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Table of Content

    25 March 2024, Volume 33 Issue 2
    Previous Issue   
    Improving the recognition of posterior ciliary artery occlusion and choroidal ischemia (Ⅰ) 
    Huang Houbin
    2024, 33(2):  81-86.  doi:10.13281/j.cnki.issn.1004-4469.2024.02.001
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     Although the manifestations of posterior ciliary artery occlusion (PCAO) are more complex than that of central retinal artery occlusion (CRAO), it has been overlooked clinically. This article starts with the descriptions of anatomy and blood supply of posterior ciliary artery (PCA), then moves on to the illustrations of compensatory mechanisms, pathologies and clinical characteristics of PCAO in depth, aiming to help understand the PCAO and associated choroid ischemia, ischemic optic neuropathy systemically. (Ophthalmol CHN, 2024, 33: 81-86)
    Preliminary observation on short-term intraocular pressure fluctuation after mydriasis in patients with pigment dispersion syndrome
    You Yanmin, Wang Yiyan, Pu Liping, Liu Yue, Qing Guoping
    2024, 33(2):  87-92.  doi:10.13281/j.cnki.issn.1004-4469.2024.02.002
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     Objective To observe the short-term intraocular pressure (IOP) fluctuation curve and its regularity in Chinese patients with pigment dispersion syndrome (PDS) after mydriasis. Design Prospective cases series. Participants Twenty-one eyes of 21 Chinese patients with PDS presenting for care at the glaucoma specialty clinic in Beijing Tongren Hospital, from August 2021 to January 2022, including 10 eyes with simple PDS and 11 eyes with PDS complicated with pigment glaucoma (PG). Methods Medical history, essential ophthalmological examination, and initial IOP was collected. One eye of each patient was randomly selected as the research object, in which compound tropicamide eye drops were instilled twice with an interval of 15 minutes. The IOP was measured 5 minutes after the second instillation and repeated hourly for eight consecutive measurements until the pupil diameter recovered to the level at enrollment. Main Outcome Measures IOP values pro- and post-mydriasis, IOP fluctuation curve. Results The initial IOP of these PDS eyes (n=21) was (18.0±3.1) mmHg, which rose to the highest level of (19.4±4.2) mmHg at the second post-mydriasis hour, with a mean increase of (1.4±2.6) mmHg (t=-2.425, P=0.025). The magnitude of IOP fluctuation was (5.4±2.8) mmHg among all enrolled eyes after pupil dilation. The initial IOP of those simple PDS eyes was (18.0±3.2) mmHg, and the average IOP of PG eyes was (18.0±3.1) mmHg. They reached the highest IOP level at the third and fourth hour after the mydriasis, at (19.4±5.2) mmHg and (19.8±5.6) mmHg, with an increase of (1.4±3.3) mmHg and (1.7±4.3) mmHg, respectively. Thirteen PDS eyes with laser peripheral iridotomy (LPI) before admission had an average IOP of (18.6±2.6) mmHg, and the remaining 8 PDS eyes without LPI had an initial IOP of (17.1±3.8) mmHg, which peaked at the third and fourth post-mydriasis hour at (19.7±4.1) mmHg and (19.2±7.3) mmHg respectively, with an increase of (1.2±2.6) mmHg and (2.0±5.1) mmHg. On admission, three (14.3%) of these enrolled PDS eyes had initial IOP of above 21 mmHg. After pupil dilation, ten of the enrolled eyes (47.6%) had at least one measurement of over 21 mmHg. IOP fluctuation of 8 mmHg or more was discerned in 3 of these PDS eyes, all of which were PG eyes, and the highest IOP was 32 mmHg. Conclusion Mydriasis has a mild effect on IOP fluctuation in Chinese patients with PDS. Pupil dilation is unlikely to causes intensive IOP spike in these patients. (Ophthalmol CHN, 2024, 33: 87-92)
    Clinical study on the selection of intraocular lens power calculation methods after radial keratotomy
    Li Enjie, Yu Yangfan, Wang Xiaozhen, Liu Zhaochuan, Song Xudong
    2024, 33(2):  94-98.  doi:10.13281/j.cnki.issn.1004-4469.2024.02.003
