Ophthalmological complications with interferon therapy are usually mild and reversible, not requiring the withdrawal of the treatment. We report a case of a patient who had visual loss probably associated with interfe...Ophthalmological complications with interferon therapy are usually mild and reversible, not requiring the withdrawal of the treatment. We report a case of a patient who had visual loss probably associated with interferon therapy. Chronic hepatitis C virus infection （genotype la） was diagnosed in a 33-year old asymptomatic man. His past medical history was unremarkable and previous routine ophthalmologic check-up was normal. Pegylated interferon alpha and ribavirin were started. Three weeks later he reported painless reduction of vision. Ophthalmologic examination showed extensive intraretinal hemorrhages and cottonwool spots, associated with inferior branch retinal vein thrombosis. Antiviral therapy was immediately discontinued, but one year later he persists with severely decreased visual acuity. This case illustrates the possibility of unpredictable and severe complications during pegylated interferon therapy.展开更多
Dear Editor,I am Rosa Gutiérrez Bonet,former ophthalmology resident at Puerta de Hierro University Hospital,Madrid,Spain.I write to present four cases of cortical blindness（CB）after bilateral lung transplant（L...Dear Editor,I am Rosa Gutiérrez Bonet,former ophthalmology resident at Puerta de Hierro University Hospital,Madrid,Spain.I write to present four cases of cortical blindness（CB）after bilateral lung transplant（LT）.展开更多
Dear Editor,We present the first reported case of unilateral optic disc swelling with subsequent persistent loss of vision triggered by ecstasy consumption in the case of a young man.Ecstasy is one of the most commonl...Dear Editor,We present the first reported case of unilateral optic disc swelling with subsequent persistent loss of vision triggered by ecstasy consumption in the case of a young man.Ecstasy is one of the most commonly consumed recreational drugs among young adults.Its main constituent and active substance is 3,4-methylenedioxymethamphetamine(MDMA).展开更多
Objective The aim of this study was to investigate macular perfusion changes and ganglion cell complex(GCC)loss in patients with unexplained visual loss following vitrectomy and silicone oil(SO)tamponade,and to evalua...Objective The aim of this study was to investigate macular perfusion changes and ganglion cell complex(GCC)loss in patients with unexplained visual loss following vitrectomy and silicone oil(SO)tamponade,and to evaluate the correlation between retinal blood flow and GCC loss using optical coherence tomography angiography(OCTA)and optical coherence tomography(OCT).Methods This retrospective study included seven eyes(seven patients)with unexpected visual loss after vitrectomy and SO tamponade.OCTA was used to evaluate the alterations in retinal vessel density(VD)in the superficial capillary plexus(SCP),deep capillary plexus(DCP),and radial peripapillary capillary plexus(RPCP).OCT was used to measure the thickness of GCC and retinal nerve fiber layer(RNFL).Medical records of patients were reviewed.Results Quantitative analysis of OCTA images revealed a significant reduction in SCP VD in the affected eyes compared with the controls(all sections P<0.05).No difference was found in GCC thickness,but FLV(focal loss volume)and GLV(global loss volume)were significantly higher in the affected eyes(both P<0.001).SCP VD was inversely correlated with FLV and GLV.Conclusions Silicone oil-related severe visual loss was associated with superficial retinal microvasculature damage and ganglion cell apoptosis.展开更多
Perioperative visual loss(POVL) is an uncommon, but devastating complication that remains primarily associated with spine and cardiac surgery. The incidence and mechanisms of visual loss after surgery remain difficult...Perioperative visual loss(POVL) is an uncommon, but devastating complication that remains primarily associated with spine and cardiac surgery. The incidence and mechanisms of visual loss after surgery remain difficult to determine. According to the American Society of Anesthesiologists Postoperative Visual Loss Registry, the most common causes of POVL in spine procedures are the two different forms of ischemic optic neuropathy: anterior ischemic optic neuropathy and posterior ischemic optic neuropathy, accounting for 89% of the cases. Retinal ischemia, cortical blindness, and posterior reversible encephalopathy are also observed, but in a small minority of cases. A recent multicenter case control study has identified risk factors associated with ischemic