2016年 · 第52卷第04期

This issue focuses on the clinical and basic research of orbital disease and ocular trauma. The responsible editorial committee responsible for the planning, composition and review of this issue is Professor Ma Zhizhong.

The principles of disinfection and sterilization of corneal surgical instruments are the same as the basic principles in the overview. This surgical instrument is divided into two categories: surgical instrument without joint and lumen, surgical instrument with joint or lumen.

Fluconazole is a novel triazole antifungal drug, which can interfere with the biosynthesis of ergosterol, an important component on fungal cell membrane, and inhibit fungal peroxidase. It is one of the best drugs for the treatment of systemic fungal diseases at present.

Chinese Journal of Ophthalmology published our article "Analysis of Common Causes and Pathogenic Strains of Fungal Endophthalmitis" (hereinafter referred to as "the original article") in Volume 51, Issue 11, 2014^[1]Dr. Shi Huidong put forward "About<Analysis of common etiologies and pathogenic bacteria of fungal endophthalmitis>Discussion in one article ", the article raised questions about whether Aspergillus is sensitive to fluconazole. We are very grateful to our readers for their attention to the original article, bringing our attention to the professional questions about antifungals that raise questions in the original article, and pay tribute to our readers for their rigorous and earnest academic attitude. We have carefully searched the information and reviewed the original data, and we hereby reply as follows.

The patient was a 26-year-old female. Due to the decrease of visual acuity in his right eye for 10 days, he went to Changchun Aier Eye Hospital on December 12, 2013. The patient was in good health, with no history of eye trauma and surgery, and no refractive error. Ophthalmological examination: visual acuity: 0.5 in the right eye and 0.1 in the left eye, neither of which could be corrected, intraocular pressure: 15 mm Hg in the right eye (1 mm Hg =0.133 kPa), 17 mm Hg in the left eye, normal anterior segment of both eyes, clear border of the optical head of the right eye, reddish color, slight tortuosity of the retinal vein, yellow-white lesions with poor borders around the optical head, slight bulge and pigmentation, about 1 PD from the fovea, radial folds in the macular area, fovea reflection disappeared, clear border of the optical head of the left eye, reddish color, slight tortuosity of the retinal vein, yellow-white lesions with poor borders around the optical head, and an unobviously affected area about 2×3 PD below the optical head, slight bulge and pigmentation, fovea involvement and reflection disappeared (Figure 1)。 FFA check (Figure 2): Mottled hyperfluorescence was observed in the lesion area of both eyes, and no obvious fluorescence leakage was observed. OCT examination (Figure 3): The choroid in the foveal nasal lesion area of the right eye was thickened and bulged, obscuring the reflected signal of the underlying tissue. The hyperreflective signal connected to the nasal tumor body was seen under the foveal nerve epithelium, and the reflected signal of the underlying tissue was seen. The choroid in the foveal nasal lesion area of the left eye was thickened and bulged, obscuring the reflected signal of the underlying tissue. The serrated changes were seen on the inner surface of the foveal neuroepithelium. The foveal IS/OS structure was staged, and the reflected signal of the underlying choroid was enhanced. B ultrasound examination (Figure 4): There is a strong echo band in the ball wall near the right eye papilla, followed by obvious sound shadows; There is an arc-shaped strong echo band with strong echoes at both ends and slightly lower echoes in the middle of the ball wall near the optic papilla of the left eye, and obvious M-shaped sound shadow can be seen afterwards. Orbital CT examination (Figure 5): A high-density shadow consistent with the orbital bone was seen at the optic nerve of the right eye, with a CT value of 356 HU, and a high-density shadow consistent with the orbital bone at both ends and slightly lower in the middle was seen at the optic nerve of the left eye, with a CT value of 387 HU. Clinical diagnosis: choroidal osteoma in both eyes. The patient is instructed to review regularly.

The child was a 5-year-old male. Abnormal hair on the upper lid of the right eye was found since birth, which grew at a rate similar to that of eyelashes, without local redness, swelling, pain or discharge. History of trauma, congenital disease, and family genetic medical history were denied. Ocular examination: A cluster of black hair was seen at the center of the upper eyelid of the right eye at a distance of 10 mm from the eyelid margin. The texture and length were similar to those of eyelashes, and the number was about 15. No definite mass was palpable under it (Figure 1)。 Other ophthalmic examinations showed no abnormalities. Preliminary diagnosis: right eyelash ectopia.

The author received a patient with periorbital necrotizing fasciitis during the medical assistance in Morocco from March 2013 to March 2015. The diagnosis and treatment process is summarized as follows.

