简介:目的:通过多焦视网膜电图(multifocalelectroretinography,mf-ERG)在中心性浆液性脉络膜视网膜病变(centralserouschorioretinopathy,CSC)治疗前后的观察,提高CSC诊断的准确性,并指导临床诊疗,评估预后。方法:设置有比较性的CSC观察组和双眼正常的对照组。观察组有31例CSC患者都是单眼发病,这些患者每只眼(包括患眼与对侧眼)在发病期与恢复期都经过眼科的系统检查,包括最佳矫正视力、眼底荧光血管造影、OCT和mf-ERG,并记录这些检查的数据。对照组有30例,与观察组年龄范围相同,同样做上述检查并记录数据。对两组数据进行对比分析。结果:在CSC发病期,mf-ERG显示患眼平均视网膜振幅密度在1环为60.54±18.20nV/degree2,比对照组(110.94±31.20nV/degree2)低45.43%(P〈0.01),在2环为38.12±10.81nV/degree2,比对照组(60.91±11.43nV/degree2)低37.42%(P〈0.05)。在恢复期,mf-ERG显示患眼平均视网膜振幅密度在1环为93.71±14.13nV/degree2,比对照组(110.94±31.20nV/degree2)低15.53%(P〈0.05);在2环为51.16±10.34nV/degree2,比对照组(60.91±11.43nV/degree2)低16.01%(P〈0.05)。另外,我们还发现,观察组31例患者中有8例对侧眼也显示出异常,平均视网膜振幅密度在1环为62.41nV/degree2,其余23例患者对侧眼未发现异常。结论:多焦视网膜电图有助于中心性浆液性脉络膜视网膜病变患者的临床治疗与随访观察,对中心性浆液性脉络膜视网膜病变患者的诊断、病情评估及预后都起着重要的作用。
简介:目的分析评价眼科激光对视网膜静脉阻塞的疗效。方法对32例经眼底荧光血管照影明确诊断的视网膜静脉阻塞的患者采用光凝治疗,治疗后预约定期随诊,并复查各项检查。结果治疗后视力增加17例,不变者10例,稍下降者5例,黄斑水肿明显减轻者21例,占65.62%;不变者5例,占15.62%;消失者6例,占18.75%,激光治疗后较激光治疗前的暗点数增加者20例,占60%,暗点数减少5例,占15.62%,不变者7例,占21.87%。并发症:激光治疗前有新生血管者5例,术后2例完全退缩。结论视网膜静脉阻塞早期行激光治疗可促进出血吸收,缩短病程,降低新生血管及玻璃体病变等并发症,是切实可行的治疗方法。
简介:目的探讨显微镜下视网膜脱离复位手术的临床效果。方法孔源性视网膜脱离36例(36眼)由同一术者进行外路手术,均在术中应用手术显微镜进行裂孔定位。冷凝封闭及巩膜外垫压。定期观察术后视力、眼内反应和视网膜复位情况。结果经显微镜直视下外路手术患者,术后随访15d-167d,视网膜完全复位35眼(97.2%),视力较术前提高33只眼(91.7%),不变2只眼,下降1只眼。最好矫正视力0.3以上33只眼(91.7%)。术后所有患者视网膜冷凝反应I-Ⅱ级,无Ⅲ-Ⅳ级。轻度屈光介质浑浊不影响手术过程。结论经手术显微镜直视下外路治疗孔源性视网膜脱离安全有效、简单可行,值得推广。
