论著
Objective: To investigate the morphological changes detected by spectral domain optical coherence tomography (OCT) and their relevance to vision in patients with idiopathic macular epiretinal membranes (IMEM). Methods: This is a retrospective study. OCT recorded 37 eyes with stage 3 and below IMEM according to the 4-level grading system based on OCT images among 35 patients. We managed to obtain thickness of all retina layers in three concentric circular regions with a diameter of 1 mm, 3 mm and 6 mm across macular fovea with the help of a third-party software. Plus we divided all 37 eyes into two groups according to whether there were cystic changes in the inner nuclear layer (INL). Multiple linear regression analyses were performed between thickness of all retina layers and current minimum resolution angle in logarithmic (logMAR) best corrected visual acuity (BCVA). The difference of BCVA between groups with cystic changes and without was also compared. Thus, the relationships between visual acuity and thickness of retina layers, cystic changes in INL were analyzed. Results: Multiple linear regression analyses revealed that thickness of both retina nerve fiber layer (RNFL) and inner nuclear layer have positive correlation with logMAR BCVA in the region with a diameter of 1 mm (P<0.05), while in regions of a diameter of 3 mm and 6 mm, only INL thickness remained positively relevant (all P<0.05). There were significant differences in BCVA and thickness of INL between groups with INL cystic changes and without (all P<0.05). Conclusion: Current visual acuity among preoperative IMEM patients was mostly associated with thickness of RNFL and INL. Cystic change in INL layer may be a good indicator of INL thickening and was visually correlated. Those with this change tend to have worse vision.
论著
Objective: To investigate the effect of conductive education training on the quality of life in visually impaired students. Methods: It was a prospective randomized controlled trial. The visual impairment students who had registered in Quanzhou Special Education School in 2020 were selected and randomly divided into two groups: conductive education training group and control group. The conductive education training group received conductive education training, while the control group received routine rehabilitation training. Chinese version low vision quality of life questionnaire (CLVQOL) was used to assess the quality of life of low vision students at baseline and 3 months after training, and comparative analysis was conducted. Results: All 72 students with visual impairment completed CLVQOL surveys. At baseline, there was no significant difference in total CLVQOL scores between groups. After 3 months, overall CLVQOL scores increased in both groups, from baseline 59 (48.5, 80.5) to 105 (97.5, 119.5) in the conductive education group (Z=?4.781, P<0.001), and 69 (56, 85) to 106 (80, 112) in the control group (Z=?4.438, P<0.001). The total score of CLVQOL (P=0.021), reading and fine work subscale (P=0.004), and daily activities subscale (P<0.003) in the conductive education training group were higher than those in the control group. Conclusion: Conductive education training is an important method of low vision rehabilitation training, which can significantly improve the quality of life of patients.
论著
Objective: To analyze the internal demands of the application of artificial intelligence technology to ophthalmic care, and provide guidance and basis for the development and application of artificial intelligence technology in ophthalmic hospitals. Methods: Using the method of combining cluster sampling with simple random sampling, a questionnaire survey was conducted on the ophthalmic nursing staff in the selected target hospitals from July to August 2019, which included general information and artificial intelligence needs. Results: Most of the respondents came from the third-class hospitals (89.2%), and hospitals in South China account for 87.2% of them. There are diverse demands of artificial intelligence in ophthalmology clinical nursing applications, including health education, clinical reception and triage, patients return visits, which have the strongest demand for the artificial intelligence, accounting for 95.7%, 93.5%, and 93.2%, respectively. Conclusion: The application of artificial intelligence in ophthalmic clinical nursing has strong and diversified demands, and the research and development of artificial intelligence in the health education of ophthalmic patients and other related applications should be promoted according to the actual demands.
综述
Posner-Schlossman syndrome (PSS), also called glaucomatocyclitic crisis, is characterized by recurrent non-granulomatous anterior uveitis, accompanied by elevated intraocular pressure. It is able to develop into chronic secondary glaucoma and eventually lead to optic nerve injury. Although the overall prognosis of PSS is favourable, there are still some patients whose optic nerve injury continues to progress and even lead to blindness due to recurrent attacks of ocular hypertension. At present, the exact cause of PSS is not clear, and the treatment is mainly to control inflammation and intraocular pressure. This article will elaborate the research status of PSS from two aspects of etiology and treatment to provide ideas and reference for the basic research clinical diagnosis and treatment of PSS.
发明与创新
To meet the demands of ophthalmic medical diagnosis, and to improve the efficiency of medical staff and patients’ treatment, the authors designed an ophthalmological multifunctional ruler. Its main material is PVC, and mainly includes a circular disk and 4 rules (the main ruler, the first ruler, the second ruler and the third ruler). Its functions mainly contain the measurement of length, visual test, illumination, the angle measurement for patients position and so on. The ruler is ingenious in design and has complete functions, which can meet the requirements of ophthalmic medical treatment and diagnosis.
医学教育
Objective: To explore the application effect of standardized training and assessment of emergency nursing skills in ophthalmology nurses. Methods: We implemented standardized training and assessment of emergency nursing skills for 142 ophthalmology nurses in our hospital, compared the difference between the first aid theory and the first aid skill operation before and after the training, and used a self-made questionnaire to conduct training evaluation surveys. Results: After implementing the standardized training of emergency nursing skills, the assessment scores of first aid theory and skill operation of ophthalmology nurses were higher than those of the pre-training assessment. And the difference was statistically significant (P<0.05). More than 90% of ophthalmology nurses had a positive opinion on first aid training. Conclusion: Standardized training and assessment of emergency nursing skills have improved the clinical emergency nursing level of ophthalmology nurses and cultivated a good emergency nursing awareness and teamwork spirit. At the same time, they have strengthened nurses’ self-worth and professional identity, and achieved better training results.
