Table of Content

25 September 2015, Volume 24 Issue 5

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Medical imaging for the diagnosis of systemic disease with ocular problem as the first symptom

YAN Fei, LI Mei

2015, 24(5):  289-291.  doi:10.13281/j.cnki.issn.1004-4469.2015.05.001

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Modern medical imaging technology plays an increasingly important role in diagnosis of ocular diseases, and can assist in speculating the origin of lesions originated from intracranial part or systemic disease. In patients with benign intracranial hypertension usually presenting with ocular symptoms as a chief complaint, the orbit or craniocerebral MRI image could disclose empty sella in 79% of cases; distension of the perioptic subarachnoid space in 74% of cases, and papilledema in 56%. MRI and CT could find metastatic tumor of retinoblastoma and provide basis for clinical treatment. MRI is useful to find the causes of most oculomotor nerve palsy. Most lesions locate at the nuclei in brain stem and oculomotor nerve trunk and the surroundings, the minority in the supraorbital fissure. The characteristic imaging findings of IgG4-related disease (IgG4-RD) with primary ocular symptom were diffuse enlargement of bilateral lacrimal glands and extraocular muscles. Somatostatin receptor scintigraphy of SPECT/CT has a good prospect for evaluating activity and treatment effect of IgG4-RD. (Ophthalmol CHN, 2015, 24: 289-291)

MRI features of benign intracranial hypertension presenting with primary ocular symptoms

WANG Yuan, YAN Fei, XIAN Jun-fang, LI Jing

2015, 24(5):  296-300.  doi:10.13281/j.cnki.issn.1004-4469.2015.05.004

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Objective To study MRI features of patients with benign intracranial hypertension(BIH) presenting with ocular symptoms as a chief complaint. Design Retrospective case series. Participants Sixty-five patients with clinical definite benign intracranial hypertension. Methods The orbit or craniocerebral MRI and clinical data of 65 patients were analyzed retrospecticvely. The incidence of each possible MR imaging sign in this group of BIH with ocular symptoms were recorded and the differences among idiopathic intracranial hypertension (IIH), cerebral venous sinus thrombosis (CVST) and pleocytosis caused intracranial hypertension (ICH) were compared. MR imaging sign and fundus examination findings were also compared. Main Outcome Measures Presence or absence of special abnormal MR findings in the orbit or craniocerebral MRI. Results The MR imaging disclosed empty sella in 78.4% of patients with BIH, distension of the perioptic subarachnoid space in 74.1%, intraocular protrusion of the prelaminar optic nerve in 55.9%,vertical tortuosity of the orbital optic nerve in 37.3%, flattening of the posterior sclera in 34%, abnormality of thickness and signal intensity and enhancement of the optic nerve in 33.9%, and cerebellar tonsillar hernia in 7.7%. The incidence of distension of the perioptic subarachnoid space in IIH was significantly different from that of CVST and pleocytosis（χ2=10.161，P=0.001； χ2=6.065，P=0.014）. Sensitivity and specificity of MRI examination for papilledema was 52.8% and 58.3% respectively. Conclusions  Elevated intracranial pressure produced a constellation of MR imaging signs in orbit. Besides empty sella, distension of the perioptic subarachnoid space is the most common promising MRI finding that may suggest BIH. This sign may provide valuable clues for further etiological diagnosis. (Ophthalmol CHN, 2015, 24: 296-300)

Imaging findings of retinoblastoma patients with direct extension and distant metastasis

