Leukemia is a common, multiple and dangerous blood disease, whose early diagnosis and treatment are very important. At present, the diagnosis of leukemia heavily relies on morphological examination of blood cell images by pathologists, which is tedious and time-consuming. Meanwhile, the diagnostic results are highly subjective, which may lead to misdiagnosis and missed diagnosis. To address the gap above, we proposed an improved Vision Transformer model for blood cell recognition. First, a faster R-CNN network was used to locate and extract individual blood cell slices from original images. Then, we split the single-cell image into multiple image patches and put them into the encoder layer for feature extraction. Based on the self-attention mechanism of the Transformer, we proposed a sparse attention module which could focus on the discriminative parts of blood cell images and improve the fine-grained feature representation ability of the model. Finally, a contrastive loss function was adopted to further increase the inter-class difference and intra-class consistency of the extracted features. Experimental results showed that the proposed module outperformed the other approaches and significantly improved the accuracy to 91.96% on the Munich single-cell morphological dataset of leukocytes, which is expected to provide a reference for physicians’ clinical diagnosis.
ObjectiveTo objectively quantitative assess the visual quality in patients with myopic foveoschisis (MF) using a double-pass optical quality analysis system (OQASⅡ). MethodsSixty-two subjects participated in this cross-sectional, observational study, who were divided into three groups based on the pathologic conditions including myopic foveoschisis group (MFG), myopic control group (MCG) and normal control group (NCG). Measurements with OQASⅡwere performed for the modulation transfer function cut off frequency (MTF cut-off), the Strehl ratio (SR) and the objective scatter index (OSI). Visual data were analyzed using ANOVA and Pearson's correlation accompanied by logMAR BCVA and axial length (AL). ResultsThe mean values for MTF cut-off, SR and OSI of MFG, MCG and NCG were 18.18±4.81, 0.13±0.03, 3.50±0.44; 22.87±2.66, 0.14±0.02, 2.42±0.29; 33.68±4.70, 0.23±0.02, 1.68±0.20 respectively, and statistical difference were proved except SR between MFG and MCG, or BCVA between MCG and NCG (P < 0.05). LogMAR BCVA and AL have negative correlations to MTF cut-off (r=-0.928, -0.658; P < 0.05) and SR (r=-0.577, -0.893; P < 0.05) with high coefficients in MFG. Log MAR BCVA has negative correlations to MTF cut-off and SR (r=-0.659, -0.806; P < 0.05) in MCG. Log MAR BCVA has negative correlations to MTF cut-off and SR (r=-0.606, -0.602; P < 0.05) and positively correlated to OSI (r=0.561, P < 0.05) in NCG. ConclusionsThe mean value of BCVA, MTF cut-off, SR, OSI of myopic foveoschisis patients were lower than those myopic patients without foveoschisis and normal people. there exists a significant negative correlation between Log MAR BCVA, AL to MTF cut-off and SR. Compared with myopic and normal subjects, myopic foveoschisis have lower BCVA, MTF cut-off, SR but higher OSI.
Objective To investigate the clinical characte ristic of vernier acuity in age-related macular degeneration (AMD) patients. Methods The vernier acuity test soft wear system was developed to detect the 23 cases (39 eyes) of AMD patients. Tweenty-one eyes were atrophic type and 17 eyes were exudative type. Two fixed targets and a movable target are shown on the computer screen. The examinee was asked to adjust the position of the central target and the relationship between it and align them by using a track ball. The computer automatically recorded the deviations of distances between the movable target and the specific one, and then computed and analysed the results of average threshold and variance.Results Both the atrophic and exudative AMD had higher vernier acuity threshold and its variance than normal subjects, and the differences were significant (P＜0.01). The correlation coefficient between visual acuity and vernier acuity threshold was -0.78, and that between visual acuity and threshold variance was -0.80. The results suggest that vernier acuity thre shold and its variance were reliable parameters that reflect the visual acuity in AMD patients.Conclusions The results suggest that vernier acuity threshold and its variance were reliable parameters that reflect the visual acuity in AMD patients.(Chin J Ocul Fundus Dis，2003，19：201-268)
Objective To measure the macular function of the fellow eye in patients with unilateral retinal vein occlusion (RVO). Methods A total of 24 cases of unilateral RVO were diagnosed by fundus fluorescein angiography (FFA), and multifocal ERG (mfERG) was recorded by RETI scan. The mfERG data of 24 fellow eyes of those RVO patients, and 18 normal control eyes were analyzed and compared. The parameters included the amplitude density, latency of the P1 and N1 wave in 6 concentric circles and 4 quadrants of the mfERG graphics. Results The amplitude densities of P1 and N1 wave in first and second concentric circles of RVO fellow eyes were significantly lower than normal eyes (t=4.520, 2.147; P＜0.05). There was no significant difference (P＞0.05) of P1/N1 latency in any concentric circles or quadrants between RVO fellow eyes and normal eyes. Conclusion The central fovea of the RVO fellow eyes was functionally impaired.
