单纯性近视鼻侧象限视网膜神经纤维层变薄与眼轴及屈光度的相关性研究

目的通过对单纯性近视眼变薄的鼻侧视网膜神经纤维层（RNFL）厚度与眼轴及屈光度的相关性研究，并探讨其原因。方法选取LASIK术前光学相干断层扫描（OCT）检查中发现鼻侧象限视网膜神经纤维层变薄的患者进行验光检测眼屈光度及眼A超检测眼轴并进行统计学分析。结果103例单纯性近视眼患者206眼中OCT检查发现鼻侧象限RNFL变薄者为31例61眼，占29．6％。其鼻侧象限RNFL厚度与眼轴长度成负相关关系（r=-0．885，p〈0．01）；鼻侧象限RNFL厚度与屈光度成负相关关系（r=-0．747，p〈0．01）。结论单纯性近视眼鼻侧象限RNFL层厚度随眼轴长度及眼屈光度的增加而减少。在出现异常数值时，需考虑其眼轴及屈光度的影响，综合评价数值意义。     

近视性屈光参差对水平隐斜视及聚散力的影响

目的：通过测量屈光不正患者戴镜后的水平隐斜视及聚散力,探讨近视性屈光参差对双眼视觉的影响。方法：随机选择近视性屈光参差患者48例,测量日常戴镜状态下的矫正视力,使用VonGraefe法检查远方（5m）、近方（40em）的分离性水平隐斜视,利用梯度法计算AC／A比率;使用综合验光仪上的Risley棱镜检查远方、近方的水平聚散力。40例近视患者作为对照组。结果：屈光参差组远方、近方的分离性水平隐斜程度均大于对照组．差异有统计学意义（心0．05）;AC／A比率与对照组相比差异无统计学意义（P〉0．05）。屈光参差组水平聚散力的模糊点、破裂点、恢复点值均小于对照组,除近方BO恢复点两组差异有统计学意义（P〈0．05）外,其他检查结果差异均无统计学意义（P〉0．05）。结论：屈光参差影响水平眼位,减弱聚散力,患者可拥有双眼单视功能,但注视近方距离时,患者可能存在单眼视状态。     

年龄对角膜塑形镜矫治效果的影响分析

目的探讨不同年龄的近视患者,相近程度近视性屈光不正眼在角膜塑形镜验配中的矫治效果。方法利用标准片试戴法验配角膜塑形镜;在成功配戴角膜塑形镜的患者中,抽选15岁以下、16～20岁和20岁以上中度近视患者72例(144只眼),利用fareast综合验光仪进行配前裸眼视力、屈光度数检查,与配戴角膜塑形镜矫治后裸眼视力检查进行对比。结果不同年龄的中度近视性屈光不正患者配戴角膜塑形镜后,青、少年组显效率分别为74.28%和86.67%,中年组显效率为4.54%,青、少年组矫治效果显著优于中年组。结论角膜塑形镜能有效矫治近视,但对年龄偏大的近视患者在矫治效果上远不及年龄较小者。     

Alteraciones oculares en submarinistas: Presentación de 2 casos clínicos y revisión de la literatura

Scuba diving can be practiced recreationally or professionally. In both modalities the diver can be exposed to risks such as decompression syndrome and thus, the use of a hyperbaric chamber, hyper-oxygenation of the gas cylinder, barotrauma, and immersion in closed circuits. These situations have some phenomena in common, such as the great pressure differences, which can cause a wide range of alterations, including ophthalmological ones. The development of index myopia and nuclear cataract are ocular findings frequently associated with increased oxygen pressure. In this context, an imbalance is established between oxidative species and antioxidant defences, such as glutathione, which has a key role in maintaining the transparency of the lens. The cases are presented of 2 young coral fisher patients, who had recently developed a progressive myopisation associated with nuclear cataracts.     

中国大学生三种近视矫正方式的生存质量调查

目的调查中国近视大学生3种不同矫正方式（LASIK术、框架眼镜配戴和接触镜配戴）人群的生存质量并进行对比研究。方法对中国3所高校的部分近视大学生分为三组进行生活质量问卷调查,Ⅰ组为近视准分子激光原位角膜磨镶术（LASIK）术后人群,Ⅱ组为近视框架眼镜配戴人群,Ⅲ组为近视软性接触镜配戴人群。生存质量调查内容包括干眼不适、夜间眩光、自信心、夜间视力下降、日常运动影响、学习影响、视疲劳、美观和满意度等多个方面。结果在日常运动影响、学习影响、视疲劳和美观4方面,Ⅰ组明显优于Ⅱ组和Ⅲ组;满意率调查Ⅰ组满意率达98．83％,明显高于Ⅱ组（92．41％）和Ⅲ组（87．01％）,生存质量明显提高。结论在中国近视大学生群体中,LASIK术后人群较配戴眼镜人群拥有更加良好的生存质量。     

