Purpose: To evaluate the role and the anatomic and visual results of primary pars plana vitrectomy (PPV) in treating cases with rhegmatogenous retinal detachment associated with choroidal detachment.Methods: All patients were divided into 2 groups. Each group included 23 consecutive eyes with rhegmatogenous retinal detachment and choroidal detachment with proliferative vitreoretinopathy less than grade C. In the study group, controlled removal of vitreous traction was achieved by primary vitrectomy and augmented by scleral buckling if needed. The breaks were treated by focused endolaser coagulation.Postoperative tamponade was done by SF6 or C3F8 gas. In the control group, all patients underwent regular scleral buckling procedure. The cases were followed up for 6 to 12 months.Results: In the study group, retinal reattachment could be achieved in 21 cases (91.30%) after the first operation and in all cases after the second procedure. No occurrence of choroidal detachment occurred after the first procedure. Retinal reattachment rate and visual results tended to be better compared with conventional surgical techniques in the control group.Conclusion: Primary vitrectomy represents a safe, effective method in the management of rhegmatogenous retinal detachment associated with choroidal detachment.
作者： 刊期： 2006年第03期
目的:拟从数学角度对角膜曲率分布特征进行探讨分析,旨在了解其光学形态特征.方法:对每位研究对象行Orbscan(Ⅱ)角膜地形图系统检测,采集角膜顶点,0°、30°、60°、90°、120°、150°、180°、210°、240°、270°、300°、330°子午线上距角膜顶点分别为1.5 mm、2.5 mm、3.5 mm、4.5 mm处点的角膜前、后表面曲率半径;分析由扁平子午线到陡峭子午线的曲率分布规律.结果:角膜前后表面斜轴子午线曲率分布与标准托力克面基本一致,符合:F'=Fa+(Fb-Fa)×Sin2a..结论:角膜前后表面为托力克面,从扁平子午线到陡峭子午线,曲率分布呈正弦相关的规律.
作者：张艳玲；施明光 刊期： 2006年第03期
Purpose: To evaluate the clinical effect of 5-μm pore filter connected with three-way cock by removing the vehicle in triamcinolone acetonide (TA) suspension.Methods: Through 5-μm pore filter connected with three-way cock, TA suspension was replaced by intraocular irrigating solution. The new suspension has been applied to 60 cases of diabetic branch retinal vein occlusion, diabetic macular edema and agerelated macular degeneration patients through intravitreal injection. It was also been applied to 41 cases of diabetic retinopathy, epimacular membrane, proliferative vitreoretinopathy and idiopathic macular hole patients to assist pas plana vitrectomy (PPV). Whether TA particles can adhere to posterior hyaloid cortex, epiretinal membrane and internal limiting membrane during the surgery have been observed.During follow up, corrected visual acuity and intraocular pressure were recorded.Results: Fiveμm pore filter connected with three-way cock can remove the vehicle in TA suspension successfully and retain TA particles. When the new suspension was applied to assist PPV, it can adhere to posterior hyaloid cortex, epiretinal membrane, internal limiting membrane and visualized them clearly. In all the 41 cases that underwent PPV surgery, visual acuity of 30 cases increased or remained stable.Intraocular hypertension happened in 4 cases. Two cases of the 41 patients had cataract formation during follow up. In the 60 cases that underwent TA intravitreal injection,45 cases increased their visual acuity at least 2 lines. Intraocular hypertension happened in 17 cases and 4 patients had cataract formation. None of the 101 patients caught endophthalmitis or other serious complications.Conclusion: Filter connected with three-way cock can remove the vehicle in TA suspension effectively and this procedure can be applied to intravitreal injection or PPV. This manipulation is so simple that it deserves to be popularized for clinical use.
