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oe1(光电查) - 科学论文

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  • Structural and Functional Outcomes in Chronic Central Serous Chorioretinopathy Treated with Photodynamic Therapy

    摘要： Purpose: To study the retinal pigment epithelium (RPE) and retinal alterations in chronic central serous chorioretinopathy treated with photodynamic therapy, and its correlation with functional parameters such as best-corrected visual acuity (BCVA) and contrast sensitivity (CS). Methods: Retrospective, noncomparative, consecutive evaluation by optical coherence tomography and its correlation with BCVA and CS in 31 eyes of 26 patients. Results: In all affected patients, 88.5% were male with a mean age of 42.9 years. The right eye was involved in 64.5% of cases, bilateral in 19% and 73.9% were hyperopic (spherical refraction between 0 and +5.0 diopters). Of these cases, 51.5% had peri-RPE abnormalities, 17.3% hyperreflective substances at RPE, 19.4% RPE atrophy, 55.3% foveolar atrophy, 3.1% pigment epithelial detachment, 5.2% subretinal fluid persistence, 8.3% fibrin deposits, 68.4% photoreceptor inner and outer segment line interruption and 31.1% external limiting membrane interruption. Conclusions: Time evolution and number of outbreaks were related to the decrease in foveal and chorodial thickness and in those with worse BCVA and CS. RPE abnormalities and atrophy were related to the age of onset of symptoms. Photoreceptor elongation has been correlated with poor BCVA and inner and outer segment line destructuring and interruption with poor CS.

    关键词： Photochemotherapy,Contrast sensitivity,Visual acuity,Central serous chorioretinopathy,Optical coherence tomography

    更新于2025-09-23 15:22:29

  • Visual Acuity at Presentation in the Second Eye versus First Eye in Patients with Exudative Age-Related Macular Degeneration

    摘要： Purpose: To assess the difference in best-corrected visual acuity (BCVA) at presentation between the first and second eye in patients with bilateral neovascular age-related macular degeneration (AMD). Methods: We reviewed the charts of all patients who had a clinical examination for neovascular AMD at the University Eye Clinic of Creteil in January 2013. We retrospectively analyzed demographic and clinical data for 264 patients. Results: In the fellow eye, choroidal neovascularization (CNV) developed in 75/264 patients (28.4%) with a time interval between the 2 events of 30.3 months (range 6-145). Data were available on 65 patients: 14/65 (21.5%) were asymptomatic, 24/65 (36.9%) had BCVA >20/40, whereas at the time of CNV diagnosis in the first eye, no patient was asymptomatic (p<0.0001), and 11/65 (16.9%) eyes had BCVA >20/40 (p<0.0001). The mean BCVA of the first affected eye was 0.68 (±0.41) logarithm of minimum angle of resolution (logMAR) and the mean BCVA for the second eye was 0.36 (±0.29) logMAR (p<0.0001). Conclusions: The BCVA at the time of diagnosis of CNV was higher in the second eye than in the first affected eye. This was possibly due to several factors including systematic bilateral examination in follow-up of unilateral exudative AMD that allowed detection of 20% of cases.

    关键词： Patient management,Optical coherence tomography,Visual acuity,Age-related macular degeneration

    更新于2025-09-23 15:22:29

  • Six-month outcomes of corneal crosslinking with dextran-free isotonic riboflavin solution

    摘要： Purpose: To analyze the short-term clinical and topographic outcomes in patients with keratoconus after corneal collagen cross-linking treatment (CXL) with dextran-free isotonic riboflavin solution. Methods: In this retrospective case series, 26 eyes from 26 patients with keratoconus were studied. The best corrected visual acuity (BCVA) and refractive and topographic findings were analyzed at a 6-month follow-up. Results: The mean BCVA (Snellen lines) values before and 1, 3, and 6 months after CXL were 0.51 ± 0.2, 0.48 ± 0.2, 0.57 ± 0.2, and 0.64 ± 0.2, respectively, and the difference between the preoperative and 6-month values was statistically significant (p=0.006). The mean spherical equivalent refraction decreased from -5.6 ± 2.4 diopters (D) preoperatively to -5.0 ± 2.1 D, and mean simulated keratometry decreased from 48.5 ± 2.5 D to 47.8 ± 2.6 D at 6 months. (p=0.145 and p=0.001, respectively). In addition, the maximum keratometry decreased progressively and significantly from the preoperative value during follow-up (p=0.003). The central and minimal corneal thicknesses, including those of the epithelium, also decreased from 442.8 ± 25.6 μm and 430.5 ± 23.9 μm preoperatively to 420.7 ± 31.8 μm and 409.3 ± 28.7 μm at the most recent follow-up (p<0.001), respectively. No intraoperative or postoperative complications were observed. Conclusions: CXL with dextran-free isotonic riboflavin solution appears to be a safe treatment alternative for keratoconus and yields sustained short-term improvements in visual acuity, keratometric readings, and corneal thickness. However, long-term results are needed to confirm these outcomes.

