Table of Content

25 May 2020, Volume 29 Issue 3

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Application of intraocular fluid testing in the diagnosis of uveitis

Yang Peizeng, Xu Jing, Su Guannan

2020, 29(3):  161-165.  doi:10.13281/j.cnki.issn.1004-4469.2020.03.001

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Intraocular fluid testing is a laboratory examination used in the diagnosis of certain intraocular inflammatory diseases or in the investigation of relevant factors associated uveitis. The specific examinations and their indications of intraocular fluid testing as well as explanation of the test results obtained are described in detail in this paper. The abused employment of intraocular fluid testing and misunderstanding of these results become a serious problem right now in clinical practice. In general, the diagnosis of uveitis is a clinical one and principally based on history taking, meticulous clinical examination and, if necessary, relevant auxiliary examinations. Intraocular fluid testing is useful only in the diagnosis of endophthalmitis, masquerade syndrome associated with malignancies, ocular toxoplasmosis and ocular toxocariasis. Extensive and indiscriminate intraocular fluid testing used in searching for underlying origins or causes of uveitis is a wasteful practice, frequently leading to misdiagnosis and mistreatment, and sometime puts patients at risk to development of intraocular infection.

Pay attention to the psychological problems of dry eye patients

Liang Qingfeng, Wei Zhenyu

2020, 29(3):  166-168.  doi:10.13281/j.cnki.issn.1004-4469.2020.03.002

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Dry eye disease (DED) is the most common ocular surface disease. Chronic ocular surface pain, irritation, and visual fatigue can affect the life quality of DED patients. All of these symptoms sometimes make DED patients lose their confidence for treatment and enthusiasm for working and life. Epidemiological studies have shown that DED was significantly associated with the anxiety and depression. Active treatment is beneficial for patients' depression, and positive emotion can reduce patients’ symptoms. Therefore, it is necessary to remind ophthalmologists to pay attention to the types, mechanisms and prevention of psychological disorders related to DED.

Clinical significance of MOG antibody in diagnosis and treatment of chronic recurrent inflammatory optic neuropathy

Qiu Huaiyu1, Cheng Kangpeng2, Liu Hongjuan3, Xu Quangang3, Kang Hao1, Song Honglu2, Zhou Huanfen3, Wei Shihui3

2020, 29(3):  169-172.  doi:10.13281/j.cnki.issn.1004-4469.2020.03.003

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Objective To evaluate the clinical significance of myelin oligodendrocyte glycoprotein immunoglobulin G (MOG-IgG) in chronic relapsing inflammatory optic neuropathy (CRION) by comparing the clinical characteristics and prognosis of MOG-IgG(+) CRION and MOG-IgG(-) CRION. Design Retrospective case control study. Participants From December 2015 to April 2018, the data of 40 in-patients with CRION who were treated in neuro-ophthalmology Department of General Hospital of Chinese PLA and Beijing Chaoyang Hospital were collected and followed up for at least one year. Methods According to the results of MOG IgG examination, the participants were divided into MOG IgG (+) CRION group and MOG IgG (-) CRION group. The database was established to compare the differences in demographic characteristics, symptoms, auxiliary examination and prognosis between the two groups. Main Outcome Measures Sex ratio, age of onset, monocular or binocular, visual prognosis, recurrence frequency, concomitant symptoms and MRI features. Results The average age of onset of MOG-IgG (+) CRION  group was 30.0±11.7 years, which was significantly younger than that of MOG-IgG (-) CRION  group (46.6±10.1 years old) (P<0.001). Six patients (23.1%) in MOG-IgG (+) CRION group suffered from simultaneous onset of both eyes for the first time, and all patients in MOG-IgG (-) CRION group onset in one eye for the first time. During the follow-up, 20 cases (76.9%) of MOG-IgG (+) CRION group had binocular involved, which was significantly higher than that of MOG-IgG (-) group (21.5%) (P<0.001). The average number of recurrences per year in MOG-IgG (+) group (3.36±0.90) was significantly higher than that in MOG-IgG (-) group (2.55±0.69) (P=0.015). In MOG-IgG(+) CRION group, 10 cases (38.5%) eventually complicated with craniocerebral and spinal cord symptoms, which was significantly higher than that in MOG-IgG(-) group (0 cases) (P=0.006). The MOG-IgG(+) CRION group was more likely to involve two or more sites (P=0.014). Conclusion MOG-IgG has important clinical significance in the diagnosis, treatment and prognosis of CRION patients. Specifically, MOG-IgG (+) CRION is younger in onset, easy to involve both eyes, and involves a longer segment of the optic nerve, easy to relapse. During follow-up, neurological symptoms such as craniocerebral and spinal cord were more likely to occur.

