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Uveitis secondary to cancer therapeutics 葡萄膜炎继发于癌症治疗
Pub Date : 2020-03-05 DOI: 10.21037/AES-19-108
W. Stark, G. Goodman, D. Goodman, J. Gottsch
Because of the high incidence and great variety of complications associated with anterior chamber intraocular lenses, we have developed a technique for the implantation of a posterior chamber intraocular lens in the absence of posterior capsular support. The posterior chamber IOL is placed in the ciliary sulcus by suturing the superior haptic to the iris and the inferior haptic to the sclera at the ciliary sulcus. We have used this technique successfully in both complicated extracapsular surgery and secondary intraocular lens implantation.
由于前房人工晶状体的高发病率和多种并发症,我们开发了一种在没有后囊膜支持的情况下植入后房型人工晶状体的技术。后房型人工晶状体是在睫状沟处将上触觉与虹膜缝合,下触觉与巩膜缝合,置入睫状沟内。我们已经成功地应用于复杂的囊外手术和继发性人工晶状体植入术。
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引用次数: 12
Optical coherence tomography angiography of non-exudative choroidal neovascularization. 非渗出性脉络膜新生血管的光学相干断层血管造影。
Pub Date : 2016-12-01 DOI: 10.3978/j.issn.1000-4432.2016.11.02
Lee Kiang, Steven T Bailey, Yali Jia, David Huang
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引用次数: 0
Approved pharmacotherapy for myopic choroidal neovascularization: a review of randomized controlled trials in ranibizumab and aflibercept. 批准的药物治疗近视脉络膜新生血管:雷尼单抗和阿非利塞普的随机对照试验综述。
Pub Date : 2016-04-19 DOI: 10.21037/JES.2016.04.15
Jiakui Wang, Tzu-Lun Huang, P. Su, P. Chang
Myopic choroidal neovascularization (mCNV) can cause severe visual impairment in highly myopic patients. We review the randomized trials of two approved pharmacotherapy for treating mCNV, including intravitreal injections of ranibizumab and aflibercept. These two vascular endothelial growth factor (VEGF) antagonists show superior ability to improve vision and reduce macular thickness, comparing with sham injections or verteporfin photodynamic therapy (vPDT). There is no severe ocular or systemic adverse reaction reported in studies associated with ranibizumab and aflibercept for mCNV. Prompt treatment with these agents can lead to a better outcome.
近视脉络膜新生血管(mCNV)可引起高度近视患者严重的视力损害。我们回顾了两种被批准用于治疗mCNV的药物治疗的随机试验,包括玻璃体内注射雷尼单抗和阿非利塞普。与假注射或维泊芬光动力治疗(vPDT)相比,这两种血管内皮生长因子(VEGF)拮抗剂显示出更好的改善视力和减少黄斑厚度的能力。在与雷尼单抗和阿非利西普治疗mCNV相关的研究中,没有报道严重的眼部或全身不良反应。及时使用这些药物治疗可以获得更好的结果。
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引用次数: 3
Intravitreal aflibercept for rubeosis iridis secondary to proliferative diabetic retinopathy. 玻璃体内注射阿布西普治疗继发于增殖性糖尿病视网膜病变的虹膜红斑。
Pub Date : 2016-04-19 DOI: 10.21037/JES.2016.04.16
Shao-Wei Weng, Tzu-Lun Huang, P. Su, P. Chang, Jiakui Wang
The purpose of this article is to report a case with rubeosis iridis treated by intravitreal aflibercept. A 61-year-old man had iris neovascularization and scanty vitreous hemorrhage secondary to proliferative diabetic retinopathy in the right eye. Neither neovascularization of angle nor elevation of intraocular pressure was found. Single intravitreal aflibercept 2 mg injection was performed. Rubeosis iridis disappeared on the next day. Scattered retinal laser photocoagulation was added 1 week later. There was no recurrence after 3-month follow-up. Aflibercept may serve as another anti-vascular endothelial growth factor (anti-VEGF) for treating rubeosis iridis.
