AIM:To investigate the affecting factors of parapapillary gamma and delta zones and other fundus morphological features in high myopia.METHODS:Seventy high myopia patients were included in this retrospective observati...AIM:To investigate the affecting factors of parapapillary gamma and delta zones and other fundus morphological features in high myopia.METHODS:Seventy high myopia patients were included in this retrospective observational study and 47 patients were female.Patients were divided into three groups:no posterior staphyloma(no PS),PS with myopic traction maculopathy(PS with MTM),and PS without MTM using 3-dimensional magnetic resonance imaging and optical coherence tomography.MTM patients were fur ther classified into three types[epiretinal membrane,macular hole,and macular retinoschisis(MRS)].Diameters of the gamma and delta zones were measured among other morphometric variables using fundus photographs.RESULTS:Of the 70 individuals(127 eyes),the mean age was 57.46±13.56y.In univariate analysis,morphological features changed most dramatically in PS with MTM patients,who had the largest gamma zone diameters,the largest disk-fovea distance(DFD)and disk-fovea angle,and the smallest angle kappa and vertical distance of temporal arterial arcade.However,their horizontal delta zone diameter was smaller than in the patients with PS yet without MTM.In multivariate analysis,with axial length(AL)and age adjusted,the horizontal diameter in the delta zone of the PS without MTM group was still significantly larger than in the PS with MTM group(P=0.024).Comparing the three subtypes of MTM patients,the diameters of the gamma zone and DFD in MRS group were the largest.CONCLUSION:The characteristics of the gamma and delta zones change inconsistently in different stages of high myopia.These changes may be associated with anatomical changes caused by local traction.Factors such as PS,AL and age play an important role.These findings may provide a hint about the pathogenesis of traction in high myopia.展开更多
Background: In highly myopic eyes, myopic foveoschisis (MF), the earliest stage of myopic traction maculopathy (MTM), is present in up to 34% of patients with pathologic myopia and slowly progresses to form foveoretin...Background: In highly myopic eyes, myopic foveoschisis (MF), the earliest stage of myopic traction maculopathy (MTM), is present in up to 34% of patients with pathologic myopia and slowly progresses to form foveoretinal detachment (FRD) or macular hole (MH) with or without macular hole retinal detachment (MHRD) as a part of its natural history. Aim: To describe the microstructural and functional results in three highly myopic eyes that underwent macular surgery for early-stage MTM. The last postoperative structural findings were correlated with the final vision and macular automated microperimetry evaluation. Methods: We retrospectively reviewed three highly myopic eyes that underwent successful fovea-saving internal limiting membrane (FS-ILM) macular surgery for chronic FRD at Oftalmologia Integral ABC, Mexico City, Mexico. We performed postoperative multimodal microstructural and functional evaluations, including SD-OCT, SS-OCT, and microperimetric macular examinations. Results: There was a substantial difference between best-corrected visual acuity (BCVA) preoperatively and postoperatively in all three cases. Postoperative surgery was associated with significant improvement in visual acuity confirmed using a paired-sample permutation test. The mean presurgical BCVA value (LogMAR;mean ± SE) was ~0.83 ± 0.15, and the postsurgical value was ~0.43 ± 0.52 (P = 0.00065). The myopic foveoretinal detachment evaluation was ~7.3 ± 3.5 months, with a mean postoperative follow-up time of ~14 ± 4.08 months. Furthermore, postoperative multimodal imaging tests demonstrated an abnormal microstructural foveal SS-OCT pattern without evidence of macular hole (MH) development at the postoperative follow-up. Macular microperimetry confirmed a subclinical reduced macula threshold sensitivity with an anomalous retinal sensitivity analysis map and a stable central foveal fixation site. Conclusions: Even with the successful microstructural disappearance of myopic macular detachment, the last multidisciplinary functional and struc展开更多
