AIM:To investigate the efficacy of a new visual acuity(VA)screening method,the baby vision test for young children.METHODS:A total 105 eyes of 65 children aged 2-8y were included in the study.Acuity testing was conduc...AIM:To investigate the efficacy of a new visual acuity(VA)screening method,the baby vision test for young children.METHODS:A total 105 eyes of 65 children aged 2-8y were included in the study.Acuity testing was conducted using a standardized recognition acuity chart(Snellen visual chart:at 3 m)and the baby vision model assessment.The baby vision device includes a screen,a near infrared camera and a computer.Children were seated at a measured distance of 33-40 cm from a display for testing.VA was estimated according to the highest resolution the children could follow.Decimal VA data were converted to logarithm of the minimum angle of resolution(logMAR)for statistical analysis.The VA results for each child were recorded and analyzed for consistency.RESULTS:The mean VA measured using the Snellen visual chart was 0.62±0.32,and that assessed using the baby vision test was 0.66±0.27.The 95%limit of agreement was-0.609 to 0.695,with 95.2%(100/105)plots within the 95%limits of agreement.VA values of the baby vision test were significantly correlated with those of the Snellen chart(R=0.274,P=0.005).CONCLUSION:The baby vision test can be used as a relatively reliable method for estimating VA in young children.This new acuity assessment might be a valid predictor of optotype-measured acuity later in preverbal children.展开更多
AIM:To investigate the effects of school-basedcomprehensive intervention on myopia development inelementary school children.METHODS:As a part of the Wenzhou Epidemiologyof Refraction Error Study,there were 1524 partic...AIM:To investigate the effects of school-basedcomprehensive intervention on myopia development inelementary school children.METHODS:As a part of the Wenzhou Epidemiologyof Refraction Error Study,there were 1524 participatingelementary students(730 girls,47.9%)in grades 1 to3 from three campuses of one school,aged 7.3±0.9y,who were examined twice every year for a 2.5y follow upperiod.Comprehensive intervention and other reminderswere given at school every semester for the interventiongroup.The control group did not receive comprehensiveintervention and did not have reminders of it.RESULTS:There were 651 students in the interventiongroup[mean age 7.3±0.9y;294(45.2%)girls]and 737students in the control group[mean age 7.2±0.9y;346(46.9%)girls].Overall mean myopia progression duringthe 2.5y follow-up was-0.49±1.04 diopters(D)in theintervention group and-0.65±1.08 D in the control group(P=0.004).The majority that not get myopia at baselinespherical equivalent(SE≤-1.0 D).Their mean myopiaprogression during the 2.5y follow-up was-0.37±0.89 Din the intervention group and-0.51±0.93 D in the controlgroup(27.5%reduction,P=0.009);Overall,mean axiallength elongation was less in the intervention group(0.56±0.32 mm)than in the control group(0.61±0.38 mm,10.5%reduction,P=0.009).The percentage of close reading distance(<30 cm)in the intervention group was less than in the control group(73.4%vs 76.2%,P<0.001),the percentage of everyday perform eye exercises in the intervention group was more than in the control group(27.8%vs 20.7%,P<0.001)30mo later.CONCLUSION:The comprehensive intervention program at elementary school has a significant alleviating effect on myopia progression for children during the 2.5y follow-up,especially for those non-myopia at baseline.展开更多
Purpose:To investigate the effect of proparacaine hydrochloride eye drops on emergence agitation after general anaesthesia for paediatric strabismus surgery.Methods:Paediatric patients(3-12 years-old)receiving strabis...Purpose:To investigate the effect of proparacaine hydrochloride eye drops on emergence agitation after general anaesthesia for paediatric strabismus surgery.Methods:Paediatric patients(3-12 years-old)receiving strabismus surgery were randomly assigned to receive 1-2 drops of isotonic saline(n=129)or proparacaine hydrochloride(n=129)after surgery.The incidence and degree of emergence agitation were recorded and compared between groups.Results:A significantly lower occurrence of emergence agitation was observed with proparacaine hydrochloride drops compared to isotonic saline(12.4% vs.31.8%;p<0.05).Conclusion:Proparacaine hydrochloride eye drops reduce the incidence of emergence agitation after general anaesthesia for paediatric strabismus surgery.展开更多
The Handan Offspring Myopia Study(HOMS)is the first offspring eye study in a Chinese population.The study design is based on another representative study,Handan Eye Study.In this study,we found 1 diopter(D)of generati...The Handan Offspring Myopia Study(HOMS)is the first offspring eye study in a Chinese population.The study design is based on another representative study,Handan Eye Study.In this study,we found 1 diopter(D)of generational myopic shift,a weak protective effect of the outdoor activity on myopia,and a modest protective effect of the eye exercises of acupoints on myopia,among the rural children in the northern area.展开更多
AIM:To evaluate whether a novel tyrosine kinase inhibitor nintedanib could inhibit basic fibroblast growth factor(bFGF)and vascular endothelial growth factor(VEGF)simultaneously for retinal vascular disease in vivo.ME...AIM:To evaluate whether a novel tyrosine kinase inhibitor nintedanib could inhibit basic fibroblast growth factor(bFGF)and vascular endothelial growth factor(VEGF)simultaneously for retinal vascular disease in vivo.METHODS:After a laser induced rabbit retinal vein occlusion(RVO)model was made,0.5 mg of nintedanib was injected intravitreally in the left eye on the third day while the right eye was as a control.Intracameral samples were taken on the day before laser treatment and days 1,3,7,14,21,and 28 after treatment.Enzyme-linked immunosorbent assay(ELISA)was used to test the bFGF and VEGF-A concentrations in the aqueous humor.RESULTS:Both bFGF and VEGF-A rose significantly on the third day after laser treatment in both eyes.In the control eye the bFGF concentration peaked on the 14th day while the VEGF-A concentration dropped rapidly soon after the third day.After nintadanib injection in the study eye,both bFGF and VEGF-A showed a significant reduction on the 4th day(7th day after laser treatment)when compared to the control eye,and kept on low level in the following several weeks.CONCLUSION:Intravitreal injection of nintedanib can inhibit the expression of bFGF and VEGF in the process of RVO model to a certain extent,which is expected to become a new method for the treatment of retinal vascular diseases or fibrotic diseases.展开更多
