血府逐瘀汤联合激光治疗视网膜静脉阻塞

目的：观察中药方剂血府逐瘀汤联合视网膜光凝术治疗不同病程视网膜静脉阻塞患者的疗效方法：①选择2004—04／2006—06新乡医学院第三附属医院眼科收治的视网膜静脉阻塞患者74例74眼。年龄25-76岁，平均62岁：病程5d～3年，其中病程〈15d者9眼，15d～3个月41眼，～6个月7眼，～12个月4眼，～18个月6眼，～24个月5眼，～36个月2眼．②口服血府逐瘀汤（当归9g，生地9g．牛膝9g，红花9g，桃仁12g，柴胡6g，枳壳6g，桔梗6g，甘草3g，1剂／d，2次／d）联合视网膜光凝术治疗观察临床疗效③疗效标准：痊愈：视网膜出血、水肿全部吸收，视力提高4行以上或恢复至病前水平：视网膜荧光血管造影显示毛细血管无灌注区消失，新生血管消退或纤维化．血管渗漏消失，黄斑水肿消退、显效：视网膜出血大部分吸收，视力提高3-4行，视网膜荧光血管造影显示视网膜循环状态大部分改善。好转：视网膜出血部分吸收，视力提高1～2行，视网膜荧光血管造影显示视网膜循环状态有所改善．无效：视力提高不足1行或下降，眼底无明显改善，视网膜荧光血管造影检查同治疗前。结果：74例患者全部获得随访，随访2-9个月：①痊愈39例（53％），其中病程〈15d6例，15d～3个月27例，～6个月4例，～12个月2例。②显效14例（19％），其中病程〈15d3例，15d-3个月8例，～6个月1例，～18个月2例。③好转13例（18％），其中病程15d-3个月6例，～6个月1例．～12个月1例，～18个月2例，～24个月3例。④无效8例（11％），其中病程～6个月1例，～12个月1例，～18个月2例，-24个月2例，～36个月2例。总有效率89％，病程在一年以上的患者无一例治愈，病程在3个月以内的患者无一例无效。结论：血府逐瘀汤联合视网膜光凝术治疗视网膜静脉阻塞效果显著，且病程愈短效果愈好。     

血栓通治疗视网膜动脉阻塞59例报告

视网膜动脉阻塞是一种急性视力下降的视网膜血管性疾病，本病一经发生，治疗效果差、过去报告的病例，发病后无光患者达17％～42％。本病的病因比较复杂，治疗比较困难。现将我院近几年来临床上所见的59例视网膜动脉阻塞，以中药血栓通为主治疗，获得了一定疗效，现报告如下。1资料和方法1．1一般资料：本组病例59例59眼，右眼34例，左眼25例，其中分支动脉阻塞19例，中央动脉阻塞40例，男33例，女26例，年龄20～78岁，其中45岁以下者22例。平均年龄46．2岁。1．2临床诊断依据：，患眼视力突然下降。眼部情况：患眼前段无异常，后极部或病变…     

飞行人员视网膜中央静脉阻塞1例引发的航卫保障的思考

对我院飞行人员视网膜中央静脉阻塞1例引发的航卫保障的思考总结如下。 1病历摘要 男,45岁,飞行人员。于2008—05因右眼视力下降10d就诊。眼科检查：视力：右眼0．2,左眼1．0。右眼屈光不能矫正。双眼前节未见明显异常。小孔眼底检查：右眼视盘水肿,边界模糊,视网膜静脉迂曲、扩张,动脉较细,视网膜水肿,     

桥本病合并视网膜中央动脉阻塞1例

1 病历摘要 女，51岁。因右眼突然视物不见1h急诊我院。眼部检查；VOD：光感，瞳孔中度散大，直接对光反射消失。眼底：视乳头边界不清，颞上、鼻上分支动脉呈节段状，余动脉分支内无血柱，视网膜水肿，黄斑区呈樱桃红色，其下方视网膜可见点、片状出血。诊断：右眼视网膜中央动脉阻塞。给予急症处理：球后注射妥拉苏林25mg，硝酸甘油0．6mg，舌下含服，口服乙酰唑胺500mg，低流量吸氧，静脉滴注丹参注射液250ml。2h后，视力恢复眼前手动。次日，继续扩张血管，降眼内压，改善微循环治疗，并配合高压氧及右侧颞浅动脉旁注射复方樟柳碱治疗。3d后VOD：0．12。10d后视力恢复为0．25。1个月后VOD：0．3，眼底视乳头边界清，色稍淡，视网膜颜色正常，动、静脉稍细，黄斑区反光强，中心凹反射欠清。追问既往史，患者慢性淋巴细胞性甲状腺炎病史20a余，未曾系统药物治疗。半个月前曾因右耳耳鸣，听力下降就诊耳科，诊断为右耳神经性耳聋，拖延未进行治疗。此次入院后实验室检查：血甲状腺球蛋白抗体2434IU／ml（／E常值0．00～115），甲状腺过氧化物酶抗体670IU／ml（／E常值0．00～34）。     

