Influence of lens position as detected by an anterior segment analysis system on postoperative refraction in cataract surgery

AIM:To predict postoperative intraocular lens(IOL)position using the Sirius anterior segment analysis system and investigate the effect of lens position and IOL type on postoperative refraction.METHODS:A total of 97 patients(102 eyes)were enrolled in the final analysis.An anterior segment biometry measurement was performed preoperatively with Sirius and Lenstar.The results of predicted lens position(PLP)and IOL power were automatically calculated by the software used by the instruments.Effective lens position(ELP)was measured manually using Sirius 3 mo postoperatively.Pearson's correlation analysis and linear regression analysis were used to determine the correlation of lens position to other parameters.RESULTS:PLP and ELP were positively correlated to axial length(AL;r=0.42,P<0.0001 and r=0.49,P<0.0001,respectively).There was a weak correlation between the peLP(ELP-PLP)and the prediction error of spherical refraction(peSR;r=0.34,P<0.0001).The peLP of Softec HD IOL differed statistically from those of both the TECNIS ZCB00 and Sensor AR40E IOLs.Multiple linear regression was used to obtain the prediction formula:ELP=0.66+0.63×[aqueous depth(AQD)+0.6 LT](r=0.61,P<0.0001),and a new variable(AQD+0.6 LT)was found to have the strongest correlation with ELP.CONCLUSION:The Sirius anterior segment analysis system is helpful to predict ELP,which reduces postoperative refraction error.

Bibliometric analysis of research relating to refractive cataract surgery over a 20-year period:from 2003 to 2022

AIM:To investigate the research trend on refractive cataract surgery,compare the contributions of different countries,institutions,journals,and authors in the past 20y,and explore its potential research hotspots.METHODS:All publications were extracted relating to refractive cataract surgery from 2003 to 2022 from Web of Science.Document types were limited to original articles and reviews,and the language was limited to English.Quantitatively and qualitatively of the publications were analyzed through Microsoft Excel and GraphPad Prism.VOSviewer and CiteSpace were used for bibliometric and visualized analysis.RESULTS:A total of 2090 publications were enrolled.The United States contributed the most publications(434,20.8%),followed by China(345,16.5%)and England(163,7.80%).Publications from the United States were cited more frequently(9552 citations)with the highest H-index of 48.China ranked second in the total number of publications,the papers were not cited that frequently(3237 citations),and the H-index ranked sixth(H-index=29).Journal of Cataract and Refractive Surgery published the most papers(333,15.9%),and the University of London had the highest number of publications(75,3.59%).Dick HB from Germany published the most papers.Corneal astigmatism-related research,cataract surgery methodrelated research,postoperative visual-quality relate to research,and postoperative complications-relate research are the hotspots in this field.The most significant limitation was that the database was updated frequently and the latest publications were not included.CONCLUSION:The bibliometric analysis shows a brief summarization of the contribution of the authors,institutions,countries,and journals.Corneal astigmatism,cataract surgery method,postoperative visual-quality and postoperative complications related researches have become the emerging hotspots,which can give a direction in the future researches.

Mutual comparative analysis:a new topography-guided custom ablation protocol referencing subjective refraction to modify corneal topographic data

Background:Several planning algorithms have been developed for topography-guided custom ablation treatment(T-CAT),but each has its own deficiencies.The purpose of this study is to demonstrate the potential of a novel mutual comparative analysis(MCA)informed by manifest refraction and corneal topographic data and the patient's subjective perception in correcting ametropia.Methods:This retrospective review included patients with significant preoperative diferences in the power or axis of astigmatism according to the manifest refraction and corneal topographic data(power>0.75 D and/or axis>10°).T-CAT planning was designed using MCA.Follow-ups were conducted for at least 6 months.Results:Seventy-nine patients(121 eyes)were included.The mean preoperative deviation in the astigmatic power and axis were 0.72±0.43 D and 20.18±23.68°,respectively.The average oculus residual astigmatism(ORA)was 0.81±0.32 D(range:0.08-1.66 D).Six months postoperatively,the mean spherical equivalent refraction was 0.04±0.42 D,and the mean cylinder was-0.27±0.24 D.The mean efficacy and safety indices were 1.10 and 1.15,respectively.The uncorrected distance visual acuity in 92%of the eyes was the same or better than the corrected distance visual acuity.The angle of error was±5°in 61%of eyes and±15°in 84%of eyes.Residual astigmatism was≤0.5 D in 91%of eyes.Optical quality and photopic contrast sensitivity did not change significantly(P>0.05),and the scotopic contrast sensitivity decreased at 3,6,and 12 cpd(P<0.05).The vertical coma and horizontal coma of the anterior corneal surface significantly decreased postoperatively but increased during follow-up.Conclusions:The MCA was demonstrated safety,ficacy,accuracy,predictability,and stability and can be used as a complementary and feasible method for T-CAT.

