ObjectiveTo evaluate the effect of form deprivation myopia on optic nerve head and retinal morphology in guinea pigs using optical coherence tomography (OCT). MethodsTwenty guinea pigs aged from 4 to 5 weeks were chosen and randomly divided into the experimental group and control group, with 10 guinea pigs in each group. Form deprivation myopia was established for the right eyes of guinea pigs in experimental group for 4 weeks. The guinea pigs of control group were not intervened. Before and 4 weeks after form deprivation, refraction was measured by retinoscopy after cycloplegia; the axial length was measured by A-scan ultrasound; retinal nerve fiber layer (RNFL) thickness, optic nerve head and retinal morphology of guinea pigs were analyzed using OCT. ResultsBefore form deprivation, there were no statistically significant differences in spherical equivalent, axial length, RNFL thickness, disc edge area, optic disc area, average cup disc ratio, vertical cup disc ratio, cup volume, retinal thickness, or retinal volume between the experimental group and control group of guinea pig (P > 0.05). After 4 weeks of form deprivation, RNFL thickness of (64.9±17.7) μm in guinea pigs in experimental group was thinner compared to (97.9±25.1) μm in control group (t=-2.845, P=0.015). Retinal thickness of (142.7±3.4) μm in guinea pigs in experimental group was thicker compared to (138.4±3.5) μm in control group (t=2.338, P=0.038). There were no significant differences in disc edge area, optic disc area, average cup disc ratio, vertical cup disc ratio, cup volume or retinal volume between groups (P > 0.05). There were statistically significant differences in spherical equivalent, axial length, RNFL thickness, vertical cup to disc ratio cup volume, and retinal thickness between after and before form deprivation in the right eye of guinea pigs in the experimental groups (t=46.001, -50.119, 5.385, 3.447, -2.814, -8.911; P < 0.05), while there were no statistically significant differences in disc edge area, optic disc area, average cup disc ratio, or retinal volume (P > 0.05). ConclusionForm deprivation myopia has an effect on RNFL and retinal thickness.
ObjectiveTo evaluate the macular visual function of patients with myopic choroidal neovascularization (MCNV) before and after intravitreal injection of conbercept.MethodsA prospective, uncontrolled and non-randomized study. From April 2017 to April 2018, 21 eyes of 21 patients diagnosed as MCNV in Shanxi Eye Hospital and treated with intravitreal injection of conbercept were included in this study. There were 9 males (9 eyes, 42.86%) and 12 females (12 eyes, 57.14%), with the mean age of 35.1±13.2 years. The mean diopter was −11.30±2.35 D and the mean axial length was 28.93±5.68 mm. All patients were treated with intravitreal injection of conbercept 0.05 ml (1+PRN). Regular follow-up was performed before and after treatment, and BCVA and MAIA micro-field examination were performed at each follow-up. BCVA, macular integrity index (MI), mean sensitivity (MS) and fixation status changes before and after treatment were comparatively analyzed. The fixation status was divided into three types: stable fixation, relatively unstable fixation, and unstable fixation. The paired-sample t-test was used to compare BCVA, MI and MS before and after treatment. The x2 test was used to compare the fixation status before and after treatment.ResultsDuring the observation period, the average number of injections was 3.5. The logMAR BCVA of the eyes before treatment and at 1, 3, and 6 months after treatment were 0.87±0.32, 0.68±0.23, 0.52±0.17, and 0.61±0.57, respectively; MI were 89.38±21.34, 88.87±17.91, 70.59±30.02, and 86.76±15.09, respectively; MS were 15.32±7.19, 21.35±8.89, 23.98±11.12, 22.32±9.04 dB, respectively. Compared with before treatment, BCVA (t=15.32, 18.65, 17.38; P＜0.01) and MS (t=4.08, 3.50, 4.26; P＜0.01) were significantly increased in the eyes 1, 3, and 6 months after treatment. There was no significant difference in the MI of the eyes before treatment and at 1, 3, and 6 months after treatment (t=0.60, 2.42, 2.58; P＞0.05). Before treatment and at 1, 3, and 6 months after treatment, the proportion of stable fixation were 28.57%, 38.10%, 38.10%, 33.33%;the proportion of relatively unstable fixation were 47.62%, 47.62%, 52.38%, 57.14% and the proportion of unstable fixation were 23.81%, 14.28%, 9.52%, 9.52%, respectively. The proportion of stable fixation and relatively unstable fixation at 1, 3 and 6 months after treatment were higher than that before treatment, but the difference was not statistically significant (x2=1.82, 1.24, 1.69; P＞0.05).ConclusionBCVA and MS are significantly increased in patients with MCNV after intravitreal injection of conbercept.