本文的目的是报告一例虹膜红肿用玻璃体腔内注射阿布西普治疗。一例61岁男性右眼继发于增殖性糖尿病视网膜病变,并发虹膜新生血管和少量玻璃体出血。未见新生血管形成,也未见眼压升高。单次玻璃体内注射阿布西普2 mg。第二天虹膜红肿消失。1周后加入分散视网膜激光光凝。随访3个月无复发。阿非利西普可能作为另一种抗血管内皮生长因子(anti-VEGF)治疗虹膜纤维化。
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引用次数: 3
Application of visual electrophysiology for the diagnosis and treatment of cataracts. 视觉电生理在白内障诊治中的应用。
Pub Date : 2016-04-19 DOI: 10.21037/JES.2016.04.14
Duoru Lin, Jingjing Chen, Haotian Lin, Weirong Chen
Visual electrophysiology is widely used in clinical ophthalmology. It is also of significant value in the objective assessment of visual function in adult and pediatric cataract patients and for the diagnosis of and research on retinal and visual pathway diseases. This article systematically reviews visual electrophysiology techniques, their applications in the diagnosis and treatment of adult and pediatric cataracts, and factors influencing the application of visual electrophysiology during surgical treatment for cataracts.
视电生理学在眼科临床中应用广泛。对于客观评价成人和儿童白内障患者的视功能,以及视网膜和视通路疾病的诊断和研究也具有重要的价值。本文系统综述了视电生理技术及其在成人和儿童白内障诊治中的应用,以及影响视电生理技术在白内障手术治疗中的应用的因素。
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引用次数: 5
External drainage for exudative retinal detachment secondary to central serous chorioretinopathy. 中央浆液性脉络膜视网膜病变继发性渗出性视网膜脱离的体外引流。
Pub Date : 2016-04-19 DOI: 10.21037/JES.2016.04.17
Sailaja Bondalapati, A. Pathengay, J. Chhablani
BACKGROUNDTo report the outcomes of external drainage of subretinal fluid (SRF) in exudative retinal detachment secondary to central serous chorioretinopathy (CSCR).METHODSRetrospective observational analysis of six eyes with exudative retinal detachment secondary to CSCR who underwent external drainage of SRF between 2004 and 2014 was performed. Collected data included demographics, steroid usage, surgical details, and visual acuity preoperatively and postoperative visual acuity and clinical examination data were collected.RESULTSSix eyes of six subjects were included with mean age of 45 years (range, 32 to 61 years). All subjects were male. Mean duration of symptoms was 4.6 months (range, 3 to 8 months). The pre-operative best-corrected visual acuity (BCVA) ranged from perception of light to 20/60. Four eyes were treated with conventional external drainage and two underwent Chandelier-assisted external drainage. Three cases had laser treatment before drainage and one case underwent photodynamic therapy (PDT) after drainage. The BCVA at last follow-up ranged from 20/2,000 (counting fingers at 2 feet) to 20/20. No recurrences were noted in any of the cases till the last follow-up. Mean duration of follow-up was 38 months.CONCLUSIONSOur study demonstrates successful management of exudative retinal detachment secondary to CSCR with external SRF drainage without any complications.
