Different modes of foveal regeneration after closure of full-thickness macular holes by(re)vitrectomy and autologous platelet concentrate

AIM: To describe using spectral-domain optical coherence tomography the regeneration of the foveal morphology after pars plana(re)vitrectomy surgery and gas tamponade combined with injection of autologous platelet concentrate to treat full-thickness macular holes, and to describe different anatomical outcome. METHODS: A retrospective case series of 8 eyes of 8 patients was described. RESULTS: In all cases investigated, the plateletassisted closure of macular holes was associated with a rapid resolution of cystic cavities in the foveal walls. In two patients, there was a regular regeneration of the foveal morphology after hole closure;the regenerated central fovea had a regular structure with a foveola and photoreceptors. In three other patients, there was an irregular regeneration of the fovea;a foveola was not formed, photoreceptor cells were absent from the foveal center, and the center was composed of Müller and retinal pigment epithelial(RPE) cells. The foveal regeneration after hole closure may proceed with or without a temporary detachment of the foveal center from the RPE, and with or without a direct contact between the central outer nuclear layer(ONL) and the RPE. Contacts between the ONL and RPE were observed only in patients with an irregular foveal regeneration after hole closure.CONCLUSION: The data show that there are different modes of foveal regeneration after closure of macular holes with(re)vitrectomy and platelet concentrate. It is suggested that the regular regeneration of the foveal morphology proceeds by Müller cell-mediated tissue movements without cell proliferation, whereas the irregular foveal regeneration proceeds in part by proliferation of Müller and RPE cells.

Three-dimensional diabetic macular edema thickness maps based on fluid segmentation and fovea detection using deep learning

AIM: To explore a more accurate quantifying diagnosis method of diabetic macular edema(DME) by displaying detailed 3D morphometry beyond the gold-standard quantification indicator-central retinal thickness(CRT) and apply it in follow-up of DME patients.METHODS: Optical coherence tomography(OCT) scans of 229 eyes from 160 patients were collected.We manually annotated cystoid macular edema(CME), subretinal fluid(SRF) and fovea as ground truths.Deep convolution neural networks(DCNNs) were constructed including U-Net, sASPP, HRNetV2-W48, and HRNetV2-W48+Object-Contextual Representation(OCR) for fluid(CME+SRF) segmentation and fovea detection respectively, based on which the thickness maps of CME, SRF and retina were generated and divided by Early Treatment Diabetic Retinopathy Study(ETDRS) grid.RESULTS: In fluid segmentation, with the best DCNN constructed and loss function, the dice similarity coefficients(DSC) of segmentation reached 0.78(CME), 0.82(SRF), and 0.95(retina).In fovea detection, the average deviation between the predicted fovea and the ground truth reached 145.7±117.8 μm.The generated macular edema thickness maps are able to discover center-involved DME by intuitive morphometry and fluid volume, which is ignored by the traditional definition of CRT>250 μm.Thickness maps could also help to discover fluid above or below the fovea center ignored or underestimated by a single OCT B-scan.CONCLUSION: Compared to the traditional unidimensional indicator-CRT, 3D macular edema thickness maps are able to display more intuitive morphometry and detailed statistics of DME, supporting more accurate diagnoses and follow-up of DME patients.

Formation of choroidal neovascularization under macular fovea after high-power laser irradiation: a case report

Dear Editor,I am Dr.Shan-Shan Li,from Northern Jiangsu People’s Hospital,Yangzhou,China.I write to present the case of formation of choroidal neovascularization(CNV)under the fovea after high-power laser irradiation.Currently,there is an increasing availability and accessibility to laser instruments,but improper use of these tools can lead to macular damage and irreversible visual impairment.

Decision Support System for Diagnosis of Irregular Fovea

Detection of abnormalities in human eye is one of the wellestablished research areas of Machine Learning.Deep Learning techniques are widely used for the diagnosis of RetinalDiseases(RD).Fovea is one of the significant parts of retina which would be prevented before the involvement of Perforated Blood Vessels(PBV).Retinopathy Images(RI)contains sufficient information to classify structural changes incurred upon PBV but Macular Features(MF)and Fovea Features(FF)are very difficult to detect because features ofMFand FF could be found with Similar Color Movements(SCM)with minor variations.This paper presents novel method for the diagnosis of Irregular Fovea(IF)to assist the doctors in diagnosis of irregular fovea.By considering all above problems this paper proposes a three-layer decision support system to explore the hindsight knowledge of RI and to solve the classification problem of IF.The first layer involves data preparation,the second layer builds the decision model to extract the hidden patterns of fundus images by using Deep Belief Neural Network(DBN)and the third layer visualizes the results by using confusion matrix.This paper contributes a data preparation algorithm for irregular fovea and a highest estimated classification accuracy measured about 96.90%.