    关键词： Dextrans,Riboflavin/therapeutic use,Collagen,Visual acuity,Ultraviolet rays,Cornea,Cross-linking reagents

    更新于2025-09-23 15:22:29

  • Influence of the level of monovision on visual outcome with an extended range of vision intraocular lens

    摘要： Purpose: The purpose of this study was to evaluate the influence of different levels of monovision on the clinical outcomes achieved with an extended range of vision (ERV) intraocular lens (IOL). Patients and methods: Subanalysis of 411 patients from the multicenter CONCERTO study aimed at evaluating the outcomes after bilateral implantation of the Tecnis Symfony IOL. Visual acuity, spectacle independence, photic phenomena incidence, and patient satisfaction outcomes were evaluated in six groups defined according to the level of monovision: 0.0 D (75 patients; group 1), 0,x#0.25 D (148 patients; group 2), 0.25,x #0.5 D (90 patients; group 3), 0.5,x#0.75 D (52 patients; group 4), 0.75,x#1.0 D (27 patients; group 5), and .1.0 D (19 patients; group 6). Results: Mean binocular uncorrected distance visual acuity (decimal) ranged from 0.90±0.17 in group 6 to 0.97±0.20 in group 2. Mean binocular uncorrected intermediate visual acuity (decimal) ranged from 0.77±0.25 in group 2 to 0.94±0.30 in group 4. Mean binocular uncorrected near visual acuity ranged from 0.64±0.23 in group 2 to 0.79±0.26 in group 6. The level of spectacle independence was high, with the highest value for near vision in group 6 (94.7%). Less patients reported halos (6.7%) in group 1, whereas only 3.8% of patients in group 4 reported disturbing glare symptoms. For near vision, the highest patient satisfaction was achieved in groups 4, 5, and 6. A total of 96.7% (group 3) and 96.2% (group 4) of patients would recommend the same procedure to their friends and family and would choose the same lens again. Conclusion: Mini-monovision of around 0.75 D after implantation of the Tecnis Symfony IOL provides a complete visual rehabilitation with minimal photic phenomena and high levels of patient satisfaction.

    关键词： Tecnis Symfony IOL,CONCERTO study,visual acuity,residual refraction,targeted monovision

    更新于2025-09-23 15:22:29

  • Preoperative automatic visual behavioural analysis as a tool for intraocular lens choice in cataract surgery

    摘要： Purpose: Cataract is the main cause of blindness, affecting 18 million people worldwide, with the highest incidence in the population above 50 years of age. Low visual acuity caused by cataract may have a negative impact on patient quality of life. The current treatment is surgery in order to replace the natural lens with an artificial intraocular lens (IOL), which can be mono- or multifocal. However, due to potential side effects, IOLs must be carefully chosen to ensure higher patient satisfaction. Thus, studies on the visual behavior of these patients may be an important tool to determine the best type of IOL implantation. This study proposed an anamnestic add-on for optimizing the choice of IOL. Methods: We used a camera that automatically takes pictures, documenting the patient’s visual routine in order to obtain additional information about the frequency of distant, intermediate, and near sights. Results: The results indicated an estimated frequency percentage, suggesting that visual analysis of routine photographic records of a patient with cataract may be useful for understanding behavioural gaze and for choosing visual management strategy after cataract surgery, simultaneously stimulating interest for customized IOL manufacturing according to individual needs.

