Effect of capsule treatment on visual acuity and quality after phacoemulsification lens implantation in myopic patients with cataract

BACKGROUND Cataracts pose a significant clinical burden due to their complex pathogenesis.In recent years,an increase in cataracts coexisting with myopia has heightened the incidence of retinopathy and posterior vitreous detachment.Additionally,symptoms of ocular axis elongation,lens nucleus hardening,and vitreous liquefaction have become more prevalent.While conventional extracapsular cataract extraction is commonly employed,it often yields suboptimal visual outcomes.Subsequent advancements in cataract phacoemulsification and lens implantation surgeries have gained widespread acceptance for their ability to improve refraction and significantly improve uncorrected visual acuity.AIM To investigate the effect of capsular treatment after phacoemulsification lens implantation in myopic patients with cataract.METHODS We selected 110 patients(with 134 eyes)with myopia and cataracts treated.These patients were categorized into two groups:an observation group(57 patients with 70 eyes)and a control group(53 patients with 64 eyes).The control group underwent cataract phacoemulsification and lens implantation,while the observation group received a refined capsular treatment based on the control group’s procedure.We assessed the differences in visual acuity and quality between the two groups before and after surgery.RESULTS At six months post-operation,the observation group exhibited significantly improved far vision,intermediate vision,near vision,lower objective scattering index,higher Modulation transfer function cut-off frequency,and overall vision metrics at different contrast levels(100%,20%and 9%)compared to the control group(P<0.05).The total score of the National Eye Institute Visual Function Questionnaire in the observation group at 6 months after operation was significantly higher than that in the control group(P<0.05).No significant difference in the incidence of adverse reactions was observed between the observation group and control group(P>0.05).CONCLUSION Capsular treatment demonstrates efficacy in improving visual acuity and quality after phacoemulsification lens implantation in myopic patients with cataracts,warranting its clinical application.

OCTA characteristics in non-arteritic central retinal artery occlusion and correlation with visual acuity

AIM:To observe the retinal and choroidal circulations in patients with non-arteritic permanent central retinal artery occlusion(NA-CRAO)via optical coherence tomography angiography(OCTA)and analyze their correlation with visual acuity.METHODS:Sixty-two eyes with clinically confirmed acute NA-CRAO were included in the study and divided into:A type(mild n=29),B type(moderate n=27)and C type(severe n=6)based on the degree of visual loss,retinal edema,and arterial blood flow delay in fundus fluorescence angiography(FFA).Contralateral healthy eyes were used as the control group.Best-corrected visual acuity(BCVA),slit lamp microscopy,indirect ophthalmoscopy,fundus color photography,OCTA,and FFA were performed.Spearman’s correlation analysis was used to determine the correlations between retinal and choroidal vessels and visual acuity.RESULTS:There were no statistically significant differences in age,gender,and intraocular pressure among the three types and the control group(P>0.05).Vessel density in deep capillary plexus(VD-DCP)significantly decreased(P<0.05)in all three types of NA-CRAO patients compared to the control group.Vessel density in superficial vascular plexus(VD-SVP)significantly decreased(P<0.05)in type A patients and choriocapillaris flow area significantly decreased(P<0.05)in type B and type C patients compared to the control group;while outer retinal flow areas significantly increased in the type A(P<0.05)and decreased in type C patients(P<0.05).The retinal thickness significantly increased in type C group(P<0.05).The VD-SVP at fovea in the type A was significantly lower than both of type B and C.The VD-SVP at nasal parafovea in type A and B was significantly lower than type C(P<0.05).The logMAR BCVA of type A was significantly better than that of type B and C groups(P<0.05).Spearman’s correlation analysis showed that the logMAR BCVA was positively correlated with VD-SVP at fovea(r=0.679,P=0.031)and nasal parafovea(r=0.826,P=0.013).CONCLUSION:OCTA is valuable for assessing retinal ischemia,and evaluating visual impairment.Deep retinal vasculature is commonly affected in all NA-CRAO types.VDSVPs at fovea and nasal parafovea can serve as reliable markers of visual impairment in NA-CRAO.