简介:目的了解嘉兴市早产儿视网膜病变(ROP)的发病情况。方法回顾分析在本院出生的ROP的发病率及其特点。结果接受筛查的早产儿共206例,发生ROP病变16例,均为双眼发病,发病率为7.77%;出生体质量≤1000g组、~1500g组、~2000g组间,发病率差异有统计学意义(X2=10.37,P〈0.05);出生胎龄≤28周组、~32周组、~34周组、〉34周组问,发病率差异有统计学意义(X2=29.66,P〈0.005);需要吸氧治疗的早产儿发生ROP者较多(X2=4.12,P〈0.05),需要机械辅助呼吸的早产儿发生ROP者较多(X2=19.98,P〈0.005);性别(X2=1.03,P〉0.05)、出生方式(X2=2.68,P〉0.05)、多胎与单胎(X2=0.21,P〉0.05)问发生ROP的发病率,差异无统计学意义。结论嘉兴市ROP的发病率为7.77%,低出生体质量、低出生胎龄、吸氧、机械通气是ROP发病的重要因素。(中国眼耳鼻喉科杂志,2013,13:176—179)
简介:目的:观察链脲佐菌素(STZ)诱发糖尿病大鼠在造模后血-视网膜屏障(blood—retinabarrier,BRB)变化情况,并以阳性药为对照研究中药芪灯明目胶囊对STZ诱发糖尿病大鼠的视网膜血管渗漏影响。方法:采用STZ腹腔注射制作糖尿病大鼠模型,在造模后6too内各时点(2wk;1,2,3,4,5,6mo)采用伊文思蓝灌注示踪显示血一视网膜的渗漏情况,在造模后3too开始用中药芪灯明目胶囊(低中高剂量组分别给予125,250,500mg/kg体质量剂量的胶囊内容物灌胃),对照组用安多明胶囊(200mg/kg体质量剂量,相当于10倍成人剂量),灌胃3mo,观察药物对BRB的影响。结果:STZ糖尿病大鼠在2wk即可出现BRB的损害,并随着高血糖状态的持续而不断加重。对造模3tooSTZ糖尿病模型大鼠连续灌胃中药芪灯治疗3mo,结果提示:中药芪灯对STZ糖尿病BRB有保护作用,可明显减少视网膜血管的渗漏。结论:STZ糖尿病模型大鼠在早期即可出现BRB损害,并随着高血糖的持续而加重,中药芪灯明目胶囊可减少高血糖导致的BRB损害。
简介:目的:分析增殖期糖尿病视网膜病变(proliferativediabeticretinopathy,PDR)患者进行围手术期干预的临床效果。方法:回顾性分析2009—05/2011—12我院40例52眼糖尿病视网膜病变的病历及随访资料,其中男15例20眼,女25例32眼,年龄31~78岁。全部患者术前均进行视力、眼压、裂隙灯显微镜眼底检查、眼B超、角膜内皮镜等检查,术后1,2wk;1,2,3,6mo随访,观察患者的视力、眼压、人工晶状体、眼底情况,围手术期观察患者的血糖、血压、全身情况、不良事件等结果。全部患者实施围手术期干预措施。依据患者患有的与糖尿病相关的全身合并症的诊断进行评分,每种合并症记1分,无合并症记0分。手术方式为玻璃体切割十全视网膜光凝,合并黄斑水肿及黄斑前膜者行黄斑内界膜剥离,合并白内障者同期行自内障超声乳化吸出,I期植入或不植入人工晶状体,根据术中情况眼内填充长效气体/硅油/曲安奈德;术中常规进行心电监护,出现明显血压波动者在麻醉医师监护下行控制性降压。结果:所有糖尿病视网膜病变患者中I型5例,双眼手术者12例(30%),左右眼各14例(35%)。PDRIV期15眼(28.8%),V期16眼(30.8%),VI期21眼(40.4%)。术前视力低于0.02者38眼(73.1%),0.02~0.1者7眼(13.5%),0.1~0.3者5眼(9.6%),0.3以上者2眼(3.8%)。术后随访视力低于0.02者17眼(32.7%),0.02~0.1者9眼(17.3%),0.1~0.3者14眼(26.9%),0.3以上者12眼(23.1%)。1次手术治愈者47眼(90.4%),再次手术者5眼(9.6%);术后早期轻度玻璃体再出血者5眼(9.6%),晚期玻璃体再出血合并新生血管性青光眼者1眼(1.9%),感染性眼内炎者1眼(1.9%)。本组患者在我院内科确诊患有合并症的患者为17例(42.