高度近视散光患者行TICL术后旋转稳定性相关影响因素的研究

目的探讨TICL（Toric Implantable Collamer Lens）植入术矫正高度近视散光的临床效果及晶体旋转稳定性的相关影响因素。方法回顾性分析接受TICL植入术的高度近视散光患者35例（70只眼）,平均随访时间（8.8±5.5）个月。采用超声生物显微镜（UBM）观察晶体4个襻的位置,眼前节照相测算术后轴向与预测轴向的偏差。结果经过随访,术前平均柱镜度数（MRC）-（2.88±1.49）D降为术后的-（0.61±0.41）D,术后MRC≤-0.50 D占48.57%（34/70）,在-0.50~-1.00D范围内占51.43%（36/70）。术前平均等效球镜度数（MRSE）-（12.08±4.22）D降为术后的-（0.41±0.61）D。术前最佳矫正视力≥1.0的占44.29%（31/70）,术后裸眼视力≥1.0占55.71%（39/70）。平均术后TICL轴向与术前预测的差别为（6.96±8.37）°,29只眼（41.43%）TICL襻顶点位置在睫状沟内,41只眼（58.57%）不在睫状沟内。TICL旋转的角度和术后人工晶体襻的位置及拱高有明显的相关性。结论 TICL矫正高度近视散光具有较好的安全性、有效性和预测性,术后TICL晶体襻的位置和拱高是引起晶体旋转的两个可能危险因素。     

准分子激光原位角膜磨镶术治疗近视散光的疗效分析

目的 评价应用小光斑扫描的激光机行准分子激光原位角膜磨镶术 (LASIK)治疗不同程度复性近视散光的疗效。方法 观察1999年2月至2000年7月在本院行LASIK的208例 (308眼 )复性近视散光患者术后1周、1月、3月、6月的视力、等效球镜度、散光度和散光轴向 ,按散光度不同分为低度、中度和高度3组进行统计分析。结果 术后6月3组患者的散光度分别为 (0.31±0.23)、(0.61±0.41)、(1.68±0.57)D。矫正散光的轴向差小于10°。术后6月3组患者的裸眼视力和术前最佳矫正视力无明显差别 (P>0.05)。 结论 应用小光斑扫瞄的激光机行LASIK治疗不同程度近视散光疗效确切。矫正散光的轴向基本准确。矫正高度散光约在1周至1月之间产生一定量的回退 ,并持续至3月以后     

Surgical outcomes of macular buckling techniques for macular retinoschisis in highly myopic eyes

Purpose

To report the anatomic and visual results following macular buckling for patients with macular retinoschisis related to high myopia.

Methods

Thirty-nine highly myopic eyes (mean refractive error −16.7 D; range, −9 to −24 D) of 36 patients (mean age 59 years; range, 35–79 years) presenting with macular retinoschisis associated with a posterior staphyloma, who underwent combined vitrectomy and macular buckling were evaluated. Main outcome measures included best-corrected visual acuity (BCVA) and optical coherence tomography (OCT) findings. Three cases were excluded due to short follow-up (less than 3 months). The mean follow-up was 16 months.

Results

The mean BCVA increased from 0.76 to 0.43 LogMAR (p = 0.001). Visual acuity improved in 30 eyes (83.3%), remained stable in three eyes (8.3%) and decreased in three eyes (8.3%). OCT showed resolution of foveoschisis with foveal reattachment in all eyes. None of the evaluated patients developed a macular hole during follow-up.

Conclusion

Macular buckling associated with vitrectomy results in good anatomic and visual outcomes in patients with myopic foveoschisis.     

Updates of pathologic myopia

Complications from pathologic myopia are a major cause of visual impairment and blindness, especially in east Asia. The eyes with pathologic myopia may develop loss of the best-corrected vision due to various pathologies in the macula, peripheral retina and the optic nerve.Despite its importance, the definition of pathologic myopia has been inconsistent. The refractive error or axial length alone often does not adequately reflect the ‘pathologic myopia’. Posterior staphyloma, which is a hallmark lesion of pathologic myopia, can occur also in non-highly myopic eyes. Recently a revised classification system for myopic maculopathy has been proposed to standardize the definition among epidemiological studies. In this META-PM (meta analyses of pathologic myopia) study classification, pathologic myopia was defined as the eyes having chorioretinal atrophy equal to or more severe than diffuse atrophy.In addition, the advent of new imaging technologies such as optical coherence tomography (OCT) and three dimensional magnetic resonance imaging (3D MRI) has enabled the detailed observation of various pathologies specific to pathologic myopia. New therapeutic approaches including intravitreal injections of anti-vascular endothelial growth factor agents and the advance of vitreoretinal surgeries have greatly improved the prognosis of patients with pathologic myopia. The purpose of this review article is to provide an update on topics related to the field of pathologic myopia, and to outline the remaining issues which need to be solved in the future.     

Glaucoma agudo de ángulo cerrado inducido por topiramato con miopización aguda y estrías maculares: a propósito de un caso

We report the case of a 29-year-old epileptic woman who had been on treatment with topiramate 25 mg/day for 9 days. She was referred to the Emergency Department due to reduction in far visual acuity (VA) after increasing the dose to 50 mg/day two days before. The ocular examination showed bilateral acute angle closure glaucoma (AACG) and macular striae in both eyes (AO) observed by Retinography and Optical Coherence Tomography (OCT). The AACG is a well-known side effect of topiramate, but the macular striae rarely accompanies it. Although macular striae have been previously described in other cases, very few document those using retinography and OCT images. Therefore, it is important to differentiate a case of AACG induced by topiramate from a case of primary AACG, since they differ in their clinical presentation, mechanism of action, and treatment. Mismanagement can have potentially serious consequences.