Arg124Cys mutation of the TGFBI gene in a Chinese pedigree of Reis-Bücklers corneal dystrophy

AIM: To analyze mutations in transforming growth factor beta-induced (TGFBI) gene in a Chinese pedigree with Reis-Bücklers corneal dystrophy (RBCD, also known as GCD3). METHODS: In a five-generation Chinese family, eight members were identified with RBCD and the rest were unaffected. All members of the family underwent complete ophthalmologic examinations. Exons of TGFBI were amplified by polymerase chain reaction, sequenced, and compared with a reference database. RESULTS: A single heterozygous C>T (R124C) point mutation was found in exon 4 of TGFBI in all the affected members of the pedigree, but not in the unaffected members. CONCLUSION: R124C which was a known mutation for lattice corneal dystrophy type I, segregated with the RBCD in this pedigree. This elucidated the correlation between genotype and phenotype in a Chinese family of RBCD.     

Head trauma can cause transient elevation of intraocular pressure in patients with open angle glaucoma

AIM: To describe a newly-recognized entity, illustrated by five cases of glaucoma in whom trauma to the head, but not the eye, resulted in marked, transient elevation of intraocular pressure (IOP). METHODS: Retrospective case series. Chart review. RESULTS: All five cases had a diagnosis of primary open-angle glaucoma prior to the experience of trauma to the head. All cases had an unusual elevation of IOP (around 70 percent) for days to weeks following the trauma, after which the IOP fell to pre-accident levels. No cause other than the trauma could be determined. CONCLUSION: The relationship between head trauma and elevation of IOP appears real.     

视盘的有效评估:与杯盘比的对比

青光眼是一种以进行性视盘变化和视野损失为特征的眼压相关性疾病。杯盘比在过去40a来都是评价视盘青光眼性改变的标准方法。然而我们却发现是一些小视盘的患者有典型青光眼性视野损失,而一些大视盘的患者却没有视野损失。杯盘比的检查效力和可重复性都低于一些新的检查方法。视盘损伤可能度分级(DDLS)是一种衡量视盘盘沿面积、并且校正了视盘大小等影响因素的新型视盘评价方法。DDLS也许是评价青光眼视盘的更为优化的方法。     

眼眶海绵状血管瘤127例临床病理分析

目的:探讨眼眶海绵状血管瘤的临床病理特点、鉴别诊断与手术方式选择。方法:对2000-01/2008-05在我科住院治疗的127例眼眶海绵状血管瘤患者临床和病理资料进行回顾性分析,并进行临床随访。结果:127例患者中男51例,女76例;右眼67例,左眼60例,年龄6~62(平均32)岁,临床表现主要是渐进性无痛性眼球突出。59例采用前路开眶,68例采用外侧开眶顺利摘除肿物。病理检查示肿瘤呈圆形或椭圆形,包膜完整、切面呈海绵状。随访未见1例复发。结论:眼眶海绵状血管瘤是包膜完整的良性肿瘤,根据术前影像学检查资料,能做出正确诊断,合理选择手术方式,可取得良好的治疗效果。     

不同切口位置白内障超声乳化吸出术后角膜散光变化的分析

目的:比较不同位置的透明角膜切口对白内障超声乳化吸出术后角膜散光及视力的影响。方法:将白内障患者44例(64眼)分成两组,A组患者采用上方10∶00～11∶00方位透明角膜切口,B组根据角膜最大屈光度子午线轴向方位透明角膜切口,所有患者均行白内障超声乳化吸出术联合折叠式人工晶状体植入术,分别于术后1wk;1,3mo随访患者,检查裸眼视力及行角膜地形图检查。结果:B组患者术后1wk;1,3mo视力好于A组。B组患者术后角膜散光度及术源性散光度在术后1wk;1,3mo时均小于A组。结论:根据角膜最大屈光度子午线轴向方位做透明角膜切口的白内障超声乳化吸出术,术后对角膜散光影响小,并可在一定程度上矫正术前已存在的角膜散光,能够使患者在术后更快、更好地恢复视力。     

将基于问题式学习融入眼科学教学初探

将"基于问题式学习"(problem-based learning,PBL)融入眼科学实习教学中的教学改革,受到老师和学生的欢迎。PBL教学模式充分发挥了学生的主观能动性,在培养学生临床技能、临床思维及自学能力方面体现出了明显优势,同时,带教老师的综合素质也得到了提高。实践证明,PBL教学模式是培养创新能力型人才的有效方法之一。     

