Objective:To evaluate the dry eye status of nursing school students and understand their ocular surface health.Methods:Using the convenience sampling method, a total of 90 nursing students studying in the Nursing College of Capital Medical University in March 2018 were selected as the research objects. The OCULUS Jenvis-OSDI dry eye questionnaire and OCULUS ocular surface comprehensive analyzer were used subjectively and objectively to analyze the heath of ocular surface.Results:According to the OSDI dry eye questionnaire, mild dry eyes were 21 cases accounted for 23.3%, moderate dry eyes were 42 cases accounted for 46.7%, and severe dry eyes were 21 cases accounted for 23.3%. The main symptom of dry eye was foreign body sensation, accounting for 53.3%. The secondary symptoms were photophobia and blurred vision, which accounted for 46.7% and 40%, respectively. The OCULUS ocular surface comprehensive analyzer showed that the amount of tear secretion in both eyes was normal. In dry eye grading based on average tear film break-up time, critical dry eye accounted for about 60% and dry eye accounted for about 10%. Eye red analysis showed that 9 patients (10%) with hyperemia score>2.0 were dry eye caused by inflammation.Conclusions:The nursing school students have a high incidence of dry eye and subjective symptoms. It indicates that the students overuse eye and do not pay attention to eye hygiene. It is the responsibility of the nursing teacher to carry out health education for students, popularize scientific and rational use of eye knowledge, and pay attention to eye health.

目的 分析屈光参差性弱视儿童短期屈光矫正治疗下视力提高效果情况及影响因素.方法 连续纳入来自于北京分布于8个区县的9家医院眼科屈光参差性弱视患儿104例,行裸眼视力、矫正视力、睫状肌麻痹下检影验光、眼位、眼球运动等检查;根据患者年龄及屈光状态予以处方配镜,戴镜3月后复查.分析不同年龄、不同弱视程度、不同屈光参差类型患儿短期屈光矫正后高度屈光不正眼最佳矫正视力提高情况及影响因素.结果 不同弱视程度及年龄各组间的疗效差异有统计学意义,而屈光参差类型中,近视组,远视组,散光组各组间的疗效差异无统计学意义,但优于近视合并散光组和远视合并散光组.结论 短期屈光矫正对儿童屈光参差性弱视的治疗有效.其疗效与弱视的程度、治疗年龄相关,而与患儿单纯近视、远视、散光屈光参差的类型无明显的相关性.

目的了解颅内静脉窦狭窄（cerebral venous sinus stenosis,CVSS）患者眼部特征,分析静脉窦支架置入术后眼底改变情况,探讨与视盘水肿程度相关的可能因素。方法回顾性纳入2014年1月-2018年8月在首都医科大学附属北京天坛医院神经介入中心确诊,并行静脉窦支架置入术的CVSS患者,收集患者一般资料、病程、视力、眼底检查、视野情况、颅内压、DSA检查、静脉窦内压测定及患者术后的眼部变化等临床资料。总结CVSS患者的眼部特征和静脉窦支架置入术后的眼底改变情况,应用Kendall’s tau-b相关分析探讨与视盘水肿程度相关的可能因素。结果共纳入125例CVSS患者,存在视功能损害者101例（80.8%）,包括视物模糊、视力下降、视物变形、阵发性黑蒙、视野缺损、复视等,其中65例（52.0%）眼部症状为首发症状,35例（28.0%）仅表现出眼部症状。视盘水肿115例,共223只眼。视盘水肿等级中位值3（2～4）级（Frisén分级）。部分患者可见视盘周围出血、渗出、棉绒斑,视网膜皱褶及静脉迂曲扩张,视盘色淡或苍白等。视盘水肿等级与颅内压正相关（Kendall’stau-b=0.271,P=0.029）,与病程负相关（Kendall’stau-b=-0.261,P=0.002）。其中79例经内科治疗无效患者接受了静脉窦支架置入术,术后患者视盘水肿均有减轻,术后1个月视盘水肿等级降为2（1～3）级;术后6个月时视盘水肿完全消退比例达94.4%（135/143）。结论对双眼视盘水肿患者要除外CVSS可能性;眼底检查是CVSS诊疗评估及判断颅内压情况的一项重要无创检查,同时也是CVSS患者治疗后随访观察的必要检查。视盘水肿程度与颅内压正相关,与病程负相关;静脉窦狭窄合并视盘水肿经内科治疗无效患者可考虑行静脉窦支架置入术治疗,促进视盘水肿消退,减少视神经不可逆性损害。