Foveal regeneration after resolution of cystoid macular edema without and with internal limiting membrane detachment:presumed role of glial cells for foveal structure stabilization

AIM: To document with spectral-domain optical coherence tomography the morphological regeneration of the fovea after resolution of cystoid macular edema(CME) without and with internal limiting membrane(ILM) detachment and to discuss the presumed role of the glial scaffold for foveal structure stabilization. METHODS: A retrospective case series of 38 eyes of 35 patients is described. Of these, 17 eyes of 16 patients displayed foveal regeneration after resolution of CME, and 6 eyes of 6 patients displayed CME with ILM detachment. Eleven eyes of 9 patients displayed other kinds of foveal and retinal disorders associated with ILM detachment. RESULTS: The pattern of edematous cyst distribution, with or without a large cyst in the foveola and preferred location of cysts in the inner nuclear layer or Henle fiber layer(HFL), may vary between different eyes with CME or in one eye during different CME episodes. Large cysts in the foveola may be associated with a tractional elevation of the inner foveal layers and the formation of a foveoschisis in the HFL. Edematous cysts are usually not formed in the ganglion cell layer. Eyes with CME and ILM detachment display a schisis between the detached ILM and nerve fiber layer(NFL) which is traversed by Müller cell trunks. ILM detachment was also found in single eyes with myopic traction maculopathy, macular pucker, full-thickness macular holes, outer lamellar holes, and glaucomatous parapapillary retinoschisis, and in 3 eyes with Müller cell sheen dystrophy(MCSD). As observed in eyes with MCSD, cellophane maculopathy, and macular pucker, respectively, fundus light reflections can be caused by different highly reflective membranes or layers: the thickened and tightened ILM which may or may not be detached from the NFL, the NFL, or idiopathic epiretinal membranes. In eyes with short single or multiple CME episodes, the central fovea regenerated either completely, which included the disappearance of irregularities of the photoreceptor layer lines and the reformation of a fovea externa, or with remaining irregularities of the photoreceptor layer lines. CONCLUSION: The examples of a complete regeneration of the foveal morphology after transient CME show that the fovea may withstand even large tractional deformations and has a conspicuous capacity of structural regeneration as long as no cell degeneration occurs. It is suggested that the regenerative capacity depends on the integrity of the threedimensional glial scaffold for foveal structure stabilization composed of Müller cell and astrocyte processes. The glial scaffold may also maintain the retinal structure after loss of most retinal neurons as in late-stage MCSD.

Obese Foveal Avascular Zone Assessed by Optical Coherence Tomography Angiography of the Retina: Is There a Relation to Comorbities?

Purpose: To investigate the foveal avascular zone (FAZ) in obese by optical coherence tomography angiography (OCT-A) and to evaluate the findings of structural optical coherence tomography (OCT) and their relations with comorbidities. Methods: It was included 35 obese (study group) and 30 normal individuals (control group). Patients with retinal diseases and retinal treatments were excluded. The images were obtained using the Topcon®;. Results: The mean areas of FAZ in superficial plexus (FAZ-SP) and deep plexus (FAZ-DP) were significantly greater in the study group: FAZ-SP was 405.0 ± 136.4 μm2 in the obese group and 307.3 ± 78.6 μm2 in the control group and in the left eye (LE) 477.1 ± 124.4 μm2 in the obese group and 384.0 ± 88.7 μm2 in the control group. This difference was statistically significant (RE: p = 0.0014 and LE: p = 0.0012). The mean area of the FAZ-DP was 491.0 ± 124.4 μm2 (Right eye—RE) in the obese group and 384.4 ± 88.7 μm2 in the control group and in the left eye (LE) was 497.9 ± 124.1 μm2 in the obese group and 484.9 ± 92.7 μm2 in the control group. There were no correlations regarding FAZ-SP and FAZ-DP in both eyes with fasting blood glucose, glycated hemoglobin, total cholesterol and fractions and triglycerides. A significant association between enlargement of FAZ-DP and type 2 diabetes mellitus (p = 0.0160) was observed. Conclusion: The FAZ areas in superficial and deep plexus achieved significantly greater values in the study group. There was a significant association between a larger deep FAZ area and type 2 diabetes mellitus. It is necessary an evaluation with a larger sample size to corroborate the findings.