AIM:To compare the diagnostic performance of isolatedcheck visual evoked potential(ic VEP) and standard automated perimetry(SAP),for evaluating the application values of ic VEP in the detection of early glaucoma.METHO...AIM:To compare the diagnostic performance of isolatedcheck visual evoked potential(ic VEP) and standard automated perimetry(SAP),for evaluating the application values of ic VEP in the detection of early glaucoma.METHODS:Totally 144 subjects(288 eyes) were enrolled in this study.ic VEP testing was performed with the Neucodia visual electrophysiological diagnostic system.A 15% positive-contrast(bright) condition pattern was used in this device to differentiate between glaucoma patients and healthy control subjects.Signal-to-noise ratios(SNR) were derived based on a multivariate statistic.The eyes were judged as abnormal if the test yielded an SNR≤1.SAP testing was performed with the Humphrey Field Analyzer II.The visual fields were deemed as abnormality if the glaucoma hemifield test results outside normal limits;or the pattern standard deviation with P<0.05;or the cluster of three or more non-edge points on the pattern deviation plot in a single hemifield with P<0.05,one of which must have a P<0.01.Disc photographs were graded as either glaucomatous optic neuropathy or normal by two experts who were masked to all other patient information.Moorfields regression analysis(MRA) used as a separate diagnostic classification was performed by Heidelberg retina tomograph(HRT).RESULTS:When the disc photograph grader was used as diagnostic standard,the sensitivity for SAP and ic VEP was 32.3% and 38.5% respectively and specificity was 82.3% and 77.8% respectively.When the MRA Classifier was used as the diagnostic standard,the sensitivity for SAP and ic VEP was 48.6% and 51.4% respectively and specificity was 84.1% and 78.0% respectively.When the combined structural assessment was used as the diagnostic standard,the sensitivity for SAP and ic VEP was 59.2%and 53.1% respectively and specificity was 84.2% and 84.6% respectivlely.There was no statistical significance between the sensitivity or specificity of SAP and ic VEP,regardless of which diagnostic standard was based on.CONCLUSION:The diagnostic performance of ic VEP is not better than that of SAP in the detection of early glaucoma.展开更多
Chalcone is a plant metabolite widely found in fruits,vegetables,spices and tea,and has anti-tumor,anti-inflammation,immunomodulation,antibacterial and anti-oxidation activities,as well as many other pharmacological a...Chalcone is a plant metabolite widely found in fruits,vegetables,spices and tea,and has anti-tumor,anti-inflammation,immunomodulation,antibacterial and anti-oxidation activities,as well as many other pharmacological and biological effects.Our team has shown that its analogs have antioxidant activity,and oxidative stress is a pathological hallmark of retinal ischemia/reperfusion injury that can lead to retinal damage and visual loss.This investigation aims to identify a chalcone that protects retinal ganglion cells in vitro from the effects of oxidative stress and examine its mechanism.Rat retinal ganglion cell-5 cells were pretreated with chalcones and then exposed to tert-butyl hydroperoxide that causes oxidative damage.Controls received dimethyl sulfoxide only or tert-butyl hydroperoxide in dimethyl sulfoxide.Only(E)-3,4-dihydroxy-2′-methylether ketone(L2 H17),of the five chalcone analogs,markedly increased the survival rate of oxidatively injured RGC-5 cells.Thus,subsequent experiments only analyzed the results of the L2 H17 intervention.Cell viability and apoptosis were measured.Intracellular superoxide dismutase and reactive oxygen species levels were used to assess induced oxidative stress.The mechanism of action by L2 H17 was explored by measuring the ER stress/UPR pathway and the expression and localization of Nrf2.All results demonstrated that L2 H17 could reduce the apoptosis of oxidatively injured cells,inhibit caspase-3 activity,increase Bcl-2 expression,decrease Bad expression,increase the activity of superoxide dismutase,inhibit the production of reactive oxygen species,increase Nrf2 immunoreactivity,and reduce the activating transcription factor 4,phospho-eukaryotic initiation factor 2 and CHOP expression.L2 H17 protects retinal ganglion cells induced by oxidative stress by regulating Nrf2,which indicates that it has the potential to become a drug for retinal ischemia/reperfusion.展开更多
AIM: To identify the mutations in RS1 gene associated with typical phenotype of X-linked juvenile retinoschisis(XLRS) and a rare condition of concomitant glaucoma. ·METHODS: Complete ophthalmic examinations were ...AIM: To identify the mutations in RS1 gene associated with typical phenotype of X-linked juvenile retinoschisis(XLRS) and a rare condition of concomitant glaucoma. ·METHODS: Complete ophthalmic examinations were performed in the proband. The coding regions of the RS1 gene that encode retinoschisin were amplified by polymerase chain reaction and directly sequenced. ·RESULTS: The proband showed a typical phenotype of XLRS with large peripheral retinal schisis in both eyes,involving the macula and combined with foveal cystic change,reducing visual acuity. A typical phenotype of recurrent glaucoma with high intraocular pressure(IOP) and reduced visual field was also demonstrated with the patient. Mutation analysis of RS1 gene revealed R102W(c.304C>T) mutations in the affected male,and his mother was proved to be a carrier with the causative mutation and another synonymous polymorphism(c.576C>CT). ·CONCLUSION: We identified the genetic variations of a Chinese family with typical phenotype of XLRS and glaucoma. The severe XLRS phenotypes associated with R102W mutations reveal that the mutation determines a notable alteration in the function of the retinoschisin protein. Identification of the disease-causing mutation is beneficial for future clinical references.展开更多
AIM:To evaluate the accuracy and predictability of ray tracing-assisted intraocular lens(IOL) calculation function in Sirius internal software and further improve the accuracy by optimizing the calculation of predicte...AIM:To evaluate the accuracy and predictability of ray tracing-assisted intraocular lens(IOL) calculation function in Sirius internal software and further improve the accuracy by optimizing the calculation of predicted lens position(PLP).METHODS:This retrospective study recruited 52 eyes of 49 patients.All of the cases with cataract had undergone phacoemulsification combined with IOL implantation.SRK-T,Haigis formula,and Sirius ray-tracing method were all used for each eye’s IOL calculation.The mean absolute value of prediction error(prediction error=predicted refraction-postoperative refraction) was defined as mean absolute prediction error(MAPE) and was determined for each method.Calculation of PLP was optimized by effective lens position(ELP).Optimized PLP was entered to Sirius internal software again to verify whether the method was improved.RESULTS:Compared with SRK-T and Haigis formulas,less accuracy was shown in Sirius ray-tracing method(P=0.001).The ELP of the IOL moved forward compared to PLP(P<0.001).The MAPE of the ELP-inputted Sirius ray-tracing method was reduced.ELP and PLP were well correlated.Taking ELP as y and PLP given by Sirius soft as x,a linear regression formula y=0.1637 x+3.1741 was concluded(R^(2)=0.1066,P=0.018).It was shown that the optimized Sirius ray-tracing method(optimized PLP entered),compared with SRK-T and Haigis formulas,worked with the same accuracy(P=0.038).CONCLUSION:The original Sirius ray tracing method is not satisfactory enough.However,in normal eyes,the optimized Sirius ray-tracing method in IOL calculation was as accurate as SRK-T and Haigis formulas.展开更多