医学教育
Objective: To evaluate the teaching needs and satisfaction of the eight-year program medical students to the whole-course tutors. Methods: An anonymous online questionnaire survey was conducted among the eight-year program medical students at Sun Yat-sen University. All students were divided the junior group and the senior group, and the differences between the two groups were compared. Results: A total of 352 valid questionnaires were collected. The proportion of students who were fairly satisfied with their whole-course tutors was 45.56% in the junior group and 37.79% in the senior group (P=0.087). The proportion of students who were fairly satisfied with the whole-course tutorial system was 36.67% in the junior group and 33.14% in the senior group (P=0.806). The proportion of students who “know well” and “know fairly well” about the whole-course tutorial system in the junior group was significantly lower than that in the senior group (16.67% vs 77.91%, P<0.001). The proportion of students in the junior group expecting their whole-course tutors “having a great impact” or “having some impact” on career planning, clinical thinking, scientific research thinking and mental health was significantly higher than that in the senior group (tests for proportions, all P<0.001, 83.33% vs 36.63%, 92.22% vs 29.07%, 91.67% vs 31.39%, 62.78% vs 38.37%). Conclusion: The eight-year program medical students are satisfied with their whole-course tutors and the whole-course tutorial system. However, some problems still exist, such as lower grade students lack of understanding of the whole-course tutorial system, insufficient contact between tutors and students, the actual influences of tutors failing to meet the students’ expectation, and insufficient opportunity of scientific research and training. It is urgent to improve the whole-course tutorial system and promote the cultivation of qualified medical talents.
论著
Objective: To evaluate the efficacy of mucosal flap punctoplasty in patients with chronic canaliculitis. Methods: In this retrospective serial case study, the clinical data of 44 patients with chronic canaliculitis were collected from the Oculoplastic Department of Zhongshan Ophthalmic Center at Sun Yat-sen University between January 2018 and December 2020. Demographic data such as gender, age, affected eye, clinical presentations and lacrimal duct irrigation results were analyzed. The efficacy of the procedure, symptom resolution and complications were assessed. Results: Of the 44 patients, most (male:female 1:3.9) were female, and the disease most often (upper:lower 1:3) involved the lower lacrimal canaliculus of only one eye. Main symptoms included increased secretion, tearing, and swelling of the inner canthus. Stones were present in 95.7% of patients and Actinomyces israelli was found to be the most common pathogen (78.3%). Most patients’ symptoms improved significantly within 1 week after surgery. Only one patient, who had infections in both the upper and lower canaliculi, had recurrence of upper canaliculitis 2 months after the surgery. The overall cure rate was 97.8%, and the follow-up time was (20.7±10.9) months. Conclusion: Mucosal flap punctoplasty is an efficacious and reliable method in the treatment of chronic canaliculitis.
论著
Objective: To compare the efficacy of bicanalicular silicone intubation assisted with epidural catheters and traditional bicanalicular silicone intubation in the anastomosis of lacrimal canaliculus rupture. Methods: Fifty-two patients (52 eyes) were randomly divided into two groups. Patients in group A (30 cases) were treated by bicanalicular silicone intubation assisted with epidural catheters, while patients in group B (22 cases) were treated with conventional operation (bicanalicular silicone intubation). The intubation time, average operation time, nasal bleeding rate, intraoperative pain score and one-time success rate were compared between the 2 groups. Results: Intubation time in group A was (11.20±3.80) min and that in group B was (21.50±12.60) min (P<0.05). The mean operation time of group A was (42.70±5.50) min and that of group B was (62.20±15.20) min (P<0.05). Intraoperative pain score was 3.10±0.80 in group A and 4.60±1.25 in group B (P<0.05). The rate of nasal hemorrhage was 3.33% (1/30) in group A and 18.2% (4/22) in group B (P<0.05). With respect to one-time anastomosis success rate assessment, the effective rate was 93.3% (28/30) in group A, and 86.4% (19/22) in group B (P>0.05). Conclusion: During lacrimal canalicular anastomosis, bicanalicular silicone intubation assisted with epidural catheters is superior to bicanalicular silicone intubation in intubation time, average operation time, nasal bleeding rate and pain degree. There is no significant difference between the two methods in one-time success rate. Bicanalicular silicone intubation assisted with epidural catheters is safe, reliable, and worthy of promotion.
论著
Clinical efficacy of surgical resection of conjunctival papillae combined with autologous conjunctival graft in treatment of vernal keratoconjunctivitis
Objective: To evaluate the efficacy and safety of surgical resection of conjunctival papillae combined with autologous conjunctival graft in the treatment of vernal keratoconjunctivitis (VKC). Methods: All 11 cases (22 eyes) with VKC were treated with surgical resection of conjunctival papillae in combination with autologous conjunctival graft. Clinical efficacy and safety were evaluated. Results: After 36 to 48 months of follow-up, 19 eyes were cured (86.36%), 2 eyes were improved (9.09%), and 1 eye was ineffective (4.55%). The total effective rate was 95.45%. Conclusion: Surgical resection of conjunctival papillae combined with autologous conjunctival graft is efficacious and safe in the treatment of VKC.