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The Practice and Effectiveness of COVID-19 RNA Detection in the Prevention and Control of Ophthalmic Hospital 新型冠状病毒核酸检测在眼科医院防控中的实践与效果
Pub Date : 2020-03-13 DOI: 10.3760/CMA.J.CN115909-20200303-00063
Meiqin Zheng, Youpei Wang, Yunfeng Gu, Liping Mao, Wencan Wu, Wei Chen, Xinping Yu, Dingxing Ye, Y. Liang, J. Qu
Objective: To explore a practical system of precision prevention and control against Corona Virus Disease 19 (COVID-19) for eye hospitals by emphasizing on systematic and standardized virus RNA detection procedures. Methods: To include standardized virus RNA detection along with blood routine test (BRT), C-reactive protein (CRP) and serum amyloid A (SAA) into preoperative screening test items for ocular surgical patients and to provide virus RNA detection for returned employees between 24 February 2020 and 2 March 2020. In addition, a questionnaire is designed to investigate the acceptability of nasopharyngeal swab sampling and the influence of virus RNA detection results on mental status of the examinee. Result: 99 examination results showed a certain percentage of abnormal, among which 13 cases showing increase in SAA, 12 cases showing decrease and 5 cases showing increase in lymphocyte count (LYM), 1 case showing decrease and 11 cases showing increase in white blood count (WBC), 2 cases showing increase in CRP. All cases showing negative in COVID-19 RNA detection, including examined patients and 33 employees of the Eye Hospital.11.7% of respondents reported a low acceptance score for nasopharyngeal swab sampling. The proportion of the examinees with higher mental stress scores before and after the virus RNA detection was 46.7% and 6.7% respectively. Conclusion: The detection procedures can offer objective basis for preoperative screening and differential diagnosis, whilst largely eliminating the possibility of transmission via asymptomatic infected individuals. On the other hand, the negative result of virus RNA detection is beneficial in adjusting patient’s preoperative psychological state and relieving the mental stress of medical staff during the epidemic. Key words: COVID-19; Infection; epidemic prevention and control; RNA detection; ophthalmology; effectiveness
目的:探索以系统、规范的病毒RNA检测程序为重点的眼科医院新型冠状病毒病(COVID-19)精准防控实用体系。方法:将标准化病毒RNA检测与血常规检测(BRT)、c反应蛋白(CRP)和血清淀粉样蛋白A (SAA)一起纳入眼科手术患者术前筛查试验项目,并于2020年2月24日至2020年3月2日对回国员工进行病毒RNA检测。此外,设计问卷调查鼻咽拭子取样的可接受性和病毒RNA检测结果对考生精神状态的影响。结果:99例检查结果有一定比例的异常,其中SAA升高13例,淋巴细胞计数(LYM)降低12例,升高5例,白细胞计数(WBC)降低1例,升高11例,CRP升高2例。所有病例的COVID-19 RNA检测均为阴性,包括接受检查的患者和眼科医院的33名员工。11.7%的受访者报告鼻咽拭子取样接受度低。病毒RNA检测前后心理压力得分较高的考生比例分别为46.7%和6.7%。结论:该检测方法可为术前筛查和鉴别诊断提供客观依据,同时在很大程度上消除了无症状感染者传播的可能性。另一方面,病毒RNA检测阴性结果有利于调整患者术前心理状态,缓解疫情期间医护人员的精神压力。关键词:COVID-19;感染;疫情防控;RNA检测;眼科;有效性
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引用次数: 0
Correct Choice of Goggles and Anti-fog Guidance Duringthe Epidemic Period of COVID-19 新冠肺炎疫情期间护目镜的正确选择与防雾指导
Pub Date : 2020-03-10 DOI: 10.3760/CMA.J.CN115909-20200301-00054
Hu Xiaoqiong, J. Qu, Chen’ Yanyan, Zhang Peihua, Zhang Chunmei, Zheng Xiuyun
During the epidemic period of COVID-19, medical staff do all kinds of effective protection in order to avoid virus infection. Masks, protective clothing and goggles are essential for preventing viral infections. It was found that most goggles worn by medical staff could fog up quickly. This situation will block vision, increase risks and interfere with clinical works, nurses can’t operate effectively, doctors can’t diagnose and treat accurately. Patients are delayed in emergency rescue, and improper protection even leads to cross infection in hospital. After literature review and clinical practice, combined with professional knowledge, we proposed how to choose protective goggles correctly, and seven methods of anti-fog. This study was expected to be helpful to the medical workers in the prevention and control of COVID-19 Key words: COVID-19; goggle; correct choice; anti-fog guidance
在COVID-19流行期间,医务人员为避免病毒感染,采取了各种有效的防护措施。口罩、防护服和护目镜是预防病毒感染必不可少的。研究发现,医务人员戴的大多数护目镜都能很快起雾。这种情况会遮挡视力,增加风险,干扰临床工作,护士不能有效操作,医生不能准确诊断和治疗。患者急救延误,防护不当甚至导致医院内交叉感染。通过文献查阅和临床实践,结合专业知识,提出了如何正确选择护目镜,防雾的七种方法。希望本研究对医务工作者做好COVID-19的防控工作有所帮助。关键词:COVID-19;护目镜;正确的选择;防雾的指导
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引用次数: 2
2019-nCoV and Eye, What We Know and What We Should Do 2019-nCoV与眼,我们知道什么,我们应该做什么