Mutual comparative analysis:a new topography-guided custom ablation protocol referencing subjective refraction to modify corneal topographic data

Background:Several planning algorithms have been developed for topography-guided custom ablation treatment(T-CAT),but each has its own deficiencies.The purpose of this study is to demonstrate the potential of a novel mutual comparative analysis(MCA)informed by manifest refraction and corneal topographic data and the patient’s subjective perception in correcting ametropia.Methods:This retrospective review included patients with significant preoperative differences in the power or axis of astigmatism according to the manifest refraction and corneal topographic data(power>0.75 D and/or axis>10°).T-CAT planning was designed using MCA.Follow-ups were conducted for at least 6 months.Results:Seventy-nine patients(121 eyes)were included.The mean preoperative deviation in the astigmatic power and axis were 0.72±0.43 D and 20.18±23.68°,respectively.The average oculus residual astigmatism(ORA)was 0.81±0.32 D(range:0.08–1.66 D).Six months postoperatively,the mean spherical equivalent refraction was 0.04±0.42 D,and the mean cylinder was−0.27±0.24 D.The mean efficacy and safety indices were 1.10 and 1.15,respectively.The uncorrected distance visual acuity in 92%of the eyes was the same or better than the corrected distance visual acuity.The angle of error was±5°in 61%of eyes and±15°in 84%of eyes.Residual astigmatism was≤0.5 D in 91%of eyes.Optical quality and photopic contrast sensitivity did not change significantly(p>0.05),and the scotopic contrast sensitivity decreased at 3,6,and 12 cpd(p<0.05).The vertical coma and horizontal coma of the anterior corneal surface significantly decreased postoperatively but increased during follow-up.Conclusions:The MCA demonstrated safety,efficacy,accuracy,predictability,and stability and can be used as a complementary and feasible method for T-CAT.

Correlation analysis and multiple regression formulas of refractive errors and ocular components

The multiple regression formulas and correlation of ocular components with refractive errors are presented by Gaussian optics. The refractive error changing rate for the cornea and lens power, the axial length, anterior chamber depth(ACD) and vitreous chamber depth(VCD) are calculated, including nonlinear terms for more accurate rate functions than the linear theory. Our theory, consistent with the empirical data, shows that the Pearson correlation coefficients for spherical equivalent(SE) and ocular components are highest for SE with axial length, ACD and VCD and weakest for corneal power, lens power and lens thickness. Moreover, our regression formulas show the asymmetric feature of the correlation that the axial length, ACD and VCD are more strongly correlated(with higher negative regression constants) with refractive errors in eyes with hyperopia than in eyes with myopia, particularly for severe hyperopia.