Forensic Study on Objective Evaluation of Visual Acuity of Ametropia with the Event-related Potential P3

Objective In this study,we aimed to assess the characteristics of the P3 component from an event-related potential(ERP)that was induced by visual acuity(VA)processing.Furthermore,we sought to provide electrophysiological evidence for the objective evaluation of VA.Methods We recruited 32 participants with myopia-related ametropia.They reported no other ocular diseases and had an uncorrected VA of 4.0 in both eyes.We used the block letter“E”at different visual angles and orientations as the graphic stimuli.The oddball paradigm,consisting of 4 modules,was used for ERP analysis.The standard stimuli of each module were identical,with a visual angle of 1°15′.The visual angles of the target stimuli were 1°15′,55′,24′,and 15′.The VA test was performed on each eye separately for all participants,and all characteristics of the P3 component were analyzed.Results There was no significant difference in the P3 peak letencies between the target stimulation angle 1°15′group and the 55′group,or between the target stimulation angle 24′group and the 15′group.There was a significant difference in the P3 peak letencies between the target stimulation angle 1°15′group and the 24′group as well as the 15′group.There was a significant difference in the P3 peak letencies between the target stimulation angle 55′group and the 24′group as well as the 15′group.No significant differences were observed in the P3 amplitude between modules.Conclusion In the oddball paradigm,P3 elicitation indicated a cognitive response to the target stimuli.These data showed that the characteristics of P3 can be used as an objective evaluation of VA.

Predicting visual acuity with machine learning in treated ocular trauma patients

AIM:To predict best-corrected visual acuity(BCVA)by machine learning in patients with ocular trauma who were treated for at least 6mo.METHODS:The internal dataset consisted of 850 patients with 1589 eyes and an average age of 44.29y.The initial visual acuity was 0.99 log MAR.The test dataset consisted of 60 patients with 100 eyes collected while the model was optimized.Four different machine-learning algorithms(Extreme Gradient Boosting,support vector regression,Bayesian ridge,and random forest regressor)were used to predict BCVA,and four algorithms(Extreme Gradient Boosting,support vector machine,logistic regression,and random forest classifier)were used to classify BCVA in patients with ocular trauma after treatment for 6mo or longer.Clinical features were obtained from outpatient records,and ocular parameters were extracted from optical coherence tomography images and fundus photographs.These features were put into different machine-learning models,and the obtained predicted values were compared with the actual BCVA values.The best-performing model and the best variable selected were further evaluated in the test dataset.RESULTS:There was a significant correlation between the predicted and actual values[all Pearson correlation coefficient(PCC)>0.6].Considering only the data from the traumatic group(group A)into account,the lowest mean absolute error(MAE)and root mean square error(RMSE)were 0.30 and 0.40 log MAR,respectively.In the traumatic and healthy groups(group B),the lowest MAE and RMSE were 0.20 and 0.33 log MAR,respectively.The sensitivity was always higher than the specificity in group A,in contrast to the results in group B.The classification accuracy and precision were above 0.80 in both groups.The MAE,RMSE,and PCC of the test dataset were 0.20,0.29,and 0.96,respectively.The sensitivity,precision,specificity,and accuracy of the test dataset were 0.83,0.92,0.95,and 0.90,respectively.CONCLUSION:Predicting BCVA using machine-learning models in patients with treated ocular trauma is accurate and helpful in the identification of visual dysfunction.

Characteristics of Pattern Visual Evoked Potential in Two Eyes with Varying Visual Acuity in One Eye and Forensic Application

In this study, we aimed to study the pattern visual evoked potentials （P-VEPs） in two eyes with varying visual acuity in one eye and to provide an objective estimation of visual acuity by comparing P-VEPs in one and two eyes. Thirty subjects were chosen, who had one eye with an acuity of 5.0, 4.85, 4.6, 4.0, or scieropia and obstructed vision and the other eye with an acuity of 5.0, respectively. P-VEPs were detected under the large grating stimuli at 3x4 spatial frequency, moderate grating stimuli （12× 16 spatial frequency） and small grating stimuli （48×64 spatial frequency）. Under large grating stimuli, there was no significant difference in P100 peak latency between the groups, nor was there a significant difference between the amplitude of two eyes and the amplitude of one normal-vision eye. Under moderate and small grating stimuli, there was a significant difference in P100 peak latency between the group with both eyes having an acuity of 5.0 and the group with visual acuity below 4.0 in one eye. There was a significant difference in P100 amplitude between the group with visual acuity of 5.0 in both eyes and the group with one normal-vision eye. There was no significant difference in the amplitude of two eyes and the amplitude of one normal-vision eye between any other two groups. In forensic identification, characteristics and variability of P-VEPs in one and two eyes can be used to identify malingering or decline in visual acuity.

