Objective To analyze the causes of missed diagnosis of sleep apnea hypopnea syndrome ( SAHS) . Methods 42 missed diagnosed cases with SAHS from May 2009 to May 2011 were retrospectively analyzed and related literatures were reviewed. Results The SAHS patients often visited the doctors for complications of SAHS such as hypertension, diabetes mellitus, metabolic syndrome, etc. Clinical misdiagnosis rate was very high. Lack of specific symptoms during the day, complicated morbidities, and insufficient knowledge of SAHS led to the high misdiagnosis rate and the poor treatment effect of patients with SAHS. Conclusion Strengthening the educational propaganda of SAHS, detail medical history collection, and polysomnography monitoring ( PSG) as early as possible can help diagnose SAHS more accurately and reduce missed diagnosis.
The pathogenesis of polypoidal choroidal vasculopathy (PCV) is still controversial. More evidence of clinical and basic research is needed to distinguish PCV from an independent disease to a subtype of age-related macular degeneration. Not only that, there are also many puzzles in the diagnosis, treatment options and prognosis of PCV. In addition to these common problems, we also face a large population with risk factors, a large number of PCV patients with multiple and complex challenges in China. There is a long way to go to reduce the damage effects of PCV on visual function. To fulfil this goal, we need make full use of the huge resources of PCV patients and turn these challenges into opportunities, and contribute the improvement of diagnosis and better understanding of PCV pathogenesis.
PURPOSE:To inquire into diagnosis and differentiation method for full thickness macular hole,lamellar macular hole and cystoid macular degeneration. METHODS:Amsler grid,Watzke' s sign and laser aiming beam test were performed in the patients:30 with full-thickness macular hole, 12 with lamellar macular hole and 8 with cystoid macular degeneration. The results were analyzed statistically with method of four table precise probability. RESULTS:The positive rate of Amsler grid,watzke's sign and laser aiming beam test was 100% in ail of the full thickness macular holes,and it was 85%，65%and 0 in lamellar macular holes and cystoid macular degeneration respectively. CONCLUSION: Amsler grid testing was sensitive but not specific,Watzke's sign was more sensitive and specific,and the laser aiming beam tesl was extremely sensitive and specific in clinical diagnosis of full thickness macular hole. （Chin J Ocul Fundus Dis,1996,12: 208-210）
The electroencephalogram (EEG) signal is a general reflection of the neurophysiological activity of the brain, which has the advantages of being safe, efficient, real-time and dynamic. With the development and advancement of machine learning research, automatic diagnosis of Alzheimer’s diseases based on deep learning is becoming a research hotspot. Started from feedforward neural networks, this paper compared and analysed the structural properties of neural network models such as recurrent neural networks, convolutional neural networks and deep belief networks and their performance in the diagnosis of Alzheimer’s disease. It also discussed the possible challenges and research trends of this research in the future, expecting to provide a valuable reference for the clinical application of neural networks in the EEG diagnosis of Alzheimer’s disease.
