was a significant correlation between ST and disease duration (r = −0.17, p = 0.04). Morning stiffness had a significant correlation with both ST (r = −0.2, p = 0.02) and RB (r = 0.22, p = 0.01) and remained significant on regression analysis. DAS-28 was not significantly associated with any of the ocular surface abnormalities.ConclusionOcular manifestations are significant in patients with RA. The most common ocular manifestation is dry eye. Ocular manifestations are significantly associated with the disease duration and should be expected regardless of disease activity in RA patients.     

Role of Purkinje cells in the ventral paraflocculus in short-latency ocular following responses

We describe the simple-spike activity of Purkin je cells (P cells) in the ventral paraflocculus (VPFL) of behaving monkeys in association with movements of the visual scene that evoke short-latency ocular following re sponses. One group of P cells discharged maximally for downward motion, and the other for motion toward the side of the recording. The onset of the simple-spike re sponse was measured in relation to the onset of ocular following in 24 P cells. The majority of P cells (79%) led by 1–9 ms. At the site of each recording, electrical stimuli (single negative pulses, 1.5–45 A; 0.2 ms in width) were applied and 60% (18/30) of the sites elicited eye movements in the preferred direction of the P cells. The latency of the single-pulse-evoked response in the ipsilateral eye ranged from 8.6 to 10.9 ms. These data suggest that the P cells in the VPFL play a role in ocular following; some discharge early enough to generate the very earliest eye movements.     

三维超声成像在眼科的初步应用

评价三维超声波成像在眼疾病中的应用价值。材料和方法：对１０只正常眼球和３５只病变眼球进行三维成像研究，描述了正常眼球和眼球内不同疾病的三维成像特征。图像采集方式为机械驱动平行扫查和磁场空间定位自由扫查。     

军事飞行员前庭诱发肌性电位临床正常值的建立

目的记录中国空军战斗机飞行员前庭诱发肌性电位（VEMP）参数,以便建立战斗机飞行员的正常值数据。方法 40名现役健康战斗机飞行员作为受试者,采用短纯音双侧给声双侧进行了记录。记录40名健康飞行员VEMP的p13和n23波潜伏期、p13/n23波间幅度以及双侧幅度不对称比,以获得正常值数据。结果 40名健康飞行员均记录到VEMP。p13波的潜伏期为（13.50±1.20）ms;n23波的潜伏期为（21.35±1.60）ms;p13/n23波间幅度为（169.70±38.50）μV;双侧幅度的不对称比（AR）为0.12±0.11。结论本研究建立了军事飞行员VEMP参数标准的常模,为促进VEMP在军事飞行员医学选拔鉴定中的应用,提供了实验依据。     

透明质酸联合A型肉毒素注射在眼周年轻化治疗中的应用效果

目的 探究在眼周年轻化治疗中应用透明质酸联合A型肉毒素注射的效果及安全性。方法 选择 2023年1月-12月于我院整形外科行眼周年轻化治疗的100例患者为研究对象,按随机数字表法分为对照组 和观察组,每组50例。对照组给予常规整形手术治疗,观察组在对照组基础上给予透明质酸联合A型肉毒 素注射治疗,比较两组临床疗效、手术满意度、康复时间及不良反应发生情况。结果 观察组治疗总有效 率为96.00%,高于对照组的78.00%（P ＜0.05）;观察组手术满意度评分高于对照组（P＜0.05）;观察组康 复时间短于对照组（P ＜0.05）;两组不良反应发生率比较,差异无统计学意义（P＞0.05）。结论 透明质 酸联合A型肉毒素注射在眼周年轻化治疗中的应用效果确切,可提升治疗效果,提高手术满意度,有利于 缩短术后康复时间,且不会增加不良反应发生几率。     

玻璃体切除术治疗严重眼外伤

目的 观察玻璃体切除术治疗严重眼外伤的临床效果.方法 应用玻璃体切除术治疗严重眼外伤28例(29眼).结果 本组28例(29眼)中,术后视力提高者24例(25眼,86%),其中0.05以上者14例(15眼,51%),3例复发视网膜脱离,2例再手术成功.结论 玻璃体切除术是目前治疗严重眼外伤较为理想的方法,对恢复视功能起到一定作用.     

大鼠视神经损伤致视网膜病变的病理形态学定量分析

目的研究视神经损伤后视网膜的病理形态学变化。方法利用大鼠视神经钳夹伤模型,运用图像分析和形态计量技术对视神经损伤后视网膜中视神经神经元胞体的节细胞(RGCs)核体积密度进行了定量分析,对视网膜各层厚度进行了测量比较。结果①光镜下观察见正常对照组视网膜各层排列整齐而致密,RGC层胞核清晰,各层界限较为清楚,内核层和外核层细胞排列紧密而整齐。损伤后1d可见节细胞层有出血,损伤7d后,节细胞核明显稀疏,外核层及内核层细胞明显减少,核排列不整齐,内网状层亦变薄,视网膜总厚度变薄;②图像分析显示:视神经损伤后7、14、28d视网膜RGCs核体积密度明显下降(P<0.01),分别下降了27.5%、39.8%、49.0%;伤后28d视网膜节细胞层和内网状层厚度明显减少(P<0.05)结论视神经不全损伤导致了视网膜形态结构的变化,伤后7d节细胞明显丢失,28d视网膜出现了萎缩厚度变薄。