玻璃体腔注射康柏西普治疗弥漫性糖尿病性黄斑水肿的眼表改变

目的:探究玻璃体腔注射康柏西普治疗弥漫性糖尿病性黄斑水肿(DDME)的眼表改变。方法:选取2019-01/06于我院眼科被诊断为DDME的患者20例,均为右眼发病,将右眼纳入试验组,左眼(未发生糖尿病性黄斑水肿)纳入对照组,试验组均行3次玻璃体腔注射康柏西普,对照组不采取任何治疗操作。观察治疗前和3次治疗后第1d矫正视力、眼压、浅表点状上皮糜烂情况、泪河高度、眼表症状及体征(OSDI)评分、泪液分泌试验(SⅠt)及角膜荧光素染色(CSF)评分。结果:治疗前,两组眼压、泪河高度、OSDI评分、SⅠt、CSF评分均无差异(P>0.05),且两组均未出现浅表点状上皮糜烂情况,但对照组矫正视力显著优于试验组(0.50±0.20 vs 1.65±0.35,P<0.05)。治疗后,试验组矫正视力、泪河高度、SⅠt明显低于对照组,OSDI和CSF评分明显高于对照组(均P<0.05),眼压升高幅度较对照组更大,但两组无差异(P>0.05),而试验组19眼出现了浅表点状上皮糜烂情况。与治疗前比较,试验组治疗后矫正视力明显改善,泪河高度和SⅠt明显降低,OSDI和CSF评分明显升高(均P<0.05),但眼压无明显变化(P>0.05);对照组各观察指标均无明显变化(P>0.05)。结论:玻璃体腔注射康柏西普治疗弥漫性糖尿病性黄斑水肿会损伤眼表。

“多元化二段式”教学模式在眼科学专业硕士研究生培养中的实践应用

目的:探讨“多元化二段式”教学模式在眼科学专业硕士研究生培养中的应用效果。方法:选取32名2017届、2018届和2019届的眼科学专业硕士研究生,将每届研究生都随机均分为研究组和对照组(各16人)。研究组采用“多元化二段式”教学模式进行教学;对照组采用传统教学模式进行教学。同组不同届研究生的教学内容相同,教学老师相同,教学时间为33mo的临床实践期,研究时间为2014~2019年,通过对研究组和对照组的眼科学专业硕士研究生的临床实践进行对比,从临床专业考核、科研能力考核、综合考核成绩、学生满意度及梦焦虑自评分数来分析“多元化二段式”教学模式与传统教学模式的不同。考试内容相同,评分标准统一。结果:研究组满意度评分为101.38±6.29分,综合成绩84.22±4.58分,梦焦虑评分17.31±5.20分;对照组满意度评分为59.13±9.61分,综合成绩75.72±5.14分,梦焦虑评分25.75±3.32分。研究组临床技能、科研创新、综合成绩的评分均高于对照组,而梦焦虑评分低于对照组(均P<0.05)。梦焦虑评分与教学模式满意度评分、学生满意度评分呈负相关(r=-0.746、-0.618,均P<0.05)。结论:“多元化二段式”教学模式相较于传统教学模式提高了眼科学专业硕士研究生理论知识、科研创新、身心健康等的综合素质,是目前眼科学专业硕士研究生教学的最佳模式。