Clinical characteristics under in vivo confocal microscopy and TGFBI gene mutation analysis in Thiel-Behnke corneal dystrophy

Wei Zhenyu, Xu Ke, Liang Qingfeng

2020, 29(3):  173-179.  doi:10.13281/j.cnki.issn.1004-4469.2020.03.004

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Objective To identify the clinical manifestations and in vivo confocal microscopy (IVCM) imaging changes of the patients with Thiel-Behnke corneal dystrophy (TBCD). Design Prospective study. Participants A TBCD patient and her family. Methods Ocular surface examinations were performed on the members of the TBCD family, which included vision acuity, slit-lamp microscope, IVCM, and anterior segment optical coherence tomography (AS-OCT). Meanwhile, 10 ml of peripheral venous blood was taken from this pedigree to prepare for leukocyte genomic DNA. The TGFBI gene was amplified by PCR, and the patient's gene sequence were analyzed. Main outcome Measures Results of vision acuity in TBCD patients, characteristics of cornea lesion with slit lamp, IVCM, AS-OCT examinations, and the condition of patient's gene sequence mutation. Results Among 35 members in this four-generation family, diffuse, grayish-white turbid deposits were detected at the Bowman layer in 10 TBCD patients. The lesions were mainly located at the Bowman layer in the central and mid-peripheral cornea area. Point-like opacity, with linear or honeycomb shape, could also be explored in the superficial stroma. With AS-OCT examination, continuous, uniform and highly reflective deposits were detected in the Bowman layer and superficial stroma layer of the cornea. The anterior part of the deposit (toward the epithelial layer) presented sawtooth-like lesion. From the epithelial layer to superficial layer, high-reflective, irregular, and amorphous deposits were detected with IVCM examination. No inflammatory cell infiltration was found in the lesion area and surrounding tissues. Molecular genetic analysis revealed a single heterozygous G>A mutation at the second base of codon 39 in exon 12 of the TGFBI gene of the pedigree affected with TBCD, but not in the unaffected members. It could result in the conversion of arginine to glutamine (R555Q). Conclusion With IVCM examinations, TBCD with R555Q mutation was manifested as highly reflective, irregular, and amorphous substance deposition in the Bowman layer of the cornea.

Novel mutations of RPGR in Chinese families with X-linked retinitis pigmentosa

Yan Bojing1, Lang Xuqiang1, Sun Xiaowei2, Yang Liping3, Li Genlin4

2020, 29(3):  180-186.  doi:10.13281/j.cnki.issn.1004-4469.2020.03.005

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Objective To identify genes and mutations in three Chinese families who presented with X-linked retinitis pigmentosa. Design Gene research. Participants 3 Chinese XLRP families including 27 participants(18 male). Methods The clinical data and ophthalmic examinations of three families were collected by the same doctor. Genomic DNA was extracted from peripheral blood. The coding regions and intron-exon boundaries of the retinitis pigmentosa GTPase regulator (RPGR) and RP2 genes, including the open reading frame 15 (ORF15) of RPGR, were amplified by PCR and then sequenced directly. Main Outcome Measures Clinical characteristcs and gene sequencing. Results Mutation screening demonstrated two novel nonsense mutations (c.1541C>G;p.S514X and c.2833G>T;p.E945X) and one missense mutation(c.607G>C;p.A203P) in RPGR genes. Genotype-phenotype correlation analysis suggested that patients with mutation close to down-stream of ORF15 in family 3 manifested the early loss of cone function; female carries with ORF15 nonsense mutation showed heavier clinical manifestations. Thus, the inheritance patterns bias to dominant heredity. Conclusion We identified three novel mutations of RPGR genes, which broaden the spectrum of RPGR mutations and the phenotypic spectrum of the disease in Chinese family.