沃丽汀联合氩激光治疗视网膜静脉阻塞疗效观察

目的探讨沃丽汀联合氩激光治疗视网膜静脉阻塞（RVO）的疗效。方法选择确诊为RVO患者共35例35眼，在发病后4周开始应用氩激光对视网膜的病变区进行光凝治疗，光凝方法包括全视网膜光凝、局部光凝和黄斑区光凝。激光参数设定：能量100～500mW，曝光时间0．1～0．3s，光斑直径100～500μm，每次光凝点在200～400点之间，光斑效应为Ⅱ～Ⅲ级。视网膜病变范围较广泛时分多次进行，第2次光凝的间隔时间为7～10d。光凝的范围包括：视网膜出血水肿渗出灶、新生毛细血管形成灶、荧光造影出现的渗漏区及无灌注区。就诊时开始13服沃丽汀片剂，用法为每天3次，每次3mg，30d为1疗程，依病程可用2～5个疗程。结果35眼中有效21眼，占60．0％，好转10眼，占28．6％，无效4眼，占11．4％。随访18～24个月，病情稳定30例，占85．7％，无一例发生新生血管性青光眼。结论沃丽汀联合氩激光治疗视网膜静脉阻塞有确定的疗效。     

蝮蛇抗酶治疗视网膜静脉阻塞39例疗效观察

视网膜静脉阻塞(RVD)是常见致盲眼病,近年来我院眼科用蝮蛇抗栓酶治疗39例RVD取得满意疗效。 1 临床资料 39例均为我院眼科检查确诊病例,全部为男性患者;年龄最小41岁,最大76岁,平均56.5岁;39例中右眼19例,左眼20例;视网膜中央静脉阻塞6例,分支静脉阻塞33例;发病至接受治疗的时间最短1周,最长2个月,平均33.5天。应用蝮蛇抗栓酶治疗时间最短一疗程(10天为1疗程,每天一次),最长为5疗     

银杏叶片治疗视网膜静脉阻塞的临床研究

目的 观察银杏叶片治疗视网膜静脉阻塞的疗效。方法 视网膜静脉阻塞患者观察组(60例60只眼)用银杏叶片为主要药物治疗，对照组(60例60只眼)用丹参片为主要药物治疗。通过荧光素眼底血管造影和视功能检查评价疗效。结果 经过6周治疗后，观察组中有效者53只眼(88．3％)，对照组有效者45只眼(75．0％)。结论 银杏叶片治疗视网膜静脉阻塞可以减轻静脉怒张，促进出血吸收，缩短静脉充盈时间，并可提高视力。     

视网膜静脉阻塞药物治疗的对比分析

目的：探讨迈之灵治疗视网膜静脉阻塞的临床疗效。方法：设治疗组(迈之灵组)和对照组(尿激酶组)，分别观察其治疗结果。结果：治疗组视力平均提高了3行，跟底出血吸收率达89．0％，眼底荧光血管造影渗漏减轻82．0％，视野扩大40．0％，总有效率达89．0％；而对照组视力平均提高了1行，眼底出血吸收率达64．0％，跟底荧光血管造影渗漏减轻53．0％，视野扩大16．0％，总有效率达62．0％。结论：迈之灵疗效明显优于尿激酶，值得临床推广应用。     

原发性视网膜脱离伴脉络膜脱离2例

例1，男，52岁，因右眼视力突然下降3天来院就诊。查视力：右眼光感，左眼0．1．眼压：右6mmHg．左13mmHg，眼轴长：右眼2s．02mm．左眼29．12mm。例2，女，59岁．因右眼规力下降1周来院就诊．查视力：右眼光感，左眼0．2，眼压：右4mmHg．左15mmHg．眼轴长：右眼24．26mm，左眼25.13mm。     