Human eye ocular component analysis for refractive state and refractive surgery

AIM： To analyze the clinical factors influencing the human vision corrections via the changing of ocular components of human eye in various applications; and to analyze refractive state via a new effective axial length.METHODS： An effective eye model was introduced by the ocular components of human eye including refractive indexes, surface radius（r1, r2, R1, R2） and thickness（t, T） of the cornea and lens, the anterior chamber depth（S1） and the vitreous length（S2）. Gaussian optics was used to calculate the change rate of refractive error per unit amount of ocular components of a human eye（the rate function M）. A new criterion of myopia was presented via an effective axial length.RESULTS： For typical corneal and lens power of 42 and 21.9 diopters, the rate function Mj（j=1 to 6） were calculated for a 1% change of r1, r2, R1, R2, t, T（in diopters） M1=＋0.485, M2=-0.063, M3=＋0.053, M4=＋0.091, M5=＋0.012, and M6=-0.021 diopters. For 1.0 mm increase of S1 and S2, the rate functions were M7=＋1.35, and M8=-2.67 diopter/mm, respectively. These rate functions were used to analyze the clinical outcomes in various applications including laser in situ keratomileusis surgery, corneal cross linking procedure, femtosecond laser surgery and scleral ablation for accommodation.CONCLUSION： Using Gaussian optics, analytic formulas are presented for the change of refractive power due to various ocular parameter changes. These formulas provide useful clinical guidance in refractive surgery and other related procedures.

Two-Dimensional Variational Analysis of Near-Surface Moisture from Simulated Radar Refractivity-Related Phase Change Observations

Because they are most sensitive to atmospheric moisture content, radar refractivity observations can provide high-resolution information about the highly variable low-level moisture field. In this study, simulated radar refractivity-related phase-change data were created using a radar simulator from realistic highresolution model simulation data for a dryline case. These data were analyzed using the 2DVAR system developed specifically for the phase-change data. Two sets of experiments with the simulated observations were performed, one assuming a uniform target spacing of 250 m and one assuming nonuniform spacing between 250 m to 4 km. Several sources of observation error were considered, and their impacts were examined. They included errors due to ground target position uncertainty, typical random errors associated with radar measurements, and gross error due to phase wrapping. Without any additional information, the 2DVAR system was incapable of dealing with phase-wrapped data directly. When there was no phase wrapping in the data, the 2DVAR produced ex- cellent analyses, even in the presence of both position uncertainty and random radar measurement errors. When a separate pre-processing step was applied to unwrap the phase-wrapped data, quality moisture anal- yses were again obtained, although the analyses were smoother due to the reduced effective resolution of the observations by interpolation and smoothing involved in the unwrapping procedure. The unwrapping procedure was effective even when significant differences existed between the analyzed state and the state at a reference time. The results affirm the promise of using radar refractivity phase-change measurements for near-surface moisture analysis.

Fixed combination of latanoprost and timolol vs the individual components for primary open angle glaucoma and ocular hypertension:a systematic review and meta-analysis

AIM:To assess the effects of the fixed combination of0.005% latanoprost and 0.5% timolol(FCLT) vs their individual components for primary open angle glaucoma(POAG) and ocular hypertension(OHT).· METHODS:After searched PubMed, EMBASE, the Cochrane Library and SCI, all randomized controlled clinical trials(RCTs) and cross-over studies were included. The control groups were the monotherapy or the concomitant therapy of latanoprost and timolol. The outcomes were visual field defect, optic atrophy, mean intraocular pressure(IOP) and IOP fluctuation. The analysis was carried out in RevMan version 5.1 software.RESULTS:Thepost-interventionmeanIOPofFCLTwas significantly lower compared to timolol [mean difference(MD)-2.92, 95%CI-3.28 to-2.55, P 【0.00001] and latanoprost(MD-1.11, 95%CI-1.51 to-0.72, P 【0.00001). The postintervention IOP fluctuation was also significantly lower compared to timolol(MD-0.88, 95%CI-1.23 to-0.53, P 【0. 00001) and latanoprost( MD- 0. 63, 95 % CI- 1. 04to-0.22, P =0.002). The mean IOP was higher in FCLT morning dose group than the one in unfixed combination of 0.005% latanoprost and 0.5% timolol(UFCLT)(MD1.10, 95% CI 0.81 to 1.39, P 【0.00001). Otherwise, there was no difference between FCLT evening dose group and UFCLT(MD 0.34, 95% CI-0.01 to 0.69, P =0.06).There was no statistical difference for the incidence ofvisual field defect and optic atrophy between FCLT and the monotherapy of components.CONCLUSION:A better IOP lowering effect has been demonstrated for FCLT compared to the monotherapy of components. The IOP lowering effect was worse for FCLT morning dose and almost same for FCLT evening dose compared to the UFCLT. We need more long-term high quality RCTs to demonstrate the outcomes of visual field defect and optic atrophy.visual field defect and optic atrophy between FCLT and the monotherapy of components.CONCLUSION:A better IOP lowering effect has been demonstrated for FCLT compared to the monotherapy of components. The IOP lowering effect was worse for FCLT morning dose and almost same for FCLT evening dose compared to the UFCLT. We need more long-term high quality RCTs to demonstrate the outcomes of visual field defect and optic atrophy.