Clinical constituent analysis of fundus lesions in AIDS and syphilis co-infected patients

Chen Chao1， Xie Lianyong1， Du Kuifang1， Jiang Taiyi2, Kong Wenjun1， Dong Hongwei1, Guo Chungang1, Wei Wenbin3

2020, 29(3):  187-192.  doi:10.13281/j.cnki.issn.1004-4469.2020.03.006

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Objective To analyze the clinical constitutions of fundus lesions in AIDS patients combined with syphilis. Design Retrospective case series. Participants 395 AIDS patients were treated in Beijing Youan Hospital from 2012 to 2019. Methods All AIDS patients were divided into AIDS group and AIDS with syphilis group according to whether they combined with syphilis or not. All patients were examined for best corrected vision acuity (BCVA), slit lamp, intraocular pressure, mydriatic fundus examination and color fundus photography. The history of AIDS and HAART treatment were recorded. Syphilis rapid plasma reagin test (RPR)，blood CD4+T cells, HIV-RNA load and CMV-DNA were tested. Compare the ocular and general conditions between the two groups. Main Outcome Measures BCVA, anterior segment reaction, funus lesion, HAART statues, blood CD4+T cell count, HIV-RNA load and CMV-DNA load. Results 266 patients in AIDS group, 163 patients (61.3%) with abnormal fundus, in which, 149 cases (91.4%) were males, 66 cases (40.5%) with HIV related microvascular retinopathy, 94 cases (57.7%) with cytomegalovirus retinitis, and the median CD4+T cell count was 27/μl. There were 129 AIDS patients with syphilis, 93 cases (72.1%) had abnormal fundus (P=0.035), 92 cases (P=0.014) were male, 40 (31.0%) with HIV related microvascular retinopathy, 26(20.2%) with syphilis related fundus changes, 25(19.4%) with cytomegalovirus retinitis. In which, 23 cases had positive reaction to anterior segment (P=0.010), 63 cases (67.7%) had central fundus lesion (P=0.040), and the median number of CD4+T cells was 33.5 /μl (P=0.007), which was significantly higher than that of AIDS group. Conclusion The incidence rate of fundus lesions and number of blood CD4+T cells in AIDS combined syphilis group was significantly higher than that in group AIDS.

Clinical features of central serous chorioretinopathy secondary to systemic corticosteroids

Cao Xusheng, Ji Haixia, Zhang Yongpeng, Peng Xiaoyan

2020, 29(3):  193-197.  doi:10.13281/j.cnki.issn.1004-4469.2020.03.007

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Objective To investigate the clinical features of central serous chorioretinopathy (CSCR) secondary to systemic corticosteroids. Design Retrospective comparative case series. Participants 35 consecutive CSCR patients (50 eyes) induced by corticosteroid who consulted at the ophthalmic clinic of Beijing Tongren Hospital from October 2012 to October 2018, and 61 consecutive CSCR patients (67 eyes) without a history of systemic corticosteroid. Methods The clinical data including medical history, visual acuity, color fundus photos, fundus fluorescence angiography (FFA) of the secondary CSCR group and control group were collected continuously, the clinical features of the two groups were analyzed and compared retrospectively. Main Outcome Measures Clinical features, ocular fundus and FFA changes. Results In 35 patients (50 eyes) with secondary CSCR, 15 cases onset in both eyes (42.9%), 20 cases in one eye (57.1%); subretinal yellowish fibrinous deposits were found in 15 eyes (30%); inferior retinal detachment in 8 eyes (15.7%); diffuse atrophic retinal pigment epithelium alterations (DARA) in 16 eyes (31.4%); one fluorescein leakage site in 21 eyes (42.0%) during FFA, more than 1 leakage site in and/or diffuse fluorescein leakage in 29 eyes (58.0%). In the control group of 61 cases (67 eyes), 6 cases (9.8%) onset in both eyes, 55 case (90.2%) in one eye; subretinal yellowish fibrinous deposits were found in 9 eyes (13.4%); exudative retinal detachment in no eyes; DARA in 2 eyes (3%); one fluorescein leakage site in 59 eyes (88.1%), more than one leakage site or diffuse fluorescein leakage in 8 eyes (11.9%).  There were significant statistic differences between the two groups (all P=0.000). Conclusion Compared with idiopathic CSCR, CSCR secondary to systemic corticosteroid was more apt to involve both eyes, and have more severe retinal pigment epithelium damage.