Prognosis value of Chinese Ocular Fundus Diseases Society classification for proliferative diabetic retinopathy on postoperative visual acuity after pars plana vitrectomy in type 2 diabetes

AIM: To compare the postoperative visual acuity among eyes with proliferative diabetic retinopathy(PDR) of different stages after pars plana vitrectomy(PPV) in type 2 diabetic patients. METHODS: A retrospective study was conducted for PDR eyes undergoing PPV in type 2 diabetic patients. All patients were divided into three groups based on Chinese Ocular Fundus Diseases Society(COFDS) classification for PDR: Group A(primary vitreous hemorrhage), Group B(primary fibrovascular proliferation) and Group C(primary vitreous hemorrhage and/or fibrovascular proliferative combined with retinal detachment). The postoperative visual acuity and the change between postoperative and preoperative visual acuity were compared among three groups. The associated risk factors for postoperative visual acuity were analyzed in the univariate and multiple linear aggression. RESULTS: In total, 195 eyes of 195 patients were collected in this study, including 71 eyes of 71 patients in Group A, 75 eyes of 75 patients in Group B and 49 eyes of 49 patients in Group C. The eyes in Group A got better postoperative best-corrected visual acuity(BCVA) compared to the eyes in Group B and C(0.48±0.48 vs 0.89±0.63, P<0.001;0.48±0.48 vs 1.04±0.67, P<0.001;respectively). The eyes in Group A got more improvement of BCVA compared to the eyes in Group B and C(1.07±0.70 vs 0.73±0.68, P=0.004;1.07±0.70 vs 0.77±0.78, P=0.024;respectively). In the multiple linear regression analysis, primary fibro-proliferative type(β=0.194, 95%CI=0.060-0.447, P=0.01), retinal detachment type(β=0.244, 95%CI=0.132-0.579, P=0.02), baseline log MAR BCVA(β=0.192, 95%CI=0.068-0.345, P=0.004), silicone oil tamponade(β=0.272, 95%CI=0.173-0.528, P<0.001) was positively correlated with postoperative log MAR BCVA. Eyes undergoing phacovitrectomy had better postoperative BCVA(β=-0.144, 95%CI=-0.389 to-0.027, P=0.025). CONCLUSION: PDR eyes of primary vitreous hemorrhage type usually have better visual acuity prognosis compared to primary fibrovascular proliferation type and retinal detachment type. COFDS classification for PDR may have a high prognostic value for postoperative visual outcome and surgical management indications.

Valproic acid's effects on visual acuity in retinitis pigmentosa: a systemic review and Meta-analysis

AIM: To gain a better understanding of the overall efficacy of valproic acid(VPA) treatment for retinitis pigmentosa(RP). METHODS: Publications in PubMed, EMBASE, Cochrane Library, Web of Science and Clinicaltrials.gov were searched for clinical trials of patients with RP assigned to treatment with VPA. Patients' pre-and post-treatment visual field(VF) and best-corrected visual acuity(BCVA) scores were extracted and compared to assess changes. RESULTS: A total of 78 reports were retrieved and 6 studies involving 116 patients were included in the Meta-analysis.The combined results showed a significant decrease in logarithm of minimal angle of resolution(logMAR) scores,calculated using baseline and post-treatment BCVA(P<0.00001, mean difference=-0.05, 95%CI:-0.05,-0.04,I2=36%) scores, which means there was considerable improvement in visual acuity. Meanwhile, more BCVA changes were observed in short-term(≤6 mo) treatment studies(P<0.00001, mean difference=-0.05, 95%CI:-0.05,-0.04, I2=38%), studies conducted in Asia(P<0.00001,mean difference=-0.05, 95%CI:-0.05,-0.04, I2=4%), studies with a sample size of 30 or fewer patients(P<0.00001,mean difference=-0.05, 95%CI:-0.05,-0.04, I2=38%) and prospective studies(P<0.00001, mean difference=-0.05,95%CI:-0.05,-0.04, I2=0%). However, VPA's effect on VF was inconsistent across studies(P=0.75, mean difference=-22.76, 95%CI:-160.56, 115.05, I2=68%). CONCLUSION: This Meta-analysis reveals that most RP patients who were treated with VPA showed improvement in BCVA. However, its effect on VF remains inconsistent.VPA may be a promising treatment for RP.

