AIM: To investigate the treatment status and prognosis of space-occupying lacrimal gland lesions at one tertiary eye center in China. METHODS: A retrospective clinical study was performed on 95 patients with space-occ...AIM: To investigate the treatment status and prognosis of space-occupying lacrimal gland lesions at one tertiary eye center in China. METHODS: A retrospective clinical study was performed on 95 patients with space-occupying lesions of the lacrimal gland surgically treated at the Eye & ENT Hospital of Fudan University from 2003 to 2007. The reviewed clinical data included age, gender, side of the lesion, duration of signs and symptoms, histopathological diagnosis, treatment modality, recurrence (local, regional, and distant metastasis) and survival. RESULTS: Of the 95 cases (99 eyes), pleomorphic adenomas were the most common lesions (43 cases), followed by lymphoid disorders (14), inflammatory pseudotumors (11), carcinoma ex-pleomorphic adenomas (11), and adenoid cystic carcinomas (ACC, 6). There were 8 patients with relapsed pleomorphic adenomas. Five of these 8 cases had malignant pathological changes. All patients with ACC had metastasis and three of them died during their follow-up. CONCLUSION: Our study indicated that the most common lacrimal gland lesions were pleomorphic adenomas. Multiple recurrence and surgical procedures may increase the risk of tumor progression. ACC had a high incidence of tumor metastasis and a poor prognosis.展开更多
AIM:To characterize spectral-domain optical coherence tomography(SD-OCT)features of chorioretinal folds in orbital mass imaged using enhanced depth imaging(EDI).METHODS:Prospective observational case-control study was...AIM:To characterize spectral-domain optical coherence tomography(SD-OCT)features of chorioretinal folds in orbital mass imaged using enhanced depth imaging(EDI).METHODS:Prospective observational case-control study was conducted in 20 eyes of 20 patients,the uninvolved eye served as a control.All the patients underwent clinical fundus photography,computed tomography,EDI SDOCT imaging before and after surgery.Two patients with cavernous hemangiomas underwent intratumoral injection of bleomycin A5;the remaining patients underwent tumor excision.Patients were followed 1 to 14mo following surgery(average follow up,5.8mo).RESULTS:Visual acuity prior to surgery ranged from 20/20 to 20/200.Following surgery,5 patients’visual acuity remained unchanged while the remaining 15 patients had a mean letter improvement of 10(range 4 to 26 letters).Photoreceptor inner/outer segment defects were found in 10 of 15 patients prior to surgery.Following surgical excision,photoreceptor inner/outer segment defects fully resolved in 8 of these 10 patients.CONCLUSION:Persistence of photoreceptor inner/outer segment defects caused by compression of the globe by an orbital mass can be associated with reduced visual prognosis.Our findings suggest that photoreceptor inner/outer segment defects on EDI SD-OCT could be an indicator for immediate surgical excision of an orbital mass causing choroidal compression.展开更多
AIM:To illustrate clinicopathological features of orbital non-rhabdomyosarcoma soft tissue sarcoma(NRSTS),and to compare the treatment outcome between postoperative radiotherapy(RT) and chemotherapy in a retrospective...AIM:To illustrate clinicopathological features of orbital non-rhabdomyosarcoma soft tissue sarcoma(NRSTS),and to compare the treatment outcome between postoperative radiotherapy(RT) and chemotherapy in a retrospective analysis nearly 20y.METHODS:A retrospective cohort study of 56 patients with orbital NRSTS were reviewed,34 of whom received postoperative RT,and 22 received postoperative chemotherapy.The clinicopathological features,local recurrence,metastases,and survival data were recorded.Survival analysis was performed using the Kaplan-Meier method.RESULTS:During follow-up(111.8mo,ranged 8-233mo) for 56 patients,19 patients of them developed local recurrence,and 7 patients developed distant metastases.Fifteen patients died during follow-up period.Overall survival rates considering the whole study group was 78.57% at 5y,and 72.16% at 10y after the initial diagnosis.Compared with chemotherapy,RT was associated with lower risk of local recurrence [hazard ratio for RT vs chemotherapy,0.263,95% confidence interval(CI),0.095-0.728,P=0.0015];with lower risk of distant metastasis(hazard ratio for RT vs chemotherapy,0.073,95%CI,0.015-0.364,P=0.0014);and with lower risk of death from disease(hazard ratio for RT vs chemotherapy,0.066,95%CI,0.022-0.200,P<0.0001).The 5-year survival rate in RT group was 97.06% compared to 50% in chemotherapy group.CONCLUSION:In patients with orbital NRSTS,postoperative RT provides better control of local recurrence,distant metastasis,and death from disease than chemotherapy.RT is the more preferrable adjuvant therapy compared to chemotherapy possibly.展开更多
AIM: To investigate the clinical and optical coherence tomography(OCT) features of focal choroidal excavation(FCE) complicated with choroidal neovascularization(CNV) in young and middle aged patients. METHODS: We perf...AIM: To investigate the clinical and optical coherence tomography(OCT) features of focal choroidal excavation(FCE) complicated with choroidal neovascularization(CNV) in young and middle aged patients. METHODS: We performed a retrospective review of 26 patients with FCE accompanied by CNV. All patients underwent a complete ophthalmic examination. We analyzed the clinical characteristics of patients, focusing on the spectral-domain OCT features. All patients received intravitreal injection of anti-vascular endothelial growth factor(anti-VEGF) agents. And we assessed the changes of central retinal thickness and best-corrected visual acuity(BCVA) after anti-VEGF therapy. RESULTS: The mean age of 26 patients was 35.5±7.3 y(range, 21-48 y). Of the 26 FCE lesions, 11 were located subfoveal, 6 were parafoveal, and 9 were extrafoveal. The mean FCE depth was 129.8±50.3 μm, and the mean width was 901.3±306.0 μm. The FCE depth was correlated positively with the width, but not correlated with age or refractive error. CNV was located within the excavation(19 eyes) or adjacent to the excavation(7 eyes). After anti-VEGF therapy, the central retinal thickness was significantly reduced and the BCVA was significantly improved. In the absorption process of subretinal fluid, we found that the fluid in the excavations needed to be absorbed at the last. A small amount of residual fluid could still be seen in a few deep excavations even after a longterm follow-up.CONCLUSION: FCE may be an important reason to cause CNV. Especially in young patients with idiopathic CNV, we should pay attention to the use of OCT to check the presence of FCE. Anti-VEGF therapy is generally effective for CNV associated with FCE.展开更多
AIM:To assess objective visual quality after presbyopia correction using the Presby MAX monocular mode.METHODS:This prospective,nonrandomized study included 28 eyes from 18 patients(mean age 50.4±5.6 y)who underw...AIM:To assess objective visual quality after presbyopia correction using the Presby MAX monocular mode.METHODS:This prospective,nonrandomized study included 28 eyes from 18 patients(mean age 50.4±5.6 y)who underwent presbyopia correction with the Presby MAX monocular mode.Monocular and binocular visual acuities were evaluated preoperatively,1 d,1 wk,1,3 mo,and 1 y after surgery.Optical quality was analyzed by HartmannShack wavefront aberration supported cornea ablation.Modulation transfer function(MTF)cutoff frequency,Strehl ratio,and objective scattering index(OSI)were analyzed using an optical quality analysis system.RESULTS:One year after surgery,100%and 94.4%of patients achieved binocular uncorrected distance and near visual acuity of 20/25,respectively.At the last visit Spherical aberration and total higher aberration were higher than the corresponding preoperative levels(P<0.001);however,no significant difference was found in MTF,OSI,or Strehl ratio.Transient decreases in OSI and MTF mainly occurred in the nondominant eyes.There was no significant difference in optical quality between the dominant and nondominant eyes,except for spherical aberration and horizontal coma(P<0.05).CONCLUSION:The Presby MAX monocular mode is safe and effective for presbyopia correction.It has little effect on optical quality,though short-term degraded optical quality occurred mainly in the bi-aspheric ablated eyes.展开更多