Report on screening of neonatal fundus diseases in Urumqi Xinjiang

Liu Zijiang1, Kabinuer1, Mei Jude1, Ma Ping1, Chen Wensi2, Xiang Daoman2

2020, 29(3):  198-202.  doi:10.13281/j.cnki.issn.1004-4469.2020.03.008

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Objective To understand the incidence of neonatal fundus disease in Urumqi, Xinjiang, and provide basis for the prevention and treatment of neonatal ophthalmopathy. Design Cross-sectional study. Participants 25 644 newborns born in Urumqi Maternal and Child Health Care Hospital from January 2014 to December 2018. Methods All the newborns were examined with wide area digital fundus imaging system (RetCam 3). The clinical data such as gestational weeks, birth weight and delivery mode were recorded, and the screening results were analyzed. Main Outcome Measures Incidence of neonatal fundus disease. Results The abnormal rate of fundus was 18.16%. The incidence rate of retinal vitreous body hemorrhage was 13%(3334 cases), the incidence of retinal hemorrhage in vaginal delivery (20.91%) was significantly higher than that in cesarean section (3.71%) (P=0.000). The incidence of familial exudative vitreoretinopathy (FEVR) was 0.34% (87 cases); the incidence of peripheral white focus of retina was 2.1%(539 cases); the incidence of persistent hyperplastic primary vitreous was 0.02%(4 cases); the incidence of morning glory syndrome was 0.02% (6 cases);  the incidence of retinoblastoma was 0.01% (2 cases), and retinopathy of prematurity (ROP) was detected in 4.79% (79 cases) of preterm infants, and the detection rate of ROP was negatively correlated with gestational age and birth weight (r=-0.879, -0.907; P=0.049, 0.034). Conclusion The incidence of most ocular fundus diseases in the region is the non urgent, non intervention, and the main blinding fundus disease is ROP.

Short-term efficacy of combined antitubercular and corticosteroids therapy for tubercular serpiginous-like choroiditis

Shi Jie1, Wang Xiaona1,2, Hu Feng1, Mao Yu1, Li Zhihua1, Peng Xiaoyan1

2020, 29(3):  203-208.  doi:10.13281/j.cnki.issn.1004-4469.2020.03.009

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Objective To observe the short-term efficacy of antitubercular drugs combined with corticosteroids in the treatment of tubercular serpiginous-like choroiditis, and explore the factors that may affect the treatment. Design Retrospective case series. Participants 16 patients (20 eyes) with tubercular serpiginous-like choroiditis presented to Beijing Tongren Hospital from January 2016 to June 2019. Methods First-line 4-drug antitubercular therapy (isoniazid, rifampicin, ethambutol, pyrazinamide) were given initially for 2 months. Thereafter, rifampicin and isoniazid were continued for another 4 months. Oral corticosteroids (prednisolone 1 mg/kg/day initially) were administered 2 weeks later than antitubercular therapy, then gradually tapered off depending on the clinical response and last for 6 months. Following-up was conducted 1, 2, 3, and 6 months after the combined therapy. During the follow-up, color fundus photography, fundus autofluorescence (FAF), optical coherence tomography (OCT) and vitreous cells were recorded. Main Outcome Measures Numbers of eyes with effectiveness or recurrence, complication. Results 11 patients with 13 eyes (68.8%) had stable lesions after antitubercular drugs combined with corticosteroids therapy, and 8 patients (72.7%) strictly followed the dosing regimen. Ten people were administered corticosteroids systemically before anti-tuberculosis, of which 5 (50%) patients had active lesions at 6 months, 1 eye (5%) developed choroidal neovascular (CNV). 6 patients who were without corticosteroids history before antitubercular all showed stable fundus at the end of the follow-up. Conclusion The lesions of tubercular serpiginous-like choroiditis in most patients responded well to combined antitubercular and corticosteroids therapy. Patients who were administered large amounts of corticosteroids systemically before the antitubercular had a poor prognosis.