Classification of congenital cataracts based on multidimensional phenotypes and its association with visual outcomes

●AIM:To establish a classification for congenital cataracts that can facilitate individualized treatment and help identify individuals with a high likelihood of different visual outcomes.●METHODS:Consecutive patients diagnosed with congenital cataracts and undergoing surgery between January 2005 and November 2021 were recruited.Data on visual outcomes and the phenotypic characteristics of ocular biometry and the anterior and posterior segments were extracted from the patients’medical records.A hierarchical cluster analysis was performed.The main outcome measure was the identification of distinct clusters of eyes with congenital cataracts.●RESULTS:A total of 164 children(299 eyes)were divided into two clusters based on their ocular features.Cluster 1(96 eyes)had a shorter axial length(mean±SD,19.44±1.68 mm),a low prevalence of macular abnormalities(1.04%),and no retinal abnormalities or posterior cataracts.Cluster 2(203 eyes)had a greater axial length(mean±SD,20.42±2.10 mm)and a higher prevalence of macular abnormalities(8.37%),retinal abnormalities(98.52%),and posterior cataracts(4.93%).Compared with the eyes in Cluster 2(57.14%),those in Cluster 1(71.88%)had a 2.2 times higher chance of good best-corrected visual acuity[<0.7 logMAR;OR(95%CI),2.20(1.25–3.81);P=0.006].●CONCLUSION:This retrospective study categorizes congenital cataracts into two distinct clusters,each associated with a different likelihood of visual outcomes.This innovative classification may enable the personalization and prioritization of early interventions for patients who may gain the greatest benefit,thereby making strides toward precision medicine in the field of congenital cataracts.

Visual acuity evaluation in children with hydrocephalus:An electrophysiological study with sweep visual evoked potential

The objective was to measure the visual acuity (VA) of children with the diagnosis of hydrocephalus with or without peritoneal-ventricular shunt (PVS). A total of 55 children were included in the study (34 Female), with an age range of 0 to 291 weeks. The VA was measured by the sweep visual evoked potential technique. Of those with a PVS, in 31 the ventricular valve was inserted before 15 days after the diagnosis whereas in 14 the ventricular valve was inserted after 15 days. The sweep VEP was performed in all children, 95 exams (94%) were abnormal and only 6 were normal. There was a statistical difference in the VA between children with a PVS inserted before 15 days of the diagnosis and children with a PVS after 15 days (p = 0.038) or those without a shunt (p = 0.031). Children with no complications of the PVS had a better VA as compared to those with shunt complications (p < 0.001). In the group of children with complications, again those who had a shunt inserted be-fore 15 days had better VA results in com- parison to those in whom the shunt was inserted after 15 days (p = 0.029). No statistical difference in the VA was found between children without the PVS and with those in which the shunt was inserted after 15 days of the di-agnosis of hydrocephalus (p = 0.699). We conclude that the delayed insertion of the PVS may compromise the visual development of these children.

DEVELOPMENT OF RETINAL STRUCTURE AND VISUAL ACUITY IN JAPANESE FLOUNDER(PARALICHTHYS OLIVACEUS)

The retinal structure and visual acuity in Japanese flounder Paralichthys olivaceus at different stages of development were examined by light microscopy. The resolving power of the retina, the visual axis and the best visual field were estimated based on the distribution of cone cells in the retina. The visual system of the larvae appears poorly developed at hatching. The larvae with total length (TL) of less than 10 mm, have single cones only and the eyes were well pigmented. At 10-11 mm TL, most single cones fused to form double cones, with the single and double cones forming a mosaic pattern. From larvae to early juvenile the retina stretches, the cones increase in diameter and rods increase in number. Based on the highest density of the cones in the ventro temporal region, the visual axis was orientated up forward. The resolving power of the retina in 40-530 mm TL Japanese flounder was found to range from 25.1 to 11.5 min. The results indicated continual improvements in the visual system of the growing fish towards higher resolving power, visual acuity and sensitivity.