LI Jing, YAN Fei,XIAN Jun-fang

2015, 24(5):  301-303.  doi:10.13281/j.cnki.issn.1004-4469.2015.05.005

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Objective To study imaging findings for retinoblastoma patients with distant metastasis. Design Retrospective case series. Participants 14 retinoblastoma patients with distant metastasis. Methods The image of 14 retinoblastoma patients with distant metastasis were analyzed retrospectively. The magnetic resonance imaging(MRI) features analyzed included lesion location, morphology, scope and the characteristics of contrast. Main Outcome Measures MRI and computed tomography (CT) findings. Results 11 cases developed direct extension. Metastatic lesions were found in central nervous system in 9 patients, in bone in 3 patients, in neck lymph nodes in 3 patients. The central nervous system was the most common involved organ. Conclusion MRI and CT could find metastatic tumor of retinoblastoma, which were very useful for guiding clinical treatment. (Ophthalmol CHN, 2015, 24: 301-303)

MRI findings of isolate oculomotor nerve palsy in 123 patients

LI Jian-hong1, YAN Fei1, XIAN Jun-fang1, WANG Zhen-chang2

2015, 24(5):  304-308.  doi:10.13281/j.cnki.issn.1004-4469.2015.05.006

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Objective To explore the etiopathogenisis of the isolate oculomotor nerve palsy with MRl. Design Retrospective case series. Participants One hundred and twenty-three patients with isolate oculcmotor nerve palsy. Methods MRI of 123 patients with isolate oculotomor nerve palsy were analyzed retrospectively. The MRI features of lesions were observed. Main Outcome Measures MRI findings.  Results In 123 cases of isolate oculomotor nerve palsy, there were 87 cases (70.7%) with abnormal. In 87 cases with abnormalities, cavernous sinus lesions were found in 62 cases (71.2%) , including nonspecific inflammations in 45, aneurysms in 8, tumors in 6, carotid-cavernous fistulas in 2 and intracavernous internal carotid artery atherosclerosis in 1. There were 16 cases (18.4%) with brainstem lesions, including infarction in 15 and inflammations in 1. Five cases(5.7%) with cranio-orbital communicating lesions were found, including inflammations in 3 and tumors in 2. Lesions in or around the cisternal segment of the oculcmotor nerve were found in 4 cases, including tumors in 2 and inflammations in 2. Conclusion The MRI findings of oculomotor nerve palsy are various, however cavernous sinus lesions is popular. MRI is useful to find the causes of oculomotor nerve palsy and helpful to guide specific treatment.(Ophthalmol CHN, 2015, 24: 304-308)

Analysis of the clinical and imaging features of ocular lesions of IgG4-related disease

CUI Li1, LUO Sha2, CHEN Nan1, GAO Yuan1, WANG Yan-ni1, WANG Zhen-gang1

2015, 24(5):  309-312.  doi:10.13281/j.cnki.issn.1004-4469.2015.05.007

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Objective To investigate the clinical and imaging features of ocular lesions of IgG4-related disease(IgG4-RD) . Design Retrospective case series. Participants Twenty-five patients presented to ophthalmology department with IgG4-RD confirmed by pathology and／or laboratory examinations. Methods The clinical manifestations and imaging characteristics were analyzed. Main Outcome Measures Clinical manifestation, orbit magnetic resonance imaging (MRI), Somatostatin receptor scintigraphy (SRS) single-photon emission computed tomography (SPECT/CT). Results The main clinical manifestations were eyelids swelling and eyeballs protrusion in 25 cases with bilateral involvement happened in 23 cases, and 22 patients had 2 or more organs involved. Salivary gland (13 cases) and nose (19 cases) were most commonly involved organs besides eyes. Radiographic findings showed diffuse enlargement of lacrimal gland (22 cases), extraocular muscle hypertrophy (14 cases), infiltration of orbital soft tissue (10 cases). SRS indicated that the uptakes of tracer in orbits were high (UR=1.87±0.43) before treatment. After treatment by glucocorticoids and immunosuppressants, the uptakes in orbits reduced or disappear(UR=1.51±0.24). Conclusions Diffuse enlargement of bilateral lacrimal glands was the most common imaging finding of ocular lesions of IgG4-RD. Immune activity in orbits involvement can be objectively assessed with SRS, which is valuable for assessing clinical therapeutic effect.  (Ophthalmol CHN, 2015, 24: 309-312)