optic neuropathy for patients undergoing prone spinal fusion surgery. These include obesity, male sex, Wilson frame use, longer anesthetic duration, greater estimated blood loss, and decreased percent colloid administration. These risk factors are thought to contribute to the elevation of venous pressure and interstitial edema, resulting in damage to the optic nerve by compression of the vessels that feed the optic nerve, venous infarction or direct mechanical compression. This review will expand on these findings as well as the recently updated American Society of Anesthesiologists practice advisory on POVL. There are no effectivetreatment options for POVL and the diagnosis is often irreversible, so efforts must focus on prevention and risk factor modification. The role of crystalloids versus colloids and the use of α-2 agonists to decrease intraocular pressure during prone spine surgery will also be discussed as a potential preventative strategy.展开更多
We are reporting a 59-year-old male who presented with features of bilateral anterior ischaemic optic neuropathy after coronary artery bypass grafting. Postoperative vision loss after major nonocular surgery is a very...We are reporting a 59-year-old male who presented with features of bilateral anterior ischaemic optic neuropathy after coronary artery bypass grafting. Postoperative vision loss after major nonocular surgery is a very rare but devastating complication since it has the potential to cause bilateral, severe and permanent loss of vision.展开更多
AIM：To determine the Bruch＇s membrane opening-minimum rim width（BMO-MRW） tipping point where corresponding visual field（VF） damages become detectable.METHODS：A total of 85 normal subjects and 83 glaucoma patie...AIM：To determine the Bruch＇s membrane opening-minimum rim width（BMO-MRW） tipping point where corresponding visual field（VF） damages become detectable.METHODS：A total of 85 normal subjects and 83 glaucoma patients（one eye per participant） were recruited for the study.All of the patients had VF examinations and spectral-domain optical coherence tomography to measure the BMO-MRW.Total deviation values for 52 VF points were allocated to the corresponding sector according to the Garway-Heath distribution map.To evaluate the relationship between VF loss and BMOMRW measurements,a ＂broken-stick＂ statistical model was used.The tipping point where the VF values started to sharply decrease as a function of BMO-MRW measurements was estimated and the slopes above and below this tipping point were compared.RESULTS：A 25.9% global BMO-MRW loss from normative value was required for the VF loss to be detectable.Sectorally,substantial BMO-MRW thinning in inferotemporal sector（33.1%） and relatively less BMO-MRW thinning in the superotemporal sector（8.9%） were necessary for the detection of the VF loss.Beyond the tipping point,the slopes were close to zero throughout all of the sectors and the VF loss was unrelated to the BMO-MRW loss.The VF loss was related to the BMO-MRW loss below the tipping point.The difference between the two slopes was statistically significant（P≤0.002）.CONCLUSION：Substantial BMO-MRW loss appears to be necessary for VF loss to be detectable in patients with open angle glaucoma with standard achromatic perimetry.展开更多
AIM:To evaluate the driving performance in young and middle-aged Chinese glaucoma patients with mild to severe visual field loss compared to those without glaucoma by using a driving simulation test.METHODS:Twenty-nin...AIM:To evaluate the driving performance in young and middle-aged Chinese glaucoma patients with mild to severe visual field loss compared to those without glaucoma by using a driving simulation test.METHODS:Twenty-nine participants were included in this study:nine patients with glaucoma but pass the binocular Esterman visual field test,ten patients with glaucoma and fail the binocular Esterman visual field test,and ten age-matched healthy controls.A driving simulation test was designed as a frequency-based analysis of a lanekeeping task.The total performance error,the controlresponse amplitude and delay were calculated.RESULTS:Esterman visual field test fail group showed the longest delay of control-response among three groups(P=0.02).And the delay in lane-keeping task was significantly associated with inferior field of better-eye(r=0.51,P=0.004)and integrated visual field(r=0.55,P=0.002).CONCLUSION:Young and middle-aged glaucoma patients with binocular visual field loss suffered from a longer delay of response in driving simulation test,while inferior visual field having more impact than superior visual field.展开更多