Pub Date : 2020-02-16 DOI: 10.3760/CMA.J.ISSN.1674-845X.2020.0001
Zhou Xiangtian, J. Qu
A high contagious virus - Novel Coronavirus (2019-nCoV) is proved to be the pathogen causing a global outbreak of Novel coronavirus pneumonia (NCP), which is threatening the global public health. This article preliminarily reviews several different aspects, including the characteristics of 2019-nCoV, the anatomical connection between ocular surface and respiratory tract, previous work on the link between respiratory virus and ocular complication,and the data of Angiotension-converting enzyme 2 (ACE2) receptor expression and molecular detection of SARS virus in tear.Based on these reviews, intervention measures are advised for ophthalmic practitioner, whilst suggestions areindicated forfurther clinical and basic investigations in the future. Key words: novel coronavirus (2019-nCoV); novel coronavirus pneumonia(NCP); eye; interventions
高传染性病毒——新型冠状病毒(2019-nCoV)被证实是导致全球爆发的新型冠状病毒肺炎(NCP)的病原体,威胁着全球公共卫生。本文从2019-nCoV的特点、眼表与呼吸道的解剖联系、呼吸道病毒与眼部并发症的关系、SARS病毒在泪液中的血管紧张转换酶2 (ACE2)受体表达和分子检测等方面进行了初步综述。在此基础上,对眼科医生的干预措施提出了建议,并对今后进一步的临床和基础研究提出了建议。关键词:新型冠状病毒(2019-nCoV);新型冠状病毒肺炎;的眼睛;干预措施
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引用次数: 4
Characteristics of Macular Microvascular Changes in Patients with Systemic Lupus Erythematosus 系统性红斑狼疮患者黄斑微血管改变的特点
Pub Date : 2020-01-25 DOI: 10.3760/CMA.J.ISSN.1674-845X.2020.01.008
Lulu Bao, Hong Wang, Yufei Wu, Rong Zhou, M. Shen, Qi Chen
Objective: To observe the characteristics of early macular microvascular changes in patients with systemic lupus erythematosus using optical coherence tomography angiography (OCTA). Methods: This was a retrospective series of case study. Thirty-one patients (62 eyes) who were diagnosed with SLE by the Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University from May to November 2018, were divided into a lupus retinopathy (LR) group of 10 patients (17 eyes) and a non-lupus retinopathy group of 24 patients (45 eyes). At the same time, 35 healthy subjects (35 eyes) who were matched by age and sex with the disease groups were recruited as a control group. All subjects had a 3 mm×3 mm area of the macula scanned by OCTA to obtain superficial and deep retinal microvascular images of the macular area, and retinal blood flow density maps were skeletonized and analyzed by a custom automated algorithm. The total annular zone (TAZ), with a diameter of 2.5 mm, was obtained after excluding the foveal avascular zone (FAZ, 0.6 mm), and the superficial and deep retinal skeletonized capillary densities (RCD) of the TAZ were further divided into 4 regions (S, T, I, N). In addition, disease activity of the patients was assessed using the SLE disease activity index (SLEDAI). Data analysis was performed using a t test and analysis of variance. Results: The RCD of the superficial retinal capillary plexus (SRCP) were found to be significantly lower in the NLR and LR groups than in the control group, and the LR group was even lower than the NLR group and the difference was significant (P<0.05). In the deep retinal capillary plexus (DRCP), the difference between the three groups was not as obvious as that in the superficial layer. Only the RCD of the LR group in the N region was significantly lower than that in the NLR group (P=0.022), which were also lower than those in the control group (P<0.05) except for the T region. In addition, the score of SLEDAI in the LR group was significantly higher than in the NLR group (P=0.006), and the incidence of SLE complications such as lupus nephritis and neuropsychiatric SLE were higher in the LR group (50% vs. 25%, 10% vs. 4% respectively). Conclusions: OCTA can effectively detect early changes in macular microvascular morphology in the patients with SLE. In patients with SLE without significant fundus and visual impairment, the RCD of SRCP is significantly altered, suggesting that it may be used as an early biomarker for monitoring SLE retinal damage. Key words: systemic lupus erythematosus; retinal capillary density; lupus retinopathy; score of systemic lupus erythematosus disease activity index