OCTA分析埃罗替尼对小鼠角膜厚度的影响

目的:通过光学相干断层扫描血管造影,对小鼠角膜上皮和角膜全层厚度进行检测并分析埃罗替尼对其的影响。方法:随机均分20只小鼠为埃罗替尼组和PBS组,制备埃罗替尼滴眼液,分别应用埃罗替尼滴眼液和PBS,于每日8∶00、12∶00、16∶00和20∶00对2组小鼠点眼。在点眼前、点眼后1、2、3wk应用OCTA测量角膜17个区域的上皮和角膜全层厚度。结果:点眼前埃罗替尼组与PBS组各区域角膜上皮和角膜全层厚度比较无差异(均P>0.05);点眼后第2wk,埃罗替尼组小鼠角膜上皮和角膜全层的17个区域中M、T5、IT5、I5、IN5、N5、T6、IT6、I6、IN6、N6区域与PBS组相比均明显增厚(均P<0.05)。第3wk,埃罗替尼组小鼠角膜上皮和角膜全层厚度的17个区域与PBS组相比均明显增厚(均P<0.05);埃罗替尼组和PBS组经处理2、3wk后,各组间角膜上皮厚度和角膜全层厚度平均值相比有差异(均P<0.05);通过角膜上皮和角膜全层厚度平均值变化趋势分析,埃罗替尼组与PBS组均有差异(均P<0.05)。结论:利用OCTA可以发现埃罗替尼具有使角膜上皮和角膜全层增厚的作用,且随着应用次数的增多,其效果越明显。

羊膜泪小管支架治疗去势雄兔干眼症的实验研究

目的:探究羊膜泪小管支架对手术阉割雄兔干眼症的影响。方法:将36只成年雄性兔分组,其中A组行假阉割手术,B组假植入泪小管支架,C组植入泪小管支架。分别于植入前和植入后2、4、6wk行角膜荧光素染色(FL)和泪液分泌试验(SⅠt)检查,共聚焦显微镜观察角膜神经变化。结果:A组角膜光滑、清晰,FL染色不明显;B组角膜粗糙,角膜上皮见点染色斑点;C组角膜较假手术组更为光滑、清晰,无明显点状染色。各组植入后2、4、6wk时FL染色评分和SⅠt比较,差异有统计学意义(均P<0.05)。共聚焦显微镜下可见A组为相对直的神经丛,量多,清晰可见;B组角膜上皮细胞下神经可见弯曲,数量有所减少;C组角膜上皮下神经相对直,与正常雄兔角膜上皮下神经相比,数量略有减少。结论:羊膜泪小管支架可显著改善阉割去势雄兔干眼症的症状和体征,具有治疗作用。

干眼成像技术的研究进展

近年来,关于干眼成像技术的研究取得了很大的进展,其不仅可以应用于临床对干眼相关指标评估测量,还可以对无法仅通过临床评估来测量的新参数进行定义。在此基础上,有利于对干眼这种病因多样性的疾病进行结构和功能参数的深入分析。本文就干眼诊治过程中使用的泪膜干涉测量、光学相干断层造影、睑板腺成像、非侵入性泪膜破裂时间、热成像和光学质量评估以及活体共聚焦显微镜等技术进行综述。

Altered spontaneous brain activity patterns in patients with diabetic retinopathy using amplitude of low-frequency fluctuation

BACKGROUND Diabetes mellitus is a metabolic disorder characterized by prolonged elevation of blood glucose due to various causes.Currently,the relationship between diabetic retinopathy(DR)and altered connectivity of brain function is unclear.AIM To investigate the relationship between this brain activity and clinical manifestations and behaviors of DR patients by using the amplitude of low-frequency fluctuation(ALFF)technique.METHODS Twenty-four DR patients and 24 healthy controls(HCs)matched for age and gender were enrolled.We measured and recorded average ALFF values of DR patients and HCs and then classified them using receiver operating characteristic(ROC)curves.RESULTS ALFF values of both left and right posterior cerebellar lobe and right anterior cingulate gyrus were remarkably higher in the DR patients than in the HCs;however,DR patients had lower values in the bilateral calcarine area.ROC curve analysis of different brain regions demonstrated high accuracy in the area under the curve analysis.There was no significant relationship between mean ALFF values for different regions and clinical presentations in DR patients.Neuronal synchronization abnormalities in some brain regions of DR patients were associated with cognitive and visual disorders.CONCLUSION Abnormal spontaneous brain activity was observed in many areas of DR patients’brains,which may suggest a possible link between clinical manifestations and behaviors in DR patients.

