Correlation between cerebral cortex changes and clinical features in patients with neuromyelitis optica spectrum disorder with normal-appearing brain tissue:a case-control study

Neuro myelitis optica spectrum disorder(NMOSD) is an inflammatory demyelinating disease of the central nervous system.However,whether and how cortical changes occur in NMOSD with normal-appearing brain tissue,or whether any cortical changes correlate with clinical chara cteristics,is not completely clear.The current study recruited 43 patients with NMOSD who had normal-appearing brain tissue and 45 healthy controls matched for age,sex,and educational background from December 2020 to February 2022.A surface-based morphological analysis of high-resolution T1-weighted structural magnetic resonance images was used to calculate the cortical thickness,sulcal depth,and gyrification index.Analysis showed that cortical thickness in the bilate ral rostral middle frontal gyrus and left superior frontal gyrus was lower in the patients with NMOSD than in the control participants.Subgroup analysis of the patients with NMOSD indicated that compared with those who did not have any optic neuritis episodes,those who did have such episodes exhibited noticeably thinner cortex in the bilateral cuneus,superior parietal co rtex,and pericalcarine co rtex.Correlation analysis indicated that co rtical thickness in the bilateral rostral middle frontal gyrus was positively correlated with scores on the Digit Symbol Substitution Test and negatively correlated with scores on the Trail Making Test and the Expanded Disability Status Scale.These results are evidence that cortical thinning of the bilateral regional frontal cortex occurs in patients with NMOSD who have normal-appearing brain tissue,and that the degree of thinning is correlated with clinical disability and cognitive function.These findings will help im prove our understanding of the imaging chara cteristics in NMOSD and their potential clinical significance.

All-trans retinoic acid regulates the expression of MMP-2 and TGF-β2 via RDH5 in retinal pigment epithelium cells

·AIM: To investigate the effect of all-trans retinoic acid(ATRA) on retinol dehydrogenase 5(RDH5), matrix metalloproteinase-2(MMP-2) and transforming growth factor-β2(TGF-β2) transcription levels, and the effect of RDH5 on MMP-2 and TGF-β2 in retinal pigment epithelium(RPE) cells.·METHODS: After adult RPE cell line-19(ARPE-19 cells) intervened with gradient concentrations of ATRA(0-20 μmol/L) for 24h, flow cytometry was used to detect the proliferation and apoptosis of cells in each group, and quantitative realtime polymerase chain reaction(q RT-PCR) was used to detect RDH5, MMP-2 and TGF-β2 m RNA expression. Then, after ARPE-19 cells transfected with three different si RNA targets for 48h, the RDH5 knockdown efficiency of each group and expression of MMP-2 and TGF-β2 m RNA within them was detected by q RT-PCR. ·RESULTS: Flow cytometry results showed that ATRA could inhibit the proliferation of RPE cells and promote the apoptosis of RPE cells, and the difference of apoptosis was statistically significant when the ATRA concentration exceeded 5 μmol/L and compared with the normal control group(P=0.027 and P=0.031, respectively). q RT-PCR results showed that ATRA could significantly inhibit the expression level of RDH5 m RNA(P<0.001) and promote the expression of MMP-2 and TGF-β2 m RNA(P=0.03 and P<0.001, respectively) in a dose-dependent manner, especially when treated with 5 μmol/L ATRA. The knockdown efficiency of RDH5 si RNA varies with different targets, among which RDH5 si RNA-435 had the highest knockdown efficiency, i.e., more than 50% lower than that of the negative control group(P=0.02). When RDH5 was knocked down for 48h, the results of q RT-PCR showed that the expressions of MMP-2 and TGF-β2 m RNA were significantly up-regulated(P<0.001).·CONCLUSION: ATRA inhibits the expression of RDH5 and promotes MMP-2 and TGF-β2, and further RDH5 knockdown significantly upregulates MMP-2 and TGF-β2. These findings suggest that RDH5 may be involved in an epithelial-mesenchymal transition of RPE cells mediated by ATRA.