Efficacy and safety of 0.0015% tafluprost versus 0.005% latanoprost in primary open angle glaucoma, ocular hypertension: a Meta-analysis

AIM:To evaluate the intraocular pressure(IOP)-lowering efficacy and safety of tafluprost 0.0015%eye drops[benzalkonium chloride(BAK)0.1 mg/mL]compared with that of latanoprost 0.005%eye drops(BAK 0.2 mg/mL)for primary open angle glaucoma(POAG)and ocular hypertension(OHT).METHODS:All the randomized controlled trials(RCTs)about treating POAG and OHT comparing tafluprost and latanoprost were collected by searching PubMed,Embase,Cochrane Library,CNKI and VIP.The outcomes of interest to evaluate the clinical efficacy and adverse effects included IOP and patient-related drop discomfort.RESULTS:Five RCTs involving 888 glaucoma patients were included.The results showed that,1)at the end of the study,no statistically significant differences were observed in IOP reduction[standard mean difference(SMD)=0.48,95%CI 0.07 to 0.88,P=0.085]between tafluprost and latanoprost;2)No statistically significant differences were observed in adverse events of foreign-body sensation[relative risk(RR)=0.62,95%CI 0.26 to 1.46,P=0.269],eye irritation(RR=1.16,95%CI 0.49 to 2.75,P=0.744),eye pain(RR=2.000,95%CI 0.949 to 4.216,P=0.07),iris hyperpigmentation(RR=0.741,95%CI 0.235 to 2.334,P=0.61),dry eye(RR=1.154,95%CI 0.409 to 3.256,P=0.79)and eye pruritus(RR=1.600,95%CI 0.536 to 4.774,P=0.4)between tafluprost and latanoprost.However,tafluprost showed more reported incidence of conjunctival hyperaemia than latanoprost(RR=2.11,95%CI 1.24 to 3.59,P=0.006).CONCLUSION:Tafluprost 0.0015%eye drops(BAK 0.1 mg/mL)and latanoprost 0.005%eye drops(BAK 0.2 mg/mL)are comparable in lowering IOP for open angle glaucoma(OAG)and OHT.It does not differ in the incidence of foreign-body sensation,eye irritation,eye pain,iris hyper-pigmentation,dry eye and eye pruritus,but tafluprost shows less ocular tolerability because of more incidence of conjunctival hyperaemia.

Negative refraction and reflection of Gaussian beam on two-dimensional photonic crystal slab

The refraction and reflection of Gaussian beam on two-dimensional photonic crystal （2DPC） slab are studied by the finite-difference time-domain （FDTD） method. It is shown that 2DPC slab enables negative refraction, which is demystified by the distribution of Poynting vector directions and values inside the 2DPC. A negative Goos-Haenchen shift is also found in the simulation.

Ray hit analysis method and its application to complex upper crustal structure survey

Based on the results obtained from Pg wavefront imaging in active source deep seismic sounding, we propose a new ray hit analysis method for high-resolution seismic refraction profile data processing. This method can be used to further determine possible refraction interface, especially spatial location of basement and its pattern characteristics in complex upper crustal structure region, making data processing for high-resolution refraction profiles more fine. We use this method to study the crystalline basement structure of east part of A＇nyemaqên suite zone at northeast side of Qinghai-Xizang Plateau and the basement patterns as well as its spreading features at the east part of Anemaqen suite zone and its adjacent region were determined.