<b>Introduction</b>: Disseminated tuberculosis (TB) may occur with skin and ocular involvement which are not common manifestations in children and may lead to debilitating complications. <b>Objective...<b>Introduction</b>: Disseminated tuberculosis (TB) may occur with skin and ocular involvement which are not common manifestations in children and may lead to debilitating complications. <b>Objective</b>: A child with multi-organ TB involving the lungs, chest abdomen, skin and eyes who had been symptomatic for 3 years is reported. <b>Case Report</b>: A 6-year-old girl presented with recurrent fever, abdominal pain and weight loss of 3 years and skin lesions of a year duration. There was history of pain and redness of the eyes associated with discharge. She was not vaccinated at all. She was chronically ill-looking with bilateral conjunctival hyperaemia, purulent eye discharge with corneal opacity of the right eye. She had significant lymphadenopathy, digital clubbing and ulcerated, discharging swellings around her neck and axilla (scrofuloderma). She had reduced breath sounds and coarse crepitations. Hepatosplenomegaly and ascites were present. She later developed bulging of the upper part of the cornea of the right eye which was diagnosed by the ophthalmologist to be cornea ulcer with anterior staphyloma. <b>Results, Treatment and Outcome</b>: Complete blood count (leucocytosis 12,800 cells), erythrocyte sedimentation rate (150 mm/hr) and tuberculin test (7 mm induration) were suggestive of TB. Radiological tests were also supportive. She received anti-Kochs in addition to systemic and ocular antibiotics. Skin lesions healed progressively and stopped discharging. Caregivers were counseled on poor visual prognosis of the right eye. She was discharged but lost to follow up. <b>Conclusion</b>: Multi-organ involvement of TB especially ocular and cutaneous TB is not common but is very debilitating. More preventive efforts with vaccination and expertise are needed at lower levels of health care in the community to aid early diagnosis.展开更多
Background: To report the clinical features of surgically induced scleral staphyloma and investigate the management.Methods: Retrospective uncontrolled study.Results: A full ophthalmological evaluation of surgically i...Background: To report the clinical features of surgically induced scleral staphyloma and investigate the management.Methods: Retrospective uncontrolled study.Results: A full ophthalmological evaluation of surgically induced scleral staphyloma in four patients was performed. The first patient was a 3-year-old young girl underwent corneal dermoid resection. The second patient was a 60-year-old man underwent nasal pterygium excision and conjunctival autograft without Mitomycin C(MMC). The other two were respectively a 74-year-old woman and a 69-year-old man underwent cataract surgery. All patients performed allogeneic sclera patch graft. In the at least half a year follow-up, the best corrected visual acuity(BCVA) of all the four patients were no worse than that of preoperative. Ocular symptoms disappeared, including eye pain, foreign body sensation, and so on. Unfortunately, the fourth patient showed sclera rejection and partial dissolution at postoperative 1 month. Conclusions: Surgically induced scleral staphyloma must be considered in the differential diagnosis of patients with staphyloma following corneal dermoid, pterygium, and cataract surgery. Allogeneic sclera patch graft is one of the methods for treating scleral staphyloma. However sclera rejection and dissolution should be considered postoperatively.展开更多
目的:描述病理性高度近视眼视盘周围局限性视网膜脱离,分析这一新认识的眼底病变发生的原因。方法:2002-12/2004-01 间,7 例 10 眼被确认存在视盘周围局限性视网膜脱离,本文评价了其 O C T、FA/IC G A 和m fER G 的临床特征。结果:视盘...目的:描述病理性高度近视眼视盘周围局限性视网膜脱离,分析这一新认识的眼底病变发生的原因。方法:2002-12/2004-01 间,7 例 10 眼被确认存在视盘周围局限性视网膜脱离,本文评价了其 O C T、FA/IC G A 和m fER G 的临床特征。结果:视盘周围视网膜脱离不是任何患者就诊检查的原因,视力减退或矫正视力低的原因是相对严重的近视性视网膜脉络膜萎缩、C N V 、黄斑前膜形成和弱视。5 只患眼表现为 1 型后巩膜葡萄肿,其视盘周围视网膜脱离均位于视盘的鼻侧半,而另 5 只患眼表现为 3 型或 2 型葡萄肿,其视盘周围视网膜脱离均位于视盘的非鼻侧半,统计学上存在差异 (P =0.01)。所有患眼的视盘周围视网膜脱离区域均为后巩膜葡萄肿累及。结论:病理性近视眼的视盘周围视网膜脱离很可能是后巩膜葡萄肿的一个良性并发症。展开更多
