目的 分析不同近视屈光度儿童应用角膜塑形镜的控制效果.方法 回顾性分析2020年7月至2021年2月于佛山爱尔眼科医院门诊就诊的80例应用角膜塑形镜治疗的不同近视屈光度儿童的临床资料,根据其屈光度的不同分为甲组(n=40,<-3.00 D)和乙组(n=40,≥-3.00 D),比较两组儿童佩戴角膜塑形镜6个月和1年后的裸眼视力、角膜曲率(平K值、陡K值)、角膜内皮细胞、等效球镜屈光度(SER)增长量及眼轴长度(AL)增长量及佩戴期间并发症发生率.结果 佩戴6个月和1年后,乙组裸眼视力高于甲组,平K值、陡K值均低于甲组(P<0.05).佩戴6个月和1年后,乙组SER增长量、AL增长量均明显低于甲组(P<0.05).两组角膜内皮细胞密度及面积、并发症发生率比较差异均无统计学意义.结论 角膜塑形镜在不同屈光度近视患儿中应用效果良好,并发症少,不会影响角膜功能,但与屈光度<3.00 D儿童比较,屈光度≥3.00 D的儿童应用角膜塑形镜的控制效果更佳,更有利于控制或延缓近视进展.

AIM:To observe and analyze the effect of non-mydriatic fundus photography in screening diabetic retinopathy(DR), so as to provide the basis for clinical screening.METHODS:In our hospital from December 2016 to November 2017, 120 patients(240 eyes)was diagnosed as diabetes(DM), which were treated as the subjects of observation. By the same operator with non-mydriatic fundus photography, fundus photography and 7 range fundus fluorescein angiography(FFA)after mydriasis were taken. Taking the international clinical classification of diabetic retinopathy(DR)as the standard, the above three examinations were review, grade and record by the same physician by blind method. The fundus fluorescein angiography as the gold standard, the other two results were compared to detect the sensitivity, specificity, Youden index, Kappa value of the two for DR with different grade.RESULTS: There was 70.0% eyes diagnosed as diabetic retinopathy after screened by fundus angiography, 66.7% by post-mydriatic fundus photography, 65.0% by non-mydriatic fundus photography. The grading results of diabetic retinopathy screened by different methods were basically consistent, with no significant difference(P>0.05). When screening for diabetic retinopathy of different degrees, the sensitivity and specificity of the non-mydriatic group were 92.9% and 90.3%, respectively. There was no significant difference between the results of the non-mydriatic group and the non-mydriatic group. Compared with the gold standard group(FFA), the Youden index(83.14%)was close to 1, with high reliability; Kappa=0.81, and the validation was consistent. When screening for moderately nonproliferative diabetic retinopathy, the sensitivity and specificity of non-mydriatic fundus photography were 90.6% and 95.5%; there was no significant difference between the results of non-mydriatic and the results of fundus photography after mydriasis. Compared to the gold standard group, the Youden index was 86.09%, the reliability is high, Kappa=0.86, and the test was consistency. CONCLUSION:Non-mydriatic fundus photography can be used as a simple and accurate method for screening diabetic retinopathy. It is simple and easy to carry out without risk. It is easy to train specialist technicians for multi-point operation. With the help of today's convenient network, the image is transmitted to an experienced ophthalmologist for reading and diagnosis, which is convenient and fast, so that the patient can be diagnosed and treated nearby, which has positive significance for the society.

目的 对比免散瞳眼底照相与散瞳后7方位眼底照相两种筛查方法 在糖尿病视网膜病变(DR)诊断中的应用价值.方法 选取120例(240眼)糖尿病并到眼科进行DR筛查的患者作为研究对象,均行免散瞳眼底照相、散瞳后7方位眼底照相及眼底荧光血管造影检查,以眼底荧光血管造影检查作为"金标准",对比两种筛查方法 诊断DR的敏感性、特异性及准确度.结果 免散瞳眼底照相诊断DR患者109眼,诊断符合率为96.25%(231/240),散瞳后7方位眼底照相诊断DR患者110眼,诊断符合率为98.33%(236/240),两种筛查方法 比较差异无统计学意义(χ2=1.977,P=0.130>0.05).免散瞳眼底照相对DR的诊断敏感性、特异性分别为94.64%(106/112)、97.66%(125/128);散瞳后7方位眼底照相的诊断敏感性、特异性分别为97.32%(109/112)、99.22%(127/128).两种筛查方法 诊断敏感性、特异性比较差异无统计学意义(χ2=1.042、1.016,P=0.249、0.311>0.05).结论 免散瞳眼底照相操作简便、诊断效能较高,是最佳的筛查DR的方法 .

目的 探究免散瞳眼底照相筛查不同分期糖尿病视网膜病变的临床意义.方法 150例(300只眼)2型糖尿病患者进行临床探究,对患者行免散瞳彩色数码眼底照相技术筛查,根据患者的不同糖尿病视网膜病变情况进行分期,按照病程情况分类统计患者的发病率;对于糖尿病视网膜病达到Ⅲ期及以上的患者行荧光素眼底血管造影术(FFA)检查,比较分析2种不同检查方式的有效情况.结果 150例(300只眼)2型糖尿病患者进行免散瞳眼底检查,检查结果显示患有不同程度视网膜病变的占31.67%(95/300).病程<1、1~、5~、10~、>20年糖尿病视网膜病变检出率分别为14.58%、17.31%、25.00%、42.16%、48.00%.免散瞳眼底照相检查和FFA检查的诊断一致性较高(P<0.05).结论 本次研究证明在进行糖尿病视网膜病变诊断筛查过程中,可以使用免散瞳眼底照相进行筛查,检测效果与FFA效果一致性较高,且操作简便,进一步为糖尿病视网膜病变的诊断与治疗提供了评价标准.

Objective:To explore the emmetropia intervention on the prevention and treatment of the myopia in early days.Methods: 200 cases of visual acuity above 1.0,refraction at 0~+0.75 D,the age at 4~7 year old,were divided into control and intervention group,each 100 cases.The control had never given any processing,the intervention was given Atropine sulfate eye ointment/week or given the Tropicamide eye drops to sleep before drop an eye/day,reexamine visual acuity and refraction annually,continuously for 5 years.The difference of group was tested with four space watch card square examination.Results: With the Visual acuity decreased below 1.0,the control group was 47 people,account for 47.5%,the intervention group was 21 people,account for 21.4%.The control group showed the specific value higher(χ2=14.78,P0.01).The refraction decreased below-0.25 D,the control group was 49 people,account for 49.5%,the intervention group was 24 people,account for 24.5%.The control group showed specific value higher(χ2=13.2,P0.01).Conclusion: It has the clinical meaning to start the intervention of the emmetropia in early days.