Optometry最新文献

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Bilateral, geographic, peripapillary, chorioretinal atrophy in a patient with porphyria cutanea tarda and high iron stores 迟发性皮肤卟啉症伴高铁储量患者双侧、地域性、乳头周围、绒毛膜视网膜萎缩1例

Optometry

Pub Date : 2011-10-01 DOI: 10.1016/j.optm.2011.02.017

William J. Denton O.D., Christian W. Jordan O.D., William J. McGill O.D.

Purpose

Porphyria cutanea tarda (PCT) is a systemic disease caused by a deficiency of the enzyme uroporphyrinogen decarboxylase, which is the fifth enzyme in the heme biosynthetic pathway. This deficiency prevents porphyrin and its byproducts from producing heme.

Case Report

This case report presents a patient with PCT that is further complicated by high iron stores, chronic hepatitis C virus (HCV), and a history of alcoholism. Bilateral, geographic, peripapillary chorioretinal atrophy is evident and shows progression over a significant period despite improving the PCT.

Conclusion

A bilateral and progressive appearance of a retinal pathology in a middle-age male patient, with no family ocular history, suggests systemic causation. One theory includes a back flow of porphyrin byproducts from PCT. This is exacerbated by a less-than-productive liver caused by high iron stores, chronic HCV, and a history of alcoholism, which prevents the normal filtering process to occur. We believe this is the first report of a case of presumed bilateral, geographic, peripapillary chorioretinal atrophy in a patient with PCT, complicated by high iron stores, HCV, and alcoholism.

目的迟发性皮肤卟啉症(PCT)是一种由血红素生物合成途径中的第五酶——尿卟啉原脱羧酶缺乏引起的全体性疾病。这种缺陷阻止卟啉及其副产物产生血红素。病例报告:本病例报告一例PCT患者并发高铁储备、慢性丙型肝炎病毒(HCV)和酗酒史。尽管pct有所改善，但双侧、地域性、乳头周围视网膜萎缩明显，并在一段时间内呈进展。结论:无家族史的中年男性患者出现双侧进行性视网膜病理，提示全身性病因。一种理论认为是PCT的卟啉副产物回流，而高铁储存、慢性丙型肝炎病毒和酗酒史导致的肝脏生产能力低下加剧了这种情况，从而阻止了正常的过滤过程的发生。我们认为这是首例PCT患者双侧、地域性、乳头周围的脉络膜视网膜萎缩，并发高铁储备、丙型肝炎和酒精中毒的病例报告。

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引用次数: 2

Acupuncture still popular 针灸仍受欢迎

Optometry

Pub Date : 2011-10-01 DOI: 10.1016/j.optm.2011.09.001

Byron Y. Newman O.D.

引用次数: 0

Spectral domain optical coherence tomography of myopic traction maculopathy 近视牵引性黄斑病变的光谱域光学相干断层扫描

Optometry

Pub Date : 2011-10-01 DOI: 10.1016/j.optm.2011.03.013

Jennifer L. Robichaud O.D., Eulogio Besada O.D., Lindsay Basler O.D., Barry J. Frauens O.D.

Purpose

Here we document 2 cases of macular schisis-like appearance in high myopia analyzed with spectral domain optical coherence tomography (SDOCT).

Methods

In Case 1, a 58-year-old patient with high myopia manifesting a recent onset of decreased vision in the right eye (OD) is presented. In Case 2, a 45-year-old patient with a lifelong history of no light perception and high myopia OD is presented.

Results

In Case 1, biomicroscopy found a posterior staphyloma associated with subtle retinal thickening in the patient’s right eye. SDOCT confirmed the presence of macular traction associated with a schisis-like appearance. In Case 2, a posterior staphyloma associated with significant macular thickening was observed during biomicroscopy. SDOCT found macular traction and a schisis-like appearance.

Conclusions

These presentations are consistent with myopic traction maculopathy. Few myopic traction maculopathy cases have been studied with SDOCT. The time domain optical coherence tomography and SDOCT analysis suggests that the etiology of this condition may be secondary to preretinal and extraretinal traction exhibited in degenerative high myopia.