Prevalence and inconformity of refractive errors and ocular biometry of 3573 medical university freshman students for 4 consecutive years

AIM:To evaluate the prevalence of refractive errors and ocular biometry in 3573 freshman students at Tianjin Medical University for 4 consecutive years.METHODS:In this university-based, cross-sectional study, comprising 3573 students, visual acuity(VA), slitlamp examination, non-cycloplegic auto-refraction, and ocular biometry were recorded.RESULTS:The prevalence of myopia increased annually, from 2017 to 2020 were 93.5%, 94.5%, 95.9%, and 96.2%, respectively(P=0.03), and the prevalence of high myopia was 25.7%, 26.9%, 28.6%, and 28.6%, respectively. Males tended to have a higher percentage of total astigmatism than females, with astigmatism ≥0.75 and ≥1.0 D criteria. The percentage of with-the-rule astigmatism, against-therule astigmatism, and oblique astigmatism was 90.3%, 5.8%, and 3.9%, respectively, with astigmatism ≥1.00 D criteria. The mean spherical equivalent, axial length(AL), central corneal thickness(CCT), anterior chamber depth(ACD), lens thickness(LT), corneal radius(CR), and lens position(LP) were 4.37±2.52 D, 25.28±1.24 mm, 539.49±34.98 μm, 3.31±0.34 mm, 3.47±0.21 mm, 7.8±0.28 mm, and 5.04±0.32 mm, respectively. With diopter increase in myopia, the AL became longer, CR became steeper, ACD became deeper, LT became thinner, and LP became more posterior(all P<0.01). Females had a shorter AL, thinner CCT, smaller CR, shallower ACD, thicker lens, and more anterior LP than males(P<0.01). The 64% of high myopia had AL≥26 mm, meanwhile, 5.8% mild myopia and 21.1% moderate myopia had AL≥26 mm. With AL≥26 mm, mild and moderate myopia compared to high myopia, AL was shorter(26.51±0.46 vs 26.87±0.70 mm), CR was larger(8.10±0.3 vs 7.85±0.23 mm) and LT was thinner(3.39±0.19 vs 3.45±0.19 mm, P<0.001).CONCLUSION:The prevalence of myopia and high myopia is significantly high in freshman students. The majority of astigmatism is with-the-rule. Inconformity of refractive errors and ocular biometry existed in some students. Attention should be paid to the ocular biometry of myopia.

Current applications of machine learning in the screening and diagnosis of glaucoma: a systematic review and Meta-analysis

AIM: To compare the effectiveness of two well described machine learning modalities, ocular coherence tomography(OCT) and fundal photography, in terms of diagnostic accuracy in the screening and diagnosis of glaucoma. METHODS: A systematic search of Embase and Pub Med databases was undertaken up to 1 st of February 2019. Articles were identified alongside their reference lists and relevant studies were aggregated. A Meta-analysis of diagnostic accuracy in terms of area under the receiver operating curve(AUROC) was performed. For the studies which did not report an AUROC, reported sensitivity and specificity values were combined to create a summary ROC curve which was included in the Meta-analysis.RESULTS: A total of 23 studies were deemed suitable for inclusion in the Meta-analysis. This included 10 papers from the OCT cohort and 13 from the fundal photos cohort. Random effects Meta-analysis gave a pooled AUROC of 0.957(95%CI=0.917 to 0.997) for fundal photos and 0.923(95%CI=0.889 to 0.957) for the OCT cohort. The slightly higher accuracy of fundal photos methods is likely attributable to the much larger database of images used to train the models(59 788 vs 1743). CONCLUSION: No demonstrable difference is shown between the diagnostic accuracy of the two modalities. The ease of access and lower cost associated with fundal photo acquisition make that the more appealing option in terms of screening on a global scale, however further studies need to be undertaken, owing largely to the poor study quality associated with the fundal photography cohort.

