Objective: To study the effect of implantable posterior chamber phakic refractive lens (PC-PRL) in the treatment of high myopia and its effect on naked eye vision and retinal complications. Methods: A total of 110 pat...Objective: To study the effect of implantable posterior chamber phakic refractive lens (PC-PRL) in the treatment of high myopia and its effect on naked eye vision and retinal complications. Methods: A total of 110 patients (220 eyes) with high myopia admitted to our hospital from June 2017 to February 2019 were selected as subjects. All patients were treated with PC-PRL implantation. The UCVA, BCVA, intraocular pressure, corneal endothelial cell count and intraocular lens position (anterior chamber depth and arch height) were compared before and after the treatment. Results: 6 months after treatment, 68.18% of patients had UCVA between 0.6 and 0.9, 31.81% of patients had UCVA of more than 1.0, and 100.00% of patients had BCVA of more than1.0. The BCVA and UCVA values of patients at 1 week, 1 month, 3 months and 6 months after operation were significantly greater than those before surgery (P<0.05). There were no significant differences in BCVA and UCVA among 1 week, 1 month, 3 months and 6 months after operation (P>0.05). The intraocular pressure was significantly greater than that of the preoperative one week after operation (P<0.05). There was no significant difference between the intraocular pressure at 1 month, 3 months and 6 months after operation (P>0.05). There was no significant difference in corneal endothelial cell count and arch height before and after treatment (P>0.05). The depth of anterior chamber at 3 months and 6 months after operation was significantly less than that before operation (P<0.05). There was no significant difference in the anterior chamber depth between 3 months and 6 months after operation (P<0.05). There were 7 cases of corneal edema, 4 cases of high pressure eyes, 2 cases of refractive regression within 6 months, and 1 case of near-difficulty within 1 month. The total complication rate was 12.73%. Conclusion: PC-PRL implantation is effective in the treatment of high myopia, which can improve the naked eye and correct vision. At the same time, the incidence of retinal complications is low, which can be promoted and applied clinically.展开更多
The article discusses the early abandonment of mechanical theories about eye enlargement in degenerative myopia at the turn of the 20th century.At that time,the number of theories about myopia grew unrestricted,but wi...The article discusses the early abandonment of mechanical theories about eye enlargement in degenerative myopia at the turn of the 20th century.At that time,the number of theories about myopia grew unrestricted,but with scant support from the experimental field.The mechanical theories vanished as a new wave of metabolism-based theories appeared,propelled by the huge advances in molecular biology.Modern techniques allow reconsidering those theories and to put them to test with higher confidence.展开更多
Background: Type 2 diabetes (T2D) remains a major global public health problem. This complex metabolic disorder can lead to various complications, including cardiovascular diseases (leading cause of death) in T2D. Amo...Background: Type 2 diabetes (T2D) remains a major global public health problem. This complex metabolic disorder can lead to various complications, including cardiovascular diseases (leading cause of death) in T2D. Among the biochemical markers associated with increased risk for cardiovascular disease, homocysteine is currently one of the predictive markers under evaluation. We investigate the link between hyperhomocysteinemia and diabetes complications in DT2 population in Brazzaville. Methodology: We conducted a cross-sectional analytical study, from October to December 2022. One hundred and fifty participants were included, 100 patients T2D (34 with complications, 33 with comorbidities, 33 without), and 50 patients controls. Sociodemographic and clinical characteristics were collected. Homocysteine (Hcy) serum levels were measured using Sandwich ELISA method. Results: Study population was composed of 50% males and 50% females with sex ratio of 1;mean age was 52.2 ± 10.8 years (30 - 83). The prevalence of hyperhomocysteinemia (HHcy) was 36% (20% moderate Hcy, 15% intermediate and 1% severe). Mean Hcy concentration was 31.9 μmol/l (18 - 103). Age, gender and physical inactivity were strongly correlated to Hcy (OR of 3.5;9.4 and 3 respectively). Multivariate analysis showed that HHcy was a risk accelerator for degenerative complications (stroke: OR = 6.2;ischemic heart disease: 4.9;neuropathy: 9.2;retinopathy: 4.5 and peripheral arterial disease: 4.9). Conclusion: These findings suggest that hyperhomocysteinemia can be considered as a predictive marker to be taken into account in targeting cardiovascular risk in Congolese subjects with T2D.展开更多