目的用光谱域光学相干断层扫描(SDOCT)分析2例高度近视患者黄斑裂片样外观。方法病例1是一例58岁的高度近视患者，近期出现右眼视力下降。病例2，患者45岁，终生无光感，高度近视眼。结果病例1在生物显微镜下发现右眼后葡萄肿伴轻微视网膜增厚。SDOCT证实黄斑牵引伴裂片样外观。在病例2中，生物显微镜观察到后部葡萄肿伴显著黄斑增厚。SDOCT发现黄斑牵拉和裂片样外观。结论这些表现符合近视牵引性黄斑病变。用SDOCT对少数近视牵引性黄斑病变病例进行了研究。时域光学相干断层扫描和SDOCT分析表明，这种情况的病因可能继发于退行性高度近视的视网膜前和视网膜外牵引力。

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引用次数: 9

A public health approach to developing primary care optometry 发展初级保健验光的公共卫生方法

Optometry

Pub Date : 2011-10-01 DOI: 10.1016/j.optm.2011.08.005

American Optometric Association

引用次数: 0

Peripapillary vitreoretinal traction 乳头周围玻璃体视网膜牵引

Optometry

Pub Date : 2011-10-01 DOI: 10.1016/j.optm.2011.02.018

Angeline Hixson O.D., Sherrol Reynolds O.D.

Background

Vitreoretinal traction syndrome may occur in patients with incomplete posterior vitreous detachment. Although vitreoretinal traction of the macula is well-documented in the literature, the manifestations of peripapillary vitreoretinal traction are rarely discussed.

Case report

A 62-year-old black woman presented for a comprehensive examination. She reported having uncontrolled diabetes and hypertension. Best-corrected visual acuities were 20/30 in the right eye (OD) and 20/25 in the left eye (OS). Dilated examination found a flame-shaped hemorrhage OD. The optic nerve margins OS were blurred, with the margins appearing elevated with peripapillary intraretinal hemorrhages. Cirrus spectral domain optical coherence tomography (OCT) found the presence of peripapillary vitreoretinal traction with concurrent vitreomacular traction OS.

Conclusion

Although the effects of vitreoretinal traction are most commonly associated with the macula or peripheral retina, residual attachment can occur at the optic nerve head. Peripapillary vitreoretinal traction can cause optic nerve head elevation with the appearance of edema that must be distinguished from sight- or health-threatening etiologies. OCT is a valuable diagnostic tool in confirming peripapillary vitreoretinal traction.

背景玻璃体视网膜牵引综合征可发生在玻璃体后不完全脱离的患者中。虽然黄斑的玻璃体视网膜牵引在文献中有很好的记载，但乳头周围玻璃体视网膜牵引的表现很少被讨论。病例报告:一名62岁黑人妇女接受全面检查。据报告，她患有未控制的糖尿病和高血压。最佳矫正视力为右眼20/30 (OD)，左眼20/25 (OS)。扩张检查发现火焰状出血。视神经边缘OS模糊，边缘升高，伴有乳头周围视网膜出血。卷云光谱域光学相干断层扫描(OCT)发现存在乳头周围玻璃体视网膜牵引术并发玻璃体黄斑牵引术。结论虽然玻璃体视网膜牵引的效果多见于黄斑或周围视网膜，但视神经头也可能出现残留附着。乳突周围玻璃体视网膜牵引可引起视神经头升高，并伴有水肿，必须与危及视力或健康的病因区分开来。OCT是诊断乳头周围玻璃体视网膜牵拉的重要工具。

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引用次数: 9

How r u? 你好吗?

Optometry

Pub Date : 2011-10-01 DOI: 10.1016/j.optm.2011.08.009

Paul B. Freeman O.D.

引用次数: 2

Response to Letter to the Editor 对给编辑的信的回应

Optometry

Pub Date : 2011-10-01 DOI: 10.1016/j.optm.2011.08.012

Paul B. Freeman O.D.