Myopia has become a major problem that threatens human health worldwide. Complications caused by high myopia are one of the leading causes of low vision and blindness. As a chronic disease that seriously threatens ocular health in the clinical practice and public health fields, the prevention and control of high myopia should actively promote a tertiary prevention strategy, and take advantages of the latest fundus imaging technology and big data technology, artificial intelligence to explore the evolution mechanism of “myopia→high myopia→pathological myopia”. Special efforts should be focused on the establishment of a scientific myopia prediction model, implementation of effective high myopia monitoring and management, and early detection and treatment of complications of high myopia to reduce the incidence of low vision and blindness.
Objective To investigate the features of optic disc formation and retinal nerve fiber layer(RNFL) changes in primary open-angle glaucoma with myopia (M-POAG). Methods On 63 eyes of 38 patients with M-POAG were imaged of the fundus,and were evaluated with the microcomputer image analyser,and were compared with the simple POAG (S-POAG) eyes. Results Variant features of the optic disc and RNFL atrophy were found in this M-POAG eyes.The shapes of the optic disc were revealed to be vertically or horizontally oval,obliquely inserted and irregular,the color of the most of optic disc was pallor.The pattern of glaucomatous cupping was saucer-like (28.6%),vertical (25.4%),oblique (23.8%),pot-like (9.5%),and focally or concentrically cupped.The quotient of the neuroretinal rim area and horizontal C/D ratio were significantly lower than those in S-POAG eyes (Plt;0.05,Plt;0.001).The focal point of the optic disc excavtions tended to be inferior.Most of the incidence in the focal atrophy of RNFL was located inferiorly,and the diffuse atrophy of RNFL was correlated positively with middle or late high-myopia POAG eyes (P＜0.005). Conclusion The variant features of the optic discs,glaucomatous cupping and RNFL atrophy formation in M-POAG eyes found in this series might be helpful in clinical diagnosis. (Chin J Ocul Fundus Dis,2000,16:81-84)
ObjectiveTo evaluate the safety and efficacy of amniotic membrane patching in the treatment of recurrent macular hole associated with retinal detachment of high myopia (MHRD). MethodsA prospective study. From March 2018 to January 2020, 11 patients (11 eyes) of recurrent macular hole associated with MHRD at the First Affiliated Hospital of Zhengzhou University were enrolled. Among them, there were 3 males (3 eyes), and 8 females (8 eyes). The average age was 63.64±5.82. The axis length (AL) was 29.10±0.59 mm, and the logarithm of the minimum angle of resolution best corrected visual acuity (logMAR BCVA) was 2.23±0.57. Patients previously received pars plana vitrectomy (PPV) combined with internal limiting membrane stripping surgery, which was more than 1 time. All eyes underwent standard pars plana three-channel 23G PPV combined with amniotic membrane covering and silicone oil filling. The silicone oil was removed 6 months after surgery. Follow-up time was up to 3 months after silicone oil removal surgery. 1, 3, and 6 months after the operation, the same equipment and methods were used to conduct relevant examinations before the operation to observe the closure of the macular hole, retinal reattachment and changes in logMAR BCVA. The logMAR BCVA before and after surgery was compared by paired t test. ResultsAt 1, 3, and 6 months after the operation, the retinas of all eyes were anatomically repositioned, the macular holes were well closed, and the amniotic membrane was attached to the retina. At 3 months after the silicone oil removal operation, there was no recurrence of macular hole in all eyes; logMAR BCVA was 1.35±0.32. No serious complications occurred during and after surgery in all eyes. ConclusionAmniotic membrane patching is a safe and effective method for recurrent macular hole associated with MHRD.