MRI manifestations and clinical pathological analysis of malignant tumors in lacrimal sac area

ZHANG Qing, YAN Fei， CHEN Guang-li, LIANG Xi-hong, XIAN Jun-fang

2015, 24(5):  313-316.  doi:10.13281/j.cnki.issn.1004-4469.2015.05.008

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Objectives To investigate MRI characteristic features of malignant tumors in lacrimal sac area. Design Retrospective case series. Participants From 2005 to 2014, MRI findings and clinical data of 13 inpatients with malignant tumors in lacrimal sac area confirmed  by pathology in Beijing Tongren Hospital were reviewed. Methods All patients underwent plain and enhanced MRI scan, and ten of them performed dynamic enhanced MRI. Time-signal intensity curve (TIC) was divided into three types (typeⅠ, stability enhancement, typeⅡ platform, and typeⅢ outflow). Main Outcome Measures T1WI, T2WI, enhanced degree, TIC, and the scope of lesions involving. Results The tumors located in lacrimal fossa, including lymphoma(n=5), malignant melanoma (n=2), sebaceous grand carcinoma(n=1), basal cell carcinoma(n=1), basal-like squamous cell carcinoma(n=1) adenoid cystic carcinoma (n=1), low differentiated adenocarcinoma (n=1) and sebaceous carcinoma (n=1). The MR signal intensity of lymphoma was isointensity to gray matter on T1-weighted and T2-weighted images. Lesions showed mild uniform enhancement on gadolinium-enhanced images. The MR signal intensity of melanoma was hyperintensity on T1-weighted and hypointensity on T2-weighted images. Lesions showed mild to medium uniform enhancement on gadolinium-enhanced images. The MR signal intensity of sebaceous grand carcinoma and low differentiated adenocarcinoma was iso-intensity on T1-weighted and T2-weighted images. The MR signal intensity of other four tumors was iso-intensity on T1-weighted, and mild hyper-intensity on T2-weighted images. The four lesions showed mild to medium enhancement on gadolinium-enhanced images. The enhancement of the adenoid cystic carcinoma was more obviously, otherwise basal cell carcinoma and sebaceous carcinoma less uniform. Two cases showed typeⅠ TIC, including low differentiated adenocarcinoma and adenoid cystic carcinoma. Two cases showed typeⅡ TIC, including malignant melanoma and base cell carcinoma. Six cases showed typeⅢ TIC, including lymphoma (n=4), meibomian gland carcinoma (n=1) and basal-like squamous cell cacinoma (n=1). The nasolacrimal duct (n=12), skin (n=9), eyelid (n=7) , and the orbital muscle cone gap (n=2) were involved.  Conclusions Different MRI features in different pathological types of malignant carcinomas in lacrimal sac area were detected. MRI demonstrated the invading extent accurately. All three types of TIC were seen, with type Ⅲ as the most common one. (Ophthalmol CHN, 2015, 24: 313-316)

Clinical study of 13 cases of scleroderma with ocular manifestations

GAO Yuan, WANG Zhen-gang

2015, 24(5):  317-319.  doi:10.13281/j.cnki.issn.1004-4469.2015.05.009

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Objective To investigate the clinical features of scleroderma patients with ocular manifestations. Design Retrospective case series. Participants 13 scleroderma patients with ocular involvement were enrolled. Methods The clinical features, laboratory investigation and ocular manifestations of 13 cases of scleroderma with eye affected were retrospectively analyzed. Main Outcome Measures Ocular manifestations. Results All of the 13 cases were female with the mean age of (43±12.2 years). The mean disease duration of scleroderma was 6.1±5.1 years. The mean disease duration of eye involvement was 1.4±1.9 years. System sclerosis 11 cases(84.6%) and localized sclerosis 2 cases(15.4%) were included. Ocular manifestations in the 53.8% (7/13) cases were the primary manifestations. The most common ocular manifestations were kerato-conjunctivitis sicca 7 cases (53.8%), and skin change of the eyelid, glaucoma 3 cases for each(23.1%)，followed by optic neuritis，keratitis，anterior uveitis 2 cases for each（15.4%）; scleritis, cataract, uveitis, central serous chorioretinopathy, enophthalmos and dacryadenitis 1 case for each (7.7%). No association between ocular manifestation and clinical as well as laboratory findings was found. Conclusion Almost any part of the eye with diverse manifestation could be involved in any type of scleroderma. Kerato-conjunctivitis sicca is the most common ocular manifestation of scleroderma. (Ophthalmol CHN, 2015, 24: 317-319, 360)

