Relationship of Retinal Nerve Fiber Layer Thickness and Retinal Vessel Calibers with Cognitive Impairment in the Asymptomatic Polyvascular Abnormalities Population

Objective Cognitive impairment(CI)in older individuals has a high morbidity rate worldwide,with poor diagnostic methods and susceptible population identification.This study aimed to investigate the relationship between different retinal metrics and CI in a particular population,emphasizing polyvascular status.Methods We collected information from the Asymptomatic Polyvascular Abnormalities Community Study on retinal vessel calibers,retinal nerve fiber layer(RNFL)thickness,and cognitive function of 3,785participants,aged 40 years or older.Logistic regression was used to analyze the relationship between retinal metrics and cognitive function.Subgroups stratified by different vascular statuses were also analyzed.Results RNFL thickness was significantly thinner in the CI group(odds ratio:0.973,95%confidence interval:0.953–0.994).In the subgroup analysis,the difference still existed in the non-intracranial arterial stenosis,non-extracranial carotid arterial stenosis,and peripheral arterial disease subgroups(P<0.05).Conclusion A thin RNFL is associated with CI,especially in people with non-large vessel stenosis.The underlying small vessel change in RNFL and CI should be investigated in the future.

Repeatability and Reproducibility of Quantitative Assessment of the Retinal Microvasculature Using Optical Coherence Tomography Angiography Based on Optical Microangiography

Objective The aim of this study was to determine the repeatability and reproducibility of optical coherence tomography angiography（OCTA） based on optical microangiography（OMAG） measurements of macular vessels in normal eyes. Methods In this prospective cohort study, 40 eyes of 40 healthy volunteers underwent repeated OCTA（Cirrus HD-OCT 5000 angiography system, Carl Zeiss Meditec, Inc.） scans on two separate visit days. On each visit day, the eyes were scanned three times. The following parameters were used to quantitatively describe the OCTA images of the superficial vascular network： vessel area density（VAD）, vessel skeleton density（VSD）, vessel diameter index（VDI）, vessel perimeter index（VPI）, vessel complexity index（VCI）, flux, and foveal avascular zone（FAZ）. Coefficient of variation（CV） and intraclass correlation coefficient（ICC） were calculated for evaluating intravisit and intervisit repeatability, as well as interobserver reproducibility. Results The measurements showed high repeatability [CVs ≤ 4.2%（intravisit） and ≤ 4.6%（intervisit）] and interobserver reproducibility（ICCs ≥ 0.923） for all parameters. Conclusion This study demonstrated good repeatability and reproducibility of OCTA based on OMAG for the measurement of superficial vessel parameters in normal eyes.

The Influence of Diabetes, Hypertension, and Hyperlipidemia on the Onset of Age-Related Macular Degeneration in North China: The Kailuan Eye Study

Objective To analyze the prevalence of dry and wet age-related macular degeneration(AMD)in patients with diabetes,hypertension and hyperlipidemia,and to analyze the risk factors for AMD.Methods A population-based cross-sectional epidemiologic study was conducted involving 14,440 individuals.We assessed the prevalence of dry and wet AMD in diabetic and non-diabetic subjects and analyzed the risk factors for AMD.Results The prevalence of wet AMD in diabetic and non-diabetic patients was 0.3%and 0.5%,respectively,and the prevalence of dry AMD was 17%and 16.4%,respectively.The prevalence of wet AMD in healthy,hypertensive,hyperlipidemic,and hypertensive/hyperlipidemic populations was 0.5%,0.3%,0.2%,and 0.7%,respectively.The prevalence of dry AMD in healthy,hypertensive,hyperlipidemic,and hypertensive/hyperlipidemic populations was 16.6%,16.2%,15.2%,and 17.2%,respectively.Age,sex,body mass index,and use of hypoglycemic drugs or lowering blood pressure drugs were corrected in the risk factor analysis of AMD.Diabetes,diabetes/hypertension,diabetes/hyperlipidemia,and diabetes/hypertension/hyperlipidemia were analyzed.None of the factors analyzed in the current study increased the risk for the onset of AMD.Conclusion There was no significant difference in the prevalence of wet and dry AMD among diabetic and non-diabetic subjects.Similarly,there was no significant difference in the prevalence of wet and dry AMD among subjects with hypertension and hyperlipidemia.Diabetes co-existing with hypertension and hyperlipidemia were not shown to be risk factors for the onset of dry AMD.

中国眼科日间手术管理专家共识(2021年)

日间手术是目前发展迅速的手术医疗服务模式,眼科因其疾病诊疗特点更适合开展日间手术。为促进我国眼科日间手术推广和健康发展,提升眼科日间手术的规范化管理水平,保障医疗质量和患者安全,中国医药教育协会眼科委员会、中国老年医学学会眼科分会会同解放军医学科学技术委员会眼科学分会,在《我国眼科日间手术流程专家共识(2018年)》的基础上,针对眼科日间手术的设施建设、组织管理模式、手术执行的具体实施、质量与安全管理等环节,通过认真、全面、充分讨论达成共识性意见,为我国眼科临床开展日间手术提供更多指导。