Myopic macularpathy is the main cause of the decline of visual function in high myopia, which including tigroid fundus, lacquer cracks, diffuse retinal choroid atrophy, plaque retinal choroid atrophy, choroidal neovascularization (CNV), Fuchs spot and posterior staphyloma. The tigroid fundus is the initial myopic retinopathy. The lacquer cracks is a special lesion in the posterior pole of high myopia. When the lacquer cracksen enlarge or lacquer cracks progress to plaque retinal choroid atrophy should be paid to monitoring the occurrence of CNV. Myopic macularpathy progression include two mode. One is from tigroid fundus——lacquer cracks——plaque retinal choroid atrophy——CNV to macular atrophy. And the other is from tigroid fundus——diffuse retinal choroid atrophy——atrophy enlarge to diffuse retinal choroid atrophy with plaque retinal choroid atrophy or plaque retinal choroid atrophy occurence on the border of posterior staphyloma. Understanding the progression patterns and natural course of these lesions will help the clinic to further understand the course of high myoipa.
PURPOSE:To examine the role of apoptosis in photoreceptor cells degeneration process in Pathologic myopia. METHODS: Nine human eyes with pathologic myopia were studied by histopathologic and TDT-mediated biotin-dUTP nick-end labelling (TUNEL) techniques. RESULT:The characteristic DNA fragmentation of apoptosis was observed in scattered photoreceptor cells in 4 of 9 eyes. CONCLUSION:The results suggested that apoptosis is one of the pathways of photoreceptor cells death in retinal degeneration of pathologic myopia. （Chin J Ocul Fundus Dis,1996,12: 144-146 ）
ObjectiveTo observe the long-term clinical effect of pars plana vitrectomy combined with fovea-sparing internal limiting peeling in the treatment of macular foveoschisis in pathologic myopic.MethodsA prospective case series study. Fifteen patients (15 eyes) with pathological myopic macular foveoschisis who received treatment in Eye Hospital of Wenzhou Medical University from December 2015 to December 2016 were enrolled. There were 4 males (4 eyes) and 11 females (11eyes), with an average age of 55.33±8.34 years. All patients underwent BCVA, diopter, spectral domain OCT and axial length measurement. The mean logMAR BCVA was 0.95±0.64. The mean central fovea thickness (CFT) was 576.00±185.32 μm. All patients underwent vitrectomy combined with fovea-sparing internal limiting peeling. After gas-liquid exchange, 12% C3F8 was filled and followed up at 1, 3, 6 and 12 months after surgery. Follow-up time was more than 12 months. The structural changes of BCVA and macular area were observed.ResultsThe foveal internal limiting membranes was successfully preserved in all eyes using the techinique. At the final follow-up, the CFT was 258.60±175.22 μm and the BCVA was 0.46±0.43, which were significantly improved compared with preoperative measurements (t=4.90, 5.20; P＜0.001). Macular foveoschisis was resovled in 13 eyes. BCVA increased in 14 eyes. Internal limiting membranes proliferation and contraction occurred in 5 eyes and full-thickness macular hole occurred in 1 eye.ConclusionsPars plana vitrectomy with fovea-sparing internal limiting peeling is effective in the treatment of myopic macular retinoschisis. It can improve BCVA and CFT.