AIM: To investigate cap morphology after small-incision lenticule extraction (SMILE) and its effects on intraocular scattering. METHODS: Sixty-five eyes of 33 patients undergoing SMILE were enrolled. In addition ...AIM: To investigate cap morphology after small-incision lenticule extraction (SMILE) and its effects on intraocular scattering. METHODS: Sixty-five eyes of 33 patients undergoing SMILE were enrolled. In addition to regular evaluation, Fourier-domain optical coherence tomography was used to investigate cap thickness at ld, lwk, 1 and 3mo postoperatively. The optical quality including modulation transfer function cutoff frequency, Strehl ratio, Optical Quality Analysis System (OQAS) values, and objective scattering index (OSI), were evaluated using OQASTM. RESULTS: Cap thickness decreased from ld to lwk (P〈0.001), but remained higher than intended thickness of 120 μm after 3mo (P〈0.001). Cap thickness in central area was thinner than that of in the paracentral and peripheral areas (P〈0.0001). Total number of microdistortions decreased from ld to 3mo (P〈0.0001). Pearson analysis revealed a weak correlation between OSI and standard deviation of cap thickness at ld and lmo, as well as between range of cap thickness and OSI at 1mo. No correlation was found between microdistortion and OSI, but a negative correlation existed between microdistortion and range at ld and lmoafter surgery. CONCLUSION: The corneal cap tends to be more accurate and regular with time lapse. Better cap morphology tends to contribute less intraocular scattering in the eyes undergoing SMILE.展开更多
Purpose: To investigate the effects of intravitreal injection of cyclopentolate on form deprivation myopia in guinea pigs. Methods: Thirty-five guinea pigs at age of 3 weeks were randomly divided into 5 groups (n = 7 ...Purpose: To investigate the effects of intravitreal injection of cyclopentolate on form deprivation myopia in guinea pigs. Methods: Thirty-five guinea pigs at age of 3 weeks were randomly divided into 5 groups (n = 7 for each group): deprived, deprived plus saline, deprived plus cyclopentolate, normal control, and cyclopentolate group. Form deprivation was only performed in right eyes with translucent membranes for 4 weeks. Physiological saline and cyclopentolate were intravitreally injected into deprived eyes at four-day intervals. All the left eyes remained untreated as group control. Refraction was measured by retinoscopy after cycloplegia. The axial dimensions were measured by A-scan ultrasound. Subsequently, retinal histology was observed by light microscopy. Results: After 4 weeks of treatment, intravitreal injection of cyclopentolate significantly reduced the degree of myopia in the deprived eyes (from -3.92 D to -0.86 D, P < 0.001), and retarded the increase of vitreous chamber depth (from 3.83 ± 0.06 mm to 3.70 ± 0.05 mm, P < 0.001) and axial length (from 8.42 ± 0.04 mm to 8.30 ± 0.05 mm, P < 0.001) in the deprived eyes. Histological ex-amination revealed no evidence of retinal damage of eyes injected with physiological saline or cy-clopentolate compared with normal control eyes. Conclusions: Intravitreal administration of cy-clopentolate reduces axial elongation of the deprived eyes in guinea pigs. Further investigations are required to identify the optimal dose.展开更多
Objective: To study the foveal displacement during the closure of idiopathic macular holes(MHs).Methods: Thirty-seven idiopathic MH patients treated by pars plana vitrectomy and internal limiting membrane peeling were...Objective: To study the foveal displacement during the closure of idiopathic macular holes(MHs).Methods: Thirty-seven idiopathic MH patients treated by pars plana vitrectomy and internal limiting membrane peeling were studied prospectively.Locations of MH center and foveal pit were measured by optic coherence tomography.Retinal displacement was observed using confocal scanning laser ophthalmoscopy.Results: A total of 40 eyes were included in this study and MHs were closed in 37 eyes(92.5%).The confocal scanning laser ophthalmoscopy showed that all of the retinal capillaries in the superior, inferior, nasal and temporal sides of the MHs moved toward the optic nerve head(ONH).The optic coherence tomography results showed that the mean nasal displacements of foveal pits were(102.9±61.2),(109.6±53.1), and(137.0±52.0) μm at 3, 6 and 12 months, respectively.And the mean vertical displacements were(55.9±49.4),(61.4±57.8) and(67.8±54.3) μm, respectively.Post-operative foveal pits were located in the nasal side of the MH centers.The extension of retina and nasal to the MH were in opposite directions: the nasal hole margin moved toward the MH, but the retina located closer to the ONH moved toward the ONH.The fellow eyes of three patients developed into idiopathic MH during the follow-up period and operations were performed for all of the three patients.Conclusion: Our results showed that center of macula does not move when an idiopathic MH develops, but it moves toward ONH during closure of hole; thus, new fovea is in nasal side of original fovea.展开更多
AIM:To investigate whether the axial length(AL)/total corneal refractive power(TCRP)ratio is a sensitive and simple factor that can be used for the early diagnosis of Marfan’s syndrome(MFS)in children.METHODS:The rel...AIM:To investigate whether the axial length(AL)/total corneal refractive power(TCRP)ratio is a sensitive and simple factor that can be used for the early diagnosis of Marfan’s syndrome(MFS)in children.METHODS:The relationship between the AL/TCRP ratio and the diagnosis of MFS for 192 eyes in 97 children were evaluate.The biological characteristics,including age,sex,AL,and TCRP,were collected from medical records.Receiver operating characteristic(ROC)curve analysis was performed to investigate whether the AL/TCRP ratio effectively distinguishes MFS from other subjects.The Youden index was used to re-divide the whole population into two groups according to an AL/TCRP ratio of 0.59.RESULTS:Of 96 subjects(mean age 7.46±3.28 y)evaluated,56(110 eyes)had a definite diagnosis of MFS in childhood based on the revised Ghent criteria,41(82 eyes)with diagnosis of congenital ectopia lentis(EL)were included as a control group.AL was negatively correlated with TCRP,with a linear regression coefficient of-0.36(R2=0.08).A significant correlation was found between age and the AL/TCRP ratio(P=0.023).ROC curve analysis showed that the AL/TCRP ratio distinguished MFS from the other patients at a threshold of 0.59.MFS patients were present in 24/58(41.38%)patients with an AL/TCRP ratio of≤0.59 and in 34/39(87.18%)patients with an AL/TCRP ratio of>0.59.CONCLUSION:An AL/TCRP ratio of>0.59 is significantly associated with the risk of MFS.The AL/TCRP ratio should be measured as a promising marker for the prognosis of children MFS.Changes in the AL/TCRP ratio should be monitored over time.展开更多
AIM:To describe a quick,cost-effective alternative to using a scraper to remove the residual posterior vitreous cortex and create an inner limiting membrane(ILM)flap during vitrectomy.METHODS:The surgical technique an...AIM:To describe a quick,cost-effective alternative to using a scraper to remove the residual posterior vitreous cortex and create an inner limiting membrane(ILM)flap during vitrectomy.METHODS:The surgical technique and a retrospective interventional single-center series of cases were described.A hook was made on the tip of a conventional syringe needle(outer diameter,0.6 mm;23 gauge)by bending the needle against a plate.We used this hook to remove the residual posterior vitreous cortex and create an ILM flap during vitrectomy.The efficacy and safety of using this instrument in ophthalmological procedures for a variety of vitreoretinal disorders were evaluated.RESULTS:The hook was effective for removing focal or diffuse residual posterior vitreous cortex in eyes with rhegmatogenous retinal detachment,proliferative diabetic retinopathy,and pathological myopia.It was also successfully used to make a free edge of the ILM and help strip the epiretinal membrane.There were no serious complications associated with using the hook in delicate ophthalmological procedures.CONCLUSION:The hook,made by bending a conventional needle,is a simple and cost-effective instrument for removing residual posterior vitreous vortex and to create epiretinal and ILM flaps during vitrectomy in eyes with various vitreoretinal diseases.展开更多