Reduction in interhemispheric functional connectivity in the dorsal visual pathway in unilateral acute open globe injury patients: a resting-state fMRI study

This study investigated the changes in interhemispheric functional connectivity （FC） of the whole brain in open globe injury （OGI） patients, using voxel-mirrored homotopic connectivity （VMHC）, and their relationships with clinical features. Totally, 16 male and 2 female acute OGI patients and 18 sex, age, and education-matched healthy volunteers were enrolled in the study. All subjects were scanned through functional magnetic resonance imaging （fMRI）. Receiver operating characteristic （ROC） curves analyses had been used to identify the VMHC in these brain areas could be used as biomarkers to distinguish OGI and from healthy control （HC）. The mean VMHC values in multiple brain areas and clinical OGI manifestations were evaluated with a Pearson correlation analysis. OGI patients had significantly decreased VMHC in the bilateral calcarine/lingual/cuneus （BA18, 19, 30） and middle occipital gyrus （BA18, 19）. The OGI patients had abnormal interhemispheric FC in the dorsal visual pathway, which may represent the pathophysiological mechanism that underlies acute vision loss after OGI.

Abnormalities of interhemispheric functional connectivity in individuals with acute eye pain: a resting-state fMRI study

AIM: To study the changes of the resting state functional connectivity(rsFC) between acute eye pain(EP) subjects and healthy controls(HCs) in the two hemispheres by using voxel-mirrored homotopic connectivity(VMHC) method.METHODS: Totally 20 patients with EP and 20 HCs were enrolled, sex, age, and education were matched, and all subjects were examined by functional magnetic resonance imaging(fMRI) scans at resting-state. The changes of rs FC between the hemispheres were evaluated by the VMHC method according to Gaussian random field(GRF) theory. In order to identify the VMHC, as biomarkers for distinguishing EP and from HC, the receiver operating characteristic curves(ROC) had been analyzed. The relationships were evaluated with Pearson correlation analysis between the mean VMHC signal values and clinical features in these patients.RESULTS: By comparing with health subjects, the significant decreased VMHC values was observed in lingual/calcarine(Brodmann area, BA 30), precentral/postcentral gyrus(PreCG/PosCG; BA 4) and medial frontal gyrus(MFG; BA 8)(false discovery rate corrected <0.01) in the acute EP individuals. The accuracy of area under curve was excellent indicated by the ROC curve analysis of each brain regions.CONCLUSION: Our study demonstrates preliminary evidence of disrupted interhemispheric rsFC in acute EP in sensorimotor and limbic system and somatosensory cortex, which might give some useful information for understanding the neurological mechanisms in acute EP individuals.

Altered regional homogeneity in patients with diabetic vitreous hemorrhage

BACKGROUND Diabetic vitreous hemorrhage(DVH)is a common complication of diabetes.While the diagnostic methods nowadays only concentrate on the eye injury in DVH patients,whether DVH leads to abnormalities of other visual systems,including the eye,the visual cortex,and other brain regions,remains unknown.AIM To explore the potential changes of brain activity in DVH using regional homogeneity(ReHo)and their relationships with clinical features.METHODS Thirty-one DVH patients and 31 matched healthy controls(HCs)were recruited.All subjects were examined by resting-state functional magnetic resonance imaging.The neural homogeneity in the brain region was estimated by ReHo method.Pearson correlation analysis was used to evaluate the relationships between average ReHo values and clinical manifestations in DVH patients.RESULTS Compared with HCs,the ReHo values in the bilateral cerebellar posterior lobes,right superior(RS)/middle occipital gyrus(MOG),and bilateral superior frontal gyrus were significantly increased.In contrast,in the right insula,bilateral medial frontal gyri,and right middle frontal gyrus,the ReHo values were significantly decreased.Furthermore,we found that best-corrected visual acuity of the contralateral eye in patients with DVH presented a positive correlation with the mean ReHo value of the RS/MOG.We also found that depression score of the DVH group presented a negative correlation with the mean ReHo values of the right insula,bilateral medial frontal gyrus,and right middle frontal gyrus.CONCLUSION We found that DVH may cause dysfunction in multiple brain areas,which may benefit the exploration of pathologic mechanisms in DVH patients.