Topographic maps technology in esotropia children with binocular suppression

LIN Qi1, WU Qian1, SHI Wei1, CAO Wen-hong1, FAN Yun-wei1, YAN Li2, CHU Hang2, YU Gang1

2015, 24(5):  320-323.  doi:10.13281/j.cnki.issn.1004-4469.2015.05.010

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 Objective We conducted this study to provide a simple and effective drawing method for examining suppression scotoma in strabismus. Design Retrospective case series. Participants We reported 16 cases of obvious visual suppression (mean age=6.81±1.68 years), including ten cases of concomitant esotropia, three cases of accommodative esotropia, and three cases of microtropia, and10 cases of normal controls with orthotropia and normal stereopsis (mean age=6.22±1.64 years). Methods The binocular vision separation was performed using polarized glasses and three-dimensional video technology. Binocular suppression was detected using two different sized sighting targets with the same shape and contrast. The computer recorded the suppression scotoma and calculated the scotoma area. Main Outcome Measures Parameters of suppression scotoma area. Results In the ten cases of concomitant esotropia, the suppression scotoma area is 101266±45695 pixels. In the 3 micrtropia cases, the suppression scotoma area is 102834±37482 pixels. In the 3 cases of accommodative esotropia inspected without glasses the scotoma area is 27206±11108 pixels, when wearing glasses it was 7664±6948 pixels (P=0.028). The greater range of suppression scotoma was produced by the relatively poor eye in all the 16 esotropia patients (t=3.444，P=0.007). In the 10 normal children, no fixed suppression scotoma was found on same inspecting condition(t=9.911，P=0.000). Conclusions The binocular vision separation by polarized glasses and three-dimensional video technology is a simple and effective method for examining suppression scotoma in strabismus. A definite correlation was found between suppression topographic map shape and size, and strabismus degree in children. (Ophthalmol CHN, 2015, 24: 320-323)

Electroencephalogram research on the visual health and fatigue induced by watching 3D video

