Critical flicker fusion frequency (CFF) is a dynamic visual function test that measures the minimum frequency at which a flicker source is perceived by the visual system as continuous light. The measurement method is convenient, the inspection time is short, and it can be effectively evaluated in the case of refractive interstitial opacity. Although CFF has many advantages, its application in the field of ophthalmology has not received sufficient attention. The pathway of CFF involves the pathway from the retina to the lateral geniculate body to the primary visual cortex, where the macrocellular pathway is sensitive to temporal resolution and responsible for transmitting rapidly changing information. Its measurements typically use red, green, or yellow light as a flashing light source to detect the functional integrity of the macular region. As a subjective test, the results of CFF can be affected by a variety of factors, such as drug use, fatigue, and luminous intensity. In order to improve the repeatability of the measurement, it is necessary to follow standardized measurement steps. CFF has important application value in the diagnosis of optic nerve diseases. It can assist in diagnosing the presence of optic neuropathy, evaluating the conduction function of the optic nerve, and monitoring the progression of the disease and the effect of treatment. As a convenient and efficient visual function evaluation tool, CFF has great potential in the diagnosis of optic nerve diseases and visual function monitoring. In view of its application prospects in the field of ophthalmology, this study calls for more attention and support from ophthalmologists, and carry out related basic and clinical research to further explore the application value of CFF in different disease conditions.
Neuromyelitis optica spectrum disorder (NMOSD) is a kind of demyelinating disease of central nervous system which mainly affect optic nerve and spinal cord. Because of its serious blindness and disability, how to effectively prevent relapse has become the focus of ophthalmologists. With the deep understanding of the pathogenesis and the progress of scientific and technological means, more and more monoclonal antibodies(mAb) continue to enter clinical trials. B cell surface antigen CD20 blocker, rituximab, has become a first-line drug for the treatment of NMOSD. CD19 blocker, inebilizumab, can reduce the recurrence and disability of NMOSD patients. The addition of interleukin 6 receptor blocker, satralizumab, and complement C5 inhibitor, eculizumab, reduce the recurrence. Some mAbs such as natalizumab and alemtuzumab may not be effective for the treatment of NMOSD. The expansion of mAb treatment indications and the launch of new drugs still require more clinical trials which are large-scale and international cooperation. At the same time, its potential adverse events and cost issues cannot be ignored.
Neuro-ophthalmology is an interdisciplinary discipline that spans multiple disciplines such as ophthalmology, neurology, and neurosurgery, and plays an important role in ophthalmology. Since the establishment of the Neuro-Ophthalmology Group in 2011, it has shown a good momentum of accelerated development of neuroophthalmology team building, promoting the process of neuroophthalmology standardization and strengthening interdisciplinary cooperation. However, there is still a gap between the level of neuro-ophthalmology in China and that in developed countries, which still cannot get rid of the stage of introduction and imitation. It is still a long way to form neuro-ophthalmology with unique characteristics in China. In the future, we should carry out clinical research while advancing basic research work, and establish a standard training system to strengthen the training of neuroophthalmologists. It is expected that in the next 10 years, China's neuro-ophthalmic diagnosis and research level will be significantly improved, and a number of landmark academic achievements will be achieved, and a number of internationally and domestically renowned neuro-ophthalmologist will be trained to further enhance the international academic status of neuro-ophthalmic research in China.
Neuromyelitis optica (NMO) is an autoimmune inflammatory diseases of the central nervous systems (CNS) mainly affecting the optic nerves and spinal cord. It has the characteristics of high recurrence rate and poor prognosis. NMO related optic neuritis is a common neuro-ophthalmic disease which often results in permanent visual loss or even blindness. Aquaporin 4 (AQP4) antibody is a specific and pathogenic autoantibody in NMO patients. Although AQP4 is expressed in multiple tissues, NMO pathology is remarkably limited to the CNS. Corticosteroids and other immunosuppressive drugs are the standard managements for NMO patients, in order to reduce the relapses and the severity of the acute attack. Multiple avenues of investigation in the laboratory have significantly advanced our understanding of NMO pathophysiology, which is helpful for our understanding of immunologic and nonimmunologic mechanisms. Many offer significant means for NMO therapy by selectively targeting pathways. In the future, moving these agents from the bench to the bedside offers the opportunity to identify safe and effective therapies that limit CNS injury and preserve visual function.
Objective To invesitigate the features of imaging of CT with high resolution (HRCT) in fracture of optic canal, and evaluate the clinical application of HRCT. Methods A total of 22 patients with facture of optic canal underwent thin layer (1.5 mm) CT scanning in axial and coronal positions. The features of the image of fractures of optic canal were analyzed. Results There were 15 cases (68.2%) of fractures in the inner wall, 1 (4.5%) in the lateral wall, 1(4.5%) in the superior wall, 2 (9.1%）in the inferior wall, and 3 (13.6%) were with the compound fracture. The direct sign of the fracture of optic canal was the osseous successional discontinuity of the wall of optic canal, including 5 types: concave (27.3%), lineal(22.7%), comminuted(27.3%), inlaid(9.1%), and mixed (13.6%) type. The indirect signs were hemorrhage of sphenoidal sinus (95.5%),hemorrhage of ethmoid sinus(50%),and optic nerve thickening(36.4%)etc. Conclusions HRCT may clearly exhibit the positions and types of the fracture of optic canal, and it can provide reliable information for the clinical diagnosis and selection of manners of the treatment. (Chin J Ocul Fundus Dis, 2006,22:387-389)
Objective To learn the hotspots of study in ischemic optic neuropathy (ION). Methods Literature on ION published in January 2000 to July 2012 was identified in Pubmed database. MeSH terms that frequently appeared were identified and co-word analysis was carried out by cluster analysis. Then a network was drawn using social network analysis. Results A total of 1045 papers were included. The United States, England, Germany, France and Netherlands together accounted for 71.53% (748) of the articles. There were 28 high-frequency MeSH terms and hot topics clustered into four fields. The appearance frequency of MeSH showed that most research focused on: (1)postoperative or arteritic ION; (2)epidemiology, pathology and diagnosis of ION; (3)pathophysiology and therapy of ION; (4) chemically induced ION. Conclusion The international main research focus of ION includes four fields, which may provide reference or scholars both in scientific research and clinical research.
Neuromyelitis optica spectrum disorders (NMOSD) are a group of inflammatory disorders of the central nervous system characterized by episodes of immune-mediated demyelination and axonal damage mainly involving optic nerves and spinal cord. Neuromyelitis optica related optic neuritis (NMO-ON) is a common neuro-ophthalmic disease which often results in permanent blindness. The discovery of aquaporin 4 antibodies confirms that neuromyelitis optica is a distinct disease entity different from multiple sclerosis. In patients with NMO-ON, the correct therapeutic approach has to recognize two distinct clinical situations: treatment of the acute attacks and prevention of the relapses. With the in-depth study of the pathogenesis of NMOSD, new treatments are emerging in different targets of the disease. This review gives an update of latest treatment of NMO-ON, emphasizing both current situation and future immunotherapy strategies.