Anti-vascular endothelial growth factor drugs combined with laser photocoagulation maintain retinal ganglion cell integrity in patients with diabetic macular edema: study protocol for a prospective, non-randomized, controlled clinical trial

The integrity of retinal ganglion cells is tightly associated with diabetic macular degeneration that leads to damage and death of retinal ganglion cells,affecting vision.The major clinical treatments for diabetic macular edema are anti-vascular endothelial growth factor drugs and laser photocoagulation.However,although the macular thickness can be normalized with each of these two therapies used alone,the vision does not improve in many patients.This might result from the incomplete recovery of retinal ganglion cell injury.Therefore,a prospective,non-randomized,controlled clinical trial was designed to investigate the effect of anti-vascular endothelial growth factor drugs combined with laser photocoagulation on the integrity of retinal ganglion cells in patients with diabetic macular edema and its relationship with vision recovery.In this trial,150 patients with diabetic macular edema will be equally divided into three groups according to therapeutic methods,followed by treatment with anti-vascular endothelial growth factor drugs,laser photocoagulation therapy,and their combination.All patients will be followed up for 12 months.The primary outcome measure is retinal ganglion cell-inner plexiform layer thickness at 12 months after treatment.The secondary outcome measures include retinal ganglion cell-inner plexiform layer thickness before and 1,3,6,and 9 months after treatment,retinal nerve fiber layer thickness,best-corrected visual acuity,macular area thickness,and choroidal thickness before and 1,3,6,9,and 12 months after treatment.Safety measure is the incidence of adverse events at 1,3,6,9,and 12 months after treatment.The study protocol hopes to validate the better efficacy and safety of the combined treatment in patients with diabetic macula compared with the other two monotherapies alone during the 12-month follow-up period.The trial is designed to focus on clarifying the time-effect relationship between imaging measures related to the integrity of retinal ganglion cells and best-corrected visual acuity.The trial protocol was approved by the Medical Ethics Committee of the Affiliated Hospital of Beihua University with approval No.(2023)(26)on April 25,2023,and was registered with the Chinese Clinical Trial Registry(registration number:ChiCTR2300072478,June 14,2023,protocol version:2.0).

NA-AION患者昼夜血压、外周血ACA变化与BCVA、GC-IPL厚度的相关性

目的分析非动脉炎性前部缺血性视神经病变(NA-AION)患者昼夜血压及外周血抗心凝脂抗体(ACA)变化与最佳矫正视力(BCVA)和视网膜神经节细胞-内丛状层(GC-IPL)厚度的相关性。方法选取沧州市人民医院2021年6月至2022年6月收治的96例NA-AION患者(共96眼)为NA-AION组,另择本院同期50岁以上无眼科疾病的40名体检者纳入对照组。对比两组性别、年龄、昼夜血压变化、外周血ACA、BCVA及GC-IPL厚度差异,并采用多因素Logistic回归分析NA-AION的危险因素;采用pearson相关性分析NA-AION患者昼夜血压、外周血ACA水平及BMI值与BCVA、GC-IPL厚度的相关性;采用spearman相关性分析NA-AION患者血压昼夜节律与BCVA、GC-IPL厚度的相关性。结果NA-AION组高血压、BMI≥25 kg/m^(2)、嗜酒、匹兹堡睡眠指数量表(PSQI)评分>7分、血压昼夜节律异常的比例均大于对照组,且白昼平均收缩压、夜间平均收缩压、舒张压及外周血ACA水平均高于对照组,差异均有统计学意义(P<0.05);多因素Logistis回归分析显示,高血压、BMI≥25 kg/m^(2)、嗜酒、PSQI评分>7分、血压昼夜节律异常、夜间平均收缩压及外周血ACA水平均是NA-AION的独立危险因素(P<0.05)。NA-AION组的BCVA(LogMAR视力)明显高于对照组,GC-IPL厚度明显低于对照组,差异均有统计学意义(P<0.05)。相关性分析显示,NA-AION患者夜间平均收缩压、舒张压及外周血ACA水平及BMI均与BCVA(LogMAR视力)呈正比(P<0.05),与GC-IPL厚度呈反比(P<0.05);血压昼夜节律与BCVA(LogMAR视力)呈反比(P<0.05),与GC-IPL厚度呈正比(P<0.05)。结论血压昼夜节律异常、外周血ACA表达异常及BMI值与NA-AION的发病相关。

