BACKGROUND Combined hamartoma of the retina and retinal pigment epithelium(CHRRPE)is a rare congenital benign tumor which is commonly monocular.Typical CHRRPE comprises slightly raised lesions at the posterior pole,wi...BACKGROUND Combined hamartoma of the retina and retinal pigment epithelium(CHRRPE)is a rare congenital benign tumor which is commonly monocular.Typical CHRRPE comprises slightly raised lesions at the posterior pole,with proliferation membrane often leading to vascular distortion.In severe cases,macular edema,macular hole,retinal detachment or vitreous hemorrhage may occur.Patients with atypical clinical manifestations are prone to misdiagnosis by inexperienced ophthalmologists.CASE SUMMARY A 33-year-old man reported onset of right eye blurred vision for one week prior.Anterior segment and intraocular pressure were normal in both eyes.Left eye fundus photography was normal.Right eye ophthalmoscopy showed vitreous hemorrhage and off-white raised retinal lesions below the optic disc.Proliferative membranes on the lesion surfaces resulted in superficial retinal detachment and tortuosity and occlusion of peripheral blood vessels.A horseshoe-like tear in the temporal periphery was surrounded by retinal detachment.Optical coherence tomography revealed retinal thickening at the focal site with structural disturbance indicated by high reflectance.Right eye ultrasound showed retinal thickening at the lesion,stretching and uplifting of the proliferative membrane,with moderately patchy echo at the optic disc edge.Cytokines and antibodies were detected in vitreous fluids during the operation to rule out other diseases.Fundus fluorescein angiography(FFA)at postoperative follow-up led to final diagnosis of CHRRPE.CONCLUSION FFA is helpful in diagnosing retinal and retinal pigment epithelial combined hamartoma.In addition,other cytokine and etiological tests facilitate further differential diagnosis to rule out other suspected diseases.展开更多
Twenty-four cases (25 eyes) of fundus hemorrhage due to obstruction of the retinal vein were treated with traditional Chinese herbal drugs and satisfactory therapeutic results were obtained. A brief report is as f... Twenty-four cases (25 eyes) of fundus hemorrhage due to obstruction of the retinal vein were treated with traditional Chinese herbal drugs and satisfactory therapeutic results were obtained. A brief report is as follows.……展开更多
Acute retinal pigment epithelitis is notan uncommon fundal disease,particularly inthe meddle-aged and adolescents,involvingone or both eyes.The symptoms includemicropsia,metamorphopsia and impairmentof visual acuity.T...Acute retinal pigment epithelitis is notan uncommon fundal disease,particularly inthe meddle-aged and adolescents,involvingone or both eyes.The symptoms includemicropsia,metamorphopsia and impairmentof visual acuity.The disease may展开更多
AIM: To evaluate the image quality of a telemedicine screening program for retinal disease using a nonmydriatic camera among rural island communities in Bocas del Toro, Panama.METHODS: In June 2018, a group of three m...AIM: To evaluate the image quality of a telemedicine screening program for retinal disease using a nonmydriatic camera among rural island communities in Bocas del Toro, Panama.METHODS: In June 2018, a group of three medical students volunteered at clinics operated by the Floating Doctors in the province of Bocas del Toro, Panama. Nonmydriatic images of the retina were obtained using the Pictor Plus(Volk Optical, Mentor OH), randomized, and sent to two board-certified ophthalmologists at the University of California, Irvine for analysis using a modified version of the FOTO-ED scale. Inter-rater reliability was calculated using the kappa statistic.RESULTS: Seventy patients provided a total of 127 images. Average image quality was 3.31, and most frequent image quality was 4/5 on the FOTO-ED scale. Thirty patients had at least one eye image with ideal quality(42.86%), while only one patient had no adequate photos taken(1.43%). However, high quality images were obtained in both eyes in only 12 patients(17.14%). The inter-rater reliability between the two ophthalmologists was 0.614.CONCLUSION: Further improvements are necessary to acquire higher quality images more reliably. This may include further training and experience or mydriasis.展开更多