糖尿病性白内障患者术后发生角膜水肿的预测模型

目的:探讨糖尿病性白内障患者术后发生角膜水肿的危险因素并构建预测模型。方法:选取2017-01/2019-12本院收治的糖尿病性白内障患者312例,均采取择期超声乳化白内障摘除联合人工晶状体(IOL)植入手术。根据术后1wk内是否出现角膜水肿分为角膜水肿组(n=62)和非角膜水肿组(n=250)。比较两组患者性别、年龄、吸烟史、饮酒史、糖尿病病程、高血压病史、青光眼病史、角膜营养不良、慢性葡萄膜炎、晶状体核硬度Emery分级、术前前房深度、术中超声能量和有效超声时间、IOL材料和植入位置、术后角膜内皮细胞数量。采用逐步Logistic回归分析确定糖尿病性白内障患者术后发生角膜水肿的危险因素,确定危险因素后构建危险评分体系,绘制ROC曲线分析危险评分模型对术后角膜水肿的预测价值。结果:纳入的312例糖尿病性白内障患者中62例(19.9%)发生术后角膜水肿。根据逐步Logistic回归分析,年龄>60岁(OR=2.657,95%CI:1.135~6.220)、糖尿病病程>10a(OR=6.932,95%CI:1.911~25.145)、高血压病史(OR=2.783,95%CI:1.037~14.510)、青光眼病史(OR=3.679,95%CI:1.128~11.999)、慢性葡萄膜炎(OR=2.601,95%CI:1.099~6.156)、晶状体核硬度Ⅳ~Ⅴ级(OR=8.658,95%CI:2.595~28.887)、术前浅前房(OR=3.431,95%CI:1.679~7.011)、术后角膜内皮细胞数量(OR=3.026,95%CI:1.137~8.053)是糖尿病性白内障患者术后发生角膜水肿的危险因素。根据上述危险因素构建危险评分体系,年龄>60岁、高血压病史、青光眼病史、慢性葡萄膜炎、术前浅前房、术后角膜内皮细胞丢失≥10%分别对应1分,糖尿病病程>10a和晶状体核硬度Ⅳ~Ⅴ级分别对应2分,总分0~10分。危险评分模型预测糖尿病性白内障患者术后角膜水肿的ROC曲线下面积为0.848(95%CI:0.772~0.934),以8.94分为最佳临界值,此时的敏感度和特异度分别为85.3%和80.2%。结论:年龄>60岁、糖尿病病程>10a、高血压病史、青光眼病史、慢性葡萄膜炎、晶状体核硬度Ⅳ~Ⅴ级、术前浅前房、术后角膜内皮细胞丢失是糖尿病性白内障患者术后发生角膜水肿的危险因素,根据上述危险因素构建的危险评分模型对术后角膜水肿有较好预测价值。

IOL Master 700在白内障中应用的研究进展

近年基于扫频光学相干断层扫描(SS-OCT)技术的光学生物测量仪逐渐用于眼科临床,较既往的部分相干干涉(PCI)等技术的生物测量仪具有更高信噪比、更长扫频光波长、更好组织穿透力、扫描速度更快的优点,白内障患者的眼轴长度(AL)检出率更好等优势。本文主要就目前临床上使用更为广泛的基于SS-OCT技术的光学生物测量仪IOL Master 700在白内障中应用的研究进展进行综述。

OA-2000测量白内障眼球生物参数的重复性及眼轴长度检出率

目的:比较扫频光相干断层扫描生物测量仪OA-2000与部分相干光干涉生物测量仪IOL Master 500测量白内障患者的AL的检出率和AL测量值的一致性,并评价OA-2000测量白内障患者眼球生物参数眼轴长度(AL)、角膜曲率(K)、前房深度(ACD)、晶状体厚度(LT)、中央角膜厚度(CCT)、瞳孔直径(PD)和白到白(WTW)的重复性。方法:采用横断面研究方法。连续纳入2018-07/09本院眼科门诊就诊的白内障患者166例270眼,由同一位操作者先进行IOL Master 500测量AL并记录结果,随后进行OA-2000对AL、K、ACD、LT、CCT、PD、WTW数据测量。结果:IOL Master 500 AL检出率为86.3%(233/270);OA-2000检出率为97.0%(262/270)。两设备测量AL差值的范围为0.007±0.129mm,测量AL的95%LoA范围为-0.24~0.26mm。OA-2000在测量白内障患者眼球生物学参数中,除PD和WTW外,余参数如AL、ACD、K(2.5mm和3mm直径)、LT、CCT具有很好的重复性。结论:OA-2000与IOL Master 500相比,对白内障患者AL测量的一致性很好,但OA-2000对AL的检出率更高。OA-2000不仅对于白内障患者AL、ACD、K、LT、CCT眼球生物学参数测量具有高重复性,并且对于混浊程度较重及后囊下混浊的白内障的AL测量更具优势。