Objective:To analyze refractive status and visual acuity and its relationship to binocular visual function in children with anisometropic amblyopia.Methods:A total of 106 children (106 eyes) with anisometropic amblyopia were recruited from November 2015 to September 2016 in nine hospitals in Beijing.All children were divided into the following groups based on risk factors for anisometropia:hyperopia anisometropia (67 cases),myopia anisometropia (5 cases),astigmatism anisometropia (12 cases),hyperopia combined astigmatism anisometropia (20 cases) and myopia combined astigmatism anisometropia (2 cases).Visual acuity,uncorrected and best corrected visual acuity,refractive status,and distant/near stereoscopic vision were tested.Pearson's correlation was used to analyze the correlation between dioptric differences and UCVA/BCVA in high refractive errors eye and distant/near stereoscopic vision.The correlation between BCVA difference of the two eyes and distant/near stereoscopic vision were also calculated.One-way ANOVA compared BCVA in high myopic eye and distant/near stereoscopic vision between groups.Results:There was a correlation for the dioptric difference between UCVA and BCVA,distant stereoscopic vision,and random dot stereograms (RDS) stereoscopic vision in high refractive errors (all P＜0.05).There was a significant correlation between the difference in BCVA and distant stereoscopic vision and RDS stereoscopic vision (all P＜0.05).There was a statistically significant difference between the five groups for BCVA,distant stereoscopic vision and RDS stereoscopic vision (F=6.221,5.271,3.622,3.647,3.464,P＜0.05).Visual acuity for high refractive error eye in the myopia anisometropia group was best compared to the other four groups.The differences were statistically significant between each group (all P＜0.05).Distant stereoscopic vision in the hyperopia anisometropia group was best compared to the other four groups.The differences were statistically significant between each group,except hyperopia combined astigmatism anisometropia and myopia combined astigmatism anisometropia groups (all P＜0.05).RDS stereopsis in the myopia anisometropia group was best compared to the other four groups.The differences were statistically significant between each group (all P＜0.05).Conclusions:Visual acuity and stereoscopic vision are correlated to the dioptric difference.Stereoscopic vision is significantly correlated with the difference in BCVA.Stereoscopic damage is different in patients based on the type of anisometropia.

AlM: To evaluate the changes of corneal endothelium density, central corneal thickness, corneal curvature and eye axial length for teenager myopia patients after wearing orthokeratology over night for 6mo.METHODS:Retrospective case-observational study was adopted. Forty-four myopia teenagers (86 eyes) aged 7~17 wearing overnight orthokeratology contact lens were observed and analyzed using ultrasonic diagnostic apparatus, non-contact corneal endothelial microscope and corneal topography. Changes and relative coefficient of corneal endothelium density, central corneal thickness, corneal curvature and eye axial length were examined before and after wearing overnight orthokeratology contact lens for 6mo.RESULTS: After wearing over night orthokeratology contact lens half a year, visual acuity was stable at 1. 0~1. 2 without serious complications. No significant differences were found in the density of corneal endothelial cells, corneal curvature and depth of anterior chamber comparing to before wearing. Central cornea thickness was smaller and length of eye axis increased after wearing for 6mo and significant differences were seen(P<0. 05). The coefficient of variation was observed between density of corneal endothelial cells and length of eye axis(right eye:P=0. 005,left eye:P=0. 013), central cornea thickness and length of eye axis ( right eye:P =0. 019,left eye:P = 0. 006) after wearing orthokeratology contact lens for 6mo.CONCLUSlON:After wearing overnight orthokeratology for 6mo, eye axis length still increased, corneal endothelial cells density decreased and central cornea thickness thinned.