AIM: To observe the clinical effect of pars plana vitrectomy(PPV) and silicone oil filling surgery combined with intraoperative posterior scleral staphyloma(PS) marginal retinal photocoagulation in the treatment of hi...AIM: To observe the clinical effect of pars plana vitrectomy(PPV) and silicone oil filling surgery combined with intraoperative posterior scleral staphyloma(PS) marginal retinal photocoagulation in the treatment of high myopic macular hole retinal detachment(MHRD) with PS.METHODS: This was a retrospective clinical study. From May 2017 to March 2020, 62 MHRD patients with PS(62 eyes) were enrolled in the study. Patients were divided into 23 G PPV combined with PS marginal retina intraoperative photocoagulation group(combined group) and conventional surgery group(conventional group), with 31 eyes in each. Triamcinolone acetonide and indocyanine green were used to remove the epiretinal membrane and the posterior macular inner limiting membrane(ILM). In the combined group, 2 to 3 rows of retinal photocoagulation were performed on the edge of the PS. The patients were followed up for an average of 8.34±3.21 mo. The first retinal reattachment rate, macular hole closure rate, Duration of silicone oil tamponade, best corrected visual acuity(BCVA) and average number of operations were observed and compared between the two groups.RESULTS: The first retinal reattachment rates of the eyes in the combined group and the conventional group were 96.7%(29/31) and 67.7%(21/31), respectively(χ~2=6.613, P=0.010). The macular hole closure rates in the combined group and the conventional group were 74.2%(23/31) and 67.7%(21/31), respectively(χ~2=0.128, P=0.721). The Duration of silicone oil tamponade of the patients in the combined group was lower than that of the routine group(t=-41.962, P≤0.001). Postoperative log MAR BCVA values of patients in the combined group and the conventional group were 1.27±0.12 and 1.26±0.11, compared with the log MAR BCVA before surgery, each group was improved(t=19.947, t=-19.517, P≤0.001, P≤0.001). There was no significant difference in the log MAR BCVA between the eyes of the two groups(t=-0.394, P=0.695). The average numbers of operations on the eyes in the conventional group and the combin展开更多
AIM:To analyze the prevalence of peripapillary intrachoroidal cavitation(PICC)in eyes with gamma peripapillary atrophy(γPPA),in eyes with peripapillary staphyloma(PPS)and in those combiningγPPA and PPS and to analyz...AIM:To analyze the prevalence of peripapillary intrachoroidal cavitation(PICC)in eyes with gamma peripapillary atrophy(γPPA),in eyes with peripapillary staphyloma(PPS)and in those combiningγPPA and PPS and to analyze border tissue discontinuity in PICC.METHODS:This prospective cross-sectional non interventional study included highly myopic eyes.Non-highly myopic eyes were used as control.Radial and linear scans centered on the optic nerve head were performed using spectral-domain optical coherence tomography.Variables were analyzed along the twelve hourly optical coherence tomography sections in both eyes of each subject.RESULTS:A total of 667 eyes of 334 subjects were included:229(34.3%)highly myopic eyes and 438(65.7%)non highly myopic eyes.The mean age of the highly myopic group was 48.99±17.81y.PICC was found in a total of 40 eyes and in 13.2%(29/220)of highly myopic eyes.PICC was found in 10.4%(40/386)of eyes withγPPA,in 20.5%(40/195)of eyes with PPS and in 22.7%(40/176)of those combiningγPPA and PPS.All the eyes with PICC showed the co-existence ofγPPA and PPS whereas none of the eyes presenting only one of these entities exhibited PICC.A border tissue discontinuity in theγPPA area was found in all eyes with PICC.CONCLUSION:We confirm the presence of a border tissue discontinuity in theγPPA area of all eyes with PICC.These findings suggest the involvement of mechanical factors in the pathogenesis of PICC which may contribute to PICC-related visual field defects.展开更多
Pathologic myopia is the major cause of the loss of the best-corrected visual acuity(BCVA)worldwide,especially in East Asian countries.The loss of BCVA is caused by the development of myopic macula patchy,myopic tract...Pathologic myopia is the major cause of the loss of the best-corrected visual acuity(BCVA)worldwide,especially in East Asian countries.The loss of BCVA is caused by the development of myopic macula patchy,myopic traction macula patchy,and myopic optic neuropathy(or glaucoma).The development of such vision-threatening complications is caused by eye deformity,characterized by a formation of posterior staphyloma.The recent advance in ocular imaging has greatly facilitated the clarification of pathologies and pathogenesis of pathological myopia and myopia-related complications.These technologies include ultra-wide field fundus imaging,swept-source optical coherence tomography,and 3D MRI.In addition,the new treatments such as anti-VEGF therapies for myopic choroid all neovascularization have improved the outcome of the patients.Swept-source OCT showed that some of the lesions of myopic maculopathy were not simply chorioretinal atrophy but were Bruch’s membrane holes.Features of myopic traction maculopathy have been analyzed extensively by using OCT.The understanding the pathophysiology of complications of pathologic myopia is considered useful for better management of this blinding eye disease.展开更多