简介:目的利用电生理方法,鉴定大鼠视网膜Muller细胞钙通道,进而研究慢性眼内压增高对Muller细胞钙通道电流的影响。方法在急性分离的大鼠Muller细胞上,利用全细胞膜片钳的电压钳技术记录钙通道电流。采用结扎巩膜上静脉的方法制备大鼠高眼压模型。结果当细胞外液中不含二价阳离子时,可以记录到电流幅度较大的钙通道介导的Na+流。该电流可被L-型钙通道阻断剂nimodipine和T-钙通道阻断剂mibefradil可逆地压抑到加药前的(39.8±5.4)%(P〈0.001)和(46.7±8.7)%(P〈0.001)。与假手术组相比,高眼压术后1周、2周和4周的大鼠视网膜Mtiller细胞钙通道的电流幅度没有明显的变化。然而,电流成分分析发现,与对照组相比,高眼压大鼠Muller细胞的nimodipine敏感电流呈降低的趋势[1周:(70,9±13.3)%;2周:(70.5±21.9)%;4周:(69.2±23.9)%],而mibefradil敏感的电流在高眼压术后1周和2周呈增高趋势[(157.5±21.2)%和(158.6±35.5)%],4周时趋于正常(109.2±37.9)%。结论大鼠视网膜Mailer细胞功能性表达L-型和T-型钙通道。慢性眼内压增高导致L-型钙通道电流减小,T-型钙通道电流增大,从而增加胞内钙,共同参与Mtiller细胞的去极化和激活。
简介:目的:研究αB-晶体蛋白对大鼠急性高眼压后视网膜组织中αB-晶体蛋白含量,视网膜神经节细胞(retinalganglioncells,RGCs)中生长相关蛋白-43(growthassociatedprotein-43,GAP-43)表达和全视野视网膜电流图(full-fieldERG,F-ERG)的b波振幅差异,探讨αB-晶体蛋白对急性高眼压后RGCs轴突再生的影响。方法:采用随机分组设计的实验研究。本实验选择120只健康、无眼疾SD大鼠,随机分为以下4组:αB晶体蛋白组(αB)30只,生理盐水组(S)30只,假手术组(P)30只,急性高眼压组(H)30只,均以右眼为实验眼,分别于术后7d和14d各取5只术眼的视网膜,行Western-blot法,观察急性高眼压后视网膜中αB-晶体蛋白的表达;术后7,14,21d各取5只术眼的视网膜,行免疫组织化学法,观察急性高眼压后RGCs的GAP-43表达;术前和术后1mo时应用全视野ERG的b波振幅变化测定视网膜功能。组间数据比较采用单因素方差分析(One-wayANOVA),组间两两比较采用SNK-q检验。结果:αB组视网膜中αB-晶体蛋白的表达于术后7d较高,14d时表达减弱(P=0.000),但同一时间点明显高于其他三组(P=0.006,P=0.024,P=0.007;P=0.006,P=0.008,P=0.010);αB组RGCs的GAP-43表达于术后7d达高峰,14d时表达减弱,21d时仍有少量表达(P=0.000),但各时间点明显高于其他三组(P=0.001,P=0.002,P=0.001;P=0.015,P=0.002,P=0.006;P=0.005,P=0.003,P=0.005);ERG-b波振幅于术后1mo较低(P=0.014,P=0.004,P=0.003,P=0.006),其中术前各组ERG-b波振幅无明显差异(P=0.993),术后1mo时αB组ERG-b波振幅明显高于其他三组(P=0.000,P=0.004,P=0.002)。结论:外源性αB-晶体蛋白能够提高视网膜αB-晶体蛋白的表达;αB-晶体蛋白通过促进RGCs中GAP-43的表达,从而促进RGCs的轴突再生;αB-晶体蛋白可促进视网膜功能的恢复,对大鼠视网膜无毒性作用。
简介:目的:利用频域三维相干光学断层扫描(threedimensionalfrequencydomaincoherentopticaltomography,3D-OCT)评估准分子激光原位角膜磨镶术(laserinsitukeratomileusis,LASIK)对视网膜神经纤维层厚度(retinalnervefibrelayerthickness,RNFLT)的影响。方法:对83例83右眼接受LASIK治疗的受试者分别于术前及术后1d;1wk;1,3mo行3D-OCT检查,测量视乳头上方、下方、鼻侧、颞侧及12个钟点位RNFLT,利用重复测量方差分析及配对t检验对术前及术后的数据统计学处理。结果:术前及术后各时间点行重复测量方差分析显示,视乳头下方、颞侧、5:00~11:00位RNFLT均值无显著差异(P〉0.05),而视乳头上方、鼻侧、1:00~4:00位、12:00位RNFLT有显著差异(P〈0.05);进一步对术前及术后各时间点视乳头上方、鼻侧、1:00~4:00位、12:00位RNFLT分别行配对t检验得出,术后1d时视乳头上方、鼻侧及1:00~4:00位、12:00位RNFLT较术前变薄,差异有统计学意义(P〈0.05),术后1wk;1,3mo时以上各方位RNFLT较术前比较均无统计学差异(P〉0.05)。同时表明RNFLT变薄与屈光度及激光时间成正相关。结论:LASIK术后早期上方及鼻侧RNFLT变薄,但术后1wk恢复至正常水平,LASIK手术对RNFLT无长远影响。