背景:报道中枢性浆液性脉络膜视网膜病变(CSCR)继发性渗出性视网膜脱离的视网膜下液外引流术(SRF)的疗效。方法回顾性观察分析2004 ~ 2014年6例CSCR继发性渗出性视网膜脱离患者行体外引流术的临床资料。收集的数据包括人口统计学、类固醇使用、手术细节、视力、术前和术后视力和临床检查数据。结果纳入受试者6只眼,平均年龄45岁(32 ~ 61岁)。所有受试者均为男性。症状的平均持续时间为4.6个月(范围3至8个月)。术前最佳矫正视力(BCVA)范围为光觉- 20/60。4只眼采用常规外引流,2只眼采用吊灯辅助外引流。引流前行激光治疗3例,引流后行光动力治疗1例。最后随访时的BCVA范围为20/ 2000(2英尺处手指计数)至20/20。直到最后一次随访,所有病例均未发现复发。平均随访时间为38个月。结论我们的研究表明体外SRF引流术治疗CSCR继发性渗出性视网膜脱离成功,无并发症。
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引用次数: 7
The safety and efficacy of modified minimally invasive trabeculectomy for the treatment of primary chronic angle-closure glaucoma. 改良微创小梁切除术治疗原发性慢性闭角型青光眼的安全性和有效性。
Pub Date : 2016-04-18 DOI: 10.21037/JES.2016.04.10
Zhenggen Wu, Chukai Huang, C. Zheng, Yuqiang Huang, Wanqi Zhang, Di Ma
BACKGROUNDPrimary chronic angle-closure glaucoma (PCACG) is one of the main types of glaucoma in China. Trabeculectomy is the most commonly used glaucoma filtration surgery for glaucoma in the world. Conventional trabeculectomy is prone to anesthesia-related complications intraoperative and operation-related complications postoperative in PCACG treatment. Modified minimally invasive trabeculectomy maybe can reduce the incidence of complications.METHODSWe conducted a prospective case series study and performed modified fornix-based trabeculectomy in 27 patients (30 eyes) under topical anesthesia; we then observed intraoperative anesthesia and cooperation effect, intraoperative and postoperative complications, preoperative and postoperative visual acuity, intraocular pressure (IOP), visual field, and the use of ocular hypotensive drugs. The patients were followed up for at least 12 months.RESULTSAll operations were completed successfully with no intraoperative complications. All 27 patients (30 eyes) were followed up for at least 12 months. No significant decrease in visual acuity was observed at days 1 or 7 and at months 1, 3, 6, and 12 after operation; however, a significant decrease in IOP was observed at days 1 and 7 and at months 1, 3, 6, and 12 after operation. Moreover, no significant progression in visual field mean defect was observed at month 12 after operation, and the number of ocular hypotensive drugs required was significantly reduced at months 6 and 12 after operation. By month 12 after operation, the overall success rate was 93.33% (28/30).CONCLUSIONSModified minimally invasive trabeculectomy is safe and effective for the treatment of PCACG.
背景原发性慢性闭角型青光眼(PCACG)是中国青光眼的主要类型之一。小梁切除术是世界上治疗青光眼最常用的青光眼滤过手术。常规小梁切除术在PCACG治疗中容易出现术中麻醉相关并发症和术后手术相关并发症。改良微创小梁切除术可以减少并发症的发生。方法进行前瞻性病例系列研究,在表面麻醉下对27例(30眼)患者行改良的穹窿型小梁切除术;观察术中麻醉及配合效果、术中术后并发症、术前术后视力、眼压(IOP)、视野、降压药物使用情况。患者随访至少12个月。结果所有手术均顺利完成,无术中并发症。27例患者(30只眼)均随访至少12个月。术后第1、7天及第1、3、6、12个月视力均未见明显下降;然而,术后第1天和第7天以及第1、3、6和12个月的IOP明显下降。术后12个月视野平均缺损无明显进展,术后6、12个月降压药用量均明显减少。术后12个月,总成功率为93.33%(28/30)。结论改良微创小梁切除术是治疗pacg安全有效的方法。
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引用次数: 3
Ophthalmic profile and systemic features of pediatric facial nerve palsy. 小儿面神经麻痹的眼部轮廓和全身特征。
Pub Date : 2016-04-18 DOI: 10.21037/JES.2016.04.07
Preeti Patil-Chhablani, S. Murthy, M. Swaminathan
BACKGROUNDFacial nerve palsy (FNP) occurs less frequently in children as compared to adults but most cases are secondary to an identifiable cause. These children may have a variety of ocular and systemic features associated with the palsy and need detailed ophthalmic and systemic evaluation.METHODSThis was a retrospective chart review of all the cases of FNP below the age of 16 years, presenting to a tertiary ophthalmic hospital over the period of 9 years, from January 2000 to December 2008.RESULTSA total of 22 patients were included in the study. The average age at presentation was 6.08 years (range, 4 months to 16 years). Only one patient (4.54%) had bilateral FNP and 21 cases (95.45%) had unilateral FNP. Seventeen patients (77.27%) had congenital palsy and of these, five patients had a syndromic association, three had birth trauma and nine patients had idiopathic palsy. Five patients (22.72%) had an acquired palsy, of these, two had a traumatic cause and one patient each had neoplastic origin of the palsy, iatrogenic palsy after surgery for hemangioma and idiopathic palsy. Three patients had ipsilateral sixth nerve palsy, two children were diagnosed to have Moebius syndrome, one child had an ipsilateral Duane's syndrome with ipsilateral hearing loss. Corneal involvement was seen in eight patients (36.36%). Amblyopia was seen in ten patients (45.45%). Neuroimaging studies showed evidence of trauma, posterior fossa cysts, pontine gliosis and neoplasms such as a chloroma. Systemic associations included hemifacial macrosomia, oculovertebral malformations, Dandy Walker syndrome, Moebius syndrome and cerebral palsyCONCLUSIONSFNP in children can have a number of underlying causes, some of which may be life threatening. It can also result in serious ocular complications including corneal perforation and severe amblyopia. These children require a multifaceted approach to their care.