目的:应用光学相干断层血管造影(OCTA)观察系统性红斑狼疮患者早期黄斑微血管改变的特点。方法:回顾性分析一系列病例。2018年5月至11月在温州医科大学附属第二医院&育婴儿童医院诊断为SLE的患者31例(62眼),分为狼疮视网膜病变组10例(17眼)和非狼疮视网膜病变组24例(45眼)。同时,招募年龄、性别与疾病组匹配的健康受试者35人(35只眼)作为对照组。所有受试者均对黄斑3 mm×3 mm区域进行OCTA扫描,获得黄斑浅层和深层视网膜微血管图像,并通过定制的自动化算法对视网膜血流密度图进行骨架化和分析。排除中央凹无血管区(FAZ, 0.6 mm)后得到直径为2.5 mm的总环区(TAZ),并将TAZ的浅、深视网膜骨化毛细血管密度(RCD)进一步划分为4个区域(S、T、I、N)。此外,采用SLE疾病活动性指数(SLEDAI)评估患者的疾病活动性。数据分析采用t检验和方差分析。结果:NLR组和LR组视网膜浅毛细血管丛(SRCP) RCD均显著低于对照组,LR组更低于NLR组,差异有统计学意义(P<0.05)。在视网膜深层毛细血管丛(DRCP)上,三组间的差异不如浅层明显。只有N区LR组的RCD显著低于NLR组(P=0.022),除T区均低于对照组(P<0.05)。此外,LR组的SLEDAI评分显著高于NLR组(P=0.006),狼疮肾炎、神经精神性SLE等SLE并发症的发生率LR组更高(分别为50%比25%、10%比4%)。结论:OCTA能有效检测SLE患者黄斑微血管形态的早期变化。在没有明显眼底和视力损害的SLE患者中,SRCP的RCD显著改变,这表明它可能被用作监测SLE视网膜损伤的早期生物标志物。关键词:系统性红斑狼疮;视网膜毛细血管密度;红斑性视网膜病变;系统性红斑狼疮疾病活动指数评分
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引用次数: 0
Clinical Application Value of a Preset Marking Line in Lacrimal Endoscopic Surgery 预设标记线在泪道内镜手术中的临床应用价值
Pub Date : 2020-01-25 DOI: 10.3760/CMA.J.ISSN.1674-845X.2020.01.011
Pan Xiao, D. Yang, Zhengru Huang, Qian Xing, Jian-Jun Tao, Yifang Meng, Jian Li, Jiong Lu
Objective: To explore the clinical application value of a preset marking line in lacrimal endoscopic surgery and evaluate its effect on surgical complications. Methods: This was a prospective analysis of clinical data from 60 patients (60 eyes) with lacrimal duct obstruction who had lacrimal endoscopic surgery in Changshu No.2 People's Hospital from June 2015 to December 2018. All patients were divided into two groups, a control group or observation group according to the even or odd numbers assigned to hospital patients. The control group (odd numbers) had no intra-surgery preset marking line. The observation group (even numbers) had an intra-surgery preset marking line. The complications of lacrimal duct mucosa injury, hemorrhage, perforation (false passage), eyelid edema and postoperative hemorrhage were observed and recorded. The data were analyzed by a Chi-square test. Results: In the observation group, the number of preset marking lines could be clearly observed during surgery, and combined with the position of the lacrimal endoscope, could be determined by the anatomical characteristics of the lacrimal passage. One marker line could be observed in the lacrimal canaliculi. The convergence of two marker lines could be observed in the common canaliculus. Two marker lines with an enlarged space could be observed in the lacrimal sac. Two marker lines with mucosal folds could be observed in the nasolacrimal duct. The incidence of lacrimal mucosal injury was 16% (χ2=8.543, P=0.003), hemorrhage incidence was 13% (χ2=8.718, P=0.003) and eyelid edema incidence was 10% (χ2=4.069, P=0.044) in the observation group, which were significantly lower than the incidences in the control group (52%, 52% and 35%, respectively). One case of perforation (false passage) occurred in the control group, which was not statistically significant compared with the observation group (χ2=0.001, P=0.973). There was no statistically significant difference in the incidence of postoperative hemorrhage between the groups (χ2=1.898, P=0.168). Moreover, all patients in the two groups had a small amount of hemorrhage, which did not affect the operation after intraoperative water injection. Patients with a small amount of postoperative hemorrhage stopped bleeding within 2 days. Conclusions: The application of preset marking lines for lacrimal endoscopic surgery can better control the endoscopic examination and surgery, and can accurately identify the location site of the surgery, which can reduce the incidence of surgical complications. Key words: lacrimal endoscope; lacrimal duct stents; preset marker line; lacrimal duct obstruction
目的:探讨预设标记线在泪道内窥镜手术中的临床应用价值,并评价其对手术并发症的影响。方法:前瞻性分析常熟市第二人民医院2015年6月至2018年12月行泪道内窥镜手术的60例(60眼)泪道梗阻患者的临床资料。所有患者按照医院患者编号的奇数或偶数分为对照组和观察组。对照组(奇数)术中无预设标记线。观察组(偶数)术中预设标线。观察并记录泪管黏膜损伤、出血、穿孔(假通道)、眼睑水肿、术后出血等并发症。数据采用卡方检验分析。结果:观察组术中可清晰观察到预设标记线的数量,并结合泪道内窥镜的解剖特点,可确定泪道的位置。泪小管内可见一条标记线。在总小管处可观察到两条标记线的汇合。泪囊内可见两条标记线,空间增大。鼻泪管内可见两条带粘膜褶皱的标记线。观察组患者泪粘膜损伤发生率为16% (χ2=8.543, P=0.003),出血发生率为13% (χ2=8.718, P=0.003),眼睑水肿发生率为10% (χ2=4.069, P=0.044),均显著低于对照组(分别为52%、52%和35%)。对照组出现1例穿孔(假通道),与观察组比较差异无统计学意义(χ2=0.001, P=0.973)。两组术后出血发生率比较,差异无统计学意义(χ2=1.898, P=0.168)。两组患者均有少量出血,术中注水后均不影响手术。术后少量出血患者2天内止血。结论:泪道内窥镜手术应用预设标记线可以更好地控制内镜检查和手术,并能准确识别手术的位置部位,减少手术并发症的发生。关键词:泪道内窥镜;泪管支架;预设标记线;泪道阻塞
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引用次数: 0
Research Progress on Ophthalmic Changes in Astronauts Induced by a Microgravity Environment and the Related Mechanism 微重力环境下航天员视力变化及其机制研究进展