简介:目的比较急性中心性浆液性脉络膜视网膜病变(CSC)的患侧与对侧眼视网膜频域相干光断层扫描(OCT)的图像特征。方法应用频域OCT对30例(60眼)单眼发病急性CSC患者患侧和对侧眼的黄斑部视网膜显微结构进行检测,比较患侧组与对侧组黄斑中心凹外核层厚度、光感受器层(IS/OS层)、视网膜色素上皮(RPE)形态差异。结果所有30例患者患侧眼均有不同程度黄斑部视网膜浆液性脱离,对侧眼中有4眼(13.3%)存在轻度视网膜浆液性脱离;患侧组黄斑中心凹外核层厚度均值为(95.32±24.87)μm,对侧组为(98.80±14.36)μm,两组差异无统计学意义(t=1.627,P=0.110)。患侧组中IS/OS层厚度均匀一致者12眼(40.0%),对侧组20眼(66.7%);患侧组IS/OS层厚度均匀一致伴内外节缺损、不均、凸起增厚者共18眼(60.O%),对侧组共10眼(33.3%),差异有统计学意义(X2=4.28,P=0.038)。患侧组中出现RPE异常者有24眼(80.0%),对侧组中有8眼(26.7%),差异有统计学意义(x。=17.143,P=0.000)。结论频域OCT能清晰显示急性CSC患者的细微病理结构改变,单眼发病CSC患者中一部分对侧眼存在IS/OS层和RPE异常,但是其发生率较患侧眼低。(中国眼耳鼻喉科杂志,2013,13:165—167)
简介:AIM:Toevaluatetheaccuracyofsphericalequivalent(SE)estimatesofadouble-passsystemandtocompareitwithretinoscopy,subjectiverefractionandatablemountedautorefractor.METHODS:Non-cycloplegicrefractionwasperformedon125eyesof65healthyadults(age23.5±3.0years)fromOctober2010toJanuary2011usingretinoscopy,subjectiverefraction,autorefraction(AutokeratorefractometerTOPCONKR-8100,Japan)andadoublepasssystem(OpticalQualityAnalysisSystem,OQAS,VisiometricsS.L.,Spain).Nineconsecutivemeasurementswiththedouble-passsystemwereperformedonasubgroupof22eyestoassessrepeatability.ToevaluatethetruenessoftheOQASinstrument,theSElaboratorybiasbetweenthedoublepasssystemandtheothertechniqueswascalculated.RESULTS:TheSEmeancoefficientofrepeatabilityobtainedwas0.22D.SignificantcorrelationscouldbeestablishedbetweentheOQASandtheSEobtainedwithretinoscopy(r=0.956,P<0.001),subjectiverefraction(r=0.955,P<0.001)andautorefraction(r=0.957,P<0.001).ThedifferencesinSEbetweenthedouble-passsystemandtheothertechniquesweresignificant(P<0.001),butlackedclinicalrelevanceexceptforretinoscopy;Retinoscopygavemorehyperopicvaluesthanthedouble-passsystem-0.51±0.50Daswellasthesubjectiverefraction-0.23±0.50D;Moremyopicvalueswereachievedbymeansofautorefraction0.24±0.49D.CONCLUSION:Thedouble-passsystemprovidesaccurateandreliableestimatesoftheSEthatcanbeusedforclinicalstudies.Thistechniquecandeterminethecorrectfocuspositiontoassesstheocularopticalquality.However,ithasarelativelysmallmeasuringrangeincomparisonwithautorefractors(-8.00to+5.00D),andrequirespriorinformationontherefractivestateofthepatient.
