Optic neuritis(ON)is an inflammatory demyelinating disease of the optic nerve, which is the main cause of vision loss in young and middle-aged people. In recent years, myelin oligodendrocyte glycoprotein antibody-positive ON(MOG-ON)has become a research hotspot in the field of neuro-ophthalmology, and reports at home and abroad are increasing.In March 2021, the Neuro-ophthalmology Group of Ophthalmology Branch of Chinese Medical Association formulated the Evidence-Based Guidelines for the Diagnosis and Treatment of Demyelinating Optic Neuritis in China(2021) , and included MOG-ON as a new optic neuritis subtype in the diagnosis and treatment system of myelinating optic neuritis providing a new reference for the majority of ophthalmologists. Therefore, clinicians need to fully understand the clinical features and treatment progress of MOG antibody-related diseases and MOG-ON, and strive to improve the level of diagnosis and treatment, so that such patients can get more benefits and benefit more patients with optic nerve diseases.
Abstract: A simple and easy to use conjunctival sac irrigator has been developed, which includes a puncture tip, an inlet passage, an outlet, a tube holding handle, and an over insertion preventing tab. It can be directly inserted into a plastic bottle of physiological saline, and the physiological saline can be extracted by tilting the bottle slightly. The outflow flow rate is more reasonable, making patients more comfortable during conjunctival sac irrigation, making nursing staff more efficient, and reducing the chance of cross infection among patients, Ensure patient safety and bring benefits to society.
Myasthenia gravis (gMG) is a serious autoimmune disease that has serious implications for the life and survival of patients. Ocular muscle weakness (oMG) is usually the initial manifestation of MG and may progress to gMG. However, to date, no clear mechanism has been found to elucidate the pathogenesis of conversion from oMG to gMG. Recent studies have shown that the development and clinical progression of MG is closely related to the function of interleukin 21 (IL-21). Therefore, this article reviews the recent research progress of IL-21 involved in the pathogenesis of MG immunity, focusing on the role of IL-21 factors and related cells (Tfh, Treg, Th17, NK, etc.) in the formation of germinal centers and antibody production in the oMG immune response.
Diabetes retinopathy is one of the microvascular diseases caused by diabetes, it is an irreversible blindness eye disease. According to its course, it can be divided into non-proliferative diabetic retinopathy and proliferative diabetic retinopathy, including diabetes macular edema.The general practitioner needs to measure the uncorrected visual acuity, corrected visual acuity ,intraocular pressure, use the slit lamp microscope to exam the anterior segment and fundus to evaluate the overall condition of the eye.Controlling blood glucose, blood pressure and blood lipid is very important to improve the prognosis. Attach importance to pre- and postprandial blood glucose, glycosylated hemoglobin and metabolic memory. The first-line antihypertensive drugs are angiotensin converting enzyme inhibitors and angiotensin Ⅱ receptor blockers.Statins are the first choice for lipid-lowering drugs,fenofibrate has additional protective effect of retinal.Intervention in lifestyle, education and early detection are also important. The general practitioner needs to perform fundus screening and scoring, timely refer to ophthalmology department for treatment.Ophthalmic treatment includes panretinal laser photocoagulation, pars plana vitrectomy, and intravitreal injection of anti-vascular endothelial growth factor drugs.