ZHANG Li1, XU Liang1, WANG Xiao2, ZHANG Yun-hong3, LI Jian-jun1

2015, 24(5):  324-331.  doi:10. 13281/j. cnki. issn.1004-4469. 2015. 05. 011

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 Objective  To explore the visual health and fatigue induced by watching three dimensional (3D) video using electroencephalogram (EEG). Design Experimental study. Participants Forty healthy subjects, aged 20 to 30 years old, with refractive status being emmetropia, or mild myopia (sphere power >-3.0 D, cylinder power changed between -1.0D~+1.0D). Methods Every subject watched 40 minutes video showed in two kinds of pattern, two dimension (2D) and tree dimension (3D) video with the same content in different two days.  Electroencephalogram (EEG) analyzer was used to record EEG signal changing when subjects watching 2D or 3D video with real time.  EEG signals of relative energy in α, β, θ and δ rhythms, R value, AB value and gravity frequency in 2D video pattern and 3D video pattern were compared, using software of EEG analyzer and statistics methods. Main Outcome Measures    EEG parameters include relative energy of α, β, θ, δ rhythms, and R value, AB value and gravity frequency. Results   EEG signals of 22 subjects watching 2D pattern video and 35 subjects watching the same film in 3D pattern were evaluated.  Relative energy of α rhythm was larger in watching 2D video pattern than that in watching 3D video pattern. Relative energy of β rhythm was lower in watching 2D video pattern than that in watching 3D video pattern. Relative energy of θ rhythm in watching 2D pattern video was close to watching 3D pattern video. Relative energy of δ rhythm was higher in watching 3D pattern. R value and AB value were larger in watching 2D pattern video than those in watching 3D pattern video, and this difference was lessened with time. Gravity frequency was higher in watching 3D pattern video. The relative energy of α, β, θ and δ rhythms in different brain areas behaved differently in watching 2D and 3D patterns video. O1, O2, Oz, TP8 and T5 channels of  relative energy ofαrhythm, the difference was significant, compared among 4 time periods (watching video for 10 min, 20min, 30 min, 40min), Pvalues were 0.03， 0.03， 0.02， 0.05， 0.04, respectively. The relative energy of α rhythm decreased with viewing time extension. The differences of relative energy of β rhythm in T3 channel was significant among 4 time periods, P value was 0.03. The relative energy of β rhythm increased with viewing time extension. T5 and T8 channels of relative energy of α rhythm was significantly higher in 2D than in 3D pattern video(P=0.02, 0.01 respectively). T3 channel of relative energy of β rhythm was significantly lower in 2D than in 3D pattern video(P=0.001). The R value in watching 3D pattern video was always higher than the ones in watching 2D pattern video, and the AB values were consistent with the change of R values. Conclusion EEG was used to evaluate the effect to health and fatigue in viewing 3D pattern video, the relative energy of α and β rhythm, and fatigue factor R value are consistent with the state of alert and nervous in the brain during 40 min for viewing 3D pattern video. Because 3D video information the brain processing is so rich, the brain may gradually produce fatigue with the viewing time extension. (Ophthalmol CHN, 2015, 24: 324-331)

The short-term efficacy of PASCAL laser combined with intravitreal injection of triamcinolone acetonide for treatment of diabetic macular edema 

DONG Ming-xia1, WANG Lin-hong2, LI Dong-yu1, DONG Ru-jiao1, ZHAO Xia1, HAN Jun-ying1, CHEN Fang1

2015, 24(5):  332-336.  doi:10.13281/j.cnki.issn.1004-4469.2015.05.012

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Objective To observe the efficacy of pattern scan laser (PASCAL) combined with intravitreal injection of triamcinolone in treatment of diabetic macular edema (DME). Design Retrospective and comparative study. Participants Eighty cases of patients with DME (135 eyes) with either severe non-proliferative diabetic retinopathy (NPDR) or proliferative diabetic retinopathy (PDR), who were treated in Tangshan ophthalmologic hospital from December 2012 to February 2014. Method The treatment group included 40 cases (70 eyes) that were treated with PASCAL laser combined with intravitreal injection of triamcinolone acetonide (IVTA) 2 mg. The control group included 40 cases (65 eyes) that were treated with traditional different wavelength krypton lasers. The two groups had no significant difference in severity of DME before treatment. The patients were examined for best-corrected visual acuity (BCVA), central macular thickness (CMT) and the mean light sensitivity within 10-degree range of the fovea with diagnostic optometry, optical coherence tomography (OCT) and micro-vision (SLO) before treatment and three months after treatment. Main Outcome Measures BCVA, CMT and the mean light sensitivity within 10-degree range of the fovea. Results The proportion of eyes with improvement in BCVA, CMT and the mean light sensitivity within 10-degree range of the fovea three months after treatment in the treatment group were significantly highger than those of control group (88.57%, 91.40% and 85.70% versus 64.30%, 72.30%, 46.15%, χ2=10.60, 8.42, 38.83; P=0.010, 0.005, 0.023 respectively). The value of  BCVA (logMAR) and the mean light sensitivity within 10 degree range of the fovea（dB) three months after treatment was significantly higher than in treatment group than in control group (0.400±0.700 and 16.000±13.500 versus 0.600±0.900 and 12.500±10.000, t=0.612,0.695，P=0.01 and 0.005), the two groups' numerical value(standard deviation) of CMT (μm)　after three months treatment, the treatment group 's numerical value was 325±125，the control group's numerical value was 350±125, they were compare with t test, the results had no statistically significant(t=0.520，P=0.223). Conclusion  IVTA combined with PASCAL laser treatment of DME is better than conventional laser treatment. The combined therapy not only can quickly improve central vision, reduced macular thickness, but also can reduce laser damage to macular visual function. (Ophthalmol CHN, 2015, 24: 332-336)