    关键词： Sickness impact profile,Cataract/psychology,Cataract extraction,Vision, ocular,Visual acuity,Lenses, intraocular,Quality of life

    更新于2025-09-23 15:22:29

  • Multifocal electroretinogram in diabetic macular edema; Correlation with visual acuity and optical coherence tomography

    摘要： Purpose: To evaluate multifocal electroretinogram (mfERG) changes in eyes with diabetic macular edema (DME) and investigate any possible correlation with optical coherence tomography (OCT) features and visual acuity (VA). Methods: Twenty?nine right eyes of 29 subjects with DME due to non?proliferative diabetic retinopathy and 30 eyes of 30 normal subjects were evaluated. All patients underwent a complete ophthalmic examination. Sixty?one scaled hexagon mfERG responses were recorded. Components of the first order kernel of N1, N2, and P1 in five concentric rings centered on the fovea, were measured in both groups. Correlation and regression analyses were performed among VA, central macular thickness (CMT) based on OCT, mfERG amplitude, and latency of the N1, N2 and P1 waves. Results: Significant differences were observed in all mfERG parameters in five?ring regions of the retina between eyes with DME versus controls (P < 0.05). There were significant correlations among VA with N2 (P = 0,001, b = 0.73) and P1 amplitudes (P = 0.001, b = ?0.84) in the central macular area, and there was a borderline association between VA and CMT (P = 0.042, b = 0.392). Conclusion: Amplitudes of mfERG components (N1, P1, and N2) are significantly reduced and their latencies are delayed in eyes with DME indicating functional impairment in the outer retina. The mfERG total amplitude was significantly correlated with VA even more than CMT, therefore the combined use of OCT and mfERG for macular evaluation may better evaluate visual status in DME patients.

    关键词： Diabetes Mellitus,Multi?focal Electroretinography,Diabetic Macular Edema,Optical Coherence Tomography,Visual Acuity

    更新于2025-09-23 15:21:01

  • Optical coherence tomography parameters predictive of visual outcome after anti-VEGF therapy for retinal vein occlusion

    摘要： Purpose: To determine the optical coherence tomography (OCT) parameters that are predictive of visual outcome after anti-VEGF therapy for a retinal vein occlusion (RVO). Methods: Fifty-seven eyes with macular edema (ME) secondary to a central or branch RVO treated with bevacizumab or ranibizumab were studied. Spectral-domain OCT and microperimetry were performed before, 1, 3, and 6 months after the treatment and at the final visit. Central retinal thickness (CRT), macular volume (MV), integrity of the external limiting membrane (ELM), ellipsoid zone (EZ), and foveal bulge (FB), and photoreceptor outer segment (PROS) length were determined. Results: The mean follow-up period was 17.8±11.5 months. In 46 of the 57 eyes, a resolution of the ME was achieved. The pretreatment CRT and MV, presence of intact ELM, EZ, and FB, and PROS length at the time of ME resolution were significantly correlated with the best-corrected visual acuity and retinal sensitivity at the final visit (P0.050). Multiple regression analyses showed that the pretreatment MV had the highest correlation with the posttreatment best-corrected visual acuity and retinal sensitivity (P0.050). Conclusion: The CRT, MV, ELM, EZ, FB, and PROS length are predictive factors for the visual outcome after anti-VEGF therapy for RVO.

    关键词： spectral-domain optical coherence tomography,visual acuity,retinal sensitivity,anti-VEGF therapy,retinal vein occlusion

    更新于2025-09-23 15:21:01

  • Disorganization of Retinal Inner Layers and Ellipsoid Zone Disruption Predict Visual Outcomes in Central Retinal Vein Occlusion

    摘要： To assess the associations and predictive value of spectral-domain (SD) OCT inner and outer retinal structural parameters and visual acuity (VA) outcomes in macular edema (ME) secondary to central retinal vein occlusion (CRVO).

    关键词： disorganization of retinal inner layers,visual acuity,ellipsoid zone disruption,macular edema,spectral-domain OCT,central retinal vein occlusion

    更新于2025-09-23 15:21:01

  • Femtosecond laser-assisted Descemeta??s stripping endothelial keratoplasty: a prospective study of 6-month visual outcomes, corneal thickness and endothelial cell loss

