Objective To determine the correlation between central macular thickness (CMT) and the visual function in patients iwht macular edema (ME). Methods The clinical data of 42 eyes of 40 patients with ME which were examined by optical coherence tomography (OCT) and microperimetry (MP-1) were retrospectively analyzed. In 40 patients (42 eyes), diabetic ME (DME) was in 27 eyes，branch retinal vein occlusion was in 11eyes, and central retinal vein occlusion was in 4 eyes. All of the eyes had undergone OCT，MP-1 and best-corrected visual acuity (BCVA) test. Central macular thickness (CMT) was measured by fast macular scans using OCT. Retinal sensitivity (MS) and fixation patterns were evaluated by Mp-1. The position was chosen :2 disc diameters (DD) temporal to the disc and one third of a DD inferior to the centre of the disc. Results The correlation between CMT and BCVA is not significant (r＝－0.429，P=0.069) as well as the correlation between CMT and MS (r＝－0.433，P=0.058). The difference of CMT between the unstable and stable group was significant (F=3.262, P=0.039）. The difference of CMT between the central fixation group and preferred retinal locus (PRL) group was significant (F=3.173, P=0.044). Conclusions BCVA and MS have no significant correlation with CMT. When CMT increases, the fixation stability decreases, fixation location.changes, and PRL occurs.
【摘要】 目的 观察综合疗法治疗大龄儿童弱视的疗效。 方法 回顾分析2008年1月-2010年10月在我院初诊并经综合治疗的8～13岁弱视儿童62例85只眼的临床资料。治疗前最佳矫正视力0.1~0.7，平均0.46±0.17。观察患者经弱视综合治疗后视力、空间对比敏感度及立体视提升效果。 结果 治疗后视力正常22例31只眼（36.5%），进步29例39只眼（45.9%），无效11例15只眼（17.6%）；总有效率82.4%，与治疗前相比，差异有统计学意义（Plt;0.001）。空间对比敏感度基本正常11例16只眼（18.8%），进步43例58只眼（68.2%），无效8例11只眼（12.9%）。弱视眼在1.5、3、6三个低空间频率的对比敏感度值与治疗前相比提升有统计学意义（Plt;0.001）；在12和18两个高空间频率，对比敏感度值与治疗前相比提升无统计学意义（Pgt;0.05）。立体视锐度正常12例（19.4%），进步26例（41.9%），无效24例（38.7%），立体视锐度与治疗前相比提升具有统计学意义（Plt;0.001）。 结论 综合疗法治疗大龄儿童弱视能取得令人较为满意的疗效，患儿视力显著提升，低到中等频率空间对比敏感度及立体视锐度也有较大提升。【Abstract】 Objective To explore the therapeutic effect of comprehensive therapy on elder children with amblyopia. Methods The clinical data of 62 patients (85 eyes) with amblyopia who underwent the comprehensive therapy between January 2008 and October 2010 were retrospectively analyzed. The best-corrected visual acuity was 0.1-0.7 (mean 0.46±0.17) before the treatment. The visual acuity, spatial contrast sensitivity and stereoacuity of the patients after the treatment were observed. Results After the comprehensive therapy, the visual acuity was normal in 22 patients (31 eyes, 36.5%), improved in 29 patients (39 eyes, 45.9%), invalid in 11 patients (15 eyes, 17.6%). The total effective rate was 82.4% which was differed significantly from that before the treatment (Plt;0.001). The spatial contrast sensitivity was almost normal in 11 patients (16 eyes, 18.8%), improved in 43 patients (58 eyes, 68.2%), and invalid in 8 patients (11 eyes, 12.9%). The examination of spatial contrast sensitivity showed that the improvement was only statistically significant when frequency equates 1.5, 3, or 6 (Plt;0.001) compared with those before the treatment; while no statistically significant improvement was observed in higher frequencies of 12, 18 (Pgt;0.05). The stereoacuity was normal in 12 patients (19.4%), improved in 26 (41.9%), and invalid in 24 (38.7%); the difference in stereoacuity before and after the treatment was significant (Plt;0.001). Conclusion The therapeutic effect of comprehensive therapy is good: the visual acuity of the patients improves obviously, and the low to middle spatial contrast sensitivity and stereoacuity improve apparently.
目的:分析探讨单眼散光弱视患儿对比敏感度(CS)视功能的受损特点。方法:对正常儿童组36例、单眼散光弱视组34例、单眼非散光弱视组33例,共103例,用静态F.A.C.T图表和计算机Gabor斑CS检查程序分别检查患儿对侧眼、弱视眼及90°和180°两主子午线方向上的对比敏感度。结果:①单眼散光弱视组和单眼非散光弱视组的对侧眼、弱视眼的CS值在所有空间频率均较正常组的CS降低(Plt;0.05),表现为中、高空间频率区CS的明显受损(Plt;0.01)。②单眼散光弱视组的弱视眼在90°和180°两主子午线方向上的对比敏感度有显著差异(Plt;0.01)。结论:弱视儿童的对侧眼不正常。用计算机Gabor斑检查可以了解弱视散光儿童不同子午线上的CS存在的差异,明确定位弱子午线,并可以针对子午线性弱视,进一步开展知觉学习的治疗。
We conducted this study to explore the influence of the ocular residual aberrations changes on contrast sensitivity (CS) function in eyes undergoing orthokeratology using adaptive optics technique. Nineteen subjects' nineteen eyes were included in this study. The subjects were between 12 and 20 years (14.27±2.23 years) of age. An adaptive optics (AO) system was adopted to measure and compensate the residual aberrations through a 4-mm artificial pupil, and at the same time the contrast sensitivities were measured at five spatial frequencies (2,4,8,16, and 32 cycles per degree).The CS measurements with and without AO correction were completed. The sequence of the measurements with and without AO correction was randomly arranged without informing the observers. A two-interval forced-choice procedure was used for the CS measurements. The paired t-test was used to compare the contrast sensitivity with and without AO correction at each spatial frequency. The results revealed that the AO system decreased the mean total root mean square (RMS) from 0.356 μm to 0.160 μm(t=10.517, P＜0.001), and the mean total higher-order RMS from 0.246 μm to 0.095 μm(t=10.113, P＜0.001). The difference in log contrast sensitivity with and without AO correction was significant only at 8 cpd (t=-2.51, P=0.02). Thereby we concluded that correcting the ocular residual aberrations using adaptive optics technique could improve the contrast sensitivity function at intermediate spatial frequency in patients undergoing orthokeratology.