简介:AIM:ToinvestigatetheeffectofY-27632onthesurvivalandneuriteoutgrowthoftheculturedretinalneurocytes.METHODS:Afterthepostnatalday2-3,Sprague-Dawleyretinalneurocyteswereculturedfor48hours,theculturemediawasreplacedwithserum-freemedia(controlgroup)andserum-freemediacontained30μmol/LY-27632(Y-27632group),andthecellswerecontinuallyculturedanother48hours.Theculturedretinalneurocyteswereidentifiedwithanti-neuronspecificenolase(NSE)immunocytochemistry.ThesurvivalstateofthosecellswasestimatedbyMTTassay,andtheneuriteoutgrowthofthosecellswasevaluatedbythecomputerizedimage-analysissystem.RESULTS:Comparedwiththecontrolgroup,theabsorbancevaluesofcellssurvivalinY-27632groupincreased12.90%and33.33%respectivelyafter72and96hoursculture.Y-27632hadnosignificanteffectonthediameterofculturedretinalneurocytes.Comparedwiththecontrolgroup,Y-27632inducedastableimprovementofneuriteoutgrowthofretinalneurocytesafter72and96hoursculture(P=0.001).CONCLUSION:Y-27632couldpromotethesurvivalandneuriteoutgrowthoftheearlypostnatalculturedretinalneurocytes.
简介:AIM:Todeterminethehistopathologicalchangesofrifampicinappliedintravitreallyonretinalganglioncellsbymeansofstereologicalandhistopathologicalmethods.METHODS:Forthisstudytwenty-fourNewZealandadultrabbitsweredividedintofourgroups(n=6foreachgroup).50μg/0.1mL(group1),100μg/0.1mL(group2),150μg/0.1mL(group3)and200μg/0.1mL(group4),rifampicinwereinjectedintothevitreousoftherighteyesofanimals,theirlefteyeswereusedascontrol(group5).Afterthe28thdayofapplication,animalswereanesthetisedwithxylazine(8mg/kg,IM)andthentheireyeswereenucleatedimmediately.Patternsweretakenawayandeyeswerepreparedforbothstereologicalandelectromicroscopicobservation.RESULTS:Dependingonthehighdoseofrifampicin,somehistopathologicalchangessuchascytoplasmicdilatationanddamagedmembranewereobservedontheelectromicroscopiclevel.Usingquantitativeexamination,whichwasdoneatthelightmicroscopiclevel,itwasshownthatthenumberofneuronsdecreasedlinearlyasrifampicindoseincreasedwhencomparedwiththecontrolgroup.CONCLUSION:Basedonthesefindings,low-doserifampicin(50μg/0.1mL)maybeusefulfortreatmentoftheoculardiseases.
简介:AIM:TodiscusstheimpactofLyciumBarbarumPolysaccharide(LBP)andDanshensupurifiedfromTraditionalChineseMedicine(TCM)onvascularendothelialgrowthfactor(VEGF)ofrabbitswithretinalneovascularization.METHODS:Fortyrabbitsweredividedintonormalcontrolgroup,modelcontrolgroup,LBPgroupandDanshensugroup.Animalsinthenormalcontrolgroupwerefedinthenormaloxygenenvironment.Animalsintheotherthreegroupswereputintotheenvironmentwith70%oxygenfor5daysinordertobuildthemodelofoxygen-inducedvascularproliferationretinopathy.AndthendifferentTCMextractwasinjectedintotheabdominalcavitiesoftheseannimals.After7days,theVEGFcontentofintheserumofrabbitwasmeasuredbydoubleantibodysandwichmethod.RESULTS:DataanalysisindicatedthatVEGFcontentwasasfollows:Danshensugroupwaslowerthanmodelcontrolgroup(12.92±3.84ng/Lvs19.32±4.15ng/L,P<0.05);LBPgroupandnormalcontrolgroupwerelowerthanmodelcontrolgroup(12.92±3.84ng/L,9.26±1.61ng/Lvs19.32±4.15ng/L,P<0.01);totalbloodviscosity,plasmaviscosity,cholesterolcontent,fibrinogencontentandtriacylglycerolcontentafterperitonealinjectionofLBPandDanshensuwereobviouslylowerthanbeforeinjection.CONCLUSION:TCMextract-LBPandDanshensucanprominentlyreducethecontentofVEGFintheprocessofvascularproliferativeretinopathyofrabbit;canpreventtheoccurrenceofretinalmicrovasculardiseasebyimprovingpartialoxygen-deficientenvironmentoraffectingallkindsofnewgrowthfactor.
