Objective To observe the clinical features and visual function of recurrent neuromyelitis optica (NMO). Methods Thirty-four patients with NMO were enrolled in this retrospective case series study. The patients included two males and 32 females. The average first onset age was (35.03plusmn;14.56) years old and the average recurrent rate were (4.24plusmn;2.45) times. The recurrent rate of optic neuritis (ON) ranged from two to 12 times. The recurrent rate of ON was two times in 15 eyes of 10 patients, ge;three times in 37 eyes of 24 patients. Vision acuity, direct ophthalmoscope, fundus pre-set lens examination, visual field and visual evoked potential (VEP) were evaluated. Clinical features were observed. The abnormal rate of optic nerve including optic edema and atrophy; abnormal rate of visual field including decreasing retinal sensitivity, central and paracentral scotoma, ring scotoma, half field defects, tunnel visual field, visual field centrality constriction; abnormal rate of VEP including Prolonged latent phase and/or decreasing amplitude of P100 wave from patients of first episode or recurrence was analyzed. Serum NMO-IgG was detected from 28 patients by indirect immunofluorescence technique to observe its positive rate. Results All patients were characterized by repeated episodes of ON and myelitis. The main clinical feature of ON was visual loss, and the main clinical features of myelitis included sensory disability, dyskinesia and vesicorectal disorder. Blindness rate was 41.67% after the first attack of ON, 33.33% after two relapses, and 64.86% after ge; three relapses. The difference of blindness rate between first attack and two episodes was not significant (chi;2=0.270,P=0.603). However, the blindness rate in patients having ge; three episodes was significantly higher than those having two episodes (chi;2=4.300,P=0.038). With recurrence rate increasing, the abnormal rate of the optic nerve (chi;2=6.750,P=0.034）and VEP（chi;2=6.990,P=0.030）increased. But the abnormal rate of visual field did not increase along with recurrent rate (chi;2=0.660,P=0.718). Seropositive rate of NMO-IgG did not differ significantly between patients with first attack ON and that with recurrent ON (chi;2=1.510,P=0.470). But the seropositive patients had significantly higher bilateral blindness rate than seronegative patients (chi;2=5.063,P=0.027). Conclusions NMO are characterized by recurrent ON and myelitis. Visual loss, sensory disability, dyskinesia and vesicorectal disorder are the main clinical features. With recurrence rate increasing, the blindness rate, abnormalities the optic nerve and the abnormity rate of VEP increase. Seropositive recurrent NMO patients have higher bilateral blindness rate than seronegative patients.
Objective To investigate the causes of blindness and low vision of the people over 50 years old in Binhu Area of Wuxi City. Methods Cluster sampling was used in randomly selected individuals over 50 years old in 28 villages. The oculopathy related to blindness and low vision of the people over 50 years old were analyzed. The vision acuity lt;0.05 was defined as blindness, while 0.05-0.3 was defined as low vision. SPSS 17.0 software was used to analyze the data. Results Totally 6150 individuals were examined. The bilateral blindness and low vision was found in 47 and 84 individuals, unilateral blindness and low vision was found in 201 and 214 individuals. Among 201 unilateral blindness individuals, there were 55 individuals have low vision in the other eye. In the 295 blind eyes, there are 116 eyes (39.32%) with cataract, 31 eyes (10.51%) with high myopia macular degeneration, and 28 (9.49%) eyes with atrophy eyeballs. In the 437 low vision eyes, there are 223 eyes (51.03%) with cataract, 41 (9.38%) eyes with high myopia macular degeneration, and 41 (9.38%) eyes with age-related macular degeneration. Conclusion Cataract is the first cause leading to blindness and low vision, followed by age-related macular degeneration, high myopia macular degeneration and atrophy eyeballs.
Objective To observe the etiologies and vision outcomes of inpatients with no light perception (NLP). Methods A total of 367 inpatients (430 eyes) with NLP in Zhongshan Ophthalmic Center were enrolled in this study. The visual acuity examination followed the international standard methods. NLP was detected by torch light in a dark room and the pupil light reflection state was also considered. The patients included 208 males (235 eyes) and 159 females (195 eyes). Sixtythree patients (126 eyes) were bilateral and 304 patients (304 eyes) were unilateral cases including 159 right eyes and 145 left eyes. The patients' ages ranged from 2.5 to 86.0 years, with a mean age of (40.85plusmn;18.03) years. All the patients were treated according to their diseases. The ratio of different eye disease and visual outcome were recorded and analyzed. Results Among 430 eyes, there were 157 eyes (36.5%) with optic neuritis, 68 eyes (15.8%) with uveitis, 54 eyes (12.6%) with retinal vascular disease, 35 eyes (8.1%) with ischemic optic neuropathy, 29 eyes (6.7%) with traumatic optic neuropathy, 28 eyes (6.5%) with optic atrophy, 18 eyes (4.2%) with trauma, 17 eyes (4.0%) with radiation optic neuropathy, 10 eyes (23%) with glaucoma, five eyes (1.2%) with retinal detachment, four eyes (0.9%) with compressive optic neuropathy, two eyes (0.5%) with orbital apex syndrome, two eyes (0.5%) with hysteria, and one eye (0.2%) with orbital cellulitis. After active treatment, 269 eyes (62.6%) remained NLP, 161 eyes (37.4%) got improved visual acuity, including light perception- 0.02 in 74 eyes (17.2%), ge;0.02-＜0.05 in 25 eyes (5.8%), ge;0.05 -＜0.1 in 14 eyes (3.3%), ge;0.1 -＜0.3 in 11 eyes (2.6%) and ge;0.3 in 37 eyes (8.6%). Conclusions The main causes of nonsurgical and non-trauma NLP are retinal disease and optic neuropathy. Some patients with NLP may restore useful vision if they received prompt referral and active intervention.