Objective To investigate the characteristics of ultrasonogram of eyes with silicon oil tamponade. Methods Forty-seven patients (47 eyes) who had undergone the operation of silicon-oil removing were examined by A-(to determine the length of ocular axis) and B-scan before and after the operation respectively. The length of ocular axis and cubage of vitreous chamber were detected and the characteristics of the ultrasonograms were observed according to the default parameters of ultrasonograph. Results The results of A-scan showed that the preoperative axial length was 1.465 times of the postoperative one in the eyes without lens, and 1.284 times in eyes with lens; after modified the parameter according to the acoustic velocity, the preoperative axial length was (0.78±0.34) mm longer than the postoperative one in the eyes without lens, and (0.56±0.32) mm in eyes with lens. The results of A-scan showed that the cubage of vitreous chamber enlarged obviously in eyes with silicon oil tamponade, and the acoustic features included complete filling and partial filling according to the amount of silicon oil. Several arc echoes at the posterior segment of eye were detected in the silicon-oil-filling eyes with retinal detachment. Conclusion In the silicon-oil-filling eyes with lengthened ocular axis, the characteristics of B-scan images are affected by acoustic velocity through silicon oil, the amount of silicon oil capacity and the emulsification of silicon oil. (Chin J Ocul Fundus Dis，2004，20：349-351)
At present, artificial intelligence (AI) has been widely used in the diagnosis and treatment of various ophthalmological diseases, but there are still many problems. Due to the lack of standardized test sets, gold standards, and recognized evaluation systems for the accuracy of AI products, it is difficult to compare the results of multiple studies. When it comes to the field of image generation, we hardly have an efficient approach to evaluating research results. In clinical practice, ophthalmological AI research is often out of touch with actual clinical needs. The requirements for the quality and quantity of clinical data put more burden on AI research, limiting the transformation of AI studies. The prediction of systemic diseases based on fundus images is making progressive advancement. However, the lack of interpretability of the research lower the acceptance. Ophthalmology AI research also suffer from ethical controversy due to unconstructed regulations and regulatory mechanisms, concerns on patients’ privacy and data security, and the risk of aggravating the unfairness of medical resources.
The improvement of diagnostic levels for fundus diseases depend on the advancements of fundus imaging technology. Different fundus imaging technologies allow doctors to inspect ocular fundus from different aspects such as morphological or functional changes of retina. As a basic fundus examination method, optical coherence tomography provides highresolution and crosssectional retinal images coupled with noninvasive advantages. Fully understanding of the advantages and disadvantages of each fundus imaging technique, appropriate choosing one or combining several imaging techniques, and optimizing diagnostic procedures for each fundus disease are crucial steps to improve our diagnostic levels of ocular fundus diseases.
The hallmark of the recent latest advances in diagnostic fundus imaging technology is combination of complex hierarchical levels and depths, as well as wide-angle imaging, ultra-wide imaging. The clinical application of wide-angle and ultra-wide imaging, not only can reevaluate the role of the peripheral retina, the classification types and treatment modalities of central retinal vein occlusion, and enhance the reliability of diabetic retinopathy screening, improve the classification and therapeutic decision of diabetic retinopathy, and but also can help guide and improve laser photocoagulation. However we must clearly recognize that the dominant role of ophthalmologists in the diagnosis of ocular fundus diseases cannot be replaced by any advanced fundus imaging technology including wide-angle imaging. We emphasize to use the three factors of cognitive performance (technology, knowledge and thinking) to improve the diagnosis of ocular fundus diseases in China.
Inherited retinal diseases (IRD) are a group of genetic disorders with high genetic and clinical heterogeneity. Patients with IRD may have their clinical diagnosis confirmed by genetic testing. Over the past 30 years, rapid advances in molecular genetics have raised the disease-causing gene variant detection rate and the accuracy of genetic testing, which provide hope to patients. The genetic diagnosis of patients with IRD is complicated due to the overlapping clinical phenotypes, and the fact that different variants lead to different phenotypes and severity even of the same gene. It is very important to overall evaluate the clinical phenotype of patients, precisely select genetic testing methods, and reasonably define disease-causing genes and variants during genetic diagnosis, which can guide the patient's subsequent treatment and provide genetic counseling.
Optical coherence tomography (OCT) has developed from time-doma in into Fourier-domain OCT (FD-OCT) which indicates clearer details and higher resolution of images. FD-OCT can indicate the structure and pathological changes of each retinal layer, and reveal the retinal external limiting membranes and changes of inner- and outer-segment of visual cells by 3D solid reconstruction. FD-OCT not only provide detailed information of the images for the clinical diagnosis, but also help us investigting the characteristics and pthological mechanisms of ocular fundus diseases, which lead us to a new era of technology of observation on ocualr fundus diseases. In the application, we should pay attention to the significance of different colors of OCT images, and focus on the cohenrence of the position in the image acquistion during the follow-up period. Dynamic observation on the lesions by FD-OCT and aggregated anaylsis of resutls of several imageological examination would be the development direction of imageological examination of ocular fundus diseases.
Ultra-wide field fundus autofluorescence (FAF) imaging is a new noninvasive technique with an imaging range of about 200 °. It can detect peripheral retinal lesions that cannot be found in previous FAFs and more objectively reflect intracellular content and distribution of lipofuscin in the retinal pigment epithelium (RPE) and RPE cell metabolic status. The ultra-wide field FAF can find the abnormal autofluorescence (AF) in the peripheral retina of the eyes of age-related macular degeneration (AMD), and different AF manifestations may have an impact on the diagnosis and treatment of the different AMD subtypes. It is helpful to evaluate subretinal fluid in the eyes of central serous choroidal retinopathy and can accurately detect the changes in the outer retina of the eyes without subretinal fluid. It can help to determine the type of uveitis and fully display the evolution of the disease. It can also assess the peripheral photoreceptor cell layer and RPE in patients with retinal dystrophy and retinitis pigmentosa, and comprehensively evaluate their retinal function and monitor the progress of disease. It can also assist in the evaluation of the short-term efficacy and RPE cell function after the scleral buckling surgery for patients with rhegmatogenous retinal detachment. In the future, ultra-wide field FAF may change the knowledge and intervention strategy of ocular fundus diseases and promote the clinical and scientific research in this field.
【Abstract】Objective To investigate the influent factors on normal intraabdominal pressure （IAP） and establish the IAP regressive equation. Methods The IAPs of 106 hospitalized patients were determined through monitoring the bladder pressures. The relationship between IAP and 14 factors including age, gender, height, weight, body mass index （BMI）, previous and recent abdominal surgical history, reasons for admission，complications and their quantities were analyzed，respectively.Results The mean IAP of the hospitalized patients was 5.5 mm Hg with a range from 0.4 mm Hg to 12.8 mm Hg. The difference among IAPs of different grades of BMIs had statistical significance （F=5.550，P＜0.01）. The male IAPs were 2.0 mm Hg higher than the female IAPs，which had statistical significance （t=3.122，P＜0.01）. The other 12 factors had no significant effects on IAP （Pgt;0.05）. Conclusion Normal IAP is possibly influenced by gender and BMI，and it is individually different.