阿柏西普联合羟苯磺酸钙在糖尿病视网膜病变黄斑水肿中的疗效观察

目的探讨阿柏西普联合羟苯磺酸钙在糖尿病视网膜病变黄斑水肿中的治疗效果。方法回顾性选取2020年10月—2023年10月天水市中医医院收治的100例糖尿病视网膜病变黄斑水肿患者的临床资料,以不同的治疗方案分为两组,各50例,对照组患者给予阿柏西普玻璃体腔内注射,研究组患者则在对照组基础上联合口服羟苯磺酸钙胶囊。比较两组的治疗效果。结果研究组患者治疗总有效率高于对照组,差异有统计学意义(P<0.05);治疗后,两组的眼压均明显降低,且研究组低于对照组,差异有统计学意义(P<0.05);治疗后,两组的最佳矫正视力均明显升高,且研究组高于对照组,差异有统计学意义(P<0.05);治疗后,两组的黄斑中心凹厚度均明显减小,且研究组小于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论在阿柏西普玻璃体腔内注射治疗糖尿病视网膜病变黄斑水肿过程中联用羟苯磺酸钙,疗效安全显著,对促进患者病情恢复、提高生活质量具有积极意义。

OCTA在阻塞性睡眠呼吸暂停低通气综合征患者中的应用

目的探讨光学相干断层扫描血管成像(OCTA)技术检测阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者视网膜微血管变化的可行性。方法选取2023年6月至2024年2月本院首次确诊为OSAHS的患者79例及年龄相匹配的健康对照25例。对所有参与者进行多导睡眠监测(PSG)检查和OCTA检查。根据患者AHI评分分组,并对视网膜血管密度(VD)和中心凹无血管区(FAZ)进行定量分析。结果中、重度OSAHS患者视网膜微血管丛的血管密度低于对照组(P<0.05),且FAZ面积大于对照组(P<0.05);Pearson相关性分析显示FAZ与AHI评分、LSaO2之间具有弱相关性(r=0.271,P=0.026;r=-0.301,P=0.007)。结论OSAHS患者视网膜微血管密度下降,FAZ较正常人扩大,且与AHI评分及LSaO2相关,OCTA检查在OSAHS病理机制和临床管理中具有一定作用。

原发性上斜肌亢进眼球客观旋转与近立体视功能的分析

目的:探讨原发性上斜肌亢进(PSOOA)患者眼球客观旋转与双眼近立体视功能之间的关系。方法:回顾性研究。收集2019-01/2023-11于我院行斜视手术并存在PSOOA的斜视患者共59例,采集眼底照相图片,根据黄斑中心凹与视乳头水平经线的相对位置将眼球分为内旋、外旋和无旋转组,进一步测量黄斑-视乳头夹角(FDA),并分析眼球客观旋转情况及FDA与患者近立体视功能的关系。结果:患者59例92眼存在上斜肌亢进。眼球外旋0例,眼球无旋转32例,眼球内旋27例,眼球无旋转组双眼总FDA明显小于眼球内旋组(2.83°±2.89°vs 16.12°±5.74°,P<0.001)。眼球无旋转组和内旋组近立体视保存率分别为66%和15%,差异显著(P<0.001);眼球无旋转组和内旋组精细近立体视保存率分别为38%和11%,差异显著(P=0.02)。所有患者近立体视与双眼总FDA存在相关性(r=-0.526,P<0.001),与内旋眼FDA相关性最大(r=-0.546,P<0.001);眼球内旋组近立体视与双眼总FDA无相关性(r=-0.366,P=0.060),与内旋眼FDA和亢进眼FDA负相关(r=-0.424,P=0.028;r=-0.485,P=0.010);眼球无旋转组近立体视与双眼总FDA、主导眼FDA、非主导眼FDA、亢进眼FDA和非亢进眼FDA均无相关性。结论:PSOOA患者出现眼球内旋者较眼球无旋转者近立体视功能保存率更低,近立体视功能与双眼总FDA负相关,尤其是内旋眼和亢进眼FDA越大,近立体视功能越差。