Stability change of tear film after 20-gauge vitrectomy in patients with systemic hypertension

FANG Xiu-ling, JIANG Hu-lin, ZHANG Liao

2015, 24(5):  336-340.  doi:10. 13281/j. cnki. issn.1004-4469. 2015. 05. 013

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 Objective To observe the changes in the stability of tear film after 20-gauge vitrectomy in patients with hypertension. Design Prospective comparative case series. Participants 103 cases (103 eyes) underwent 20-gauge vitrectomy were enrolled. 103 patients (103 eyes) were divided into 2 groups: 53 patients with hypertension (group A) and 50 eyes without system hypertension (group B). The contralateral eyes were regarded as their respective control group. Method The stability of tear film and associated symptoms of all cases on 1 day before surgery and 1day, 3days, 7days, 1month, and 3 months after surgery were tested and recorded. The changes between two groups and the changes within each group at different time were compared and analyzed. Main Outcome Measures Schirmer I test (SIT), break-up time (BUT), corneal fluorescein staining (CFS) scores and dry eyes symptom (DES) scores. Results Compared to non-surgical controlled eyes of group A, CFS score (Z=5.253, 4.362, 5.248; all P=0.000), DES score (Z=3.852, 2.541, 2.018; P=0.000, 0.013, 0.034), and BUT value (t=4.073, 4.521, 3.545; P=0.000, 0.000, 0.008) of surgical eyes was higher, and SIT length (t=4.621, 4.272, 4.358; all P=0.000) was shorter at the 1st, 3rd, and 7th day after vitrectomy. Compared to non-surgical controlled eyes of group B, CFS score (Z=5.221, 4.305, 5.253; all P=0.000), DES score (Z=4.324, 3.263, 2.432; P=0.000, 0.002, 0.018), and BUT value (t=3.953, 4.257, 3.423; P=0.000, 0.000, 0.009) of surgical eyes was higher, and SIT length (t=4.257, 4.238, 4.137; all P=0.000) was shorter at the 1st, 3rd, and 7th day after vitrectomy. The DES score of Group A was higher than that of Group B at the 1st, and 3rd day after vitrectomy (Z=3.726, 2.357; P=0.000, 0.018) and the CFS score of Group A was higher than that of Group B at the 1st, 3rd day, and 1 month after vitrectomy (Z=3.589, 3.317, 2.794; P=0.000, 0.008, 0.029). The BUT value of Group A was lower than that of Group B at the 1st, 7th day, and 1 month after vitrectomy (t=2.224, 2.157, 2.010; P=0.028, 0.032, 0.046) and the SIT length of Group A was longer than that of Group B at the 3rd, and 7th day after vitrectomy (t=4.724, 3.486; all P=0.000). Conclusion In the early period of post 20-gauge vitrectomy, the stability of tear film and the amount of tear secretion in patients with systemic hypertension is poorer than without hypertension patients. This situation will improve and recover to normal in the late period of post 20-gauge vitrectomy. Artificial tears should be used to promote ocular surface recovery and relieve discomfort in early period after 20-gauge vitrectomy. (Ophthalmol CHN, 2015, 24: 336-340)

Comparison of normal corneal structures with light microscope and electron microscope in seven animals

