Table of Content

25 November 2015, Volume 24 Issue 6

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2015, 24(6):  361. 

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Reconsideration on laser photocoagulation for diabetic retinopathy in the anti-VEGF era

LI Yi-bin

2015, 24(6):  361-363.  doi:10.13281/j.cnki.issn.1004-4469.2015.06.001

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 Proliferative diabetic retinopathy (PDR) is the leading cause of diabetic blindness. At present, panretinal photocoagulation (PRP) is the standard treatment for PDR, however it can cause side effects, such as increasing risk of macular edema, or decreasing peripheral vision. Anti-vascular endothelial growth factor (VEGF) therapy shows the possibility of treatment as a substitution for PRP: intrvitreal anti-VEGF agent can effectively clear intraocular VEGF, cause regression of new vessels, and improve retinopathy severity.  It may improve the prognosis of PDR to explore the module and methods of combination of PRP and anti-VEGF therapy.

Problem and improvement of the bottles of preservative-free eye drops

SUN Xu-guang, ZHANG Xiao-yu

2015, 24(6):  365-367.  doi:10.13281/j.cnki.issn.1004-4469.2015.06.002

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With the focus on the role of preservative in eye drops, preservative-free eye drops came into being. At present, there is no preservative in eye drops following the improvement of the packaging bottle. From a single dose to a multi dose packaging bottle, each has its advantages and disadvantages. Single dose packaging bottle is convenient to carry and can basically avoid microbial contamination because of the short exposure time. But the production cost is high and can lead to the waste of eye drops. Multi-dose packaging bottle can achieve preservatives-free, and can be used repeatedly. But patients need to change using habits. It needs certain viscosity of eye drops, and the ratio of bottle production cost increases. With the deeper study, eye drop bottles should be designed to be more safe, convenient, cost-effective and dose-controllable.

Comparison of visual qualities after the implantation of two different aspherical multifocal intraocular lens

ZHAO Yang1, ZHAO Shi-qiang1, GU Qu-fei2, ZHU Si-quan1

2015, 24(6):  369-372.  doi:10.13281/j.cnki.issn.1004-4469.2015.06.005

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Objective To compare the visual quality after the implantation of the two kinds of aspheric diffractive multifocal intraocular lens (Tecnis ZM A00 and ReSTOR +3.0D). Design Retrospective comparative case series. Participants 78 patients (113 eyes) with senile cataract that underwent phacoemulsification and aspheric diffractive multifocal intraocular lenses implantation in Beijing Tongren Hospital were included. 78 patients (113 eyes) were divided into two groups, Tecnis ZM A00 group (41 patients, 60 eyes) and ReSTOR +3.0D group(37 patients, 53 eyes). Methods The difference of best corrected distance visual acuity (BCDVA), best corrected near visual acuity (BCNVA), best corrected mid-distance visual acuity (BCMVA, 60cm） under light and shade circumstance, defocus testing and pseudo accommodation were compared at 1 and 3 months after the operation. The questionnaire of visual quality was used to observe the patents’ visual condition at 3 months after the operation. Main Outcome Measures BCDVA, BCNVA, BCMVA (60cm) under light and shade circumstance; defocus testing; questionnaire scores. Results Under light circumstance, BCDVA, BCNVA, BCMVA (60 cm) in the Tecnis ZM A00 and ReSTOR +3.0D group was 0.975±0.182 and 0.953±0.133, 0.713±0.234 and 0.621±0.299, 0.262±0.110 and 0.309±0.090 respectively at 3 months after the operation (all P>0.05). Under shade circumstance, BCNVA was 0.283±0.103 and 0.201±0.082 (P<0.05), BCMVA(60 cm) was 0.339±0.097 and 0.367±0.101 (P>0.05) respectively in the two groups at 3 months after the operation. The pseudo accommodation were 1.323±1.033 and 1.301±1.127 in the two groups at 3 months after the operation (P>0.05). There are two peak focus in the two groups at -0.25D, -0.25D and -2.75D, -2.25D respectively in the defocus testing. Conclusion Patients with Tecnis ZM A00 and  ReSTOR +3.0D have better BCDVA, BCNVA and BCMVA (60cm) under light circumstance. Tecnis ZM A00 could provide better BCNVA and BCMVA (60 cm) under shade circumstance.

