The improvement of diagnostic levels for fundus diseases depend on the advancements of fundus imaging technology. Different fundus imaging technologies allow doctors to inspect ocular fundus from different aspects such as morphological or functional changes of retina. As a basic fundus examination method, optical coherence tomography provides highresolution and crosssectional retinal images coupled with noninvasive advantages. Fully understanding of the advantages and disadvantages of each fundus imaging technique, appropriate choosing one or combining several imaging techniques, and optimizing diagnostic procedures for each fundus disease are crucial steps to improve our diagnostic levels of ocular fundus diseases.
In the research process of uveal melanoma (UM), the Collaborative Ocular Melanoma Study (COMS) is a landmark and outstanding clinical study. Its research conclusions are the foundation for today's UM clinical work and guidelines. COMS is the first and largest randomized clinical trials conducted to date, comparing the survival outcomes of two or more treatment regimens for primary malignant intraocular tumors with high reliability. Its research design, methods, and conclusions are still widely cited in this day. Learning from the research experience of COMS, summarizing research data based on Asian populations, and studying treatment methods suitable for Asian UM patients is a powerful supplement to COMS data, but also an expansion of this global research, further improving the level of UM diagnosis and treatment in China.
ObjectiveTo analyze the reasons for the failure of scleral buckling (SB) in the treatment of rhegmatogenous retinal detachment, and observe the efficacy and safety of re-buckling.MethodsThis was a retrospective non-comparative clinical research. From July 2014 to June 2020, patients with first-time SB failure who visited the Beijing Tongren Hospital were included in this study. There were 42 patients, including 30 males and 12 females, with the average age of 29.40±16.13 years, and they were all monocular. The retinal detachment range＜1, 1-2 and＞2 quadrants were 9, 22 and 11 eyes, respectively. The macula was involved in 38 eyes. The average logarithm of the minimum angle of resolution (logMAR) best corrected visual acuity (BCVA) was 0.99±0.57. Forty eyes and 2 eyes were performed 1 and 2 SB, and all the retina were not reattached. All patients were under general anesthesia, according to the conditions during the operation, re-freeze and located the holes under indirect ophthalmoscope. And selected the new external pressure material or retained the old one in combination with the other operations to reattaced the retina. The average follow-up time was 31.93±18.97 months. The reasons for the failure of the first surgery based on the records of this surgery were analyzed. The visual acuity changes, the rate of retinal reattachment and the occurrence of complications were observed. The visual changes were compared by paired t test.ResultsThe top three reasons for the failure were: 16 case of the displacement of the compression spine (38.10%); 9 cases of missing the retinal holes and 9 case of improper selection of compression substances (account for 21.43%, respectively); 6 cases of insufficient height of compression spine (14.29%). All of retina were reattached (100%, 42/42). The average logMAR BCVA was 0.52±0.40. The difference of logMAR BCVA between before and after surgery was statistically significant (t=6.106, P=0.000). There were a slight increase in intraocular pressure in 8 eyes, the average intraocular pressure was 25.00±2.61 mmHg (1 mmHg=0.133 kPa). No serious complications occurred after surgery.ConclusionsThe position deviation of the compression spine, the missed hole during the operation, the improper selection of external compression material, and the insufficient height of the compression spine are the main reasons for the failure of SB. After adjusting the reasons for the failure, there is still a higher rate of retinal reattachment.
The treatment for retinoblastoma (RB) has been reached the stage of life-saving and vision-saving care. It is necessary to improve the survival rate and prolong the life time of RB children, retaining the eyeball and improving the quality of life. If the diagnosis is not timely and the treatment is inappropriate, the tumor recurrence, extraocular spread and metastasis of retinoblastoma will occur. The rate of eye protection and the survival chance of RB children will be reduced. With the continuous exploration of RB therapy and the emergence of new treatment methods, how to correctly select and evaluate these treatment methods and to adopt the most safe and effective treatment for RB children, to achieve long-term cure effect, is an important problem which clinicians need to consider.
The current understanding of lamellar hole-associated epiretinal proliferation (LHEP) is based on OCT examination. This preretinal proliferation is seen at the edge of the lamina macular hole (LMH) as a meso-reflective substance under linear strong reflection, located between the internal limiting membranes and the nerve fiber layer. LHEP is often associated with LMH, but its histological origin, morphology and OCT characteristics are different from LMH, and its visual prognosis is worse. At present, the relationship between the occurrence of LHEP and clinical prognosis is still under study. This article reviews the pathology, morphology, clinical features, diagnosis and treatment of LHEP, in order to enhance clinical understanding of this disease.
We have studied retrospectively 13 eyes with postoperative choroidal detachment of retinal detachment surgery in 126 cases(129 eyes).The frequency of choroidal detachment in this series is 10.1%(13/129).And we found that the middle-aged patients were more common sufferers,and drainaging the subretinal fluid,the extent of retinal degeneration and the buckling procedure might be the related factors to the occurence of postoperative choroidal detachment of retinal detachment surgery. （Chin J Ocul Fundus Dis,1993,9:210-213）