β thalassemia is a hereditary hemolytic disease caused by the defect of β globin gene. Transfusion-dependent β thalassemia patients need long-term blood transfusion to survive, and a series of systemic and ocular complications will occur in the disease itself and long-term blood transfusion. Retinal blood vessel density decreases, retinal thickness thinned and elastic pseudoxanthoxanoma syndrome are found in fundus due to long-term anemia and side effects of iron chelating agent. At present, there are few reports about eye changes in thalassemia patients, and the cognition is relatively scarce. Therefore, it is necessary to be vigilant for physicians, deeply explore the cause and symptomatic treatment, combined with individual disease characteristics, to provide a more scientific and accurate plan for clinical treatment.
Objective To investigate the attitude and its influencing factors of Henan provincial rural residents towards the partial usage of funds from the New Rural Co-operative Medical System (NRCMS) for the disease control and prevention, in order to provide evidence for policy making. Methods In Henan province, 1 117 rural residents were randomly sampled with questionnaire from the 156 villages distributing in 44 townships of 19 counties (cities, districts). The frequency analyses, the multiple linear regression analysis and the one-way analysis of variance were conducted. Results Among all the respondents, only 3.4% of the rural residents absolutely disagreed (Zero agreement degree score), 34.4% fully agreed (10 agreement degree scores), and 90.6% had agreement degree scores equal to or more than five. The agreement degree was direct proportional to NRCMS satisfaction degree. The agreement degrees from residents who were relieved from medical financial burdens by NRCMS were higher than the others. 13.2% of rural residents believed that NRCMS did not alleviate their medical financial burden. For the men and women who believed that their village general practitioner was timely at vaccination, their agreement degree was higher than the others who considered vaccination time was late or common. The “timely group” was alone a subset. The “late group” and the “common group” were homogeneous subsets. The proportion of those who answered that the vaccination timeliness at late or common reached 40.6%. Conclusion The proposition to pay funds from the existing NRCMS for disease control and prevention is in line with the will of the majority of rural residents. The combination of disease control and prevention and NRCMS is a strategy in rural healthcare management. A bettering NRCMS and disease control and prevention are the basis of this policy in the future. More attention should be paid to the timeliness of the village general practitioners’ disease control work. It is necessary to perfect the NRCMS policy focusing on residents who hasn’t been relieved from medical financial burdens, so that more population will be benefited.
Ocular fundus imaging technology has developed rapidly in the past decade. The exsiting imaging technology is constantly updated and new imaging technology emerges one after another. The related research and development investment, equipment usage and paper publication are all growing rapidly. At the same time, it is developing towards the direction of multi-technology combination, integration of artificial intelligence and big data, as well as small-size and automation use of equipment. However, there are many challenges behind the prosperity of ocular fundus imaging, such as professionally remodeling of fundus diseases knowledge system standardization, balance and independence of scholarly communication, misunderstanding of "multimodal images", validation of the effectiveness and applicability of emerging technologies, clinical imaging research innovation, original technology innovation and technology reserve, fundus imaging data integration and analysis system for the future.
