Objective To observe the clinical effects of vitreoretinal surgery for myopic foveoschisis, evaluate the visual prognostic factors. Methods Twentyseven eyes of 23 patients with myopic foveoschisis underwent vitreoretinal surgery were analyzed retrospectively. All the patients had undergone the examinations of best corrected visual acuity (BCVA), intraocular pressure, slit lamp microscope, direct ophthalmoscope, binocular indirect ophthalmoscope, A or B ultrasonic scan and optical coherence tomography (OCT). Follow-up duration varied from 6 to 36 months, with the mean of (19.4±10.03) months. The visual acuity, retinal reattachment and the complications were observed. Logistic regression analysis was performed to predict the prognosis of visual acuity. Results Twentyone eyes (7778%) were anatomically reattached, six eyes (2222%) were not anatomically reattached. Postoperative BCVA improved in 24 eyes (8889%), reduced or remained unchanged in three eyes (11.11%). No ocular complications such as fundus hemorrhage, low or high intraocular pressure, endophthalmitis were found. The preoperative BCVA (OR=9.11, P=0.007), axial length (OR=0.31, P=0.038) and the photoreceptor inner and outer segment (IS/OS) junction line continuity (OR=4。32,P=0.001) are closely related to visual prognosis. Conclusions Vitreoretinal surgery is an effective approach to treat myopic foveoschisis with both anatomical and visual improvement. The preoperative BCVA, axial length and IS/OS line continuity are closely related to visual prognosis.
Objective To know the training status and expectation of village doctors in remote and poor areas of Sichuan province and to provide the preferences for developing a viable and efficient training model. Methods The cluster sampling method, combined with questionnaire surveys and qualitative interviews, was used. A total of 463 village doctors of 302 village clinics in Pengzhou and Baoxing of Sichuan province were interviewed. Results The “three-side” phenomenon including the doctor being old, poor academic background and lack of female doctor in remote and poor areas of Sichuan was serious. In-service village doctors’ knowledge on public health and Chinese medicine increased through training. There were differences between the training village doctors participated and that they had expected. The cost of the training was somewhat high for rural doctors. The training system has not been established yet in remote areas. Conclusions Both quantity and quality should be considered in in-service village doctor training in remote areas of Sichuan Province, which should also consider local conditions and farmers’ needs . The in-service training system should be developed as soon as possible. It is suggested that the treatment of village doctors should be improved. Cultivating more young village doctors should be based on the stability of the medical team.