Background:To explore the safety and effectiveness of Sclera patch grafts in the management of scleral defects.Methods:This is a retrospective uncontrolled study.Medical records were retrospectively reviewed for 8 eye...Background:To explore the safety and effectiveness of Sclera patch grafts in the management of scleral defects.Methods:This is a retrospective uncontrolled study.Medical records were retrospectively reviewed for 8 eyes of 8 patients with sclera patch grafts.Two patients had necrotizing scleritis,2 patients had scleral melting/perforation secondary to thermal burns,4 patients had scleral staphyloma secondary to surgery.Sclera was reconstructed with allogenic sclera patch grafts,6 in 8 patients combined autologous conjunctival pedicle flap,1 patient combined partial medial rectus translocation,1 patient combined autologous pedicle tenon graft,simultaneously.Treatment outcomes were evaluated using structural integrity,best corrected visual acuity(BCVA),scleritis remission,sclera rejection and melt,and ocular symptoms.Results:Eight patients were reviewed.In all of these cases,satisfactory anatomic and functional outcomes were achieved.In the at least half a year follow-up,the BCVA of all the eight patients were no worse than that of preoperative.No eye pain,foreign body sensation and other discomforts showed in all the patients,except one woman,who showed sclera rejection and melt 1 month postoperative.In addition,one patient showed high intraocular pressure(28 mmHg),which can be controlled by a kind of medicine.Conclusions:In this series,sclera patch grafts is an effective method for management scleral defects in the at least half a year following-up.Attention should be paid to the sclera patch rejection and melt post operatively.展开更多
基金Supported by the National Natural Science Foundation of China(No.81870686)Beijing Municipal Natural Science Foundation(No.7184201)Capital’s Funds for Health Improvement and Research(No.2018-1-2021)。
文摘AIM:To investigate the affecting factors of parapapillary gamma and delta zones and other fundus morphological features in high myopia.METHODS:Seventy high myopia patients were included in this retrospective observational study and 47 patients were female.Patients were divided into three groups:no posterior staphyloma(no PS),PS with myopic traction maculopathy(PS with MTM),and PS without MTM using 3-dimensional magnetic resonance imaging and optical coherence tomography.MTM patients were fur ther classified into three types[epiretinal membrane,macular hole,and macular retinoschisis(MRS)].Diameters of the gamma and delta zones were measured among other morphometric variables using fundus photographs.RESULTS:Of the 70 individuals(127 eyes),the mean age was 57.46±13.56y.In univariate analysis,morphological features changed most dramatically in PS with MTM patients,who had the largest gamma zone diameters,the largest disk-fovea distance(DFD)and disk-fovea angle,and the smallest angle kappa and vertical distance of temporal arterial arcade.However,their horizontal delta zone diameter was smaller than in the patients with PS yet without MTM.In multivariate analysis,with axial length(AL)and age adjusted,the horizontal diameter in the delta zone of the PS without MTM group was still significantly larger than in the PS with MTM group(P=0.024).Comparing the three subtypes of MTM patients,the diameters of the gamma zone and DFD in MRS group were the largest.CONCLUSION:The characteristics of the gamma and delta zones change inconsistently in different stages of high myopia.These changes may be associated with anatomical changes caused by local traction.Factors such as PS,AL and age play an important role.These findings may provide a hint about the pathogenesis of traction in high myopia.