ZHANG Rui1, XIE Ruo-zhong2, ZHOU Xiang-tian2, LV Fan2, QU Jia2

2015, 24(5):  341-347.  doi:10.13281/j.cnki.issn.1004-4469.2015.05.014

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Objective To compare morphologic characteristics of the corneal structures under light microscope and transmission electron microscope(TEM) among seven experimental animals which included BALB/c mice, guinea pigs, New Zealand rabbits, cats, dogs, pigs and cattle. Design Experimental study. Participants BALB/c mice, guinea pigs, New Zealand rabbits, cats, dogs, pigs and cattle. Methods BALB/c mice (8-12 weeks), guinea pigs (350-450g), New Zealand rabbits (2.5-3.5Kg), cats, dogs, pigs and cattle were chosen for study and six fresh eyeballs per kind were acquired. Cornea of each eye was fixated and sliced for observation under light microscope and TEM. Pictures were taken for comparison. Main Outcome Measures Corneal morphology and thickness of every layer, Bowman's membrane and Descemet's membrane exist or not, characteristics of basal layers and hemidesmosomes. Results In terms of thickness distribution, the central corneas of rabbits, dogs, pigs and cattle are thin, the limbal corneas of them are thick, which is similar to that of human corneas; the central corneas of guinea pigs and cats are thick, the limbal corneas of them are thin; the central cornea and limbal cornea thickness is similar in BALB/c mice. The thickness of central corneal epithelium of guinea pig is the nearest to that of human among seven kinds of animals. The average thickness of corneal epithelium, the thickness of central cornea, the thickness of central and paracentral corneal stroma of rabbits are the nearest to that of human. The thickness of corneal limbus of cattle is the nearest to that of human. The average thickness of corneal stroma of dog is the nearest to that of human. The thickness of Descemet's membrane of cattle is the nearest to that of human. The thickness of corneal endothelium, the thickness ratio of Descemet's membrane to endothelium of pig are the nearest to those of human. Under light microscope, the epithelial morphology of seven kinds of animalsis similar: stratified aquamous epithelial cells are long and flat, wing cells are polygonal, basal cells are single-layer cylindrical. It's unclear whether Bowman's membranes exist or not in the corneas of seven kinds of animal under light microscope. Under light microscope, the collageous fibers of corneal stroma are in alignment; the Descemet's membrane can be differentiated which is amorphous; the endothelium is single flat. Under TEM, there is no Bowman's membrane in  BALB/c mouse and dog cornea. However, the Bowman's membranes exist in the corneas of rabbits, cats, pigs and cattle. It's unclear whether the Bowman's membranes exist in the corneas of guinea pigs because of the unclear pictures. The Descemet's membrane in the cornea of BALB/c mouse appears like containing many shuttles or mitochondriae, however, in the cornea of cattle, it looks like latticework. The average diameters of hemidesmosomes of seven kinds of animals are as following: mice 0.16±0.01, rabbits 0.18±0.02, cats 0.27±0.06, dogs 0.19±0.08, pigs 1.72±0.08, cattle 1.13±0.82 μm. The average area of hemidesmosomes of seven kinds of animals are as following: mice 0.03, rabbits 0.04, cats 0.09, dogs 0.05, pigs 3.76, cattle 2.09 μm2.  The diameter and area of hemidesmosomes of BALB/c mice are the nearest to those of human. Conclusions Rabbit cornea is the most similar to human cornea in measured parameters. Therefore, in general, the rabbits have advantage in modeling corneal diseases. (Ophthalmol CHN, 2015, 24: 341-347)

Survey on rehabilitation services for low vision of medical institutions in Beijing