Objective: To observe the otolithic function in sudden sensorineural hearing loss (SSHL) patients in different age groups by using vestibular evoked myogenic potentials (VEMPs). Methods: One hundred and seventy unilat...Objective: To observe the otolithic function in sudden sensorineural hearing loss (SSHL) patients in different age groups by using vestibular evoked myogenic potentials (VEMPs). Methods: One hundred and seventy unilateral SSHL patients were divided into 5 age groups. The 170 affected ears belonged to study group. The opposite healthy ears of 170 patients and 138 normal ears of 69 age and sex-matched normal people at different ages were set as control groups. Ocular VEMP (oVEMP) and cervical VEMP (cVEMP) both evoked by air-conducted sound (ACS) were employed for vestibular otolithic function assessment. Results: The response rates of cVEMP and oVEMP were lower and abnormal rates were higher in affected ears of SSHL patients compared to the opposite healthy ears and normal control ears in all age groups, except patients over 60 years. The response rates of VEMPs significantly declined with increasing age, not only in normal control ears, but also in affected and healthy ears of SSHL patients. But, the abnormal rates of VEMPs showed no significant difference in affected ears at different ages. Conclusions: Dysfunction of vestibular otolithic organs in SSHL patients presented respective features at different ages. It is necessary to consider the age when the clinicians determine the otolithic condition of patients based on the VEMPs.展开更多
Objective:To investigate the relationship between renal blood distribution and the physiological activities of the kidney. Methods:A mathematical model is developed based on Hagan-Poiseuille law and mass transport, co...Objective:To investigate the relationship between renal blood distribution and the physiological activities of the kidney. Methods:A mathematical model is developed based on Hagan-Poiseuille law and mass transport, coupling mechanics of myogenic response (MR), tubuloglomerular feedback (TGF) and the tubular system in the renal medulla. The model parameters, including the permeability coefficients, the vascular lumen radius and the solute concentration at the inlet of the tubes, are derived from the experimental results. Simulations of the blood and water flow in the loop of Henel, the collecting duct and vas rectum, are carried out by the model of the tubular system in the renal medulla, based on conservations of water and solutes for transmural transport. Then the tubular model is coupled with MR and TGF mechanics. Results:The results predict the dynamics of renal autoregulation on its blood pressure and flow,and the distributions are 88.5% in the cortex, 10.3% in the medulla, and 1.2% at papilla,respectively. The fluid flow and solute concentrations along the tubules and vasa recta are obtained. Conclusion:The present model could assess renal functions qualitatively and quantitatively and provide a methodological approach for clinical research.展开更多
<strong>Background:</strong> Patients who had total laryngectomy not only have a pressure from the possible diagnosis of laryngeal cancer, but also suffer from unspeakable misery. To relieve the suffering,...<strong>Background:</strong> Patients who had total laryngectomy not only have a pressure from the possible diagnosis of laryngeal cancer, but also suffer from unspeakable misery. To relieve the suffering, some patients choose esophageal speech training. However, most of the current researches focus solely on the results of the training with the negligence of the patients’ mental health and their life experience during the training. A qualitative research is highly sensitive to patients’ subjective feelings, and thus able to capture their subtle emotional changes. <strong>Objective:</strong> To explore deeply patients’ real experiences of esophageal speech training after total laryngectomy and reveal the public their training experience of the unique and special group. <strong>Methods:</strong> In May 2018, researchers conducted a two-month field observation on and in-depth interviews with 15 patients who were on esophageal speech training after total laryngectomy in the esophageal speech training room of the Eye and ENT Hospital of Fudan University. The research applied phenomenological research method and Colaizzi Data Analysis. <strong>Results:</strong> The data analysis indicated four main themes: changes of mindset;showing positive attitudes and behaviors in training;shift in social relations;and arduous training process. <strong>Conclusion:</strong> The study has the finding that patients on esophageal speech training had negative emotions in the early stage of the training and dissatisfaction with its teaching. The repercussion of the surgery brought them changes of social relations, social bias and prejudice ensued. It is, therefore, urgent and crucial to give the speech trainees psychological counseling in the early stage to improve their qualities of life, to mobilize social support to incentivize their training, to optimize esophageal speech training teaching, and to regulate the management of the esophageal speech training environment.展开更多
Background:The aim of the study was to investigate the changes in the periarterial capillary-free zone(paCFZ)after anti-vascular endothelial growth factor(VEGF)therapy in patients with branch retinal vein occlusion(BR...Background:The aim of the study was to investigate the changes in the periarterial capillary-free zone(paCFZ)after anti-vascular endothelial growth factor(VEGF)therapy in patients with branch retinal vein occlusion(BRVO)by widefield swept-source optical coherence tomography angiography(SS-OCTA)and assess their associations with clinical outcomes.Methods:In this retrospective observational study of 54 treatment-naive BRVO patients with macular edema,we reviewed the findings of 12×12 mm^(2)SS-OCTA at baseline,3,6,and 12 months after intravitreal ranibizumab injections.The paCFZ and major retinal artery areas were measured on SS-OCTA images.The paCFZ area to artery area(P/A)ratio was calculated.Results:The paCFZ areas and P/A ratios of first-and second-order arteries were significantly greater in BRVO eyes than in contralateral eyes(all P<0.01),but there were no differences in the first-and second-order artery areas(P=0.20 and 0.25,respectively).The paCFZ areas and P/A ratios decreased significantly at 3,6,and 12 months after anti-VEGF therapy(all P<0.01).The baseline P/A ratio was significantly correlated with the baseline best-corrected visual acuity(BCVA),central retinal thickness,and their improvements at 3,6,and 12 months(all P<0.05).Baseline BCVA and P/A ratios of first-and second-order arteries were independently associated with the final BCVA in multivariate linear regression.Conclusions:Wide-field SS-OCTA shows that anti-VEGF therapy can lead to a significant improvement in the paCFZ parameters in BRVO.Smaller baseline P/A ratios on SS-OCTA tend to predict better visual outcomes at 12 months after anti-VEGF therapy.展开更多
Background:The accuracy of using total keratometry(TK)value in recent IOL power calculation formulas in highly myopic eyes remained unknown.Methods:Highly myopic patients who underwent uneventful cataract surgery were...Background:The accuracy of using total keratometry(TK)value in recent IOL power calculation formulas in highly myopic eyes remained unknown.Methods:Highly myopic patients who underwent uneventful cataract surgery were prospectively enrolled in this prospective comparative study.At one month postoperatively,standard deviation(SD)of the prediction errors(PEs),mean and median absolute error(MedAE)of 103 highly myopic eyes were back-calculated and compared among ten formulas,including XGboost,RBF 3.0,Kane,Barrett Universal II,Emmetropia Verifying Optical 2.0,Cooke K6,Haigis,SRK/T,and Wang-Koch modifications of Haigis and SRK/T formulas,using either TK or standard keratometry(K)value.Results:In highly myopic eyes,despite good agreement between TK and K(P>0.05),larger differences between the two were associated with smaller central corneal thickness(P<0.05).As to the refractive errors,TK method showed no differences compared to K method.The XGBoost,RBF 3.0 and Kane ranked top three when considering SDs of PEs.Using TK value,the XGboost calculator was comparable with the RBF 3.0 formula(P>0.05),which both presented smaller MedAEs than others(all P<0.05).As for the percentage of eyes within±0.50 D or±0.75 D of PE,the XGBoost TK showed comparable percentages with the RBF 3.0 TK formula(74.76%vs.66.99%,or 90.29%vs.87.38%,P>0.05),and statistically larger percentages than the other eight formulas(P<0.05).Conclusions:Highly myopic eyes with thinner corneas tend to have larger differences between TK and K.The XGboost enhancement calculator and RBF 3.0 formula using TK showed the most promising outcomes in highly myopic eyes.展开更多