AIM:To evaluate the optic nerve and axon impairment of relapsing - remitting multiple sclerosis ( RRMS) and neuromyelitis optica spectrum disorders ( NMOSD ) via detecting the peripapillary retinal nerve fiber layer (pRNFL) and the ganglion cell complex( GCC) thickness by optic coherence tomography(OCT). METHODS: Retrospective case control study. Two hundred three cases were collected from August 2014 to January 2016 in Beijing Tian Tan Hospital. They were divided into four groups, including the normal group (n=60), the RRMS group ( n = 60 ), the NMOSD anti -aquaporin- 4 autoantibody seropositive( NMOSD- AQP4 -Ab seropositive) group (n= 48), and the NMOSD-AQP4-Abseronegative group (n = 35). All people were detected for the average and four quadrants ( superior, inferior, nasal, temporal) of pRNFL thickness and the average and two quadrants (superior, inferior) of GCC thickness with OCT. One way analysis of variance or nonparametric tests was used to compare the differences of pRNFL and GCC thickness between groups. RESULTS: Comparing with the normal group, the average and all quadrants of pRNFL and GCC thickness in the RRMS, the NMOSD - AQP4 - Ab seropositive and the NMOSD-AQP4-Ab seronegative group were thinner (P<0. 01). Among them, the pRNFL and GCC thickness in the NMOSD- AQP4 - Ab seropositive group was the thinnest. Differences between groups in the pRNFL thickness:compared with the RRMS group, all quadrants of pRNFL and GCC thickness in the NMOSD-AQP4-Ab seropositive group were significantly thinner(P<0. 01); compared with the NMOSD- AQP4- Ab seronegative group, the inferior, nasal and temporal pRNFL thickness in the NMOSD-AQP4-Ab seropositive group were significantly thinner(P<0. 05), while the superior quadrant did not show significant differences( P > 0. 05); compared with the RRMS group, the superior pRNFL thickness in the NMOSD - AQP4 - Ab seronegative group was significantly thinner ( P < 0. 05), while the inferior, nasal and temporal quadrants did not show significant differences ( P > 0. 05 ). Differences between groups in the GCC thickness: compared with both the RRMS and the NMOSD- AQP4- Ab seronegative group, all quadrants of GCC thickness in the NMOSD -AQP4-Ab seropositive group were significantly thinner (P<0. 05); compared with the RRMS group, the superior GCC thickness in the NMOSD - AQP4 - Ab seronegative group was significantly thinner(P<0. 01), while the inferior quadrant did not show significant difference(P>0.05). CONCLUSION: The optic nerve and axon impairment in NMOSD - AQP4 - Ab seropositive group was the most severe and the impairment in RRMS group was the least severe. The impairment in NMOSD - AQP4 - Ab seronegative group was between the former two, and could be more similar to that of RMMS.

Abstract? AIM: To analyze the ocular manifestations of meningiomas in the trigone of the lateral ventricle, discuss the relevant factors of visual impairment in these patients and things need attention clinically.?METHODS:Retrospectively study on the clinical data of 90 eyes in 45 patients diagnosed of trigonal meningiomas treated at Beijing Tian Tan Hospital from October 2011 to October 2015.Preoperative examinations including visual acuity, optic disc findings, visual field, size of tumors and other change in MRI were analyzed.?RESULTS: Patients'age was 12-68 years old ( mean 41.7 ±13.7 years ). Male/female ratio was 1 ∶4.6. Decreased visual acuity occurred in 18 eyes.Optic disc edema was found in 24 eyes and optic disc pale in 6 eyes. Fourty -seven eyes had visual field defect, mostly homonymous hemianopia or defect. The maximum diameter of tumors was 2.1-9.6cm (4.8±1.7cm).Range of tumor volume was 3.02-193.2cm3(48.3±47.8cm3).A positive correlation of preoperative visual field defect was found with tumor volume, tumor maximum diameter, and brain midline shift respectively. While the preoperative visual field defect was not found any correlation with age, gender, course, and the enlargement of the ventricle and the edema of the tissue around the tumors. After Mann-Whitney U test, the&nbsp;differences on tumor volume, the maximum diameter of tumors, and brain midline shift between the two groups were significant.? CONCLUSION: Patients with trigonal meningiomas often have ocular signs and symptoms.The major reason of visual field defect is the damage of optic radiation around the tumor.The specific position of injured optic radiation determines the type and extent of visual field defect.Both ophthalmologist and neurosurgeon should pay attention to tumors nearby posterior visual pathway. Doing neurophthalmology examinations for these patients and realizing the position between the tumor and posterior visual pathway will be helpful and necessary in surgical planning.