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    Objective To evaluate the accuracy of Barrett True-K formula, Shammas formula and Haigis formula in the intraocular lens (IOL) of cataract patients after radial keratotomy (RK). Design Retrospective case series. Participants 28 patients (49 eyes) diagnosed with cataracts after RK at Beijing Tongren Hospital from January 2017 to February 2024. Methods IOL Master was used to obtain the parameters of the anterior segment of the patient before surgery. SRK/T formula, Shammas formula or Barrett True-K formula were used to calculate IOL diopter before surgery. The refractive status of the eye was obviously checked by optometry one month after surgery. The actual diopter was recorded by equivalent spherical (SE). Log on to the official website of American Refractive Association (www. ascrs.org) and apply Barrett True-K formula, Shammas formula and Haigis formula to calculate the predicted IOL diopter by replacing the actual postoperative diopter and the measured data of IOL Master. Then the actual implanted IOL diopter was subtracted from each formula to predict IOL diopter, denoted as IOL diopter error, and its absolute value was denoted as absolute diopter error. Main Outcome Measures Refractive error and absolute refractive error. Results For the 28 patients (49 eyes) included in the study, the refractive error of Barrett True-K formula method was 0.13 (-0.75, 0.89) D at one month after surgery, which was significantly lower than that of Shammas formula method -1.20 (-1.94, -0.54) D, Haigis formula method -1.59 (-2.54，-0.49) D (S=39.837, P<0.001). The absolute refractive error of Barrett True-K formula method was 0.79 (0.39, 1.58) D, which was lower than that of Shammas formula method 1.21 (0.57, 1.94) D and Haigis formula method 1.59 (0.49, 2.54) D (S=9.959, P=0.007). In all 28 patients (49 eyes), Barrett True-K formula method accounted for 39%, 67% and 96% of refractive errors in the range of ±0.5 D, ±1.0 D and ±2.0 D, respectively.  Shammas formula method accounted for 29%, 51%, 88%, and Haigis formula method accounted for 33%, 43%, 80%, respectively. The difference of refractive error between the three formulas in the range of ±1.0 D (χ2=6.130, P=0.047) and ±2.0 D (χ2=6.078, P=0.048) was statistically significant. The absolute refractive error of Barrett True-K formula was negatively correlated with the axial length of the eye (r=-0.397, P=0.008). For patients (19 cases, 33 eyes) who applied Barrett True-K formula method to calculate IOL diopter before surgery, the diopter error of Barrett True-K formula method was 0.30 (-0.78, 1.56) D, which was significantly lower than that of Shammas formula method-1.18 (-1.77, -0.59)D, -1.31 (-2.46, -0.34)D (S=28.42, P<0.001) for Haigis formula method. There was no statistical significance in the absolute refractive error of Barrett True-K formula compared with Shammas formula and Haigis formula (S=3.697, P=0.157). In the patients with IOL diopter calculated by Barrett True-K formula before surgery, Barrett True-K formula method accounted for 24%, 61% and 97% of refractive errors in the range of ±0.5 D, ±1.0 D and ±2.0 D, respectively. Shammas formula method accounted for 15%, 42% and 87%. Haigis formula method accounted for 30%, 39% and 64%, respectively. The proportion of refractive error of Barret True-K formula method within ±2.0 D was higher than that of Shammas formula method and Haigis formula method (χ2=13.778, P=0.001). Conclusion For cataract patients after RK, there are some differences in the accuracy of Barrett True-K formula method, Shammas formula method and Haigis formula method. The absolute refractive error of Barrett True-K formula method is negatively correlated with the length of the axis of the eye, that is, the longer the axial length of the eye, the lower the absolute refractive error and the higher the accuracy. (Ophthalmol CHN, 2024, 33: 94-98)
    Macular blood flow density and macular thickness in femtosecond laser-assisted cataract surgery
    Li Kang, He Tingting, Guo Qiongtian, Sima Jing
    2024, 33(2):  99-104.  doi:10.13281/j.cnki.issn.1004-4469.2024.02.004