Pub Date : 2020-01-25 DOI: 10.3760/CMA.J.ISSN.1674-845X.2020.01.013
Chenchen Zhang, Jia Li, Lingzhi Niu, Yuanping Wang
A series of ophthalmic changes can occur after astronauts enter the microgravity environment. If these changes are not intervened or treated in a timely manner, it will cause long-term or permanent visual impairment to astronauts, which will not only affect the execution of flight missions, but also threaten the personal safety of astronauts. Although the precise mechanism of these ophthalmic changes in astronauts is still unclear, related studies have found that when astronauts enter the microgravity environment, there is intracranial pressure elevation, nervous system changes, biochemical changes, and lymphoid and venous circulation disorders, which may be involved in the occurrence and development of the disease. This paper summarizes these ophthalmic changes over a period of the last 50 years at home and abroad and their possible mechanisms after astronauts enter the microgravity environment. We want to identify the preventive and treatment measures for these ophthalmic changes, and provide relevant theoretical support for the screening and training of astronauts. Key words: microgravity; simulated microgravity; astronaut; visual impairment; space flight-associated neuro-ocular syndrome
宇航员进入微重力环境后,会发生一系列的眼部变化。这些变化如果不及时干预或处理,会对航天员造成长期或永久性的视力损害,不仅影响飞行任务的执行,而且会威胁航天员的人身安全。虽然航天员这些眼部变化的确切机制尚不清楚,但相关研究发现,航天员进入微重力环境后,存在颅内压升高、神经系统改变、生化改变、淋巴和静脉循环紊乱等,可能参与了疾病的发生发展。本文综述了航天员进入微重力环境后近50年来国内外眼科的这些变化及其可能的机制。我们希望找出这些眼部变化的预防和治疗措施,为航天员的筛选和训练提供相关的理论支持。关键词:微重力;模拟微重力;宇航员;视力损害;与太空飞行有关的神经眼综合症
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引用次数: 0
Effects of Inter-Arm Systolic Blood Pressure Differences on Visual Field Progression in Primary Glaucoma 臂间收缩压差对原发性青光眼视野进展的影响
Pub Date : 2020-01-25 DOI: 10.3760/CMA.J.ISSN.1674-845X.2020.01.006
Qiong Liu, Minna Rong, Wenhui Deng, Qin Wang, Xing Cao, Dan Zhou, Changhua Ye
Objective: To investigate the effects of inter-arm systolic blood pressure differences (IASBPD) on visual field progression in primary glaucoma patients with controlled intraocular pressure. Methods: In this prospective clinical study, 69 primary glaucoma patients (69 eyes) who had visited Changsha Aier Eye Hospital from August 2013 to November 2018 and who had at least 5 reliable visual reportson file were selected. According to the guided progression analysis (GPA) of the Humphrey Field Analyzer, subjects were divided into two groups, the visual field progression group and the non-progression group. All of the patients underwent multiple sets of sequential blood pressure measurements on both arms. A student t test, Fisher's exact test and logistic regression analysis were used for data analysis. Results: Thirty-four patients (34 eyes) were included in the analysis, among which 15 patients (15 eyes) were in the progression group and the other 19 patients (19 eyes) were in non-progression group. The IASBPD of the two groups was 10.6±9.0 mmHg (1 mmHg=0.133 kPa) and 5.3±2.8 mmHg, respectively, and IASBPD in the progression group was 5.26 mmHg (95% credibility interval: 0.14-10.37 mmHg) higher than that in the non-progression group (t=-2.177, P=0.045). There were no significant differences in pulse pressure, mean arterial pressure, or diastolic ocular perfusion pressure between the two groups (t=0.946, -1.118, -1.967, all P>0.05). Logistic regression analysis showed that an IASBPD of ≥10 mmHg was a risk factor for visual field progression (OR=20.310, P=0.022). Participants were also stratified into two groups with an IASBPD of <10 mmHg (n=26) and ≥10 mmHg (n=8). The rates of visual field progression for the two groups were 30.8% and 87.5%, and rates of retinal nerve fiber layer thickness progression were 42.3% and 87.5%, respectively (P=0.011, 0.030). Conclusions: Increased IASBPD may be one of the risk factors for visual field progression in primary glaucoma patients with controlled intraocular pressure. Key words: primary glaucoma; intraocular pressure; visual field; inter-arm systolic blood pressure differences