Efficacy and safety of phacoemulsification with 3.2 mm clear corneal incision for cataract after radial keratotomy

LIU Xue, WANG Jin-da, ZHANG Jing-shang, XIONG Ying, LI Jing, LI Xiao-xia, ZHAO Jing, WAN Xiu-hua

2015, 24(6):  373-376.  doi:10.13281/j.cnki.issn.1004-4469.2015.06.006

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Objective To evaluate the efficacy and safety of phacoemulsification with 3.2 mm clear corneal incision for the cataract patients after radial keratotomy (RK). Design Retrospective cases series. Participants Patients with cataractous lens with previous RK 8 cases (13 eyes). In which, 2 cases (4 eyes) with 8 incisions RK, 3 cases (4 eyes) with 12 incisions RK and 3 cases (5 eyes) with 16 incision RK. Methods Phacoemulsification and IOL implantation was performed through 3.2 mm clear corneal incision by the same surgeon. In the 8 incisions RK group, the clear corneal incision was performed between the adjacent RK incisions without intersecting the RK incisions. In the 12 incisions RK group, the clear corneal incision intersected 1 RK incision. In the 16 incisions RK group, the clear corneal incision intersected 2 adjacent RK incisions. The condition of RK incisions, management of complications and postoperative visual acuity was observed at 1 day, 1 week, 1 month, 3 months, 6 months, 1 year, 2 years and 3 years after the surgery. Main Outcome Measures Presence or absence of RK incision dehiscence during or after the surgery, postoperative best-corrected visual acuity (BCVA), corneal astigmatism, and corneal endothelial cell density. Results No RK incision dehiscence noted in all the 8 and 12 RK incisions groups and the clear corneal incisions were well apposed. Dehiscence was noted in one of the adjacent RK incisions in 2 eyes of the 16 RK incisions group. The dehiscences of RK incisions were closed by injecting air bubble with and without viscoelastic agent into the anterior chamber. During the follow-up, the incisions were well apposed in all of the 13 eyes and no new dehiscence of RK incisions occurred. In the last follow-up, the mean of BCVA (0.67±0.18) was better than preoperative BCVA（0.29±0.20）(t=-6.077, P=0.000); There was no significant difference between the final postoperative (1.69 ± 1.23 D) and preoperative corneal astigmatism (1.69±1.23 D)(t=-0.758, P= 0.470); while the mean postoperative corneal endothelial cell density (1716.95±906.79/mm2) was significantly less than the mean preoperative corneal endothelial cell density(2383.97±833.39/mm2) (t=2.995, P=0.012). Conclusion Phacoemulsification and IOL implantation with a 3.2 mm clear corneal incision in eyes with previous 8 and 12 incisions RK is safe. While a manageable dehiscence is possible to occur in eyes with previous 16 RK incisions, it suggests the smaller clear corneal incision or scleral tunnel incision should be used in eyes with 16 RK incisions.