OCTA在检测阿尔茨海默症临床前期视网膜微血管改变中的应用

阿尔茨海默病(Alzheimer's disease,AD)是老年痴呆症最常见的病因之一,症状往往在大脑退化性改变数年后才出现,早期诊断困难,既往诊断方法一般为侵入性的检查。大部分AD患者伴有视觉障碍,利用近年来兴起的光学相干断层扫描血管成像技术(optical coherence tomography angiography,OCTA),可以无创、快速地评估视网膜和脉络膜不同血管丛内的结构,将视网膜作为观察大脑的窗口以提高我们对神经系统疾病的认识,可能有助于AD患者的早期诊断。本文将对OCTA应用于神经系统疾病研究的特点,以及在AD患者大脑和视网膜结构、功能研究的相关文献进行综述。

IOL Master 700测量白内障眼球生物参数的重复性及眼轴长度检出率

目的:评价基于扫频光相干断层扫描(SS-OCT)技术的IOL Master 700生物测量仪测量白内障眼球生物参数的重复性,以及与部分相干光干涉生物测量仪IOL Master 500测量眼轴长度(AL)的一致性和检出率。方法:采用横断面研究方法,共纳入2018-07/09门诊就诊的白内障患者133例225眼进行研究。由同一位经验丰富的检查者分别用IOL Master 700和IOL Master 500测量白内障患者眼球生物参数3次,记录AL、角膜曲率(K)、前房深度(ACD)、晶状体厚度(LT)、中央角膜厚度(CCT)、白到白角膜直径(WTW)。结果:IOL Master 700测量白内障患者AL、Km、K1、K2、ACD、LT、CCT、WTW的组内标准差(Sw)分别为0.027mm、0.112、0.148、0.162D、0.015、0.010mm、2.355μm、0.134mm,相对变异系数(CoV)为0.115%~1.162%,组内相关系数(ICC)≥0.923,其中AL的ICC最大为1.000,所有参数均有较高的重复性。IOL Master 700与IOL Master 500测量的AL分别为23.805±2.162、23.782±2.162mm,二者差值为0.023±0.010mm(t=33.645,P<0.001);95%一致性限(95%LoA)为0.003~0.043mm,两仪器测量的AL呈高度正相关(r=1.000,P<0.001),一致性较好。IOL Master 700的AL检出率为93.8%(211/225),IOL Master 500为87.6%(197/225)(χ^2=5.147,P=0.023)。结论:IOL Master 700测量白内障患者眼球生物参数AL、Km、K1、K2、ACD、LT、CCT、WTW均有较高的重复性,其中AL重复性最好;与IOL Master 500测量AL参数有较好一致性,但IOL Master 700对混浊严重及后囊下白内障AL检出率更高。

IOL Master 700测量健康眼生物参数的重复性与再现性

目的:评价扫频光相干断层扫描生物测量仪IOL Master 700测量健康眼球生物参数的重复性及再现性。方法:采用诊断试验研究方法。纳入健康受试者103人,均对右眼进行测量。由两位操作熟练的检查者分别应用IOL Master 700测量眼轴长度(AL)、前房深度(ACD)、房水深度(AQD)、角膜曲率(Km、K1、K2)、中央角膜厚度(CCT)、晶状体厚度(LT)、白到白的角膜直径(WTW)、瞳孔直径(PD),评估IOL Master 700测量眼球生物参数的重复性及再现性。结果:评价重复性时,A(B)检查者获得的AL、Km、K1、K2、ACD、AQD、LT、CCT、WTW、PD的重测试重复性(TRT)分别为0.018(0.017)mm、0.215(0.270)D、0.325(0.334)D、0.303(0.366)D、0.049(0.041)mm、0.048(0.042)mm、0.058(0.047)mm、6.168(5.779)μm、0.395(0.406)mm、1.097(1.099)mm;除PD以外,相对变异系数(CoV)均≤1.219%;组内相关系数(ICC)均≥0.815。评价再现性时,两位检查者获得的AL、Km、K1、K2、ACD、AQD、LT、CCT、WTW、PD的TRT分别为0.018mm、0.240D、0.329D、0.337D、0.048mm、0.048mm、0.055mm、6.396μm、0.420mm、1.144mm;ICC均≥0.900;除PD的CoV为8.750%外,其余参数CoV均≤1.263%。此外,测量AL时重复性及再现性的ICC均为1.000。结论:IOL Master 700对除瞳孔直径以外的健康眼生物参数测量具有较好的重复性及再现性,尤其是对于眼轴长度的测量。