Evaluation of the Clinical Efficacy of Full Femtosecond Laser Surgery in the Treatment of Myopia

Objective:To evaluate the clinical effect of full femtosecond laser surgery in the treatment of myopia patients.Methods:120 myopia patients admitted to our hospital from January 2022 to June 2023 were selected.According to the random number table method,60 patients in the observation group underwent full femtosecond laser surgery,and 60 patients in the control group underwent femtosecond laser-assisted in situ keratomileusis(FS-LASIK)surgery.The clinical effects of the two groups were compared.Results:10 days postoperatively and 6 months after operation,the visual acuity level of the observation group was higher than that of the control group,the postoperative corneal asphericity coefficient and corneal full-thickness were lower than those of the control group,and the total effective rate 6 months after operation was higher than that of the control group(P<0.05).Conclusion:Full femtosecond laser surgical treatment can improve the postoperative visual acuity of patients with myopia,enhance the corneal asphericity coefficient(Q)and corneal full-thickness,and exert significant clinical effects.

康柏西普玻璃体腔注射联合二甲双胍及曲安奈德注射液对糖尿病视网膜病变患者BCVA及血糖水平的影响

目的康柏西普玻璃体腔注射联合二甲双胍及曲安奈德注射液对糖尿病视网膜病变(diabetic retinopa⁃thy,DR)患者最佳矫正视力(best corrected visual acuity,BCVA)、血糖水平的影响。方法选取2021年5月—2023年12月日照市中心医院收治的92例DR患者为研究对象,按照治疗方法不同分为两组,各46例。对照组予以二甲双胍及曲安奈德注射液治疗,观察组在对照组基础上联合康柏西普玻璃体腔注射治疗。比较两组BCVA、血糖水平(空腹血糖、餐后2 h血糖、糖化血红蛋白)、血管生长因子(血管内皮生长因子-A、血管内皮生长因子-B)、不良反应(恶心呕吐、失眠、眼内压增高、结膜充血)发生情况。结果治疗后,两组空腹血糖、餐后2 h血糖、糖化血红蛋白水平均低于治疗前,差异有统计学意义(P均<0.05)。治疗后,观察组BCVA高于对照组,血管内皮生长因子-A、血管内皮生长因子-B水平均低于对照组,差异有统计学意义(P均<0.05)。两组不良反应发生率相比,差异无统计学意义(P>0.05)。结论康柏西普玻璃体腔注射联合二甲双胍及曲安奈德注射液能够改善DR患者视力及血管生长因子,降低血糖水平。

Visual outcome after removal of silicone oil in patients undergoing retinectomy for complex retinal detachment

AIM：To evaluate the functional outcome after removal of silicone oil（ROSO）in patients undergoing retinectomy for complex retinal detachment.·M ETHODS：We performed a retrospective case note review of patients who underwent ROSO after retinectomy for complex retinal detachment.Patients with less than 6mo follow up and recurrent retinal detachment following ROSO were excluded.·RESULTS：Thirty-six patients were included.The mean best corrected visual acuity（BCVA）pre-ROSO was1.13 log MAR（SD 0.5）.The mean BCVA 3mo following ROSO was 1.16 log MAR（SD 0.53）,6mo following ROSO1.13（SD 0.63）,and 12mo following ROSO 1.18（SD 0.69）.At 12mo after ROSO,the BCVA improved in 38.9%of patients,remained unchanged in 25%,and deteriorated in 36.1%,although there was no statistical significant difference in BCVA after ROSO at 3,6 and 12mo（=0.93）.The size of retinectomy ranged from 15°to 270°（SD 53）and did not influence the visual outcome（=0.11）.·C ONCLUSION：There was no statistically significant difference in BCVA between pre-and post-ROSO following retinectomy for complex retinal detachment.There was no statistical difference in visual outcome related to the size of the retinectomy.