ObjectiveTo observe the contrast sensitivity (CS) of patients with branch retinal vein occlusion (BRVO) without involving the macular region. Methods92 BRVO patients (93 eyes) and 56 cases (112 eyes) without eye diseases (control group) were included in the study. According to different region, BRVO patients were divided into the nasal BRVO group (31 eyes) and temporal BRVO (62 eyes) group, and the average corrected visual acuity was 1.02±0.13 and 0.98±0.12 respectively. According to the type of ischemia, BRVO patients were divided into the nonischemic BRVO group (58 eyes) and ischemic BRVO group (35 eyes), the average corrected visual acuity was 1.01±0.14 and 0.99±0.12 respectively. The average corrected visual acuity of the control group was 1.03±0.11. There was no statistically significant difference of the average corrected visual acuity between nasal BRVO group, temporal BRVO group and control group (F=3.03, P=0.06), and between nonischemic BRVO group, ischemic BRVO group and control group (F=1.60,P=0.20). Contrast sensitivity (CS) was measured by OPTEC 6500 vision tester (Stereo Company, USA) under the standard lighting conditions and different spatial frequencies including low (1.5 and 3.0 c/d), medium (6.0 c/d) and high frequencies (12.0 and 18.0 c/d). ResultsThe CS under each spatial frequency of the nasal BRVO group was the same as the control group (t=4.25, 9.48, 3.08, 5.86, 0.94; P>0.05), but the CS under each spatial frequency of the temporal BRVO group was different from the control group (t=8.59, 19.11, 10.38, 17.28, 6.01; P<0.05). The CS under high spatial frequency of the temporal and nasal BRVO group was statistically different (t=11.42, 6.95; P<0.05). The CS under each spatial frequency of the ischemic BRVO group was different from the control group (t=8.88, 10.56, 11.64, 19.06, 6.67; P<0.05).The CS under 6, 12 and 18 c/d spatial frequency of the nonischemic BRVO group was statistically different with the control group (t=10.14, 11.54, 2.82; P<0.05). The CS under 12 and 18 c/d spatial frequency of the nonischemic BRVO group was statistically different with the ischemic BRVO (t=7.52, 3.84; P<0.05). ConclusionsThe CS of the temporal BRVO and ischemic BRVO decreased more significantly under each spatial frequency. CS is a better indicator to evaluate the visual function than the visual acuity in BRVO without involving the macular region.
ObjectiveTo observe the changes of macular visual function after myopic foveoschisis (MF) and pars plana vitrectomy (PPV) combined with internal limiting membrane peeling and air filling. MethodsA single-center, retrospective study. From October 2018 to October 2019, 29 MF inpatients (32 eyes) in Tianjin Eye Hospital were included in this study. There were 3 males (4 eyes) and 26 females (28 eyes). The age was 63.00±3.45 years old. Equivalent spherical lens degree was －14.16±2.54 D, and axial length was 29.14±1.04 mm. Among them, 3 patients (3 eyes) had lamellar macular holes. All eyes underwent standard pars plana three-channel 25G PPV combined with internal limiting membrane peeling and air filling. Before surgery and at 1, 3, and 6 months after surgery, macular microperimetry was performed with a macular integrity assessment instrument, and the mean retinal sensitivitie (MS) within 10° of the macula, fovea 2° and 4° fixation rates (P1, P2), 63% and 95% bivariate contour ellipse area (BCEA) were recorded. The comparison of MS, P1, P2, 63%BCEA and 95%BCEA at different times before and after surgery was performed by paired t test; the comparison of fixation stability rate was performed by χ2 test. ResultsCompared with before surgery, there were significant differences in the improvement of MS in affected eyes at 1, 3 and 6 months after surgery (t=－2.208, －3.435,－4.919; P=0.038, 0.002, 0.000). In the pairwise comparison at different times after surgery, only 6 months after surgery and 1 month after surgery were significantly different (P=0.036). Compared with the preoperative P1, P2, 63%BCEA and 95%BCEA, the P1 and P2 of the eyes gradually increased after surgery, while the 63%BCEA and 95%BCEA gradually decreased, however, the difference was not statistically significant (P1: t=－1.595,－1.698,－1.966; P=0.125, 0.104, 0.062. P2: t=－1.622,－1.654,－1.707; P=0.119, 0.112, 0.102. 63%BCEA: t=1.410, 1.409, 1.553; P=0.172, 0.173, 0.135. 95%BCEA: t=1.412, 1.408, 1.564; P=0.172, 0.173, 0.132). Six months after surgery, all the eyes underwent anatomical repositioning of the macular area, and no serious complications such as full-thickness macular hole and macular hole retinal detachment were found. ConclusionsPPV with internal limiting membrane peeling and air filling is an effective and safe method for MF, and the macular function improved significantly within 6 months postoperatively.