AIM:To investigate the association of axial length(AL)and ocular factors on AL elongation.METHODS:A retrospective chart review of patients who underwent two or more AL examinations for more than two years.Totally 4 gr...AIM:To investigate the association of axial length(AL)and ocular factors on AL elongation.METHODS:A retrospective chart review of patients who underwent two or more AL examinations for more than two years.Totally 4 groups were divided according to initial AL(<24 mm,24-26 mm,26-28 mm,≥28 mm).Initial fundus photograph was used to find risk factors associated AL elongation.RESULTS:The mean age of the patients was 47.21±7.79 y.AL remained almost unchanged in the groups with AL<24 mm and 24≤AL<26 mm.On the contrary,AL increased by 0.011 mm/y in the group with 26≤AL<28 mm and 0.035 mm/y in the group with AL≥28 mm(P<0.001).In high myopia,AL elongation increased in eye with longer AL(r=0.003,P=0.024),female gender(r=0.014,P=0.019),eye with larger peripapillary chorioretinal atrophic area(r=0.002,P=0.019),and smaller vascular arcade angle(r=-0.004,P=0.006).The risk of elongation 0.03 mm/y in high myopia was increased in female gender(P=0.040),and gradually increased in eye with large peripapillary chorioretinal atrophy area(P<0.01).CONCLUSION:AL elongate significantly in the eye with longer AL,female gender,and the eye with larger atrophic area and smaller arcade angle on fundus photography.展开更多
Dynesys,a pedicle-based dynamic stabilization system,was introduced to overcome some undesirable complications of fusion procedures.Nevertheless,the theoretical advantages of Dynesys over fusion have not been clearly ...Dynesys,a pedicle-based dynamic stabilization system,was introduced to overcome some undesirable complications of fusion procedures.Nevertheless,the theoretical advantages of Dynesys over fusion have not been clearly confirmed.The purpose of this editorial was to compare clinical and radiological outcomes of patients who underwent Dynesys system with those who underwent posterior lumbar fusion according to the existing literature and to see if the application of the Dynesys system is superior to the traditional lumbar fusion surgery.According to published clinical reports,the short-term effects of the Dynesys dynamic stabilization system are similar to that of traditional lumbar fusion surgery.Three comparative studies of Dynesys dynamic stabilization and fusion surgery with medium-term follow-up are encouraging.However,the results from four single-treatment-arm and small-sample studies of case series with long-term follow-up were not encouraging.In the present circumstances,it is not possible to conclude that the Dynesys dynamic stabilization system is superior to fusion surgery for lumbar degenerative diseases.展开更多
Objective:To analyze the instrumentation-related complications of patients with lumbar degenerative disc diseases(LDD)who underwent minimally invasive transforaminal lumbar interbody fusion(MISTLIF)and to discuss the ...Objective:To analyze the instrumentation-related complications of patients with lumbar degenerative disc diseases(LDD)who underwent minimally invasive transforaminal lumbar interbody fusion(MISTLIF)and to discuss the potential strategy for the control of these complications.Methods:A total of 87 patients with LDD were treated with the MIS-TLIF procedure.Complications,including malposition or breakage of guide pin,percutaneous pedicle screw(PPS)or cages,neurological deficit,and superior-level facet joint violations,were determined during and after the surgery.Computed tomography(CT)was used to evaluate the PPS accuracy and the superior-level facet joint violations.Results:A total of 386 PPSs were used.During the surgery,3(0.8%)guide pin and 1(0.3%)PPS perforated the anterior wall of the vertebral body,respectively.One(0.3%)PPS was pulled out during the reduction of slip.Malposition of the cages occurred in 6(1.6%)PPSs.These were all adjusted accordingly during the surgery.All the patients received>2 years of follow-up.No loosening or breakage of PPS and cage was observed,but CT showed 27(7.0%)PPSs misplaced.No neurological deficit related to misplaced PPS was observed.The total facet joint violation(FJV)rate was 36.2%,with grade 2 and grade 3 violations is 21(12.1%)and 6(3.4%),respectively.Conclusion:MIS-TLIF has similar instrumentation-related complications with open TLIF.Accurate preoperative evaluation and improved surgical techniques can effectively reduce these instrumentation-related complications.展开更多
