基于支配度迁移模型的多目标生物地理学优化算法

针对传统多目标算法在解决MOPs问题时会出现Pareto前沿收敛结果不好、解集分布性不佳的情况,提出了基于支配度迁移模型的多目标生物地理学算法（MOBBO）。新的迁移模型充分利用了Pareto解之间的支配信息,有助于算法进行有效的个体评价和栖息地排序;为了强化算法的收敛效果,提出了基于优选特征库的自适应迁移策略,以便产生携带较好特征的候选解强化搜索能力;同时为了增强算法进化中Pareto解集的分布性,提出了改进的KNN密度估计方法淘汰过密的个体。通过ZDT和DTLZ系列测试函数以及MDI缩合过程的多目标问题优化上的比较,验证了MOBBO算法具有较快的收敛性和较好的分布延展性。     

原发性良性阵发性位置性眩晕患者前庭诱发肌源性电位检测的意义

目的：探讨检测眼肌前庭诱发肌源性电位（oVEMP）和颈肌前庭诱发肌源性电位（cVEMP）对单侧原发性良性阵发性位置性眩晕（BPPV）患者进行可能发病部位的定位诊断价值。方法：对52例单侧原发性BP-PV患者（BPPV组）和38例正常人（对照组）分别进行气导短纯音诱发的oVEMP和cVEMP检测,分析两种反射的引出率、潜伏期、振幅等数据。结果;BPPV组患侧oVEMP的引出率为46．15％,cVEMP的引出率为67．31％;其健侧oVEMP的引出率为48．08％,cVEMP的引出率为65．38％。对照组左侧oVEMP的引出率84．21％,cVEMP的引出率92．11％;右侧oVEMP的引出率为81．58％,cVEMP的引出率为94．74％。对照组双侧cVEMP和oVEMP的P1、N1潜伏期及N1-P1振幅值差异均无统计学意义。BPPV组和对照组cVEMP和oVEMP耳间振幅比及不对称率差异有统计学意义（P〈0．05）。结论：单侧原发性BPPV患者双侧前庭耳石器传导通路功能受损状况,可以通过oVEMP和cVEMP检测进行客观评估,并且oVEMP的异常率比cVEMP高。     

不同种类刺激声对国人正常青年人群眼肌前庭诱发肌源性电位的影响

目的：观察不同种类刺激声对中国正常青年人群气导声刺激诱发的眼肌前庭诱发肌源性电位（ACS-oVEMP）的影响。方法：选择22例正常人为研究对象,分别采用500Hz tone brust、125Hz tone burst和Click作为诱发刺激声进行双耳（44耳）ACS-oVEMP检测,观察和比较ACS-oVEMP波形的引出率、阈值、nⅠ潜伏期、pⅠ潜伏期、nⅠ-pⅠ波间期、振幅及耳间对称性情况。结果：500Hz tone burst诱发的ACS-oVEMP引出率为100%（44/44）,125Hz tone burst的引出率为40.9%（18/44）,Click的引出率为29.6%（12/44）。500Hz tone burst与其他2组间引出率比较差异有统计学意义（P〈0.05）;500Hz tone burst的振幅最大[（7.3±5.5）μV],与125Hz tone burst[（3.8±1.5）μV]和Click[（5.8±1.3）μV]2组间振幅比较差异有统计学意义（P〈0.05）;其他波形参数比较亦差异有统计学意义。结论：不同刺激声可以对ACS-oVEMP的波形造成影响,500Hz tone burst诱发的ACS-oVEMP引出率最高,振幅最大,波形最易辨认。     

Interferon-gamma release assays in tuberculous uveitis: a comprehensive review

Tuberculous uveitis (TBU) comprises a broad clinical spectrum of ocular manifestations, making its diagnosis challenging. Ophthalmologists usually require evidence from investigations to confirm or support a clinical diagnosis of TBU. Since direct isolation of the causative organism from ocular specimens has limitations owing to the small volume of the ocular specimens, resultant test positivities are low in yield. Immunodiagnostic tests, including the tuberculin skin test and interferon-gamma release assays (IGRAs), can help support a clinical diagnosis of TBU. Unlike the tuberculin skin test, IGRAs are in vitro tests that require a single visit and are not affected by prior Bacillus Calmette-Guerin vaccination. Currently, available IGRAs consist of different techniques and interpretation methods. Moreover, newer generations have been developed to improve the sensitivity and ability to detect active tuberculosis. This narrative review collates salient practice points as a reference for general ophthalmologists, such as evidence for the utilization of IGRAs in patients with suspected TBU, and summarizes basic knowledge and details of clinical applications of these tests in a clinical setting.     

Insights on the possibility of SARS-CoV-2 transmission through the eyes

A novel coronavirus, named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 or 2019-nCOV), causing coronavirus disease 2019 (COVID-19), has rapidly spread to most countries and regions worldwide since it broke out at the end of 2019. Epidemic of the virus produces a tremendous pressure on the global health systems. With progressive insight into SARS-CoV-2, the role of eye tissue has attracted wide attention in the spread of COVID-19. Whether SARS-CoV-2 can enter the human body through eyes and cause infection? The fact that unprotected exposure of the eyes to 2019-nCoV might have allowed the virus to infect the body implies that 2019-nCOV can invade eye tissue and set foot in organism. Facing the severe challenge of preventing spread of the COVID-19, combined with the high-risk environment of ophthalmology, it is crucial to investigate ocular tropism of coronavirus. This paper explores the possibility of coronavirus transmission through the eye from aspects of probable mechanisms, clinical cases, detection of coronavirus; and puts forward precautions for ophthalmologists and nurses. Consequently, this review reveals our understanding of ocular tropism of coronavirus and contributes to determining risk of ocular transmission, raising awareness of necessary eye protection among medical workers and reducing further prevalence of SARS-CoV-2.     