Change of binocular disparity information in children with amblyopia

LIN Nan1, LU Wei1, SUN A-li1, YAN Li2, ZHANG Ling-ge2, LIU Jun2, WU Dian-peng2

2015, 24(6):  377-380.  doi:10.13281/j.cnki.issn.1004-4469.2015.06.007

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Objective To explore the change of binocular disparity information in children with amblyopia. Design Prospective case series. Participants 90 mild, moderate, severe amblyopic children (with 30 cases in each group) with normal eye position. Method The main test method was the computer based visual perceptual test software. Each amblyopic child must take the random dot zero-order disparity, line zero-order disparity, 2nd-order disparity and random dot dynamic 1st-order disparity. Main Outcome Measures The measured value and the pass rate of each disparity. Results In mild, moderate, severe amblyopic children, the proportion of reaching 100＂in random dot zero-order disparity was 43.3%, 16.7%, 0% respectively（χ2=25.550，P=0.000）； the proportion of reaching 100＂in line zero-order disparity was 83.3%,  50.0%, 13.3% respectively （χ2=30.835，P=0.000）； the proportion of passing the 2nd-order disparity was 86.7%, 80.0%, 40.0% respectively （χ2=22.144，P=0.000）and the proportion of passing the random dot dynamic 1st-order disparity in a low speed was 80.0%, 50.0%, 13.3% respectively （χ2=27.379，P=0.000）. Conclusion The binocular disparity information  in the amblyopic children with normal eye position was abnormal. The more severe the degree of amblyopia, the more serious the binocular disparity abnormality.

Efficacy of 25G vitrectomy and internal limiting membrane peeling with room air tamponade for myopic foveoschisis

LIANG Jun, YANG Yan, GU Wei, MA Lie, YANG Cheng-xun

2015, 24(6):  381-383.  doi:10.13281/j.cnki.issn.1004-4469.2015.06.008

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Objective To evaluate visual and anatomical outcomes in patients with myopic foveoschisis who underwent vitrectomy and internal limiting membrane (ILM) peeling with room air tamponade. Design Retrospective case series. Participants 24 eyes of 20 patients with myopic foveoschisis were included. Methods Pars plana vitrectomy (25 Gauge) and ILM peeling with room air tamponade were performed in all patients. 6 eyes which combined with cataract were simultaneously accepted phacoemulsification with intraocular lens implantation. All recruits were accepted best-corrected visual acuity (BCVA) testing (logMAR), slit lamp, indirect ophthalmoscope and optical coherence tomography scans. Central foveal thickness (CFT) detected by OCT in pre-operation and 3, 6 months after surgery. According to the ETDRS, CFT was recorded in 5 areas (C, central; S, superior; I, inferior; N, nasal; T, temporal). All patients completed follow-up for more than 3 months (20.54±38.63 weeks). Main Outcome Measures BCVA and CFT. Results Preoperative and postoperative CFT was (1.41±0.51) and (0.58±0.69) LogMAR units respectively (P=0.001). The CFT of the postoperative eyes in the areas of C, S, I, N,T (233.09±78.72 μm, 260.18±41.04 μm, 260.36±29.85 μm, 289.41±28.38 μm, 237.55±53.57 μm) were significantly thinner than the corresponding areas of preoperative eyes (452.36±111.28 μm, 425.05±78.39 μm, 415.10±74.43 μm, 404.55±56.03 μm, 451.45±93.49 μm)(all P=0.000). Conclusion Vitrectomy combined ILM peeling and room air tamponade results in favorable visual and anatomical outcomes in myopic foveoschisis.