非球面人工晶状体植入术后偏心和倾斜与视觉质量的相关性研究

目的:探讨新型眼前节扫频光相干断层扫描仪CASIA2测量年龄相关性白内障患者植入非球面人工晶状体(IOL)术后的偏心和倾斜与视觉质量的关系。方法:观察性研究。纳入年龄相关性白内障术后1mo随访的患者62例90眼。应用CASIA2于散瞳后测量IOL偏心和倾斜的大小和方向,进行3次测量,取其矢量平均值。再使用KR-1W波前像差仪和双通道视觉质量分析系统(OQAS)进行测量,获取4、6mm瞳孔直径下全眼总高阶像差(tHOA)、球面像差(SA)、彗差(Coma)、客观散射指数(OSI)、调制传递函数截止频率(MTF cut off)和斯特列尔比(SR)等参数。结果:IOL偏心与4mm瞳孔直径下SA(r=0.347,P=0.001)和OSI(r=0.343,P=0.002)成正相关,与MTF cut off(r=-0.244,P=0.032)呈负相关,与tHOA、Coma和SR无相关。IOL倾斜与4mm瞳孔直径下MTF cut off(r=-0.345,P=0.002)和SR(r=-0.256,P=0.023)呈负相关,与tHOA、SA、Coma、OSI均无相关性。IOL的偏心和倾斜与6mm瞳孔直径下的tHOA、SA、Coma、MTF cut off、SR均无相关性。结论:年龄相关性白内障患者植入非球面IOL后,除IOL偏心与4mm瞳孔直径下SA呈弱相关性,偏心和倾斜与其余各项高阶像差均无明显相关性,与视觉质量参数OSI值及MTF cut off值弱相关,提示临床医生在精准白内障手术中关注高阶像差及视觉质量。

散光矫正型人工晶状体偏心倾斜和旋转对视觉质量影响的研究进展

随着屈光性白内障手术的发展,散光矫正型人工晶状体(Toric IOL)作为一种功能性IOL已在临床上广泛应用,植入后能有效地矫正白内障患者术前的角膜散光,减少术后残余散光,获得更好的裸眼视力和视觉质量。轻微的Toric IOL偏心、倾斜和旋转不会引起患者明显的主观不适,但一定程度的偏心、倾斜和旋转反而增加散光和高阶像差,导致视力和视觉质量下降。本文根据相关国内外研究结果,结合基础和临床两个层面分析了Toric IOL的偏心、倾斜和旋转对视觉质量的影响,并对目前存在的问题和展望进行了讨论。

扫频光相干断层扫描生物测量仪OA-2000的临床应用研究进展

随着白内障超声乳化联合人工晶状体植入技术的提高,眼科医生及患者越来越重视术后效果,用于白内障术前测量的检查设备也在不断发展,各类眼部生物参数测量仪器应运而生,已经从超声原理发展到扫频光源光学相干层析成像原理。近来新上市的眼部生物测量仪器OA-2000全自动三维扫频生物测量仪是一种新型扫频光相干断层扫描成像(SS-OCT)设备,具有操作简便安全、分辨率高、重复性好、测量速度快及组织穿透好等特点,一次测量可获得多个眼部生物参数,具有广泛的应用前景。本文就OA-2000测量原理及临床应用进展进行综述。

Relationship between higher-order aberrations and myopia progression in schoolchildren: a retrospective study