文摘Background: In highly myopic eyes, myopic foveoschisis (MF), the earliest stage of myopic traction maculopathy (MTM), is present in up to 34% of patients with pathologic myopia and slowly progresses to form foveoretinal detachment (FRD) or macular hole (MH) with or without macular hole retinal detachment (MHRD) as a part of its natural history. Aim: To describe the microstructural and functional results in three highly myopic eyes that underwent macular surgery for early-stage MTM. The last postoperative structural findings were correlated with the final vision and macular automated microperimetry evaluation. Methods: We retrospectively reviewed three highly myopic eyes that underwent successful fovea-saving internal limiting membrane (FS-ILM) macular surgery for chronic FRD at Oftalmologia Integral ABC, Mexico City, Mexico. We performed postoperative multimodal microstructural and functional evaluations, including SD-OCT, SS-OCT, and microperimetric macular examinations. Results: There was a substantial difference between best-corrected visual acuity (BCVA) preoperatively and postoperatively in all three cases. Postoperative surgery was associated with significant improvement in visual acuity confirmed using a paired-sample permutation test. The mean presurgical BCVA value (LogMAR;mean ± SE) was ~0.83 ± 0.15, and the postsurgical value was ~0.43 ± 0.52 (P = 0.00065). The myopic foveoretinal detachment evaluation was ~7.3 ± 3.5 months, with a mean postoperative follow-up time of ~14 ± 4.08 months. Furthermore, postoperative multimodal imaging tests demonstrated an abnormal microstructural foveal SS-OCT pattern without evidence of macular hole (MH) development at the postoperative follow-up. Macular microperimetry confirmed a subclinical reduced macula threshold sensitivity with an anomalous retinal sensitivity analysis map and a stable central foveal fixation site. Conclusions: Even with the successful microstructural disappearance of myopic macular detachment, the last multidisciplinary functional and struc
文摘<b>Introduction</b>: Disseminated tuberculosis (TB) may occur with skin and ocular involvement which are not common manifestations in children and may lead to debilitating complications. <b>Objective</b>: A child with multi-organ TB involving the lungs, chest abdomen, skin and eyes who had been symptomatic for 3 years is reported. <b>Case Report</b>: A 6-year-old girl presented with recurrent fever, abdominal pain and weight loss of 3 years and skin lesions of a year duration. There was history of pain and redness of the eyes associated with discharge. She was not vaccinated at all. She was chronically ill-looking with bilateral conjunctival hyperaemia, purulent eye discharge with corneal opacity of the right eye. She had significant lymphadenopathy, digital clubbing and ulcerated, discharging swellings around her neck and axilla (scrofuloderma). She had reduced breath sounds and coarse crepitations. Hepatosplenomegaly and ascites were present. She later developed bulging of the upper part of the cornea of the right eye which was diagnosed by the ophthalmologist to be cornea ulcer with anterior staphyloma. <b>Results, Treatment and Outcome</b>: Complete blood count (leucocytosis 12,800 cells), erythrocyte sedimentation rate (150 mm/hr) and tuberculin test (7 mm induration) were suggestive of TB. Radiological tests were also supportive. She received anti-Kochs in addition to systemic and ocular antibiotics. Skin lesions healed progressively and stopped discharging. Caregivers were counseled on poor visual prognosis of the right eye. She was discharged but lost to follow up. <b>Conclusion</b>: Multi-organ involvement of TB especially ocular and cutaneous TB is not common but is very debilitating. More preventive efforts with vaccination and expertise are needed at lower levels of health care in the community to aid early diagnosis.