Objective To evaluate the successful rate of surgical treatment of retinal detachment due to macular hole in high myopia, and to analyze the relative reasons. Methods Eleven eyes of 11 high myopic patients with retinal detachment due to macular hole underwent vitrectomy combined with the adjunct of 18% C3F88or silicone oil. Strict prone position was conducted at least 2 weeks postoperatively. Results Macular hole closed and retina reattached in 10 eyes. Visual acuity was increased in 10 eyes, and no change in 1 eye. Postoperative complications mainly included nuclear sclerosis of the lens(1 eye), intraocular pressure elevation (1 eye), fibrosis exudates (2 eyes)，and diplopia (1 eye). Conclusion The use of vitrectomy combined with the adjunct of 18% C3F8or silicone oil is a safe and effective method in treating retinal deta chment due to macular hole in high myopia. Preoperative careful examination of o cular fundus, rational surgical design, and better surgical expertise are basic factors in treating this disease. (Chin J Ocul Fundus Dis, 2001,17:90-92)
ObjectiveTo investigate the effect of “noncycloplegic retinoscopy for screening myopia + subsequent wearing orthokeratology lens” process for primary and secondary school students based on physical examination center.MethodsA total of 172 primary and secondary school students undergoing vision examination in the Health Management Department (i.e. physical examination center) of the Second Affiliated Hospital of Xi’an Jiaotong University between January 2017 and December 2018 were selected as the research objects. After examination by noncycloplegic retinoscopy in the health management department, they were examined by mydriatic retinoscopy in the ophthalmology department, and then the consistency of the results of the two methods was analyzed. Then 93 students with myopia diagnosed by both methods were randomly divided into control group (n=46) and trial group (n=47), wearing frame glasses and orthokeratology lenses respectively. The diopter, eye axial length, corneal curvature and vitreous cavity depth before wearing glasses, as well as the increment of the above indicators at 3, 6 and 12 months after wearing glasses/lenses were compared between the two groups, and the incidence of complications of the two groups were compared.ResultsCompared with mydriatic retinoscopy, the positive predictive value of noncycloplegic retinoscopy was 88.6%, the sensitivity was 96.9% and the specificity was 84.2%, and the consistency kappa coefficient was 0.821 (P<0.001). Before wearing glasses/lenses, there was no significant difference in diopter, eye axial length, corneal curvature or vitreous cavity depth of both eyes between the two groups (P>0.05); at 3, 6 and 12 months after wearing glasses/lenses, the diopter increment and eye axial increment of both eyes of the trial group were less than those of the control group [left eye diopter increment: (0.48±0.07) vs. (0.73±0.08) D, (0.69±0.13) vs. (1.04±0.11) D, (0.88±0.11) vs. (1.13±0.11) D; left eye axial increment: (0.18±0.05) vs. (0.26±0.04)mm, (0.22±0.04) vs. (0.36±0.04) mm, (0.27±0.05) vs. (0.40±0.05) mm; right eye diopter increment: (0.46±0.10) vs. (0.73±0.09) D, (0.71±0.12) vs. (1.04±0.10) D, (0.90±0.10) vs. (1.17±0.11) D; right eye axial increment: (0.17±0.04) vs. (0.24±0.04) mm, (0.23±0.04) vs. (0.37±0.04) mm, (0.26±0.05) vs. (0.42±0.05) mm] (P<0.05). At 3, 6 and 12 months after wearing glasses/lenses, the changing trends of corneal curvature and vitreous cavity depth in both eyes of the trial group were different from those of the control group (PInteraction<0.05), and the corneal curvature of both eyes at each time point was lower than that before wearing lenses and that of the control group (P<0.05), while the vitreous cavity depth of both eyes was not statistically different from that before wearing lenses (P>0.05) but lower than that of the control group (P<0.05). There was no statistical difference in the incidence of common complications between the two groups (P>0.05).ConclusionIn the physical examination center, the accuracy of noncycloplegic retinoscopy for general survey of myopia in primary and secondary school students is high, and then after the diagnosis by mydriatic retinoscopy in the special department, the use of orthokeratology lens can effectively control the progress of myopia, so the process of “noncycloplegic retinoscopy for screening myopia in physical examination center + subsequent wearing orthokeratology lens in specialty” is feasible.