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     Objective Using optical coherence tomography angiography (OCTA) to observe the changes in macular blood flow density and macular thickness in patients with femtosecond laser cataract surgery. Design Retrospective comparative case series. Participants From July 2020 to June 2021, 60 patients (60 eyes) diagnosed with age-related cataract and treated with surgery in Shenzhen Aier Eye Hospital were selected. 30 patients (30 eyes) who underwent femtosecond laser-assisted cataract surgery (femtosecond laser group) and 30 patients (30 eyes) who underwent common phacoemulsification cataract surgery (traditional phacoemulsification group). Methods Patients in each group underwent OCTA examination before surgery, 1 day, 1 week, 1 month, and 3 months after surgery. The superficial retinal blood flow perfusion density in the macular area 3 mm×3 mm (3 mm) and 6 mm×6 mm (6 mm) and the 3 mm macular area of all patients were recorded. Intra-layer and full-layer retinal thickness were measured and compared. Main Outcome Measures Blood flow density and macular thickness. Results Superficial retinal blood flow density in the macular region of 3 mm and 6 mm: femtosecond laser group decreased in 1 day, 1 week and 1 month after surgery compared with that before surgery (P(3 mm)=0.016, 0.014, 0.011, P(6 mm)=0.042, 0.013, 0.007). In traditional phacoemulsification group, the blood flow density decreased in 1 day and 1 week after operation (P(3 mm)=0.033, 0.040, P(6 mm)=0.031, 0.040). The superficial retinal blood flow density in the 3 mm and 6 mm areas in traditional phacoemulsification group was significantly higher than that in the femtosecond laser group at 1 month after surgery (t=3.536, P=0.001; t=3.259, P=0.003). Retinal thickness of 3 mm in macular area: the average thickness of inner and whole retinal in traditional phacoemulsification group increased at 1 month and 3 months after surgery compared with the preoperative thickness (P=0.036, 0.031; P=0.019, 0.016), and showed an increasing trend with time, and tended to be stable at 3 months after surgery. The average thickness of inner retina and whole retina in femtosecond group increased at 1 week, 1 month and 3 months after operation (P=0.045, 0.020, 0.005; P=0.038, 0.027, 0.007), and showed an increasing trend with time, and tended to be stable at 3 months after surgery. There was no significant difference in the average thickness of inner and whole retina between the two groups at each time (all P>0.05). Conclusion The superficial retinal blood flow density and retinal thickness in the macular area of femtosecond laser-assisted cataract surgery patients showed no difference 3 months after surgery compared with traditional phacoemulsification cataract surgery patients. Femtosecond laser-assisted cataract surgery is a safer surgical method. (Ophthalmol CHN, 2024, 33: 99-104)
    Observation of imaging features in different stages of idiopathic posterior scleritis using swept-source optical coherence tomography#br#
    Wang Ge, Ma Ya, Guan Wenxue, Cheng Yizhe, Zhang Zhihan, Peng Xiaoyan
    2024, 33(2):  107-113.  doi:10.13281/j.cnki.issn.1004-4469.2024.02.005
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    Objective To observe the image features of swept-source optical coherence tomography (SS-OCT) in patients with idiopathic posterior scleritis at different disease stages. Design Retrospective case series. Participants A total of 27 patients with idiopathic posterior scleritis diagnosed at Beijing Tongren Hospital from September 2018 to February 2021 were included in the study. Among them, 14 patients were bilateral involved and other 13 patients were unilateral involved. A total of 41 affected eyes were selected as the study group, and other 13 eyes were selected as the control group. Methods Disease staging was conducted based on the clinical manifestations of the enrolled patients. The active stage was defined as the period from the onset of symptoms to the stabilization stage. The stabilization stage was defined as the disappearance of patient discomfort complaints, discontinuation of medication, or use of the minimum maintenance dose of oral glucocorticoids (5-10 mg/day) and/or immunosuppressants (oral methotrexate 7.5 mg per week or lower doses). The recurrence stage was defined as the reappearance of symptoms and/or re-diagnosis of active posterior scleritis after the stabilization stage. All patients underwent SS-OCT examination at the initial visit, 1 and 2 weeks, and at 1, 3, 6, and 12 months after treatment. The abnormal features of the retina and choroid, as well as the thickness of the retinal and choroidal layers in the posterior pole of SS-OCT images, were compared among different stages. Main Outcome Measures The abnormal signs of retina and choroid showed by SS-OCT and their resolving time, thickness of retinal and choroid. Results Abnormal signs observed using SS-OCT in the active stage (n=41) included retinal folds in 23 eyes (56.10%), subretinal fluid in 11 eyes (26.83%), punctate hyperreflectivity in the retina and/or choroid in 35 eyes (85.37%),  RPE wave-like change in 11 eyes (26.83%), optic disc and/or macular edema in 25 eyes (60.98%), and choroidal structural abnormalities in 12 eyes (29.27%). These abnormal signs could occur simultaneously in different or the same regions of the fundus in the same patient. The choroidal thickness in the macular fovea of the eyes in the stabilization stage (n=41) was (245.923±6.829) μm, which was significantly lower than that in the active stage (n=41) (405.640±40.629) ?