Ocular development in children with unilateral congenital cataract and persistent fetal vasculature

AIM: To investigate the ocular development of patients who had unilateral congenital cataract (CC) combined with persistent fetal vasculature (PFV). METHODS: This cross-sectional, observational study included patients who had unilateral CC and PFV and those with isolated unilateral CC. Axial length (AL), keratometry, anterior chamber depth (ACD), lens thickness, and vitreous length were obtained. The ocular biometric parameters of the affected eyes of patients with CC and PFV were compared with the fellow eyes and with the affected eyes of patients with isolated CC. RESULTS: A total of 110 patients were included and divided into 4 groups: group 1 (18 patients with CC and PFV, <24mo), group 2 (22 patients with CC and PFV, ≥24mo), group 3 (35 patients with CC, <24mo), and group 4 (35 patients with CC, ≥24mo). The ALs of the affected eyes were shorter than those of the fellow eyes in group 1 (20.02±1.06 vs 20.66±0.63 mm, P=0.025). While the ALs of the affected eyes were longer than those of the fellow eyes in group 2 (23.18±2.00 vs 22.31±1.06 mm, P=0.044) and group 4 (22.64±1.80 vs 22.02±1.01 mm, P=0.033). The keratometries of the affected eyes were steeper than those of the fellow eyes in group 2 (44.78±1.66 vs 43.83±1.38 D, P=0.041) and group 4 (43.76±1.91 vs 43.34±1.46 D, P=0.043). No difference of ACDs between two eyes was found in all groups (all P>0.05). CONCLUSION: Compared with the fellow eyes, the ALs of the eyes with unilateral CC and PFV are shorter in patients younger than 24mo and longer in those older than 24mo; the keratometries of the eyes with unilateral CC and PFV are steeper in patients older than 24mo and similar with those younger than 24mo. These findings provide further understanding of ocular development in patients with both CC and PFV.     

角膜地形图引导下不同手术切口对超声乳化术后角膜表面形态和泪膜的影响

目的：分析在角膜地形图引导下不同角膜切口对白内障超声乳化术后角膜表面形态和泪膜的影响。

方法：回顾性研究。选取2019-06/2020-12在我院行白内障超声乳化术患者56例60眼为研究对象,分为透明角膜切口组和角巩膜缘切口组,对存在角膜散光的患者,做与散光同轴向切口。比较术前及术后1wk,1、3mo最佳矫正视力(BCVA)、OSDI问卷、泪膜破裂时间(TBUT)、角膜表面规则指数(SRI)、角膜表面非对称指数(SAI)和角膜表面散光值(CYL)。

结果：两组术后BCVA较术前均提高(P<0.01); 术后1wk,3mo两组患者OSDI评分较术前有差异(P<0.01); 术后1mo两组TBUT较术前均有不同程度缩短(P<0.05); 两组术后SAI和SRI均呈现不同程度上升,术后1wk,1mo角巩膜缘切口组SAI值明显低于透明角膜切口组(P<0.05); 术后1wk两组CYL增长较术前均显著(P<0.05),随着时间的推移逐渐下降,术后3mo时透明角膜切口组较术前仍有所增高。

结论：角巩膜缘切口对术后角膜表面形态及泪膜的影响更小,能有效降低患者术后眼部不适症状。     

角膜神经漩涡结构的形态特点以及与眼表状态的关系

目的　探讨角膜神经漩涡结构的形态特点以及与眼表状态的关系。方法　回顾性分析2018年1月至2020年6月在北京大学第三医院眼科行眼表检查的451例（836眼）患者资料,共计分析1262人次检查结果。所有患者下睑中央泪河高度、泪膜破裂时间和上睑睑板腺形态均由眼表综合分析仪（德国OCULUS公司)获得,角膜神经漩涡图像由激光断层扫描系统(德国海德堡公司) Rostock 角膜模块获得,图像大小为400 μm×400 μm。每眼获取的角膜神经漩涡图像不低于5张。结果　本研究观察到2种神经漩涡形态:螺旋状漩涡和网状漩涡。在本次观察结果中,螺旋状漩涡占65.9%,网状漩涡占34.1%。漩涡有3种方向:顺时针、逆时针和无方向。以顺时针方向最多见,占81.2%。随访期内,漩涡神经沿其漩涡方向发生旋转式位移,但其形态类型和方向不发生转换。双眼角膜神经漩涡的形态类型及方向大多相同。螺旋状漩涡眼的下睑中央泪河高度［（0.19±0.07）mm］较网状漩涡［（0.21±0.07）mm］低,差异有统计学意义（P<0.05）。顺时针漩涡眼的泪膜破裂时间［（4.34±1.94）s］比逆时针漩涡［（3.76±1.66）s］长,差异有统计学意义（P<0.05）;上睑板腺缺损评分［（1.94±0.83）分］较逆时针漩涡［（2.23±0.76）分］低,差异有统计学意义（P<0.05）。结论　角膜神经漩涡结构存在2种形态和3种方向,以顺时针多见。神经沿其漩涡方向进行旋转式位移,不发生形态和方向的逆转。不同漩涡形态、方向伴随不同的眼表状态。