ObjectiveTo investigate the prognosis and differences of visual function and fundus structure in retinopathy of prematurity (ROP) undergoing anti-vascular endothelial growth factor agents (VEGF) or laser photocoagulation treatment with long-term follow-up. MethodsRetrospective case control series. From January 2010 to December 2021, A total of 35 children (63 eyes) with ROP who were first diagnosed in Department of Ophthalmology, Peking University People's Hospital and followed up for as long as 5 years were included. Among them, 21 males (36 eyes) and 15 females (27 eyes) were enrolled. The average gestational age (GA) of the children at birth was 29.30±1.77 weeks. Among the included 12 aggressive ROP (A-ROP) eyes and 51 pre-threshold type 1 ROP eyes, no retinal detachment occurred. Each eye received only intravitreal injection of anti-VEGF agents or laser monotherapy after diagnosis, and divided into anti-VEGF group or laser group according to the treatment. Thirty-five eyes of 20 infants were included in the anti-VEGF group and 28 eyes of 15 infants were included in the laser group. GA, birth weight (BW) and postmenstrual age receiving first treatment were compared and no significant difference between the two groups was defined (P=0.844, 0.859, 0.694). The number of A-ROP, pre-threshold type 1 ROP eyes were also compared, and statistically significance can be defined (P=0.005). During the follow-up period, best corrected visual acuity (BCVA), refractive status, visual field, optical coherence tomography (OCT) and fluorescein fundus angiography (FFA) were performed. The BCVA examination was carried out using the international standard decimal visual acuity chart, which was converted into the logarithm of the minimum angle of resolution (logMAR) visual acuity for statistics. Refractive status was calculated as spherical equivalent (SE). Comparative observation of 5-year outcomes including BW, GA, fundus examination at the initial diagnosis, and BCVA, refractive status, visual field defect, central foveal thickness (CFT), subfoveal choroidal thickness (SFCT) and abnormality of peripheral retina in FFA were performed between the two groups. Differences between groups were compared using t test or nonparametric test for measurement data, and χ2 test was used for comparison between groups in enumeration data. ResultsFive years after treatment, retinal avascular areas were seen around the eyes in the anti-VEGF treatment group, with a size of 2.32±1.84 optic disc diameters, and 1 eye had fluorescein leakage at the junction of the peripheral avascular areas; eyes in the laser treatment group old photocoagulation spots were seen in the peripheral retina, and no fluorescein leakage was seen. The logMAR BCVA of the eyes in the anti-VEGF treatment group and laser treatment group were 0.15 (0.00, 0.20), 0.10 (0.00, 0.16), respectively; SE were 0.50 (－1.25, 1.31), 0.38 (－4.25, 1.75) D, respectively; mean defect (MD) values of visual field were 2.70 (1.20, 4.80), 4.25 (2.83, 6.98) dB; CFT, SFCT were 225.00±29.31, 287.18±68.56 μm and 237.17±32.81, 279.79±43.61 μm. There was no significant difference in logMAR BCVA, CFT and SFCT between the two groups (P=0.363, 0.147, 0.622); the lower quartile of SE and visual field MD value in the laser treatment group were significantly higher than those in the laser treatment group, but there was no significant difference in the median SE (P=0.109), and there was a statistically significant difference in the median MD value of the visual field (P=0.037). ConclusionsAnti-VEGF agents and laser therapy can achieve similar good visual prognosis for early ROP, and the peripheral visual field can be preserved to a greater extent, however, the peripheral visual field defect in the laser group is more significant than that in the anti-VEGF group. For ROP without retinal detachment, the thickness of the retina and choroid in the fovea is generally normal.
