Purpose: To describe characteristics of eye-related emergency department (ED) visits and investigate differences in priorities assigned to patients by triage nurses and ophthalmologists.Methods: A prospective survey was conducted at the ED of Zhongshan Ophthalmic Center from January 1, 2021, to May 31, 2021. Clinical data from patients with acute ophthalmic conditions lasting less than 7 days were collected via a standard questionnaire and the urgency levels assigned by nurses and physicians were also recorded. Binary logistic regression was performed to identify characteristics associated with truly emergency conditions and up- or down-triage.Results: A total of 1907 patients were enrolled, with 582 (30.5%) classified as “non-emergency.” Red eye (69.7%), eye pain (53.0%), ocular trauma (44.1%), tearing (43.6%), and blurred vision (43.1%) were the most common complaints. Truly emergency tended to be male (OR 2.019, p < 0.001) and with unilateral eye involvement (OR 2.992, p < 0.001). Nurses prioritized conjunctival, scleral, closed ocular trauma and eyelid diseases over doctors while giving less priority to open ocular trauma, cornea, uveitis, and vitreoretinal diseases (p < 0.05). Overemphasis on mild blurred vision (OR 3.718, p = 0.001) and insufficient understanding of conjunctival diseases without red eye (OR 0.254, p = 0.001) were associated with conjunctival disease “up-triage.” Insufficient awareness of moderate and severe blurred vision was associated with “down-triage” for ocular trauma (OR 3.475, p = 0.001 and OR 2.422, p = 0.020, respectively).Conclusion: Ophthalmic EDs are typically flooded with patients suffering from acute ocular problems, with a considerable portion for non-emergency conditions. The identification of characteristics associated with truly emergency cases and nurses’ triage preferences is valuable in providing target guidance for future ED practice and facilitating the proper allocation of emergency resources.
Background: The metabolic activity of retina is higher than other human tissues and is crucial to the vision. Cynomolgus macaques is widely used in ophthalmic disease research. The evaluation and comparison of macular and optic disc vascular circulation parameters between normal adult cynomolgus macaques and healthy adult humans using OCT-A can promote better use of nonhuman primate models in studies of ophthalmic vascular disease.Methods: Twelve normal adult cynomolgus macaques with a mean age of 4.91 ± 0.43 years were studied for data collection. The macula of 28 adult healthy humans (14 males and 14 females), with a mean age of 25.11 ± 6.21 years and the optic discs of 9 adult healthy humans (4 males and 5 females) with a mean age of 28.56 ± 6.78 years were measured. The vessel density (VD) was measured using an RTVue XR with AngioVue. The scan sizes of the macular and optic discs were 3 × 3 mm and 4.5 × 4.5 mm, respectively.Results: OCT-A can image the superficial and deep capillary plexuses and radial peripapillary capillary network. In RPC layer of the optic disc, the VD in the nasal quadrant was lower than the VD in the inferior temporal quadrant. Similarities and significant differences in VD between healthy humans and cynomolgus macaques were obtained using OCT-A.Conclusions: This study provides normal vascular parameters for adult cynomolgus macaques using OCT-A to help establish an optical parameter database for cynomolgus macaques and compare VD between healthy humans and cynomolgus macaques to promote choroid-retinopathy research.Trial registration: Current Controlled TrialsNCT03692169, retrospectively registered on 26 sept 2018.
Introduction: Weill-Marchesani syndrome (WMS) is a hereditary connective tissue disorder with substantial heterogeneity in clinical features and genetic etiology, so it is essential to define the full mutation spectrum for earlier diagnosis. In this study, we report Weill-Marchesani-like syndrome (WMS-like) change to autosomal dominance inheritance caused by novel haplotypic mutations in latent transforming growth factor beta-binding protein 2 (LTBP2). Methods: Twenty-five members from a 4-generation Chinese family were recruited from Guangzhou, of whom nine were diagnosed with WMS-like disease, nine were healthy, and seven were of “uncertain” clinical status because of their young age. All members received detailed physical and ocular examinations. Whole exome sequencing, Sanger sequencing, and real-time PCR were used to identify and verify the causative mutations in family members. Results: Genetic sequencing revealed novel haplotypic mutations on the same LTBP2 chromosome associated with WMS-like, c. 2657C>A/p.T886K in exon 16 and deletion of exons 25-36. Real-time PCR and Sanger sequencing verified both mutations in patients with clinically diagnosed WMS-like, and in one “uncertain” child. In these patients, the haplotypic mutations led to ectopia lentis, short stature and obesity. Conclusion: Our study revealed that WMS-like may be associated with haplotypic LTBP2 mutations with autosomal dominant inheritance.
Corrigendum: Characteristics of eye-related emergency visits and triage differences by nurses and ophthalmologists: perspective from a single eye center in southern China
20 February 2024 in The American Journal of Emergency Medicine
Non-human primates are important research models for basic vision research, preclinical pathogenesis and treatment studies due to strong similarities in retinal structure and function with humans. We compared retinal parameters between healthy normal rhesus macaques (Macaca mulatta) and cynomolgus macaques (Macaca fascicularis) by optical coherence tomography and electroretinography. The retinal parameters of 10 male rhesus macaques and 10 male cynomolgus macaques were compared. The Heldelberg Spectralis® HRA+OCT and Roland multifocal electrophysiometer were used to analyze retinal morphology, multifocal electroretinogram (mfERG), and full-filed electroretinogram (ff-ERG). Mean retinal thickness was lowest in the central fovea of macaques and did not differ significantly between species, but the retinal thickness of the nerve fiber ganglion cell layer and the inner plexiform layer were significantly different. The amplitude density of the N1 wave is lower in rhesus macaques than in cynomolgus macaques in ring and quadrant areas between species. Dark-adapted 3.0 oscillatory potentials (reflection of amacrine cells’ activity) and light-adapted 30hz flicker ERG (a sensitive cone-pathway-driven response) waveforms of the ff-ERG were similar in both species while the time reached peaks in dark-adapted 0.01 ERG (the rod-driven response of bipolar cells) and dark-adapted 3.0 ERG (combined rod and cone system responses) as well as the implicit time of a-wave and b-wave in light-adapted 3.0 ERG (the single-flash cone response) really differed. This study provides normative retinal parameters for nonhuman primate research on basic and clinical ophthalmology, as well as a reference for researchers in the appropriate selection of rhesus or cynomolgus macaques as models for ophthalmology studies.