AIM:To analyze the prevalence of peripapillary intrachoroidal cavitation(PICC)in eyes with gamma peripapillary atrophy(γPPA),in eyes with peripapillary staphyloma(PPS)and in those combiningγPPA and PPS and to analyz...AIM:To analyze the prevalence of peripapillary intrachoroidal cavitation(PICC)in eyes with gamma peripapillary atrophy(γPPA),in eyes with peripapillary staphyloma(PPS)and in those combiningγPPA and PPS and to analyze border tissue discontinuity in PICC.METHODS:This prospective cross-sectional non interventional study included highly myopic eyes.Non-highly myopic eyes were used as control.Radial and linear scans centered on the optic nerve head were performed using spectral-domain optical coherence tomography.Variables were analyzed along the twelve hourly optical coherence tomography sections in both eyes of each subject.RESULTS:A total of 667 eyes of 334 subjects were included:229(34.3%)highly myopic eyes and 438(65.7%)non highly myopic eyes.The mean age of the highly myopic group was 48.99±17.81y.PICC was found in a total of 40 eyes and in 13.2%(29/220)of highly myopic eyes.PICC was found in 10.4%(40/386)of eyes withγPPA,in 20.5%(40/195)of eyes with PPS and in 22.7%(40/176)of those combiningγPPA and PPS.All the eyes with PICC showed the co-existence ofγPPA and PPS whereas none of the eyes presenting only one of these entities exhibited PICC.A border tissue discontinuity in theγPPA area was found in all eyes with PICC.CONCLUSION:We confirm the presence of a border tissue discontinuity in theγPPA area of all eyes with PICC.These findings suggest the involvement of mechanical factors in the pathogenesis of PICC which may contribute to PICC-related visual field defects.展开更多
基金Sichuan provincial health and family planning commission universal application project(17PJ536)Mianyang science and technology bureau(15S-02-9)+1 种基金The health bureau of Mianyang city(2014010)Mianyang health bureau(201310)
文摘Objective: To study the effect of implantable posterior chamber phakic refractive lens (PC-PRL) in the treatment of high myopia and its effect on naked eye vision and retinal complications. Methods: A total of 110 patients (220 eyes) with high myopia admitted to our hospital from June 2017 to February 2019 were selected as subjects. All patients were treated with PC-PRL implantation. The UCVA, BCVA, intraocular pressure, corneal endothelial cell count and intraocular lens position (anterior chamber depth and arch height) were compared before and after the treatment. Results: 6 months after treatment, 68.18% of patients had UCVA between 0.6 and 0.9, 31.81% of patients had UCVA of more than 1.0, and 100.00% of patients had BCVA of more than1.0. The BCVA and UCVA values of patients at 1 week, 1 month, 3 months and 6 months after operation were significantly greater than those before surgery (P<0.05). There were no significant differences in BCVA and UCVA among 1 week, 1 month, 3 months and 6 months after operation (P>0.05). The intraocular pressure was significantly greater than that of the preoperative one week after operation (P<0.05). There was no significant difference between the intraocular pressure at 1 month, 3 months and 6 months after operation (P>0.05). There was no significant difference in corneal endothelial cell count and arch height before and after treatment (P>0.05). The depth of anterior chamber at 3 months and 6 months after operation was significantly less than that before operation (P<0.05). There was no significant difference in the anterior chamber depth between 3 months and 6 months after operation (P<0.05). There were 7 cases of corneal edema, 4 cases of high pressure eyes, 2 cases of refractive regression within 6 months, and 1 case of near-difficulty within 1 month. The total complication rate was 12.73%. Conclusion: PC-PRL implantation is effective in the treatment of high myopia, which can improve the naked eye and correct vision. At the same time, the incidence of retinal complications is low, which can be promoted and applied clinically.