IVA+PRP治疗增殖性糖尿病视网膜病变的疗效及对视网膜各层次厚度、视力的影响

目的 针对增殖性糖尿病视网膜病变者应用玻璃体腔注射阿柏西普(intravitreous injection of arbacicept, IVA)、全视网膜光凝(panretinal photocoagulation, PRP)的疗效及对视网膜各层次厚度、视力的影响。方法 方便选取2021年9月—2022年9月泰州市中医院收治的96例增殖性糖尿病视网膜病变患者作为研究对象,以随机数表法分为观察组(48例,IVA+PRP治疗)与对照组(48例,PRP治疗),比较两组视网膜各层次厚度、中心黄斑厚度、最佳矫正视力、血清指标、治疗效果、不良事件发生率。结果 术前及术后30 d,两组黄斑区视网膜神经纤维层、神经节细胞层、内丛状层厚度比较,差异无统计学意义(P>0.05)。术前,两组中心黄斑厚度、最佳矫正视力比较,差异无统计学意义(P>0.05);术后30 d,观察组中心黄斑厚度、最佳矫正视力均低于对照组,差异有统计学意义(P<0.05)。术前,两组血清同型半胱氨酸、血清视黄醇结合蛋白4水平比较,差异无统计学意义(P>0.05);术后30 d,观察组血清同型半胱氨酸、血清视黄醇结合蛋白4水平均较对照组低,差异有统计学意义(P<0.05)。观察组治疗有效率97.92%高于对照组83.33%,差异有统计学意义(χ^(2)=4.512,P<0.05)。两组不良事件发生率比较,差异无统计学意义(P>0.05)。结论 对增殖性糖尿病视网膜病变患者实行IVA+PRP治疗,能有效改善中心黄斑厚度,提升其最佳矫正视力,调节其血清指标,其临床治疗效果更理想,可推广。

Amniotic membrane covering promotes healing of cornea epithelium and improves visual acuity after debridement for fungal keratitis

AIM:To investigate the effect of amniotic membrane covering(AMC) on the healing of cornea epithelium and visual acuity for fungal keratitis after debridement.METHODS:Twenty fungal keratitis patients were divided into two groups randomly, the AMC group and the control group, ten patients each group. Both debridement of the infected cornea tissue and standard anti-fungus drugs treatments were given to every patients, monolayer amniotic membrane were sutured to the surface of the entire cornea and bulbar conjunctiva with 10-0 nylon suture for patients in the AMC group.The diameter of the ulcer was determined with slit lamp microscope and the depth of the infiltration was determined with anterior segment optical coherence tomography. Uncorrected visual acuity(UCVA) was tested before surgery and three month after healing of the epithelial layer. The healing time of the cornea epithelium, visual acuity(VA) was compared between the two groups using t- test.RESULTS:There was no statistical difference of the diameter of the ulcer, depth of the infiltration, height of the hypopyon and VA between the two groups beforesurgery(P 】0.05). The average healing time of the AMC group was 6.89 ±2.98 d, which was statistically shorter than that of the control group(10.23±2.78d)(P 【0.05).The average UCVA of the AMC group was 0.138 ±0.083,which was statistically better than that of the control group(0.053±0.068)(P 【0.05).CONCLUSION:AMC surgery could promote healing of cornea epithelium after debridement for fungal keratitis and lead to better VA outcome.

Contrast visual acuity after multifocal intraocular lens implantation: aspheric versus spherical design

AIM: To evaluate contrast visual acuity(CVA) after implantation of an aspheric apodized diffractive intraocular lens(IOL) or a spherical apodized diffractive IOL in cataract surgery. ·METHODS: This prospective randomized controlled study with a 12-month follow-up compared the results of cataract surgery with implantation of an aspheric AcrySof ReSTOR SN6AD3 IOL(30 eyes) and a spherical AcrySof ReSTOR SN60D3 IOL(30 eyes). CVA with best distance correction was measured at 4 contrast levels(100%,25%,10% and 5%) under 3 levels of chart luminance [250,85 and 25 candelas per square meter(cd/m2)] using a multi-functional visual acuity tester(MFVA-100). ·RESULTS: At 12 months after surgery,there were no statistically significant differences in 100% CVA and 25% CVA under 250cd/m2(P100% =0.875 and P25% =0.057) and 85cd/m2(P100% =0.198 and P25% =0.193) between the aspheric group and the spherical group. However,the 10% CVA and 5% CVA were significant better in aspheric group than spherical group under 250cd/m2(P10% =0.042 and P5% = 0.007) and 85cd/m2(P10% =0.002 and P5%=0.039). Under the luminance level of 25cd/m 2,no significant differences was found in the 100% CVA between the 2 group(P100% = 0.245),while aspheric group had better visual acuity in the remaining 3 contracts(P25% =0.023,P10% =0.026 and P5% = 0.002,respectively). ·CONCULSION: The aspheric AcrySof ReSTOR SN6AD3 IOL provided patients with better low-contrast visual acuity than the spherical AcrySof ReSTOR SN60D3 IOL.