滋m (P=0.001). Compared with the stabilization stage, the choroidal thickness in the eyes in the recurrence stage (n=12) (354.917±62.034 ?滋m) increased again (P=0.001). Conclusion Abnormal imaging signs including punctuate hyperreflectivity in retina and/or choroid, increased choroidal thickness could be seen in active idiopathic posterior scleritis, while the choroidal thickness decreased significantly during stabilization stage and re-increased during recurrence stage. (Ophthalmol CHN, 2024, 33: 107-113)
    The effect of a computer lens filter on visual performance in subjects with retinitis pigmentosa
    Guo Zhangmei, Ni Lingzhi, Lin Na, Jiang Longfei, Zhu Yu, Deng Ruzhi
    2024, 33(2):  116-119.  doi:10.13281/j.cnki.issn.1004-4469.2024.02.006
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     Objective To explore the effects of a computer lens filter (CLF) on patients with retinitis pigmentosa (RP) on visual quality. Design Prospective case series. Participants A total of 22 patients with binocular RP were studied in the Low Vision Center of the Optometry Hospital affiliated to Wenzhou Medical University from March 2018 to June 2018. Methods All patients underwent refractive error correction. Mars contrast sensitivity table was used to measure the bright contrast sensitivity before and after wearing the CLF, the time required to read the same text on the computer screen was measured with a timer. The comfort and perception for the brightness of the display screen after wearing the CLF were scored with a score table. Main Outcome Measures Bright contrast sensitivity, reading speed, visual comfort, perception for brightness. Results The visual comfort score of RP patients before wearing CLF was set to 0, after wearing CLF it significantly increased to 4.0±2.8 (t=6.897, P<0.001). The perception score for the brightness of display of RP patients before wearing CLF was set to 0, and after wearing the CLF it decreased significantly, which was -2.8±2.4 (t=-5.412, P<0.001). The bright contrast sensitivity was 1.0±0.5 logCS in RP patients before wearing the CLF, but no significant change was 1.0±0.5 logCS after wearing the CLF (t=0.68, P=0.504). The screen reading speed of RP patients before wearing CLF was 209.1±95.0 (words/min), which was not significantly improved after wearing CLF, and was 210.2±92.8 (words/min)(t=-0.233, P=0.826). Conclusion CLF can improve the reading comfort of computer display screen and reduce the perception of brightness of display screen for RP patients. (Ophthalmol CHN, 2024, 33: 116-119)
    Clinical characteristics of dry eye outpatients in China: a multicenter study
    Ren Jie, Liu Chang, Zhou Qizhi, Zeng Qingyan, Li Ling, Dou Zexia, Wang Congxiang, Chen Tiehong, Lu Jing, Yan Yanshuang, Niu Xiaoxia, Sun Xuguang, Li Shaowei
    2024, 33(2):  120-125.  doi:10.13281/j.cnki.issn.1004-4469.2024.02.007
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    Objective To analyze the clinical characteristics associated with dry eye disease (DED) in China. Design Multicenter clinical research. Participants A total of 4497 patients with a diagnosis of DED from 8 Aier Eye Hospitals (Shenyang, Beijing, Harbin, Chongqing, Changsha, Chengdu, Wuhan and Guangzhou) in China. Methods The clinical data of patients with DED from June 2017 to June 2019 were collected. The Ocular Surface Disease Index (OSDI), the Chinese Dry Eye Questionnaire was administered, and ocular surface staining, Schirmer’s test, and fluorescein breakup time test (FBUT) were performed, and meibomian scores were calculated. The patients were classified into North group (Beijing, Shenyang, Harbin) and South group (Chongqing, Wuhan, Changsha, Chengdu, Guangzhou). The types of DED were purely aqueous deficient, purely evaporative and mixed-type groups. The severity of DED was graded into mild, moderate and severe. Main Outcome Measures OSDI, China Dry Eye Questionnaire, FBUT, Schirmer’s test, corneal fluorescent staining and meibomian gland score. Results A total of 4497 patients were included in the study. 