To assess all available data to compare the efficacy of glucocorticoids treatment and orbital decompression for dysthyroid optic neuropathy(DON).PubMed,EMBASE,the Cochrane Library databases as well as other sources we...To assess all available data to compare the efficacy of glucocorticoids treatment and orbital decompression for dysthyroid optic neuropathy(DON).PubMed,EMBASE,the Cochrane Library databases as well as other sources were searched by two independent reviewers followed by extensive hand-searching for the identification of relevant studies.The primary outcomes were the improvement in visual acuity and responder rate.Secondary outcomes were the proptosis reduction,change in diplopia,and clinical activity score(CAS).One randomized controlled trial,three retrospective case series and one prospective case series met the inclusion criteria.They were divided into intravenous high-dose glucocorticoids(ivGC)group and orbital decompression(OD)group.Both groups demonstrated improvement in visual acuity.In addition,the proportion of patients with improved vision in OD group was higher than that in ivGC group(P<0.001).Post-treatment proptosis reduction was also reported in both groups.Overall,weighted mean in proptosis reduction estimated at 1.64 and 5.45 mm in patients treated with ivGC and OD respectively.This study also presented results regarding pre-existing and new-onset diplopia.Apart from diplopia,a wide variety of minor and major complications were noted in 5 included studies.The most common complication in ivGC group and OD group was Cushing's syndrome and epistaxis respectively.The present systematic review shows that both glucocorticoids treatment and OD are effective in treating DON and OD may work better in improving visual acuity and reducing proptosis.However,high-quality,large-sample,controlled studies need to be performed in the future.展开更多
Transscleral suturing is a commonly applied technique to fix intraocular Implants in the sulcus.A major problem after transscleral implantation is suture erosion that normally happens in the late post-surgery period a...Transscleral suturing is a commonly applied technique to fix intraocular Implants in the sulcus.A major problem after transscleral implantation is suture erosion that normally happens in the late post-surgery period and may result In an Increased incidence of endophthalmitis.Here we describe an original cauterization method by using a glass rod to melt the exposed suture end without damaging the suture knot in the sclera to avoid suture exposure in sclera-fixed IOL implantation.This is a simple,quick and effective technique that can be performed without conjunctiva incisions and will help to reduce suture erosion related complications.展开更多
AIM: To evaluate contrast visual acuity(CVA) after implantation of an aspheric apodized diffractive intraocular lens(IOL) or a spherical apodized diffractive IOL in cataract surgery. ·METHODS: This prospective ra...AIM: To evaluate contrast visual acuity(CVA) after implantation of an aspheric apodized diffractive intraocular lens(IOL) or a spherical apodized diffractive IOL in cataract surgery. ·METHODS: This prospective randomized controlled study with a 12-month follow-up compared the results of cataract surgery with implantation of an aspheric AcrySof ReSTOR SN6AD3 IOL(30 eyes) and a spherical AcrySof ReSTOR SN60D3 IOL(30 eyes). CVA with best distance correction was measured at 4 contrast levels(100%,25%,10% and 5%) under 3 levels of chart luminance [250,85 and 25 candelas per square meter(cd/m2)] using a multi-functional visual acuity tester(MFVA-100). ·RESULTS: At 12 months after surgery,there were no statistically significant differences in 100% CVA and 25% CVA under 250cd/m2(P100% =0.875 and P25% =0.057) and 85cd/m2(P100% =0.198 and P25% =0.193) between the aspheric group and the spherical group. However,the 10% CVA and 5% CVA were significant better in aspheric group than spherical group under 250cd/m2(P10% =0.042 and P5% = 0.007) and 85cd/m2(P10% =0.002 and P5%=0.039). Under the luminance level of 25cd/m 2,no significant differences was found in the 100% CVA between the 2 group(P100% = 0.245),while aspheric group had better visual acuity in the remaining 3 contracts(P25% =0.023,P10% =0.026 and P5% = 0.002,respectively). ·CONCULSION: The aspheric AcrySof ReSTOR SN6AD3 IOL provided patients with better low-contrast visual acuity than the spherical AcrySof ReSTOR SN60D3 IOL.展开更多
AIM:To observe whether silicone oil(SO)tamponade could decrease macular perfusion after retinal detachment repair.METHODS:A prospective observational case-control study.Patients diagnosed with primary macular off rheg...AIM:To observe whether silicone oil(SO)tamponade could decrease macular perfusion after retinal detachment repair.METHODS:A prospective observational case-control study.Patients diagnosed with primary macular off rhegmatogenous retinal detachment undergoing successful retinal repair surgery with vitrectomy were strictly selected.Optical coherence tomography angiography findings were compared between SO and air tamponade groups.Two postoperative visiting points were set(1 and 3 mo).RESULTS:Totally 29 patients(29 eyes)were enrolled.Twenty cases had SO tamponade while 9 cases were with air tamponade.At the first visiting point,superficial parafoveal vessel density(PFSVD)significantly decreased in the SO group(P=0.0403),especially in the superior quadrant or superior-hemi area(P=0.0089,0.0426,respectively).Parafoveal deep vessel density(PFDVD)had no difference between the two groups.At the second visiting point,all quadrants of PFSVD reduced significantly in the SO group(P=0.0256,0.0001,0.0031,<0.0001 in temporal,superior,nasal,and inferior area,respectively),but PFDVD remained no different.In the air group,all areas of PFSVD showed significantly improving from the first visit to the second one(P=0.0324,0.0001,0.0371,0.0026,in temporal,superior,nasal,and inferior area,respectively);however,almost all quadrants of PFDVD showed no changes during this period.In the SO group,both PFSVD and PFDVD showed no obvious changes between the two visiting points.Besides,parafoveal full retinal thickness in the SO group reduced significantly at both visiting points over the air tamponade,while the foveal avascular zone area showed no difference in the two groups.CONCLUSION:After retinal detachment surgery with vitrectomy and SO tamponade,superficial macular perfusion and full retinal thickness could decrease obviously when compared to air tamponade.This reduction process could persist throughout the tamponade period.展开更多
BACKGROUND Retrocorneal hyaline scrolls are a rare phenomenon.We report a case of bilateral retrocorneal hyaline scrolls that were likely induced by asymptomatic congenital syphilis.CASE SUMMARY A 71-year-old woman pr...BACKGROUND Retrocorneal hyaline scrolls are a rare phenomenon.We report a case of bilateral retrocorneal hyaline scrolls that were likely induced by asymptomatic congenital syphilis.CASE SUMMARY A 71-year-old woman presented with blurred vision due to cataracts.Slit-lamp microscopy revealed bilateral hyaline scrolls with a dichotomous branching pattern extending to the anterior chamber or rods attaching to the rough posterior surface of the cornea.The patient was positive for syphilis-specific antibodies,with no ocular or systemic evidence of congenital or acquired syphilis.Binocular cataract,retrocorneal scroll,and corneal endothelial gutta were considered.The scroll of the right eye was removed during cataract surgery and further observed using hematoxylin–eosin staining and scanning electron microscopy.The cornea of the right eye remained transparent,and the residual scroll seemed stable,however,the corneal endothelial density declined at 13 mo after surgery.In vivo confocal microscopy revealed coalescence of corneal guttae at the level of the corneal endothelium or adhesion to the posterior surface of the endothelium,with enlarged endothelial cells in both eyes.Activated keratocytes in the stroma and a highly reflective acellular structure at the level of the Descemet’s membrane were observed.The removed scroll had a cartilage-like hardness and a circularly arranged fiber-like acellular structure.CONCLUSION Occult congenital syphilis could induce corneal endothelial gutta and theformation of retrocorneal scrolls without other signs of ocular syphilis.展开更多
