强直性脊柱炎并发虹睫炎易感性与LMP2和LMP7基因多态性的探讨

目的　研究LMP基因多态性与强直性脊柱炎并发虹睫炎发病的关系.方法　应用PCR对正常人和病人进行HLA-B27检测以及LMP2和LMP7扩增.CfoI进行限制性酶切图谱分析.结果　强直性脊柱炎有虹睫炎(AS+AAU)病史以及单纯虹睫炎(AAU)患者LMP2基因BB纯合型较正常人以及强直性脊柱炎(AS)患者明显增高(P＜0.05).AS+AAU患者BB型OR＝3.6,AAU患者BB型OR＝5.83.LMP7基因多态性无明显差别.结论　在我国汉人中,LMP2基因多态性与AS+AAU以及AAU发病存在明显相关关系.     

10例带状疱疹性角膜炎、虹膜睫状体炎的治疗体会

目的 评价静滴氢化可的松、0．5％阿托品眼液与0．5％托吡酰胺眼液点眼在治疗带状疱疹性角膜炎、虹膜睫状体炎中的疗效。方法 在带状疱疹性角膜凝、虹膜睫状体炎的早期应用静滴氢化可的松、0．5％阿托品眼液与0．5％托吡酰忮眼液点眼。结果 虹膜睫状体炎症缓解，角膜炎症被控制。结论 在带状疱疹性角膜炎、虹膜睫状体炎早期应用静滴氢化可的松。0．5％阿托品眼液与0．5％托吡酰忮眼液点眼疗效确切，可降低虹膜睫状体炎的并发症。     

中药对人工晶状体植入术后虹膜睫状体炎的治疗效果

目的：探讨中药对人工晶体状体植入术后虹膜睫状体炎的治疗效果。方法：对２４例（２９只眼）人工晶状体植入术后虹膜睫状体炎患者，在后马托品或托品酰胺滴眼散瞳的情况下，用口服血栓通胶囊和凉血清热泻肝汤加减进行了治疗和为期３个月￣１２个月的随访观察。结果：治疗时间最短为５天，最长者２１天，平均１１天。治愈２２例２７只眼（９３．１０％），未见复发，视力达０．６以上。好转２例２只眼（６．９％）。结论：在应用散瞳     

糖尿病与非视网膜眼部并发症相关性的研究进展

糖尿病是一种以持续高血糖为特征的慢性代谢性疾病,可引起全身大血管、微血管和神经系统的并发症。眼是受该病影响的主要器官之一。然而,糖尿病性眼病不仅包括糖尿病性视网膜病变,还包括非视网膜并发症。本文综述了与糖尿病相关的非视网膜眼部病变包括:角膜病变、干眼、青光眼、白内障、屈光不正、视神经病变、虹膜睫状体炎、星状玻璃体变性等,它们也可能导致视力丧失,在糖尿病患者中也应该引起重视。     

曲安奈德不同给药方式的临床观察

目的评价曲安奈德经不同给药方式治疗人工晶状体植入术后迟发性虹膜睫状体炎、早期甲状腺相关眼病及婴幼儿眼睑血管瘤的疗效。方法曲安奈德半球周注射治疗人工晶状体植入术后迟发性虹膜睫状体炎60例(60眼),曲安奈德眶周注射治疗早期甲状腺相关眼病38例(46眼),曲安奈德瘤体内注射治疗婴幼儿眼睑血管瘤16例(16眼)。结果迟发性虹膜睫状体炎60眼中56眼治愈,有效率93.33%;早期甲状腺相关眼病46眼中42眼有效,有效率91.30%;婴幼儿眼睑血管瘤16眼中14眼有效,有效率87.50%。结论曲安奈德经不同的给药方式局部注射能迅速而有效地治愈迟发性虹膜睫状体炎,早期甲状腺相关眼病及婴幼儿眼睑血管瘤,是治疗上述疾病可行而有效的方法。     

清肝泻火汤对内毒素诱发家兔肝火证的疗效和机理

采用内毒素诱发家兔肝火证模型，观察了清肝泻火汤的疗效。实验结果表明该方具有以下作用：（１）减轻肝火证临床症状，如皮肤温度、饮水量、呼吸、尿量、易怒、心率等明显缓解（Ｐ〈０．０５或Ｐ〈０．０１）；（２）改善眼部症状，裂隙灯下虹膜充血与房水混浊均显著好转（Ｐ〈０．０１）；（３）减少房水炎性渗出，房水白细胞数与蛋白含量明显降低（Ｐ〈０．０１）。（４）降低血液和房水中炎症介质的浓度（Ｐ〈０．０１，Ｐ〈０．     

Surgical management of cataract and posterior chamber intraocular lens implantation in Fuchs‘ heterochromic iridocyclitis