127 cases (3.0%) were classified as having purely aqueous-deficient dry eye, 2308 cases (53.7%) were classified as having purely evaporative dry eye resulting from meibomian gland dysfunction (MGD), and 1864 cases (43.4%) were classified as having mixed-type dry eye. Overall, 92.8% of these patients showed signs of MGD. Among the patients, 3970 cases (88.3%) were mild, 381 cases (8.5%) were moderate and 119 cases (2.6%) were severe. The Schirmer test in North group (8.1±6.6 mm) was lower than that in South group (9.6±7.4)mm (t=-6.470, P<0.001). OSDI in North group (22.3±14.4) was higher than that in South group (20.7±13.2) (t=3.652, P<0.001), and meibomian scores in North group (1.6±0.7) was higher than that in South group (1.5±0.7) (t=5.351, P<0.001). The proportions of moderate (9.9%) and severe (3.5%) DED were higher in North group than that in South group (5.4%, 0.9%). Conclusion The proportion of dry eye patients associated with MGD is very high in many dry eye clinics in China. The proportions of moderate and severe DED were higher in North group than in South group in China. (Ophthalmol CHN, 2024, 33: 120-125)
    Clinical characteristics and quality of life of adult patients with sensory exotropia
    Gao Fei, Fu Jing, Ma Yingnan, Li Ran, An Ying, Wang Xin, Zhao Bowen
    2024, 33(2):  127-131.  doi:10.13281/j.cnki.issn.1004-4469.2024.02.008
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     Objective To study the clinical characteristics and quality of life of adult patients with sensory exotropia in China, and to analyze the factors affecting the quality of life of patients. Design Prospective case-control study. Participants Twenty-seven adult patients with sensory exotropia were enrolled in Beijing Tongren Hospital from January 2023 to September 2023 as the case group, and 54 patients with other types of strabismus were collected as the strabismus control group, and 54 orthotropic people were enrolled as the normal control group. Methods The causes of disused eyes in patients with sensory exotropia were analyzed. Patients aged 18-40 years were treated with compound topiramate mydriasis refraction, patients aged over 40 years were treated with apparent refraction, best corrected visual acuity (BCVA) was tested by standard logarithmic visual acuity chart. The near stereopsis was tested by Yan-style stereogram, the far stereopsis was tested by synoptophore, and the horizontal and vertical deviations were measured by prism+alternate covering or prism+corneal reflection (low vision, unable to gaze). The quality of life of patients was evaluated by the Chinese version of the Adult Strabismus Patients Quality of Life Scale (CAS-20). The differences in general characteristics, visual function and quality of life among normal control group, sensory exotropia group and other type’s strabismus group were analyzed. The effects of individual factors and visual function on the quality of life of patients with sensory exotropia were analyzed. Main Outcome Measures BCVA, refraction, deviation, far and near stereopsis, course of disease, the quality of life scores of social psychology and visual function. Results The BCVA of 27 patients with disused exotropia was lower than 0.1. The average deviation was (84.60±12.73)△. The average deviation of other strabismus group was (57.45±17.65)△, the difference was statistically significant (Z=5.063, P=0.014). The main causes of sensory exotropia were acquired (ocular trauma was the most common). The proportion of patients with family history (0%) was lower than that of other types of strabismus group (16.67%) (P=0.024). All patients with sensory exotropia had no stereopsis, which was significantly lower than that of normal group and other strabismus groups (P<0.001). The course of sensory exotropia was longer than that of other strabismus groups (Z=9.556, P=0.002). There were statistically significant differences in the social psychological scores and visual function scores among the three groups. The total score of social psychological score insensory exotropia group was significantly lower than that of normal group (Z=-7.368, P<0.001) and