OBJCTIVE :To investigate the fundus ocu]i changes in hypnxie isehemic encepbalnpa ally(HIE)of new[x,rns. METHODS:One hundred and two newblt;~rns suffered from HIE were investi- gated to observe lhe pathological neular fundus changes by di~et ophthabnoseopy after mydria~s. RE- SULTS:Seventy seven ca.~s(154 eyes)were found to have ophthalmoscopic changes in the ~ular fundi including papilledema .white retina vaseolar abnormality and hemorrhage. CONCLUSIONS:In clinical view .the severity of HIE depends on the pathological ebanges of the brain .and ftmdus ahnormalby will be very often in middle and .~vere sufforers of HIE.
ObjectiveTo compare the consistency of artificial analysis and artificial intelligence analysis in the identification of fundus lesions in diabetic patients.MethodsA retrospective study. From May 2018 to May 2019, 1053 consecutive diabetic patients (2106 eyes) of the endocrinology department of the First Affiliated Hospital of Zhengzhou University were included in the study. Among them, 888 patients were males and 165 were females. They were 20-70 years old, with an average age of 53 years old. All patients were performed fundus imaging on diabetic Inspection by useing Japanese Kowa non-mydriatic fundus cameras. The artificial intelligence analysis of Shanggong's ophthalmology cloud network screening platform automatically detected diabetic retinopathy (DR) such as exudation, bleeding, and microaneurysms, and automatically classifies the image detection results according to the DR international staging standard. Manual analysis was performed by two attending physicians and reviewed by the chief physician to ensure the accuracy of manual analysis. When differences appeared between the analysis results of the two analysis methods, the manual analysis results shall be used as the standard. Consistency rate were calculated and compared. Consistency rate = (number of eyes with the same diagnosis result/total number of effective eyes collected) × 100%. Kappa consistency test was performed on the results of manual analysis and artificial intelligence analysis, 0.0≤κ＜0.2 was a very poor degree of consistency, 0.2≤κ＜0.4 meant poor consistency, 0.4≤κ＜0.6 meant medium consistency, and 0.6≤κ＜1.0 meant good consistency.ResultsAmong the 2106 eyes, 64 eyes were excluded that cannot be identified by artificial intelligence due to serious illness, 2042 eyes were finally included in the analysis. The results of artificial analysis and artificial intelligence analysis were completely consistent with 1835 eyes, accounting for 89.86%. There were differences in analysis of 207 eyes, accounting for 10.14%. The main differences between the two are as follows: (1) Artificial intelligence analysis points Bleeding, oozing, and manual analysis of 96 eyes (96/2042, 4.70%); (2) Artificial intelligence analysis of drusen, and manual analysis of 71 eyes (71/2042, 3.48%); (3) Artificial intelligence analyzes normal or vitreous degeneration, while manual analysis of punctate exudation or hemorrhage or microaneurysms in 40 eyes (40/2042, 1.95%). The diagnostic rates for non-DR were 23.2% and 20.2%, respectively. The diagnostic rates for non-DR were 76.8% and 79.8%, respectively. The accuracy of artificial intelligence interpretation is 87.8%. The results of the Kappa consistency test showed that the diagnostic results of manual analysis and artificial intelligence analysis were moderately consistent (κ=0.576, P＜0.01).ConclusionsManual analysis and artificial intelligence analysis showed moderate consistency in the diagnosis of fundus lesions in diabetic patients. The accuracy of artificial intelligence interpretation is 87.8%.
Based on the current situation of patients with retinal diseases in China and the clear requirements of the "14th Five-Year Plan for Eye Health (2021-2025)" to strengthen the construction of the prevention and control system for retinal diseases, experts in the field of retinal diseases in China have conducted in-depth and comprehensive thematic discussions, and used the modified Delphi method for collective decision-making and opinion solicitation, ultimately forming consensus and consistent guidance suggestions for the management of chronic diseases of retinal diseases that are in line with China's national conditions. This consensus includes key content such as definitions, treatment plans, and follow-up frequency for the management of chronic diseases of the fundus. It clearly proposes relevant measures to improve the management process of chronic diseases of the fundus, and elaborates on the advantages and feasibility of establishing an online remote platform for the management of chronic diseases of the fundus, in order to assist doctors in formulating personalized treatment plans and ensure that patients receive standardized treatment and follow-up. This consensus will provide guidance and reference for the management of chronic diseases and long-term standardized diagnosis and treatment of major fundus diseases in China.