作者： 刊期： 2006年第03期
目的:通过视功能调查量表比较第一眼和第二眼白内障超声乳化吸除联合人工晶状体植入术后患者视功能的变化.方法:先后作双眼白内障超声乳化吸除联合人工晶状体植入术的患者47人,分别在第一眼和第二眼手术前和手术后1周作眼科检查并完成视功能调查量表.结果:第一眼手术后视功能及各指标得分均高于术前;第二眼术后视功能及周边视野和立体觉的得分高于第二眼手术前,与视力有关的日常生活限制和感觉适应的得分在第二眼术后无明显变化.结论:第一眼和第二眼术后视功能均得到提高,第二眼手术后以周边视野和立体觉的改善为主.
作者：刘杰为；许京京；何明光 刊期： 2006年第03期
目的:从术中术后并发症的发生率评价蚕食式膜切除术在糖尿病视网膜病变中的作用.方法:对比分析了行普通撕膜技术的31例(34只眼)和行蚕食式膜切除术的52例(58只眼)术中术后并发症的发生率.结果:蚕食式膜切除术组发生医源性视网膜裂孔2只眼,普通手术组7例(P＜0.05);蚕食式膜切除术组术中出血4只眼,普通手术组15只眼(P＜0.01);蚕食式膜切除术组术后有6只眼发生Ⅲ级反应,普通手术组有5只眼(P＞0.05).结论:糖尿病视网膜病变中使用蚕食式膜切除术剥膜比较安全,能减少手术中及手术后并发症.
作者：张静琳；吕林；吕秀兰；李永浩 刊期： 2006年第03期
目的:探讨眼铁质沉着症的超声生物显微镜(Ultrasound Biomicroscopy,UBM)图像特征及异物的检出率.方法:应用UBM对16例眼铁质沉着症患者进行检查,分析UBM图像,同时与X线眼眶照片检查结果及手术结果进行对照.结果:16例眼铁质沉着症患者UBM检查均显示不同组织的铁锈沉着.X线眼眶照片显示异物残留者10例中,UBM检查显示异物残留者4例,X线检查未见异物残留者6例中,UBM检查显示异物残留者1例,手术取出异物11例.UBM显示异物图像为高强反射声影,有超声伪影,铁质沉着症的UBM图像特征为多发性点状、斑片状或线状高强回声、无超声伪影.结论:UBM能准确显示眼内异物位置及铁锈沉着部位,但异物的检出率较X线照片低.
作者：罗益文；蔡小于；汪振芳；陈秀琦 刊期： 2006年第03期
目的:在较大样本病例的基础上,探讨息肉状脉络膜血管病变(polypoidal choroidal vasculopathy,PCV)的分类标准,并提出PCV的系统分类法.方法:42例(48只眼)国人PCV患者根据PCV的眼底表现和吲哚青绿血管造影(indocyanine green angiography,ICGA)特征,按息肉状病灶发生的部位、息肉状病灶渗漏程度、有无与息肉状病灶相连的分支状脉络膜血管网及眼底出血、渗出的严重程度进行分类.结果:48只PCV患眼按息肉状病灶发生的部位分为黄斑型(30只眼,占62.5%)、血管弓型(6只眼,占12.5%)、视乳头旁型(3只眼,占6.3%)、中周型及结合型(9只眼,占18.8%);按息肉状病灶渗漏程度分为活动性(34只眼,占73.8%)与非活动性(14只眼,占29.2%);按有无与息肉状病灶相连的分支状脉络膜血管网分为典型(36只眼,75.0%)与非典型(12只眼,25.0%);按眼底出血、渗出的严重程度分为渗出型(13只眼,占27.1%)与出血型(35只眼,占72.9%).其中按息肉状病灶发生的部位和按有无与息肉状病灶相连的分支状脉络膜血管网进行分类为本研究首次提出.结论:PCV的上述分类有助于PCV的诊断与鉴别诊断、指导治疗及判断预后.眼科学报2006;22:160-165.