背景:与成人相比,面神经麻痹(FNP)在儿童中发生的频率较低,但大多数病例继发于可识别的病因。这些儿童可能有多种与麻痹相关的眼部和全身特征,需要详细的眼部和全身评估。方法回顾性分析某三级眼科医院2000年1月至2008年12月9年间收治的16岁以下FNP病例。结果共纳入22例患者。平均发病年龄为6.08岁(4个月至16岁)。双侧FNP 1例(4.54%),单侧FNP 21例(95.45%)。先天性麻痹17例(77.27%),其中综合征相关性5例,出生创伤3例,特发性麻痹9例。后天性麻痹5例(22.72%),其中外伤性麻痹2例,肿瘤性麻痹1例,血管瘤术后医源性麻痹1例,特发性麻痹1例。3例患儿为同侧第六神经麻痹,2例患儿为莫比乌斯综合征,1例患儿为同侧Duane综合征伴同侧听力丧失。累及角膜8例(36.36%)。弱视10例(45.45%)。神经影像学研究显示创伤,后窝囊肿,脑桥胶质增生和肿瘤如氯瘤的证据。系统性关联包括面肌巨大儿、眼椎畸形、Dandy Walker综合征、Moebius综合征和脑瘫。结论儿童sfnp可能有许多潜在原因,其中一些可能危及生命。它还会导致严重的眼部并发症,包括角膜穿孔和严重的弱视。照顾这些孩子需要多方面的方法。
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引用次数: 3
Age-determined referral criteria of myopia for large-scale vision screening. 年龄决定的近视转诊标准用于大规模视力筛查。
Pub Date : 2016-04-18 DOI: 10.21037/JES.2016.04.08
Hongjie Yu, Y. Shao, H. Yuan, Bo Yan
BACKGROUNDThis study aimed to explore the best screening measure of myopia and its associated optimal referral criteria for children aged between 6 and 16.METHODSAfter informed consent of cycloplegia was obtained, a total of 6,321 children aged between 6 and 16 from 53 primary or junior middle schools in Jiading District of Shanghai were included in our population-based study. Receiver operating characteristic (ROC) curve was performed to determine the best cutoff points, sensitivities and specificities of different screening tests, including uncorrected visual acuity (UCVA), noncycloplegic autorefraction (NCAR) and the combination of these two tests.RESULTSThere was significant difference in prevalence of myopia between boys and girls (χ2 = 6.358, P = 0.012). Compared with children of low age, the prevalence of older children was significantly higher (χ2 = 1,386.404, P < 0.001). For the combination of UCVA and NCAR, the best cutoff point was UCVA less than or equal to 0.2 logarithm of minimum angle of resolution (MAR) (20/30) and NCAR spherical equivalent refraction (SER) less than or equal to -0.75 diopters (D), with associated sensitivity and specificity of 75.0% and 85.0%, respectively, which were higher than those of UCVA and NCAR alone. After stratified by age, the best cutoff points were varied among children. The accuracy for children aged between 9 and 12 was higher than that for other ages.CONCLUSIONSThe best screening measure of myopia was the combination of UCVA and NCAR. The optimal referral criteria of myopia for children should be age-determined.