Objective To assess the change of the motion perception of cones in patients with AMD. Methods Motion perceptions of B、G and R cones of 20 eyes with dry type AMD were isolated by blue,green and red random dots stimulus displayed on the yellow,purple and blue-green background respectively,and keeping equiluminance between stimulus and background. Results The detecting displacement threshold and identifying threshold of motion perception from B,G and R cones were all damaged in eyes with dry type AMD compared with the normal group. Conclusion The abnormal changes of motion perception may reveal preclinical damage of visual function damage in dry type AMD. (Chin J Ocul Fundus Dis, 1999, 15: 219-221)
ObjectiveTo observe the clinical characteristics of patients with visual impairment caused by fungal sphenoid sinusitis and analyze the influencing factors related to visual prognosis. Methods A retrospective clinical study. From January 2006 to December 2020, 44 patients (55 eyes) with visual impairment caused by fungal sphenoid sinusitis confirmed by imaging and pathological examination in the Department of Ophthalmology of Beijing Tongren Hospital were included in the study. Patients was first diagnosed in the Department of Ophthalmology due to monocular or binocular vision loss, or binocular diplopia, limited eye movement and ptosis. All patients underwent visual acuity examination and fundus color photography. CT examination of paranasal sinus or orbit was performed in 37 cases; magnetic resonance imaging (MRI) of paranasal sinus, brain or orbit was performed in 34 cases. All patients underwent endoscopic sinus opening combined with intrasinus lesion clearance; 14 cases were treated with antifungal drugs after operation. The average follow-up time was 59.61±37.70 months. Comparison of clinical characteristics between invasive and non-invasive fungal sphenoid sinusitis were by χ2 test or Fisher exact test. The influencing factors with P＜0.2 in univariate analysis were selected for multivariate regression analysis. ResultsAmong the 44 patients, there were 19 males and 25 females; the ratio of male to female was 1:1.3; the average age of visual symptoms was 61.48 ± 12.17 years; 23 cases (52.3%, 23/44) suffered from immune dysfunction, including 21 cases of diabetes mellitus. The visual acuity decreased in 33 cases (44 eyes) (75.0%, 33/44). There were 15 cases of binocular diplopia with eye movement disorder (34.0%, 15/44), including 6 cases with visual impairment. The visual acuity of the affected eye was no light perception-0.8. There were 35 cases with headache (79.5%, 35/44). Nasal symptoms were found in 14 cases (31.8%, 14/44). There were 40 and 4 cases of Aspergillus and Mucor infection in sphenoid sinus, respectively. Among the 37 cases who underwent CT examination of paranasal sinus or orbit, there were soft tissue filling in the sinus cavity, including 19 cases of high-density calcification in the sinus cavity (51.4%, 19/37); bone defect of sinus wall were in 24 cases (64.9%, 24/37). There were 26 cases (70.3%, 26/37) of sinus wall osteosclerosis. MRI of paranasal sinus, brain or orbit was performed in 34 cases. T1WI of sphenoid sinus lesions showed low signal, high signal and equal signal in 14, 10 and 9 cases, respectively; T2WI showed high signal, low signal and equal signal in 13, 16 and 2 cases respectively. After enhancement, the lesions were strengthened in 11 cases, no obvious enhancement in 23 cases, and the surrounding mucosa was thickened and strengthened. The lesions involved the orbital apex and cavernous sinus in 18 and 16 cases, respectively; orbital apex and cavernous sinus were involved in 12 cases. Six months after operation, visual acuity was significantly improved in 27 eyes (65.9%, 27/41); visual acuity did not improve in 14 eyes (34.1%, 14/41). Multivariate regression analysis showed that the change of sinus wall osteosclerosis was associated with higher visual acuity improvement rate (odds ratio= 0.089, 95% confidence interval 0.015-0.529, P=0.008). ConclusionsFungal sphenoid sinusitis related visual impairment is relatively common in elderly female patients with low immune function; monocular vision loss with persistent headache is the most common clinical symptom; imaging findings of sphenoid sinus lesions are an important basis for diagnosis. Sphenoid sinus opening combined with sinus lesion clearance is an effective treatment. After operation, the visual acuity of most patients can be improved. The prognosis of visual acuity was relatively good in patients with hyperplasia and sclerosis of sphenoid sinus wall bone.