[Abstract] Objective To understand the disease situation of glaucoma in Tianjin area, and to compare it with domestic and international studies, to explore the causes of disease occurrence and progression, and to provide new epidemiological data for the prevention and treatment of glaucoma. Methods The data of glaucoma outpatients from September 2019 to September 2022 in the hospital were analyzed retrospectively, statistical analysis of patients' disease type composition ratio, disease seasonality, age distribution, sex ratio and other clinical data. Results Primary glaucoma, secondary glaucoma (SG) and congenital glaucoma (CG) accounted for 89.88%, 9.32% and 0.80% of the total glaucoma, of which primary angle closure glaucoma (PACG) accounted for 74.06% of primary glaucoma and primary open angle glaucoma (POAG) accounted for 25.94%. Among primary angle closure glaucoma, acute angle closure glaucoma accounted for 62.26% and 37.74% of chronic angle closure glaucoma. Patients with aPACG, cPACG, and POAG in winter and summer represented 42.10% and 40.60%, 27.63% and 24.70%, 20.26% and 27.4% of the total number of patients with their respective diseases. In this retrospective survey, both the cumulative number of patients and the proportion of patients in the total number of aPACG in winter were significantly higher than that in summer, and the seasonal difference between cPACG patients and POAG was not obvious. Among the total PACG patients, 65.86% were female over 40 years and 34.14% male.However, 58.84% were women over 40 years while male were 41.16% among POAG patients. Among the 7523 glaucoma outpatients, the age distribution ranged from 7 months and 25 days to 98 years old, including 2914 males and 4609 females, 1167 cases (15.51%) were younger than 40 years old and 6,356 cases (84.49%) were 40 years or older. Conclusion The composition of primary glaucoma outpatients in our hospital was mainly PACG, and the proportion of POAG was higher than that reported in other studies. There were obvious seasonal differences in aPACG cases, and the number of cases was significantly higher in winter than in summer. PACG women had a higher prevalence than males, with nearly twice that of male patients in aPACG patients, while still slightly more female than men in POAG patients. The age distribution of POAG patients was less concentrated than PACG patients and the age was younger. People under 40 years old are the focus of POAG prevention and treatment, and people over 40 years old are the focus of PACG prevention and control.
[Abstract] Objective To understand the disease situation of glaucoma in Tianjin area, and to compare it with domestic and international studies, to explore the causes of disease occurrence and progression, and to provide new epidemiological data for the prevention and treatment of glaucoma. Methods The data of glaucoma outpatients from September 2019 to September 2022 in the hospital were analyzed retrospectively, statistical analysis of patients' disease type composition ratio, disease seasonality, age distribution, sex ratio and other clinical data. Results Primary glaucoma, secondary glaucoma (SG) and congenital glaucoma (CG) accounted for 89.88%, 9.32% and 0.80% of the total glaucoma, of which primary angle closure glaucoma (PACG) accounted for 74.06% of primary glaucoma and primary open angle glaucoma (POAG) accounted for 25.94%. Among primary angle closure glaucoma, acute angle closure glaucoma accounted for 62.26% and 37.74% of chronic angle closure glaucoma. Patients with aPACG, cPACG, and POAG in winter and summer represented 42.10% and 40.60%, 27.63% and 24.70%, 20.26% and 27.4% of the total number of patients with their respective diseases. In this retrospective survey, both the cumulative number of patients and the proportion of patients in the total number of aPACG in winter were significantly higher than that in summer, and the seasonal difference between cPACG patients and POAG was not obvious. Among the total PACG patients, 65.86% were female over 40 years and 34.14% male.However, 58.84% were women over 40 years while male were 41.16% among POAG patients. Among the 7523 glaucoma outpatients, the age distribution ranged from 7 months and 25 days to 98 years old, including 2914 males and 4609 females, 1167 cases (15.51%) were younger than 40 years old and 6,356 cases (84.49%) were 40 years or older. Conclusion The composition of primary glaucoma outpatients in our hospital was mainly PACG, and the proportion of POAG was higher than that reported in other studies. There were obvious seasonal differences in aPACG cases, and the number of cases was significantly higher in winter than in summer. PACG women had a higher prevalence than males, with nearly twice that of male patients in aPACG patients, while still slightly more female than men in POAG patients. The age distribution of POAG patients was less concentrated than PACG patients and the age was younger. People under 40 years old are the focus of POAG prevention and treatment, and people over 40 years old are the focus of PACG prevention and control.
Objective: To assess changes of choroidal thickness (CT) after administration of 1% atropine for 1 week in children with hyperopia. Methods: A total of 42 hyperopia children aged 4–7 years were included into the study.A single drop of 1% atropine gel was used twice a daily for 7 days.The thickness of retina and choroid was measured by OCT, and the changes before and after administration of 1% atropine gel were analyzed at the subfovea and at 1.0-mm intervals (up to 3.0mm) from the fovea at superior, inferior, nasal, and temporal locations. Results: In the hyperopia children,baseline CT vary with the location(F=27.08,P<0.05).Compared with the fovea, the CT at the nasal side, 2mm and 3mm above the fovea and 3mm from the temporal side of the fovea were thinner (p<0.05). After using 1% atropine gel, there was no significant difference in the CT changes of SFCT and other sites of parafovea (P > 0.05).There was no significant change in retinal thickness before and after using 1% atropine gel (P > 0.05). Conclusions: Short term use of 1% atropine gel did not change the thickness of choroid and retina in hyperopia children.