Background:Genetic information is stored in the bases of double-stranded DNA.However,the integrity of DNA molecules is constantly threatened by various mutagenic agents,including pollutants,ultraviolet light(UV),and m...Background:Genetic information is stored in the bases of double-stranded DNA.However,the integrity of DNA molecules is constantly threatened by various mutagenic agents,including pollutants,ultraviolet light(UV),and medications.To counteract these environmental damages,cells have established multiple mechanisms,such as producing molecules to identify and eliminate damaged DNA,as well as reconstruct the original DNA structures.Failure or insufficiency of these mechanisms can cause genetic instability.However,the role of genome stability in eye diseases is still under-researched,despite extensive study in cancer biology.Main text:As the eye is directly exposed to the external environment,the genetic materials of ocular cells are constantly under threat.Some of the proteins essential for DNA damage repair,such as pRb,p53,and RAD21,are also key during the ocular disease development.In this review,we discuss five ocular diseases that are associated with genomic instability.Retinoblastoma and pterygium are linked to abnormal cell cycles.Fuchs’corneal endothelial dystrophy and age-related macular degeneration are related to the accumulation of DNA damage caused by oxidative damage and UV.The mutation of the subunit of the cohesin complex during eye development is linked to sclerocornea.Conclusions:Failure of DNA damage detection or repair leads to increased genomic instability.Deciphering the role of genomic instability in ocular diseases can lead to the development of new treatments and strategies,such as protecting vulnerable cells from risk factors or intensifying damage to unwanted cells.展开更多
Astigmatism is inevitable and inherent to progressive addition lenses(PALs), which are typically distributed in the lateral areas on both sides of the progressive corridor. In this study, we took into account the spec...Astigmatism is inevitable and inherent to progressive addition lenses(PALs), which are typically distributed in the lateral areas on both sides of the progressive corridor. In this study, we took into account the spectacle frame for the customized freeform PAL design with the variational-difference numerical approach. The PAL surface with minimized astigmatism, approximately equal to 84% of the added power, was numerically resolved without expending the zone for clear vision. We validated our approach by experimentally demonstrating the procedure from tool path generation to surface power measurement, thus providing an efficient solution to the personalization of astigmatism-minimized PAL design and manufacture.展开更多
Background:To construct a real-time computerized location system(RCLS)to analyze and display the axis of corneal astigmatism and to compare its accuracy with the Scheimpflug method.Methods:Fifty-seven eyes of 39 volun...Background:To construct a real-time computerized location system(RCLS)to analyze and display the axis of corneal astigmatism and to compare its accuracy with the Scheimpflug method.Methods:Fifty-seven eyes of 39 volunteers with corneal astigmatism more than 1.00 diopter(D)were recruited.The RCLS was composed of a circular light-emitting diode(LED)light source,surgical microscope,surgical video system,computer and self-programming image analysis software.Scheimpflug imaging measurements(Pentacam HR,Oculus,Wetzlar,Germany)were performed on all subjects to determine the axis and power of corneal astigmatism.Thereafter,the axis of corneal astigmatism was analyzed in real-time and displayed by the RCLS on supine position,and videos were recorded.The MB-Ruler 4.0 software was used to measure the astigmatic axis.The accuracy of the RCLS was compared with the Scheimpflug method.Results:The RCLS was able to display the axis of corneal astigmatism in real-time.The axial deviation of corneal astigmatism between the two methods was 0.63±3.78°when astigmatism was 1.00 to 2.00 D and decreased to 0.06±1.38°when astigmatism was greater than 2.00 D.A linear correlation of astigmatic axis was noted between the two methods:Axis_(RCLS)=1.01×Axis_(Scheimpflug)−1.02(R^(2)=0.998,P<0.001).The Bland-Altman analysis revealed that the RCLS agreed sufficiently well with the Scheimpflug method.Conclusions:The RCLS can accurately analyze and display the axis for corneal astigmatism greater than 1.00 D in real-time.The RCLS simplifies marking procedures and may have potential clinical application to improve the postoperative visual outcomes in surgical correction of corneal astigmatism.展开更多
Background:To describe the surgical technique and assess the clinical efficacy and safety of modified endoscopic transnasal orbital apex decompression in the treatment of dysthyroid optic neuropathy.Methods:In this re...Background:To describe the surgical technique and assess the clinical efficacy and safety of modified endoscopic transnasal orbital apex decompression in the treatment of dysthyroid optic neuropathy.Methods:In this retrospective research,forty-two subjects(74 orbits)who underwent modified endoscopic transnasal orbital apex decompression for the treatment of dysthyroid optic neuropathy were enrolled.Preoperative and postoperative best-corrected visual acuity(BCVA),visual field mean deviation(MD),Hertel exophthalmometry,and new onset diplopia were assessed before and after the intervention.The Wilcoxon test was used for differential analysis.Linear mixed-models’analyses were conducted to assess the potential predictors for BCVA change.Results:Postoperatively,the mean BCVA improved from 0.70±0.62 logMAR to 0.22±0.33 logMAR.BCVA significantly improved in 69 eyes(93%),remained stable in 4 eyes(5%)and deteriorated in 1 eye(1%).MD of visual fields improved from−13.73±9.22 dB to−7.23±7.04 dB.Proptosis decreased from 19.57±3.38mm to 16.35±3.01mm.Preoperative BCVA,MD of visual fields and medical rectus diameter were independent factors associated with improvements in BCVA(P<0.05)by linear mixed-models’analyses.Eighteen patients(42.9%)developed new diplopia postoperatively.Conclusion:Modified endoscopic transnasal orbital apex decompression effectively restores vision in dysthyroid optic neuropathy.展开更多
文摘AIM:To investigate the efficacy of a new visual acuity(VA)screening method,the baby vision test for young children.METHODS:A total 105 eyes of 65 children aged 2-8y were included in the study.Acuity testing was conducted using a standardized recognition acuity chart(Snellen visual chart:at 3 m)and the baby vision model assessment.The baby vision device includes a screen,a near infrared camera and a computer.Children were seated at a measured distance of 33-40 cm from a display for testing.VA was estimated according to the highest resolution the children could follow.Decimal VA data were converted to logarithm of the minimum angle of resolution(logMAR)for statistical analysis.The VA results for each child were recorded and analyzed for consistency.RESULTS:The mean VA measured using the Snellen visual chart was 0.62±0.32,and that assessed using the baby vision test was 0.66±0.27.The 95%limit of agreement was-0.609 to 0.695,with 95.2%(100/105)plots within the 95%limits of agreement.VA values of the baby vision test were significantly correlated with those of the Snellen chart(R=0.274,P=0.005).CONCLUSION:The baby vision test can be used as a relatively reliable method for estimating VA in young children.This new acuity assessment might be a valid predictor of optotype-measured acuity later in preverbal children.