Background:To investigate the decentration and tilt of plate-haptic multifocal intraocular lenses(MfIOLs)in myopic eyes.Methods:Myopic(axial length[AXL]>24.5 mm)and non-myopic(21.0 mm<AXL≤24.5 mm)cataract eyes ...Background:To investigate the decentration and tilt of plate-haptic multifocal intraocular lenses(MfIOLs)in myopic eyes.Methods:Myopic(axial length[AXL]>24.5 mm)and non-myopic(21.0 mm<AXL≤24.5 mm)cataract eyes were enrolled in this prospective study and randomly assigned to receive implantation of Zeiss AT LISA tri 839MP lenses(Group A)or Tecnis ZMB00 lenses(Group B).In total,122 eyes of 122 patients were available for analysis.Decentration and tilt of MfIOLs,high-order aberrations(HOAs),and modulation transfer functions(MTFs)were evaluated using the OPD-Scan III aberrometer 3 months postoperatively.Subjective symptoms were assessed with a Quality of Vision questionnaire.Results:Near and distance visual acuities,tilt and horizontal decentration did not differ between the two groups,postoperatively.However,myopic eyes of Group B showed greater vertical decentration than those of Group A(−0.17±0.14 mm vs.-0.03±0.09 mm,respectively),particularly when the MfIOLs were placed horizontally or obliquely.Overall decentration of myopic eyes was greater in Group B than in Group A(0.41±0.15 mm vs.0.16±0.10 mm,respectively).In Group B,AXL was negatively correlated with vertical decentration and positively correlated with overall decentration.No such correlations were found in Group A.Intraocular total HOAs,coma,trefoil and spherical aberrations were lower in Group A than in Group B for a 6.0 mm pupil among myopic eyes.Generally,Group A had better MTFs and fewer subjective symptoms than Group B among myopic eyes.Conclusions:Plate-haptic design of MfIOLs may be a suggested option for myopic cataract eyes due to the less inferior decentration and better visual quality postoperatively.展开更多
AIM:To investigate the safety and efficacy of using a onestep viscoelastic agent technique for posterior chamber phakic implantable collamer lens with a central hole(ICL V4 c)implantation for myopia correction.METHODS...AIM:To investigate the safety and efficacy of using a onestep viscoelastic agent technique for posterior chamber phakic implantable collamer lens with a central hole(ICL V4 c)implantation for myopia correction.METHODS:The one-step viscoelastic agent technique for ICL V4 c implantation was used in 100 eyes of 52 patients.Refractive outcomes,intraocular pressure(IOP),corneal endothelial cell,and corneal densitometry values were evaluated at 1 d,1 wk,1 and 3 mo postoperatively.RESULTS:All the surgeries were uneventful.No corrected distance visual acuity was lost after 3 mo.IOP was 16.12±3.18 mm Hg before surgery,and 14.74±3.08 mm Hg at 1d and 14.50±2.56 mm Hg at 3 mo after surgery(P<0.05).Corneal endothelial cell density was 2580±242 cell/mm^(2),the coefficient of variation in cell size was 42.11%±7.92%,and the percentage of hexagonal cells was 40.98%±9.46%before surgery.No significant difference was found when these outcomes were compared between the studied time points(P>0.05).The corneal densitometry values of the central 2 mm and 2 to 6 mm areas showed similar regularities.After surgery,the values significantly increased at 1 d,then decreased to the preoperative values at 1 wk,and then continued to decrease at 3 mo(P<0.05).CONCLUSION:The one-step viscoelastic agent technique for ICL V4c implantation is found to be safe and effective for myopia correction and causes little disturbance to the cornea.展开更多
In this paper,^(99m)Tc-TRODAT-1 Micro-SPECT (single-photon emission computed tomography) was used for imaging dopamine transporter (DAT) in retinas and to investigate the changes of DAT in retinas of guinea pigs with ...In this paper,^(99m)Tc-TRODAT-1 Micro-SPECT (single-photon emission computed tomography) was used for imaging dopamine transporter (DAT) in retinas and to investigate the changes of DAT in retinas of guinea pigs with form deprivation myopia.Pigmented guinea pigs aged 3 weeks were derided into form deprivation myopia (FDM) group (n=6) and normal control group (n=6).The test group wore translucent goggles randomly for 4 weeks, and both groups underwent biometric measurement (refraction and axial length) before and after the experiment. Micro-SPECT retinas imaging was performed at the 4^(th) week after injection of ^(99m)Tc-TRODAT-1.The retinas were clearly resolved in the images.The ratio of ^(99m)Tc-TRODAT-1 uptake in the myopic retinas (11.55±2.80) was 3.64±1.40 lower than that in the control eye (15.20±1.98),and 2.35±1.05 lower than that in the fellow eyes (13.90±2.04).The results showed that ^(99m)Tc-TRODAT-1 Micro-SPECT eye imaging can be used to trace the distribution and changes of DAT in retina,and DAT in the myopic retinas were lower than that in the normal control eyes and fellow eyes.Micro-SPECT may provide a new approach for further studies on the role of dopamine system in the experimental myopia.展开更多
Background:Herpes simplex keratitis (HSK) caused by herpes simplex virus 1 (HSV-1),which has high recurrent rate and incidence of severe vision loss,is the leading cause of infectious blindness in the world.The a...Background:Herpes simplex keratitis (HSK) caused by herpes simplex virus 1 (HSV-1),which has high recurrent rate and incidence of severe vision loss,is the leading cause of infectious blindness in the world.The aim was to explore the clinical efficacy of oral ganciclovir (GCV) in the prevention of recurrent HSK.Methods:A multicenter,prospective,randomized,single-blind,and controlled clinical trial was conducted from April 2010 to June 2013.One hundred seventy-three patients (173 eyes involved) who were diagnosed as recurrent HSK definitely,including stromal keratitis and corneal endotheliitis,were divided into three groups randomly:negative control (placebo) group was topically administered with 0.15% GCV ophthalmic gel,4 times per day and 0.1% fluorometholone eye drops,3 times per day until resolution of HSK; positive control acyclovir (ACV) group was topically adopted the same ophthalmic gel and eye drops and additionally received oral ACV 400 mg 5 times a day for 10 weeks and followed by 400 mg 2 times per day for 6 months; test GCV group was topically adopted the same treatment as negative control group and additionally received oral GCV 1000 mg 3 times per day for 8 weeks.The symptoms and signs were evaluated before and after the therapy 1^st week,2^nd week and then followed up every 2 weeks until recovery.Furthermore,we followed up recurrence of HSK for every 3 months after recovery and then assessed the cure time,recurrent rate and adverse reactions.Results:One hundred and seventy-three patients were followed up 7-48 months (mean 32.1 ± 12.3 months),but 34 patients were failed to follow-up.The cure time was 12.1± 4.3,11.9 ± 4.0 weeks in negative control (placebo) group and positive control ACV group respectively (P =0.991),which was longer than that in test GCV group (8.6 ± 2.8 weeks) and there was a significant difference between test GCV group and negative control (placebo) group or positive control ACV group (P =0.000).Furthermore,the recurrent rate was higher in negative control (placebo) group (47.3%) than that in positive control group ACV (26.7%) and test GCV group (17.2%),and there was a great significant difference among the three groups (P =0.007),but there was no significant difference between positive control ACV group and test GCV group (P =0.358).In addition,there was no obvious adverse reaction expect neutropenia (only one patient in test GCV group).Conclusion:Short-term oral GCV could cure recurrent HSK and endotheliitis,shorten the course,reduce recurrent rate of HSK and have confirmed safety.展开更多
文摘AIM: To investigate the treatment status and prognosis of space-occupying lacrimal gland lesions at one tertiary eye center in China. METHODS: A retrospective clinical study was performed on 95 patients with space-occupying lesions of the lacrimal gland surgically treated at the Eye & ENT Hospital of Fudan University from 2003 to 2007. The reviewed clinical data included age, gender, side of the lesion, duration of signs and symptoms, histopathological diagnosis, treatment modality, recurrence (local, regional, and distant metastasis) and survival. RESULTS: Of the 95 cases (99 eyes), pleomorphic adenomas were the most common lesions (43 cases), followed by lymphoid disorders (14), inflammatory pseudotumors (11), carcinoma ex-pleomorphic adenomas (11), and adenoid cystic carcinomas (ACC, 6). There were 8 patients with relapsed pleomorphic adenomas. Five of these 8 cases had malignant pathological changes. All patients with ACC had metastasis and three of them died during their follow-up. CONCLUSION: Our study indicated that the most common lacrimal gland lesions were pleomorphic adenomas. Multiple recurrence and surgical procedures may increase the risk of tumor progression. ACC had a high incidence of tumor metastasis and a poor prognosis.
