2016年 · 第52卷第02期

The patient was a 60-year-old male. On January 22, 2013, I went to the Department of Ophthalmology, West China Hospital, Sichuan University due to head trauma caused by a car accident with visual loss of my right eye for more than one year and exophthalmos of my right eye for half a year. Ophthalmic examination: visual acuity 0.12 in the right eye and 1.2 in the left eye; IOP was 21.6 mmHg (1 mmHg =0.133 kPa) in the right eye and 21.0 mmHg in the left eye. Exophthalmos: right eye 18 mm, left eye 13 mm, orbital distance 103 mm. Palpable pulsation in the right eyeball, restricted movement in all directions, swelling of the eyelid, congestion of the bulbar conjunctiva (+ + +), thick and tortuous blood vessels in the bulbar conjunctiva (Figure 1), the cornea is transparent, the remaining anterior segment (-), the border of the optic papilla is clear in the fundus, the retinal vein is tortuous and thick, and the posterior pole omentum is scattered with patchy superficial hemorrhagic foci (Figure 2), left eye (-). Eye B-ultrasound: An oval weakly echoic area was seen behind the right eyeball, with a size of about 14.55 mm ×21.53 mm (Figure 3）。 Ocular CT showed that the right eyeball was slightly protruding forward, the superior vein of the right eye was tortuous, and the diameter of the tube was obviously thickened up to 1.5 cm (Figure 4）。 Preliminary diagnosis: right carotid cavernous fistula (CCF), recommended to neurosurgery. On January 27, 2013, he went to our hospital for digital subtraction angiography (DSA) examination (Figure 5), diagnosed as right internal carotid cavernous fistula; Aneurysm of left internal carotid and ophthalmic artery segments. Interventional embolization of right internal carotid artery cavernous fistula and left internal carotid artery and ophthalmic artery segment aneurysm was performed. Ocular examination 1 week after surgery: visual acuity of right eye 0.4, intraocular pressure 20.4 mmHg, exophthalmos 14 mm. The swelling of the eyelid obviously subsided, the bulbar conjunctiva was congested (+ +), the bulbar conjunctiva was thick and tortuous, the remaining anterior segment (-), the retinal vein was thick and tortuous, and the posterior pole retina was scattered with superficial hemorrhagic foci.

The patient was a 63-year-old male. He was admitted to hospital for examination on June 27, 2013 due to double vision of both eyes for 6 days. On June 18, 2013, the patient developed double vision in both eyes without obvious trigger, with obvious double vision to the left and reduced double vision to the right. At first, the patient did not pay attention to it, but the symptoms have not improved significantly in the past week. He came to see a doctor and was admitted to the hospital with "left eye external rectus paralysis". Eye examination: visual acuity 0.4 for right eye (correction 0.6+), 0.5 for left eye (correction 0.8); Both eyes: the lens was slightly opaque, and no obvious abnormality was seen in the remaining anterior and posterior segments; There was no obvious abnormality in the rotation of the right eyeball in all directions, while the external rotation of the left eye was obviously limited, and there was no obvious abnormality in the rotation in other directions. After admission, skull MRI plain scan showed abnormal signal focus in the slope area (Figure 1), MRI enhancement revealed a patchy abnormal signal in the slope area, with enhancement, suggesting chordoma (Figure 2）。 Later, the patient went to a hospital in Shanghai and was diagnosed with "skull base chordoma". The patient abandoned treatment for personal reasons and was subsequently lost to follow-up.

Miller-Fisher syndrome (MFS) is an acute, immune-related cranial nerve demyelinating disease. Clinically, ophthalmoplegia, ataxia and loss of tendon reflexes are the classic triad manifestations, often accompanied by increased blood GQ1B antibody. The pupillary sphincter can also be involved in this syndrome, so except for diplopia, ataxia, unstable walking and other symptoms, some patients may be accompanied by tonic pupil or mydriasis and fixation, photophobia, and blurred near vision. Patients with pupillary sphincter paralysis as the first or main symptom often see an ophthalmologist rather than a neurologist department. We report the clinical characteristics of pupillary involvement in 2 patients with MFS syndrome, so as to provide a basis for better interpretation of the pathogenesis and localization diagnosis of MFS syndrome.

The patient was a female, 45 years old. Because of blurred vision in both eyes since childhood, he went to Tianjin Eye Hospital. There was no other medical history. The whole body examination showed no obvious abnormalities. Eye examination: visual acuity was 0.5 for the right eye and 0.2 for the left eye; The cornea of the right eye is transparent, and the upper part of the pupil area is obscured by the iris residual membrane. After the pupil is dilated, the membranous residual membrane in the central part is adhered to the anterior pole of the lens, and the peripheral filamentous residual membrane is radially connected to the iris ring, and the lower part of the filamentous residual membrane seems to be broken (Essence Picture 1A）； The cornea of the left eye is transparent, and the residual iris almost completely covers the pupil, with small holes in between. After the pupil is dilated, the residual iris is partially adhered to the anterior pole of the lens, and its base is connected to the small iris ring in the shape of a cord (Quintessence Picture 1B）； The pupils of both eyes reacted to light, the lens was transparent, and no obvious abnormalities were found in the vitreous body and fundus examination. Ultrasound biomicroscopy is shown inQuintessence Picture 2。 Clinical diagnosis: congenital residual membranes of pupils in both eyes; Amblyopia in both eyes.

The patient was a 12-year-old girl. Since childhood, both eyes are photophobic with white hair and skin, and he was seen in Changchun Aier Eye Hospital. Eye examination: visual acuity in both eyes was 1.0; IOP was 12 mmHg (1 mmHg =0.133 kPa) in the right eye and 11 mmHg in the left eye; The iris was light gray in both eyes (Quintessence Picture 1), for fundus conditions seeQuintessence Picture 2。 Clinical diagnosis: binocular albinism.

Ophthalmology Branch of Chinese Medical Association (formerly known as Chinese Ophthalmology Society) is the first and largest ophthalmology academic group in China, with a history of 78 years, and has played a great role in promoting the development of ophthalmology in China. Carefully studying the history of its establishment and development can make more ophthalmologists, especially the younger generation of ophthalmologists, understand the development process of modern ophthalmology in China, the hardships and the joy of success of ophthalmology predecessors, which is conducive to better carrying out and consciously doing a good job in the work of Ophthalmology Branch of Chinese Medical Association in the future, and continue to promote the development of ophthalmology in China.

The first "West Lake International Cataract and Intraocular Lens Summit Forum" sponsored by Zhejiang Medical Doctors Association and jointly organized by Ophthalmologist Branch of Zhejiang Medical Doctors Association and Ophthalmology Center of the Second Affiliated Hospital of Zhejiang University School of Medicine was held in Hangzhou from September 17 to 19, 2015. This forum was attended by more than 70 ophthalmologists, more than 1,500 registered representatives and more than 500 manufacturer representatives from home and abroad.

This issue focuses on the clinical and basic research of cataract and intraocular lens. The responsible editorial committee responsible for the planning, composition and review of this issue is Professor Liu Yizhi.