OBJECTIVES:To analyze the differences and correlation between the ganglion cell complex (GCC), peripapillary retinal nerve fiber layer (pRNFL) and mean deviation (MD), mean sensitivity (MS) of saddle area tumor patients, and to evaluate the feasibility of using OCT to diagnose the visual pathway damage of saddle area tumor patients.METHODS:It was a case-control study. One hundred and eighty-eight normal persons and 279 saddle area tumor patients treated in Beijing Tiantan hospital, from November 2010 to June 2011, were recruited; the saddle area tumor patients were diagnosed by surgical sample pathological analysis. The recruits were divided into four groups, including the normal group, the pituitary gland tumours group, the meningiomas group and the craniopharyngiomas group. All patients received the visual field (VF) test using the Octopus 900 automated perimeter with the central 30 degree program, and the mean thickness measurements of GCC and pRNFL were made by RTVue OCT. The Spearman rank correlation coefficient was used to assess the correlation between GCC, pRNFL and MD, MS. The differences between pRNFL and GCC among the four groups were compared.RESULTS:The average thickness of the pRNFL (r(sOD) = 0.369 - 0.735, r(sOS) = 0.369 - 0.691) and GCC (r(sOD) = 0.357 - 0.797, r(sOS) = 0.375 - 0.681) were correlated with MD and MS (P < 0.01), and the measurements from the meningiomas was the most significant. Comparing with the normal group's thickness of pRNFL and GCC [OD: (113.60 ± 9.13) µm and (98.04 ± 6.85) µm; OS: (114.06 ± 8.99) µm and (97.70 ± 5.83) µm], the pituitary gland tumours group [OD: (101.25 ± 19.95) µm and (91.08 ± 13.19) µm; OS: (99.96 ± 20.95) µm and (89.82 ± 15.47) µm], meningiomas group [OD:(89.54 ± 19.19) µm and (80.77 ± 10.43) µm; OS: (92.79 ± 22.00) µm and (80.43 ± 10.09) µm] and craniopharyngiomas group [OD: (94.96 ± 16.59) µm and (86.46 ± 11.65) µm; OS: (94.92 ± 15.77) µm and (86.77 ± 9.56) µm] were thinner. There was statistically significant difference of pRNFL and GCC, among the three tumor groups, and the thickness of pRNFL and GCC of the meningiomas group was the thinnest (P < 0.05).CONCLUSIONS:The average thickness of the pRNFL and GCC is correlated with vision field damage, which can be used to evaluate optic nerve damage of saddle area tumor patients quantitatively, where the meningiomas was the most significant. The thickness of the pRNFL and GCC was thinner, and the damage to visual functions was more serious. In the three tumor groups, the meningiomas group was the most serious. In the clinic, visual field test combined with OCT were helpful to find and assess the damage to visual pathway and prognosis.

目的 分析颈动脉海绵窦瘘引起的眼部改变,加强眼科医师对该病的认识,减少临床误诊和漏诊.方法 回顾性分析我院神经介入科收治的经全脑血管数字减影确诊的颈动脉海绵窦瘘39例患者的临床资料,分析其临床眼科表现.结果 39例患者中,搏动性突眼21例(53.85%),颅内血管杂音21例(53.85%),结膜充血20例(51.28%),眼底改变20例(51.28%),视力下降19例(48.72%).结论 颈动脉海绵窦瘘瘤患者眼部改变特征明显,最常见的表现为搏动性突眼和颅内血管杂音.