引用次数: 0

Turn being “lunchtime entertainment” into a marketing opportunity 把“午餐娱乐”变成一个营销机会

Optometry

Pub Date : 2011-10-01 DOI: 10.1016/j.optm.2011.08.007

Gary Gerber O.D.

引用次数: 0

Delinquent tax returns 拖欠纳税申报表

Optometry

Pub Date : 2011-10-01 DOI: 10.1016/j.optm.2011.08.006

James R. Armstrong C.P.A.

引用次数: 0

Case Report: The correction of a high magnitude of astigmatism with laser-assisted in situ keratomileusis 病例报告:激光辅助原位角膜磨砂术矫正高度数散光

Optometry

Pub Date : 2011-10-01 DOI: 10.1016/j.optm.2011.02.019

Phillip B. Brunson O.D., Paul M. Mann M.D.

Background

Laser-assisted in situ keratomileusis (LASIK) has undergone several evolutions since it was first approved by the U.S. Food and Drug Administration. Currently, excimer lasers are approved by the U.S. Food and Drug Administration to treat refractive errors with a standard ablation profile, a wavefront-optimized ablation profile, or a wavefront-guided ablation profile. Wavefront-optimized ablation profiles provide a simple method to precompensate for the expected fourth-order spherical aberration and higher-order astigmatism in the average eye.

Case report

We report a case of a 39-year-old white man, with a high magnitude of mixed astigmatism in the right and left eyes, who was seeking refractive surgical options because he was unable to tolerate contact lenses. The patient underwent bilateral wavefront-optimized LASIK to correct his high degree of astigmatism. Wavefront-guided ablation, as in this patient, can not always be performed because the parameters are not within the allowable treatment profile. Four months after the primary LASIK treatment, the patient underwent a bilateral wavefront-optimized LASIK enhancement for residual astigmatism.

Conclusion

This case focuses on the utilization of a wavefront-optimized LASIK treatment profile to eliminate a high magnitude of astigmatic refractive error without inducing higher-order aberrations. Wavefront-guided treatments are not required in most cases but should be considered if the magnitude of preoperative root-mean-square higher-order aberrations is greater than 0.35 μm. Wavefront-optimized aspheric corneal ablations attempt to avoid reducing the prolate eccentricity of the average cornea, and optimized treatments have shown improved visual outcomes compared with conventional LASIK treatments. A thorough knowledge of refractive surgery is important for any treating eye care practitioner to provide patients with the full range of options to correct all types of refractive errors.

激光辅助原位角膜磨除术(LASIK)自首次被美国食品和药物管理局批准以来，经历了几次发展。目前，准分子激光已被美国食品和药物管理局批准用于治疗屈光不正，包括标准消融剖面、波前优化消融剖面或波前引导消融剖面。波前优化烧蚀曲线提供了一种简单的方法来预先补偿预期的四阶球差和高阶散光在普通眼睛。病例报告:我们报告了一个39岁的白人男性，右眼和左眼混合性散光高度严重，由于不能忍受隐形眼镜而寻求屈光手术选择。患者接受双侧波前优化LASIK矫正高度散光。像本例患者一样，由于参数不在允许的治疗范围内，因此不能总是进行波前引导消融。初次LASIK治疗4个月后，患者接受了双侧波前优化LASIK增强治疗残余散光。结论本病例的重点是利用波前优化LASIK治疗轮廓来消除高量级的散光屈光不正而不引起高阶像差。大多数情况下不需要波前引导治疗，但如果术前均方根高阶像差大于0.35 μm，则应考虑进行波前引导治疗。波前优化的非球面角膜消融试图避免减少平均角膜的延长偏心，与传统的LASIK治疗相比，优化的治疗方法显示出更好的视力结果。全面了解屈光手术对任何眼科医生来说都是很重要的，因为他们可以为患者提供全方位的选择来矫正所有类型的屈光不正。

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