Background: To determine the inflammatory course and level of visual rehabilitation after cataract extraction and posterior chamber lens implantation in patients withFuchs‘ heterochromic iridocyclitis complicated by cataract. Methods: In a clinical trial, 32 eyes (visual acuity of 20/160 or worse) of 30 patients underwent extracapsular cataract extraction (19 eyes) or lensectomy(13 eyes) accompanied by posterior chamber intraocular lens implantation. Indirect ophthalmoscopy was performed intraoperatively prior to intraocular lens implantation and the extent of vitreous haze was assessed. If vitreous haziness was 3+ or more, core vitrectomy (two eyes) or three-port pars plana deep vitrectomy (four eyes) was performed. Results: After an average follow up of14.4 months (6 to 24 months), there was no statistically significant increase in cell and flare in the anterior chamber and vitreous or in keratic precipitates compared with the preoperative status of the eyes. However, 12%of the eyes developed synechiae (anterior and/or posterior) in comparison to preoperative condition (p< 0.05). Eighty-seven percent of the eyes gained visual acuity of 20/40 or better (P < 0.005). Using the logistic regression model, a higher level of preoperative inflammation was associated with reduced likelihood of gaining visual acuity of 20/25 or more (OR = 0.25, 95%CI 0.049, 1.255). The complications of surgery were synechiae, 12%; opaque posterior capsule, 12%; vitreous loss, 3%; chronic glaucoma, 3%; and retinal detachment,3%. Conclusions: Implantation of a posterior chamber intraocular lens can be well tolerated in patients with Fuchs‘ heterochromic iridocyclitis. Vitrectomy, whenever indicated in addition to cataract extraction, improves visual rehabilitation. This revised version was published online in August 2006 with corrections to the Cover Date.     

Acute anterior uveitis in primary care

Acute anterior uveitis is an important ocular disease of considerable interest to therapeutically and non‐therapeutically qualified optometrists. This review examines the role of optometrists in the primary care setting and gives guidelines for appropriate care of patients with anterior uveitis. Diagnosis and differentiation from other forms of anterior segment inflammation are the initial requirement. In parallel, possible medical conditions associated with acute anterior uveitis must be considered, with appropriate referral to medical practitioners. In uncomplicated cases of recurrent acute anterior uveitis, optometrists can initiate topical treatment and monitor resolution of inflammation, while being aware of possible complications of both the disease and its treatment. It is especially important in new attacks of anterior uveitis to liaise with the patient’s general practitioner about medical investigation for underlying disease. Atypical, complicated or severe anterior uveitis should be promptly referred for specialist care.     

Acute idiopathic corneal endotheliitis

Seven patients presenting with acute corneal stromal edema without prior surgery, trauma, ocular disease or known exposure to noxious agents are reported. One patient had a severe iridocyclitis; two others subsequently developed herpetic keratouveitis. Four cases, however, were unassociated with other known ocular disease. All four of these patients exhibited keratic precipitates and displayed minimal or no flare and cells in the anterior chamber, although the latter was largely obscured by the corneal edema. In each of these four instances, the inflammation and corneal edema resolved following topical corticosteroid therapy. In two of the four cases, both children, antibody to Herpes simplex virus could not be identified. We suggest that, in patients without known prior corneal disease or trauma, acute diffuse corneal stroma edema may stem from severe iridocyclitis or a primary endotheliitis due either to herpetic infection, the recently described presumed autoimmune corneal endotheliopathy, or a condition which we herein designate acute idiopathic corneal endotheliitis.     

THE SIGNIFICANCE OF ANTINUCLEAR ANTIBODIES IN JUVENILE RHEUMATOID ARTHRITIS ASSOCIATED WITH CHRONIC BILATERAL IRIDOCYCLITIS

ABSTRACT. Serum samples from 8 children with juvenile rheumatoid arthritis (JRA) and chronic bilateral iridocyclitis were significantly distinguished from 5 children with JRA and no eye symptoms by the presence of large immune complexes (IC)>22S, IgM antinuclear antibodies (ANA), IgG granulocyte-specific (GS-) ANA, C3 fixing ANA, and IgM anti-IgG. One serum with and two sera without IC>22S, all from patients with iridocyclitis, were fractionated by rate zonal ultracentrifugation. Each fraction relevant for the study was separately concentrated and reexamined. In one of the sera without IC>22S this technique exposed the presence of IgA GS-ANA not detectable in the corresponding whole serum. IgG ANA were precipitated in an area with higher molecular weight than the one for IgG indicating the presence of aggregated IgG ANA. Fractionation of the serum with IC>22S demonstrated IgM GS-ANA not present in whole serum. The results support previous suggestions that ANA may be involved in the pathogenesis of chronic iridocyclitis and may explain why ANA (In particular C3 fixing ANA) negative patients with JRA rarely develop chronic iridocyclitis.