Structural and optical analysis of Cr_2N thin films prepared by DC magnetron sputtering

Chromium nitride （Cr2N） thin films were prepared by a DC magnetron sputtering technique. The deposition temperature was raised from 50 to 300℃, and its influence on the film structure and refractive index was investigated. X-ray diffraction analysis shows that the crystalline strucure of the films transforms from the （101） to （002） oriented hexagonal CrzN phase as the increase of substrate tempera- ture above 50℃, and a highly texatred film grows at 100℃. An empirical relation between the crystalline orientation and infrared active modes of the films is obtained, i.e., the Fourier transform infrared （FTIR） spectrum of the film prepared at 50℃ exhibits only A1 （TO） mode. The prominent peak in the FTIR spectra of the film prepared above 50℃is assigned to the E1 （TO） mode and is correlated with the （002） or c-axis oriented hexagonal wurtzite phase of Cr2N. In the surface analysis of atomic force microscopy, a transformation from the featureless surface to columnar-type morphology is observed with the increase of substrate temperature from 50 to 100℃, exhibiting c-axis oriented crystallite growth. A further increase in substrate temperature to 200℃ causes the c-axis crystallites to merge, resulting in the formation of voids. The refractive index （n） of the deposited films is obtained using spectroscopic ellipsometry.

The 100 most influential articles in myopia:a bibliometric analysis

AIM:To identify and characterize the 100 most influential articles in the field of myopia over the last decades.METHODS:Articles on myopia published between January 1975 and March 2020 were searched through the Web of Science Core Collection database.Two independent authors reviewed and determined the 100 most cited articles.The characteristics of each eligible article were recorded,including authors,institutions,countries,journals,publication date,total citations(TCs),annual citations(ACs),research focus and article type.RESULTS:The top 100 most influential articles were published between 1983 and 2016,with 1999 as the most prolific year.The mean number of TCs was 288(range:193-537)and the mean number of ACs was 19(range:7-109).Treatment and epidemiology of myopia were the most important research focus.These articles were published in 21 journals led by Ophthalmology(29%)followed by Investigative Ophthalmology&Visual Science(23%).The number of ACs for articles published in the last ten years was significantly higher than that for the other most-cited articles(44 vs 16,Mann-Whitney U test P<0.01).There is no difference in the number of TCs between original articles and review articles,while the number of ACs for review articles was significantly higher than that for original articles(22 vs 17,Mann-Whitney U test P<0.05).CONCLUSION:This bibliometric analysis can provide us with concise information about the development trend of research in the field of myopia in the past few decades,and provide an important reference for researchers to guide future research.

Bibliometric analysis of glaucoma-related literature based on SCIE database:a 10-year literature analysis from 2009 to 2018

AIM:To explore the global trends and focus of glaucoma research from 2009 to 2018.METHODS:Searching for glaucoma-related articles published in Science Citation Index Expanded(SCIE)database during 2009-2018,and describing the distribution of the published year,countries,authors,institutions,funding agencies,journals,impact factor,citation and hot research topic of articles by using bibliometric methods.Meanwhile,we compared some of these indicators over two five-year periods,from 2009 to 2013 and from 2014 to 2018.RESULTS:A total of 19609 glaucoma-related articles were retrieved and the global SCIE articles have increased yearly from 2009 to 2018.The USA was the pioneer which has made great contributions.China kept the second place and the number of publications has increased rapidly between 2014 and 2018.The author with the highest number of publications was Weinreb,RN.Co-occurrence maps were built amongst the top 50 authors or the top 50 institutions with the most articles,which visualize the closer collaboration of international authors or institutions.The journal Investigative Ophthalmology&Visual Science has published the most papers.Glaucoma literature with an impact factor of 3-5 points accounted for the largest proportion(28.96%).The most frequently cited paper had 798 citations.The top three hot areas on glaucoma were intraocular pressure,optical coherence tomography(OCT)and retinal ganglion cells.And trabecular meshwork,primary angle-closure glaucoma and Spectral-domain OCT have become new hot research topics in recent five years during 2014-2018.CONCLUSION:Bibliometric analysis is an effective method to describe the global literature on glaucoma.In a 10-year literature survey from 2009 to 2018,global glaucoma research has developed in a balanced manner,and the cooperation between various institutions and teams has become closer.Glaucoma-related pathogenesis research,imaging examinations of OCT and surgery therapy have attracted most attention.