AIM: To investigate the relationship between higher- order aberration (HOA) and myopic progression in schoolchildren. ·METHODS: Between April 23 2011 and August 29, 2011 in the children's myopia outpatient clinic of the West China Hospital of Sichuan University, 148 eyes of 74 schoolchildren were reviewed. HOAs for a 6 -mm pupil were measured with an aberrometer. Myopic progression rate was defined according to the change in spherical equivalent refraction (SER) divided by the time span (years). Subjects with myopic progression rate of ≥0.50 diopters (D) were classified as the 'fast'group and the subjects with myopic progression rate of <0.50D were classified as the'slow'group. A retrospective study was conducted to compare HOA between the two groups, using root mean square (RMS) values and Zernike coefficients. ·RESULTS: The RMS values of HOA (t =2.316, P =0.02), HOA without Z 4 0 (t =2.224, P =0.03),third-order aberrations (t' =2.62, P =0.01), and coma (t' =2.49, P =0.01) were significantly higher in the fast group than those in the slow group. The individual Zernike coefficients of Z 3 -1 (t = -2.072, P =0.04) and Z 5 1 (Z =-2.627, P =0.01) displayed statistically significant differences between the two groups. Significant correlations were found between the RMS values of HOA (r =0.193, P =0.019), RMS values of HOA without Z 4 0 (r =0.23, P =0.005), RMS values of coma(r =0.235,P =0.004),RMS values of third-order aberrations (r =0.243, P =0.003), and the progression rate. · CONCLUSION: Our results provide evidence of a relationship between HOA and myopic progression. In a future prospective longitudinal study, we aim to verify whether HOA is a risk factor for myopic progression.

Association between lumican gene-1554 T/C polymorphism and high myopia in Asian population:a meta-analysis

AIM:To investigate the association between lumican gene-1554 T/C polymorphism and high myopia susceptibility.METHODS:We searched the published literature in the Medline,Embase,and CBM databases from inception to July 2013.A meta-analysis was performed by the programs RevMan 5.1 and Stata 12.0,and the odds ratio(OR) with 95% confidence interval(CI) was calculated in fixed or random effect model based on heterogeneity test among studies.RESLUTS:Seven case-control studies with a total of 1 233 cases and 936 controls were included.A statistical significant association with high myopia was observed in the recessive model(TT vs CT +CC:OR=1.92;95% CI=1.14-3.23) and codominant model(TT vs CT:OR=1.81,95%CI=1.19-2.75).CONCLUSION:The present meta-analysis suggested that lumican-1554 T/C polymorphism might be moderately associated with high myopia susceptibility.This conclusion warrants confirmation by further studies.

Myopia genetics in genome-wide association and postgenome-wide association study era

Genome-wide association studies(GWAS) of myopia and refractive error have generated exciting results and identified novel risk-associated loci. However, the interpretation of the findings of GWAS of complex diseases is not straightforward and has remained challenging. This review provides a brief summary of the main focus on the advantages and limitations of GWAS of myopia, with potential strategies that may contribute to further insight into the genetics of myopia in the post-GWAS or omics era.

Comparison of visual quality after implantation of Al-UV and SN60WF aspheric intraocular lens

AIM:To compare the visual performance of pseudophakic eyes implanted with Al-UV and SN60WF aspheric intraocular lens(IOL),and to investigate the correlations between visual quality parameters and pupil size.METHODS:This prospective comparative study included 105 eyes of 90 patients with age-related cataract who underwent uneventful phacoemulsification.The subjects were divided into two groups according to the implanted IOL type.Three months postoperatively,visual acuity and contrast sensitivity were measured,wave-front aberrations were assessed using a KR-IW aberrometer(Topcon),and objective optical quality parameters were performed using an optical quality analysis system-OQAS Il(Visiometrics).Independent sample Mest and Spearman correlation analysis were used for data analysis.RESULTS:There were no significant differences found in visual acuity,contrast sensitivity and visual quality parameters between the two groups(P>0.05).The measured intraocular spherical aberration(SA)in Al-UV IOL eyes of-0.19±0.05 pm was close to the designed SA value of-0.20 pm.The modulation transfer function cutoff,Strehl ratio and OQAS values were negatively correlated with pupil size in both groups(P<0.01).CONCLUSION:The subjective and objective visual quality in pseudophakic eyes with A1-UV and SN60WF IOLs are comparable.For aspheric IOL eyes,visual quality decreases with increasing pupil size.

