目的:探讨手术显微镜下行视网膜脱离外路手术的方法及治疗效果.方法:对21例(21眼)孔源性视网膜脱离患者,行视网膜脱离外路手术,术中对裂孔的定位,放视网膜下液,及巩膜外顶压冷凝均在手术显微镜下进行.6例同时行环扎术.术后随访3～9个月.结果:手术显微镜直视下患眼视网膜冷凝反应均清晰可见.轻度屈光间质混浊不影响眼底病变观察,无严重的手术并发症.21眼中视网膜复位20例,再次手术复位1例,视力均有不同程度提高,视力≥0.3者15例占71.42%.结论:视网膜脱离显微外路手术具有方便、可靠、安全、快捷等优点,提高手术成功率.
作者：梁伟亮；关卫文；余超明；胡小玲 刊期： 2006年第04期
目的:用眼底荧光血管造影(fundus fluorescein angiography,FFA)和吲哚菁绿血管造影(indocyanine green angiography,ICGA)随访一例系统性红斑性狼疮(systemic lupus erythematosus,SLE)脉络膜视网膜炎患者.方法:回顾性研究随访1例SLE脉络膜视网膜炎患者临床和眼底造影影像学特征.结果:本病例ICGA特征包括造影早期脉络膜血管模糊弥漫性高荧光、局灶性低荧光,造影晚期点状脉络膜高荧光.经泼尼松治疗后,造影晚期点状脉络膜点状高荧光随着视网膜小血管阻塞出现而增加,当视网膜出现新生血管时点状高荧光消失.结论:ICGA可以揭示SLE脉络膜病变临床和FFA不能发现的信息.免疫复合物沉积在脉络膜毛细血管可能是SLE脉络膜炎发病机制的重要因素.眼科学报 2006;22:224-228.
作者：陈长征；左成果；武犁；邢怡桥 刊期： 2006年第04期
Purpose: To evaluate the efficacy of topical 0.1% FK506 used alone or combined with keratoplasty on patients with recurrent Mooren's ulcer.Methods: This is a retrospective interventional consecutive case series. Nine patients(15 eyes) with recurrent Mooren's ulcer were treated with topical 0.1% FK506 alone or combined with keratoplasty. Two eyes with ulcers involving less than half the corneal limbus were treated with topical 0.1% FK506. Of the other 13 eyes with ulcers involving more than half the limbus, twelve were treated with excision of the ulcer and adjacent conjunctiva combined with lamellar keratoplasty. One eye with a central impending corneal perforation was treated with penetrating keratoplasty.Topical0.1% FK506 was given post-operatively to all thirteen eyes after re-epithelia-lisation of the cornea. FK506 levels in the surgically resected cornea and conjunctiva of the operated eyes were measured using enzyme immunoassay procedures. Twelve patients(17 eyes) with recurrent Mooren's ulcer treated with lamellar keratoplasty combined with topical 0.1% dexamethasone were taken as the control. The main measure of the outcome was the recurrence of Mooren's ulcer in the patients.Results: Nine patients (15 eyes) with recurrent Mooren's ulcer were all successfully treated. Vision in 5 eyes improved by two lines or better after treatment. No recurrence was observed during the follow up period of 12 to 22 months. After topical application of 0.1% FK506, concentrations of 30～350 ng/g of FK506 were found in the cornea and conjunctiva. Seven eyes of Mooren's ulcer in the control group recurred during the follow up period.Conclusion: Topical 0.1% FK506 used alone or combined with keratoplasty is a safe and effective therapy for patients with recurrent Mooren's ulcer.
作者： 刊期： 2006年第04期
目的:报道玻璃体切割在梅毒性葡萄膜炎中的应用.观察其治疗效果及安全性.方法:文献复习及病例报道.结果:一双眼梅毒性葡萄膜炎患者经药物治疗后,左眼视力明显提高而右眼停滞不前.右眼经标准三切口玻璃体手术后半个月,右眼视力大幅提高并超过左眼.结论:玻璃体切割手术在部分晚期梅毒性葡萄膜炎患者的治疗中有积极作用.尽管在本例患者中未见任何并发症,但其安全性及作用机制仍有待进一步研究证实.
作者：杨方列；潘晓燕；闫红；王红梅；刘顺英；易长贤 刊期： 2006年第04期
目的:对比观察准分子激光上皮瓣下角膜磨削术(LASEK)与准分子激光原位角膜磨削术(LASIK)治疗高度近视的临床疗效.评估2种手术的安全性和有效性.方法:对行LASEK治疗的39例75只眼和同期行LASIK治疗的41例79只眼高度近视分别进行6个月以上的临床观察.结果:LASEK组术后1周至1个月达佳矫正视力,术后3个月部分出现视力回退,术后6个月裸眼视力达术前矫正视力占95.83%,主要并发症有术后高眼压及Haze形成;LASIK组术后6个月裸眼视力达术前矫正视力占94.35%,主要并发症为屈光回退,角膜上皮内生或角膜瓣皱折等.结论:LASIK与LASEK均能安全、有效地矫正高度近视.