The mining loss rate and dilution rate are the key indicators for the mining technology and management level of mining enterprises. Aiming at the practical problems such as the large workload but inaccurate data of th...The mining loss rate and dilution rate are the key indicators for the mining technology and management level of mining enterprises. Aiming at the practical problems such as the large workload but inaccurate data of the traditional loss and dilution calculation method, this thesis introduces the operating principle and process of calculating the loss rate and dilution rate at the mining fields by adopting geological models. As an example, authors establishes 3D models of orebody units in the exhausted area and mining fields in Yangshu Gold Mine in Liaoning Province, and conduct Boolean calculation among the models to obtain the calculation parameters of loss and dilution, and thereby calculate out the dilution rate and loss rate of the mining fields more quickly and accurately.展开更多
Dear Editor,We present a rare case of postoperative visual loss attributed to haemorrhagic retinopathy with delayed presentation following an uncomplicated unilateral biportal endoscopic L5S1 rhizolysis.Postoperative ...Dear Editor,We present a rare case of postoperative visual loss attributed to haemorrhagic retinopathy with delayed presentation following an uncomplicated unilateral biportal endoscopic L5S1 rhizolysis.Postoperative visual loss is a rare but devastating complication following spinal surgery^([1-2]).Recognised causes include ischemic optic neuropathy,occlusive vasculopathy and cortical blindness^([1]).Bilateral haemorrhagic retinopathy is an uncommon complication mentioned in the literature.展开更多
The acute onset of the vision loss by optic never injury following orbital wall reconstruction, has been reported in 0.5% - 5.0% of the cases. Visual impairment can be recovered within an early period after injury. De...The acute onset of the vision loss by optic never injury following orbital wall reconstruction, has been reported in 0.5% - 5.0% of the cases. Visual impairment can be recovered within an early period after injury. Delayed visual recovery from optic nerve injury during a procedure of orbital wall reconstruction has not been reported. We report a case of delayed recovery from optic nerve injury which occurred following orbital wall reconstruction. A 78-year-old man underwent orbital wall reconstruction for medial wall fracture and resulting enophthalmos in the right eye, one week after a traffic accident. Immediate after surgery, postoperative visual acuity in the right eye decreased to light perception, and relative afferent pupillary defect (RAPD) was detected. In spite of mega-dose steroid treatment, the visual acuity did not improve. However, 8 months after surgery, visual acuity began to recover to 0.1, and the degree of RAPD decreased. Twelve months after surgery, visual acuity in the right eye was 0.4, and pupillary light reflex was normal. Our report suggests that patients with optic neuropathy by surgery or trauma require long-term follow-up, regardless of early response to mega-dose steroid treatment.展开更多
The deep learning model is overfitted and the accuracy of the test set is reduced when the deep learning model is trained in the network intrusion detection parameters, due to the traditional loss function convergence...The deep learning model is overfitted and the accuracy of the test set is reduced when the deep learning model is trained in the network intrusion detection parameters, due to the traditional loss function convergence problem. Firstly, we utilize a network model architecture combining Gelu activation function and deep neural network;Secondly, the cross-entropy loss function is improved to a weighted cross entropy loss function, and at last it is applied to intrusion detection to improve the accuracy of intrusion detection. In order to compare the effect of the experiment, the KDDcup99 data set, which is commonly used in intrusion detection, is selected as the experimental data and use accuracy, precision, recall and F1-score as evaluation parameters. The experimental results show that the model using the weighted cross-entropy loss function combined with the Gelu activation function under the deep neural network architecture improves the evaluation parameters by about 2% compared with the ordinary cross-entropy loss function model. Experiments prove that the weighted cross-entropy loss function can enhance the model’s ability to discriminate samples.展开更多