ObjectiveTo observe the clinical characteristics and risk factors associated with pachydrusen in eyes affected by central serous chorioretinopathy (CSC). MethodsA retrospective clinical study. From July 2021 to June 2024, 144 cases and 158 eyes of CSC patients diagnosed through ophthalmological examination at Department of Ophthalmology of The First Affiliated Hospital of Zhengzhou University were included. All affected eyes underwent a series of assessments, including refraction, intraocular pressure measurement, fundus color photography, fluorescein fundus angiography (FFA), and swept-source optical coherence tomography (OCT). Additionally, 58 eyes underwent indocyanine green angiography (ICGA). Cross-sectional (en-face) OCT was utilized to observe the colocalization of pachydrusen with areas of dilation of large choroidal vessels and attenuation of the choriocapillaris layer. The device was used for OCT included software for calculating subfoveal choroidal thickness (SFCT). FFA fluorescein leakage was categorized into “ink stain”, “cooking smoke”, and “diffuse point leakage”. Patients were classified into groups of CSC patients complicated by pachydrusen and groups of CSC patients without pachydrusen. Comparisons between the groups were performed using the χ2 test, and factors associated with the presence of pachydrusen were analyzed using logistic regression. ResultsAmong 158 eyes, 72 eyes (45.6%, 72/158) were complicated by pachydrusen. In en-face OCT images, pachydrusen were co-located with dilated large choroidal vessels in 59 eyes (81.94%, 59/72) and corresponded to choroidal capillary layer blood flow holes in 61 eyes (84.72%, 61/72). Among the 58 eyes that underwent ICGA examination, pachydrusen corresponded to punctate strong fluorescence in 46 eyes (79.31%, 46/58) and were located in areas of choroidal hyperpermeability in 43 eyes (74.14%, 43/58). Compared with the CSC group without pachydrusen, the incidence of choroidal neovascularization, flat irregular pigment epithelial detachment, diffuse punctal leakage and multiple leakage points increased in the CSC group, and the differences were statistically significant (χ2=6.217, 8.455, 5.363, 17.749; P＜0.05). Logistic regression analysis indicated that age [odds ratio (OR)=1.116, 95% confidence interval (CI) 1.060-1.176, P＜0.001], chronic CSC [OR=2.628, 95%CI 1.250-5.526, P=0.011] were independent risk factors for the occurrence of pachydrusen. ConclusionsThe incidence of pachydrusen in eyes with CSC is 45.6%, with age and chronic CSC identified as independent risk factors for their occurrence. Pachydrusen correspond to dilated choroidal vessels and areas of choroidal hyperpermeability, which may serve as potential risk factors for CSC activity or development.
Objective
To investigate the features of ocular fundus of retinal pigment epithelial detachment (PED) in Chinese patients more than 50.
Methods
The clinical data of 31 continuous patients (34 eyes) with PED diagnosed by ocular fundus photochromy, fundus fluorescein angiography (FFA) and indocyanine green angiography ( ICGA ) from Oct, 2001 to Aug, 2004 were analyzed retrospectively.
Results
In 34 eyes with PED, the results of FFA showed serous PED in 18 (52.9%), hemorrhagic PED in 8 (23.5%), and serosanguineous PED in 8 (23.5%); the results of ICGA revealed PED associated with choroidal neovascularization (CNV) in 12 (35.3%), PED associated with ploypoidal choroidal vasculopathy (PCV) in 17 (50.0%), PED associated with both CNV and PCV in 1 (2.9%), and avascular PED in 4 (11.8%).
Conclusions
PED in Chinese patients more than 50 can be associated with CNV, PCV or other avascular diseases, and PCV is the most common intercurrent choroidal vascular disease.
(Chin J Ocul Fundus Dis, 2006, 22: 224-227)
Objectives To analyze the status quo of projects on pension services funded by the National Natural Science Foundation of China (NSFC), with the aim of enlarging the perspective and horizon of related studies, and improving both the quantity and quality of such projects in NSFC. Methods NSFC website was systematically searched to collect information of pension service projects funded by NSFC from 2008 to 2017. SPSS 19.0 software was subsequently applied to analyze the characteristics of the projects in terms of study type, regional distribution, profession and institution, and fund scale, etc. Results A total of 39 projects on pension service were included, among which 12 were focused on related strategies (30.8%), 11 on related models (28.2%), and 6 on the effects of different interventions (15.4%). The 39 projects were unbalanced in terms of geographical distribution, institutions and research types. Conclusions NSFC should facilitate the research of pension service by expanding the related fund scale, increasing the fund support, strengthening the exchange of domestically different regions, and enhancing international cooperation.