Objective To investigate the characteristics of the ocular fundus of Chinese patients with polypoidal choroidal vasculopathy (PCV).Methods The photographs of ocular fundus of 42 Chinese patients (48 eyes) with PCV diagnosed by fundus photography, fundus fluorescein angiography (FFA), and indocyanine green angiography (ICGA) were analyzed.Results In 48 eyes with PCV, 35 (72.9%) had subretinal hemorrhage, 13 (27.1%) had yellow-white exudation, 7 (14.6%) had subretinal tuberculum-like focus in tangerine peel at the posterior pole, and 26 (54.2%) had hemorrhagic or serous pigment epithelium detachment (PED). Thirty-six eyes（75.0%）had polypoidal dilations with branching vascular network, and the other 12 (25.0%) had scattered polypoidal dilations without identifiable continuous branching vascular network. The location for these lesions were at the macular region in 30 eyes (62.5%), arcade region in 6 (12.5%), peripapillary region in 3 (6.3%), and combination region in 9 (18.8%).Conclusions Most of the lesions in Chinese patients with PCV locate at the macular region and temporal vascular arcade. Most eyes are characterized by branching choroidal vessels with polyplike terminal aneurysmal dilations in ICGA. (Chin J Ocul Fundus Dis，2003，19：269-332)
Objective To observe the imaging features of ultra-wide field short wave fundus autofluorescence (SW-FAF) in eyes with multiple evanescent white dot syndrome (MEWDS), and analysis the correspondence to conventional images. Methods It was a retrospective case series study. Thirteen patients (14 eyes) diagnosed with MEWDS were enrolled. There were 12 females and 1 male, aged from 22 to 57 years, mean age was 34.5 years. All the eyes underwent fundus color photography, optical coherence tomography (OCT) and ultra-wide field autofluorescence (FAF). Simultaneous fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) were performed in 6 eyes. The characteristic changes of SW-FAF in studied eyes were observed and compared with the images of FFA and ICGA. All the eyes were followed up every 1 to 2 weeks, with an average of 16.7 weeks. The characteristic images of SW-FAF and corresponding OCT were studied during follow up. Results MEWDS presented with numerous multiple hyper-autofluorescent spots, sized from 50-500 μm, with a vague boundary in ultra-wide field SW-FAF. These spots located mainly at the peripapillary area and the posterior pole with a confluent pattern. The lesions extended to the mid-peripheral retina as well and became more scattered. The distribution of the hyper-autofluorescent lesions in SW-FAF corresponded roughly to that of the greyish-white spots seen in color photograph and the hyper-fluorescent spots detected by FFA. It was consistent with the distribution of hypo-fluorescent spots in late-phase ICGA as well. But the number of the spot showed in FAF is much more than that in FFA, and slightly less than that in ICGA. The OCT scans through the hyper-autofluorescent lesions in SW-FAF showed impairment of outer retina. After the recovery, the hyper-autofluorescent spots disappeared with the outer retina structure repaired completely. Conclusions MEWDS presented with numerous multiple hyper-autofluorescent spots which located mainly at the peripapillary area in ultra-wide field SW-FAF. The distribution of the hyper-autofluorescent lesions in SW-FAF corresponded roughly to color photograph, FFA and ICGA in late-phase. The OCT scans through the hyper-autofluorescent lesions in SW-FAF showed impairment of outer retina.
ObjectiveTo elucidate the clinical and pathological features and review the progress of diagnosis and treatment in patients with brain metastasis (BM) from colorectal cancer (CRC), so as to provide a reference for the whole process management for patients with BM from CRC in China.MethodThe latest research results and previous literatures about patients with BM from CRC were reviewed.ResultsThe prognosis of BM from CRC was poor, its molecular pathological mechanism was complex and diverse, and some risk factors associated with the occurrence of BM had been identified. Typical imaging features of BM from CRC were helpful to the diagnosis of patients. At present, radiotherapy was still the main treatment. Bevacizumab treatment or immunotherapy combined with radiotherapy was expected to improve the survival of BM from CRC.ConclusionScientific and standardized prevention, diagnosis, and treatment are beneficial to reduce incidence of BM from CRC and improve survival.