羟苯磺酸钙联合阿柏西普玻璃体腔内注射治疗糖尿病视网膜病变的效果

目的:观察糖尿病视网膜病变患者采取羟苯磺酸钙联合阿柏西普玻璃体腔内注射治疗的效果。方法:选取2019年6月—2022年3月于苏州市相城人民医院就诊的92例糖尿病视网膜病变患者作为研究对象,采用随机数表法将患者分为常规组(46例,阿柏西普玻璃体腔内注射治疗)与研究组(46例,羟苯磺酸钙联合阿柏西普玻璃体腔内注射治疗)。比较两组治疗前及治疗后1个月、2个月、3个月后最佳矫正视力(BCVA)、5 mm直径范围内黄斑视网膜体积(TMV)、黄斑中心凹厚度(CMT),比较两组临床疗效、不良反应。结果:两组治疗后1个月、2个月、3个月BCVA、TMV优于治疗前,治疗后2个月、3个月BCVA、TMV优于治疗后1个月,且研究组治疗后1个月、2个月、3个月BCVA高于常规组,TMV低于常规组,差异有统计学意义(P<0.05)。两组治疗后1个月、2个月、3个月CMT低于治疗前,治疗后2个月、3个月CMT低于治疗后1个月,治疗后3个月CMT低于治疗后2个月,且研究组治疗后1个月、2个月、3个月CMT低于常规组,差异有统计学意义(P<0.05)。研究组总有效率高于常规组,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:糖尿病视网膜病变患者采取羟苯磺酸钙联合阿柏西普玻璃体腔内注射治疗效果显著,可改善视力及黄斑水肿,且安全可靠。

视网膜静脉阻塞继发黄斑水肿抗VEGF治疗后OCTA指标变化与基线房水细胞因子的相关性分析

目的探讨视网膜静脉阻塞继发黄斑水肿(RVO-ME)患者抗血管内皮生长因子(VEGF)治疗后光学相干断层扫描血管成像(OCTA)指标变化与基线房水细胞因子的关系。方法纳入2021年10月至2023年1月在南京医科大学眼科医院确诊为RVO-ME的患者30例30眼,均采用3+PRN方案的玻璃体内注射抗VEGF药物。分别收集第1次和第3次注射前的房水,采用Luminex液相芯片技术测定VEGF、白细胞介素(IL)、γ-干扰素(IFN-γ)、细胞间黏附分子-1(ICAM-1)和血小板源性生长因子(PDGF)等细胞因子的表达水平。利用OCTA测量黄斑中心凹视网膜厚度(CMT)、黄斑中心凹无血管区(FAZ)面积、周长(PERIM)、非圆度指数(AI)、FAZ范围300μm宽度内的血管密度(FD-300)。采用国际标准对数视力表检查最佳矫正视力(BCVA),并换算为最小分辨角对数(logMAR)视力。比较RVO-ME患者抗VEGF治疗前后房水中细胞因子表达水平和OCTA指标的变化,分析治疗后OCTA指标变化与基线房水细胞因子的关系。结果RVO-ME患者患眼治疗后房水细胞因子中VEGF、ICAM-1、PDGF、IL-8、IL-10表达水平均下降,差异均有统计学意义(均为P<0.05);治疗后BCVA改善(P<0.001),CMT、AI及FD-300指标均下降,差异均有统计学意义(均为P<0.05)。相关性分析结果显示,基线IL-13水平与AI变化值呈负相关(r=-0.388,P<0.05);基线IL-8水平与FD-300变化值呈负相关(r=-0.421,P<0.05)。结论基线房水细胞因子IL-13和IL-8可能与RVO-ME患眼抗VEGF治疗后视网膜黄斑区微血管结构改善程度有关。针对RVO-ME的治疗与管理不应局限于抗血管治疗,还应针对性进行抗炎治疗。