Chronic disease is a major threat to human health. Fundus disease has become a major ophthalmic disease affecting daily life. Although great breakthroughs have been made in the treatment, compared with other chronic disease management, the management of patients with fundus disease is still in its infancy. To strengthen the management exploration of patients with fundus diseases, establish a management model of fundus diseases and strive to improve patients' awareness of fundus diseases and adherence to treatment and follow-up are the great challenges at present. All ophthalmic centers should strengthen patient education, establish a regional cooperation network, support the construction of grassroots medical capacity, cultivate talents, enhance training, promote the standardized treatment of fundus diseases, standardize fundus imaging inspection and diagnosis, and promote the homogeneous construction of diagnosis and treatment of chronic fundus diseases. We will accelerate the construction of a hierarchical diagnosis and treatment system and the ability to link consultation and referral. Through systematic management and intervention of fundus diseases, a large number of patients with fundus diseases will receive early screening, diagnosis, standardized continuous treatment and systematic management, and improve the quality of life of patients with fundus diseases.
We have made a statistic analysis on all the theses carried in the 31 issues of the journal of The Ocular Fundus published in the nine years from its first issue to the change of its title by using the method of informetrics.The results show that the journal carries 18.03 original papers each issue on the average,and the average citation is 6.54 articles each paper.The main sources of the information for the authors of the ocular fundus diseases in China is from the periodicals (78.65%).The language for the citation is mainly English(58.39%).The half-life periods for Chinese and English periodicals are 3.67 years and 8.42 years respectively.We recommend 4 Chinese periodicals,6 English periodicals and 1 Japanese periodical as the key periodicals of this special field.This study reflects the present situation and future trend of the special field of oculare fundus diseases of China's ophthalmology.It provides reference materials for authorship in this field and data for infomation science.It is also part of the summary about the journal of The Ocular Fundus. （Chin J Ocul Fundus Dis,1993,9:225-228）
Hydroxychloroquine retinopathy is an ocular lesions that develops following long-term or excessive use of hydroxychloroquine. The early clinical presentation of this lesion is nonspecific and is often detected when severe central vision impairment occurs in late stage. It currently mainly includes hydroxychloroquine binding to melanin, inducing degeneration of the retinal pigment epithelium, increasing the pH of lysosomes in the retinal pigment epithelium and interfering with the visual cycle. In recent years, with the development of retinal imaging technology and the in-depth study of hydroxychloroquine retinopathy, characteristic fundus structural changes such as retinal and choroidal thickness and blood vessels may occur in the early stage. This not only provides an important basis for the early diagnosis of hydroxychloroquine retinopathy, but also provides important clues for investigating its pathogenesis. Clinicians' proficiency in relevant fundus changes and pathogenesis will facilitate early diagnosis and treatment, while also minimizing irreversible central vision impairment in patients.
Objective To explore the frequency, clinical features, and characteristics of results of fundus fluorescein angiography (FFA) of uveitis related cystoid macular edema (CME). Methods The clinical data and FFA results of 67 patients (106 eyes) with posterior uveitis examined in our hospital from July 2002 to June 2005 were collected. The clinical features and characteristics of FFA images of CME were observed and analyzed. Results Among the106 eyes of 67 patients with uveitis,the CME was observed in 28 eyes (26.4%) of 18 patients, including 7 males and 11 females with the average age of (42.5plusmn;10.8) years. The dark area due to the choroidal fluorescence blocked by the macular edema was found at the early FFA phase, and th en followed by the punctate and sheetlike leakage of fluorescein; the capillar y was dilated at the venous phase, and the typical petaloid appearance was seen at the late phase because the fluorescein cumulated in several small vesicles in the macular area. After treated by corticosteroids and topical non-steroidal anti-inflammatory medicine and carbonic anhydrase inhibitors, the extent of CME diminished, and the visual acuity improved in varying degrees. Conclusi ons Uveitis may seriously harm the visual function, in which CME induces the damage of visual acuity. Early detection and timely treatment may prevent thepermanent visual damage. (Chin J Ocul Fundus Dis, 2006, 22: 394-396)