斑状角膜营养不良治疗的研究进展

斑状角膜营养不良(macular corneal dystrophy,MCD)是一种常染色体隐性遗传病,是由角膜基质层营养不良导致的进行性视野缺损。CHST 6基因的突变被认为是其主要致病因素。一般来说,全厚度穿透性角膜移植术可作为提高患者视力的一种标准治疗手段。然而一些其它的外科干预措施如深板层角膜移植术(deep anterior lamellar keratoplasty,DALK)和准分子激光治疗性角膜切除术(phototherapeutic keratectomy,PTK)在治疗MCD中也显示了其有效性。一些新的治疗技术如基因靶向疗法和酶替代疗法,也正在被积极地研究。本文就其发病机制、遗传基础、临床表现、治疗及预后作一简要综述。

Surgical correction of recurrent epiblepharon in Chinese children using modified skin re-draping epicanthoplasty

AIM:To evaluate the clinical efficacy of the modified skin re-draping epicanthoplasty procedure for correction of recurrent lower lid epiblepharon in Chinese children.METHODS:From 2016 to 2018,18 children(10 males and 8 females,average age 6.2±1.7 y;30 eyes)with recurrent epiblepharon who attended Beijing Children’s Hospital were included in the study.All the children had undergone lower eyelid surgery for epiblepharon.Surgical design included using an additional incision along the upper palpebral margin,to avoid vertical scarring on the upper lid.The re-draping method was used to correct recurrent epiblepharon.Follow-up ranged from 3 to 24 mo.Postoperative surgical outcomes,complications,and subjective satisfaction were evaluated.RESULTS:Complete correction of cilia touching the cornea was observed in all patients during an average follow-up of 7.1 mo.No"dog ears"or obvious scars were formed after surgery.All parents were satisfied with the cosmetic results and none complained.Mean astigmatism decreased from 2.39±0.79 diopter(D)preoperatively to 2.19±0.79 D at 6 mo after surgery;however,the difference was not significant.Best-corrected visual acuity improved,although the change in mean visual acuity was not significant.No recurrence occurred during the follow-up period.CONCLUSION:This surgical modified skin re-draping technique is effective and highly satisfactory for correction of recurrent epiblepharon.The approach is characterized by a simple design,a straightforward procedure,inconspicuous scarring,and good postoperative appearance.

Quantum metrology with a non-Markovian qubit system

The dynamics of the quantum Fisher information(QFI) of phase parameter estimation in a non-Markovian dissipative qubit system is investigated within the structure of single and double Lorentzian spectra. We use the time-convolutionless method with fourth-order perturbation expansion to obtain the general forms of QFI for the qubit system in terms of a non-Markovian master equation. We find that the phase parameter estimation can be enhanced in our model within both single and double Lorentzian spectra. What is more, the detuning and spectral width are two significant factors affecting the enhancement of parameter-estimation precision.

Altered brain network centrality in patients with retinal vein occlusion: a resting-state fMRI study

AIM:To explore the intrinsic brain activity variations in retinal vein occlusion(RVO)subjects by using the voxel-wise degree centrality(DC)technique.METHODS:Twenty-one subjects with RVO and twentyone healthy controls(HCs)were enlisted and underwent the resting-state functional magnetic resonance imaging(rs-f MRI)examination.The spontaneous cerebrum activity variations were inspected using the DC technology.The receiver operating characteristic(ROC)curve was implemented to distinguish the DC values of RVOs from HCs.The relationships between DC signal of definite regions of interest and the clinical characteristics in RVO group were evaluated by Pearson’s correlation analysis.RESULTS:RVOs showed notably higher DC signals in right superior parietal lobule,middle frontal gyrus and left precuneus,but decreased DC signals in left middle temporal gyrus and bilateral anterior cingulated(BAC)when comparing with HCs.The mean DC value of RVOs in the BAC were negatively correlated with the anxiety and depression scale.CONCLUSION:RVO is associated aberrant intrinsic brain activity patterns in several brain areas including painrelated as well as visual-related regions,which might assist to reveal the latent neural mechanisms.