文摘The article discusses the early abandonment of mechanical theories about eye enlargement in degenerative myopia at the turn of the 20th century.At that time,the number of theories about myopia grew unrestricted,but with scant support from the experimental field.The mechanical theories vanished as a new wave of metabolism-based theories appeared,propelled by the huge advances in molecular biology.Modern techniques allow reconsidering those theories and to put them to test with higher confidence.
文摘Background: Type 2 diabetes (T2D) remains a major global public health problem. This complex metabolic disorder can lead to various complications, including cardiovascular diseases (leading cause of death) in T2D. Among the biochemical markers associated with increased risk for cardiovascular disease, homocysteine is currently one of the predictive markers under evaluation. We investigate the link between hyperhomocysteinemia and diabetes complications in DT2 population in Brazzaville. Methodology: We conducted a cross-sectional analytical study, from October to December 2022. One hundred and fifty participants were included, 100 patients T2D (34 with complications, 33 with comorbidities, 33 without), and 50 patients controls. Sociodemographic and clinical characteristics were collected. Homocysteine (Hcy) serum levels were measured using Sandwich ELISA method. Results: Study population was composed of 50% males and 50% females with sex ratio of 1;mean age was 52.2 ± 10.8 years (30 - 83). The prevalence of hyperhomocysteinemia (HHcy) was 36% (20% moderate Hcy, 15% intermediate and 1% severe). Mean Hcy concentration was 31.9 μmol/l (18 - 103). Age, gender and physical inactivity were strongly correlated to Hcy (OR of 3.5;9.4 and 3 respectively). Multivariate analysis showed that HHcy was a risk accelerator for degenerative complications (stroke: OR = 6.2;ischemic heart disease: 4.9;neuropathy: 9.2;retinopathy: 4.5 and peripheral arterial disease: 4.9). Conclusion: These findings suggest that hyperhomocysteinemia can be considered as a predictive marker to be taken into account in targeting cardiovascular risk in Congolese subjects with T2D.
文摘AIM:To investigate the association of axial length(AL)and ocular factors on AL elongation.METHODS:A retrospective chart review of patients who underwent two or more AL examinations for more than two years.Totally 4 groups were divided according to initial AL(<24 mm,24-26 mm,26-28 mm,≥28 mm).Initial fundus photograph was used to find risk factors associated AL elongation.RESULTS:The mean age of the patients was 47.21±7.79 y.AL remained almost unchanged in the groups with AL<24 mm and 24≤AL<26 mm.On the contrary,AL increased by 0.011 mm/y in the group with 26≤AL<28 mm and 0.035 mm/y in the group with AL≥28 mm(P<0.001).In high myopia,AL elongation increased in eye with longer AL(r=0.003,P=0.024),female gender(r=0.014,P=0.019),eye with larger peripapillary chorioretinal atrophic area(r=0.002,P=0.019),and smaller vascular arcade angle(r=-0.004,P=0.006).The risk of elongation 0.03 mm/y in high myopia was increased in female gender(P=0.040),and gradually increased in eye with large peripapillary chorioretinal atrophy area(P<0.01).CONCLUSION:AL elongate significantly in the eye with longer AL,female gender,and the eye with larger atrophic area and smaller arcade angle on fundus photography.