Clinical efficacy comparation of intravitreal injection of ranibizumab and macular photocoagulation for macular edema secondary to non-ischemic retinal branch vein occlusion

Yuan Yu, Wang Jingjing

2020, 29(3):  209-213.  doi:10.13281/j.cnki.issn.1004-4469.2020.03.010

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Objective To compare the clinical efficacy and safety of intravitreal injection of ranibizumab and macular photocoagulation in the treatment of macular edema secondary to non-ischemic retinal vein occlusion (BRVO). Design Retrospective comparative case series. Participants 68 patients (68 eyes) who were clinically diagnosed as non-ischemic BRVO secondary macular edema in Hanzhong Central Hospital from June 2015 to June 2018. Methods A total 68 patients (68 eyes) were divided into control group and observation group, 34 cases (34 eyes) in each group. The control group was treated with standard macular grid photocoagulation, while the observation group received intravitreal ranibizumab as needed. LogMAR best corrected visual acuity (BCVA) and central macular thickness (CMT) and adverse events in the two groups were reviewed and compared before and 1, 2, 3, and 6 months after the treatment. Main Outcome Measures BCVA, CMT and adverse events. Results There was no significant differences in LogMAR BCVA and CME between the two groups before treatment ( all P>0.05). Compared with pre-treatment, LogMAR BCVA decreased significantly at 1, 2, 3, and 6 months after treatment in two groups (all P<0.05); the LogMAR BCVA was significantly lower in the observation group than in the control group at 1, 2, 3, and 6 months after treatment (t=3.320, 4.412, 5.580, 5.859, all P<0.05). There were statistically significant differences in CMT between the two groups after treatment (F=5.603, 5.122, all P<0.05), and with the prolongation of time, the CMT of the two groups decreased significantly. The decrease in the observation group was significantly more than that in the control group (t=-8.358, -11.599, -7.792, -4.889, all P<0.05). There were no serious adverse events in both groups. There was no significant difference in the incidence of intraocular and non-intraocular adverse events between the two groups (χ2=1.063, 0.216, both P>0.05). Conclusion The effecicay of ranibizumab in improving the visual acuity and reducing the degree of macular edema of patients with non-ischemic BRVO is significantly better than that of traditional macular grid photocoagulation, and the safety is good.

Surgical effect in different types of congenital epiblepharon combined entropion

Li Yang, Hou Zhijia, Ding Jingwen, Zhang Ju, Li Dongmei

2020, 29(3):  214-218.  doi:10.13281/j.cnki.issn.1004-4469.2020.03.011

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Objective Try to classify congenital epiblepharon combined entropion, and to observe the surgical effect of the surgical design according to the classification. Design Prespective case series. Participants 122 patients (232 eyes) with congenital epiblepharon combined entropion were performed surgical treatment in Beijing Tongren Hospital from January 2017 to December 2018. Methods Congenital epiblepharon combined entropion was divided into three types: medial, central and diffuse. The diorthosis of epiblepharon combined entropion with small incision in the medial type, the correction of epiblepharon combined entropion with “crescent incision” in the central type, and the correction of epiblepharon combined entropion with full length incision in diffuse type were performed. The definition of effectiveness was that the eyelid position was normal one month after the operation; the lower eyelid lashes deviate from the eyeball surface with no touch of the cornea; the corneal irritation symptoms such as photophobia, tears, eye tingling disappear, and the corneal staining was negative. The definition of relapse was the recurrence of eyelashes back to the eyeball and corneal irritation 1 month after operation. The follow-up time was 24 months. Main Outcome Measures Effective rates and recurrence rate. Results 122 cases (232 eyes) were performed surgical treatment. In which, 98 eyes (42.24%) was medial type. 20 eyes (8.62%) was central type, and  114 eyes (49.14%)  was the diffuse type, all of which were successfully operated. All of them were followed up for 24 months, and the effective rate was 100%. Recurrence: 2 eyes (2.04%) in the medial type group and 2 eyes (1.75%) in the diffuse type group relapsed with no relapse in the central group. Conclusion The satisfactory results could be obtained by selecting the corresponding surgical design for congenital epiblepharon combined entropion with different types.

