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)
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.
Objective To evaluate the correlation between antiphospholipid (APLA) antibodies and retinal vein occlusion (RVO). Methods A computerized search was conducted in the Pubmed, Chinese Biological Medicine Database, China National Knowledge Infrastructure, VIP database, Wanfang Database combined with manually searching of literature reference proceedings. The search time was ranged from establishment of each database to August 1st, 2012. After the data extraction, quality of RCT was assessed. The meta analysis was performed by Stata 11.0. Results In total, 12 case-control studies (1324 subjects) that fulfilled the eligibility criteria were included in the meta-analysis involving 505 patients in RVO group and 819 subjects in control group. The odds ratio (OR) and 95% confidence interval (CI) of APLA, anticardiolipin antibodies (ACA), lupus coagulation inhibitor and RVO were 5.01 and 3.33 - 7.53,4.38 and 2.38 - 8.05, 1.72 and 0.73 - .88, 6.02 and 2.06 - 17.63, respectively. The OR and 95% CI of APLA, ACA, lupus coagulation inhibitor and branch RVO were 4.22 and 1.67 - 10.63, 3.69 and 1.32 - 10.32, 2.07 and 0.79 - 5.41, respectively. Conclusions APLA may increase the rick of RVO, especially ACA has a prediction function to RVO. It is necessary to screening for APLA in RVO patients.
Objective To observe the therapeutic effect of vitrectomy on Eales disease and the correlated factors affecting the visual prognosis and disease outcomes. Methods The clinical and follow-up data from 128 patients (142 eyes) with Eales disease undergone vitrectomy were retrospec tively analyzed. The statistical methods including t test,chi;2test, one-way Anova method of square-deviation(SD), and logistic regression were used to analyze the relationship between the general data of the patients (including age, sex, laterality of the eye, visual acuity before the treatment, stages of disease, duration from vitreous hemorrhage to vitrectomy, neovascularization and proliferative vitreoretinopathy, and whether or not combined with retinal detachment and other complications) and the prognosis of the visual acuity after surgery (including the surgical method, techniques, and times and complications after the surgery). The patients were 18-45 years old (mean 28.5 years) with single vitreous hemorrhage in 28 and proliferative changes in 114 in whom 59 had retinal detachment. The follow-up period after the surgery was more than 3 months (mean 35.8 months). The success criteria of the surgery were complete or part retinal reattachment, and failure of retinal reattachment, eye-ball atrophy or excis ion of the affected eye were the failure criteria. Results Successful vitrectomies had been performed on 129 eyes (90.8%) and unsuccessful ones on 13 eyes (9.2%). The difference between the stages of the disease and prognosis of visual acuity after the surgery was significant (chi;2=64.0, Plt;0.01); the duration of vitreous hemorrhage obviously affected the prognosis of visual acuity (OR=11.6，Plt;0.01); the degree, quality, curable possibility, and recurrent probability of combined retinal detachment were the key factors affecting the visual acuity after vitrectomy; the visual acuity before and after the surgery was interrelated; the method and techniques of the surgery and the different filling matters affected the visual acuity after the surgery; the difference between multiple times and once of surgery was significant (chi;2=66.84，Plt;0.01); the degree of complexity of the operative procedure, especially repetitious vitrectomies obviously affected the surgical prognosis and the improvement of visual acuity; the possibility of fa ilure of the surgery differs 7 times in patients with or without post-operative complications ( chi;2=67.23，Plt;0.01); whether the post-operative complications occurred or not significantly affected the prognosis of the visual acuity a-fter the surgery. Conclusions Vitrectomy is effective for Eales disease. The important factors affecting the prognosis of visual acuity after the operation include stages of disease, degree and extent of proliferative vitreoretinopathy, whether or not combined with retinal detachment and other complic ations, duration from vitreous hemorrhage to vitrectomy, the degree of complexity of the operation, and the complications during or after the operation. (Chin J Ocul Fundus Dis, 2006, 22:291-294)
Objective To observe the clinical manifestations and treatment of ocular myasthenia gravis. Methods The clinical manifestations, results of laboratory examination and thymic CT, and therapeutic data of 84 patients with ocular myasthenia gravis, hospitalized from July, 1998 to July, 2005, were retrospective ly analyzed. Results These patients were 2.5 to 70 years old. All of the patients had ptosis, includine 35.77% with diplopia 25% with strabismus; 1 with obnormal sphincter muscle and 1 with blurry vision.The positive rate of examination of AchR antibody was 27.6%, and abnormal rate of examination of thymic CT was 64.3%. The cure rate was 48.1% in oral administration with tabellae in whomdostigmini group, 66.7% in methylprednisolonum hormone therapy group, and 51.9%in thymectomy group. Conclusions Ocular myasthenia gravis is mostly involved levator palpebrae superiors and sometimes also involved other ocular muscles. Anticholinesterase medication, methylprednisolonum hormone therapy or thymec tomy are effective. (Chin J Ocul Fundus Dis, 2006,22:379-381)