Background：Obstructive sleep apnea syndrome （OSAS） has been shown to generate hypertension and endothelial dysfunction.Retinal vessel is the only vessel that can be observed directly and noninvasively;retinal vascu...Background：Obstructive sleep apnea syndrome （OSAS） has been shown to generate hypertension and endothelial dysfunction.Retinal vessel is the only vessel that can be observed directly and noninvasively;retinal vascular abnormalities can serve as a predictive marker for the occurrence,clinical course,and prognosis of cardiovascular and cerebrovascular diseases.The objective of this study was to identify the effect of OSAS severity on the morphological changes of retinal vessels.Methods：Adult patients complained of snoring were included in this study.The patients＆#39; general information,polysomnography,and fundus photography parameters including central retinal artery equivalent （CRAE）,central retinal vein equivalent （CRVE）,and arteriole-to-venule ratio （AVR） were collected.Patients were divided into four groups according to their apnea-hypopnea index （AHI） results：Group Ⅰ,AHI ≤5/h;Group ll,5/h 〈 AHI ≤30/h;Group Ⅲll,30/h 〈 AHI ≤60/h;and Group Ⅳ,AHI 〉60/h.Results：A total of 133 patients were included in this study with 111 males （83.5%） and 22 females （16.5%）.Mean age was 41.6 ± 9.9 years,and the mean body mass index was 28.1 ± 4.0 kg/m2.AHI ranged between 0 and 130.8/h with a mean of 39.l ± 30.7/h.There were 24,34,35,and 40 patients in Group Ⅰ,Group Ⅱ,Group Ⅲ,and Group Ⅳ,respectively.Significant differences were found for AHI （F =388.368,P 〈 0.001）,minimal pulse oxygen saturation （F-91.902,P 〈 0.001）,and arousal index （F =31.014,P 〈 0.001） among four groups;no significant differences were found for CRAE （F=0.460,P =0.599） and CRVE （F =0.404,P =0.586） among groups;there were significant differences for AVR between Group l and Group Ⅳ （63.6 ± 5.1% vs.67.2 ± 5.5%,P =0.010） Group Ⅱ and Group Ⅳ （64.5 ± 6.0% vs.67.2 ± 5.5%,P =0.030）,and Group ll and Group Ⅳ （64.7 ± 4.1% vs.67.2 ± 5.5%,P=0.043）.A main group-by-AHI effect was found on the AVR：patients with higher AHI showed higher AVR results （r =0.225,P =0.009）.Multivariate logistic regression analysis was used for multi-variable factors.A group-by-age effect was found on the AVR：younger patients showed higher AVR results （β =-0.001,P =0.020）.Conclusions：This study indicated that increased AVR of retinal vessel can be observed in extremely severe OSAS patients.For patients with OSAS,retinal vascular abnormalities may become an early indication for further cardiovascular abnormalities.展开更多
Adaptive optics scanning laser ophthalmoscopy（AOSLO） has been a promising technique in funds imaging with growing popularity. This review firstly gives a brief history of adaptive optics（AO） and AO-SLO. Then it co...Adaptive optics scanning laser ophthalmoscopy（AOSLO） has been a promising technique in funds imaging with growing popularity. This review firstly gives a brief history of adaptive optics（AO） and AO-SLO. Then it compares AO-SLO with conventional imaging methods（fundus fluorescein angiography, fundus autofluorescence, indocyanine green angiography and optical coherence tomography） and other AO techniques（adaptive optics flood-illumination ophthalmoscopy and adaptive optics optical coherence tomography）. Furthermore, an update of current research situation in AO-SLO is made based on different fundus structures as photoreceptors（cones and rods）, fundus vessels, retinal pigment epithelium layer, retinal nerve fiber layer, ganglion cell layer and lamina cribrosa. Finally, this review indicates possible research directions of AO-SLO in future.展开更多
文摘BACKGROUND Combined hamartoma of the retina and retinal pigment epithelium(CHRRPE)is a rare congenital benign tumor which is commonly monocular.Typical CHRRPE comprises slightly raised lesions at the posterior pole,with proliferation membrane often leading to vascular distortion.In severe cases,macular edema,macular hole,retinal detachment or vitreous hemorrhage may occur.Patients with atypical clinical manifestations are prone to misdiagnosis by inexperienced ophthalmologists.CASE SUMMARY A 33-year-old man reported onset of right eye blurred vision for one week prior.Anterior segment and intraocular pressure were normal in both eyes.Left eye fundus photography was normal.Right eye ophthalmoscopy showed vitreous hemorrhage and off-white raised retinal lesions below the optic disc.Proliferative membranes on the lesion surfaces resulted in superficial retinal detachment and tortuosity and occlusion of peripheral blood vessels.A horseshoe-like tear in the temporal periphery was surrounded by retinal detachment.Optical coherence tomography revealed retinal thickening at the focal site with structural disturbance indicated by high reflectance.Right eye ultrasound showed retinal thickening at the lesion,stretching and uplifting of the proliferative membrane,with moderately patchy echo at the optic disc edge.Cytokines and antibodies were detected in vitreous fluids during the operation to rule out other diseases.Fundus fluorescein angiography(FFA)at postoperative follow-up led to final diagnosis of CHRRPE.CONCLUSION FFA is helpful in diagnosing retinal and retinal pigment epithelial combined hamartoma.In addition,other cytokine and etiological tests facilitate further differential diagnosis to rule out other suspected diseases.