作者：文峰；吴德正；孙祖华；陈艳丽；黄时洲；罗光伟 刊期： 2006年第03期
目的:探讨中心性浆液性脉络膜视网膜病变(Central serous chorioretinopathy,CSC)的微视野检查特征.方法:应用MP-1微视野计(MP-1 Nidek Technologies,Vigonza,Italy)检测了19例(21只眼)CSC患者,年龄30～50岁,平均(39.3±6.8)岁.其中迁延型5只眼、急性型6只眼、恢复型5只眼、复发型5只眼.其中视力≥1.0的10只眼、0.6～0.9的6只眼、≤0.5的5只眼.正常对照20例(20只眼),年龄30～50岁,平均年龄(37.6±6.7)岁.记录患眼和正常眼的固视情况,以及中心20°的光敏感度.结果:不同类型及不同视力的患眼与正常眼的2°固视率和4°固视率差异无显著性意义.不同类型及不同视力的患眼与正常眼相比,黄斑20°视网膜平均光敏感度(Mean sensitivity,MS)明显下降,差异具有显著性意义(P＜0.05).不同类型及不同视力患眼之间的视网膜MS差异具有显著性意义(P＜0.05).结论:MP-1微视野计检查可以量化地评价CSC患眼的固视情况和黄斑区MS,进一步提高了患眼的功能评价.
作者：陈红玲；吴德正；黄时洲；关天芹；刘彩娇 刊期： 2006年第03期
目的:加深对眼球内视网膜母细胞瘤CT表现的认识.方法:眼球内视网膜母细胞瘤20例24只眼,均做眼眶轴位CT平扫,详细分析观察其CT表现.结果:视网膜母细胞瘤24只眼均表现为球内肿块伴钙化;按视网膜母细胞瘤生长模式分类,内生性者7只眼,外生性14只眼,混合性3只眼;伴有视网膜脱离17只眼,其中14只眼为外生性,3只眼为混合性.结论:根据CT表现可对视网膜母细胞瘤进行分类,有利于临床选择治疗方案.
作者：吴楚忠；林瑶敏；谢苏民 刊期： 2006年第03期
Purpose: To research the mechanism of neurophysiological treatment of amblyopia by observing the visual cortex activation under rotating grating stimulus with functional magnetic resonance imaging (MRI), and identify the components of the activation.Methods: Nine healthy volunteers were examined using gradient-recalled echo and echo-planar imaging (GRE-EPI) pulse sequence performed at the 1.5 Tesla MRI scanner. In the block designing, rotating grating, stationary grating and luminance were plotted as task states, stationary grating, luminance and darkness as control states, respectively. The tasks of stimuli included 6 steps. Imaging processing and statistical analysis were carried out off-line using statistical parametric mapping (SPM99) software in single-subject.Results: Some individual areas of visual cortex were activated by various stimuli information supplied by rotating grating. The strong activation in the middle of occipital lobe related to the stimuli of luminance, bilateral activation of Brodmann's 19th area related to visual motion perception, and the mild activation in the middle of occipital lobe related to form perception.Conclusion: The plotting of control state is important in bock design. The effective visual information of rotating grating includes components of luminance, visual motion perception and form perception. Functional MRI has potential as a tool for studying the physiological mechanism of visual cortex.
作者： 刊期： 2006年第03期
目的:探讨汉防己甲素滴眼液防治角膜移植排斥反应效果及佳用药浓度.方法:建立大鼠角膜移植排斥反应模型,随机分5组:A、B、C、D、E组为SD-Wistar大鼠行同种异体角膜移植术,SD鼠为受体,Wistar鼠为供体,其中A组为空白对照组,B～D组分别为0.3%、0.5%、1.0%汉防己甲素滴眼液治疗组,E组为0.1%地塞米松治疗组.术后不同时间裂隙灯显微镜记录及比较各组角膜植片新生血管情况,并观察植片病理学改变.结果:植片内主要为淋巴细胞及巨噬细胞浸润.B、C、D组术后7 d、14 d、21 d、28 d时角膜植片水肿、淋巴细胞及巨噬细胞浸润及新生血管明显少于A组(P＜0.05).术后2周不同Tet浓度组间比较C组排斥指数低,与E组无统计学差异(P＞0.05).结论:0.5%浓度汉防己甲素滴眼液可有效抑制角膜移植排斥反应.