other strabismus groups (Z=-3.139, P=0.020). The total score of visual function in sensory exotropia group was significantly lower than that of normal group (Z=-7.286, P<0.001), but there was no statistically significant difference between sensory exotropia group and other strabismus groups (Z=-1.540, P=0.124). Among the influencing factors of the quality of life of patients with sensory exotropia, the diopter of the disused eye was negatively correlated with the social psychological score (r=-0.375, P=0.002). The diopter of the disused eye was negatively correlated with the visual function score (r=-0.366, P=0.003). The BCVA of the disused eye was positively correlated with the social psychological score (r=0.326, P=0.005). The BCVA of the disused eye was positively correlated with the visual function score (r=0.313, P=0.006). The longer the course of strabismus was, the lower the social psychological score was (Z=7.037, P=0.021). Conclusion Compared with the normal population and other strabismus patients, the visual function of the affected eye in Chinese adult patients with sensory exotropia is seriously damaged, completely without binocular visual function, and the health-related quality of life is significantly reduced. The higher diopter of the disused eye, the poorer corrected visual acuity, and the longer course of strabismus are the main factors affecting the quality of life of patients. (Ophthalmol CHN, 2024, 33: 127-131)
    Impact of visual impairment on activities of daily living in the hospitalized elderly patients
    Zhou Lin, Zhang Gaigai, Zou Yanhong
    2024, 33(2):  132-137.  doi:10.13281/j.cnki.issn.1004-4469.2024.02.009
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     Objective To evaluate the impact of visual impairment on activities of daily living (ADL) in the hospitalized elderly patients. Design Cross-sectional study. Participants 123 patients aged 60 years and older, hospitalized in the Department of Gerontology from January to December in 2019 were recruited. Methods General information including age, gender, education, reading habits and accompanying diseases were recorded by questionnaire. According to the living habits of patients, the living distant and near vision acuity were measured. The distance vision acuity ≤0.63 was classified as distant vision impairment, and the near vision acuity <0.5 was classified as near vision impairment. Reading visual acuity was measured using Chinese reading visual acuity chart. Basic activities of daily living (BADL) and instrumental activities of daily living（IADL） were evaluated with Barthel index scale and Lawton's scale separately. The evaluation of each activity in the scale was divided into "need help" and "completely independent". One of activity in the scale was rated as "need help", which was defined as BADL limitation or IADL limitation. Logistic regression model was used for multivariate analysis. Main Outcome Measures Distant visual acuity, near visual acuity, reading acuity, Barthel index scale, Lawton's scale. Results There were 56 patients (45.5%) with distant visual impairment and 24 patients (19.5%) with near visual impairment in the 123 patients. 50 patients (40.7%) with limitation in BADL and 44 patients (35.8%) with limitation in IADL. 31 patients (55.4%) with distant vision impairment had limitation in BADL and 27 patients (48.2%) in IADL, which showed statistically significant differences with patients without distance vision impairment (x2=8.131，P=0.004; x2=5.968，P=0.015). 19 patients (79.2%) with near vision impairment had limitation in BADL and 17 patients (70.8%) in IADL, which showed statistically significant differences with patients without near vision impairment (x2=16.405，P＜0.001; x2=13.842, P＜0.001). Limitation in BADL was found associated with near visual acuity (OR=1.73, 95%CI: 1.24~2.43, P＜0.001), age (OR=1.24, 95%CI: 1.14~1.35, P＜0.001), education(OR=0.18, 95%CI: 0.05~0.69, P=0.013). Both near visual acuity and education were protective factors for BADL. Similarly, limitation in IADL was found associated with reading visual acuity(OR=1.69, 95%CI: 1.22~2.34, P=0.002), age (OR=1.15, 95%CI: 1.07~1.24, P＜0.001), cancer (OR=3.59, 95%CI: 1.12~11.54, P=0.032), experience of fall (OR=2.98, 95%CI: 1.11~8.02, P=0.031). Good reading visual acuity was the only protective factor found. Age was the risk factor for both limitation in BADL and IADL. Conclusion Visual impairment was the risk factor of limited ADL in the hospitalized elderly patients. (Ophthalmol CHN, 2024, 33: 132-137)