阿托伐他汀钙片治疗老年白内障术后患者的效果

目的:研究阿托伐他汀钙片治疗老年白内障术后患者的效果。方法:选择2020年1月—2022年1月南漳县中医医院眼科收治的88例拟行手术治疗的老年白内障患者作为研究对象,按照随机数表法分为两组,各44例。所有患者均行超声乳化手术,观察组在术后给予阿托伐他汀钙片口服,对照组不另外服药。比较两组治疗效果、术后不同时段黄斑中心凹视网膜厚度(CRT)、最佳矫正视力(BCVA)、血脂水平[总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]。结果:观察组治疗总有效率为95.45%,显著高于对照组的81.82%,差异有统计学意义(P<0.05)。术后3周、12周、24周,两组CRT均高于术后1 d,但观察组低于对照组;术后12周、24周,两组CRT低于术后3周;术后24周,两组CRT均低于术后12周,差异有统计学意义(P<0.05)。术后1周、3周、6周,两组BCVA均高于术前;术后3周、6周,两组BCVA均高于术后1周;术后6周,两组BCVA均高于术后3周;术后3周、6周,观察组BCVA均高于对照组,差异有统计学意义(P<0.05)。术后12周,两组TC、LDL-C水平均低于术前,HDL-C水平高于术前,且观察组TC、LDL-C水平均低于对照组,HDL-C水平高于对照组,差异有统计学意义(P<0.05)。结论:老年白内障患者术后应用阿托伐他汀钙片可有效控制患者血脂水平,从而改善视力,降低黄斑水肿发生风险,提升治疗效果。

仿猛禽视觉多分辨率的海上无人艇协同跟踪

针对海上无人艇跟踪过程中大场景与高分辨间的矛盾问题,本文提出一种仿猛禽视觉多分辨率机制的海上目标无人艇协同跟踪方法。模拟猛禽双中央凹多分辨率成像规律,构建目标无人艇跟踪大小场景;在大场景中,模拟猛禽视顶盖-峡核通路中视觉刺激的竞争选择机制进行海上无人艇显著性检测,用于纠正核相关滤波目标跟踪的结果;在小场景中,建立仿猛禽色彩分辨空间,并采用颜色显著性检测方法提取无人艇上的合作靶标;建立大场景纠正及小场景引导协同跟踪策略,实现对海上目标无人艇的协同跟踪。对比实验结果表明,本文方法的跟踪成功率高于对比方法,且有最高的平均重叠率和最低的平均像素误差,适于无人机完成对海上目标无人艇的跟踪任务。

保留中央凹或标准内界膜剥除联合玻璃体切割术治疗近视牵引性黄斑病变的Meta分析

目的:评估玻璃体切割术中保留中央凹(FSIP)或标准内界膜剥除(CMIP)治疗近视牵引性黄斑病变(MTM)的疗效及安全性。方法:计算机检索中国知网、万方、维普、PubMed、Embase、Cochrane Library、Web of Science数据库,搜集2000-01-01/2022-07-01玻璃体切割术中FSIP或CMIP治疗MTM的对比研究。比较两组患者术后最佳矫正视力(BCVA)的变化值和改善率、术后全层黄斑裂孔(FTMH)发生率、视网膜中央凹厚度(CFT)变化值、术后中心凹完全解剖复位率。结果:共12篇文献484眼纳入研究,其中FSIP组203眼,CMIP组281眼。Meta分析结果显示:FSIP组患者术后BCVA的变化值(SMD=0.52,95%CI:0.20~0.85,P=0.002)、BCVA改善率(RR=1.50,95%CI:1.22~1.85,P=0.0002)及术后FTMH发生率(RR=0.23,95%CI:0.10~0.54,P=0.0008)优于CMIP组,两组患者CFT变化值(SMD=0.04,95%CI:-0.19~0.26,P=0.75)及术后中心凹完全解剖复位率(RR=1.12,95%CI:0.94~1.32,P=0.20)比较均无差异。结论:现有证据表明,两种术式解剖改善结果相似,但在改善视觉效果及降低术后全层黄斑裂孔发生率方面,FSIP明显优于CMIP。

