2023年 · 第59卷第08期

This issue focuses on the research progress of ophthalmic epidemiology investigation. The responsible editorial committee responsible for the planning, composition and review of this issue is Professor Guan Huaijin.

The patient was a 21-year-old male. Because of blurred vision in both eyes for 1 month, he went to the Department of Ophthalmology of PLA Army Characteristic Medical Center (Daping Hospital). No cold symptoms before the onset, no history of systemic disease, denial of medication or vaccine injection history. Eye examination: the corrected visual acuity of both eyes was 0.8; Anterior segment examination showed no abnormalities; The optic discs of both eyes were mildly congested, and multifocal, patchy yellow-white lesions of different sizes were seen in the retina, with pigment masses in some lesions (Essence Picture 1). Fundus autofluorescence examination: the lesions in both eyes showed low autofluorescence, and some lesions in the left eye were mixed with dot-like high autofluorescence (Essence Picture 2). Coherence light tomography examination: varying degrees of structural disorder and atrophy from the external plexiform layer to the retinal pigment epithelium (Quintessential Picture 2). Clinical diagnosis: Acute multiple squamous pigment epithelial lesions of the posterior pole in both eyes.

The child was a male, 8 years old. Because of an epileptic seizure, he was diagnosed as tuberous sclerosis in the Department of Neurology, the First Affiliated Hospital of the Air Force Medical University of the People's Liberation Army, and requested ophthalmic consultation to check the fundus. Eye examination: visual acuity was 0.6 for the right eye (correction did not improve) and 0.8 for the left eye; The intraocular pressure in both eyes was normal, and there was no abnormality in the anterior segment of the eye; A round gray-white bulge lesion with a diameter of about 1 optic disc was seen at the infratemporal retinal vascular arch in the right eye, but no obvious lesion was seen in the left eye (Quintessential Picture 1). optical coherence tomography (OCT) examination: the retina at the tumor under the optic disc of the right eye was dome-shaped, with enhanced reflection signal, slightly obscuring the underlying tissue, thickening of the nerve fiber layer on its surface, compressing the underlying retinal lining structure, partial detachment of the posterior vitreous cortex, and localized adhesion to the top of the tumor; Infrared light reflection shows that the retinal tumor body is weakly reflective (A in Quintessential Picture 2). The retinas of the left eye at the three tumors above the temporal optic disc, below the vascular arch above the macular area, and above the vascular arch below the macular area were dome-shaped, and the reflection signal was enhanced, and the nerve fiber layer on its surface was thickened, which compressed the inner layer structure of the lower retina, in which an optical cavity was visible in the tumor above the temporal optic disc; Infrared light reflection showed that the three tumors of the retina showed weak reflection (B ~ D in Quintessential Picture 2). Clinical diagnosis: Tuberous sclerosis with multiple retinal astrocytic hamartomas in both eyes. Different from the right eye, multiple retinal astrocytic hamartomas in the left eye are more insidious, and the color fundus image is not displayed, while OCT clearly shows the location and size of the lesion.