基金Supported by National Natural Science Foundation of China(No.81873683)。
文摘AIM:To investigate the effects of school-basedcomprehensive intervention on myopia development inelementary school children.METHODS:As a part of the Wenzhou Epidemiologyof Refraction Error Study,there were 1524 participatingelementary students(730 girls,47.9%)in grades 1 to3 from three campuses of one school,aged 7.3±0.9y,who were examined twice every year for a 2.5y follow upperiod.Comprehensive intervention and other reminderswere given at school every semester for the interventiongroup.The control group did not receive comprehensiveintervention and did not have reminders of it.RESULTS:There were 651 students in the interventiongroup[mean age 7.3±0.9y;294(45.2%)girls]and 737students in the control group[mean age 7.2±0.9y;346(46.9%)girls].Overall mean myopia progression duringthe 2.5y follow-up was-0.49±1.04 diopters(D)in theintervention group and-0.65±1.08 D in the control group(P=0.004).The majority that not get myopia at baselinespherical equivalent(SE≤-1.0 D).Their mean myopiaprogression during the 2.5y follow-up was-0.37±0.89 Din the intervention group and-0.51±0.93 D in the controlgroup(27.5%reduction,P=0.009);Overall,mean axiallength elongation was less in the intervention group(0.56±0.32 mm)than in the control group(0.61±0.38 mm,10.5%reduction,P=0.009).The percentage of close reading distance(<30 cm)in the intervention group was less than in the control group(73.4%vs 76.2%,P<0.001),the percentage of everyday perform eye exercises in the intervention group was more than in the control group(27.8%vs 20.7%,P<0.001)30mo later.CONCLUSION:The comprehensive intervention program at elementary school has a significant alleviating effect on myopia progression for children during the 2.5y follow-up,especially for those non-myopia at baseline.
文摘Purpose:To investigate the effect of proparacaine hydrochloride eye drops on emergence agitation after general anaesthesia for paediatric strabismus surgery.Methods:Paediatric patients(3-12 years-old)receiving strabismus surgery were randomly assigned to receive 1-2 drops of isotonic saline(n=129)or proparacaine hydrochloride(n=129)after surgery.The incidence and degree of emergence agitation were recorded and compared between groups.Results:A significantly lower occurrence of emergence agitation was observed with proparacaine hydrochloride drops compared to isotonic saline(12.4% vs.31.8%;p<0.05).Conclusion:Proparacaine hydrochloride eye drops reduce the incidence of emergence agitation after general anaesthesia for paediatric strabismus surgery.
基金This study is funded by Wenzhou Medical University R&D Fund(No.QTJ13009)Zhejiang Province Health Innovation Talents Fund(No.2016025).
文摘The Handan Offspring Myopia Study(HOMS)is the first offspring eye study in a Chinese population.The study design is based on another representative study,Handan Eye Study.In this study,we found 1 diopter(D)of generational myopic shift,a weak protective effect of the outdoor activity on myopia,and a modest protective effect of the eye exercises of acupoints on myopia,among the rural children in the northern area.
基金Supported by Medical Health Science and Technology Project of Zhejiang Province(No.2020KY654).
文摘AIM:To evaluate whether a novel tyrosine kinase inhibitor nintedanib could inhibit basic fibroblast growth factor(bFGF)and vascular endothelial growth factor(VEGF)simultaneously for retinal vascular disease in vivo.METHODS:After a laser induced rabbit retinal vein occlusion(RVO)model was made,0.5 mg of nintedanib was injected intravitreally in the left eye on the third day while the right eye was as a control.Intracameral samples were taken on the day before laser treatment and days 1,3,7,14,21,and 28 after treatment.Enzyme-linked immunosorbent assay(ELISA)was used to test the bFGF and VEGF-A concentrations in the aqueous humor.RESULTS:Both bFGF and VEGF-A rose significantly on the third day after laser treatment in both eyes.In the control eye the bFGF concentration peaked on the 14th day while the VEGF-A concentration dropped rapidly soon after the third day.After nintadanib injection in the study eye,both bFGF and VEGF-A showed a significant reduction on the 4th day(7th day after laser treatment)when compared to the control eye,and kept on low level in the following several weeks.CONCLUSION:Intravitreal injection of nintedanib can inhibit the expression of bFGF and VEGF in the process of RVO model to a certain extent,which is expected to become a new method for the treatment of retinal vascular diseases or fibrotic diseases.