Analysis on incidence of primary ocular malignant tumor in Beijing household registration according to database of World Health Organization's Cancer Incidence in Five Continents

Zhou Jichao, Wang Wei, Zhang Chun, Tian Yanjie, Zhao Suyan, You Debo

2020, 29(3):  219-223.  doi:10.13281/j.cnki.issn.1004-4469.2020.03.012

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Objective To analyze the incidence characteristics of primary ocular malignant tumor in Beijing household registration according to database of World Health Organization's Cancer Incidence in Five Continents (CI5). Design Cross-sectional study. Participants Cancer registration data of Beijing registered population from January 1, 2003 to December 31, 2012 published by the World Health Organization's CI5 database. Methods Using the database information, combined with each annual demographic data provided by the Beijing Municipal Public Security Bureau, Beijing residents primary ocular tumor incidence and world standard demographic standardized incidence were calculated. The sites and pathological subtypes were analyzed. Main Outcome Measures Incidnece and standardized incidence of world standard population composition. Results According to the database, in the past 10 years, 740 patients with primary ocular malignant tumors were diagnosed in Beijing, with a population incidence of 6.11/million, the average age is 56.5 ± 17.6 years old, from 6 months old to 96 years old. Male/female is 1.2:1. The main pathological types were basal cell carcinoma (27.3%), followed by adenocarcinoma, sarcoma, retinoblastoma, and malignant melanoma, accounting for 13.2%, 11.8%, 10.9%, and 8.8%, respectively. Eyelid is the leading attacked site (68.3%), followed by eyeballs (18.3%) and orbits (4.8%). Within 10 years, no matter male or female, the incidence of ocular malignant tumors in different age groups was not statistically significant (all P>0.05). Conclusion According to the database, the incidence of primary ocular malignant tumor in Beijing residents registered in CI5 is 6.11/million, and the average age is 56.5±17.6 years. The top pathological types are basal cell carcinoma, followed by sebaceous gland carcinoma, sarcoma, retinoblastoma and malignant melanoma. Eyelid is the leading attacked site.

Analysis of disease spectrum and epidemiological characteristics of emergency ocular trauma during outbreak of novel coronavirus pneumonia