Application of rigorous coupled-wave theory on quality analysis of natural jadeite

In order to make more available methods for natural jadeite quality evaluation,this study applied rigorous coupled wave theory to calculate and simulate the reflection characteristics of various natural jadeites,and establish evaluation standard based on the relationship between refractive index and reflectivity and responses of reflection efficiency to refractive index,grating thickness and incident angles,etc.The results suggest that reflection efficiency varies significantly as a function of the natural jadeite quality,which can provide a new method to evaluate natural jadeite.

基于列线图建立儿童双眼屈光不均衡的风险因素模型及应用价值探讨

目的探讨儿童双眼屈光不均衡的风险因素。方法回顾性分析2020年1月—2022年12月在江苏大学附属医院眼科接受视力检查的156例儿童的临床资料,根据检查结果分为屈光正常组82例和屈光不均衡组74例。收集两组儿童的性别、年龄、体质量指数、睡眠时间、用眼时间、阅读距离、眼部家族病史等资料;采用眼科光学生物测量仪和角膜地形图仪等仪器检测两组儿童的视力测试指标,包括眼压、角膜前表面平均屈光力、等效球镜度、眼轴长度、瞳孔直径、功能性光学区、球差和彗差;采用多因素Logistic回归模型分析筛选儿童双眼屈光不均衡的风险因素,构建列线图预测模型,并评价模型的拟合效果。结果屈光不均衡组儿童的用眼时间更长(P<0.05),眼部疾病家族史比例、双眼眼压、屈光力、等效球镜度、眼轴长度和瞳孔直径的差值及高阶像差均高于屈光正常组(P<0.05),而每日睡眠时间、阅读距离和功能性光学区均低于屈光正常组(P<0.05)。多因素Logistic回归分析结果显示,眼部家族病史[OR=13.523(95%CI:3.358,54.461)]、睡眠时间[OR=0.064(95%CI:0.023,0.179)]、用眼时间[OR=21.424(95%CI:6.121,74.983)]、阅读距离[OR=0.087(95%CI:0.036,0.211)]、眼压差值[OR=86.960(95%CI:14.687,514.897)]、角膜屈光力差值[OR=1.736(95%CI:1.043,2.890)]、等效球镜度差值[OR=12.937(95%CI:4.300,38.925)]、眼轴长度差值[OR=29.077(95%CI:10.166,83.170)]、瞳孔直径差值[OR=14.179(95%CI:4.880,41.198)]、功能性光学区差值[OR=0.495(95%CI:0.291,0.844)]、球差[OR=68.843(95%CI:16.304,290.687)]、彗差[OR=2.085(95%CI:1.007,4.318)]均是儿童双眼不均衡的风险因素(P<0.05)。结论儿童的用眼习惯和眼部检测指标均是影响其双眼屈光不均衡的重要因素,针对这些因素可以及时采取干预措施,防止儿童屈光异常的发生。