血府逐瘀汤联合激光治疗视网膜静脉阻塞

目的:观察中药方剂血府逐瘀汤联合视网膜光凝术治疗不同病程视网膜静脉阻塞患者的疗效。方法:①选择2004-04/2006-06新乡医学院第三附属医院眼科收治的视网膜静脉阻塞患者74例74眼。年龄25～76岁,平均62岁;病程5d～3年,其中病程<15d者9眼,15d～3个月41眼,～6个月7眼,～12个月4眼,～18个月6眼,～24个月5眼,～36个月2眼。②口服血府逐瘀汤(当归9g,生地9g,牛膝9g,红花9g,桃仁12g,柴胡6g,枳壳6g,桔梗6g,甘草3g,1剂/d,2次/d)联合视网膜光凝术治疗观察临床疗效。③疗效标准:痊愈:视网膜出血、水肿全部吸收,视力提高4行以上或恢复至病前水平。视网膜荧光血管造影显示毛细血管无灌注区消失,新生血管消退或纤维化,血管渗漏消失,黄斑水肿消退。显效:视网膜出血大部分吸收,视力提高3～4行,视网膜荧光血管造影显示视网膜循环状态大部分改善。好转:视网膜出血部分吸收,视力提高1～2行,视网膜荧光血管造影显示视网膜循环状态有所改善。无效:视力提高不足1行或下降,眼底无明显改善,视网膜荧光血管造影检查同治疗前。结果:74例患者全部获得随访,随访2～9个月。①痊愈39例(53%),其中病程<15d6例,15d～3个月27例,～6个月4例,～12个月2例。②显效14例(19%),其中病程<15d3例,15d～3个月8例,～6个月1例,～18个月2例。③好转13例(18%),其中病程15d～3个月6例,～6个月1例,～12个月1例,～18个月2例,～24个月3例。④无效8例(11%),其中病程～6个月1例,～12个月1例,～18个月2例,～24个月2例,～36个月2例。总有效率89%,病程在一年以上的患者无一例治愈,病程在3个月以内的患者无一例无效。结论:血府逐瘀汤联合视网膜光凝术治疗视网膜静脉阻塞效果显著,且病程愈短效果愈好。     

Theoretical estimation of retinal oxygenation during retinal artery occlusion

The aim of the present work was to simulate the oxygenation of the whole retina under normal conditions as well as during retinal ischemia. A differential equation describing how oxygen is transported from blood to tissue, diffuses through the tissue and is consumed according to Michaelis-Menten kinetics was constructed. The outer retina was divided into three regions of which one was set to have consumption. The inner retina was considered as one uniform region with respect to maximal rate of oxygen consumption and blood flow. The results suggest that extreme hyperoxia would be needed to make the choroid capable of supplying the whole retina during total retinal artery occlusion and moreover confirm that light might to some extent be beneficial. As supplying 100% oxygen by nose cannula or common oxygen mask can hardly increase the arterial oxygen tension to the levels needed to rescue the whole retina, the effects of oxygen treatment of total retinal artery occlusion are expected to be modest, both in darkness and light, unless a non-rebreather face mask system is used.     

Multi-MHz retinal OCT

We analyze the benefits and problems of in vivo optical coherence tomography (OCT) imaging of the human retina at A-scan rates in excess of 1 MHz, using a 1050 nm Fourier-domain mode-locked (FDML) laser. Different scanning strategies enabled by MHz OCT line rates are investigated, and a simple multi-volume data processing approach is presented. In-vivo OCT of the human ocular fundus is performed at different axial scan rates of up to 6.7 MHz. High quality non-mydriatic retinal imaging over an ultra-wide field is achieved by a combination of several key improvements compared to previous setups. For the FDML laser, long coherence lengths and 72 nm wavelength tuning range are achieved using a chirped fiber Bragg grating in a laser cavity at 419.1 kHz fundamental tuning rate. Very large data sets can be acquired with sustained data transfer from the data acquisition card to host computer memory, enabling high-quality averaging of many frames and of multiple aligned data sets. Three imaging modes are investigated: Alignment and averaging of 24 data sets at 1.68 MHz axial line rate, ultra-dense transverse sampling at 3.35 MHz line rate, and dual-beam imaging with two laser spots on the retina at an effective line rate of 6.7 MHz.OCIS codes: (170.4500) Optical coherence tomography, (170.3880) Medical and biological imaging, (170.4460) Ophthalmic optics and devices, (120.3890) Medical optics instrumentation, (140.3510) Lasers, fiber     