Ma Yan, Shi Xiangyu, Ma Jing, Qiao Chunyan

2020, 29(3):  224-229.  doi:10.13281/j.cnki.issn.1004-4469.2020.03.013

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Objective To investigate the trend change of ocular trauma disease spectrum and epidemiological characteristics of ophthalmic emergency patients during novel coronavirus pneumonia outbreak period. Design Retrospective comparative case series. Participants One thousand two hundred and nine patients with ocular trauma who admitted ophthalmic emergency department of Beijing Tongren Hospital from January 23, 2020 to March 31, 2020 were enrolled as the study group, and 2444 emergency ocular trauma patients in the same period in 2019 as the control group. Methods Data were extracted from hospital information system, including ages, genders, admitting times, ocular trauma classifications, injury locations, and number of patients. Disease spectrum distribution of emergency ocular trauma and epidemiological characteristics were analyzed. Main Outcome Measures Ages, genders, admitted time, emergency diagnoses, number of patients. Results The total number of ophthalmic emergency patients is 5978 during epidemic period, including 1209 ocular trauma patients (20.2%). The total number of ophthalmic emergency patients is 12776 in the same period in 2019, including 2444 ocular trauma patients (19.1%) (χ2=3.111，P=0.078). Male patients were 835 cases (69.1%) in the study group and 1743 cases (71.3%) in the control group (χ2=1.976，P=0.160). The age of patients was 37.0 (26.5, 52.0) years in the study group and 35.0 (22.0, 50.0) in the control group (U=1369248.50，P＜0.001). Young patients (age from 18 to 44 years) accounted for the most proportion in both groups (561 cases, 46.4%, in the study group; 1090 cases, 44.6%, in the control group) (χ2=1.062, P=0.303). The number and proportion of children (age from 0 to 17 years) showed difference between two groups with statistically significant (199 cases, 16.5%, in the study group; 548 cases, 22.4%, in the control group) (χ2=36.437, P＜0.001). The number of patients with non-mechanical ocular trauma was growing during epidemic period. The patients of electric ophthalmia were more than control group (141 cases, 81.0%, in the study group; 53 cases, 46.9%, in the control group) (χ2=36.437, P＜0.001). The patients of mechanical ocular trauma were less than control group (1035 cases, 85.6%, in the study group; 2331 cases, 95.4%, in the control group) (χ2=106.619, P＜0.001). Eyelid was the most frequently involved part in mechanical eye injuries (599 cases, 57.9%, in the study group; 1351 cases, 58.0%, in the control group) (χ2=0.002, P=0.964). Compared with the control group, conjunctiva injuries were increase (213 cases, 20.6%, in the study group; 336 cases, 14.4%, in the control group) (χ2=19.959, P＜0.001) and uvea injuries were decrease (39 cases, 3.8%, in the study group; 131 cases, 5.6%, in the control group) (χ2=5.125, P=0.024). The difference of open globe injury proportions between two groups was not statistically significant (101 cases, 9.8%, in the study group; 193 cases, 8.3%, in the control group) (χ2=1.966, P=0.161). Conclusion The numbers of ophthalmic emergency visits and ocular trauma patients were decreased sharply during novel coronavirus pneumonia outbreaks period. Males, young people and children were still at high risk of eye injuries. The incidence of ocular trauma in children was dropped. The incidence of electric ophthalmia was increased while the incidence of mechanical ocular trauma was decreased significantly.

Effectiveness of EYESI binocular indirect ophthalmoscope simulation training system as an assessment and training platform for ophthalmic residents

Liu Ziyuan, Ao Mingxin, Wang Wei, Hou Zhiqiang

2020, 29(3):  230-234.  doi:10.13281/j.cnki.issn.1004-4469.2020.03.014

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Objective To evaluate the effectiveness of EYESI binocular indirect ophthalmoscope simulation training system (EYESI) as a training and assessment platform for indirect ophthalmoscope operation and fundus mapping skills of ophthalmic residents. Design Comparative teaching study. Participants Twenty residents in Ophthalmology Department. Methods  The participants were divided into 0 group, 1 month group, 3 month group and 6 month group according to the experience of using indirect ophthalmoscope. Participants finished the examination on EYESI to evaluate the effectiveness of the system as a method of assessment. Five of the residents were trained by this system. The training contents of operation and fundus mapping were completed for 2 weeks each. The results were compared with other 5 residents who received the traditional practice training for 2 months. Main Outcome Measures The operation or drawing time, light exposure time, drawing accuracy and total score. Results The length of operation time in group 0 was the longest (1359.25±729.82) s, while in other groups it decreased with the increase of experience. The longest time of light exposure was (442.00±188.79) s in group 0. The time of drawing fundus map decreased gradually with the increase of experience in indirect ophthalmoscope use. The longest drawing time of group 0 (1860.50±188.80) s and the drawing shortest time of group 6 month(968.75±336.58) s were significantly different (P=0.026). The operation time in EYESI training group decreased from (1226.67±832.76) s to (761.00±307.32) s, and the decreasing percentage was 30.58%±19.22%. However, the operation time in traditional practice training group decreased from (765.00±306.92) s to (595.67±158.71) s, and the decreasing percentage was 19.09%±12.87%. In EYESI training group the drawing time decreased from (1001.00±507.72) s to (667.00±333.75) s, and the decreasing percentage was 33.90%±1.46%. The accuracy of drawing increased from 81.28%±3.50% to 88.88%±1.45%, and the increasing percentage was 9.41%±2.93%. After two months of traditional practical training, the drawing time decreased from (1810.00±424.08) s to (1429.67±180.47) s, the shortening percentage was 19.40%±10.40%. The accuracy of drawing increased from 75.13%±11.29 % to 81.62%±10.31%, the increasing percentage was 15.59%±12.26%. Conclusion EYESI system is an effective and accurate platform for ophthalmologists to study indirect ophthalmoscopes.