Effect of strabismus surgery on binocular vision of comitant strabismus patients

QI Meng, ZHAO Bo-wen, ZHOU Jin-qiong, WANG Jing-hui, SUN Xing-li, FU Jing

2015, 24(6):  384-387.  doi:10.13281/j.cnki.issn.1004-4469.2015.06.009

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Objective To analyze the changes and its influence factors of binocular vision in patients with comitant strabismus after strabismus surgery. Design Retrospective case series. Participants 191 patients undergoing strabismus surgeries in Beijing Tongren Hospital from Dec 2013 to Aug 2014 are involved. Methods All patients are categorized into three groups according to the type of strabismus: concomitant esotropia, constant exotropia and intermittent exotropia; into two groups according to surgery age: ≤9 year and ＞9 year. Binocular visual function preoperation, one-month and three-month postoperation was observed. Main Outcome Measures Grade I, II, III binocular function and near stereoacuity. Results Of all 191 cases, 26.7%, 19.4%, 11.0% and 41.9% patients have Grade I, II, III binocular function and near stereoacuity preoperation, which improve to 90.1%, 64.4%, 33.0% and 57.1% one-month postoperation (P＜0.001) and 94.8%, 79.1%, 37.7% and 63.9% three-month postoperation (P＜0.001). Preoperatively, 38.1%, 29.5% and 72.4% patients of intermittent exotropia group have Grade I, II binocular vision and near stereoacuity, which are better than the other two groups (P＜0.01). At three-month postoperation, 93.3%, 48.6% and 87.6% patients of intermittent exotropia group have Grade II, III binocular vision and near stereoacuity, which are better than the other two groups (P＜0.05); 55.8% patients of constant exotropia group have near stereoacuity, which is better than concomitant esotropia group (P＜0.001). In ＞9 year group, 28.1%, 21.9%, 14.6% and 31.3% patients have Grade I, II, III binocular function and near stereoacuity preoperation, which improve to 93.8%, 75.0%, 37.5% and 58.3% three-month postoperation (P＜0.01). Conclusion Strabiusmus surgery is an effective way to rebuild binocular vision. Intermittent exotropia patients have better binocular vision than patients with other types of strabismus. For the elder patients, strabismus surgery should also be performed if necessary.

Application of Accommodation Analyzer-1 on assessment of visual fatigue induced by watching 3D video

ZHANG Li, XU Liang, WANG Xiao-bing, ZHAO Shi-qiang, LI Jian-jun

2015, 24(6):  388-392.  doi:10.13281/j.cnki.issn.1004-4469.2015.06.010

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 Objective  To explore the visual fatigue induced by watching three dimensional (3D) video using Accommodation Analyzer-1(AA-1) and accommodative functional examination. Design Experimental study. Participants 48 healthy young subjects with refractive status being emmetropia, mild or moderate myopia (sphere degree>-5.0 D, cylinder degree within +1.0 D)，whose corrected visual acuity were 1.0 or more. Methods Each subject was arranged to watch two kinds of stereo television for 40 minutes in two different morning. Television A is the polarized 4K stereo display, and television B is the shutter-glass 4K stereo display. Before and after watching, accommodative functional examination was undergone by phoropter, accommodative response and microfluctuation high frequency (HFC) values were examined by AA-1. Subjective questionnaire (including eye dry, pain, blur, dizzy and headache. Scores are from 1 to 10, the higher score, the severer fatigue) should be finished after watching. The difference between accommodative measures before and after watching each kind of 3D display, and the difference of accommodative measures after watching between two kinds of 3D displays were analyzed. Main Outcome Measures Amplitude of accommodation, positive relative accommodation (PRA), negative relative accommodation (NRA), ratio of accommodation converge to accommodation (AC/A), HFC values, and subjective questionnaire scores. Results After watching television B, the mean value of amplitude of accommodation (13.92±4.13 D) was larger than that (13.22±3.39 D) before watching in right eye (P=0.035); before watching (13.93±3.99 D) in left eye was larger than that (15.28±6.13 D) after watching (P=0.018). After watching television A, the mean value of amplitude of accommodation only in left eye was larger than before watching (P=0.010). After watching television A, the mean value of HFC in right eyes (60.10±10.96 D) and in left eye (61.22±9.00 D) were larger than before watching (60.26±10.74 D in right eye, 61.84±9.67D in left eye) (P=0.450 for right eye, and P=0.001 for left eye). After watching television B, the mean values of HFC in right and left eye (58.45+10.63 D and 59.59+13.09 D, respectively) were smaller than before watching(58.93+11.20 D and 60.87+11.31 D, respectively)(all P=0.000). The score of subjective questionnaire for television A (3.13+2.35) was better than that for television B (3.70+2.27)(P=0.450). Conclusion Watching 3D video induces visual fatigue. Through examining HFC value and accommodative response using Accommodative Analyzer-1, we may objectively measure the extent of accommodative strain and visual fatigue.