本研究旨在探讨6 - 16岁儿童近视的最佳筛查方法及其最佳转诊标准。方法在获得睫状体麻痹患者知情同意后,选取上海市嘉定区53所中小学6 ~ 16岁的6321名儿童进行人群研究。采用受试者工作特征(ROC)曲线确定未矫正视力(UCVA)、非睫状体麻痹性自折射(NCAR)及两项检测联合的最佳分界点、灵敏度和特异性。结果男童、女童近视患病率差异有统计学意义(χ2 = 6.358, P = 0.012)。与低龄儿童相比,大龄儿童的患病率明显高于低龄儿童(χ2 = 1386.404, P < 0.001)。UCVA与NCAR联合应用时,最佳截断点为UCVA小于等于最小分辨角(MAR)(20/30)的0.2对数,NCAR球面等效折射(SER)小于等于-0.75屈光度(D),相关灵敏度和特异度分别为75.0%和85.0%,高于UCVA和NCAR单独应用。在按年龄分层后,最佳分界点在儿童中有所不同。9 - 12岁儿童的准确率高于其他年龄段的儿童。结论UCVA与NCAR结合是近视的最佳筛查手段。儿童近视的最佳转诊标准应由年龄决定。
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引用次数: 8
Analysis of different vision charts used for visual acuity assessment after retinal surgery. 不同视力表用于视网膜手术后视力评估的分析。
Pub Date : 2016-04-18 DOI: 10.21037/JES.2016.04.11
Hongpeng Li, Linxing Chen, H. Fang, Hongxing Diao, Wenyan Liu
BACKGROUNDDifferent visual acuity chart can be targeted to evaluate the visual function of patients with different eye diseases. We conducted a comparative analysis of the digital logarithm of the minimum angle of resolution (LogMAR) vision chart and the standard logarithmic vision chart for the measurement of visual acuity after retinal detachment surgery.METHODSWe used the digital LogMAR vision chart and the standard logarithmic vision chart to measure the visual acuity of 100 patients (100 eyes) who underwent retinal detachment surgery at our hospital using the LogMAR recording method and compared the differences between the mean measurements obtained by both methods for all patients and for different age groups.RESULTSWhen all of the patients were analyzed, the mean visual acuity differed between the digital LogMAR vision chart and the standard logarithmic vision chart by -0.07 LogMAR units. No significant difference was observed in the mean visual acuity between the two vision charts in the 10-20 year and 21-40 year age groups (P > 0.05), while a significant difference was observed in post-operative mean visual acuity between the two vision charts for patients aged 41-65 years (P < 0.05).CONCLUSIONSBoth the digital LogMAR vision chart and the standard vision chart were effective and reliable for the measurement of visual acuity. The visual acuity measured by the standard vision chart was higher than that measured by the digital LogMAR vision chart. We recommend using the digital LogMAR vision chart as the preferred chart for measuring visual acuity after retinal detachment surgery.
背景不同的视力表可以有针对性地评价不同眼病患者的视功能。我们对数字对数最小分辨角(LogMAR)视力表与标准对数视力表进行对比分析,用于测量视网膜脱离手术后的视力。方法采用数字LogMAR视力表和标准对数视力表,采用LogMAR记录法测量100例(100眼)视网膜脱离手术患者的视力,比较两种方法在所有患者和不同年龄组的平均测量值的差异。结果对所有患者进行分析时,数字对数视力表与标准对数视力表的平均视力差为-0.07个LogMAR单位。10-20岁和21-40岁年龄组两种视力表术后平均视力比较差异无统计学意义(P < 0.05), 41-65岁两种视力表术后平均视力比较差异有统计学意义(P < 0.05)。结论数字LogMAR视力表与标准视力表均能有效、可靠地测量视力。标准视力表测得的视力高于数字LogMAR视力表测得的视力。我们建议使用数字LogMAR视力表作为测量视网膜脱离手术后视力的首选图表。
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引用次数: 0
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