作者：杨阳；何阳 刊期： 2006年第04期
目的:检测大鼠视网膜色素上皮细胞系(RPE-J)是否表达载脂蛋白的基因及其是否具有合成和分泌中性脂质的功能.方法:将RPE-J细胞培养于组织培养板及TransweⅡ上,用RT-PCR检测载脂蛋白mRNA的表达.将荧光标记颗粒加入细胞中培养以检测细胞吞噬功能.细胞中加入光感受器细胞外节,培养不同时间点后提取脂质,用薄层层析法和酶学荧光法分析细胞中脂质含量及变化.用放射性标记的Oleic Acid([3H]-oleate)检测细胞新合成和分泌中性脂质的功能.结果:RPE-J细胞有载脂蛋白A-Ⅰ,A-Ⅱ,B,E,C-Ⅰ,C-Ⅱ,C-Ⅲ,以及微粒体甘油三酯酸转移蛋白基因的表达.RPE-J细胞具有吞噬功能.吞噬光感受器细胞外节后,RPE-J细胞中甘油三酯含量增加5.8倍,磷脂含量增加2.6倍,非酯化胆固醇增加1.5倍,酯化胆固醇增加0.3倍.RPE-J细胞和培养基内可以检测到新合成的放射标记的中性脂质.细胞内脂质含量随时间延长而增加:培养基中只有磷脂随时间延长而增多.结论:RPE-J细胞有多种载脂蛋白及微粒体甘油三酯酸转移蛋白的基因表达.吞噬光感受器细胞外节后,RPE-J细胞中脂质增加.培养基中加入长链脂肪酸后,RPE-J细胞可以新合成和分泌中性脂质.
作者：王岚；Chuan-Ming Li；Martin Rudolf；Christine A.Curcio；彭大伟；刘杏；曾淑君 刊期： 2006年第04期
目的:探讨维生素A对角膜移植排斥反应后结膜杯状细胞的影响.方法:建立大鼠角膜移植排斥反应模型,随机分3组:A、B、C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组为(维生素A)诺沛凝胶滴眼液组,C组为0.1%地塞米松滴眼液组,另设D组为正常眼组.术后不同时间裂隙灯显微镜记录及比较各组角膜移植排斥指数(Rejection Index,RI).通过结膜组织学切片HE、PAS染色,并运用显微图像分析系统对结膜上皮杯状细胞数量及形态进行分析.结果:观察期间检测结膜杯状细胞发现,A、B、C组杯状细胞数量均少于D组(P＜0.01),A、B、C组内部比较,以C组数量为多,其次为B组,有差异有显著性(P＜0.05).结论:维生素A具有保护角膜移植引起的结膜杯状细胞减少的作用.
作者：张悦；刘祖国；陈小平；张适；虞东芳；李朝阳 刊期： 2006年第04期
目的:测定腹腔注射单次剂量的葛根素后不同时间点新西兰白兔眼房水、玻璃体中葛根素的浓度变化,探讨葛根素在兔眼房水和玻璃体中的药动学变化.方法:新西兰白兎随机分组,每只白兔腹腔注射葛根素80mg/kg,在用药前(0 h)和用药后0.5、1、2、3、4、6、8、12、16、24 h取房水液、玻璃体液,采用反相高效液相色谱法(RP-HPLC)进行测定.3P87软件拟合药动学参数.结果:腹腔注射葛根素后,其浓度在正常新西兰白兔房水、玻璃体呈开放式二房室模型.理论值:高峰浓度(Cmax)分别为1.61、0.09 μg/ml,达峰时间(tmax)为1.68、1.81 h,半衰期t1/2α为1.36、1.05 h,t1/2β为19.72、15.18 h,清除率(CL)分别为2.17、12.43 L/h.实测值30 min分别为(0.78±0.29)μg/ml、(0.06±0.02)μg/ml,2 h达高峰,分别为(2.32±0.15)μg/ml、(0.12±0.04)μg/ml,随后逐渐下降,6 h后房水中葛根素含量降至0.57 μg/ml,玻璃体为0.05 μg/ml,16 h后,葛根素在房水和玻璃体中的浓度降至0.03 μg/ml或以下.结论:本方法灵敏、特异、准确和快速,可用于房水、玻璃体中葛根素浓度的测定;葛根素通过腹腔注射能透过血-眼屏障进入房水、玻璃体,进入房水的葛根素药量较大,进入玻璃体的药量有限.