During the past two decades, a number of studies have investigated the health-related quality of life (HRQOL) of older people with visual impairment, but the information is fragmented concerning health care providers ...During the past two decades, a number of studies have investigated the health-related quality of life (HRQOL) of older people with visual impairment, but the information is fragmented concerning health care providers in the field of gerontology. In this review, findings of HRQOL studies in older adults with different types of age-related ocular disorders or conditions are summarized. Apart from medical treatment and vision rehabilitation, factors that may influence the HRQOL of visually impaired older adults are also examined, including age, gender, socioeconomic status, mobility, comorbidity, family support, social support, use of eye care services, and psychological and spiritual factors. Finally, existing problems are discussed and recommendations for future research are provided. Given the high prevalence of visual impairment among older adults and their unmet needs for eye care and vision rehabilitation, multidisciplinary interventions that may enhance visually impaired older people’s HRQOL are warranted.展开更多
Dear Editor,Diabetic macular edema(DME)is a major cause of visual loss in diabetic patients,which is mainly caused by disruption of the blood-retinal barrier and loss of pericytes and endothelial cells,resulting in th...Dear Editor,Diabetic macular edema(DME)is a major cause of visual loss in diabetic patients,which is mainly caused by disruption of the blood-retinal barrier and loss of pericytes and endothelial cells,resulting in the leakage of plasma and lipids[1].Nowadays,laser photocoagulation,intravitreal injections of anti-vascular endothelial growth factor(anti-VEGF)drugs and dexamethasone implant.展开更多
文摘Ophthalmological complications with interferon therapy are usually mild and reversible, not requiring the withdrawal of the treatment. We report a case of a patient who had visual loss probably associated with interferon therapy. Chronic hepatitis C virus infection （genotype la） was diagnosed in a 33-year old asymptomatic man. His past medical history was unremarkable and previous routine ophthalmologic check-up was normal. Pegylated interferon alpha and ribavirin were started. Three weeks later he reported painless reduction of vision. Ophthalmologic examination showed extensive intraretinal hemorrhages and cottonwool spots, associated with inferior branch retinal vein thrombosis. Antiviral therapy was immediately discontinued, but one year later he persists with severely decreased visual acuity. This case illustrates the possibility of unpredictable and severe complications during pegylated interferon therapy.
文摘Dear Editor,I am Rosa Gutiérrez Bonet,former ophthalmology resident at Puerta de Hierro University Hospital,Madrid,Spain.I write to present four cases of cortical blindness（CB）after bilateral lung transplant（LT）.
文摘Dear Editor,We present the first reported case of unilateral optic disc swelling with subsequent persistent loss of vision triggered by ecstasy consumption in the case of a young man.Ecstasy is one of the most commonly consumed recreational drugs among young adults.Its main constituent and active substance is 3,4-methylenedioxymethamphetamine(MDMA).
基金supported by Capital Medical University Affiliated Beijing Tongren Hospital Key Medical Development Plan[trzdyxzy201801].
文摘Objective The aim of this study was to investigate macular perfusion changes and ganglion cell complex(GCC)loss in patients with unexplained visual loss following vitrectomy and silicone oil(SO)tamponade,and to evaluate the correlation between retinal blood flow and GCC loss using optical coherence tomography angiography(OCTA)and optical coherence tomography(OCT).Methods This retrospective study included seven eyes(seven patients)with unexpected visual loss after vitrectomy and SO tamponade.OCTA was used to evaluate the alterations in retinal vessel density(VD)in the superficial capillary plexus(SCP),deep capillary plexus(DCP),and radial peripapillary capillary plexus(RPCP).OCT was used to measure the thickness of GCC and retinal nerve fiber layer(RNFL).Medical records of patients were reviewed.Results Quantitative analysis of OCTA images revealed a significant reduction in SCP VD in the affected eyes compared with the controls(all sections P<0.05).No difference was found in GCC thickness,but FLV(focal loss volume)and GLV(global loss volume)were significantly higher in the affected eyes(both P<0.001).SCP VD was inversely correlated with FLV and GLV.Conclusions Silicone oil-related severe visual loss was associated with superficial retinal microvasculature damage and ganglion cell apoptosis.