Macular edema is a rare complication associated with nab-paclitaxel. This article presents the case of a 60-year-old female patient who experienced bilateral visual decline after undergoing right breast cancer surgery. Following a 7-week course of nab-paclitaxel chemotherapy, the patient exhibited bilateral macular edema, which was diagnosed through ophthalmic examination. Discontinuation of the medication and oral acetazolamide treatment led to the regression of macular edema in both eyes, resulting in a visual acuity recovery to 1.0. This case highlights chemotherapy-induced macular edema, with mechanisms involving the toxic effects of taxane agents on Müller cells and the retinal pigment epithelium. The article reviews the clinical course, summarizes the clinical characteristics and management of nab-paclitaxel-induced macular edema, and explores its potential mechanisms. The aim is to provide ophthalmologists with insights into early diagnosis and treatment approaches.
Purpose: To observe the changes in the retinal and choroidal vessels in patients with central retinal artery occlusion (CRAO) and their correlation with visual acuity via optical coherence tomography angiography (OCTA). Methods: This was a retrospective case analysis.Sixty-two eyes with clinically confirmed acute CRAO (symptom onset ≤ 7 days) were included in the study. All examined eyes underwent best-corrected visual acuity (BCVA), slit lamp microscopy, indirect ophthalmoscopy, fundus color photography, OCTA and fundus fluorescence angiography (FFA) examinations. The results of the OCTA-B scan and FFA examination were recorded, and the type of CRAO was divided into three groups: incomplete type, subcomplete type and complete type. The software built into the OCTA system used to measure the superficial and deep retinal vessel density, outer retinal blood flow area, retinal thickness and choroidal blood flow area. BCVA statistics were converted to the logarithm of the minimum angle of resolution (logMAR). Contralateral healthy eyes were used as the control group.Spearman’s correlation analysis was used to determine the correlations between retinal blood vessel density, retinal thickness, and choroidal blood flow area and visual acuity.Results: In whole-image analysis, compared with the control group, the incomplete-type group showed significantly decreased blood vessel density of the superficial and deep retina (t=-0.028, 0.058; p=0.014, 0.000 < 0.05), significantly increased outer retinal flow areas (t=2.42, p=0.031 < 0.05), and no significant changes in the choriocapillaris flow area and retinal thickness (t=0.315, 1.535, p=0.17, 0.136 > 0.05). For the subcomplete type, the superficial retinal vessel density, retinal thickness and outer retina flow area were not significantly different from those of the control group (t=-0.427, 1.216, 1.117, p=0.485, 0.244, 0.286 > 0.05), but the deep retinal vessel density and choriocapillaris flow area were (t=0.098, -2.362, p=0.031, 0.036 < 0.05). The superficial retinal vessel density was not significantly different between the complete-type group and its control group (t=-0.255, p=0.899 > 0.05), but the deep retinal vessel density, retinal thickness, outer retinal flow area and choriocapillaris flow area were (t=-5.618, 27.06, 4.68, -13.05, p=0.005, 0.000, 0.018, 0.001 < 0.05). The logMAR BCVA of the incomplete-type group was significantly lower than that of both the subcomplete-type and complete-type groups (F=15.524, p=0.000 < 0.05). The vessel density of the superficial central fovea of the incomplete-type group was significantly lower than that of both the subcomplete-type and complete-type groups, and that of the subcomplete-type group was significantly lower than that of the complete-type group. The nasal vessel density near the superficial central fovea of both the incomplete-type and subcomplete-type groups were significantly lower than that of the complete-type group (F=7.807, 7.437, p=0.001, 0.001 < 0.05). The choroidal blood flow area of the complete-type group was significantly lower than that of the incomplete type group (F=8.025, p=0.018 < 0.05). Spearman’s correlation analysis showed that the logMAR BCVA was positively correlated with the vessel density of the superficial central fovea and the nasal vessel density near the superficial central fovea (r=0.279, 0.326, p=0.031, 0.013 < 0.05) but was not significantly correlated with the choroidal blood flow area (r=-0.157, p=0.257 > 0.05). Conclusions: OCTA observation of choroidal blood flow area and retinal vessel density is helpful for determining the type of CRAO and evaluating retinal ischemia and visual impairment in CRAO eyes. The vessel density of the superficial central fovea and nasal vessel density near the superficial central fovea may be reliable markers of visual impairment in CRAO.
