Purpose: To analyze clinical features and main causes of multiple sclerosis-related optic neuritis (MS-ON), providing evidence for the differential diagnosis of MS-ON.
Methods: Clinical data were collected from 527 patients, 123 males and 404 females, diagnosed with MS-ON between June 2008 and June 2013. Visual acuity, optometry, visual field, slit-lamp microscopy, indirect ophthalmoscopy (20D), optical coherence tomography (OCT) and magnetic resonance imaging (MRI) were performed. Venous blood was sampled for detection of autoimmune antibodies and Aquaporin (AQP- 4).
Results: Fifty nine cases were diagnosed with neuromyelitis optica-related optic neuritis (NMO-ON), 27 Sjogren's syndrome-related optic neuropathy, 22 tumors, 21 anterior ischemic optic neuropathy, 15 radiation-induced optic neuropathy, 14 optic neuropathy-related infection, 17 genetic eye diseases and 10 open angle glaucoma. Among 168 MS-ON patients undergoing optic nerve MRI,90 cases (53.57%) had a lesion < 15 mm in size, 15-30 mm in 76 (45.24%) and > 30 mm in two (1.19%).
Conclusion: MS-ON is more commonly misdiagnosed with NMO-ON and Sjogren's syndrome, when compared to optic neuropathy, tumors and ischemic optic neuropathy.
The femtosecond laser has a number of advantages, such as short pulse time, high instantaneous power, high repetition rate, low monopulse energy, and small thermal effect. Femtosecond laser-assisted small incision lenticule extraction (SMILE) is becoming the new direction in refractive surgery, and the ocular surface changes after SMILE are attracting increasingly more attention. This article reviews adverse effects, including dry eye, injury of corneal nerves, and ocular surface inflammation, occurring after SMILE.
Purpose: Glaucoma is an eye disease that can lead to irreversible optic nerve damage and cause blindness. Optical coherence tomography (OCT) allows an early diagnosis of glaucoma by the measurements of the retinal nerve fiber and optic disc parameters. A retrospective study was designed to analyze the effects of the measurement of the retinal nerve fiber layer (RNFL) thickness and the optic disc tomography by spectral-domain OCT on the early diagnosis of suspected glaucoma and primary open angle glaucoma (POAG).
Methods: This was a clinical case-control study. The RNFL thickness around the optic disc and optic disk tomographic parameters of the control (n = 51, 98 eyes), suspected glaucoma (n = 81, 146 eyes), and POAG groups (n = 55, 106 eyes) were measured by OCT. The parameters included superior, inferior, nasal and temporal mean RNFL thickness, disc area (DA), cup area (CA), rim area (RA), disc volume (DV), cup volume (CV), rim volume (RV), cup/disc area ratio (CA/DA), rim/disc area ratio (RA/DA), cup/disc volume ratio (CV/DV) and rim/disc volume ratio (RV/DV).
Results: Superior, nasal, and mean RNFL parameters, DA, CA,RA, DV, CV, CA/DA, RA/DA, CV/DV and RV/DV significantly differed among three groups by single-factorial ANOVA. Inferior and temporal RNFL thickness significantly differed between the control and POAG groups. No significant difference was observed in RV among three groups. In the POAG group, the maximum area under the ROC curve (AROC) of mean RNFL thickness was 0.845. The maximum AROC of optic disk parameters was RA/DA (0.998), followed by CA/DA (0.997). The AROC of CA, RA, CV, and DV were all > 0.900.
Conclusion: OCT may serve as a useful diagnostic modality in distinguishing suspected glaucoma from POAG.
Purpose: To explore the nursing care following surgical treatment of fungal endophthalmitis in children.
Methods: Thirty two children (32 eyes) with fungal endophthalmitis were enrolled in this study. After receiving antifungal medication, the children underwent either intravitreal injection, intravitreal injection of medicine combined with vitrectomy, or intravitreal injection in combination with vitrectomy and intraocular C3F8 tamponade. Prior to surgery, psychological and quarantine nursing, and medication use was properly prepared. After the surgery, the changes in the severity of diseases were strictly observed. A suitable body posture was selected and the eyes were protected from infection.
Results: Among 32 patients with fungal endophthalmitis, 8 (25% ) cases presented with alleviated inflammation and no changes in visual acuity. The visual acuity of 18 cases (56.25%) was improved to different extents postoperatively. The inflammation in 6 children (18.75%) was properly controlled and the visual acuity declined. No cross-infection was noted in any patient.
Conclusion: Prior to surgery, quarantine nursing and drug administration should be properly prepared. Postoperatively, the changes in the severity of diseases should be tightly monitored. The patients should be treated with effective therapies in a proper position, aiming to enhance the surgical efficacy.
Purpose: To compare vision quality following phacoemulsification cataract extraction and implantation of a Big Bag or Akreos Adapt intraocular lens (IOL) in patients diagnosed with high myopia complicated with cataract.
Methods: This was a randomized prospective control study. The patients with high myopia. complicated with cataract, with axial length ≥ 28 mm, and corneal astigmatism ≤ 1D were enrolled and randomly divided into the Big Bag and Akreos Adapt IOL groups. All patients underwent phacoemulsification cataract extraction and lens implantation. At 3 months after surgery, intraocular high-order aberration was measured by a Tracey-iTrace wavefront aberrometer at a pupil diameter of 5 mm in an absolutely dark room and statistically compared between two groups. The images of the anterior segment of eyes were photographed with a Scheimpflug camera using Penta-cam three-dimensional anterior segment analyzer. The tilt and decentration of the IOL were calculated by Image-pro plus 6.0 imaging analysis software and statistically compared between two groups.
Results: In total, 127 patients (127 eyes), including 52 males and 75 females, were enrolled in this study. The total high-order aberration and coma in the Akreos Adapt group (59 eyes) were significantly higher compared with those in the Big Bag (P < 0.05). The clover and spherical aberration did not differ between the two groups (P > 0.05). The horizontal and vertical decentration were significantly smaller in the Big Bag lens group than in the Akreos Adapt group (both P < 0.05), whereas the tilt of IOL did not significantly differ between the two groups (P > 0.05).
Conclusion: Both Big Bag and Akreos Adapt IOLs possess relatively good intraocular stability implanted in patients with high myopia. Compared with the Akreos Adapt IOL, the Big Bag IOL presents with smaller intraocular high-order aberration. Coma is the major difference between the two groups.
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