Influence of severity and types of astigmatism on visual acuity in school-aged children in southern China

AIM： To investigate the influence of astigmatism on visual acuity in school-aged children, and to define a cutoff for clinically significant astigmatism. METHODS： This is a population-based, cross-sectional study. Among 5053 enumerated children aged 5-15 y in Guangzhou, 3729（73.8%） children aged 7-15 with successful cycloplegic auto-refraction（1% cyclopentolate） and a reliable visual acuity measurement were included. Ocular measurement included external eye, anterior segment, media and fundus and cycloplegic auto-refraction. Primary outcome measures included the relationship between severity and subtypes of astigmatism and the prevalence of visual impairment. Three criteria for visual impairment were adopted： best-corrected visual acuity（BCVA） ≤0.7, uncorrected visual acuity（UCVA） ≤0.5 or 〈0.7 in the right eye.RESULTS： Increases of cylinder power was significantly associated with worse visual acuity（UCVA： β=0.051, P〈0.01; BCVA： β=0.025, P〈0.001）. A substantial increase in UCVI and BCVI was seen with astigmatism of 1.00 diopter（D） or more. Astigmatism ≥1.00 D had a greater BCVI prevalence than cylinder power less than 1.00 D（OR=4.20, 95%CI： 3.08-5.74）, and this was also true for hyperopic, emmetropic and myopic refraction categories. Oblique astigmatism was associated with a higher risk of BCVI relative to with the rule astigmatism in myopic refractive category（OR=12.87, 95%CI： 2.20-75.38）.CONCLUSION： Both magnitude and subtypes of astigmatism influence the prevalence of visual impairment in school children. Cylinder ≥1.00 D may be useful as a cutoff for clinically significant astigmatism.

Comparison of visual acuity of the patients on the first day after sub-Bowman keratomileusis or laser in situ keratomileusis

AIM：To compare recovery of the visual acuity in patients one day after sub-Bowman keratomileusis（SBK）or laser in situ keratomileusis（LASIK）.· METHODS：Data from 5923 eyes in 2968 patients that received LASIK（2755 eyes） or SBK（3168 eyes） were retrospectively analyzed.The eyes were divided into 4groups according to preoperative spherical equivalent：between-12.00 to-9.00 D,extremely high myopia（n =396,including 192 and 204 in SBK and LASIK groups,respectively）;-9.00 to-6.00 D,high myopia（n=1822,including 991 and 831 in SBK and LASIK groups,respectively）,-6.00 to-3.00 D,moderate myopia（n=3071,including 1658 and 1413 in SBK and LASIK groups,respectively）,and-3.00 to 0.00 D,low myopia（n =634,including 327 and 307 in SBK and LASIK groups,respectively）.Uncorrected logMAR visual acuity values of patients were assessed under standard natural light.Analysis of variance was used for comparisons among different groups.· RESULTS：Uncorrected visual acuity values were0.0115±0.1051 and 0.0466±0.1477 at day 1 after operation for patients receiving SBK and LASIK,respectively（P〈0.01）;visual acuity values of 0.1854±0.1842,0.0615±0.1326,-0.0033±0.0978,and-0.0164±0.0972 were obtained for patients in the extremely high,high,moderate,and low myopia groups,respectively（P〈0.01）.In addition,significant differences in visual acuity at day 1 after operation were found between patients receiving SBK and LASIK in each myopia subgroup.· CONCLUSION：Compared with LASIK,SBK is safer and more effective,with faster recovery.Therefore,SBK is more likely to be accepted by patients than LASIK for better uncorrected visual acuity the day following operation.