基金Supported by the Plan of Wenzhou Science and Technology(No.Y20160439)
文摘AIM:To compare the diagnostic performance of isolatedcheck visual evoked potential(ic VEP) and standard automated perimetry(SAP),for evaluating the application values of ic VEP in the detection of early glaucoma.METHODS:Totally 144 subjects(288 eyes) were enrolled in this study.ic VEP testing was performed with the Neucodia visual electrophysiological diagnostic system.A 15% positive-contrast(bright) condition pattern was used in this device to differentiate between glaucoma patients and healthy control subjects.Signal-to-noise ratios(SNR) were derived based on a multivariate statistic.The eyes were judged as abnormal if the test yielded an SNR≤1.SAP testing was performed with the Humphrey Field Analyzer II.The visual fields were deemed as abnormality if the glaucoma hemifield test results outside normal limits;or the pattern standard deviation with P<0.05;or the cluster of three or more non-edge points on the pattern deviation plot in a single hemifield with P<0.05,one of which must have a P<0.01.Disc photographs were graded as either glaucomatous optic neuropathy or normal by two experts who were masked to all other patient information.Moorfields regression analysis(MRA) used as a separate diagnostic classification was performed by Heidelberg retina tomograph(HRT).RESULTS:When the disc photograph grader was used as diagnostic standard,the sensitivity for SAP and ic VEP was 32.3% and 38.5% respectively and specificity was 82.3% and 77.8% respectively.When the MRA Classifier was used as the diagnostic standard,the sensitivity for SAP and ic VEP was 48.6% and 51.4% respectively and specificity was 84.1% and 78.0% respectively.When the combined structural assessment was used as the diagnostic standard,the sensitivity for SAP and ic VEP was 59.2%and 53.1% respectively and specificity was 84.2% and 84.6% respectivlely.There was no statistical significance between the sensitivity or specificity of SAP and ic VEP,regardless of which diagnostic standard was based on.CONCLUSION:The diagnostic performance of ic VEP is not better than that of SAP in the detection of early glaucoma.
基金supported by the National Natural Science Foundation of China,No.81473295(to ZMS),81373312(to XZ)and 81371028(to WCW)
文摘Chalcone is a plant metabolite widely found in fruits,vegetables,spices and tea,and has anti-tumor,anti-inflammation,immunomodulation,antibacterial and anti-oxidation activities,as well as many other pharmacological and biological effects.Our team has shown that its analogs have antioxidant activity,and oxidative stress is a pathological hallmark of retinal ischemia/reperfusion injury that can lead to retinal damage and visual loss.This investigation aims to identify a chalcone that protects retinal ganglion cells in vitro from the effects of oxidative stress and examine its mechanism.Rat retinal ganglion cell-5 cells were pretreated with chalcones and then exposed to tert-butyl hydroperoxide that causes oxidative damage.Controls received dimethyl sulfoxide only or tert-butyl hydroperoxide in dimethyl sulfoxide.Only(E)-3,4-dihydroxy-2′-methylether ketone(L2 H17),of the five chalcone analogs,markedly increased the survival rate of oxidatively injured RGC-5 cells.Thus,subsequent experiments only analyzed the results of the L2 H17 intervention.Cell viability and apoptosis were measured.Intracellular superoxide dismutase and reactive oxygen species levels were used to assess induced oxidative stress.The mechanism of action by L2 H17 was explored by measuring the ER stress/UPR pathway and the expression and localization of Nrf2.All results demonstrated that L2 H17 could reduce the apoptosis of oxidatively injured cells,inhibit caspase-3 activity,increase Bcl-2 expression,decrease Bad expression,increase the activity of superoxide dismutase,inhibit the production of reactive oxygen species,increase Nrf2 immunoreactivity,and reduce the activating transcription factor 4,phospho-eukaryotic initiation factor 2 and CHOP expression.L2 H17 protects retinal ganglion cells induced by oxidative stress by regulating Nrf2,which indicates that it has the potential to become a drug for retinal ischemia/reperfusion.
基金Supported by the National Key Basic Research Program(2013CB967502,2013CB967503)Most Major Projects(2012YQ12008004)+1 种基金Qianjiang Talents Project(2012R10072)Zhejiang Provincial Natural Science Foundation of China(No.LR13H120001)
文摘AIM: To identify the mutations in RS1 gene associated with typical phenotype of X-linked juvenile retinoschisis(XLRS) and a rare condition of concomitant glaucoma. ·METHODS: Complete ophthalmic examinations were performed in the proband. The coding regions of the RS1 gene that encode retinoschisin were amplified by polymerase chain reaction and directly sequenced. ·RESULTS: The proband showed a typical phenotype of XLRS with large peripheral retinal schisis in both eyes,involving the macula and combined with foveal cystic change,reducing visual acuity. A typical phenotype of recurrent glaucoma with high intraocular pressure(IOP) and reduced visual field was also demonstrated with the patient. Mutation analysis of RS1 gene revealed R102W(c.304C>T) mutations in the affected male,and his mother was proved to be a carrier with the causative mutation and another synonymous polymorphism(c.576C>CT). ·CONCLUSION: We identified the genetic variations of a Chinese family with typical phenotype of XLRS and glaucoma. The severe XLRS phenotypes associated with R102W mutations reveal that the mutation determines a notable alteration in the function of the retinoschisin protein. Identification of the disease-causing mutation is beneficial for future clinical references.
基金Supported by the Basic Scientific Research Project of Wenzhou (No.2020Y0599)。
文摘AIM:To evaluate the accuracy and predictability of ray tracing-assisted intraocular lens(IOL) calculation function in Sirius internal software and further improve the accuracy by optimizing the calculation of predicted lens position(PLP).METHODS:This retrospective study recruited 52 eyes of 49 patients.All of the cases with cataract had undergone phacoemulsification combined with IOL implantation.SRK-T,Haigis formula,and Sirius ray-tracing method were all used for each eye’s IOL calculation.The mean absolute value of prediction error(prediction error=predicted refraction-postoperative refraction) was defined as mean absolute prediction error(MAPE) and was determined for each method.Calculation of PLP was optimized by effective lens position(ELP).Optimized PLP was entered to Sirius internal software again to verify whether the method was improved.RESULTS:Compared with SRK-T and Haigis formulas,less accuracy was shown in Sirius ray-tracing method(P=0.001).The ELP of the IOL moved forward compared to PLP(P<0.001).The MAPE of the ELP-inputted Sirius ray-tracing method was reduced.ELP and PLP were well correlated.Taking ELP as y and PLP given by Sirius soft as x,a linear regression formula y=0.1637 x+3.1741 was concluded(R^(2)=0.1066,P=0.018).It was shown that the optimized Sirius ray-tracing method(optimized PLP entered),compared with SRK-T and Haigis formulas,worked with the same accuracy(P=0.038).CONCLUSION:The original Sirius ray tracing method is not satisfactory enough.However,in normal eyes,the optimized Sirius ray-tracing method in IOL calculation was as accurate as SRK-T and Haigis formulas.