    Clinical features of prelaminar optic neuritis
    Jia Qingxia, Yang Qinglin, Wang Jiawei
    2024, 33(2):  140-144.  doi:10.13281/j.cnki.issn.1004-4469.2024.02.010
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     Objective To summarize the clinical features, treatment and outcome of prelaminar optic neuritis patients. Design Retrospective case series. Participants A total of 18 patients with prelaminar optic neuritis who were hospitalized in the Department of Neurology of Beijing Tongren Hospital from January 2019 to June 2023 were included. Methods The demographic data, past medical history, clinical manifestations, ancillary test results, including visual acuity, visual field, fundus photographs, visual evoked potential (VEP), oligoclonal bands (OB) in cerebrospinal fluid, central nervous system demyelination antibodies, treatment options and visual prognosis of the patients were collected. Main Outcome Measures Best corrected visual acuity (BCVA) at the acute stage of the disease and 3 months after onset, patterns of visual field defects, degrees of optic disc edema, with or without peridisc hemorrhage, latencies and amplitudes of P100, demyelinating antibodies, OB in cerebrospinal fluid, treatment options. Results Among the 18 patients with prelaminar optic neuritis, 13 were females, with an average age of (43.61±2.94) years at onset. There were 20 affected eyes, of which 9 eyes (45%) had BCVA≤0.1 at the worst stage of the disease and 8 eyes (40%) had BCVA≥0.5. Diffuse visual field defects occurred in 8 eyes (40%), irregular patchy visual field defects in 6 eyes (30%), and central scotomas in 3 eyes (15%). Moderate to severe optic disc edema were seen in 10 eyes (50%), and peridisc hemorrhage in 7 eyes (35%). Only the P100 latency was prolonged in 16 eyes (80%), and prolonged latency with decreased amplitudes in 4 eyes (20%). There were 3 cases (16.7%) with positive OB in cerebrospinal fluids, 4 cases (22.2%) with positive MOG antibody in serum, and negative for biomarkers in other 11 cases (61.1%). Three patients received oral prednisone acetate tablets and 15 patients received intravenous high-dose methylprednisolone, and no patients received immunosuppressants. Eleven eyes (55%) showed significant improvement or complete recovery in visual acuity at 3 months, 8 eyes (40%) showed partial improvement, and only 2 eyes (10%) showed no changes in visual acuity. Conclusion Patients with prelaminar optic neuritis have varying degrees of visual impairment, with diffuse visual field defects and severe optic disc edema being more common, but visual function is usually restored well with glucocorticoid therapy. (Ophthalmol CHN, 2024, 33: 140-144)
    Comparison of wide field digital retinography and binocular indirect ophthalmoscopy in teaching of the retinopathy of prematurity
    Liu Lili, Li Li, Yan Honggai
    2024, 33(2):  145-149.  doi:10.13281/j.cnki.issn.1004-4469.2024.02.012
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     Objective To compare the advantages and effects of wide area digital retinography and binocular indirect ophthalmoscope in teaching retinopathy of prematurity (ROP). Design Prospective comparative teaching study. Participants 42 interns in the ophthalmology department of Beijing Children's Hospital from 2019 to 2023. Methods 42 subjects were divided into two groups according to a random comparison table. Group A included 21 subjects. In the first month, binocular indirect ophthalmoscope (BIO) was used for fundus teaching and training of premature infants and then wide field digital retinography (WFDR) was used for teaching and training for the second month. In group B, 21 subjects were treated with WFDR for the first month, followed by BIO for the second month. At the end of the first month, the BIO teaching of group A and WFDR teaching of group B were evaluated. At the end of second months, the WFDR teaching of group A and BIO teaching of group B were evaluated. The assessment contents include disease diagnosis and monocular fundus examination time. At the end of the second month, a questionnaire survey was conducted. Main Outcome Measures Mastering time, monocular examination time, disease diagnosis score, ten