文摘Background: To report the clinical features of surgically induced scleral staphyloma and investigate the management.Methods: Retrospective uncontrolled study.Results: A full ophthalmological evaluation of surgically induced scleral staphyloma in four patients was performed. The first patient was a 3-year-old young girl underwent corneal dermoid resection. The second patient was a 60-year-old man underwent nasal pterygium excision and conjunctival autograft without Mitomycin C(MMC). The other two were respectively a 74-year-old woman and a 69-year-old man underwent cataract surgery. All patients performed allogeneic sclera patch graft. In the at least half a year follow-up, the best corrected visual acuity(BCVA) of all the four patients were no worse than that of preoperative. Ocular symptoms disappeared, including eye pain, foreign body sensation, and so on. Unfortunately, the fourth patient showed sclera rejection and partial dissolution at postoperative 1 month. Conclusions: Surgically induced scleral staphyloma must be considered in the differential diagnosis of patients with staphyloma following corneal dermoid, pterygium, and cataract surgery. Allogeneic sclera patch graft is one of the methods for treating scleral staphyloma. However sclera rejection and dissolution should be considered postoperatively.
文摘目的:描述病理性高度近视眼视盘周围局限性视网膜脱离,分析这一新认识的眼底病变发生的原因。方法:2002-12/2004-01 间,7 例 10 眼被确认存在视盘周围局限性视网膜脱离,本文评价了其 O C T、FA/IC G A 和m fER G 的临床特征。结果:视盘周围视网膜脱离不是任何患者就诊检查的原因,视力减退或矫正视力低的原因是相对严重的近视性视网膜脉络膜萎缩、C N V 、黄斑前膜形成和弱视。5 只患眼表现为 1 型后巩膜葡萄肿,其视盘周围视网膜脱离均位于视盘的鼻侧半,而另 5 只患眼表现为 3 型或 2 型葡萄肿,其视盘周围视网膜脱离均位于视盘的非鼻侧半,统计学上存在差异 (P =0.01)。所有患眼的视盘周围视网膜脱离区域均为后巩膜葡萄肿累及。结论:病理性近视眼的视盘周围视网膜脱离很可能是后巩膜葡萄肿的一个良性并发症。
基金Supported by the Project of Integrated Traditional Chinese and Western Medicine by Tianjin Municipal Health Commission(No.2021067)。
文摘AIM: To observe the clinical effect of pars plana vitrectomy(PPV) and silicone oil filling surgery combined with intraoperative posterior scleral staphyloma(PS) marginal retinal photocoagulation in the treatment of high myopic macular hole retinal detachment(MHRD) with PS.METHODS: This was a retrospective clinical study. From May 2017 to March 2020, 62 MHRD patients with PS(62 eyes) were enrolled in the study. Patients were divided into 23 G PPV combined with PS marginal retina intraoperative photocoagulation group(combined group) and conventional surgery group(conventional group), with 31 eyes in each. Triamcinolone acetonide and indocyanine green were used to remove the epiretinal membrane and the posterior macular inner limiting membrane(ILM). In the combined group, 2 to 3 rows of retinal photocoagulation were performed on the edge of the PS. The patients were followed up for an average of 8.34±3.21 mo. The first retinal reattachment rate, macular hole closure rate, Duration of silicone oil tamponade, best corrected visual acuity(BCVA) and average number of operations were observed and compared between the two groups.RESULTS: The first retinal reattachment rates of the eyes in the combined group and the conventional group were 96.7%(29/31) and 67.7%(21/31), respectively(χ~2=6.613, P=0.010). The macular hole closure rates in the combined group and the conventional group were 74.2%(23/31) and 67.7%(21/31), respectively(χ~2=0.128, P=0.721). The Duration of silicone oil tamponade of the patients in the combined group was lower than that of the routine group(t=-41.962, P≤0.001). Postoperative log MAR BCVA values of patients in the combined group and the conventional group were 1.27±0.12 and 1.26±0.11, compared with the log MAR BCVA before surgery, each group was improved(t=19.947, t=-19.517, P≤0.001, P≤0.001). There was no significant difference in the log MAR BCVA between the eyes of the two groups(t=-0.394, P=0.695). The average numbers of operations on the eyes in the conventional group and the combin