目的:探讨臂间收缩压差(IASBPD)对控制眼压的原发性青光眼患者视野进展的影响。方法:本前瞻性临床研究选择2013年8月至2018年11月在长沙市爱尔眼科医院就诊的69例原发性青光眼患者(69只眼),且至少有5份可靠的视力报告文件。根据汉弗莱视野分析仪的引导进行性分析(GPA)将受试者分为视野进行性组和非进行性组。所有患者都接受了多组连续的双臂血压测量。数据分析采用学生t检验、Fisher精确检验和logistic回归分析。结果:34例患者(34眼)纳入分析,其中进展组15例(15眼),非进展组19例(19眼)。两组患者的IASBPD分别为10.6±9.0 mmHg (1 mmHg=0.133 kPa)和5.3±2.8 mmHg,进展组的IASBPD为5.26 mmHg(95%可信区间:0.14 ~ 10.37 mmHg)高于非进展组(t=-2.177, P=0.045)。两组患者脉压、平均动脉压、眼舒张灌注压比较,差异均无统计学意义(t=0.946, -1.118, -1.967, P均>0.05)。Logistic回归分析显示,IASBPD≥10 mmHg是视野恶化的危险因素(OR=20.310, P=0.022)。参与者也被分为IASBPD <10 mmHg (n=26)和≥10 mmHg (n=8)两组。两组患者视野进展率分别为30.8%和87.5%,视网膜神经纤维层厚度进展率分别为42.3%和87.5% (P=0.011, 0.030)。结论:IASBPD升高可能是眼压控制的原发性青光眼患者视野恶化的危险因素之一。关键词:原发性青光眼;眼压;视野;臂间收缩压差
{"title":"Effects of Inter-Arm Systolic Blood Pressure Differences on Visual Field Progression in Primary Glaucoma","authors":"Qiong Liu, Minna Rong, Wenhui Deng, Qin Wang, Xing Cao, Dan Zhou, Changhua Ye","doi":"10.3760/CMA.J.ISSN.1674-845X.2020.01.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1674-845X.2020.01.006","url":null,"abstract":"Objective: \u0000To investigate the effects of inter-arm systolic blood pressure differences (IASBPD) on visual field progression in primary glaucoma patients with controlled intraocular pressure. \u0000 \u0000 \u0000Methods: \u0000In this prospective clinical study, 69 primary glaucoma patients (69 eyes) who had visited Changsha Aier Eye Hospital from August 2013 to November 2018 and who had at least 5 reliable visual reportson file were selected. According to the guided progression analysis (GPA) of the Humphrey Field Analyzer, subjects were divided into two groups, the visual field progression group and the non-progression group. All of the patients underwent multiple sets of sequential blood pressure measurements on both arms. A student t test, Fisher's exact test and logistic regression analysis were used for data analysis. \u0000 \u0000 \u0000Results: \u0000Thirty-four patients (34 eyes) were included in the analysis, among which 15 patients (15 eyes) were in the progression group and the other 19 patients (19 eyes) were in non-progression group. The IASBPD of the two groups was 10.6±9.0 mmHg (1 mmHg=0.133 kPa) and 5.3±2.8 mmHg, respectively, and IASBPD in the progression group was 5.26 mmHg (95% credibility interval: 0.14-10.37 mmHg) higher than that in the non-progression group (t=-2.177, P=0.045). There were no significant differences in pulse pressure, mean arterial pressure, or diastolic ocular perfusion pressure between the two groups (t=0.946, -1.118, -1.967, all P>0.05). Logistic regression analysis showed that an IASBPD of ≥10 mmHg was a risk factor for visual field progression (OR=20.310, P=0.022). Participants were also stratified into two groups with an IASBPD of <10 mmHg (n=26) and ≥10 mmHg (n=8). The rates of visual field progression for the two groups were 30.8% and 87.5%, and rates of retinal nerve fiber layer thickness progression were 42.3% and 87.5%, respectively (P=0.011, 0.030). \u0000 \u0000 \u0000Conclusions: \u0000Increased IASBPD may be one of the risk factors for visual field progression in primary glaucoma patients with controlled intraocular pressure. \u0000 \u0000 \u0000Key words: \u0000primary glaucoma; intraocular pressure; visual field; inter-arm systolic blood pressure differences","PeriodicalId":10142,"journal":{"name":"Chinese Journal of Optometry & Ophthalmology","volume":"53 1 1","pages":"32-38"},"PeriodicalIF":0.0,"publicationDate":"2020-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77469577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Influence of Overnight Orthokeratology on the Ocular Surface and Meibomian Glands in Children and Adolescents 夜间角膜塑形术对儿童及青少年眼表及睑板腺的影响
Pub Date : 2020-01-25 DOI: 10.3760/CMA.J.ISSN.1674-845X.2020.01.009
Li Yang
Objective: To investigate the effect of overnight orthokeratology (OOK) on the ocular surface and changes in meibomian gland morphology in children and adolescents with myopia. Methods: In this prospective cohort study, choosing myopia children from the Second Affiliated Hospital of Zhejiang Chinese Medical University, sixty myopic patients (60 eyes) with OOK were selected as the OOK group, and 60 patients (60 eyes) with eye glasses were selected as the glasses group. The following tests were performed before OOK and eyeglass wear and after 1, 3, 6 and 12 months of wear. Tests included ocular surface disease index (OSDI) questionnaire, noninvasive tear break-up time (NIBUT), tear meniscus height (TMH), corneal epithelial staining (CSF), and meiboscore using