    摘要： Purpose To report 6-month outcomes of visual acuity, the corneal thickness and endothelial cell density (ECD) in patients undergoing femtosecond laser-assisted Descemet’s stripping endothelial keratoplasty (FS-DSEK). Methods This prospective, consecutive, interventional series examined 25 eyes of 25 patients who underwent FS-DSEK for Fuchs endothelial dystrophy and bullous keratopathy. The pre-cut endothelial graft thickness (CET) was 150 lm. Best-corrected visual acuity (BCVA), central corneal thickness (CCT), donor CET, recipient corneal stromal thickness (CST) and ECD were assessed at 1 week and 1, 2, 3 and 6 months postoperatively. Results The mean BCVA at 6 months was 0.76 ± 0.35 logMAR units, improving from 1.54 ± 0.52 logMAR. CCT decreased significantly, from 759.8 ± 152.4 lm at 1 week to 631.7 ± 79.7 lm at 6 months postoperatively (P = 0.001). CET recovered to 153.4 ± 33.7 lm (P = 0.076) at 6 months as pre-cut status. The CST decreased from 561.5 ± 96.3 lm at 1 week to 479.7 ± 57.9 lm at 6 months (P < 0.001). Preoperatively, the donor ECD was 2747.6 ± 255.4 cells/mm2, and the ECD decreased to 1729.1 ± 562.9 cells/mm2 at 6 months, for a peak ECD loss of 36.86%. A greater decrease in CST observed from 1 week to 6 months postoperatively correlated with a lower ECD loss (P = 0.019) and a lower preoperative ECD (P = 0.012). However, a thinner CET correlated with a higher preoperative ECD (P = 0.028). Conclusions FS-DSEK is a safe and effective surgical alternative for corneal endothelial decompensation. The donor ECD and its changes could be used as predictive factors for the improvement of CST and CET.

    关键词： Visual acuity,Corneal endothelial cell density,Graft thickness,Femtosecond laser,Descemet’s stripping endothelial keratoplasty

    更新于2025-09-23 15:19:57

  • Objective assessment of visual acuity: a refined model for analyzing the sweep VEP

    摘要： Purpose The aim of this study was to develop a simple and reliable method for the objective assessment of visual acuity by optimizing the stimulus used in commercially available systems and by improving the methods of evaluation using a nonlinear function, the modified Ricker model. Methods Subjective visual acuity in the normal subjects was measured with Snellen targets, best-corrected, and in some cases also uncorrected and with plus lenses (+1 D, +2 D, +3 D). In patients, subjective visual acuity was measured best-corrected using the Freiburg Visual Acuity Test. Sweep VEP recordings to 11 spatial frequencies, with check sizes in logarithmically equidistant steps (0.6, 0.9, 1.4, 2.1, 3.3, 4.9, 7.3, 10.4, 18.2, 24.4, and 36.5 cpd), were obtained from 56 healthy subjects aged between 17 and 69 years (mean 42.5 ± 15.3 SD years) and 20 patients with diseases of the lens (n = 6), retina (n = 8) or optic nerve (n = 6). The results were fit by a multiple linear regression (2nd-order polynomial) or a nonlinear regression (modified Ricker model) and parameters compared (limiting spatial frequency (sflimiting) and the spatial frequency of the vertex (sfvertex) of the parabola for the 2nd-order polynomial fitting, and the maximal spatial frequency (sfmax), and the spatial frequency where the amplitude is 2 dB higher than the level of noise (sfthreshold) for the modified Ricker model. Results Recording with 11 spatial frequencies allows a more accurate determination of acuities above 1.0 logMAR. Tuning curves fitted to the results show that compared to the normal 2nd-order polynomial analysis, the modified Ricker model is able to describe closely the amplitudes of the sweep VEP in relation to the spatial frequencies of the presented checkerboards. In patients with a visual acuity better than about 0.5 (decimal), the predicted acuities based on the different parameters show a good match of the predicted visual acuities based on the models established in healthy volunteers to the subjective visual acuities. However, for lower visual acuities, both models tend to overestimate the visual acuity (up to *0.4 logMAR), especially in patients suffering from AMD. Conclusions Both models, the 2nd-order polynomial and the modified Ricker model performed equally well in the prediction of the visual acuity based on the amplitudes recorded using the sweep VEP. However, the modified Ricker model does not require the exclusion of data points from the fit, as necessary when fitting the 2nd-order polynomial model making it more reliable and robust against outliers, and, in addition, provides a measure for the noise of the recorded results.

    关键词： Sweep VEP,Visual acuity,Visual electrophysiology,Visual evoked potentials

    更新于2025-09-19 17:15:36