基金Supported by National Natural Science Foundation of China(No.81300805)。
文摘AIM:To characterize spectral-domain optical coherence tomography(SD-OCT)features of chorioretinal folds in orbital mass imaged using enhanced depth imaging(EDI).METHODS:Prospective observational case-control study was conducted in 20 eyes of 20 patients,the uninvolved eye served as a control.All the patients underwent clinical fundus photography,computed tomography,EDI SDOCT imaging before and after surgery.Two patients with cavernous hemangiomas underwent intratumoral injection of bleomycin A5;the remaining patients underwent tumor excision.Patients were followed 1 to 14mo following surgery(average follow up,5.8mo).RESULTS:Visual acuity prior to surgery ranged from 20/20 to 20/200.Following surgery,5 patients’visual acuity remained unchanged while the remaining 15 patients had a mean letter improvement of 10(range 4 to 26 letters).Photoreceptor inner/outer segment defects were found in 10 of 15 patients prior to surgery.Following surgical excision,photoreceptor inner/outer segment defects fully resolved in 8 of these 10 patients.CONCLUSION:Persistence of photoreceptor inner/outer segment defects caused by compression of the globe by an orbital mass can be associated with reduced visual prognosis.Our findings suggest that photoreceptor inner/outer segment defects on EDI SD-OCT could be an indicator for immediate surgical excision of an orbital mass causing choroidal compression.
基金Supported by the National Natural Science Foundation of China (No.82171099,No.82000940,No.81970835,No.81800867)the Natural Science Foundation of Shanghai (No.20ZR1409500)。
文摘AIM:To illustrate clinicopathological features of orbital non-rhabdomyosarcoma soft tissue sarcoma(NRSTS),and to compare the treatment outcome between postoperative radiotherapy(RT) and chemotherapy in a retrospective analysis nearly 20y.METHODS:A retrospective cohort study of 56 patients with orbital NRSTS were reviewed,34 of whom received postoperative RT,and 22 received postoperative chemotherapy.The clinicopathological features,local recurrence,metastases,and survival data were recorded.Survival analysis was performed using the Kaplan-Meier method.RESULTS:During follow-up(111.8mo,ranged 8-233mo) for 56 patients,19 patients of them developed local recurrence,and 7 patients developed distant metastases.Fifteen patients died during follow-up period.Overall survival rates considering the whole study group was 78.57% at 5y,and 72.16% at 10y after the initial diagnosis.Compared with chemotherapy,RT was associated with lower risk of local recurrence [hazard ratio for RT vs chemotherapy,0.263,95% confidence interval(CI),0.095-0.728,P=0.0015];with lower risk of distant metastasis(hazard ratio for RT vs chemotherapy,0.073,95%CI,0.015-0.364,P=0.0014);and with lower risk of death from disease(hazard ratio for RT vs chemotherapy,0.066,95%CI,0.022-0.200,P<0.0001).The 5-year survival rate in RT group was 97.06% compared to 50% in chemotherapy group.CONCLUSION:In patients with orbital NRSTS,postoperative RT provides better control of local recurrence,distant metastasis,and death from disease than chemotherapy.RT is the more preferrable adjuvant therapy compared to chemotherapy possibly.
基金Supported by the National Natural Science Foundation for Young Scholar of China(No.81600739)the Shanghai Hospital Development Center(No.SHDC12016116)the Science and Technology Commission of Shanghai Municipality(No.16411953700)
文摘AIM: To investigate the clinical and optical coherence tomography(OCT) features of focal choroidal excavation(FCE) complicated with choroidal neovascularization(CNV) in young and middle aged patients. METHODS: We performed a retrospective review of 26 patients with FCE accompanied by CNV. All patients underwent a complete ophthalmic examination. We analyzed the clinical characteristics of patients, focusing on the spectral-domain OCT features. All patients received intravitreal injection of anti-vascular endothelial growth factor(anti-VEGF) agents. And we assessed the changes of central retinal thickness and best-corrected visual acuity(BCVA) after anti-VEGF therapy. RESULTS: The mean age of 26 patients was 35.5±7.3 y(range, 21-48 y). Of the 26 FCE lesions, 11 were located subfoveal, 6 were parafoveal, and 9 were extrafoveal. The mean FCE depth was 129.8±50.3 μm, and the mean width was 901.3±306.0 μm. The FCE depth was correlated positively with the width, but not correlated with age or refractive error. CNV was located within the excavation(19 eyes) or adjacent to the excavation(7 eyes). After anti-VEGF therapy, the central retinal thickness was significantly reduced and the BCVA was significantly improved. In the absorption process of subretinal fluid, we found that the fluid in the excavations needed to be absorbed at the last. A small amount of residual fluid could still be seen in a few deep excavations even after a longterm follow-up.CONCLUSION: FCE may be an important reason to cause CNV. Especially in young patients with idiopathic CNV, we should pay attention to the use of OCT to check the presence of FCE. Anti-VEGF therapy is generally effective for CNV associated with FCE.
基金Supported by National Natural Science Foundation of China(No.81770955)National Natural Science Foundation of China for Young Scholar(No.81600762)+1 种基金Project of Shanghai Science and Technology(No.17411950200)Joint Research Project of New Frontier Technology in Municipal Hospitals(No.SHDC12018103)。
文摘AIM:To assess objective visual quality after presbyopia correction using the Presby MAX monocular mode.METHODS:This prospective,nonrandomized study included 28 eyes from 18 patients(mean age 50.4±5.6 y)who underwent presbyopia correction with the Presby MAX monocular mode.Monocular and binocular visual acuities were evaluated preoperatively,1 d,1 wk,1,3 mo,and 1 y after surgery.Optical quality was analyzed by HartmannShack wavefront aberration supported cornea ablation.Modulation transfer function(MTF)cutoff frequency,Strehl ratio,and objective scattering index(OSI)were analyzed using an optical quality analysis system.RESULTS:One year after surgery,100%and 94.4%of patients achieved binocular uncorrected distance and near visual acuity of 20/25,respectively.At the last visit Spherical aberration and total higher aberration were higher than the corresponding preoperative levels(P<0.001);however,no significant difference was found in MTF,OSI,or Strehl ratio.Transient decreases in OSI and MTF mainly occurred in the nondominant eyes.There was no significant difference in optical quality between the dominant and nondominant eyes,except for spherical aberration and horizontal coma(P<0.05).CONCLUSION:The Presby MAX monocular mode is safe and effective for presbyopia correction.It has little effect on optical quality,though short-term degraded optical quality occurred mainly in the bi-aspheric ablated eyes.