文摘 Twenty-four cases (25 eyes) of fundus hemorrhage due to obstruction of the retinal vein were treated with traditional Chinese herbal drugs and satisfactory therapeutic results were obtained. A brief report is as follows.……
文摘Acute retinal pigment epithelitis is notan uncommon fundal disease,particularly inthe meddle-aged and adolescents,involvingone or both eyes.The symptoms includemicropsia,metamorphopsia and impairmentof visual acuity.The disease may
文摘AIM: To evaluate the image quality of a telemedicine screening program for retinal disease using a nonmydriatic camera among rural island communities in Bocas del Toro, Panama.METHODS: In June 2018, a group of three medical students volunteered at clinics operated by the Floating Doctors in the province of Bocas del Toro, Panama. Nonmydriatic images of the retina were obtained using the Pictor Plus(Volk Optical, Mentor OH), randomized, and sent to two board-certified ophthalmologists at the University of California, Irvine for analysis using a modified version of the FOTO-ED scale. Inter-rater reliability was calculated using the kappa statistic.RESULTS: Seventy patients provided a total of 127 images. Average image quality was 3.31, and most frequent image quality was 4/5 on the FOTO-ED scale. Thirty patients had at least one eye image with ideal quality(42.86%), while only one patient had no adequate photos taken(1.43%). However, high quality images were obtained in both eyes in only 12 patients(17.14%). The inter-rater reliability between the two ophthalmologists was 0.614.CONCLUSION: Further improvements are necessary to acquire higher quality images more reliably. This may include further training and experience or mydriasis.
文摘Background：Obstructive sleep apnea syndrome （OSAS） has been shown to generate hypertension and endothelial dysfunction.Retinal vessel is the only vessel that can be observed directly and noninvasively;retinal vascular abnormalities can serve as a predictive marker for the occurrence,clinical course,and prognosis of cardiovascular and cerebrovascular diseases.The objective of this study was to identify the effect of OSAS severity on the morphological changes of retinal vessels.Methods：Adult patients complained of snoring were included in this study.The patients＆#39; general information,polysomnography,and fundus photography parameters including central retinal artery equivalent （CRAE）,central retinal vein equivalent （CRVE）,and arteriole-to-venule ratio （AVR） were collected.Patients were divided into four groups according to their apnea-hypopnea index （AHI） results：Group Ⅰ,AHI ≤5/h;Group ll,5/h 〈 AHI ≤30/h;Group Ⅲll,30/h 〈 AHI ≤60/h;and Group Ⅳ,AHI 〉60/h.Results：A total of 133 patients were included in this study with 111 males （83.5%） and 22 females （16.5%）.Mean age was 41.6 ± 9.9 years,and the mean body mass index was 28.1 ± 4.0 kg/m2.AHI ranged between 0 and 130.8/h with a mean of 39.l ± 30.7/h.There were 24,34,35,and 40 patients in Group Ⅰ,Group Ⅱ,Group Ⅲ,and Group Ⅳ,respectively.Significant differences were found for AHI （F =388.368,P 〈 0.001）,minimal pulse oxygen saturation （F-91.902,P 〈 0.001）,and arousal index （F =31.014,P 〈 0.001） among four groups;no significant differences were found for CRAE （F=0.460,P =0.599） and CRVE （F =0.404,P =0.586） among groups;there were significant differences for AVR between Group l and Group Ⅳ （63.6 ± 5.1% vs.67.2 ± 5.5%,P =0.010） Group Ⅱ and Group Ⅳ （64.5 ± 6.0% vs.67.2 ± 5.5%,P =0.030）,and Group ll and Group Ⅳ （64.7 ± 4.1% vs.67.2 ± 5.5%,P=0.043）.A main group-by-AHI effect was found on the AVR：patients with higher AHI showed higher AVR results （r =0.225,P =0.009）.Multivariate logistic regression analysis was used for multi-variable factors.A group-by-age effect was found on the AVR：younger patients showed higher AVR results （β =-0.001,P =0.020）.Conclusions：This study indicated that increased AVR of retinal vessel can be observed in extremely severe OSAS patients.For patients with OSAS,retinal vascular abnormalities may become an early indication for further cardiovascular abnormalities.
基金Supported by National Key Scientific Instrument and Equipment Development Project of China (No.2012YQ12008005)
文摘Adaptive optics scanning laser ophthalmoscopy（AOSLO） has been a promising technique in funds imaging with growing popularity. This review firstly gives a brief history of adaptive optics（AO） and AO-SLO. Then it compares AO-SLO with conventional imaging methods（fundus fluorescein angiography, fundus autofluorescence, indocyanine green angiography and optical coherence tomography） and other AO techniques（adaptive optics flood-illumination ophthalmoscopy and adaptive optics optical coherence tomography）. Furthermore, an update of current research situation in AO-SLO is made based on different fundus structures as photoreceptors（cones and rods）, fundus vessels, retinal pigment epithelium layer, retinal nerve fiber layer, ganglion cell layer and lamina cribrosa. Finally, this review indicates possible research directions of AO-SLO in future.