Objective To investigate the clinical characteristics and mechanisms of ocular manifestations related to carotid artery stenosis. Methods The general clinic data and related ocular manifestations in 124 patients with carotid artery stenosis were retrospectively. Results In the 124 patients, 36 (29%) had ocular manifestations, and 28 (22. 6 %) complained the ocular discomfort as the first symptom. Among the 36 patients, 31 patients (86.1%) had been disclosed unilateral or double stenosis of internal carotid artery by carotid Doppler ultrasound examination, and the result of digital subtract angiography revealed middle and severe degree of internal carotid artery stenosis in 8 and 23 patients respectively. There was no statistic difference of incidence of ocular manifestations between 67 patients of severe internal carotid artery stenosis and 34 patients with middle one（chi;２test,P =0.266 2，P＞0.05). The ocular manifestations included amaurosis fugax (52.8%),acute decline or loss of the visual ability and defect of visual fields (36.1%), binocular diplopia (13.9%), ptosis (13.9%), and persistent high intraocular pressure(2.8%) one patient might had several ocular manifestations simultaneously. In 36 patients, central retinal artery occlusion had been diagnosed in 4, venous stasis retinopathy in 1,central or branch retinal vein occlusion in 6, neovascular glaucoma in 1, and anterior ischemic opticneuropathy in 2. One patient with double occlusion of internal carotid artery didnrsquo;t have any ocular manifestation. Conclusion Carotid artery stenosis, especially internal carotid artery may lead to acute or chronic ocular ischemic lesions, and the occurrence of ocular manifestations in chronic ocular ischemic lesions relates to compensa tion of collateral circulation；patients with ocular ischemic lesions are recomm end to undergo a routine carotid artery examination. (Chin J Ocul Fundus Dis, 2006,22:376-378)
Objective To explore the ocular clinical features in patients with cranial venous sinus thrombosis (CVST). Methods The clinical data from 118 inpatients with CVST diagnosed by digital subtraction angiography (DSA).The patients included 53 males and 65 females with the sexual rate of1 :1.2. The initial onset age of the patients ranged from 15 to 67; 20-45 are the most common onset ages, and 30-40 reached the peak. The CVST patients were divided into 3 groups a c cording to the onset styles, including acute onset (within 2 days), subacute ons et (2 days to 1 month), and chronic onset (more than 1 month). The features of o cular and systemic manifestations was analyzed. A total of 58 out of 118 patient s with CVST were followed up for about 1 year after the diagnosis and treatment. Results Among the 118 patients with CVST, 25 (21.2%) had the ocular symptoms as the initial onset, 36 (305%) had ocular syndrome with other symptoms, and 57 (48.3%) had non ocular symptoms. There was no statistical significance among each group. The most common chief complains were the blurred and decreased vision (in 61 eyes, occupying 85.9% of all the chief complains). The most common symptom was papilloedema (in 57 eyes, accounting for 48.3% of all the patients with CVST). In 58 follow-up patients, 13 (22.4%) had serious visual decrease due to the optic atrophy. All the ocular manifestations related to the intracranial hyper tension caused by CVST. Conclusions In patients with CVST, 1/3 have ocular symptoms, and 1/5 have ocular symptoms as the initial manifestation. Visual decrease and papilloedema are the common symptoms in patients with CVST. We should especially advert to the patients with intracranial hypertension with unknown origins. (Chin J Ocul Fundus,dis,2006,22:373-375)
Objective To detect the clinical manifestations, diagnos is and treatment of painful ophthalmoplegia syndrome. Methods The data of onset, clinical m anifestations, laboratory examination, imaging and treatment from 12 patients with painful ophthalmoplegia, hospitalized from Mar, 2000 to Aug. 2005, were retro spectively analyzed. Results Multiple characters and extents of the headache were found in these 12 patients. The involved cranial nerves included the Ⅲ,Ⅳ, V1-2 and Ⅵ, especially the cranial nerve Ⅲ(83.3%). Several simultaneously in volved cranial nerves were frequently found (75%). Diseases which could cause hea dache along with ophthalmoplegia must be excluded before the diagnosis of the painful ophthalmoplegia syndrome was established. The examination of imaging was important for the diagnosis of painful ophthalmoplegia syndrome. Patients were sensitively responsive to cortico-steoid therapy. The cure rate was 75%. Conclusion The features of clinical manifestations, imaging results and the patients response to cortico-steoid therapy accorded with the etiology of nonspecific inflammation granuloma. Cortico-steoid therapy is effective after the definitude of the disease. (Chin J Ocul Fundus Dis, 2006,22:385-386)