Corneal Q value and its ralated factors in Chinese older than 30 years

XIONG Ying, WAN Xiu-hua, LI Jing, WANG Ning-li, LIU Xue, WANG Zhao

2015, 24(6):  393-396.  doi:10.13281/j.cnki.issn.1004-4469.2015.06.011

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Objective To describe the corneal Q value in Chinese older than 30 and to evaluate the associated factors. Design Cross-sectional study. Participants 1683 participants from the Handan Eye Study whose right eyes accepted the corneal topography, of which 955 were female and 728 were male. The average age was (53.6±11.0) years (30 ~ 107 years). Methods The corneal Q values of anterior surface and posterior surface were measured at the 3 mm, 5 mm and 7 mm diameter annulus by Orbscan corneal topography. The association of the corneal Q values with age, gender, and dioptre was analyzed. Main Outcome Measures The corneal Q value of anterior and posterior surface. Results The average corneal Q value of anterior surface at 3 mm, 5 mm and 7 mm diameter annulus was -0.28±0.175, -0.28±0.175, and -0.29±0.175 respectively and the values at 5 mm diameter annulus were negatively associated with age (B=-0.003, P<0.01) and dioptre (B=-0.013, P=0.016). The average Q value of posterior surface at 3 mm, 5 mm and 7 mm diameter annulus was -0.26±0.216, -0.26±0.214, and -0.26±0.215, respectively and the values at 5 mm diameter annulus were positively associated with age (B=0.002, P=0.036) and dioptre (B=0.016, P=0.043). Conclusion The corneal Q value in Chinese was different from that of Europeans and affected by age and dioptre.

Clinical diagnosis, treatment and efficacy of 97 cases of pediatric orbital cellulitis

FAN Yun-wei, WU Qian, YU Gang, CAO Wen-hong, WANG Yuan, LIU Wen

2015, 24(6):  397-401.  doi:10.13281/j.cnki.issn.1004-4469.2015.06.012

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Objective To investigate the clinical diagnosis, treatment and efficacy of children orbital cellulitis. Design Retrospective case series． Participants 97 cases (106 eyes) of orbital cellulitis in children with age from 7 day after birth to 11-year old (average 11±9 months). Methods All of the patients underwent the following examinations: orbit and paranasal sinus computed tomography (CT), blood routine test, C reactive protein (CRP), blood culture and drug sensitivity. Visual acuity, eye position, anterior segment, fundus examination were examed for cooperative children older than 4 years. All the patients were treated with antibiotic eyedrops, oral or intravenous antibiotics. Indication of incision and drainage: (1) definite diagnosis of preorbital cellulitis; (2) white blood cells (WBC) and CRP much higher than normal; (3) antibiotics cannot control the infection; (4) eyelid swelling and fluctuant feeling of the abscess; (5) support of orbital CT. Germicultures were performed after the incision and drainage. Then clinical manifestations, WBC, CRP, and the efficacy, etiological examination, and complications were observed and analysed. Main Outcome Measures Clinical manifestations, WBC, CRP, and the efficacy, etiological examination, and complications. Results 74 cases (76%) were younger than 3-year old, of which 23 cases were within 1 month after birth. 71 eyes (67%) manifested as preorbital cellulitis and 35 eyes (33%) as orbital cellulitis. 63 eyes (59%) with the indications underwent the operation of incision and drainage on top of using systemic antibiotics. WBC, CRP and body temperature was (23.6±9.1) ×109/L, (52±17) mg/L, and (38.8±1.4) °C before treatment, which decreased to (16.3±5.1)×109/L，(37±12)mg/L，and (38.2±0.4)°C respectively at first day after the drainage. Infection symptoms were completely controlled after removal of the drainage strip 7~10 days postoperatively. Staphylococcus aureus was the most common pathogen (81%). And conjunctival prolapse and exposure keratitis were the most commom complications(27%). Conclusion The incidence of orbital cellulitis often happened in infants. A combination of systemic antibiotic, incision and drainage works well to control the sympotoms of children orbital cellulitis.

