According to incomplete statistics, an average of 5-12 million cases of ocular trauma occur every year in China. Among them, complex ocular trauma is caused by various factors and serious injury. In the past, the lack of light perception of vision means the need for eyeball enucleation, which seriously affects the quality of work and life of patients.
Recently, based on more than 20 years of clinical and basic research on the treatment of complex ocular trauma, Professor Yan Hua, head of the ocular trauma group of the ophthalmology branch of the Chinese Medical Association of Tianjin Medical University, joined hands with multidisciplinary experts to establish the world's first visiongo vision prediction system, which can predict the possibility of light perception after vitrectomy, To provide scientific basis for evaluating the outcome and prognosis of injured eyes. The system can also evaluate which risk factors can make the non light sensitive eye obtain a better visual prognosis and avoid the blindness of vitrectomy.
Complex ocular trauma faces the problem of "blind resection"
Ocular trauma is the damage of ocular structure and function caused by mechanical, physical, chemical and other factors directly acting on the eyes. Due to the special position of the eyes, the chance of injury is much higher than other parts of the body, and the eye structure is also fine and special. A serious eye injury can involve multiple internal structures and tissues of the eyes at the same time, resulting in serious consequences.
Yan Hua introduced that complex eye trauma is not only harmful, but also very complex and difficult to treat. "Complex ocular trauma involves corneal scleral laceration, iris injury, hyphema, lens injury, vitreous hemorrhage, intraocular foreign bodies, intraocular infection, retinal detachment, choroidal detachment, etc. in severe cases, it can lead to visual acuity without light perception and eyeball atrophy." Yan Hua said that in the past, visual acuity without light perception meant that eyeball extraction was needed, This will bring great pain to patients and their families.
Through the collection and research of a large number of complex eye trauma cases in China, Yan Hua team found that the causes of visual acuity without light perception include optic nerve damage, thick hematocele in vitreous cavity, retinal and choroidal hemorrhage or detachment, as well as central retinal artery and vein occlusion. After vitrectomy, vitreous and subretinal hematocele were completely removed to restore the retina and choroid. About 1 / 3 of the patients can recover the sense of light. Therefore, there is no light sensation in the visual acuity after eye trauma, which can not explain that this eye has lost its therapeutic value.
"However, for patients with complex ocular trauma who have no light perception, only a few people can recover their vision above light perception after operation. Most people still have no light perception after operation, and even can't avoid the fate of eyeball atrophy." Yan Hua said, therefore, a device or intelligent system is needed to predict the recovery of postoperative vision before operation and achieve accurate treatment, Avoid the blindness of surgical treatment.
Vision prediction system can guide doctors to operate
To this end, Yan Hua team and multidisciplinary experts have jointly established the world's first visiongo vision prediction system based on machine learning technology.
Machine learning is a sub field of artificial intelligence. Its personalized prediction has been verified to have high accuracy in predicting the outcome and prognosis of a variety of diseases. For example, machine learning can accurately predict the development of autism and myopia in children, and provide basis for early intervention. However, there is no report on the application of machine learning in the prediction of visual prognosis of complex ocular trauma without light perception.
Yan Hua's team, together with 14 research centers in China, collected the original clinical data of patients with complex ocular trauma without light perception in recent 10 years through the medical record system, normalized and formatted the data, filled in some missing data, and established the largest database of ocular trauma without light perception in China.
Through detailed analysis and processing of these samples, the team constructed visiongo vision prediction system by using machine learning method.
After inputting the clinical characteristics of the patient with ocular trauma into the prediction system, the system will analyze the possibility of the patient's regaining light perception after vitrectomy through a series of algorithms, and can also analyze which clinical characteristics of the patient will play a key role in this visual outcome.
"For the eyeballs that can restore light perception vision, doctors can get better vision prognosis for non light perception eyes through vitrectomy and symptomatic treatment for key clinical features." Yan Hua said that at present, the accuracy of visiongo vision prediction system can reach more than 90%, and the prediction accuracy of the same data using OTS method of international ocular trauma score is only 49%.
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The research of ocular trauma in China has been in the forefront of the world.
Over the past 20 years, China has made a series of breakthroughs in the research of ocular trauma. A number of clinical studies have achieved good results, including the surgical tratment of complex ocular trauma, non light sensitive eye, huge intraocular foreign body, corneal blood stained non light sensitive eye and so on.
In recent years, Professor Yan Hua's team of Tianjin Medical University and Professor Ma Zhizhong's team of Peking University have jointly carried out critical and in-depth scientific research in the treatment of severe ocular trauma, conquered a number of key technologies in the field of ocular trauma treatment, and widely promoted them at home and abroad, greatly improving the visual recovery opportunities of patients with ocular trauma.
In order to standardize the treatment of ocular trauma in China, Yan Huawei, leader, and experts and scholars of the ocular trauma group of the ophthalmology branch of the Chinese Medical Association, jointly wrote the expert consensus on the standardization of emergency treatment of ocular trauma in China (2019), the expert consensus on the treatment of non light sensitive eyes with mechanical ocular trauma in China (2020) and the expert consensus on the treatment of intraocular foreign bodies in China (2021), It has greatly improved China's treatment level in these three fields. At present, Professor Yan Hua is organizing domestic and foreign eye trauma experts to jointly write the international guide for the treatment of non light sensitive eyes with mechanical eye trauma. At that time, he will once again make a Chinese voice in the field of international eye trauma treatment. (Chen Xi)
This article is transferred from science and technology daily