糖尿病视网膜病变患者视网膜新生血管形态与激光治疗效果的关系

目的探讨糖尿病视网膜病变患者视网膜新生血管形态与激光治疗效果的关系。 方法对2009年1月至2012年11月就诊接受激光治疗的糖尿病视网膜病变患者362例587眼,使用Zeiss Visucam型眼底造影机采集视网膜新生血管的形态、面积和分布,将视网膜新生血管按形态分为4个类型：隐匿型、轻型、中型、重型。隐匿型采用全视网膜激光光凝术,其余采用超全视网膜激光光凝术,记录患者激光治疗参数、激光治疗前后视力、眼压和眼底的动态变化,进行为期9～12个月随访,总结不同类型新生血管对激光治疗的反应和预后。采用SPSS16.0统计软件进行数据处理,临床疗效采用行×列表的χ²检验,以P<0.05为差异有统计学意义。 结果糖尿病视网膜病变患者不同视网膜新生血管类型激光治疗的有效率：视力维持或提高：(1)隐匿型：77.3%;(2)轻型：56.7%;(3)中型：41.0%;(4)重型：17.2%;新生血管消退且无灌注区减少：(1)隐匿型：42.3%;(2)轻型：34.9%;(3)中型：16.9%;(4)重型：5.4%。 结论糖尿病视网膜病变患者视网膜激光治疗的预后,与视网膜新生血管的不同类型相关,及时进行视网膜激光治疗是挽救患者视力的关键。     

Expression of peptide NAP in rat retinal Müller cells prevents hypoxia-induced retinal injuries and promotes retinal neurons growth

NAP (NAPVSIPQ) is a short peptide derived from activity-dependent neuroprotective protein (ADNP) sequence, whose potent and direct neuroprotective capabilities have been widely accepted. However, due to the high risk and inconvenience of intraocular injections, NAP is difficult to be clinically administered as therapeutic agent in treating retinal diseases. Currently, stable transfection of this octapeptide into cells has not been reported, partly because of its small size and lacking of 5’ signal sequence. Here, we have developed a novel NT4-NAP fusion gene by attaching the 5’ nonfunctional preproregion of neurotrophin 4 (NT4) to NAP cDNA. Recombinant adeno-associated virus was established to introduce NT4-NAP construct into cultured rat retinal Müller cells (RMC), resulting in sustained high level NAP production from stable transfection. Functional analyses of RMC cells transfected with NAP revealed the remarkably reduced cytotoxicity and apoptosis of the cells under hypoxia. Furthermore, coculturing of transfected RMC-NAP cells with primary rat retinal neural cells offer marked protection to the latter against hypoxia induced cellular damages. Together our data indicate that stable transfection of NAP into retinal Müller cells with constant NAP production is possible. NAP produced from cellular transfection maintained its biological neuroprotective activities. This targeted gene expression may provide an effective treatment for retinal diseases in the near future.     

Virucidal activity of retinal.

Herpes simplex virus type 2 and simian virus 40 were rapidly inactivated by retinal at micromolar concentrations. Other fat-soluble vitamins, particularly vitamin A derivatives, were also active against herpes simplex virus type 2 and several lipid-containing bacteriophages.     

Quantitative analysis of retinal OCT

Clinical acceptance of 3-D OCT retinal imaging brought rapid development of quantitative 3-D analysis of retinal layers, vasculature, retinal lesions as well as facilitated new research in retinal diseases. One of the cornerstones of many such analyses is segmentation and thickness quantification of retinal layers and the choroid, with an inherently 3-D simultaneous multi-layer LOGISMOS (Layered Optimal Graph Image Segmentation for Multiple Objects and Surfaces) segmentation approach being extremely well suited for the task. Once retinal layers are segmented, regional thickness, brightness, or texture-based indices of individual layers can be easily determined and thus contribute to our understanding of retinal or optic nerve head (ONH) disease processes and can be employed for determination of disease status, treatment responses, visual function, etc. Out of many applications, examples provided in this paper focus on image-guided therapy and outcome prediction in age-related macular degeneration and on assessing visual function from retinal layer structure in glaucoma.     

Genetic causes of retinal degeneration

Premature death of rod and cone photoreceptor cells in the human retina leads to severe visual handicaps in affected patients. The two most important groups of retinal dystrophies, macular degeneration and retinitis pigmentosa, differ in primary symptoms and disease progression. Macular degeneration starts in the central retina and progresses towards the periphery. In RP, photoreceptor cell death starts in the periphery and then proceeds to the central part of the retina. Molecular studies have revealed important new findings during the last decade. There are two important results to be emphasized: 1. The very same clinical symptoms can result from mutations in different genes. RP is a prominent example for this phenomenon. 2. Mutations in the same gene can result in different phenotypes. The correlation between genotype and phenotype is not essentially straight forward. This may indicate that other factors can influence the phenotypic consequences of mutations. Different X-linked retinal dystrophies represent excellent examples for these findings.