Comparisons of morphologic characteristics between thin-flap LASIK and SBK

AIM: To compare the morphologic characteristics between thin-flap laser in situ keratomileusis (LASIK) and Sub-Bowman keratomileusis (SBK), and to evaluate the uniformity of flap and to explore the correlative factors of corneal flap thickness. METHODS: A prospective, randomized, comparative clinical study was performed in Department of Ophthalmology, West Hospital of China, Chengdu, Sichuan Province, China. Totally 59 patients 114 eyes underwent LASIK or SBK to correct myopia, 29 patients 57 eyes underwent SBK, 30 patients 57 eyes underwent LASIK. Anterior optical coherence tomography(OCT) was used to measure corneal flap thickness in all the patients 1 week after surgeries, 16 positions were set to be measured in each eye. Comparisons of flap thickness in each group and between 2 groups were evaluated. Correlative factors of flap thickness were evaluated. RESULTS: Coefficient of variation（CV, s/x ×%）in SBK group were lesser than that in LASIK group, t test showed there was significant statistical difference between 2 groups(P=0.000). Comparisons of the difference of 2 paired positions(temporal-nasal; superior-inferior) showed there were no significant differences in each group, but between 2 groups , there were statistical significance of value of difference (D-value) of superior and inferior positions between SBK and LASIK group(P=0.036). Linear regression analysis of correlative factors of flap thickness showed there were no statistic significances related to central corneal thickness(CCT)(P=0.060, t=1.921) and corneal curvature(P=0.083, t=1.766). CONCLUSION: SBK is better than LASIK in creating much uniform corneal flap. There was no evidence showing correlations between flap thickness and CCT or corneal curvature.     

Comparison between two autorefractor performances in large scale vision screening in Chinese school age children

AIM: To assess the prevalence of meibomian gland dysfunction (MGD) in staffs and faculty members of Sichuan University, China. METHODS: The records of the annually systemic physical examination of 4404 consecutive staffs and faculty members of Sichuan University were analyzed retrospectively. Ocular symptoms and signs of ocular surface were evaluated. RESULTS: MGD was diagnosed in 1424 participants (32.3%), with a mean age of 43.0±9.6y. Of these, 718 (50.4%) were females and no significant difference was found between males and females. The highest prevalence was found in the age 50-59y (36.0%). Logistic regression analysis showed that age is an impact factor of MGD (P<0.001, odds ratio=1.014). CONCLUSION: The prevalence of MGD in staffs and faculty members of a Chinese university is 32.3%, and increases with age.     

YAG激光后囊切开术治疗晚期囊袋阻滞综合征伴后发性白内障

目的：观察YAG激光后囊切开术治疗晚期囊袋阻滞综合征伴后发性白内障的疗效。

方法：对临床确诊为囊袋阻滞综合征伴后发性白内障的13例18眼患者行YAG激光后囊切开术,观察术后1,4,24h; 1,2wk的非矫正远视力、眼压、房水、玻璃体及主观症状的变化。

结果：YAG激光后囊切开术治疗囊袋阻滞综合征伴后发性白内障,可以提高患者非矫正远视力; 部分患者可出现前房内游走颗粒,但不引起炎症反应; 术后1,4,24h部分患者会引起一过性眼压升高,甚至需降眼压治疗,但术前术后眼压变化无统计学意义; 所有患者术后均出现玻璃体混浊加重,眼前漂浮影增多,但均在2wk内恢复。

结论：YAG激光后囊切开术治疗囊袋阻滞综合征伴后发性白内障,可以提高患者视力,但应严密观察患者眼压、前房内炎症反应等,及时给予处理。     

青光眼滤过术后抗瘢痕药物研究进展

青光眼是临床常见致盲眼病,目前以手术治疗为主,但术后复发率较高,主要原因是术区成纤维细胞增生,致瘢痕形成阻塞滤过道。为提高手术成功率,一些抗瘢痕形成的药物被越来越多的应用于青光眼滤过手术的实验与临床研究中,但这些药物也有一定的并发症及毒副作用。随着医疗技术的进步,人们正在寻找更为安全有效的给药方式和新的抑制瘢痕形成的药物。 