Objective To observe the effects of local macular foveal photoreceptor defects on visual acuity.Methods Thirty-one patients (31 eyes) with photoreceptor defect in macular fovea (case group) diagnosed by spectral domain optical coherence tomography (SD-OCT) and 30 patients (30 eyes) age- and diopter- matched normal subjects (control group) were enrolled in this study. There were 22 eyes with full photoreceptor defects and 9 eyes with outer segment defects in case group. All subjects were examined for best corrected visual acuity (BCVA), slit-lamp microscopy, direct ophthalmoscope and SD-OCT. Independent sample t-test was used to compare central foveal thickness (CFT) between case group and control group. Difference of logMAR BCVA, CFT, maximum width and height of photoreceptor defects, defected area and residual retinal thickness in macular between patients with full photoreceptor defects and outer segment defects were also compared.Results The CFT of case group and control group were (225.32plusmn;19.70),(240.02plusmn;10.70) mu;m, the difference was not statistically significant (t=-1.96, P＞0.05). In full photoreceptor defects and outer segment defects patients, the mean logMAR BCVA were 0.22plusmn;0.31, 0.32plusmn;0.43; the mean CFT were (224.09plusmn;20.57), (228.33plusmn;18.17) mu;m; the maximum width of photoreceptor defects were (131.32plusmn;108.18), (143.22plusmn;66.93) mu;m; the mean defected area were (0.022plusmn;0.054), (0.019plusmn;0.019) mm2; the mean maximum height of photoreceptor defects were (77.41plusmn;6.62), (44.89plusmn;4.26) mu;m; the mean residual retinal thickness were (87.00plusmn;20.31), (128.33plusmn;23.54) mu;m respectively. There was no statistical significance between full photoreceptor defects and outer segment defects patients in the mean logMAR BCVA, CFT, maximum width of photoreceptor defects and defected area (t=-0.76, -0.538, -0.305, 0.166; P＞0.05), but there were significant difference in mean maximum width of photoreceptor defects and residual retinal thickness (t=12.72, -4.91;P＜0.05). Conclusions The local photoreceptor defects in macular fovea can lead to decrease of visual acuity. The wider the photoreceptor defects, the worse the visual acuity.
ObjectiveTo evaluate the characteristics of electroretinagram (EGR) in children with history of pre-threshold or threshold retinopathy of prematurity (ROP). MethodsA total of 24 children (48 eyes) with history of pre-threshold ROP or threshold ROP received F-ERG examination.Ten age and body weight-matched children with a history of premature birth (20 eyes) but without ROP were recruited as control group. The rod response, maximal rod-cone response and cone response of F-ERG were recorded respectively following the International Standard Protocal of ISCEV (2000 version).The latency and amplitude of a-wave and b-wave of various responses were analyzed. The trial was approved by the Ethic Committee of Hunan Children's Hospital and informed consent was obtained from the parents of patients prior to any medical procedure. ResultsThere was significant difference between ROP and control group in rod response,the latency was longer (t=5.643,P<0.05) and the amplitude was lower in ROP group(t=7.068,P<0.05).In maximal rod-cone response both in a and b wave, the latency wave was longer(t=3.099, 2.886;P<0.05) and the amplitude was lower(t=5.614, 2.850;P<0.05) in ROP group. But there is no difference between ROP and control group in cone response latency(t=0.819, 0.948)and amplitude(t=0.904, 0.850). ConclusionERG in ROP children with history of pre-threshold or threshold ROP is abnormal, which mainly in rod response,but the cone response remains normal.