noncontact meibography. The effect of OOK wear on the ocular surface and changes that occurred were evaluated and summarized by comparing the differences between these two groups. Results: There were no significant differences in the OSDI score or tear meniscus height between these two groups. The NIBUT of the OOK group showed a significant decrease after 6 and 12 months of lens wear (both P<0.05). There were no statistically significant differences at other time points. Corneal fluorescence staining in the OOK group increased after wearing the lenses (χ2=19.511, P=0.013), but there were no statistically significant differences at the other time points. The score of the meibomian gland orifice in the OOK group was slightly increased before wearing the lenses and after 1, 3 and 6 months, but the differences were not statistically significant. The final 12 months were significantly higher than before wearing eye glasses and 1 month after wearing eye glasses, and the difference was statistically significant (P<0.05). Conclusions: It is relatively safe to wear OOK lenses overnight. Short-term wear of OOK will not cause discomfort and it will not reduce tear meniscus height or the amount of tear secretion in the short term, however, it reduces the stability of the tear film and increases the corneal fluorescence staining score. OOK lens wear affected meibomian gland function. In particular, the upper meibomian gland changed first. Key words: orthokeratology; ocular surface; meibomian glands; children and adolescents
目的:探讨夜间角膜塑形术(OOK)对儿童青少年近视眼表及睑板腺形态的影响。方法:本前瞻性队列研究选取浙江中医药大学附属第二医院近视儿童,选择60例近视患者(60眼)戴OOK作为OOK组,60例近视患者(60眼)戴眼镜作为眼镜组。在佩戴OOK和眼镜前以及佩戴1、3、6和12个月后进行以下测试。测试包括眼表疾病指数(OSDI)问卷调查、无创泪液破裂时间(NIBUT)、泪液半月板高度(TMH)、角膜上皮染色(CSF)和使用非接触式减数记录仪的meiboscore。通过比较两组之间的差异,评估和总结OOK佩戴对眼表的影响和发生的变化。结果:两组患者OSDI评分及撕裂半月板高度差异无统计学意义。OOK组在佩戴6个月和12个月后NIBUT明显下降(P<0.05)。其他时间点差异无统计学意义。OOK组角膜荧光染色在配戴后升高(χ2=19.511, P=0.013),其他时间点差异无统计学意义。OOK组在配戴前及配戴后1、3、6个月睑板腺孔评分略有升高,但差异无统计学意义。最后12个月均显著高于配戴前和配戴后1个月,差异有统计学意义(P<0.05)。结论:夜间佩戴OOK隐形眼镜是相对安全的。短期佩戴OOK不会引起不适,短期内不会降低泪液半月板高度或泪液分泌量,但会降低泪液膜的稳定性,增加角膜荧光染色评分。OOK镜片磨损影响睑板腺功能。特别是,上睑板腺首先改变。关键词:角膜塑形术;眼表面;睑板腺;儿童和青少年
{"title":"The Influence of Overnight Orthokeratology on the Ocular Surface and Meibomian Glands in Children and Adolescents","authors":"Li Yang","doi":"10.3760/CMA.J.ISSN.1674-845X.2020.01.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1674-845X.2020.01.009","url":null,"abstract":"Objective: \u0000To investigate the effect of overnight orthokeratology (OOK) on the ocular surface and changes in meibomian gland morphology in children and adolescents with myopia. \u0000 \u0000 \u0000Methods: \u0000In this prospective cohort study, choosing myopia children from the Second Affiliated Hospital of Zhejiang Chinese Medical University, sixty myopic patients (60 eyes) with OOK were selected as the OOK group, and 60 patients (60 eyes) with eye glasses were selected as the glasses group. The following tests were performed before OOK and eyeglass wear and after 1, 3, 6 and 12 months of wear. Tests included ocular surface disease index (OSDI) questionnaire, noninvasive tear break-up time (NIBUT), tear meniscus height (TMH), corneal epithelial staining (CSF), and meiboscore using noncontact meibography. The effect of OOK wear on the ocular surface and changes that occurred were evaluated and summarized by comparing the differences between these two groups. \u0000 \u0000 \u0000Results: \u0000There were no significant differences in the OSDI score or tear meniscus height between these two groups. The NIBUT of the OOK group showed a significant decrease after 6 and 12 months of lens wear (both P<0.05). There were no statistically significant differences at other time points. Corneal fluorescence staining in the OOK group increased after wearing the lenses (χ2=19.511, P=0.013), but there were no statistically significant differences at the other time points. The score of the meibomian gland orifice in the OOK group was slightly increased before wearing the lenses and after 1, 3 and 6 months, but the differences were not statistically significant. The final 12 months were significantly higher than before wearing eye glasses and 1 month after wearing eye glasses, and the difference was statistically significant (P<0.05). \u0000 \u0000 \u0000Conclusions: \u0000It is relatively safe to