文摘Perioperative visual loss(POVL) is an uncommon, but devastating complication that remains primarily associated with spine and cardiac surgery. The incidence and mechanisms of visual loss after surgery remain difficult to determine. According to the American Society of Anesthesiologists Postoperative Visual Loss Registry, the most common causes of POVL in spine procedures are the two different forms of ischemic optic neuropathy: anterior ischemic optic neuropathy and posterior ischemic optic neuropathy, accounting for 89% of the cases. Retinal ischemia, cortical blindness, and posterior reversible encephalopathy are also observed, but in a small minority of cases. A recent multicenter case control study has identified risk factors associated with ischemic optic neuropathy for patients undergoing prone spinal fusion surgery. These include obesity, male sex, Wilson frame use, longer anesthetic duration, greater estimated blood loss, and decreased percent colloid administration. These risk factors are thought to contribute to the elevation of venous pressure and interstitial edema, resulting in damage to the optic nerve by compression of the vessels that feed the optic nerve, venous infarction or direct mechanical compression. This review will expand on these findings as well as the recently updated American Society of Anesthesiologists practice advisory on POVL. There are no effectivetreatment options for POVL and the diagnosis is often irreversible, so efforts must focus on prevention and risk factor modification. The role of crystalloids versus colloids and the use of α-2 agonists to decrease intraocular pressure during prone spine surgery will also be discussed as a potential preventative strategy.
文摘We are reporting a 59-year-old male who presented with features of bilateral anterior ischaemic optic neuropathy after coronary artery bypass grafting. Postoperative vision loss after major nonocular surgery is a very rare but devastating complication since it has the potential to cause bilateral, severe and permanent loss of vision.
文摘AIM：To determine the Bruch＇s membrane opening-minimum rim width（BMO-MRW） tipping point where corresponding visual field（VF） damages become detectable.METHODS：A total of 85 normal subjects and 83 glaucoma patients（one eye per participant） were recruited for the study.All of the patients had VF examinations and spectral-domain optical coherence tomography to measure the BMO-MRW.Total deviation values for 52 VF points were allocated to the corresponding sector according to the Garway-Heath distribution map.To evaluate the relationship between VF loss and BMOMRW measurements,a ＂broken-stick＂ statistical model was used.The tipping point where the VF values started to sharply decrease as a function of BMO-MRW measurements was estimated and the slopes above and below this tipping point were compared.RESULTS：A 25.9% global BMO-MRW loss from normative value was required for the VF loss to be detectable.Sectorally,substantial BMO-MRW thinning in inferotemporal sector（33.1%） and relatively less BMO-MRW thinning in the superotemporal sector（8.9%） were necessary for the detection of the VF loss.Beyond the tipping point,the slopes were close to zero throughout all of the sectors and the VF loss was unrelated to the BMO-MRW loss.The VF loss was related to the BMO-MRW loss below the tipping point.The difference between the two slopes was statistically significant（P≤0.002）.CONCLUSION：Substantial BMO-MRW loss appears to be necessary for VF loss to be detectable in patients with open angle glaucoma with standard achromatic perimetry.
基金Supported by State Key Program of National Natural Science Foundation of China(No.81430007)National Natural Science Foundation of China(No.81790641,No.81401533)Natural Science Foundation of Shanghai(No.18ZR1406000)。
文摘AIM:To evaluate the driving performance in young and middle-aged Chinese glaucoma patients with mild to severe visual field loss compared to those without glaucoma by using a driving simulation test.METHODS:Twenty-nine participants were included in this study:nine patients with glaucoma but pass the binocular Esterman visual field test,ten patients with glaucoma and fail the binocular Esterman visual field test,and ten age-matched healthy controls.A driving simulation test was designed as a frequency-based analysis of a lanekeeping task.The total performance error,the controlresponse amplitude and delay were calculated.RESULTS:Esterman visual field test fail group showed the longest delay of control-response among three groups(P=0.02).And the delay in lane-keeping task was significantly associated with inferior field of better-eye(r=0.51,P=0.004)and integrated visual field(r=0.55,P=0.002).CONCLUSION:Young and middle-aged glaucoma patients with binocular visual field loss suffered from a longer delay of response in driving simulation test,while inferior visual field having more impact than superior visual field.