Objective To analyze the ophthalmologic characteristics caused by cerebral infarction and evaluate their diagnostic value of visual pathway diseases through vision field defects.Methods Retrospective analysis of 90 cases of cerebral infarction patients with ophthalmologic signs were performed.Ophthalmologic features and incidences,the main dangerous factors of cerebral infarction and vision field defects features were observed.Results Among all 90 patients with the corresponding eye symptoms,visual acuity decreased in 31 cases,vision field defects was in 28 cases,fundus arteriosclerosis in 25 cases,diplopia in 10 cases,nystagmus in 3 cases,ocular movement disorder in 5 cases and ptosis in 3 cases.Among 75 patients who took cervical vascular ultrasound,unilateral and bilateral internal carotid atherosis in 30 cases and 45 cases.Among 54 cases who received the digital subtraction angiography(DSA)and/or ranscranial Doppler ultrasound(TCD),vertebral artery was abnormal in 42 cases,abnormal anterior cerebral artery(PCA)and middle cerebral artery(MCA)and posterior cerebral artery(PCA)in 16 and 33 and 6 cases,respectively.Conclusion Cerebral infarction may cause eye-related symptoms and distinctive vision field defects may assist to judge the position of visual pathway.Patients with cerebral infarction maybe first appear at the department of ophthalmology,so we should pay attention to it.

神经眼科疾病中相当一部分为跨学科疾病.将基于问题的学习(Problem-Based Learning,PBL)教学法引入到住院医师培训阶段对此类疾病的学习中,带教医师有针对性地选择典型病例,科学地、多方面、多角度地设计问题,指导住院医师对病例分析论证,进行发散性思维训练,使其了解以眼科症状首发的脑血管病这一临床上较少见的眼科-神经内科相关联性疾病,提高其临床思维能力.

目的 探讨人类免疫缺陷病毒(HIV)感染者的眼底病变特征.方法 收集2006年9～12月105例人类免疫缺陷病毒感染者,进行眼科和全身检查,包括视力、眼底照相,腹B超、胸片、血尿常规、肝肾功能等检查.进行血液CD4+T淋巴细胞计数.结果 86.5%的患者CD4+T淋巴细胞计数大于200×106/L.11.4%患者有眼底微血管病变表现,12.4%患者有限局性视网膜神经纤维层缺损.有眼底病变的患者与无眼底病变患者相比,视力差异无显著性.结论 本组HIV感染者最常见的眼底病变是视网膜微血管病变和限局性视网膜神经纤维层缺损,病变与 CD4+T 淋巴细胞计数呈负相关关系,一般不影响视力.

Objective To explore early diagnosis and trelatment strategy for optic nerve lesion induced by close brain trauma to anterior cranial fossa. Methods Analyze 112 patients of close anterior cranial fossa trauma who had received treatment in Tian Tan Hospital,retrospectively.Elucidate the mechanism of optic nerve injury and key points of diagnosis and therapy. Results There are 54 cases(48.21%) who had optic injury along with close brain trauma.It was very critical to carry out follow up evaluation for visual acuity,check up for pupils and eye fudi as well as CT scan.The general effective rate amounted to 67.86%(76/112),33 cases had shown effects(68.75%) among 48 patients who had received non-surgical therapy;remarkable effects were demonstrated from 4 patients(66.67%) among 6 cases who underwent surgery. Conclusions Optic nerve injury might be attributed to both ischemia and anoxia,the relevant crucial factors.Early comprehensive medical therapy will play a decisive role for clinical outcome.Timely surgical performance in addition to medicine treatment are strongly recommended for the patients who present with optic nerve canal fracture while vision is deteriorating.Surgical approach through frontal part is highly recommended to the patients with fracture on superior wall or posterior segment of optic nerve canal;Likewise,surgical approach via orbital ethmoidal pathway is recommended to the cases who suffer fracture to anterior segment of optic nerve canal.

为探讨确定蝶骨嵴脑膜瘤的眼部改变特征、术前定位诊断及视功能的保护,对天坛医院1995年1月至2001年6月共45例资料完整、经手术证实的蝶骨嵴脑膜瘤进行回顾性分析.其中39例(占 87%)出现眼征,前床突型脑膜瘤全部有眼部改变,而且大部分以首发症状出现.结果提示:头痛伴有单侧视力减退及视神经萎缩、单侧眼球突出合并眼睑水肿、单侧视野缺损、多条眼外肌麻痹等症状,应考虑到蝶骨嵴脑膜病的可能.早期诊断及治疗,有助于视功能的恢复,术后进行眼科治疗是必要的.