基金Supported by the Natural Science Foundation of China(No.81770926)the Natural Key Research and Development Program of China(No.2016YFC1101200)。
文摘To assess all available data to compare the efficacy of glucocorticoids treatment and orbital decompression for dysthyroid optic neuropathy(DON).PubMed,EMBASE,the Cochrane Library databases as well as other sources were searched by two independent reviewers followed by extensive hand-searching for the identification of relevant studies.The primary outcomes were the improvement in visual acuity and responder rate.Secondary outcomes were the proptosis reduction,change in diplopia,and clinical activity score(CAS).One randomized controlled trial,three retrospective case series and one prospective case series met the inclusion criteria.They were divided into intravenous high-dose glucocorticoids(ivGC)group and orbital decompression(OD)group.Both groups demonstrated improvement in visual acuity.In addition,the proportion of patients with improved vision in OD group was higher than that in ivGC group(P<0.001).Post-treatment proptosis reduction was also reported in both groups.Overall,weighted mean in proptosis reduction estimated at 1.64 and 5.45 mm in patients treated with ivGC and OD respectively.This study also presented results regarding pre-existing and new-onset diplopia.Apart from diplopia,a wide variety of minor and major complications were noted in 5 included studies.The most common complication in ivGC group and OD group was Cushing's syndrome and epistaxis respectively.The present systematic review shows that both glucocorticoids treatment and OD are effective in treating DON and OD may work better in improving visual acuity and reducing proptosis.However,high-quality,large-sample,controlled studies need to be performed in the future.
基金The Bureau of Science and Technology of Wenzhou,Zhejiang Province,China(No.Y20100196)
文摘Transscleral suturing is a commonly applied technique to fix intraocular Implants in the sulcus.A major problem after transscleral implantation is suture erosion that normally happens in the late post-surgery period and may result In an Increased incidence of endophthalmitis.Here we describe an original cauterization method by using a glass rod to melt the exposed suture end without damaging the suture knot in the sclera to avoid suture exposure in sclera-fixed IOL implantation.This is a simple,quick and effective technique that can be performed without conjunctiva incisions and will help to reduce suture erosion related complications.
文摘AIM: To evaluate contrast visual acuity(CVA) after implantation of an aspheric apodized diffractive intraocular lens(IOL) or a spherical apodized diffractive IOL in cataract surgery. ·METHODS: This prospective randomized controlled study with a 12-month follow-up compared the results of cataract surgery with implantation of an aspheric AcrySof ReSTOR SN6AD3 IOL(30 eyes) and a spherical AcrySof ReSTOR SN60D3 IOL(30 eyes). CVA with best distance correction was measured at 4 contrast levels(100%,25%,10% and 5%) under 3 levels of chart luminance [250,85 and 25 candelas per square meter(cd/m2)] using a multi-functional visual acuity tester(MFVA-100). ·RESULTS: At 12 months after surgery,there were no statistically significant differences in 100% CVA and 25% CVA under 250cd/m2(P100% =0.875 and P25% =0.057) and 85cd/m2(P100% =0.198 and P25% =0.193) between the aspheric group and the spherical group. However,the 10% CVA and 5% CVA were significant better in aspheric group than spherical group under 250cd/m2(P10% =0.042 and P5% = 0.007) and 85cd/m2(P10% =0.002 and P5%=0.039). Under the luminance level of 25cd/m 2,no significant differences was found in the 100% CVA between the 2 group(P100% = 0.245),while aspheric group had better visual acuity in the remaining 3 contracts(P25% =0.023,P10% =0.026 and P5% = 0.002,respectively). ·CONCULSION: The aspheric AcrySof ReSTOR SN6AD3 IOL provided patients with better low-contrast visual acuity than the spherical AcrySof ReSTOR SN60D3 IOL.
基金Wenzhou Municipal Science and Technology Bureau(No.Y20180730)。
文摘AIM:To observe whether silicone oil(SO)tamponade could decrease macular perfusion after retinal detachment repair.METHODS:A prospective observational case-control study.Patients diagnosed with primary macular off rhegmatogenous retinal detachment undergoing successful retinal repair surgery with vitrectomy were strictly selected.Optical coherence tomography angiography findings were compared between SO and air tamponade groups.Two postoperative visiting points were set(1 and 3 mo).RESULTS:Totally 29 patients(29 eyes)were enrolled.Twenty cases had SO tamponade while 9 cases were with air tamponade.At the first visiting point,superficial parafoveal vessel density(PFSVD)significantly decreased in the SO group(P=0.0403),especially in the superior quadrant or superior-hemi area(P=0.0089,0.0426,respectively).Parafoveal deep vessel density(PFDVD)had no difference between the two groups.At the second visiting point,all quadrants of PFSVD reduced significantly in the SO group(P=0.0256,0.0001,0.0031,<0.0001 in temporal,superior,nasal,and inferior area,respectively),but PFDVD remained no different.In the air group,all areas of PFSVD showed significantly improving from the first visit to the second one(P=0.0324,0.0001,0.0371,0.0026,in temporal,superior,nasal,and inferior area,respectively);however,almost all quadrants of PFDVD showed no changes during this period.In the SO group,both PFSVD and PFDVD showed no obvious changes between the two visiting points.Besides,parafoveal full retinal thickness in the SO group reduced significantly at both visiting points over the air tamponade,while the foveal avascular zone area showed no difference in the two groups.CONCLUSION:After retinal detachment surgery with vitrectomy and SO tamponade,superficial macular perfusion and full retinal thickness could decrease obviously when compared to air tamponade.This reduction process could persist throughout the tamponade period.
基金Zhejiang Provincial Medical and Health Technology Project,No.2020KY215.
文摘BACKGROUND Retrocorneal hyaline scrolls are a rare phenomenon.We report a case of bilateral retrocorneal hyaline scrolls that were likely induced by asymptomatic congenital syphilis.CASE SUMMARY A 71-year-old woman presented with blurred vision due to cataracts.Slit-lamp microscopy revealed bilateral hyaline scrolls with a dichotomous branching pattern extending to the anterior chamber or rods attaching to the rough posterior surface of the cornea.The patient was positive for syphilis-specific antibodies,with no ocular or systemic evidence of congenital or acquired syphilis.Binocular cataract,retrocorneal scroll,and corneal endothelial gutta were considered.The scroll of the right eye was removed during cataract surgery and further observed using hematoxylin–eosin staining and scanning electron microscopy.The cornea of the right eye remained transparent,and the residual scroll seemed stable,however,the corneal endothelial density declined at 13 mo after surgery.In vivo confocal microscopy revealed coalescence of corneal guttae at the level of the corneal endothelium or adhesion to the posterior surface of the endothelium,with enlarged endothelial cells in both eyes.Activated keratocytes in the stroma and a highly reflective acellular structure at the level of the Descemet’s membrane were observed.The removed scroll had a cartilage-like hardness and a circularly arranged fiber-like acellular structure.CONCLUSION Occult congenital syphilis could induce corneal endothelial gutta and theformation of retrocorneal scrolls without other signs of ocular syphilis.