文摘The mining loss rate and dilution rate are the key indicators for the mining technology and management level of mining enterprises. Aiming at the practical problems such as the large workload but inaccurate data of the traditional loss and dilution calculation method, this thesis introduces the operating principle and process of calculating the loss rate and dilution rate at the mining fields by adopting geological models. As an example, authors establishes 3D models of orebody units in the exhausted area and mining fields in Yangshu Gold Mine in Liaoning Province, and conduct Boolean calculation among the models to obtain the calculation parameters of loss and dilution, and thereby calculate out the dilution rate and loss rate of the mining fields more quickly and accurately.
文摘Dear Editor,We present a rare case of postoperative visual loss attributed to haemorrhagic retinopathy with delayed presentation following an uncomplicated unilateral biportal endoscopic L5S1 rhizolysis.Postoperative visual loss is a rare but devastating complication following spinal surgery^([1-2]).Recognised causes include ischemic optic neuropathy,occlusive vasculopathy and cortical blindness^([1]).Bilateral haemorrhagic retinopathy is an uncommon complication mentioned in the literature.
文摘The acute onset of the vision loss by optic never injury following orbital wall reconstruction, has been reported in 0.5% - 5.0% of the cases. Visual impairment can be recovered within an early period after injury. Delayed visual recovery from optic nerve injury during a procedure of orbital wall reconstruction has not been reported. We report a case of delayed recovery from optic nerve injury which occurred following orbital wall reconstruction. A 78-year-old man underwent orbital wall reconstruction for medial wall fracture and resulting enophthalmos in the right eye, one week after a traffic accident. Immediate after surgery, postoperative visual acuity in the right eye decreased to light perception, and relative afferent pupillary defect (RAPD) was detected. In spite of mega-dose steroid treatment, the visual acuity did not improve. However, 8 months after surgery, visual acuity began to recover to 0.1, and the degree of RAPD decreased. Twelve months after surgery, visual acuity in the right eye was 0.4, and pupillary light reflex was normal. Our report suggests that patients with optic neuropathy by surgery or trauma require long-term follow-up, regardless of early response to mega-dose steroid treatment.
文摘The deep learning model is overfitted and the accuracy of the test set is reduced when the deep learning model is trained in the network intrusion detection parameters, due to the traditional loss function convergence problem. Firstly, we utilize a network model architecture combining Gelu activation function and deep neural network;Secondly, the cross-entropy loss function is improved to a weighted cross entropy loss function, and at last it is applied to intrusion detection to improve the accuracy of intrusion detection. In order to compare the effect of the experiment, the KDDcup99 data set, which is commonly used in intrusion detection, is selected as the experimental data and use accuracy, precision, recall and F1-score as evaluation parameters. The experimental results show that the model using the weighted cross-entropy loss function combined with the Gelu activation function under the deep neural network architecture improves the evaluation parameters by about 2% compared with the ordinary cross-entropy loss function model. Experiments prove that the weighted cross-entropy loss function can enhance the model’s ability to discriminate samples.
文摘During the past two decades, a number of studies have investigated the health-related quality of life (HRQOL) of older people with visual impairment, but the information is fragmented concerning health care providers in the field of gerontology. In this review, findings of HRQOL studies in older adults with different types of age-related ocular disorders or conditions are summarized. Apart from medical treatment and vision rehabilitation, factors that may influence the HRQOL of visually impaired older adults are also examined, including age, gender, socioeconomic status, mobility, comorbidity, family support, social support, use of eye care services, and psychological and spiritual factors. Finally, existing problems are discussed and recommendations for future research are provided. Given the high prevalence of visual impairment among older adults and their unmet needs for eye care and vision rehabilitation, multidisciplinary interventions that may enhance visually impaired older people’s HRQOL are warranted.
基金Supported by National Natural Science Foundation of China(No.82171062No.82301222)Zhejiang Provincial Natural Science Foundation of China(No.LY20H120002).
文摘Dear Editor,Diabetic macular edema(DME)is a major cause of visual loss in diabetic patients,which is mainly caused by disruption of the blood-retinal barrier and loss of pericytes and endothelial cells,resulting in the leakage of plasma and lipids[1].Nowadays,laser photocoagulation,intravitreal injections of anti-vascular endothelial growth factor(anti-VEGF)drugs and dexamethasone implant.