简介:目的:探讨超声乳化术治疗玻璃体切割术后并发性白内障的手术特点、安全性及临床疗效。方法:对39例39眼玻璃体切割术后并发性白内障的患者行超声乳化术,其中对有硅油充填的23眼联合硅油取出术,观察手术前后视力及术中、术后并发症。术后随访3~24(平均10)mo。结果:所有病例术中无严重并发症发生。术后最佳矫正视力37眼(95%)提高,2眼(5%)无改变,无视力下降者。1眼硅油取出后2wk视网膜脱离复发,1眼术后1mo玻璃体出血,均行玻璃体切割联合硅油填充术而治愈。无脉络膜出血、低眼压等并发症。结论:玻璃体切割术后并发性白内障眼内情况复杂,手术难度大,超声乳化术是一种安全有效的手术方法。
简介:目的探讨翼状胬肉切除术后并发角巩膜病变的可能原因及相应治疗对策.方法对2009年12月至2013年5月期间于安徽省第二人民医院就诊的6例(6只眼)翼状胬肉切除术后并发角巩膜病变患者的病史、相关检查和治疗等资料进行回顾性分析.结果6例翼状胬肉患者术后并发角巩膜病变,其中2例发生角膜溃疡,分别为真菌性角膜炎和病毒性角膜炎所致;1例患者胬肉病灶切除位置烧灼引起巩膜变薄、溶解;1例患者术后发生巩膜病变,检查发现免疫指标升高;1例患者术后发生角膜脓肿,检查发现结膜囊G+杆菌阳性;1例患者有高血压,脑梗塞,术后发生角膜溃疡.结论单纯胬肉切除、术中烧灼过度、全身抵抗力下降、自身免疫功能异常,不规范用药、术后护理不当,是翼状胬肉并发角巩膜病变的主要原因.注重全身因素影响、加强术后眼部卫生护理,翼状胬肉切除联合角膜缘干细胞移植术后及时复查治疗可避免术后严重并发症.
简介:AIM:Toassesstheeffectofmyopiaonthethicknessofretinalnervefiberlayer(RNFL)measuredby3Dopticalcoherencetomography(3D-OCT)inagroupofnonglaucomatousChinesesubjects.METHODS:Twohundredandfifty-eighteyesof258healthyChinesemyopicindividualswererecruitedandfourgroupswereclassifiedaccordingtotheirsphericalequivalent(SE):lowmyopia(n=42,-0.50
简介:AIM:Toassessthequantitativeassociationbetweenanisometropiamagnitude(AM)andthelossesofresolutionandcontrastsensitivity;andtoexemplifyhowthefunctionoffusionandstereopsisvarywithAMinpreviouslyuntreatedanisometropicamblyopia.METHODS:Atotalof57patientswithpreviouslyuntreatedanisometropicamblyopiawithoutstrabismus(range:8-35years),weremeasuredrefractiveerror,bestcorrectedvisualacuity(BCVA),fusionandstereopsis,and48patientshavecompletedcontrastsensitivityfunctiontest.AMwasdeterminedbydioptricvectoradditionmodel,andtheamblyopiadepthwasdeterminedbythedifferenceofBCVAinlogMARunitsbetweentheamblyopicandfelloweyes.RESULTS:AMwassignificantlycorrelatedwithbothamblyopiadepth(PearsonR=0.728,P<0.001)andtheinter-oculardifferenceoftheareaunderthelogcontrastsensitivityfunction(AULCSF)(R=0.505,P<0.001).Depthofamblyopiaandtheinter-oculardifferenceofAULCSFwasalsosignificantlycorrelated(R=0.761,P<0.001).Themoreseverityofamblyopia,thepoorerlevelsofcontrastsensitivity.MostpureanisometropeswithAMwaslessthan3.0Dretainfusionandsomestereopsis,butwhenAMweremorethan3.0D,especiallyfortheanisometropeswhoseAMwasmorethan6.0D,fusionandstereopsisfunctionwereseriouslyimpaired.CONCLUSION:Inthepatientswithpreviouslyuntreatedanisometropicamblyopia,higherdegreeofanisometropiaissignificantlyassociatedwithdeeperamblyopia,worsecontrastsensitivity,fusionandstereopsisfunctions.