ObjectiveTo investigate the clinical effects of laparoscopic hiatus reconstruction with Bard Crurosoft patch associated with Nissen fundoplication in elderly patients with gastroesophageal reflux disease (GERD). MethodsFrom July 2006 to July 2009, 22 consecutive elderly patients （≥65 years） with GERD underwent laparoscopic hiatus reconstruction associated with Nissen fundoplication， 10 of them underwent laparoscopic Crurosoft patch hiatus reconstruction (hiatus diameter≥5 cm in 2 patients， lt;5 cm in 8 patients) and 12 underwent laparoscopic simple sutured hiatus reconstruction (hiatus diameter≥5 cm in 2 patients， lt;5 cm in 10 patients). Intra and perioperative data including symptoms (heartburn, regurgitation, dysphagia, and respiratory complications), functional evaluations (esophagogastroscopy, manometric evaluations in lower esophageal segment, and 24 h pH-monitoring values) were compared and analyzed. ResultsPatients in 2 groups had similar preoperative values in demographics, symptom scores, functional evaluations, as well as operative data except for mean operative time. Three-month and 1-year follow-up after operation, the results of symptoms scores and functional evaluations of patients in 2 groups compared with preoperative values wear improved （Plt;0.05）, but symptoms scores and functional evaluations of patients in patch group were evaluated to demonstrate more significant improvement than suture group （Plt;0.05）. In suture group, the results of 3 months after operation were better than 1 year after operation, with statistically significant difference （Plt;0.05）. Two patients underwent postoperative intrathoracic immigration of wrap in suture group, but this complication did not happen in patch group （Plt;0.05）. ConclusionsLaparoscopic hiatus reconstruction with Bard Crurosoft patch associated with Nissen fundoplication is a safe and effective treatment for elderly patients(≥65 years) with GERD.
Fundus neovascularization is a significant cause of ocular diseases, mainly including retinal neovascularization and choroidal neovascularization. Anti-vascular endothelial growth factor therapy, though effective, has limitations such as a short half-life, non-responsiveness, and drug resistance. 6-Phosphofructo-2-kinase/fructose-2,6-bisphosphatase 3 (PFKFB3), a key regulator of glycolysis, affects the generation of pathological blood vessels by modulating the metabolism of vascular endothelial cells. Small molecule inhibitors targeting PFKFB3 protein have been confirmed in animal and cell models to significantly inhibit pathological angiogenesis, showing good therapeutic potential. However, most of them are still in the preclinical research stage. In the future, it is necessary to further investigate the mechanism of PFKFB3 gene, optimize the specificity and safety of the inhibitors, and explore the effects of combining them with existing therapies, so as to provide new strategies for the treatment of fundus neovascular diseases.
Objective To investigate the iconographic characteristics and clinical significances of synchronic examination of indocyanine green angiography (ICGA) and fundus fluorescein angiography (FFA) for high myopia.Methods Thirty patients (57 eyes) with high myopia（gt;-6.00D）, selected randomly and consecutively, were examined by ICGA and FFA synchronically.Results The result of early phase of FFA showed hypofluorescence of the background in 25 eyes，while of late phase showed subretinal neovascularization (SRNV) in 10 eyes and streak formation in 40 eyes. The result of ICGA showed choroidal retrobulbar arteries in 8 eyes, hypofluorescence of the background in 35 eyes, SRNV in 8 eyes, and streak formation in 52 eyes.Conclusion The iconographic characteristics of ICGA and FFA of high myopia include hypofluorescence of the background, SRNV and streak formation. ICGA can givemore exact information on the lesions of choroid in high myopia. The synchronic examination of ICGA and FFA may act as a guide to the therapy for high myopia.(Chin J Ocul Fundus Dis，2003，19：87-89)
Hydroxychloroquine retinopathy is an ocular lesions that develops following long-term or excessive use of hydroxychloroquine. The early clinical presentation of this lesion is nonspecific and is often detected when severe central vision impairment occurs in late stage. It currently mainly includes hydroxychloroquine binding to melanin, inducing degeneration of the retinal pigment epithelium, increasing the pH of lysosomes in the retinal pigment epithelium and interfering with the visual cycle. In recent years, with the development of retinal imaging technology and the in-depth study of hydroxychloroquine retinopathy, characteristic fundus structural changes such as retinal and choroidal thickness and blood vessels may occur in the early stage. This not only provides an important basis for the early diagnosis of hydroxychloroquine retinopathy, but also provides important clues for investigating its pathogenesis. Clinicians' proficiency in relevant fundus changes and pathogenesis will facilitate early diagnosis and treatment, while also minimizing irreversible central vision impairment in patients.