光学相干断层血管造影成像应用于非增殖期糖尿病视网膜病变微血管的临床筛查

目的探讨光学相干断层血管造影成像(OCTA)应用于非增殖期糖尿病视网膜病变(NPDR)患者视网膜微血管筛查中的临床效果。方法选取在苏州大学附属第三医院确诊的30例NPDR患者(NPDR组)和30例健康志愿者(对照组)行OCTA检查,对其黄斑中心凹无血管区(FAZ)的面积、周长、圆度变化以及黄斑区视网膜浅层毛细血管层(SCP)和视盘盘周放射状毛细血管层(RPC)上侧、下侧、鼻侧、颞侧4个象限的血流密度进行量化分析。结果NPDR组患者黄斑区SCP和视盘RPC 4个象限的血流密度较对照组均显著下降(43.68±3.03vs.46.98±3.04、42.79±3.17vs.50.45±2.25、43.21±2.67vs.47.44±2.42、44.21±3.22vs.51.72±5.32、46.43±3.54vs.53.02±2.62、45.97±3.67vs.52.53±2.82、44.63±2.73vs.48.19±3.67、41.73±3.15vs.45.12±3.31),差异均有统计学意义(均P<0.01)。NPDR组患者FAZ面积和周长较正常对照组均明显增大[(0.50±0.06vs.0.43±0.47)mm2、(3.10±0.21vs.2.87±0.22)mm],圆度较对照组明显变小[(0.63±0.05vs.0.67±0.05)%],差异也均有统计学意义(均P<0.01)。结论OCTA可检测出NPDR的早期视网膜微结构改变,可作为NPDR的辅助筛查,为早期诊治提供信息。

光学相干断层扫描血管造影技术在初诊2型糖尿病患者眼底筛查中的应用

目的 探讨光学相干断层扫描血管造影技术(OCTA)在初诊为2型糖尿病的患者中进行眼底筛查的诊断价值。方法 将2019年11月—2021年3月初诊确诊的40例2型糖尿病患者纳入本研究,由临床经验丰富的医师对其进行眼底检查,根据患者糖尿病性视网膜病变(DR)情况进行分组,将非DR(NDR)患者纳入NDR组(n=20),将已出现轻度非增殖期糖尿病性视网膜病变(NPDR)的患者纳入早期DR组(n=20)。同时,将与其年龄匹配的20例健康者纳入对照组。采用OCTA对研究对象的黄斑区进行扫描并作定量分析,获得视网膜浅层视网膜血管丛(SVC)、深层视网膜血管丛(DVC)和脉络膜毛细血管层(CC)的黄斑区血流密度(MVD)和黄斑中心凹无血管区(FAZ)面积;比较各组不同指标的差异以及对早期DR的筛查和诊断价值。结果 NDR组SVC的血流密度为(0.52±0.09), DVC为(0.54±0.13), CC为(0.51±0.07);早期DR组SVC的血流密度为(0.45±0.09), DVC为(0.43±0.09), CC为(0.45±0.06),对照组SVC的血流密度为(0.54±0.01), DVC为(0.57±0.01), CC为(0.52±0.02)。与对照组比较,NDR组、早期DR组SVC、DVC、CC血流密度均减小。NDR组的FAZ面积为(0.39±0.06) mm~2,早期DR组为(0.43±0.05) mm~2,对照组为(0.29±0.01) mm~2。NDR组和早期DR组的FAZ面积大于对照组,且早期DR组的FAZ面积扩大最明显。多因素回归Logistic分析发现,DVC血流密度和FAZ面积均会对诊断产生影响。结论 初诊糖尿病患者采用OCTA检查,可以筛查出视网膜黄斑区的早期血运改变。早期糖尿病性视网膜病变患者的MVD减少,且FAZ面积扩大。DVC的血流密度和FAZ面积均能对早期DR的诊断产生影响,而FAZ面积对早期DR有更高的诊断价值。

云南红药胶囊治疗气滞血瘀、气阴两虚证视网膜静脉阻塞患者眼底的效果

目的探究云南红药胶囊治疗气滞血瘀、气阴两虚证视网膜静脉阻塞患者眼底的效果。方法2019年6月至2020年5月云南省中医医院眼科收治的50例视网膜静脉阻塞眼底出血住院患者,按照随机数字表法分为对照组、试验组,每组25例。对照组、试验组分别实施羟苯磺酸钙、联合云南红药胶囊治疗。比较两组视力水平、眼底情况、黄斑水肿、整体治疗效果、凝血功能指标。结果治疗后,两组视力水平高于治疗前,且实验组高于对照组,差异有统计学意义(P<0.05)。试验组眼底改善情况优于对照组,差异有统计学意义(P<0.05)。治疗后,两组黄斑水肿低于治疗前,且试验组低于对照组,差异有统计学意义(P<0.05)。试验组整体治疗效果优于对照组,差异有统计学意义(P<0.05)。治疗后,两组凝血酶时间、活化部分凝血活酶时间、凝血酶原时间短于治疗前,纤维蛋白原低于治疗前,且试验组凝血酶时间、活化部分凝血活酶时间、凝血酶原时间长于对照组,纤维蛋白原高于对照组,差异有统计学意义(P<0.05)。结论在视网膜静脉阻塞眼底出血中,应用云南红药胶囊联合羟苯磺酸钙治疗可以有效改善视力水平、眼底情况及凝血功能指标,进而减少黄斑中心凹厚度,提升治疗效果。