wear OOK lenses overnight. Short-term wear of OOK will not cause discomfort and it will not reduce tear meniscus height or the amount of tear secretion in the short term, however, it reduces the stability of the tear film and increases the corneal fluorescence staining score. OOK lens wear affected meibomian gland function. In particular, the upper meibomian gland changed first. \u0000 \u0000 \u0000Key words: \u0000orthokeratology; ocular surface; meibomian glands; children and adolescents","PeriodicalId":10142,"journal":{"name":"Chinese Journal of Optometry & Ophthalmology","volume":"16 1","pages":"51-57"},"PeriodicalIF":0.0,"publicationDate":"2020-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81694169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Observation on the Functioning of the Anterior Chamber Angle after Combined Glaucoma and Cataract Surgery in the Chronic Phase of Acute Angle-Closure Glaucoma with Cataract 急性闭角型青光眼合并白内障慢性期术后前房角功能的观察
Pub Date : 2020-01-25 DOI: 10.3760/CMA.J.ISSN.1674-845X.2020.01.002
Y. Chu, Xiao-yuan Yang, Haiyan Zhu, Hai-Jia Li, Yangzeng Dong
Objective: To investigate the functioning of the anterior chamber angle after combined surgery in the treatment of the chronic phase of acute angle-closure glaucoma with cataract. Methods: A retrospective analysis was performed on 37 patients (37 eyes) in the chronic phase of acute angle-closure glaucoma with cataract who were treated in the glaucoma center of Henan Provincial People's Hospital from November 2017 to March 2018: All patients were treated with drugs after an acute attack for 3-14 days; preoperative intraocular pressure (IOP) was higher than 21 mmHg; gonioscopic examination: angle closure >2 quadrant; ultrasound biomicroscopy (UBM): Anterior chamber shallow, peripheral iris root and trabecular meshwork attachment range >2 quadrant; lens nuclear turbidity ≥Ⅲ. All patients underwent conventional double-incision surgery combined with trabeculectomy, phacoemulsification cataract extraction, intraocular lens implantation, and angle separation. No anti-metabolite drugs were used during the surgery. The scleral flap was tightly closed with an adjustable suture. The best corrected visual acuity (BCVA), IOP, central anterior chamber depth, angle opening range and filtration bleb formation were observed before and after surgery. The Wilcoxon test, analysis of variance, paired t test and Pearson correlation were used to analyze the observation index. Results: At 7 days after surgery: The mean IOP was 18.8±1.7 mmHg, which was significantly lower than IOP before surgery (t=16.562, P 2 quadrants after surgery, and there was no correlation between postoperative IOP and preoperative anterior angle (r=0.016, P=0.926); the depth of the central anterior chamber was deeper than before surgery (t=-25.195, P<0.001); the postoperative BCVA of 33 patients was improved compared with BCVA before surgery, the BCVA of 4 patients did not improve, the difference in BCVA before and after surgery was statistically significant (Z=-5.017, P<0.001); 5 patients had functional filtering blebs formation in the upper conjunctiva, 32 patients had no obvious filtering blebs after surgery, ultrasound biomicroscopy also confirmed that no effective filtering blebs formed under the conjunctiva. Conclusions: For patients in the chronic phase of acute angle-closure glaucoma with cataract, combined trabeculectomy plus cataract surgery plus angle separation can effectively reduce intraocular pressure. The decrease in intraocular pressure is likely to depend on the recovery of the function of the trabecular meshwork, rather than to rely on the establishment of an external filtration channel. Key words: acute angle-closure glaucoma; chronic phase; glaucoma and cataract combined surgery; the function of anterior chamber angle
目的:探讨急性闭角型青光眼合并白内障慢性期联合手术后前房角的功能。方法:回顾性分析2017年11月至2018年3月在河南省人民医院青光眼中心治疗的急性闭角型青光眼合并白内障慢行期患者37例(37眼),均在急性发作3 ~ 14天后给予药物治疗;术前眼压(IOP) > 21 mmHg;角镜检查:闭角>2象限;超声生物显微镜(UBM):前房浅,周围虹膜根及小梁网附着范围>2象限;晶状体核浊度≥Ⅲ。所有患者均行常规双切口手术联合小梁切除术、超声乳化白内障摘除、人工晶状体植入术和角度分离。术中未使用抗代谢药物。巩膜瓣用可调节缝线紧密闭合。观察手术前后最佳矫正视力(BCVA)、IOP、中央前房深度、角开范围及滤过泡形成情况。观察指标分析采用Wilcoxon检验、方差分析、配对t检验和Pearson相关分析。结果:术后7 d:平均IOP为18.8±1.7 mmHg,明显低于术前IOP (t=16.562,术后P 2象限,术后IOP与术前前角无相关性(r=0.016, P=0.926);中央前房深度较术前加深(t=-25.195, P<0.001);33例患者术后BCVA较术前改善,4例患者BCVA未改善,术前、术后BCVA差异有统计学意义(Z=-5.017, P<0.001);5例患者上结膜形成功能性滤过泡,32例术后未见明显滤过泡,超声生物显微镜检查也证实结膜下未形成有效滤过泡。结论:对于急性闭角型青光眼合并白内障的慢性期患者,联合小梁切除术加白内障手术加角度分离可有效降低眼压。眼压的降低可能依赖于小梁网功能的恢复,而不是依赖于外滤过通道的建立。关键词:急性闭角型青光眼;慢性阶段;青光眼、白内障联合手术;前房角的作用