Primary stromal cysts of the iris are very rare, and even rarer in patients with congenital glaucoma as the first symptom. Of the 14 cases of primary iris stromal cysts admitted to Tianjin Eye Hospital from 1990 to 2012, 2 children were initially diagnosed with congenital glaucoma, and the iris cysts were found at the time of surgery and in the specimens with enucleated eyeballs, respectively. The clinicopathological features are reported as follows.

The patient was a 45-year-old male. He went to Changchun Aier Eye Hospital because of repeated hyphema after ciliary body condensation in his right eye for 4 years. He had a history of neovascular glaucoma in his right eye for 5 years (etiology unknown). Four years ago, he underwent ciliary body condensation in his right eye. Postoperatively, the intraocular pressure dropped significantly, and there was no eye pain. However, the anterior chamber bled repeatedly and repeatedly, and no special treatment was given. Eye examination: visual acuity was 1.0 in the right eye and no light sensation in the left eye; IOP was 15 mmHg (1 mmHg =0.133 kPa) in the right eye and 17 mmHg in the left eye; See anterior segment of right eyeQuintessence Picture 1No obvious abnormalities were observed in the left eye. Clinical diagnosis: old hyphema in right eye; Postoperative ciliary body condensation in neovascular glaucoma of the right eye.

The patient was a 10-year-old male. He was admitted to the Department of Ophthalmology of the First Hospital of Jilin University due to hematuria for 10 years, proteinuria for 6 years and edema for 4 months. The patient's mother developed hematuria at the age of 14 and died of renal failure at the age of 30. The patient's sensory deafness progressively aggravated. Biopsy pathological examination of kidney puncture showed mild mesangial proliferative glomerulonephritis, and biopsy pathological examination of skin showed continuous linear distribution of type IV collagen with staining intensity (+ + +); Type IV collagen a5 chain showed negative distribution, and the staining intensity was (-). Eye examination: the visual acuity of both eyes was 0.8 and the intraocular pressure was normal; Fundus changes in both eyes seeQuintessence Picture 1。 Diagnosis: Alport syndrome (X-linked).

The patient was a 28-year-old male. He went to the Department of Ophthalmology, Dushanzi People's Hospital, Xinjiang, due to shadow in front of his right eye and visual acuity decrease for 1 d due to breath-holding jumping. Previous physical fitness, denying history of hypertension, diabetes, blood diseases, eye trauma, myopia and other eye diseases. General physical examination: normal blood pressure. Eye examination: visual acuity was 30 cm manual in the right eye, which could not be corrected, and 1.2 in the left eye; No abnormalities were observed in the anterior segment of both eyes; Dilated pupil examination of right eye vitreous point flocculate turbid bleeding, no posterior vitreous detachment, fundus condition seeQuintessence Picture 1； No abnormalities were observed in the vitreous body and fundus of the left eye. Three-sided mirror examination: No abnormalities such as vascular white sheath, small spot bleeding and atresia of small blood vessels were found in the peripheral retina of both eyes. FFA examination was performed 4 days later: retinal artery imaging at 14.4 s, retinal vein laminar flow at 17.5 s, occluded fluorescence was seen in the bleeding area, and the morphology of fluorescence filling blood vessels was vaguely seen above and above the temporal anterior retinal bleeding area, but no fluorescence leakage was observed. Laboratory tests: blood routine and urine routine were normal; There were no abnormalities in blood biochemistry, blood coagulation series, inflammation and rheumatism, chest X-ray and electrocardiogram. Clinical diagnosis: Valsalva retinopathy in the right eye. The treatment of bed rest and dressing of both eyes, the use of hemostatic drugs and drugs to promote absorption had no effect, and the vitreous hemorrhage of the right eye was aggravated, and only the nasal retina could be seen clearly. Vitrectomy was performed in the external hospital by himself 45 d later. Follow-up visit 1 month after operation: visual acuity of right eye 1.0, no opacity of vitreous body, fundus condition is shownQuintessence Picture 2。 FFA examination: Intermittent arc-shaped occlusion fluorescence was faintly visible in the boundary contour of the original bleeding area, and no fluorescence leakage was observed. No abnormalities were observed after 10 years of follow-up.

On January 8, 2016, the 2015 National Science and Technology Awards Conference was grandly held in the Great Hall of the People in Beijing. The "Key Technologies and Clinical Applications of Diagnosis and Treatment of Corneal Diseases" declared by Professor Shi Weiyun, Party Secretary of Shandong Institute of Ophthalmology and Dean of Shandong Eye Hospital, and Academician Xie Lixin, Director of Shandong Institute of Ophthalmology, and the "Creation and Application of Key Technology System of Orbital Surgical Repair and Reconstruction" declared by Professor Fan Xianqun of the Ninth People's Hospital affiliated to Shanghai Jiaotong University School of Medicine and Shanghai Youyiji Medical Equipment Co., Ltd. won the second prize of the National Science and Technology Progress Award in 2015.