Clustering cases of Chlamydia psittaci pneumonia mimicking COVID-19 pneumonia

BACKGROUND The onset symptoms of people infected by Chlamydia psittaci can mimic the coronavirus disease 2019(COVID-19).However,the differences in laboratory tests and imaging features between psittacosis and COVID-19 remain unknown.AIM To better understand the two diseases and then make an early diagnosis and treatment.METHODS Six patients from two institutions confirmed as psittacosis by high-throughput genetic testing and 31 patients confirmed as COVID-19 were retrospectively included.The epidemiology,clinical characteristics,laboratory tests and computed tomography(CT)imaging features were collected and compared between the two groups.The follow-up CT imaging findings of patients with psittacosis were also investigated.RESULTS The white blood cell count(WBC),neutrophil count and calcium were more likely to be decreased in patients with COVID-19 but were increased in patients with psittacosis(all P=0.000).Lymphocyte count and platelet count were higher in patients with psittacosis than in those with COVID-19(P=0.044,P=0.035,respectively).Lesions in patients with psittacosis were more likely to be unilateral(P=0.001),involve fewer lung lobes(P=0.006)and have pleural effusions(P=0.002).Vascular enlargement was more common in patients with COVID-19(P=0.003).Consolidation in lung CT images was absorbed in all 6 patients.CONCLUSION Psittacosis has the potential for human-to-human transmission.Patients with psittacosis present increased WBC count and neutrophil count and have specific CT imaging findings,including unilateral distribution,less involvement of lung lobes and pleural effusions,which might help us to differentiate it from COVID-19.

Ophthalmic characteristics of carotid cavernous fistula:a case report

Dear Editor,We report a case of traumatic carotid cavernous fistula(CCF)that initially presented in the Ophthalmology Department because of the ocular manifestations.CFF is a clinical syndrome characterized by ocular abnormalities,which is caused by abnormal communication between the cavernous sinus and the cavernous segment or other meningeal branches of the internal carotid artery(ICA)due to traumatic or spontaneous factors.

白内障手术相关的不等像及其对术后双眼视觉的影响

目的:探讨双眼白内障术后不等像的变化,并分析不等像对术后双眼视觉状态的影响。方法:前瞻性临床研究。2019年1—11月于萨鲁斯大学宾夕法尼亚视光学院和LewisLASIK眼科诊所招募拟接受双眼白内障手术的患者(≥50岁)73例。所有受检者在第1眼手术前接受不等像检查,第2眼手术后接受不等像检查和综合双眼视检查。综合双眼视检查方案包括立体视、眼位、融像性聚散、聚散灵活度及集合近点检查等。根据双眼视检查结果确定受检者的双眼视觉状态(正常双眼视或双眼视异常)。采用McNemar卡方检验比较手术前、后有临床意义的不等像比例(≥3%);Spearman检验分析不等像与屈光参差、双眼人工晶状体(IOL)度数差值及立体视之间的相关性;Logistic回归分析不等像对术后双眼视觉状态的影响;受试者工作特征(ROC)曲线确定能预测术后是否存在双眼视异常的不等像临界值。结果:术后平均随访时间为2个月。最终纳入51例受检者,其中13例(25%)在术后被诊断为非斜视性双眼视异常,主要为集合不足11例(22%)。术后有临床意义的不等像比例较术前差异无统计学意义(χ^(2)=1.14,P=0.286)。术前、术后及术源性不等像与屈光参差、双眼IOL度数差值及立体视均无相关性。Logistic回归分析显示,术后的双眼视异常与术前(OR=1.46,P=0.047)、术后(OR=1.67,P=0.031)及术源性(OR=1.48,P=0.021)不等像之间均存在相关性。ROC曲线分析显示,术源性不等像显示出最佳的曲线下面积(AUC),其AUC值为0.74,术源性不等像>2.4%时,其预测术后双眼视异常的敏感性和特异性最佳,分别为80.6%和65.0%。术前和术后的不等像AUC值分别为0.68、0.66,分别取临界值3.3%和2.9%时,预测的敏感性和特异性最佳。结论:双眼白内障手术并不明显改变不等像。然而,双眼白内障手术群体的不等像可作为预测因子,用来预测术后发生双眼视异常的风险。