ObjectiveTo observe the features of the manifestations of fundus fluorescein angiography （FFA） in multiple sclerosis （MS） and their value in clinical diagnosis.MethodsThe clinical data of 42 patients (84 eyes) with MS diagnosed by magnetic resonance imaging (MRI) and examination of cerebrospinal fluid (CSF) were retrospectively analyzed. The clinical data included visual acuity, ocular fundus examined by direct ophthalmoscope after mydriasis, FFA, visual field, CSF，visual evoked potential (VEP) and MRI examination.ResultsIn 42 patients (84 eyes),the positive detectable rate of examination of direct ophthalmoscope, CSF, visual field, VEP, and MRI was 36.9%, 21.4%, 71.4%, and 83.3% respectively. Abnormal results of FFA were found in 44 eyes (52.38%), including papillitis in 4 eyes（4.76%）at the early stage with extended physiological scotoma and central scotoma; neuroretinitis in 7 eyes （8.33%）at the medium stage with central or para-central scotoma; optic atrophy in 33 eyes（39.29%） at the late stage with centripetal constriction and even tubular visual field. ConclusionThe main angiographic features of MS are papillitis, neuroretinitis and optic atrophy. The manifestations of FFA combined with the results of examination of CSF，visual field, VEP and MRI is helpful for comprehensive and exact diagnosis of MS.(Chin J Ocul Fundus Dis, 2005,21:300-302)
Objective To compare the short-term curative results between Nissen, Thal and Toupet fundoplications in treatment of gastroesophageal reflux(GER) and to provide the basis for operative procedure. Methods Thirty-three male Japan rabbits were randomly divided into six groups: group reflux(n=7), transabdominal Heller’s esophagomyotomy (TAHE)；group Nissen(n=7)，TAHE and Nissen fundoplication；group Thal(n=7)，TAHE and Thal fundoplication；group Toupet(n=7)，TAHE and Toupet fundoplication； control group (n=5)，ventrotomy. The anti-reflux efficacy of fundoplication was evaluated by intraesophageal pH monitoring and MGV（maximal gastric volume sustained by lower esophageal sphincter）4 weeks postoperatively. Results ① The total number of reflux episodes and the reflux ratio（0.83±0.41,2.20%±1.12%） of group Nissen were significantly lower than those of group Thal (2.20±0.45, 4.32%±0.82%) and group Toupet (1.80±0.45, 4.20%±0.57%), respectively (Plt;0.05). ② MGV of group Nissen (233.00±9.44)ml was significantly larger than those of group Thal （203.40±11.13）ml and group Toupet（197.60±10.99）ml, respectively (Plt;0.05). ③There were no significant difference in total number of reflux episodes, reflux ratio and MGV between group Thal and group Toupet (Pgt;0.05).Conclusion Nissen fundoplication was better than Thal and Toupet fundoplications,Thal and Toupet fundoplications are similar in short-term curative result.
ObjectiveTo observe the prevalence of fundus tessellation in college students with high myopia and analyze the relationship of fundus tessellation and ocular biological parameters.MethodsA cross-sectional study. A total of 202 eyes of 161 individuals were included in the study. Among them, there were 49 males and 112 females with the average age of 19.73 ± 1.12 years old, and the average spherical equivalent of －7.39 ± 1.12 D. All participants underwent computer optometry, non-mydriatic fundus photography, OCT, OCT angiography (OCTA) examination and axial length (AL) measurement. The non-mydriatic fundus camera was used to take the photo of fundus. Fundus tessellation was differentiated to no leopard eye fundus (grade 0), mild leopard eye fundus (grade 1) and middle leopard eye fundus (grade 2) and for severe leopard eye fundus (grade 3). The lenstar was used for eye axis measurement. The choroid, retinal thickness and microvessel density of the macular fovea at the posterior pole of the fundus were measured using a swept-frequency source optical coherence tomography scanner. According to the ETDRS, the choroid within 6 mm of the fovea was divided into 3 concentric circles centered on the macula, which were the central area with a diameter of 1 mm, the inner ring area of 1-3 mm and the outer ring area of 3-6 mm. The outer ring area of 3-6 mm included a total of 9 zones. The inner ring and outer ring 4 regions were superior, inferior, nasal and temporal, respectively. The distribution characteristics of choroid and retinal thickness in different regions and the density of superficial microvessels in the macular area of the retina were observed. Bivariate correlation analysis was used to analyze the relationship of fundus tessellation and ocular biological parameters.ResultsAmong 202 eyes, 37 eyes with leopard pattern fundus with 0 grade (18.32%, 37/202), 165 eyes with grade 1 to 3 (81.68%, 165/202), of which grade 1, 2 and 3 were respectively 125 (61.88%, 125/202), 28 (13.86%, 28/202), 12 (5.94%, 12/202) eyes. The thickness of the retina, both horizontally and vertically, increased first and then decreased from the nasal side to the central area, was lowest in the central area, then increased and then decreased; the overall thickness of the temporal side was slightly lower than that of the nasal side, and the overall thickness of the lower part was slightly lower than the upper part. The choroidal thickness gradually thickened from the nasal side to the temporal side in the horizontal direction; it gradually decreased in the vertical direction from the top to the central area, then increased and then decreased. The SCP blood flow density in the central area in the horizontal and vertical directions was lower than that in other areas. In multivariate regression analysis, Leopard-like fundus classification and AL (β=0.291, OR=1.338, 95%CI 1.064-1.682, P=0.013), SCP blood flow density in the central area of the macula (β=0.080, OR=1.084, 95% CI 1.006-1.167, P=0.034) and choroidal thickness (β=－0.033, OR=0.968, 95%CI 0.960-0.975, P＜0.001) were related.ConclusionsPatients with high myopia have a higher prevalence of tessellation. The deepening of tessellation is related to the thinning of the choroid thickness, the growth of the eye axis, and the larger density of the superficial microvessels in the fovea.