文摘AIM: To investigate cap morphology after small-incision lenticule extraction (SMILE) and its effects on intraocular scattering. METHODS: Sixty-five eyes of 33 patients undergoing SMILE were enrolled. In addition to regular evaluation, Fourier-domain optical coherence tomography was used to investigate cap thickness at ld, lwk, 1 and 3mo postoperatively. The optical quality including modulation transfer function cutoff frequency, Strehl ratio, Optical Quality Analysis System (OQAS) values, and objective scattering index (OSI), were evaluated using OQASTM. RESULTS: Cap thickness decreased from ld to lwk (P〈0.001), but remained higher than intended thickness of 120 μm after 3mo (P〈0.001). Cap thickness in central area was thinner than that of in the paracentral and peripheral areas (P〈0.0001). Total number of microdistortions decreased from ld to 3mo (P〈0.0001). Pearson analysis revealed a weak correlation between OSI and standard deviation of cap thickness at ld and lmo, as well as between range of cap thickness and OSI at 1mo. No correlation was found between microdistortion and OSI, but a negative correlation existed between microdistortion and range at ld and lmoafter surgery. CONCLUSION: The corneal cap tends to be more accurate and regular with time lapse. Better cap morphology tends to contribute less intraocular scattering in the eyes undergoing SMILE.
文摘Purpose: To investigate the effects of intravitreal injection of cyclopentolate on form deprivation myopia in guinea pigs. Methods: Thirty-five guinea pigs at age of 3 weeks were randomly divided into 5 groups (n = 7 for each group): deprived, deprived plus saline, deprived plus cyclopentolate, normal control, and cyclopentolate group. Form deprivation was only performed in right eyes with translucent membranes for 4 weeks. Physiological saline and cyclopentolate were intravitreally injected into deprived eyes at four-day intervals. All the left eyes remained untreated as group control. Refraction was measured by retinoscopy after cycloplegia. The axial dimensions were measured by A-scan ultrasound. Subsequently, retinal histology was observed by light microscopy. Results: After 4 weeks of treatment, intravitreal injection of cyclopentolate significantly reduced the degree of myopia in the deprived eyes (from -3.92 D to -0.86 D, P < 0.001), and retarded the increase of vitreous chamber depth (from 3.83 ± 0.06 mm to 3.70 ± 0.05 mm, P < 0.001) and axial length (from 8.42 ± 0.04 mm to 8.30 ± 0.05 mm, P < 0.001) in the deprived eyes. Histological ex-amination revealed no evidence of retinal damage of eyes injected with physiological saline or cy-clopentolate compared with normal control eyes. Conclusions: Intravitreal administration of cy-clopentolate reduces axial elongation of the deprived eyes in guinea pigs. Further investigations are required to identify the optimal dose.
基金supported by National Basic Research Program of China(973 Program,No.2013CB967503)National Natural Science Foundation of China(No.81170857)Shanghai Key Laboratory of Visual Impairment and Restoration,Fudan University,Shanghai,China
文摘Objective: To study the foveal displacement during the closure of idiopathic macular holes(MHs).Methods: Thirty-seven idiopathic MH patients treated by pars plana vitrectomy and internal limiting membrane peeling were studied prospectively.Locations of MH center and foveal pit were measured by optic coherence tomography.Retinal displacement was observed using confocal scanning laser ophthalmoscopy.Results: A total of 40 eyes were included in this study and MHs were closed in 37 eyes(92.5%).The confocal scanning laser ophthalmoscopy showed that all of the retinal capillaries in the superior, inferior, nasal and temporal sides of the MHs moved toward the optic nerve head(ONH).The optic coherence tomography results showed that the mean nasal displacements of foveal pits were(102.9±61.2),(109.6±53.1), and(137.0±52.0) μm at 3, 6 and 12 months, respectively.And the mean vertical displacements were(55.9±49.4),(61.4±57.8) and(67.8±54.3) μm, respectively.Post-operative foveal pits were located in the nasal side of the MH centers.The extension of retina and nasal to the MH were in opposite directions: the nasal hole margin moved toward the MH, but the retina located closer to the ONH moved toward the ONH.The fellow eyes of three patients developed into idiopathic MH during the follow-up period and operations were performed for all of the three patients.Conclusion: Our results showed that center of macula does not move when an idiopathic MH develops, but it moves toward ONH during closure of hole; thus, new fovea is in nasal side of original fovea.
基金Supported by the National Natural Science Foundation of China(No.81770908)the Shanghai Science and Technology Commission(Scientific Innovation Project,No.20Y11911000)。
文摘AIM:To investigate whether the axial length(AL)/total corneal refractive power(TCRP)ratio is a sensitive and simple factor that can be used for the early diagnosis of Marfan’s syndrome(MFS)in children.METHODS:The relationship between the AL/TCRP ratio and the diagnosis of MFS for 192 eyes in 97 children were evaluate.The biological characteristics,including age,sex,AL,and TCRP,were collected from medical records.Receiver operating characteristic(ROC)curve analysis was performed to investigate whether the AL/TCRP ratio effectively distinguishes MFS from other subjects.The Youden index was used to re-divide the whole population into two groups according to an AL/TCRP ratio of 0.59.RESULTS:Of 96 subjects(mean age 7.46±3.28 y)evaluated,56(110 eyes)had a definite diagnosis of MFS in childhood based on the revised Ghent criteria,41(82 eyes)with diagnosis of congenital ectopia lentis(EL)were included as a control group.AL was negatively correlated with TCRP,with a linear regression coefficient of-0.36(R2=0.08).A significant correlation was found between age and the AL/TCRP ratio(P=0.023).ROC curve analysis showed that the AL/TCRP ratio distinguished MFS from the other patients at a threshold of 0.59.MFS patients were present in 24/58(41.38%)patients with an AL/TCRP ratio of≤0.59 and in 34/39(87.18%)patients with an AL/TCRP ratio of>0.59.CONCLUSION:An AL/TCRP ratio of>0.59 is significantly associated with the risk of MFS.The AL/TCRP ratio should be measured as a promising marker for the prognosis of children MFS.Changes in the AL/TCRP ratio should be monitored over time.
基金Supported by the National Natural Science Foundation of China(No.81770944,No.81800846)Shanghai Hospital Development Center(No.SHDC2020CR2041B)。
文摘AIM:To describe a quick,cost-effective alternative to using a scraper to remove the residual posterior vitreous cortex and create an inner limiting membrane(ILM)flap during vitrectomy.METHODS:The surgical technique and a retrospective interventional single-center series of cases were described.A hook was made on the tip of a conventional syringe needle(outer diameter,0.6 mm;23 gauge)by bending the needle against a plate.We used this hook to remove the residual posterior vitreous cortex and create an ILM flap during vitrectomy.The efficacy and safety of using this instrument in ophthalmological procedures for a variety of vitreoretinal disorders were evaluated.RESULTS:The hook was effective for removing focal or diffuse residual posterior vitreous cortex in eyes with rhegmatogenous retinal detachment,proliferative diabetic retinopathy,and pathological myopia.It was also successfully used to make a free edge of the ILM and help strip the epiretinal membrane.There were no serious complications associated with using the hook in delicate ophthalmological procedures.CONCLUSION:The hook,made by bending a conventional needle,is a simple and cost-effective instrument for removing residual posterior vitreous vortex and to create epiretinal and ILM flaps during vitrectomy in eyes with various vitreoretinal diseases.