基金supported by the Shandong Provincial Natural Science Foundation (ZR2020QH140 to B.N.Z.)the National Natural Science Foundation of China (82101091 to B.N.Z.).
文摘Background:Genetic information is stored in the bases of double-stranded DNA.However,the integrity of DNA molecules is constantly threatened by various mutagenic agents,including pollutants,ultraviolet light(UV),and medications.To counteract these environmental damages,cells have established multiple mechanisms,such as producing molecules to identify and eliminate damaged DNA,as well as reconstruct the original DNA structures.Failure or insufficiency of these mechanisms can cause genetic instability.However,the role of genome stability in eye diseases is still under-researched,despite extensive study in cancer biology.Main text:As the eye is directly exposed to the external environment,the genetic materials of ocular cells are constantly under threat.Some of the proteins essential for DNA damage repair,such as pRb,p53,and RAD21,are also key during the ocular disease development.In this review,we discuss five ocular diseases that are associated with genomic instability.Retinoblastoma and pterygium are linked to abnormal cell cycles.Fuchs’corneal endothelial dystrophy and age-related macular degeneration are related to the accumulation of DNA damage caused by oxidative damage and UV.The mutation of the subunit of the cohesin complex during eye development is linked to sclerocornea.Conclusions:Failure of DNA damage detection or repair leads to increased genomic instability.Deciphering the role of genomic instability in ocular diseases can lead to the development of new treatments and strategies,such as protecting vulnerable cells from risk factors or intensifying damage to unwanted cells.
基金supported by the National Natural Science Foundation of China(No.61775171)the Natural Science Foundation of Zhejiang Province(Nos.LY14F050009 and LY16H120007)+1 种基金the Science and Technology Program of Wenzhou(Nos.G20160033 and Y20160438)the National Key Research and Development Program of China(No.2016YFC0100200)
文摘Astigmatism is inevitable and inherent to progressive addition lenses(PALs), which are typically distributed in the lateral areas on both sides of the progressive corridor. In this study, we took into account the spectacle frame for the customized freeform PAL design with the variational-difference numerical approach. The PAL surface with minimized astigmatism, approximately equal to 84% of the added power, was numerically resolved without expending the zone for clear vision. We validated our approach by experimentally demonstrating the procedure from tool path generation to surface power measurement, thus providing an efficient solution to the personalization of astigmatism-minimized PAL design and manufacture.
基金funded by the Nature and Science Foundation of China(Grant No.81570869)Nature and Science Foundation of Zhejiang Province,China(Grant No.Y2110784)+2 种基金Zhejiang Provincial Foundation of China for Distinguished Young Talents in Medicine and Health(Grant No.2010QNA018)Foundation of Wenzhou City Science&Technology Bureau(Grant No.Y20140705)Engineering Development Project of Ophthalmology and Optometry(Grant No.GCKF201601).
文摘Background:To construct a real-time computerized location system(RCLS)to analyze and display the axis of corneal astigmatism and to compare its accuracy with the Scheimpflug method.Methods:Fifty-seven eyes of 39 volunteers with corneal astigmatism more than 1.00 diopter(D)were recruited.The RCLS was composed of a circular light-emitting diode(LED)light source,surgical microscope,surgical video system,computer and self-programming image analysis software.Scheimpflug imaging measurements(Pentacam HR,Oculus,Wetzlar,Germany)were performed on all subjects to determine the axis and power of corneal astigmatism.Thereafter,the axis of corneal astigmatism was analyzed in real-time and displayed by the RCLS on supine position,and videos were recorded.The MB-Ruler 4.0 software was used to measure the astigmatic axis.The accuracy of the RCLS was compared with the Scheimpflug method.Results:The RCLS was able to display the axis of corneal astigmatism in real-time.The axial deviation of corneal astigmatism between the two methods was 0.63±3.78°when astigmatism was 1.00 to 2.00 D and decreased to 0.06±1.38°when astigmatism was greater than 2.00 D.A linear correlation of astigmatic axis was noted between the two methods:Axis_(RCLS)=1.01×Axis_(Scheimpflug)−1.02(R^(2)=0.998,P<0.001).The Bland-Altman analysis revealed that the RCLS agreed sufficiently well with the Scheimpflug method.Conclusions:The RCLS can accurately analyze and display the axis for corneal astigmatism greater than 1.00 D in real-time.The RCLS simplifies marking procedures and may have potential clinical application to improve the postoperative visual outcomes in surgical correction of corneal astigmatism.
基金supported by the Natural Key Research and Development Program of China(2016YFC1101200).
文摘Background:To describe the surgical technique and assess the clinical efficacy and safety of modified endoscopic transnasal orbital apex decompression in the treatment of dysthyroid optic neuropathy.Methods:In this retrospective research,forty-two subjects(74 orbits)who underwent modified endoscopic transnasal orbital apex decompression for the treatment of dysthyroid optic neuropathy were enrolled.Preoperative and postoperative best-corrected visual acuity(BCVA),visual field mean deviation(MD),Hertel exophthalmometry,and new onset diplopia were assessed before and after the intervention.The Wilcoxon test was used for differential analysis.Linear mixed-models’analyses were conducted to assess the potential predictors for BCVA change.Results:Postoperatively,the mean BCVA improved from 0.70±0.62 logMAR to 0.22±0.33 logMAR.BCVA significantly improved in 69 eyes(93%),remained stable in 4 eyes(5%)and deteriorated in 1 eye(1%).MD of visual fields improved from−13.73±9.22 dB to−7.23±7.04 dB.Proptosis decreased from 19.57±3.38mm to 16.35±3.01mm.Preoperative BCVA,MD of visual fields and medical rectus diameter were independent factors associated with improvements in BCVA(P<0.05)by linear mixed-models’analyses.Eighteen patients(42.9%)developed new diplopia postoperatively.Conclusion:Modified endoscopic transnasal orbital apex decompression effectively restores vision in dysthyroid optic neuropathy.