文摘AIM:To analyze the prevalence of peripapillary intrachoroidal cavitation(PICC)in eyes with gamma peripapillary atrophy(γPPA),in eyes with peripapillary staphyloma(PPS)and in those combiningγPPA and PPS and to analyze border tissue discontinuity in PICC.METHODS:This prospective cross-sectional non interventional study included highly myopic eyes.Non-highly myopic eyes were used as control.Radial and linear scans centered on the optic nerve head were performed using spectral-domain optical coherence tomography.Variables were analyzed along the twelve hourly optical coherence tomography sections in both eyes of each subject.RESULTS:A total of 667 eyes of 334 subjects were included:229(34.3%)highly myopic eyes and 438(65.7%)non highly myopic eyes.The mean age of the highly myopic group was 48.99±17.81y.PICC was found in a total of 40 eyes and in 13.2%(29/220)of highly myopic eyes.PICC was found in 10.4%(40/386)of eyes withγPPA,in 20.5%(40/195)of eyes with PPS and in 22.7%(40/176)of those combiningγPPA and PPS.All the eyes with PICC showed the co-existence ofγPPA and PPS whereas none of the eyes presenting only one of these entities exhibited PICC.A border tissue discontinuity in theγPPA area was found in all eyes with PICC.CONCLUSION:We confirm the presence of a border tissue discontinuity in theγPPA area of all eyes with PICC.These findings suggest the involvement of mechanical factors in the pathogenesis of PICC which may contribute to PICC-related visual field defects.
文摘Pathologic myopia is the major cause of the loss of the best-corrected visual acuity(BCVA)worldwide,especially in East Asian countries.The loss of BCVA is caused by the development of myopic macula patchy,myopic traction macula patchy,and myopic optic neuropathy(or glaucoma).The development of such vision-threatening complications is caused by eye deformity,characterized by a formation of posterior staphyloma.The recent advance in ocular imaging has greatly facilitated the clarification of pathologies and pathogenesis of pathological myopia and myopia-related complications.These technologies include ultra-wide field fundus imaging,swept-source optical coherence tomography,and 3D MRI.In addition,the new treatments such as anti-VEGF therapies for myopic choroid all neovascularization have improved the outcome of the patients.Swept-source OCT showed that some of the lesions of myopic maculopathy were not simply chorioretinal atrophy but were Bruch’s membrane holes.Features of myopic traction maculopathy have been analyzed extensively by using OCT.The understanding the pathophysiology of complications of pathologic myopia is considered useful for better management of this blinding eye disease.
文摘Background:To explore the safety and effectiveness of Sclera patch grafts in the management of scleral defects.Methods:This is a retrospective uncontrolled study.Medical records were retrospectively reviewed for 8 eyes of 8 patients with sclera patch grafts.Two patients had necrotizing scleritis,2 patients had scleral melting/perforation secondary to thermal burns,4 patients had scleral staphyloma secondary to surgery.Sclera was reconstructed with allogenic sclera patch grafts,6 in 8 patients combined autologous conjunctival pedicle flap,1 patient combined partial medial rectus translocation,1 patient combined autologous pedicle tenon graft,simultaneously.Treatment outcomes were evaluated using structural integrity,best corrected visual acuity(BCVA),scleritis remission,sclera rejection and melt,and ocular symptoms.Results:Eight patients were reviewed.In all of these cases,satisfactory anatomic and functional outcomes were achieved.In the at least half a year follow-up,the BCVA of all the eight patients were no worse than that of preoperative.No eye pain,foreign body sensation and other discomforts showed in all the patients,except one woman,who showed sclera rejection and melt 1 month postoperative.In addition,one patient showed high intraocular pressure(28 mmHg),which can be controlled by a kind of medicine.Conclusions:In this series,sclera patch grafts is an effective method for management scleral defects in the at least half a year following-up.Attention should be paid to the sclera patch rejection and melt post operatively.