Objective To measure optic disc parameters in Mongolian and Han healthy subjects with or without family history of glaucoma, to explore the causes of the differences and their significance in the diagnosis of early glaucoma. Methods Fifteen healthy Mongolian individuals (30 eyes), 30 healthy Han individuals (60 eyes) with a family history of open-angle (30 eyes) or angle-closure (30 eyes) glaucoma, and 45 healthy Han individuals (90 eyes) without a family history of glaucoma were enrolled in this study. The 45 healthy Han individuals without a family history of glaucoma included three age-groups: 20 to 29 years old group, 30 to 39 years old group and 40 to 49 years old group, each group have 15 subjects (30 eyes). Thirteen parameters were measured by Heidelberg retina tomography (HRT) for all subjects, including disc area, cup area, rim area, cup volume, rim volume, cup/disc area ratio, linear cup/disc ratio, mean cup depth, maximum cup depth, cup shape, disc height variation contour, mean retinal nerve fiber layer (RNFL) thickness and optic nerve fiber layer crosssectional area. The results were analyzed and compared between the above groups. Results There was no statistically significant (t=0.791,P=0.132) of the height variation contour between Mongolian and Han without a family history of glaucoma (20 to 29 years old) group. The other parameters of Mongolian were smaller than Han without a family history of glaucoma (20 to 29 years old) group, but the difference was not statistically significant (t=-1.039, -0.799, -0.840,-1.108, -0.956, -0.695, -0.931, -1.099, -1.074, -0.580, -0.204, -1.425; P＞0.05). The parameters in Han with a family history of open-angle glaucoma group were bigger than Han without a family history of glaucoma (30 to 39 years old) group. The differences were statistically significant for disc area, cup area, rim area, cup volume, rim volume, cup area ratio, linear cup/disc ratio, mean cup depth, cup shape measure, nerve fiber layer cross-sectional area (t=4.758, 3.187, 2.544, 2.674, 1.798, 3.676, 2.721, 2.715, 2.510, 2.373; P＜0.05), but were not statistically significant for maximum cup depth, disc height variation contour and mean RNFL thickness (t=1.649, 1.565, 0.767; P＞0.05). Most parameters in Han with a family history of angle-closure glaucoma group were the same as that in Han without a family history of glaucoma (40 to 49 years old) group, including cup area, rim area, cup volume, rim volume, cup/disc area ratio, linear cup/disc ratio, mean optic cup depth, maximum cup depth, cup shape, disc height variation contour, mean RNFL thickness, optic nerve fiber layer cross-section (t=1.201, 1.697, 1.000, 0.516, 0.740, -0.172, -0.070, -0.972, 1.530, -0.390, -0.091, 0.659; P＞0.05); but the difference of disc area between these 2 groups was statistically significant (t=2.224,P＜0.05). Conclusions The family history of glaucoma can change the optic disc parameters of healthy individuals, especially those with a family history of open-angle glaucoma. There is no difference of optic disc parameters between healthy Mongolian and Han subjects.
Objective To observe the autofluorescence of dated fundus hemorrhage excited by the excitaton light with different wavelength. Methods A total of 23 patients (23 eyes) with dated fundus hemorrhage were observed. The blue light under the fundus fluorescence angiography (FFA) mode of Topcon 50IA fundus camera was the excitation light, and the whiteandblack images of 4 patients and colorized images of 16 patients were collected, respectively. The autofluorescence of dated fundus hemorrhage in other 3 patients was observed by excitation of scanning laser with the wavelength of 488 nm and 795 nm emitted from Heidelberg retina angiography apparatus (HRA2). Results The black and white images showed the b red autofuorescence of dated fundus hemorrhage in 4 patients, while the colorized ones revealed the red autofluorescence in 16 patients. The hemorrhage autofluorescence could be also excited by blue laser (488 nm) and infrared laser (795 nm) using HRA2, but with different extent and intensity. Conclusions Due to the complex composition of dated fundus hemorrhage, different excitation light can excite the autofuorescence with different wavelength.
Objective To investigate the clinical features of polypoidal choroidal vasculopathy. Methods The clinical manifestations and the findings of fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) of 7 eyes in 6 patients with polypoidal choroidal vasculopathy were analyzed retrospec tively.Results The ophthalmoscopic examination of PCV in this series of patients revealed orange-red lesions mainly in macular region in early stage, and then hemorrhage, exudation, edema, serous and (or) hemorrhagic detachment of retinal pigment epithelium in affected portions in advanced stage, and retinal and choroidal atrophy in late stage. FFA discovered the vascular dilation at the border of the choroidal vascular network in 1 eye, dotted hyperfluorescence in 6 eyes, and patches of hyperfluorescence in late phase. ICGA disclosed a vascular branching network in choroid with polypoid pattern of the terminal path of the vessels of network in early phase in 5 eyes, and the typical dotted or clustered polypoidal hyperfluorescence in 7 eyes in late phase.Conclusion The characteristic findings of FFA and ICGA are very diagnostic for PCV. (Chin J Ocul Fundus Dis，2003，19：269-332)