儿童近视发生前后的屈光度和眼生物参数变化:安阳儿童眼病研究

目的分析小学生5年间的屈光度和眼生物参数变化趋势,探讨其在近视发生前后的变化规律。方法采用队列研究方法,以“安阳儿童眼病研究”中的1年级小学生为研究对象,共纳入1986人,其中男生1126人,女生860人,均取右眼数据进行分析。每年采用1%环戊通滴眼液进行睫状肌麻痹后电脑验光获得等效球镜度(SE),采用眼生物测量仪测量眼轴长度(AL)、前房深度、晶状体厚度、平均角膜曲率(Km)等,采用Bennett公式计算晶状体屈光力(LP)。根据随访时近视发生情况将受检者分为持续近视组、非近视组和新发近视组,又根据发病年龄将新发近视组细分为8岁近视组、9岁近视组、10岁近视组、11岁近视组和12岁近视组,比较各组屈光度和眼生物参数在不同随访时间点的差异。结果随着年龄增加,所有儿童的屈光度均逐渐向近视漂移、眼轴逐渐增长,各组内相邻随访年龄间SE和AL比较,差异均有统计学意义(均P<0.05)。在相同随访年龄下,近视发生越早,其近视屈光度数越高,AL越长;各相邻组间SE比较差异均有统计学意义(均P<0.05);8~12岁随访年龄下各相邻组间AL比较,差异均有统计学意义(均P<0.05)。在非近视组,屈光度以缓慢均匀的速度向正视漂移,5年平均SE变化速度为(-0.23±0.27)D/年,AL亦缓慢均匀增长,5年平均增长速度为(0.18±0.13)mm/年;在新发近视组中,近视发生前第3年、第2年和第1年的SE年变化量分别为(-0.32±0.25)、(-0.45±0.33)和(-0.98±0.44)D,AL年增长量分别为(0.25±0.12)、(0.32±0.15)和(0.48±0.19)mm,SE和AL变化速度均在近视发生前开始加快,并于近视发生后变缓,各近视前后不同时间段SE和AL变化速度总体比较差异均有统计学意义(均P<0.001)。新发近视组中发生近视时男生的AL为(24.11±0.70)mm,明显长于女生的(23.60±0.66)mm,差异有统计学意义(t=159.71,P<0.001)。LP随年龄增加而下降,9岁前下降速度较快,9岁后下降速度变缓。持续近视组和8~11岁近视组的LP平均下降速度分别为(-0.48±0.19)、(-0.44±0.20)、(-0.49±0.16)、(-0.51±0.18)、(-0.48±0.19)D/年,明显快于12岁近视组的(-0.42±0.17)D/年和非近视组的(-0.37±0.15)D/年,差异均有统计学意义(均P<0.05)。各组不同随访年龄Km比较差异均无统计学意义(均P>0.05)。结论AL在儿童近视发生的前3年内开始加速增长,在近视发生后增长速度逐渐变缓,但仍明显快于非近视儿童;在此过程中,LP下降起到一定的代偿作用,Km无显著变化。相同年龄下男生发生近视时的AL比女生长。AL是近视防控的重要指标,评估时要考虑性别差异,更要关注AL的增长速度。

28例猫高血压眼病的回顾性分析

为了探究猫高血压眼病的临床病例特征、治疗方法和转归,本文对2018年1月—2022年12月在中国农业大学动物医院就诊的28例猫高血压眼病病例进行了回顾性分析,归纳总结了患猫的发病年龄、品种、性别、眼部症状、初诊血压、伴发疾病、治疗方法、治疗后血压和眼部症状转归。结果显示,所纳入患猫71.4%(20/28)为家养短毛猫和家养长毛猫,平均诊断年龄为16岁,其中英国短毛猫和异国短毛猫确诊年龄显著小于家养短毛猫和家养长毛猫(P<0.05);雄性和雌性患猫占比均为50.0%(14/28);75.0%(21/28)患猫首诊时双眼失明,眼科检查异常表现包括:视网膜脱离(64.3%,18/28)、视网膜出血(57.1%,16/28)、眼内炎(57.1%,16/28)、玻璃体溢出(3.6%,1/28)和前房积血(3.6%,1/28),患猫出现失明至就诊的平均时间为43 d(范围:2~365 d);初诊时平均收缩压为238 mmHg(范围:186~300 mmHg);患猫系统性高血压的病因调查结果显示,11.5%(3/26)为特发性高血压,69.2%(18/26)继发于慢性肾病,15.4%(4/26)继发于甲状腺机能亢进,3.8%(1/26)继发于肾上腺肿物。18只患猫口服氨氯地平进行治疗,2只患猫口服甲巯咪唑进行治疗。15只患猫进行了眼科复查,5只患猫视网膜重新贴附,其中3只患猫双眼和1只患猫单眼威胁反应恢复阳性,视网膜重新贴附比例随着眼部异常持续时间增加而降低,其中视网膜重新贴附患猫的初诊收缩压显著高于视网膜未贴附患猫(P<0.05)。由于老年猫高血压发病率高,眼睛是高血压损伤的靶器官,因此建议老年猫定期体检(包括眼科检查),以对该类疾病起到良好的预防作用。