Efficacy of scleral buckling procedures for longstanding rhegmatogenous retinal detachment

SHEN Zhi-jun, DUAN An-li

2015, 24(6):  402-405.  doi:10.13281/j.cnki.issn.1004-4469.2015.06.013

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Objective To investigate the therapeutic effects of scleral buckling operation on longstanding rhegmatogenous retinal detachment. Design Retrospective case series. Participants Sixteen patients (16 eyes) with proliferative vitreoretinopathy (PVR) C3 (9 eyes) and D1 (7 eyes) who had undergone scleral buckling operation in Tongren Hospital from March 2013 to May 2014. Methods The clinical data, therapeutic methods, visual acuity and retinal reattachment of the 16 patients (16 eyes) were retrospective analyzed. Main Outcome Measures Classification of PVR, visual acuity, reattachment of retina. Results 15 eyes (93.8%) had one-off successful reattachment. Visual acuity of all the 16 eyes was improved during the follow-up duration, in which the visual acuity was improved 2 lines in six eyes. Conclusion Scleral buckling operation can be used to treat some longstanding rhegmatogenous retinal detachment with PVR C3 and D1.

Inhibition of Akt activity enhances the sensitivity of retinoblastoma SO-Rb50 cell line to carboplatin in vitro

ZHANG Hao1, WANG Yi-chen2, LI Bin2, YANG Su-hong1, GONG Yue-qiu1

2015, 24(6):  405-408.  doi:10.13281/j.cnki.issn.1004-4469.2015.06.014

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Objective To discuss the correlation between Akt activity and the chemosensitivity of retinoblastoma SO-Rb50 cells to carboplatin. Design Experimental study. Participants SO-Rb50 cell line. Methods Cytotoxicity of carboplatin was determined using a standard colorimetric cell counting kit-8(CCK-8) assay. Western Blot was used to detect the changes of Akt, p-Akt, caspase 3, bax, p21 expression with drug treatments. Flow cytometer was used to examine the cell cycle distribution before and after drug treatments. Main Outcome Measures IC50 values，expression of proteins，cell percentage of each phase of cell cycle. Results IC50 value of carboplatin on SO-Rb50 cells was （30.1±5.9）mg/L. Preincubating cells with LY294002 to inhibit Akt activity, IC50 values to carboplatin were lowered to （16.3±0.83）mg/L for 5μM and （8.64±0.11）mg/L for 10 μM LY294002. Treated with Carboplatin or LY294002 alone or their combinations for 48 hours, p-Akt expressions of cells were all reduced. caspase-3, bax expressions were all increased and p21 expressions were increased only with carboplatin treatment. The percentage of each cell phase did not change much due to the application of LY294002 alone, while the exposure to carboplatin caused a significant accumulation of cells in G2/M phase [from (0.34±0.34)% to (43.62±11.01)%] with a concomitant reduction in G0/G1 phase [from (57.89±2.16)% to (12.11±2.87)%], and the additive combination with LY294002 did not further alter the cell percentage of each cell phase. Conclusion Inhibition of Akt activity can increase the sensitivity of SO-Rb50 cells to carboplatin and Akt may be a target for reducing drug resistance that improves the treatment for retinoblastoma.

Clinical efficacy of laser therapy to juxtapapillary capillary hemangioma

JI Hai-xia, ZHANG Feng, GAO Li-qin, ZHOU Hai-ying, YAN Wei, JIAO Xuan, XIONG Ying

