Ocular tuberculosis encompasses a variety of clinical manifestations, which is easily misdiagnosed sometimes. In this article, a young male was admitted to our hospital with a chief complaint of sudden blurred vision in his right eye. His ocular examination detected a tiny mass in the choroid and a small lesion in the retina. After interferon-gamma release assay (IGRA) and chest CT scan, the patient was diagnosed with military tuberculosis. The ocular examination confirmed the diagnosis of choroidal tubercle complicated with intrarentinal tubercle, which were healed after systemic anti-tuberculosis therapy.
Objective: To observe the morphology and changes of leakage points in the natural course of acute central serous chorioretinopathy (CSC). Methods: This study was a prospective study, using optical coherence tomography to observe the OCT morphology of leakage points in CSC patients from onset to 5 to 13 months after onset, measuring the thickness and ratio of Hall layer and the whole choroid, and then compare them. Results: A total of 20 patients were included in the study, including 14 males and 6 females, aged from 33 to 59, with the median being 41 years old. The follow-up time ranged from 5 months to 13 months. Minute retinal pigment epithelial detachments (PED) were observed in 19 patients. A small bulge of retinal pigment epithelium (RPE) was observed in 1 patient. During the follow-up, only one patient totally recovered. Small separation between RPE and Bruch membrane still exit even subretinal fluid were absorbed completely in the other 19 patients. The thickness of Haller layer or choroid at the leakage point was significantly higher than that of the fovea (0.806±0.08 vs 0.863±0.06, P=0.003, at the first visit; 0.801±0.07 vs 0.851±0.06, P=0.004, at the last follow-up). Conclusion: This study observed that in the natural course of acute CSC patients, even if the subretinal fluid was absorbed, OCT still showed that there was persistent PED at the leakage point, thicker Haller layer and thinner inner choroid layer. These findings provided more clues to the pathogenesis of CSC.
Objective: To conduct a preliminary study of the Lea Symbols and HOTV charts to explore the visual development of children aged 2.5 to 5.0 years, and evaluate the application values of the two charts. Methods: A total of 461 children (922 eyes) in 2 early education centers and 3 kindergartens in Guangzhou were examined by using the Lea Symbols visual acuity chart and HOTV visual acuity chart in random order. All the children underwent low-pupil photometry, anterior section slit-lamp examination, retinal condition, eye movement, and eye position examination 1 day in advance. Children with no organic eye disease and normal diopter were selected as subjects. Visual acuity was recorded with 5 points. Results: 1) Measurable rate (visual acuity chart use degree of cooperation). 407 children completed visual examination of Lea Symbols, with an overall detectable rate of 92.08%; 402 children completed HOTV vision examination, with an overall detectable rate of 90.95%. The detectable rate of the former was higher than that of the latter, but the difference was not statistically significant (χ2 =0.417, P=0.580). Further study found that the detectable rate of both visual acuities increased with age, and children were able to complete both visual acuity tests after the age of 3. 2) Results and comparison of two visual acuity (5-point recording method). The visual acuity of Lea was 4.89±0.05 in the right eye and 4.90±0.05 in the left eye. HOTV visual acuity was 4.84±0.05 in the right eye and 4.85±0.04 in the left eye. The visual acuity of the former was better than that of the latter, the difference was statistically significant (right eye: t=3.171, P=0.003; left eye: t=3.230, P=0.003). 3) Correlation between visual development and age. There was a significant positive correlation between the two types of visual development and age (P<0.001), that is, visual acuity gradually improves with age. 4) The relationship between visual development and eye and sex. There was no difference in visual development between the left and right eyes, but male children had better visual development than female, and the difference was statistically significant (P<0.05). Conclusion: Lea Symbols and HOTV visual acuity charts are recommended for visual acuity examination of children over 3 years old, and children are more likely to receive examination of Lea Symbols visual acuity chart. With the growth of age, the visual development of children shows a trend of improvement. Lea vision is superior to HOTV vision. Vision development has nothing to do with the eye, male children’s vision development is faster than female children.
The prevention and control of myopia has become a national strategy, and the axial length is an important parameter in the documentation of myopia prevention and control. This review summarized the measurement technology and factors associated with axial length. Axial length can be measured in various ways and can be influenced by age, gender, choroidal thickness, and other factors. A standardized definition of axial length is warranted to be established for clinical and scientific purposes.
Non-organic vision loss is also known as psychogenic or functional vision loss. In addition to vision loss, it can also be accompanied by visual field defect. It is mostly caused by conversion obstacles caused by mental and psychological diseases. Some patients cheat to obtain benefits. This paper reports a 6-year-old female patient who complained of repeated visual acuity decline for more than one year. She was misdiagnosed as pediatric optic neuritis in the early stage and was treated with glucocorticoid shock therapy, which her condition improved slightly after treatment. The misdiagnosis of this patient teaches us that when children have unexplained visual acuity decline, we should think of the possibility of non-organic visual acuity decline when there is no clear evidence of organic diseases, master the examination methods to identify non-organic visual acuity decline, and cannot ignore the basic neuro-ophthalmic examination such as relative afferent pupillary defect (RAPD).