文摘Objective: To observe the otolithic function in sudden sensorineural hearing loss (SSHL) patients in different age groups by using vestibular evoked myogenic potentials (VEMPs). Methods: One hundred and seventy unilateral SSHL patients were divided into 5 age groups. The 170 affected ears belonged to study group. The opposite healthy ears of 170 patients and 138 normal ears of 69 age and sex-matched normal people at different ages were set as control groups. Ocular VEMP (oVEMP) and cervical VEMP (cVEMP) both evoked by air-conducted sound (ACS) were employed for vestibular otolithic function assessment. Results: The response rates of cVEMP and oVEMP were lower and abnormal rates were higher in affected ears of SSHL patients compared to the opposite healthy ears and normal control ears in all age groups, except patients over 60 years. The response rates of VEMPs significantly declined with increasing age, not only in normal control ears, but also in affected and healthy ears of SSHL patients. But, the abnormal rates of VEMPs showed no significant difference in affected ears at different ages. Conclusions: Dysfunction of vestibular otolithic organs in SSHL patients presented respective features at different ages. It is necessary to consider the age when the clinicians determine the otolithic condition of patients based on the VEMPs.
文摘Objective:To investigate the relationship between renal blood distribution and the physiological activities of the kidney. Methods:A mathematical model is developed based on Hagan-Poiseuille law and mass transport, coupling mechanics of myogenic response (MR), tubuloglomerular feedback (TGF) and the tubular system in the renal medulla. The model parameters, including the permeability coefficients, the vascular lumen radius and the solute concentration at the inlet of the tubes, are derived from the experimental results. Simulations of the blood and water flow in the loop of Henel, the collecting duct and vas rectum, are carried out by the model of the tubular system in the renal medulla, based on conservations of water and solutes for transmural transport. Then the tubular model is coupled with MR and TGF mechanics. Results:The results predict the dynamics of renal autoregulation on its blood pressure and flow,and the distributions are 88.5% in the cortex, 10.3% in the medulla, and 1.2% at papilla,respectively. The fluid flow and solute concentrations along the tubules and vasa recta are obtained. Conclusion:The present model could assess renal functions qualitatively and quantitatively and provide a methodological approach for clinical research.
文摘<strong>Background:</strong> Patients who had total laryngectomy not only have a pressure from the possible diagnosis of laryngeal cancer, but also suffer from unspeakable misery. To relieve the suffering, some patients choose esophageal speech training. However, most of the current researches focus solely on the results of the training with the negligence of the patients’ mental health and their life experience during the training. A qualitative research is highly sensitive to patients’ subjective feelings, and thus able to capture their subtle emotional changes. <strong>Objective:</strong> To explore deeply patients’ real experiences of esophageal speech training after total laryngectomy and reveal the public their training experience of the unique and special group. <strong>Methods:</strong> In May 2018, researchers conducted a two-month field observation on and in-depth interviews with 15 patients who were on esophageal speech training after total laryngectomy in the esophageal speech training room of the Eye and ENT Hospital of Fudan University. The research applied phenomenological research method and Colaizzi Data Analysis. <strong>Results:</strong> The data analysis indicated four main themes: changes of mindset;showing positive attitudes and behaviors in training;shift in social relations;and arduous training process. <strong>Conclusion:</strong> The study has the finding that patients on esophageal speech training had negative emotions in the early stage of the training and dissatisfaction with its teaching. The repercussion of the surgery brought them changes of social relations, social bias and prejudice ensued. It is, therefore, urgent and crucial to give the speech trainees psychological counseling in the early stage to improve their qualities of life, to mobilize social support to incentivize their training, to optimize esophageal speech training teaching, and to regulate the management of the esophageal speech training environment.
基金supported by Three-year Action Plan of Shanghai Shenkang Hospital Development Center to Promote Clinical Skills and Clinical Innovation in Municipal Hospitals[SHDC2020CR3050B and SHDC2022CRS003A]key project of“Double First-Class”initiativeFudan-Fosun Nursing Research Fund[FNF202237].
基金supported by grants from the National Natural Science Foundation of China(Grant Nos.82101150,82171078)Shanghai clinical 3-year action plan-major clinical research(Grant Nos.SHDC2020CR2041B,SHDC2020CR5014-003)+1 种基金Shanghai Sailing Program(Grant No.21YF1405300)Shanghai Committee of Science and Technology(Grant Nos.20Y11911100,18411965100).
文摘Background:The aim of the study was to investigate the changes in the periarterial capillary-free zone(paCFZ)after anti-vascular endothelial growth factor(VEGF)therapy in patients with branch retinal vein occlusion(BRVO)by widefield swept-source optical coherence tomography angiography(SS-OCTA)and assess their associations with clinical outcomes.Methods:In this retrospective observational study of 54 treatment-naive BRVO patients with macular edema,we reviewed the findings of 12×12 mm^(2)SS-OCTA at baseline,3,6,and 12 months after intravitreal ranibizumab injections.The paCFZ and major retinal artery areas were measured on SS-OCTA images.The paCFZ area to artery area(P/A)ratio was calculated.Results:The paCFZ areas and P/A ratios of first-and second-order arteries were significantly greater in BRVO eyes than in contralateral eyes(all P<0.01),but there were no differences in the first-and second-order artery areas(P=0.20 and 0.25,respectively).The paCFZ areas and P/A ratios decreased significantly at 3,6,and 12 months after anti-VEGF therapy(all P<0.01).The baseline P/A ratio was significantly correlated with the baseline best-corrected visual acuity(BCVA),central retinal thickness,and their improvements at 3,6,and 12 months(all P<0.05).Baseline BCVA and P/A ratios of first-and second-order arteries were independently associated with the final BCVA in multivariate linear regression.Conclusions:Wide-field SS-OCTA shows that anti-VEGF therapy can lead to a significant improvement in the paCFZ parameters in BRVO.Smaller baseline P/A ratios on SS-OCTA tend to predict better visual outcomes at 12 months after anti-VEGF therapy.
基金supported by research grants from the National Natural Science Foundation of China(Grant Nos.82122017,81870642,81970780 and 81670835)Science and Technology Innovation Action Plan of Shanghai Science and Technology Commission(Grant Nos.19441900700 and 21S31904900)+1 种基金Clinical Research Plan of Shanghai Shenkang Hospital Development Center(Grant Nos.SHDC2020CR4078 and SHDC12019X08)the Fudan University“Outstanding 2025”Program.
文摘Background:The accuracy of using total keratometry(TK)value in recent IOL power calculation formulas in highly myopic eyes remained unknown.Methods:Highly myopic patients who underwent uneventful cataract surgery were prospectively enrolled in this prospective comparative study.At one month postoperatively,standard deviation(SD)of the prediction errors(PEs),mean and median absolute error(MedAE)of 103 highly myopic eyes were back-calculated and compared among ten formulas,including XGboost,RBF 3.0,Kane,Barrett Universal II,Emmetropia Verifying Optical 2.0,Cooke K6,Haigis,SRK/T,and Wang-Koch modifications of Haigis and SRK/T formulas,using either TK or standard keratometry(K)value.Results:In highly myopic eyes,despite good agreement between TK and K(P>0.05),larger differences between the two were associated with smaller central corneal thickness(P<0.05).As to the refractive errors,TK method showed no differences compared to K method.The XGBoost,RBF 3.0 and Kane ranked top three when considering SDs of PEs.Using TK value,the XGboost calculator was comparable with the RBF 3.0 formula(P>0.05),which both presented smaller MedAEs than others(all P<0.05).As for the percentage of eyes within±0.50 D or±0.75 D of PE,the XGBoost TK showed comparable percentages with the RBF 3.0 TK formula(74.76%vs.66.99%,or 90.29%vs.87.38%,P>0.05),and statistically larger percentages than the other eight formulas(P<0.05).Conclusions:Highly myopic eyes with thinner corneas tend to have larger differences between TK and K.The XGboost enhancement calculator and RBF 3.0 formula using TK showed the most promising outcomes in highly myopic eyes.