i.Profiler和iTrace波前像差仪测量健康人眼波前像差的一致性

目的:评价i.Profiler和iTrace波前像差仪测量健康人眼波前像差的一致性,分析角膜高阶像差与瞳孔直径的相关性。方法:系列病例研究。连续纳入健康青年受检者96例(96眼),采用i.Profiler和iTrace进行波前像差测量,参数包括2~6 mm瞳孔直径下角膜和3、5 mm瞳孔直径下全眼高阶像差,包括总高阶像差(tHOA)、球差(Z4^(0))、彗差(Z3^(-1)、Z3^(1))和三叶草像差(Z3^(-3)、Z3^(3))。采用配对t检验、Pearson相关、Bland-Altman散点图、一致性界限(95%LoA)分析2种设备测量结果的一致性。结果:i.Profiler和iTrace测量角膜和全眼tHOA、Z4^(0)、Z3^(-1)、Z3^(1)、Z3^(-3)和Z3^(3)的95%LoA均小于0.1μm,显示一致性较好。i.Profiler和iTrace在4 mm瞳孔直径下测得的角膜Z4^(0)分别为(0.049±0.016)μm和(0.048±0.016)μm;6 mm瞳孔直径下,角膜Z4^(0)分别为(0.270±0.040)μm和(0.266±0.037)μm。2~6 mm瞳孔直径下,i.Profiler测量的角膜tHOA、Z4^(0)、Z3^(-1)、Z3^(1)、Z3^(-3)和Z3^(3)与瞳孔直径呈高度相关(r=0.960、0.916、0.978、0.970、0.982、0.984,均P<0.05);iTrace测量的角膜高阶像差与瞳孔直径也呈高度相关(r=0.960、0.916、0.983、0.970、0.984、0.969,均P<0.05)。3 mm和5 mm瞳孔直径下,i.Profiler测量的全眼Z4^(0)分别为(0.010±0.008)μm和(0.073±0.052)μm,角膜Z4^(0)分别为(0.016±0.007)μm和(0.116±0.031)μm,同一瞳孔直径下,全眼Z4^(0)小于角膜Z4^(0)。结论:i.Profiler和iTrace测量角膜和全眼高阶像差值具有良好一致性,二者的高阶像差测量值方面可以相互参考。

川东北地区基于某视光门诊的非斜视性双眼视觉异常患病情况及相关因素研究

目的:调查川东北地区某眼视光门诊12~35岁患者的非斜视性双眼视觉异常(NSBVD)患病情况及相关因素。方法:系列病例研究。招募于川北医学院附属医院眼视光门诊寻求常规视力检查的12~35岁志愿者172例。检查内容包括主觉验光、立体视觉、水平隐斜、正融像性聚散(PFV)和负融像性聚散(NFV)、聚散灵活度(VF)、集合近点(NPC)、单眼调节幅度(MAA)、单眼调节灵活度(MAF)、调节反应(MEM)、集合不足症状问卷(CISS)等。综合上述检查结果进行各类NSBVD分类诊断并计算其患病率。采用相关分析及Logistic回归分析NSBVD患病的相关因素。结果:NSBVD在门诊患者中占比为36.1%,其中以集合不足最为常见,为12.8%。Logistic回归分析未发现性别、年龄、等效球镜度(SE)和双眼SE差值为NSBVD发病的相关因素。线性相关分析未发现双眼SE差值与任何一项双眼视觉指标相关,但右眼SE与远距PFV(r=-0.243,P=0.010)、远距NFV(r=-0.247,P=0.009)及CISS(r=-0.211,P=0.027)呈负相关,与NPC呈正相关(r=0.224,P=0.019)。结论:NSBVD在眼视光门诊12~35岁人群中较为普遍,年龄、性别、屈光状态不是NSBVD患病的相关因素,但随着近视度数加深,远距融像性聚散功能增加,NPC移近,CISS评分变差。