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引用次数: 0
Quantitative Measurement of Iris Curvature and Its Application in Evaluating the Changes in Iris Curvature in Primary Angle Closure Suspect 虹膜曲率的定量测量及其在评价主角闭合嫌疑犯虹膜曲率变化中的应用
Pub Date : 2020-01-25 DOI: 10.3760/CMA.J.ISSN.1674-845X.2020.01.003
Zhiwei Xu, Haijian Wu
Objective: To evaluate the accuracy of the quantitative measurement of iris curvature by Rhinoceros and to assess the changes iniris curvature in primary angle closure suspect after laser periphery iridectomy (LPI). Methods: This was a prospective study. Sixteen patients (16 eyes) with primary angle closure suspect (PACS) who planned to undergo LPI treatment in Taizhou Municipal Hospital were selected. The anterior segment images of different axes were captured by Allegro Oculyzer. The curvature radius of the anterior iris surface was quantitatively measured by Rhinoceros 5.0. The repeatability of image capturing and image measurement was assessed. The iris curvature of the patients with PACS was compared before and after LPI. Sixteen normal persons (16 eyes) matched for age, sex, and pupil size were selected as the control group. The iris curvature was compared between the PACS and control groups. The correlation between iris curvature and central anterior chamber depth, anterior chamber volume and peripheral anterior chamber depth at 6 mm in the PACS group were analyzed. The correlation between changes in iris curvature and central anterior chamber depth, anterior chamber volume, and 6 mm peripheral anterior chamber depth before and after LPI treatment were also analyzed. A paired t test, independent t test and Pearson correlation coefficient were used for statistical analysis. Results: The coefficient of variation of anterior segment image capturing was 3.02%. The coefficient of variation of anterior segment image measurement was 2.54%. The radius of the iris curvature in the PACS group was 7.81±1.63 mm, which increased to 9.20±2.22 mm after LPI (t=-9.45, P<0.001). The radius of the iris curvature in the control group was 9.99±4.00 mm. The difference between the PACS group and control group was statistically significant (t=-5.69, P<0.001). After correction for the central anterior chamber depth, there was a correlation between the iris curvature radius in the direction of 0° (r=0.879, P<0.001), 90° (r=0.684, P=0.005), 180° (r=0.619, P=0.014), 270° (r=0.740, P=0.002) and the peripheral anterior chamber depth at 6 mm in the corresponding directions. After the treatment with LPI, except for the direction of 270° (r=0.453, P=0.078), there was a correlation between the changes in iris curvature in the direction of 0° (r=0.693, P=0.003), 90° (r=0.560, P=0.024), 180° (r=0.580, P=0.019) and the changes in peripheral anterior chamber depth at 6 mm in the corresponding directions. Conclusions: This quantitative measurement of iris curvature has good accuracy and repeatability. It can be used for the early diagnosis and quantitative evaluation of the therapeutic effect of PACS. Key words: iris curvature; quantitative measurement; primary angle closure suspect
目的:评价犀牛定量测量虹膜曲率的准确性,评价激光周围虹膜切除术(LPI)原发性闭角疑似患者虹膜曲率的变化。方法:前瞻性研究。选取拟在泰州市市立医院行LPI治疗的原发性闭角疑似患者16例(16眼)。利用Allegro Oculyzer采集不同轴向的前段图像。采用Rhinoceros 5.0软件定量测量虹膜前表面曲率半径。评估了图像采集和图像测量的重复性。比较PACS患者LPI前后的虹膜曲率。选取年龄、性别、瞳孔大小相匹配的正常人16人(16只眼)作为对照组。比较PACS组和对照组的虹膜曲率。分析PACS组虹膜曲率与中央前房深度、前房容积、周围前房深度6 mm的相关性。分析LPI治疗前后虹膜曲率变化与中央前房深度、前房容积、周围前房6mm深度的相关性。采用配对t检验、独立t检验和Pearson相关系数进行统计分析。结果:前段图像采集变异系数为3.02%。前段图像测量变异系数为2.54%。PACS组虹膜曲率半径为7.81±1.63 mm, LPI后增加到9.20±2.22 mm (t=-9.45, P<0.001)。对照组虹膜曲率半径为9.99±4.00 mm。PACS组与对照组比较,差异有统计学意义(t=-5.69, P<0.001)。中央前房深度校正后,虹膜曲率半径在0°方向(r=0.879, P<0.001)、90°方向(r=0.684, P=0.005)、180°方向(r=0.619, P=0.014)、270°方向(r=0.740, P=0.002)与相应方向6 mm处周围前房深度存在相关性。LPI治疗后,除270°方向(r=0.453, P=0.078)外,虹膜曲率在0°方向(r=0.693, P=0.003)、90°方向(r=0.560, P=0.024)、180°方向(r=0.580, P=0.019)的变化与相应方向6 mm处周围前房深度的变化均有相关性。结论:该方法定量测定虹膜曲率具有良好的准确性和重复性。可用于早期诊断和定量评价PACS的治疗效果。关键词:虹膜曲率;定量测定;主角闭合怀疑
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引用次数: 0
期刊
Chinese Journal of Optometry & Ophthalmology
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