作者：邓新国；张清炯；胡世兴；高杨；杨柳 刊期： 2006年第04期
Purpose: To investigate the expression of thrombospondin 1 (TSP-1) in retinal pigment epithelium (RPE) and choroidal neovascular membranes (CNVMs) from patients with age-related macular degeneration (AMD).Methods: Tissue sections from normal human fetal and adult eyes and surgically removed CNVMs were immunostained for TSP-1 localization. Polymerase chain reaction and Western blotting were used to analyze TSP-1 mRNA and protein from human RPE cells, respectively. TSP-1 in the supernatant of cultured RPE cells and eye explants were measured using enzyme-linked immunosorbent assay. MTT assay was used to evaluate the RPE survival after TSP-1 treatment.Results: The strongest immunostaining for TSP-1 was observed in the RPE monolayer around drusen in early AMD. The intensity of TSP-1 staining in normal eye sections was much weaker than that of early AMD and CNVM. TSP-1 mRNA was positive in cultured fetal and adult RPE cells. There was increasing secretion of TSP-1 into the supernatant of cultured RPE and eye explants. The specific band of TSP-1 was identified by Western blot. No significant inhibition of RPE survival was found with the exposure to TSP-1.Conclusions: TSP-1 expression in drusen and CNVM was upregulated and associated with RPE monolayer. TSP-1 may be a natural negative regulator for choroidal neovascularization.
作者： 刊期： 2006年第04期
目的:研究雌激素受体(estrogen receptor,ER)基因多态性与绝经后干眼症的相关性.方法:收集绝经后干眼症患者65例及正常对照73例血液标本,提取基因组DNA,用聚合酶链反应方法检测ER基因的XbaⅠ和PvuⅡ酶切多态性并进行统计学分析.结果:干眼症患者与正常人比较,ER基因的PvuⅡ酶切多态性存在显著性差异(P＜0.05),而ER基因的Xba Ⅰ酶切多态性没有明显差异(P＞0.05).结论:ER基因的PvuⅡ酶切多态性与绝经后干眼症发病存在相关性,不同个体的基因差异可能影响干眼症的发生.
作者：何燕玲；黎晓新；鲍永珍；孙建民；刘金荣 刊期： 2006年第04期
目的:观察FK506对常规及高糖培养条件下的人视网膜微血管内皮细胞(HRCECs)的增殖状态、细胞周期及凋亡的影响.方法:分离培养HRCECs,并应用第Ⅷ因子相关抗原抗体鉴定.取P3-4代HRCECs进行高糖培养(30 mmol/l右旋葡萄糖)培养,应用MTT法检测其生长状态.应用100 pM的FK506对常规培养的高糖培养条件的HRCECs进行干预,通过MTT法、流式细胞仪检测其对生长状态、细胞周期及凋亡的影响.结果:FK506可抑制常规及高糖培养条件下HRCECs的增殖,其可抑制高糖培养下细胞周期,但可同时减少凋亡的发生,但对常规培养的细胞周期及凋亡则无影响.结论:上述结果提示FK506可能有抑制新生血管发生的作用,成为增殖性糖尿病视网膜病变的有效药物.
作者：马红婕；李涛；梁小玲；丁小燕；谢素贞；唐仕波 刊期： 2006年第04期
Purpose: To investigate the effect of polyol pathway on lens epithelial cells apoptosis and the activity of caspase-3 and its reversal by pyruvate in diabetic rats.Methods: 220 Wister rats were divided into 3 groups: control group, model group and treatment group. After streptozotocin (STZ) induced cataract, the treatment group received 2% pyruvate in the diet and drinking. The opacification of lens was detected by microscope every 2 weeks. On 4W, 8W and 12W of the experiment, glucose and sorbitol in the lens were quantified by high-performance liquid chromatography. The percentage of lens epithelial cells undergoing apoptosis was measured by Annexin V/PI staining. The activity of caspase-3 was analyzed by Western-blot.Results: Studies show that there was significant increase of glucose, sorbitol in lens of model group, the apoptosis rate and caspase-3 activity of lens epithelial cells were also gradually increase. Pyruvate treatment decreased the levels of sotbitol, glucose, lens epithelial cells apoptosis and caspase-3 activity. The progress of cataract was also significantly delayed.Conclusions: Polyol pathway, possibly through regulation of the activity of caspase-3,can induce apoptosis of lens epithelial cell. Pyruvate ingested orally can effective inhibit diabetic cataractogenesis in rats through inhibit polyol pathway.
作者： 刊期： 2006年第04期