characteristics of questionnaire survey. Results The ROP zone scores of BIO and WFDR were 78.80±9.67 and 79.21±8.90 (t=0.352, P=0.726). Plus lesion score was 79.53±9.09 for BIO and 77.85±7.81 for WFDR (t=0.901, P=0.370). The stage score of BIO was 82.61±7.67, higher than that of WFDR 78.09±6.34 (t=6.165, P<0.001). The hour range score of BIO was 80.85±7.17, which was lower than that of WFDR (83.33±6.11) (t=-10.664, P<0.001). The monocular examination time was (7.47±1.64) minutes for BIO, which was higher than that for WFDR (3.30±0.56) minutes (t=15.582, P<0.001). The mastery time of BIO was (15.97±2.77) days, which was higher than that of WFDR (7.74±1.13) days (t=13.919, P<0.001). Questionnaire survey show that the scores of difficulty of mastering, color judgment of optic disc, authenticity of image color, three-dimensional image, clarity of peripheral retinopathy, crying degree of children during examination, and benefit to treatment in BIO were 8.78±0.84, 9.07±0.67, 9.09±0.69, 9.01±0.64, 7.33±0.93, 7.61±1.73, 6.57±1.11 respectively, which were higher than those of WFDR(6.07±1.06, 5.42±0.86, 7.40±0.70, 7.04±1.01, 5.88±1.06, 4.85±1.71, 4.47±0.92) (all P<0.001). The scores of suitable for large-scale screening, data preservation, and disease recognition in WFDR were 7.67±0.85, 8.97±0.68, 9.14±0.68 respectively, which were higher than those of BIO (4.90±0.84, 6.85±0.92, 3.16±0.73) (all P<0.001). Conclusion In the teaching of ROP, the wide field digital retinography is easier to master, with shorter examination time, more advantages in the diagnosis of ROP range. Binocular indirect ophthalmoscopy has more advantages in identification of ROP stage I and stage II. (Ophthalmol CHN, 2024, 33: 145-149)
    Exploration of the application of a new ophthalmic probationary assessment method
    Shi Xiangyu, Wang Yidi, Zhou Jun, Qin Yi
    2024, 33(2):  150-153.  doi:10.13281/j.cnki.issn.1004-4469.2024.02.013
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     Objective To explore the application effect of a new ophthalmic probationary assessment method. Design Prospective comparative teaching study. Participants 22 ophthalmic graduate students in probationary training. Methods After completing standardized training for 4 weeks, a clinical oriented assessment method with a total of 7 items scoring 100 points for each, covering the basic content of clinical work (diagnosis and management of common diseases, application of electronic consultation system, medical record writing, and surgical microscope suturing operation) were designed and applied.  There were slit lamp operation, surgical microscope operation, external eye examination, direct ophthalmoscope, diplopia imaging examination, electronic system application for consultation, outpatient medical record writing. 22 students were randomly divided into two groups, assessment group A and non-assessment group B. At the end of the probation, group A conducted all assessment, and the teacher provided a detailed explanation for error afterwards. Immediately after, all students started clinical work for 4 weeks, and all students participated in the same assessment. The scores of two groups were compared. Main Outcome Measures Assessment scores. Results After 4 weeks clinical work, the average score of seven assessments for two groups was 94.47±1.96 in group A, which was significantly higher than group B's 86.51±5.38 (t=12.83, P<0.001). Group A scored higher than Group B in each assessment (all P<0.05). For slit lamp operation, the score was 96.0±1.9 in group A and 89.0±3.9 in group B. For surgical microscope operation, the score was 94.0±2.0 in group A and 88.0±4.9 in group B. For external eye examination, the score was 95.0±2.0 in group A and 83.0±5.0 in group B. For direct ophthalmoscope, the score was 94.0±1.7 in group A and 83.0±1.8 in group B. For diplopia imaging examination, the score was 93.8±2.4 in group A and 83.0±7.1 in group B. For electronic system application for consultation, the score was 95.2±1.5 in group A and 91.0±3.2 in group B. For outpatient medical record writing, the score was 94.0±2.1 in group A and 87.0±3.0 in group B. Conclusion The ophthalmic probationary assessment method in this study can improve the effect of clinical learning in ophthalmic graduate students. (Ophthalmol CHN, 2024, 33: 150-153)
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