文摘Dynesys,a pedicle-based dynamic stabilization system,was introduced to overcome some undesirable complications of fusion procedures.Nevertheless,the theoretical advantages of Dynesys over fusion have not been clearly confirmed.The purpose of this editorial was to compare clinical and radiological outcomes of patients who underwent Dynesys system with those who underwent posterior lumbar fusion according to the existing literature and to see if the application of the Dynesys system is superior to the traditional lumbar fusion surgery.According to published clinical reports,the short-term effects of the Dynesys dynamic stabilization system are similar to that of traditional lumbar fusion surgery.Three comparative studies of Dynesys dynamic stabilization and fusion surgery with medium-term follow-up are encouraging.However,the results from four single-treatment-arm and small-sample studies of case series with long-term follow-up were not encouraging.In the present circumstances,it is not possible to conclude that the Dynesys dynamic stabilization system is superior to fusion surgery for lumbar degenerative diseases.
基金supported by the National Natural Science Foundation of China(No.81272024).
文摘Objective:To analyze the instrumentation-related complications of patients with lumbar degenerative disc diseases(LDD)who underwent minimally invasive transforaminal lumbar interbody fusion(MISTLIF)and to discuss the potential strategy for the control of these complications.Methods:A total of 87 patients with LDD were treated with the MIS-TLIF procedure.Complications,including malposition or breakage of guide pin,percutaneous pedicle screw(PPS)or cages,neurological deficit,and superior-level facet joint violations,were determined during and after the surgery.Computed tomography(CT)was used to evaluate the PPS accuracy and the superior-level facet joint violations.Results:A total of 386 PPSs were used.During the surgery,3(0.8%)guide pin and 1(0.3%)PPS perforated the anterior wall of the vertebral body,respectively.One(0.3%)PPS was pulled out during the reduction of slip.Malposition of the cages occurred in 6(1.6%)PPSs.These were all adjusted accordingly during the surgery.All the patients received>2 years of follow-up.No loosening or breakage of PPS and cage was observed,but CT showed 27(7.0%)PPSs misplaced.No neurological deficit related to misplaced PPS was observed.The total facet joint violation(FJV)rate was 36.2%,with grade 2 and grade 3 violations is 21(12.1%)and 6(3.4%),respectively.Conclusion:MIS-TLIF has similar instrumentation-related complications with open TLIF.Accurate preoperative evaluation and improved surgical techniques can effectively reduce these instrumentation-related complications.
文摘AIM:To analyze the prevalence of peripapillary intrachoroidal cavitation(PICC)in eyes with gamma peripapillary atrophy(γPPA),in eyes with peripapillary staphyloma(PPS)and in those combiningγPPA and PPS and to analyze border tissue discontinuity in PICC.METHODS:This prospective cross-sectional non interventional study included highly myopic eyes.Non-highly myopic eyes were used as control.Radial and linear scans centered on the optic nerve head were performed using spectral-domain optical coherence tomography.Variables were analyzed along the twelve hourly optical coherence tomography sections in both eyes of each subject.RESULTS:A total of 667 eyes of 334 subjects were included:229(34.3%)highly myopic eyes and 438(65.7%)non highly myopic eyes.The mean age of the highly myopic group was 48.99±17.81y.PICC was found in a total of 40 eyes and in 13.2%(29/220)of highly myopic eyes.PICC was found in 10.4%(40/386)of eyes withγPPA,in 20.5%(40/195)of eyes with PPS and in 22.7%(40/176)of those combiningγPPA and PPS.All the eyes with PICC showed the co-existence ofγPPA and PPS whereas none of the eyes presenting only one of these entities exhibited PICC.A border tissue discontinuity in theγPPA area was found in all eyes with PICC.CONCLUSION:We confirm the presence of a border tissue discontinuity in theγPPA area of all eyes with PICC.These findings suggest the involvement of mechanical factors in the pathogenesis of PICC which may contribute to PICC-related visual field defects.