Objective To understand the current status and influencing factors of SPB in wet AMD patients. Methods The convenience sampling method was used to select 204 wet AMD patients who were treated in a hospital in Guangzhou from January to November 2021 as the research objects. General information questionnaire, SPB scale, family support self-rating scale and medical coping questionnaire were used. Evaluate it. Results The SPB score of the patients was (21.98±6.68) points, and the patients belonged to mild SPB. SPB levels in wet AMD patients were negatively correlated with family support (r=-0.326, P<0.001) and coping (r=-0.365, P<0.001), and were positively correlated with avoidance and yielding coping styles (r= 0.456, r=0.310, both P<0.001). Multiple linear regression showed that the self-perceived burden of patients living alone, advanced age, self-paying, binocular disease and avoidance coping was higher, while the self-perceived burden of patients with high educational level and high family support was lower. This equation can explain 45.5% of the total variation of the self-perceived burden level of the patients in this group. Conclusion Wet AMD patients have mild SPB, but there is still room for improvement. Medical workers should focus on patients with advanced age, low education level, low family income, self-pay, living alone, binocular disease and low vision patients in their work, and carry out timely treatment. Psychological counseling to reduce the SPB level of patients.
Dry eye is one of the most common eye diseases caused by multiple factors. With the increasing incidence of dry eye year by year, dry eye gradually attracts people's attention. Its pathogenesis is complex. Unstable tear film, high osmotic pressure, ocular surface inflammation and injury, and nerve paresthesia are common causes of dry eye disease (DED). The instability of tear film and the high osmotic pressure of ocular surface can cause inflammation of ocular surface cells and further promote the development of dry eye. Ocular surface inflammation is one of the key links, in which a variety of inflammatory mediators and immune cells participate. The comprehensive treatment of dry eye includes changes in the eye environment and etiology. Cyclosporine A (CsA), an immunosuppressant that treats this inflammation by improving tear quality, has been shown to be effective in the treatment of dry eyes, but its clinical use is limited due to its poor water solubility and low ocular availability. Therefore, this paper reviews the application of cyclosporine A in dry eye, analyzes the latest views and research hotspots, and provides reference for the treatment of dry eye.
Objective: To obtain the comprehensive information of the anterior eye image, establish complementary information for the diagnosis and evaluation of ocular diseases. Methods: We developed a multi-modal, non-invasive optical imaging platform by combining ultra-high resolution optical coherence tomography (UHR-OCT) with a microvascular imaging system based on slit-lamp biomicroscopy. Results: The uHR-OCT module achieved an axial resolution of approximately 2 μm in tissues. The lateral resolution of the ocular surface microvascular imaging module under maximum magnification was approximately 3.5 μm. By combining the imaging optical paths of different modules, the customized multi-modal eye imaging platform was capable of performing real-time cross-sectional UHR-OCT imaging of the anterior eye, conjunctival vessel network imaging, high-resolution conjunctival blood flow videography, and traditional slit-lamp imaging on a single device. With self-developed software, a conjunctival vessel network image and blood flow videography were further analyzed to acquire quantitative morphological and hemodynamics parameters, including vessel fractal dimensions, blood flow velocity and vessel diameters. Conclusion: The ability of the multi-modal anterior eye imager to provide both structural and functional information for ophthalmic clinical applications can be demonstrated in a healthy human subject and a keratitis patient.
Objective: To analyze the morphological characteristics of meibomian glands in human eyes and to explore the application research of meibomian glands analysis system in ocular surface diseases. Methods: A total of 24 healthy subjects were recruited by Zhongshan Ophthalmic Center to infrared photography of meibomian glands. Ten of healthy subjects were selected by the two operators for infrared photography of meibomian glands on the same model of equipment. The images were repeatedly measured and analyzed by the self-designed analysis software on the morphological measurements of the five glands in the center of the upper eyelid. Results: The measured biological parameters are shown below: the average gland diameter was (0.48±0.09) mm, the average gland length was (5.25±0.68) mm, the average gland area was (2.12±0.53) mm, the gland deformation coefficient was 10.01±3.85, the development value was 6.32±1.23, the percentage of the five central glands in the central area was (10.94±2.20)%, and the glands accounted for (58.07±8.13)% of the upper conjunctiva area. There was no statistical difference between the two measurements of each index (P>0.05). Repeatability analysis results showed that coefficients of variation (CV) of all biological parameters of glands were less than 5% and the intraclass correlation coefficient (ICC) in both groups were greater than 0.95. Conclusion: The Meibomian Gland Bioimage Analyzer provides good reliability and consistency for morphological measurements of the meibomian gland, and it is expected to provide new non-invasive indicators for clinical assessment of the meibomian glands function.