作者：张悦；张适；陈小平；胡世兴 刊期： 2006年第03期
Purpose: To characterizes the progression of glaucoma in DBA/2J mice by measuring intraocular pressure (IOP) and retinal ganglion cells (RGCs) numbers in mice of various ages.Methods: A quantitative assessment of the pathophysiology of the DBA/2J mice was performed and the C57/BL6 mice was used as control. The IOP was measured by the servo-null micropipette system; the regional patterns of the loss of RGCs were determined by cell count of retrogradely-labeled RGCs.Results: The baseline IOP for DBA/2J mice at 7 weeks was (16.6 ± 1.2)mm Hg.Then IOP increased extend to 12 months, with the peak of (25.2 ± 1.2)mm Hg at 6 months of age. Retinal ganglion cell numbers did not decrease relative to control until 12 months of age (P=0.006), when the loss was proportionally higher in peripheral regions (P＜0.05).Conclusion: The elevation in IOP precedes the loss of RGCs by several months.RGCs cell loss occurs particularly in peripheral regions of the retina. These findings expand our understanding of the changes in DBA/2J mice and provide information for experiments design when they are used as a glaucoma model for future studies of RGCs degeneration in glaucoma.
作者： 刊期： 2006年第03期
Purpose: To improve our understanding of macular schisis in highly myopic eyes.Methods: From 2002.6-2003.12, the highly myopic eyes (＞6D) which has macular schisis found by OCT at our hospital were included in the study. Each eye then received further examinations including visual acuity, refractive error and ultrasonography. Then the results were analyzed to find the characteristic of the entity.Results: During that period, OCT found macular schisis in 38 highly myopic eyes from 36 patients. Their vision was low, and their average axial length and refractive error were 29.6mm and -10.5D respectively. The appearance and the area of the schisis are different among the eyes. But the schisis can be largely divided into two types: inner and outer schisis. They can exit independently or concurrently in the same eye. And the schisis was often accompanied by other macular findings, like retinal detachment, macular hole.Conclusion: Macular schisis in highly myopic eyes is not uncommon in the clinic.OCT is useful in its diagnosis.
作者： 刊期： 2006年第03期
Purpose: Choroidal neovascularization (CNV) plays an important role in pathogenesis of age-related macular degeneration (AMD), ocular histoplasmosis syndrome (OHS) and so on. However, mechanisms of CNV formation are not fully understood. The aim of this study is to investigate the correlation between expressions of CD105 and vascular endothelial growth factor (VEGF) in experimental laserinduced CNV in rats.Methods: CNV model was established by 532 nm laser photocoagulation in BrownNorway rats. The expression of CD105 and VEGF in CNV was observed by immunohistochemistry at 3, 7, 14, 21, 28 and 56 days after laser photocoagulation.The image analysis was performed with the professional software of Image-Pro Plus.Results: Fluorescein angiography showed fluorescein leakage in CNV from days 7 to 56 after photocoagulation. VEGF expression was mainly observed in vascular endothelial cells, ganglion cells, inner nuclear layers and retinal pigment epithelial cells in normal retina and vascular endothelial cells in normal choroid of the rats. On day 3 after photocoagulation, VEGF began to express in laser-induced lesions. VEGF was strongly expressed in CNV after 7 days (P＜0.05) and decreased after 14 days (P＞0.05). CD105 was initially presented in CNV at 7 days and obviously expressed at 14 days after photocoagulation (P＜0.05). Four weeks later, when angiogenesis tended toward inactive status, expression of CD 105 was markedly decreased (P＞0.05).There was notablely direct correlation between CD105-positive-microvessel density and positively semiquantitative scoring of VEGF in the CNV(r=0.989, P＜0.01).Conclusions: There is direct correlation between the expression of CD105 and VEGF in the laser-induced CNV in rat. It suggests that CD105 and VEGF might participate in the new blood vessel formation and promote the growth of CNV.
作者： 刊期： 2006年第03期