Objective To explore the application effect of virtual reality (VR) technology in low vision teaching for optometry students. Methods Undergraduate students majoring in optometry at West China School of Medicine of Sichuan University were selected as the research subjects. The students enrolled in 2020 adopted the traditional lecture-based learning (LBL) teaching mode (LBL teaching group), while the students enrolled in 2021 adopted the VR teaching mode (VR teaching group). Both groups of students studied the content of the same chapter on low vision, completed in-class tests after learning, and completed a questionnaire survey. Results There were 28 students in the VR teaching group and 30 students in the LBL teaching group. There was no statistically significant difference in age or gender composition between the two groups of students (P>0.05). The in-class test scores of students in the VR teaching group were higher than those in the LBL teaching group (86.43±6.10 vs. 78.10±7.69, P<0.05). Except for “subjective discomfort with this teaching mode”, the differences in other evaluation results between the two groups were statistically significant (P<0.05). VR teaching group students generally believed that applying VR technology to low vision teaching helped understand the visual experience and daily life status of low vision patients, improved learning efficiency and hands-on ability, reduced learning burden, and hoped to use this teaching mode routinely in other subject teaching. All students in the VR teaching group believed that this teaching mode was interesting, highly innovative, and enhanced teacher-student interaction.Conclusions Applying VR technology to low vision teaching can enable students to personally experience the impact of various diseases on patients’ visual function and daily life. This teaching method not only optimizes and improves teaching effectiveness, but also has a high acceptance rate among students, which is worth further promoting in future optometry teaching.
Objective To investigate the morbidity of ocular fundus diseases in Tibetan above 40 in Maqin county, Qinghai Province. Methods A total of 2511 Tibetan above 40 in Maqin county, Qinghai Province were seelected by cluster sampling method. The sampling survey of ocular fundus diseases was performed on the individuals with indirect ophthalmoscope, and the results were compared with the domestic existing epidemiological data. Results Two hundred and thirty five (9.35%) cases were found to have abnormal ocular fundus, and the blindness rate due to the abnormal ocular fundus was 20.5% (80/391 eyes) which was lower than the blindness rate due to cataract (52.5%). Low vision and blindness led by ocular fundus diseases were found in 155 eyes (65.96%)，including 74(47.74%) with age-related macular degeneration (AMD) and 23 (9.79%) with retinoangiopathy. Conclusions The morbidity of ocular fundus disorder is higher in high plateau than that in backland; AMD and retinoangiopathy are the main diseases leading to blindness. (Chin J Ocul Fundus Dis, 2006, 22: 321-323)
ObjectiveTo invesitigate the relationship between the macular histomorphological changes and the prognosis of the visual acuity (VA) in eyes with rhegmatogenous retinal detachment (RRD).MethodsOptical coherence tomography (OCT) was performed on 39 patients (39 eyes) with rhegmatogenous retinal detachment. According to the macular neurepithelial configuration displayed by OCT, the patients were divided into 3 groups: neurepithelial edema group, neurepithelial detachment group, and neurepithelial cystoid degeneration group. The time of retinal detachment, pre- and post-operative VA, and macular neurepithelial thickness OCT images were observed and analyzed statistically.ResultsThere was no difference of pre-operative VA among the three groups (P＞0.05). Significant differences of post-operative VA, time of retinal detachment, and neurepithelial thickness were found (P＜0.05). The differences of time of retinal detachment and neurepithelial thickness between neurepithelial degeneration group and cystoid degeneration group were significant (P＜0.05) except the postoperative VA (P＞0.05).ConclusionsThe time of retinal detachment and post-operative VA in patients with retinal detachment relate to the neurepithelial thickness detected by OCT. When the duration of retinal detachment becomes longer, the macular neurepithelium becomes thicker, the histomorphological changes increase, and the post-operative VA decreases. (Chin J Ocul Fundus Dis, 2005,21:83-85)
Objective To observe the changes of visual acuity and multifocal electroretinogram （mfERG）before and after pars plana vitrectomy (PPV) combined with internal limiting membrane（ILM）peeling with ICG on idiopathic macular hole surgery. Methods The clinical data of 19 patients (19 eyes) with idiopathic macular hole（IMH） who had undergone PPV combined with ILM peeling assisted by 0.25% ICG from Zhongshan Ophthalmic Center were retrospectively analyzed. The closure of macular holes was confirmed by OCT two months after surgery. VERIS Science 4.9 visual evoked response image system was used to record the amplitude density of P1 waves according to six concentric rings before and two,six,twelve months after surgery, meanwhile compared and analyzed best corrected visual acuity（BCVA）before and after surgery. Results The results of OCT showed that 16 eyes (84.21%) had anatomic closure of the macular hole two months after the surgery while three eyes (15.79%) failed in the closure. The BCVA after surgery improved significantly which was more obvious at the second month (F=6.389，Plt;0.05). Compared with before surgery, the responses were depressed severely in P1 wave amplitude densities in six rings, the differences were statistically significant (t=6.140，Plt;0.05). Conclusion The postoperative BCVA of IMH patients improved but the amplitude densities of P1 wave depressed compared with before surgery.