2015, 24(6):  409-413.  doi:10.13281/j.cnki.issn.1004-4469.2015.06.015

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Objective To observe the clinical efficacy of laser therapy to juxtapapillary capillary hemangioma. Design Retrospective case series. Participants 11 patients（12 eyes）with juxtapapillary capillary hemangioma were reviewed. Methods All patients were treated with single or combined laser therapy, among which traditional laser therapy (532 nm green laser or 577 nm yellow laser) for 5 eyes, photodynamic therapy (PDT) for 4 eyes, PDT combined with traditional laser therapy for 3 eyes. Treatment times were 1 to 7 times, with a mean of （3.3±2.1） times; The follow-up period ranged from 2 months to 132 months, with a mean of （42.5±41.8）months. Visual acuity, tumor change, subretinal fluid, hemorrhage and epiretinal membrane were observed and analysis before and after treatment. Main Outcome Measures Vision, tumor change, subretinal fluid, hemorrhage and epiretinal membrane before and after treatment. Results The visual acuity before treatment ranged from CF/30 cm to 1.0, in which ≥0.5 in 3 eyes, <0.5 and ≥0.1 in 5 eyes, <0.1 in 4 eyes. The visual acuity after treatment ranged from hand motion (HM) to 1.0, in which ≥0.5 in 1 eye, <0.5 and ≥0.1 in 7 eyes, <0.1 in 4 eyes. Tumor regressed in 8 eyes, remained no change in 1 eye and became larger in 3 eyes. Subretinal fluid reduced or disappeared in 8 eyes, enlarged in 3 eyes. 5 eyes developed secondary epiretinal membrane, and 4 eyes developed secondary pigmentation in macula. Conclusion Timely treatment with single or combined laser therapy can help to control tumor growth of juxtapapillary capillary hemangioma in a certain extent.

Clinical observation of optic disc parameters and pRNFL thickness in tuberculum sellae meningiomas

WANG Li-na, YANG Liu, QU Yuan-zhen

2015, 24(6):  414-418.  doi:10.13281/j.cnki.issn.1004-4469.2015.06.016

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Objective To observe the characteristics of optic disc parameters and the change of peripapillary retinal nerve fiber layer (pRNFL) thickness in the patients with tuberculum sellae meningiomas. Design Retrospective case series. Participants The clinical data were collected in Tiantan Hospital from July 2010 to December 2011, which involved 40 patients (80 eyes) with tuberculum sellae meningiomas, 40 normal controls(80 eyes) and 40 glaucoma patients (80 eyes). Methods A total of 40 cases with tuberculum sellae meningiomas received the examination of fundus photography, pRNFL and optic disc parameters measurement by OCT, compared with the control group and glaucoma group. The relationship of optic disc parameters and tumor size were analysised. Describe the morphological characteristics of nuroretinal rim of optic discs (superior, S; nasal, N; inferior, I; temporal, T). Main Outcome Measures Rim volume, cup/disc（C/D） area ratio, horizontal C/D ration, vertical C/D ratio, rim area, cup area, cup volume and pRNFL. Results Optic disc parameters such as cup volume, optic disk area, C/D area ratio, horizontal C/D ratio, vertical C/D ratio, rim area, cup area in tumor group were bigger than in the normal group, rim volume were smaller than in the normal group (all P=0.000); C/D area ratio, horizontal C/D ratio, rim area, rim volume in the tumor group were bigger than in the glaucoma group, vertical C/D ratio, cup area, cup volume were smaller than in the glaucoma group (all P=0.000); The thickness of pRNFL in tumor group was 124.022±26.100 μm in ST, 105.856±23.410 μm in SN, 75.784±19.260 μm in NU, 65.983±15.708 μm in NL, 105.915±25.526 μm in IN, 133.591±24.429 μm in IT, 76.592±19.679 μm in TL, 77.352±26.100 μm in TU respectively, which were all significantly decreased compared with the thicknesses of pRNFL in normal group (all P<0.05). There was no significant differrence in SN (P=1.114) but significantly decreased in the other quadrants compared with the thicknesses of pRNFL in normal group (all P<0.05). The rim volume in tuberculum sellae meningioma evidently showed correlations with tumor size (r=0.492, P=0.000). Conclusion The features of optic disc parameters in the tuberculum sellae meningiomas shown as the temporal neuroretinal rim become narrow and pale;  compared with the normal control, the pRNFL thickness showed significant thiner in IN section; compared with glaucoma group, the except for SN region, other regions were significantly thiner, especially in IT section.