HU Ai-lian, SUN Bao-chen, ZHANG Xu, YANG Xiao-hui, LIU Ying, CHEN Wei-wei

2015, 24(5):  348-351.  doi:10.13281/j.cnki.issn.1004-4469.2015.05.015

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 Objective To understand the ability and situation of low vision rehabilitation services in medical institutions of Beijing and to provide evidence for future planning and policy making for low vision rehabilitation in Beijing. Design Cross-sectional study. Participants 90 medical institutions in the second-tier and third-tier municipal hospitals of Beijing. Method A questionnaire survey was conducted to investigate the low vision rehabilitation servicesin the 90 hospitals of Beijing. Persons who were charge of optometry and ophthalmology department filled the questionnaire. The data were collected and statistical analysis was performed. Main Outcome Measures Response rate, provide low vision rehabilitation services or not, main reason of no low vision rehabilitation services, the annual workload andtype of low vision rehabilitation services, staff of low vision rehabilitation service, and types of low vision devices. Results In 90 medical institutions, the effective response rate was 95.56%(86/90). There were 6 medical institutions(6.98%) which could provide low vision rehabilitation services. Main reasons of no low vision rehabilitation services includedshortage of basic equipmentand low vision devices, shortage of fund, shortage of low vision professionals and limited source of patients. The annual workload in the six medical institutions was as low as 0-49 cases, and high as more than 250 cases. The total annual workload in all institutions was less than 600 cases. There were only 19 staff members working for low vision rehabilitation. Optical near devices were provided in 6 hospitals, and optical distance devices were provided in 3 hospitals, while digital devices were provided in 2 hospitals. All the 6 hospitals did not provide functional visual rehabilitation training for children, daily life and technical training, vocational training, adaption and mobility orientation. The cost of low vision devices was not covered by medical insurance, and mainly paid by patients themselves or fund from non-governmental organizations. Conclusion The capacity of low vision rehabilitation services in municipal medical institutions of Beijing was far from enough to meet the needs of low vision patients. The capacity of low vision rehabilitation services in Beijing need be improved. (Ophthalmol CHN, 2015, 24: 348-351)

Take full advantage of clinical medical images in ophthalmic anatomy teaching

PENG Xiao-yan, XU Zhang-xing

2015, 24(5):  354-355.  doi:10.13281/j.cnki.issn.1004-4469.2015.05.017

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This paper suggests clinical medical images such as surgery videos and ophthalmic images have great advantages in ophthalmic anatomy teaching. Students can acquire a vivid and complete understanding of ophthalmic anatomy by interpreting these multimedia materials. By this way we can also raise students’ learning interest and improve teaching quality. (Ophthalmol CHN, 2015,24: 354-355)

Pay attention to the value of medical literature and information resources in ophthalmologic post-graduate student education

LI Bin, LIANG Qing-feng

2015, 24(5):  356-357.  doi:10.13281/j.cnki.issn.1004-4469.2015.05.018

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Modern ophthalmology education can not be separated from literature information resources. The role of medical literature in ophthalmology education is worth attention. In order to improve the utilization of information resources, and to explore the new mode of medical postgraduate education in the information age, we should pay more attention to the information retrieval, cultivating basic literature searching skills, improving students' ability in utilizing literature resources, and improving the allocation of information resources in library. （Ophthalmol CHN， 2015, 24： 356-357）
 

Shanghai Glaucoma Club: a bridge between doctors and patients

KONG Xiang-mei, SUN Xing-huai

2015, 24(5):  358-360.  doi:10.13281/j.cnki.issn.1004-4469.2015.05.019

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Glaucoma is a kind of typical physical-mental disease. It is good to educate the patients about glaucoma knowledge, relieve their psychological disturbance, and improve the compliance and therapeutic effect. Shanghai Glaucoma Club is the earliest and biggest organization of glaucoma patients in China. Through regular activities, it can effectively improve the patient's awareness of the disease, reduce the psychological problems of patients such as anxiety and depression, and provide good resource to carry out epidemiological investigation based on a stable patients group. Furthermore, through Shanghai Glauoma Club such a bridge, the doctor-patient relationship has been effectively improved. (Ophthalmol CHN, 2015, 24: 358-360)