Background Evaluation of intra-retinal layer thickness plays an important role in the diagnosis and monitor of various eye diseases,and spectral domain optical coherence tomography (OCT) is a frequently used tool.Software analysis method was used to measure the retinal thickness in previous study,but the study on the reliability of automatic layered software is lack.Objective This study was to evaluate the repeatability and reproducibility of thickness profile measurement of intra-retinal layers determined by an automated algorithm applied to OCT images from RTVue100 OCT instrument.Methods In this prospective cross-sectional study,retinal thickness images at 6 mm around fovea were obtained from 18 right eyes of 18 normal subjects with RTVue100 OCT instrument.The retinal images were segmented into retinal nerve fiber layer (RNFL),ganglion cell layer and inner plexiform layer(GCL+IPL),inner nuclear layer (INL),outer plexiform layer (OPL),outer nuclear layer (ONL),inner segment (IS),outer segment (OS) and retinal pigment epithelial (RPE) layer using automated algorithm method.Then Matlab software was used to analyze the measuring outcome.Interclass correlation coefficient (ICC) and coefficients of reproducibility (COR) were calculated from the results of two-time examination by the same examiner to evaluate the repeatability and from the results of two different examiners to assess the reproducibility.Written informed consent was obtained from each subject prior to any medical procedure.Results The entire retinal thickness measured by RTVue-OCT was (303.22± 14.10) μm in the horizontal meridian and (306.68 ± 13.32) μm in the vertical meridian,with the maximum values of retinal thickness in the GCL+ IPL and ONL.Whether in the horizontal meridian or in the vertical meridian,the ICC and COR were ＜0.60 in the OPL,IS and OS;while those in the RNFL,GCL+IPL,INL,ONL and RPE layer were ＞0.70.Conclusions RTVue OCT with automated algorithm is a useful and reliable approach to the measurement of intra-retinal layer thickness.Automated segmentation can offer accurate and repeatable thickness profile of OCT retinal image.This method may improve the diagnosis and monitoring of retinal diseases.

Recently,various eye refractive problems have attracted widespread attentions from scholars.In order to further explore the mechanism of the occurrence and development of eye refractive problems,a large amount of eye imaging technologies and analysis systems were born and applied to eye refractive researches,such as the mechanism of myopia and presbyopia,as well as the whole eye biological parameters measurement.In this literature,combining the research progress of our laboratory,we described the advances of eye imaging technology and its application in the field of ophthalmology.Based on the importance of eye imaging technology in the eye refractive researches,we propose that in order to realize the regulatory effect research of 'visual cognition feedback system monitoring technology',the development of eye imaging technology should be based on the need of 'in vivo,nondestructive,objective and accurate' and develop in the direction of 'real-time,dynamic,intelligent analysis'.

Background Tear meniscus gained by OCT device is essential to the dry eye diagnosis.Currently,RTVue Fourier-domain optical coherence tomography (FD-OCT) is commercially available to image the tear menisci.However,there were few studies to report the repeatability and reproducibility of lower and upper tear meniscus parameters measured by RTVue FD-OCT.Objective The purpose of this study was to assess the repeatability and reproducibility of lower and upper tear meniscus parameters measured by RTVue FD-OCT in normal and dry eyes.Methods In this prospective study,20 dry eyes of 20 patients were finally recruited,and 20 normal eyes of 20 age-and gender-matched healthy subjects were included during the same period.Successive three-time scans were performed at a 3-minute interval with RTVue FD-OCT in optional eye by one well-trained examiner,and the other operator performed the same measurement 10-15 minutes later.Six parameters of tear meniscus were yielded by custom software,including upper meniscus curvature (UMC),upper meniscus height(UMH),upper meniscus area (UMA),lower meniscus curvature (LMC),lower meniscus height (LMH) and lower meniscus area (LMA).The between-image repeatability was assessed using mean coefficient of repeatability (MCOR),while between-operator reproducibility were evaluated using coefficient of repeatability (COR) and interclass correlation of coefficients (ICC).Results As for the between-image repeatability,the results of MCOR for UMH,UMA,LMH and LMA were 5.11％,3.58％,4.98％ and 4.82％ respectively in the normal eyes and 5.60％,5.80％,5.03％ and 5.74％ respectively in the dry eyes.As for the between-operator reproducibility,the results of COR and ICC for UMA were 5.38％ and O.975,the COR and ICC for LMA were 5.28％ and 0.961 respectively in the normal eyes,and the results of COR and ICC for LMA were 9.69％ and 0.964 in the dry eyes.Conclusions The UMA,LMH and LMA tear meniscus parameters obtained by RTvue FD-OCT show good between-image repeatability,and LMA also presents good between-operator reproducibility.Measurement of tear meniscus parameters with RTVue FD-OCT measuring is a potential diagnostic index for the diagnosis of dry eye.

Objective To compare the impact of continuous profound neuromuscular blockade versus con-ventional neuromuscular blockade on postoperative shoulder pain in patients undergoing robot-assisted laparoscopic surgery during steep Trendelenburg position.Methods This study was a single-center,randomized,double-blind clinical trial.The inclusion criteria encompassed individuals aged between 18 and 80 years,with an American Society of Anesthesiologists status of Ⅰ or Ⅱ,and a body mass index ranging from 18 kg/m2 to 30 kg/m2.A total of one hundred patients were randomly assigned to either the deep neuromuscular blockade group(D group)or the conventional neuromuscular blockade group(C group),with equal distribution of fifty cases in each group.Rocuronium dosage was titrated to achieve post-tetanic count values of 1～2 and train-of-four stimulation levels of 1～2 during surgery for D and C groups respectively.At the end of surgery,sugammadex was administered for reversal of neuromuscular blockade.The primary endpoint assessed the incidence of postoperative shoulder pain within three days after surgery.Secondary endpoints included Leiden score evaluation during intraoperative period,number of additional neuromus-cular blockers required by the surgeon,recovery time for muscle relaxation postoperatively,nausea and vomiting scores during recovery phase,visual analog scale(VAS)scores in Post-Anesthesia Care Unit(PACU)as well as within three days after surgery,incidence rate for postoperative pulmonary complications,length of hospital stay duration and patient satisfaction score.Results The incidence of postoperative shoulder pain was significantly lower in group D compared to group C(D group 32%vs.C group 56%;P<0.05).However,there were no significant differences in postoperative shoulder pain VAS scores between the two groups(P>0.05).No significant differences were observed between the groups in terms of Leiden score,surgeon's requirement for additional neuromuscular blockers,nausea and vomiting in PACU,and VAS score(P>0.05).Group D exhibited better early postoperative activity pain scores than group C(P<0.05).There were no significant differences in VAS scores between the groups at other time points(P>0.05).Furthermore,there were no significant differences in the incidence of postoperative pulmonary complications,length of stay,and satisfaction scores between the two groups.Conclusion The imple-mentation of continuous deep neuromuscular blockade in patients undergoing robot-assisted laparoscopic surgery with steep Trendelenburg position can effectively mitigate the occurrence of postoperative shoulder pain.