基金Publication of this article was supported by research grants from the National Natural Science Foundation of the People’s Republic of China(grant nos.81870642,81670835 and 81470613)the Shanghai High Myopia Study Group,the International Science and Technology Cooperation Foundation of Shanghai(grant no.14430721100)the Outstanding Youth Medical Talents Program of Shanghai Health and Family Planning Commission(grant no.2017YQ011).
文摘Background:To investigate the decentration and tilt of plate-haptic multifocal intraocular lenses(MfIOLs)in myopic eyes.Methods:Myopic(axial length[AXL]>24.5 mm)and non-myopic(21.0 mm<AXL≤24.5 mm)cataract eyes were enrolled in this prospective study and randomly assigned to receive implantation of Zeiss AT LISA tri 839MP lenses(Group A)or Tecnis ZMB00 lenses(Group B).In total,122 eyes of 122 patients were available for analysis.Decentration and tilt of MfIOLs,high-order aberrations(HOAs),and modulation transfer functions(MTFs)were evaluated using the OPD-Scan III aberrometer 3 months postoperatively.Subjective symptoms were assessed with a Quality of Vision questionnaire.Results:Near and distance visual acuities,tilt and horizontal decentration did not differ between the two groups,postoperatively.However,myopic eyes of Group B showed greater vertical decentration than those of Group A(−0.17±0.14 mm vs.-0.03±0.09 mm,respectively),particularly when the MfIOLs were placed horizontally or obliquely.Overall decentration of myopic eyes was greater in Group B than in Group A(0.41±0.15 mm vs.0.16±0.10 mm,respectively).In Group B,AXL was negatively correlated with vertical decentration and positively correlated with overall decentration.No such correlations were found in Group A.Intraocular total HOAs,coma,trefoil and spherical aberrations were lower in Group A than in Group B for a 6.0 mm pupil among myopic eyes.Generally,Group A had better MTFs and fewer subjective symptoms than Group B among myopic eyes.Conclusions:Plate-haptic design of MfIOLs may be a suggested option for myopic cataract eyes due to the less inferior decentration and better visual quality postoperatively.
基金the National Natural Science Foundation of China for Young Scholars(No.81700872)the National Natural Science Foundation of China(No.81770955)+4 种基金the Project of Shanghai Science and Technology(No.17411950200No.20410710100)the Joint Research Project of New Frontier Technology in Municipal Hospitals(No.SHDC12018103)the Clinical Research Plan of SHDC(No.SHDC2020CR1043B)the Project of Shanghai Xuhui District Science and Technology(No.2020-015)。
文摘AIM:To investigate the safety and efficacy of using a onestep viscoelastic agent technique for posterior chamber phakic implantable collamer lens with a central hole(ICL V4 c)implantation for myopia correction.METHODS:The one-step viscoelastic agent technique for ICL V4 c implantation was used in 100 eyes of 52 patients.Refractive outcomes,intraocular pressure(IOP),corneal endothelial cell,and corneal densitometry values were evaluated at 1 d,1 wk,1 and 3 mo postoperatively.RESULTS:All the surgeries were uneventful.No corrected distance visual acuity was lost after 3 mo.IOP was 16.12±3.18 mm Hg before surgery,and 14.74±3.08 mm Hg at 1d and 14.50±2.56 mm Hg at 3 mo after surgery(P<0.05).Corneal endothelial cell density was 2580±242 cell/mm^(2),the coefficient of variation in cell size was 42.11%±7.92%,and the percentage of hexagonal cells was 40.98%±9.46%before surgery.No significant difference was found when these outcomes were compared between the studied time points(P>0.05).The corneal densitometry values of the central 2 mm and 2 to 6 mm areas showed similar regularities.After surgery,the values significantly increased at 1 d,then decreased to the preoperative values at 1 wk,and then continued to decrease at 3 mo(P<0.05).CONCLUSION:The one-step viscoelastic agent technique for ICL V4c implantation is found to be safe and effective for myopia correction and causes little disturbance to the cornea.
文摘In this paper,^(99m)Tc-TRODAT-1 Micro-SPECT (single-photon emission computed tomography) was used for imaging dopamine transporter (DAT) in retinas and to investigate the changes of DAT in retinas of guinea pigs with form deprivation myopia.Pigmented guinea pigs aged 3 weeks were derided into form deprivation myopia (FDM) group (n=6) and normal control group (n=6).The test group wore translucent goggles randomly for 4 weeks, and both groups underwent biometric measurement (refraction and axial length) before and after the experiment. Micro-SPECT retinas imaging was performed at the 4^(th) week after injection of ^(99m)Tc-TRODAT-1.The retinas were clearly resolved in the images.The ratio of ^(99m)Tc-TRODAT-1 uptake in the myopic retinas (11.55±2.80) was 3.64±1.40 lower than that in the control eye (15.20±1.98),and 2.35±1.05 lower than that in the fellow eyes (13.90±2.04).The results showed that ^(99m)Tc-TRODAT-1 Micro-SPECT eye imaging can be used to trace the distribution and changes of DAT in retina,and DAT in the myopic retinas were lower than that in the normal control eyes and fellow eyes.Micro-SPECT may provide a new approach for further studies on the role of dopamine system in the experimental myopia.
文摘Background:Herpes simplex keratitis (HSK) caused by herpes simplex virus 1 (HSV-1),which has high recurrent rate and incidence of severe vision loss,is the leading cause of infectious blindness in the world.The aim was to explore the clinical efficacy of oral ganciclovir (GCV) in the prevention of recurrent HSK.Methods:A multicenter,prospective,randomized,single-blind,and controlled clinical trial was conducted from April 2010 to June 2013.One hundred seventy-three patients (173 eyes involved) who were diagnosed as recurrent HSK definitely,including stromal keratitis and corneal endotheliitis,were divided into three groups randomly:negative control (placebo) group was topically administered with 0.15% GCV ophthalmic gel,4 times per day and 0.1% fluorometholone eye drops,3 times per day until resolution of HSK; positive control acyclovir (ACV) group was topically adopted the same ophthalmic gel and eye drops and additionally received oral ACV 400 mg 5 times a day for 10 weeks and followed by 400 mg 2 times per day for 6 months; test GCV group was topically adopted the same treatment as negative control group and additionally received oral GCV 1000 mg 3 times per day for 8 weeks.The symptoms and signs were evaluated before and after the therapy 1^st week,2^nd week and then followed up every 2 weeks until recovery.Furthermore,we followed up recurrence of HSK for every 3 months after recovery and then assessed the cure time,recurrent rate and adverse reactions.Results:One hundred and seventy-three patients were followed up 7-48 months (mean 32.1 ± 12.3 months),but 34 patients were failed to follow-up.The cure time was 12.1± 4.3,11.9 ± 4.0 weeks in negative control (placebo) group and positive control ACV group respectively (P =0.991),which was longer than that in test GCV group (8.6 ± 2.8 weeks) and there was a significant difference between test GCV group and negative control (placebo) group or positive control ACV group (P =0.000).Furthermore,the recurrent rate was higher in negative control (placebo) group (47.3%) than that in positive control group ACV (26.7%) and test GCV group (17.2%),and there was a great significant difference among the three groups (P =0.007),but there was no significant difference between positive control ACV group and test GCV group (P =0.358).In addition,there was no obvious adverse reaction expect neutropenia (only one patient in test GCV group).Conclusion:Short-term oral GCV could cure recurrent HSK and endotheliitis,shorten the course,reduce recurrent rate of HSK and have confirmed safety.