Purpose To identify the expression of alternatively spliced mRNA isoforms of the NMDA-R1 in the visual cortex of strabismic cats. Methods Two pai rs of normal and strabismic cats were used．The amblyopic cats had been made monocularly esotropic (by tenotomy) at the age of weeks，resulting in behavioral am blyopia．Animals were sacrificed about 6 months by intraperitoneal administration of Nembutal．Cryostat sections of fresh，frozen central visual cortex of the ats were cut to 20 micron thickness．A series of digoxygenin-labelled oligonucle otide probes basing on the human gene sequence were used for ISH．Control probes included sense oligonucleotides and short segment probes which were adjacent to ，but did not，span the splice junctions．A computer-assisted systematic morphometric ounting procedure was used to enumerate hybridising cells． Results The number of positive cells expressing NMDA-R1 mRNA in t he strabismic amblyopic cats was decreased，notably in layer IV of visual cortex (P＜0．0001)．The pattern of isoform expression varied between normal and strabismic amblyopic cats with decreased numbers of 1-a，1- b and 1-1 isoforms and apparently increased expression of 1-3 P ＜0．0001)，whereas no significant difference was found for the 1-2 and 1-4 isoforms (P＞0．05)． Conclusion Transcriptional inhibition of NMDA-R1 mRNA and of specifie isoforms may underlie the change in receptor expression．Alternatively，preferentialloss of neurones bearing particular NMDA-R1 isoforms and compensation with a proportional increase in cells expressing other isoforms may occurr during the critical period of visual plasticity． (Chin J Ocul Fundus Dis，2000，16：71-138)
ObjectiveTo observe the changes of multifocal electroretinogram(mfERG)and central visual field before and after surgery in patients with rhegmatogenous retinal detachment (RRD) involving the macular area. MethodsThis is a retrospective study. Sixteen patients (16 eyes) with RRD involving the macular area (RRD group) and age-matched normal 20 cases (20 eyes, normal control group) were enrolled in the study. All patients in RRD group underwent scleral buckling surgery. Before surgery and 1, 3, 6 months after surgery, RRD eyes and normal eyes were checked by using mfERG and central visual field examination, and macular reaction wave amplitude density, incubation period and 4° visual field mean sensitivity (MS) were observed. The correlation between amplitude density, incubation period and MS in RRD group and the consistency between mfERG and central visual field examination in normal control group and RRD group were analyzed. ResultsCompared with the normal control group, in RRD group before surgery the macular reaction wave N1 and P1 amplitude density reduced, the incubation period prolonged, the differences were statistically significant (P < 0.05). Postoperative 1, 3, 6 months, in RRD group macular reaction wave amplitude density improved, the incubation period reduced than before surgery, the differences were statistically significant (P < 0.05). Postoperative 1, 3, 6 months, in RRD group macular reaction wave amplitude density reduced, the incubation period prolonged compared with the normal control group, the differences were statistically significant (P < 0.05). Compared with the normal control group, 4° visual field MS significantly reduced in RRD group before surgery reduced, the differences were statistically significant (t=49.752, P < 0.05). Postoperative 1, 3, 6 months, 4° visual field MS significantly increased compared with the preoperative value, the differences were statistically significant (t=-9.580, -16.533, -19.580; P < 0.05); but were lower than that of the normal control group, the differences were statistically significant (t=-6.286, -7.493, -6.366; P < 0.05). Postoperative 1, 3, 6 months, macular reaction wave amplitude density and MS in RRD group showed positive correlation (P < 0.05), and there was no correlation between incubation period and MS (P > 0.05). mfERG and vision consistency in normal control group and RRD group showed good agreement(K=0.886, P < 0.05). ConclusionsCompared with normal control eyes, in RRD eyes involving the macula area before and after surgery, macular reaction wave amplitude density reduced, the incubation period prolonged and MS values reduced; compared with the preoperative mfERG and central visual field, macular reaction wave amplitude density improved, the incubation period reduced and MS values increased.