超声乳化术对糖尿病与非糖尿病白内障患者黄斑中心凹厚度及视网膜厚度的影响

目的 分析超声乳化术对糖尿病与非糖尿病白内障患者黄斑中心凹厚度及视网膜厚度的影响。方法 搜集于2021年1月至2023年1月于本医院进行超声乳化手术治疗的白内障患者作为研究对象,共105例。根据患者是否合并糖尿病疾病作为分组依据将研究对象分为糖尿病组和非糖尿病组,其中糖尿病组共52例,非糖尿病组共53例,两组患者的超声乳化手术均有同一组眼科医师完成,并行人工晶体置入术。比较糖尿病组和非糖尿病组经超声乳化术治疗前与治疗后3个月的黄斑中心凹厚度、视网膜厚度。结果 手术前,糖尿病与非糖尿病白内障患者的黄斑中心凹厚度及黄斑区平均视网膜厚度比较差异无统计学意义(P> 0.05);手术结束后3个月,两组患者的黄斑中心凹厚度及黄斑区平均视网膜厚度均大于手术治疗前,同组治疗前后对比差异有统计学意义(P <0.05);糖尿病组患者手术结束后3个月的黄斑中心凹厚度及黄斑区平均视网膜厚度均大于非糖尿病组患者,组间对比差异有统计学意义(P <0.05)。结论 与非糖尿病白内障患者相比,糖尿病白内障患者经过超声乳化术治疗后,其黄斑中心凹厚度及黄斑区平均视网膜厚度均明显增加。

七叶洋地黄双苷滴眼液对白内障术后黄斑水肿的影响

目的探讨七叶洋地黄双苷滴眼液对白内障术后黄斑水肿的影响。方法80例白内障术后黄斑水肿患者,采用随机数字表法将其分对照组和观察组,各40例。对照组服用维生素E、维生素C治疗,观察组在对照组基础上接受七叶洋地黄双苷滴眼液治疗。比较两组患者治疗前以及治疗后2周、1个月的最佳矫正视力、阅读速度评分、黄斑色素密度、黄斑中心凹神经上皮层厚度。结果观察组患者治疗后2周、1个月的最佳矫正视力分别为(0.43±0.02)、(0.81±0.05),均高于对照组的(0.37±0.04)、(0.51±0.03),差异具有统计学意义(P<0.05)。观察组患者治疗后2周、1个月阅读速度评分分别为(3.19±0.51)、(4.32±0.25)分,均高于对照组的(2.85±0.51)、(3.68±0.23)分,差异具有统计学意义(P<0.05)。观察组患者治疗后2周、1个月的黄斑色素密度分别为(0.16±0.04)、(0.25±0.06)DU,均高于对照组的(0.11±0.03)、(0.15±0.07)DU,差异具有统计学意义(P<0.05)。观察组患者治疗后2周、1个月的黄斑中心凹神经上皮层厚度分别为(185.25±1.32)、(181.21±1.69)μm,均低于对照组的(198.35±1.32)、(195.24±1.02)μm,差异具有统计学意义(P<0.05)。结论七叶洋地黄双苷滴眼液能更好的缓解白内障术后黄斑水肿,改善患者视力,提升阅读速度。

眼底图像中黄斑中心与视盘自动检测新方法

在眼底图像自动分析中,视盘与黄斑的定位是糖尿病性视网膜病变计算机辅助诊断或筛查的先决条件。该文提出一种应用方向局部对比度滤波结合局部血管密度的方法,直接先行检测黄斑中心再行定位视盘,不同于现有的先行检测视盘或血管再行定位黄斑的一般方法,有效地提高黄斑定位正确率,能更好地应用于糖尿病性黄斑水肿的自动评估。实验选取了网络公开的HEI-MED数据集中169幅黄斑水肿眼底图像,黄斑和视盘的定位正确率同步达到98.2%,算法简单且无监督,优于现有的方法,具有良好的临床应用前景。