BACKGROUND Silicone oil(SiO)migration to the central nervous system(CNS)is a rare complication of SiO tamponade after vitreo-retinal surgeries,it could masquerade hemorrhage on computed tomography neuro-imaging.Only l...BACKGROUND Silicone oil(SiO)migration to the central nervous system(CNS)is a rare complication of SiO tamponade after vitreo-retinal surgeries,it could masquerade hemorrhage on computed tomography neuro-imaging.Only limited cases were reported in the literature,certain intra-operative and post-operative ocular risk factors might contribute to the different extend of SiO migration in the CNS.AIM To study the risk factors for cerebral ventricular migration(CVM)on top of visual pathway migration(VPM).METHODS Conforming to the preferred reporting items for systematic reviews and metaanalyses guidelines,literature searches on PubMed,MEDLINE,EMBASE were performed on June 1,2024.Publications on SiO migration to CNS were included in this review.Non-English articles,and studies without neuro-imaging of the CNS were excluded.Patient demographics,SiO filled eyes'ocular characteristics and vitrectomy surgical details were extracted from included studies in this review.VPM and CVM were assigned as group 1 and group 2 respectively.Fisher's exact tests,Mann-Whitney U tests and binary logistic regression were performed.RESULTS Total 68 articles were obtained after searches,48 publications were included for analysis.Total 54 SiO filled eyes were analyzed.Post-vitrectomy intraocular pressure(IOP)was found to be significant in both Mann-Whitney U test(P=0.047)and binary logistic regression(P=0.012).Diabetic was found to be significant in binary logistic regression(P=0.037),but at borderline risk for CVM in Fisher's exact test(P=0.05).Other significant factors include longer SiO tamponade time(P=0.002 in Fisher's exact test)and visual acuity(P=0.011 in binary logistic regression).Optic nerve atrophy or disc cupping(P=1.00,P=0.790)and congenital optic disc anomalies(P=0.424)were all with P>0.05.CONCLUSION SiO migration to CNS is rare with limited case reports only.Our analysis of the existing literature demonstrated higher post-vitrectomy IOP was associated with CVM,followed by patients’diabetic status,longer SiO tamponade time and visual acuity.Optic nerve atrophy,disc cupping and congenital optic disc anomalies were not associated.Modifiable risk factors of post-vitrectomy IOP and SiO tamponade time should be closely monitored by vitreoretinal surgeons.Lower IOP target post-vitrectomy and earlier SiO removal surgeries should be arranged.展开更多
背景：美国医学院仍在继续改变其组织结构、职员模式和教育计划。
目的：与1993—1994年度进行比较，回顾2003～2004年度美国医学院教育计划的情况。
数据来源：医学教育联络委员会（Liaison Committee on Medical Education，LCME）2...背景：美国医学院仍在继续改变其组织结构、职员模式和教育计划。
目的：与1993—1994年度进行比较，回顾2003～2004年度美国医学院教育计划的情况。
数据来源：医学教育联络委员会（Liaison Committee on Medical Education，LCME）2003～2004年度医学院问卷调查，以及美国医学院联合会编写的1983—1984年度、1993—1994年度和2003～2004年度美国医学教育指南。
数据分析：在126所LCME立案医学院，全职教员数由1993～1994年度的90975人增长到2003—2004年度的114549人（＋26％），而录取学生人数基本保持不变（1993-1994年度为66453人，2003—2004年度为67166人）。2003～2004年度48％的医学院的院长同时兼职于医学中心或综合大学（如主管健康事务的副校长）。有94所医学院采用标准化病人／客观结构临床考试的形式对学生进行全面的临床测试；其中有54所学校要求学生必须通过这项测试才能毕业。从2004年春季学年开始，58所学校将要求2005年入学的医学生通过新的美国行医执照考试第二阶段临床技能考试。
结论：医学院院长的职责范围逐渐扩大，并伴一个独立的教育计划主管机构的建立。医学院全职教员的人数持续增长，而录取学生的人数则保持稳定。不同医学院所用的标准临床评估方法存在着巨大差异。展开更多
文摘BACKGROUND Silicone oil(SiO)migration to the central nervous system(CNS)is a rare complication of SiO tamponade after vitreo-retinal surgeries,it could masquerade hemorrhage on computed tomography neuro-imaging.Only limited cases were reported in the literature,certain intra-operative and post-operative ocular risk factors might contribute to the different extend of SiO migration in the CNS.AIM To study the risk factors for cerebral ventricular migration(CVM)on top of visual pathway migration(VPM).METHODS Conforming to the preferred reporting items for systematic reviews and metaanalyses guidelines,literature searches on PubMed,MEDLINE,EMBASE were performed on June 1,2024.Publications on SiO migration to CNS were included in this review.Non-English articles,and studies without neuro-imaging of the CNS were excluded.Patient demographics,SiO filled eyes'ocular characteristics and vitrectomy surgical details were extracted from included studies in this review.VPM and CVM were assigned as group 1 and group 2 respectively.Fisher's exact tests,Mann-Whitney U tests and binary logistic regression were performed.RESULTS Total 68 articles were obtained after searches,48 publications were included for analysis.Total 54 SiO filled eyes were analyzed.Post-vitrectomy intraocular pressure(IOP)was found to be significant in both Mann-Whitney U test(P=0.047)and binary logistic regression(P=0.012).Diabetic was found to be significant in binary logistic regression(P=0.037),but at borderline risk for CVM in Fisher's exact test(P=0.05).Other significant factors include longer SiO tamponade time(P=0.002 in Fisher's exact test)and visual acuity(P=0.011 in binary logistic regression).Optic nerve atrophy or disc cupping(P=1.00,P=0.790)and congenital optic disc anomalies(P=0.424)were all with P>0.05.CONCLUSION SiO migration to CNS is rare with limited case reports only.Our analysis of the existing literature demonstrated higher post-vitrectomy IOP was associated with CVM,followed by patients’diabetic status,longer SiO tamponade time and visual acuity.Optic nerve atrophy,disc cupping and congenital optic disc anomalies were not associated.Modifiable risk factors of post-vitrectomy IOP and SiO tamponade time should be closely monitored by vitreoretinal surgeons.Lower IOP target post-vitrectomy and earlier SiO removal surgeries should be arranged.
文摘背景：美国医学院仍在继续改变其组织结构、职员模式和教育计划。
目的：与1993—1994年度进行比较，回顾2003～2004年度美国医学院教育计划的情况。
数据来源：医学教育联络委员会（Liaison Committee on Medical Education，LCME）2003～2004年度医学院问卷调查，以及美国医学院联合会编写的1983—1984年度、1993—1994年度和2003～2004年度美国医学教育指南。
数据分析：在126所LCME立案医学院，全职教员数由1993～1994年度的90975人增长到2003—2004年度的114549人（＋26％），而录取学生人数基本保持不变（1993-1994年度为66453人，2003—2004年度为67166人）。2003～2004年度48％的医学院的院长同时兼职于医学中心或综合大学（如主管健康事务的副校长）。有94所医学院采用标准化病人／客观结构临床考试的形式对学生进行全面的临床测试；其中有54所学校要求学生必须通过这项测试才能毕业。从2004年春季学年开始，58所学校将要求2005年入学的医学生通过新的美国行医执照考试第二阶段临床技能考试。
结论：医学院院长的职责范围逐渐扩大，并伴一个独立的教育计划主管机构的建立。医学院全职教员的人数持续增长，而录取学生的人数则保持稳定。不同医学院所用的标准临床评估方法存在着巨大差异。