Investigation and analysis on the participant status of medical staff from primary hospital in a tele-ophthalmology project

MA Yi1, 2, LI Jian-jun2, LIU Li-juan2, WANG Shuang2, LU Qing-jun2,3, XU Liang2, CHEN Juan1

2015, 24(6):  418-424.  doi:10.13281/j.cnki.issn.1004-4469.2015.06.017

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Objective To survey the participant situation of the medical staff from primary hospital in a tele-ophthalmology project. Design Questionnaire investigation. Participants 276 medical staff from the 44 primary hospital， in which the implementation was more than six months in tele-ophthalmology project of Beijing Institute of Ophthalmology. Methods A self-designed questionnaire. The questionnaire included basic information of the respondents, and their awareness of the background of the cooperation projects, whether using the software system and use degree, whether there is additional income and whether satisfaction with the status quo of additional income in the tele-ophthalmology. Logistic analysis was used to analyze the influence factors of the use rate and the degree of the use of tele-ophthalmology system. The considered factors included the personal characteristics (gender, age, department, education, position and professional title) and hospital types (level, nature, category, department setting). Main Outcome Measures Awareness rate, usage rate of software system in tele-ophthalmology, satisfaction rate. Results All respondents (256 cases) are familiar with the background of the project cooperation. 217 (84.8%) medical staff use the tele-ophthalmology software system, which include164 (75.6%) doctors. 15 (6.9%) medical staff involved in tele-ophthalmology with additional income. 129 (59.4%) medical staff are not satisfied on the status quo of income. The use rate of tele-ophthalmology software system in chief physician/associate chief physicians was higher than that in the general staffs (P<0.05). The use rate of software system in the doctors working in the hospital without the setting of the ophthalmology department was higher than that in the hospitals with the setting of the ophthalmology department (P<0.05). 116 (70.7%) doctors used tele-ophthalmology software system for the patients in need. 48 (29.3%) doctors used it for all outpatients. The selective use rate for patients in need of the doctor aged 31~40 was higher than that of the doctors aged 41~50 or older (P<0.05). Conclusion All respondents are familiar with the tele-ophthalmology work, and the use rate of the tele-ophthalmology software system takes the higher percentage. Doctor is the main force of tele-ophthalmology. But most of the respondents have no additional income. They are not satisfied with the status quo. The doctors with administrative function or working in the hospital without ophthalmology department setting are more motivated to the work. Most doctors, especially younger doctors, provide patients with a selective tele-ophthalmology service.

Application of integral medicine in problem-based learning of ophthalmic clinical courses

XIAO Lin, XU Jing-mei, SUN Lin-qing, YAO Jing-lei

2015, 24(6):  425-426.  doi:10.13281/j.cnki.issn.1004-4469.2015.06.019

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In order to improve the teaching efficacy of clinical ophthalmology, discussed the efficacy of problem-based learning (PBL) reform practice combining the concept of medical integration. Systemic disease chapters content of ophthalmology courses was chosed to assess the teaching efficacy. The using of the student-centered education mode and group content preparation improved the teaching. Therefore, PBL teaching method combined with integral medicine is more suitable for the  clinical course education stage for the medical students, which makes students build up the idea of the whole and local, eye and body, and improves the autonomous learning ability of the students.

New anti-glaucoma therapy: fixed combination drugs

HE Xiang-ge

2015, 24(6):  427-430.  doi:10.13281/j.cnki.issn.1004-4469.2015.06.020

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 In recent years, new type antiglaucoma medication, fixed combination drugs,  were commercially available in our country. The drugs were combination by two or three anti-glaucoma medication individual components with different mechanism of lowering Intraocular pressure. The efficacy of fixed combination drugs was increased than their individual components. There were the same adverse effects as or less their individual components. These simplify the anti-glaucoma therapeutic regimen, reducing exposure to preservative, and improved the tolerability and compliance of patients.