全层黄斑裂孔的鉴别诊断

目的：探讨全层黄斑裂孔与板层黄斑裂孔以及囊样黄斑变性的诊断和鉴别诊断方法。方法：用Ａｍｓｌｅｒ方格表、Ｗａｔｚｋｅ征检查和激光瞄准光检查对３０例全层黄斑裂孔、１２例板层黄斑裂孔和８例囊样黄斑变性患者进行检查，其结果用四格表确切概率法进行统计分析。结果：Ａｍｓｌｅｒ方格表检查、Ｗａｔｚｋｅ征检查及５０μｍ激光瞄准光试验在全层黄斑裂孔组中阳性率均为１００％；板层黄斑裂孔和囊样黄斑变性组中分别为８５％、６５％及０。结论：对全层黄斑裂孔的诊断，Ａｍｓｌｅｒ表检查具有敏感性，但不具特异性；Ｗａｔｚｋｅ征敏感而且较特异；激光瞄准光检查非常敏感而且特异。这些检查有助于对全层黄斑裂孔的准确诊断。     

PRK术后房水中TGF-β1含量与haze的相关性

目的 探讨兔眼准分子激光角膜切削术（photorefractkeratectomy,PRK）术后3个月房水中TGF-β1含量的动态变化及其与角膜上皮下混浊（haze)形成的关系。方法 52只新西兰白兔，取4只兔（8眼）作术前对照；另48只兔（96眼）平均分两组，行PRK术，即切削深度为100μm组和150μm组，消融直径5.6mm。于术后3、7、21d及1、2、3个月抽取房水并同时记录haze分级，ELISA法测定房水中TGF-β1含量。 结果 PRK术后两种切消浓度的兔眼角膜上皮均于5-7d愈合；haze均自术后2周开始形成，术后2个月时达到高峰，3个月时明显下降。但150μm切削组术后3个月时，haze仍较100μm组明显，伴有房水中TGF-β1含量的相应改变；150μm切削组在术后7d和3个月时，haze和TGF-β1含量均明显高于100μm切削组。结论 PRK术后TGF-β1影响haze的形成并具有一种剂量依赖的关系，而且与切削深度相关。     

He－Ne瞄准激光诊断全层黄斑裂孔

为评估Ｈｅ－Ｎｅ瞄准激光在全层黄斑裂孔的诊断与鉴别诊断中的价值，我们对经过临床诊断的３０例全层黄斑裂孔患者和２６例假性黄斑裂孔患者进行了Ｈｅ－Ｎｅ瞄准光试验。结果：３０例全层黄斑裂孔患者无一例能看见５０μｍ的瞄准光斑；２６例假性黄斑裂孔患者都能看见５０μｍ的瞄准光斑。结论：通过Ｈｅ－Ｎｅ瞄准光试验检测绝对暗点对全层黄斑裂孔是敏感的而且特异的，该试验有助于临床医生对全层黄斑裂孔诊断的准确性。     

倍应Nd—YAG激光治疗黄斑裂孔疗效分析

本文报告应用倍应Ｎｄ－ＹＡＧ５３２激光治疗６０例黄斑裂孔的疗效。治疗结果：治愈５９例，好转１例，有效率１００％。治疗后视力提高２３例，不变３１例，下降６例。光凝一次成功４４例，光凝二次１５例，光凝三次１例。     

近视性黄斑出血24例的临床观察

目的：观察和探讨近视性黄斑出血的临床特点。 方法：对确诊为近视性黄斑出血的24例患者的30只眼作视力、眼前节、眼底、A/B超声仪、眼底荧光血管造影(fundus fluorecein angiography，FFA)等检查，中西药物治疗并随访观察3～18个月(平均12个月)。 结果：作FFA检查的26只眼中22只眼为单纯型黄斑出血，其中19只眼伴有漆裂样纹，出血多在1～3个月吸收；另外4只眼FFA检查发现为脉络膜新生血管出血，视力预后均较差，且均伴有后葡萄肿。 结论；近视性黄斑出血可分为单纯型和脉络膜新生血管膜型，前者出血吸收快，后者反复出血视力预后较差。 （中华眼底病杂志，1996，12：220-222）     

经瞳孔温热疗法照射对视网膜组织中VEGF和MMP-1 mRNA表达的影响

目的研究经瞳孔温热疗法（transpupillary thermotherapy,TTT）照射对视网膜组织中血管内皮生长因子（vascular endothelial growth factor，VEGF）和基质金属蛋白酶-1（matrix metalloproteinase-1，MMP—1）表达的影响。方法使用唧照射正常灰免视网膜．激光参数为：3min光斑直径，1min曝光时间，450mW功率。每眼照射15点。于照射后1d、3d、7d、2周和3周处死动物并取视网膜组织。抽提RNA后使用RT-PCR方法进行扩增。结果与正常视网膜相比，TTT照射后1d和3d时VEGF mRNA表达降低，7d时恢复正常；MMP-1 mRNA在TTT照射后升高，持续至2周，3周时明显下降。结论TTT照射可能通过降低视网膜组织VEGF的表达来起到抑制新生血管的作用．TTT照射引起MMP-1的表达升高可能通过增加胶原成分的降解来促进新生血管纤维膜的回退。     

脉络膜新生血管经TTT治疗前后微视野变化

目的 应用微视野检查技术评价经瞳孔温热疗法（TTT）治疗脉络膜新生血管（CNV）前后的视功能变化.方法 12例13只经荧光素眼底血管造影证实有CNV的年龄相关性黄斑病变（AMD）和高度近视患眼,在接受TTT治疗前后分别行微视野检查.结果 TTT治疗前,6眼有相对暗点,7眼有绝对暗点.治疗后与治疗前相比较,6眼TTT前检出相对暗点的患眼中,治疗后视力提高者4眼,1眼视力下降,1眼视力无明显变化;6眼中5眼TTT治疗后激光照射处视网膜的光敏度提高,1眼降低.所有被检出有绝对暗点的患眼治疗后视力均无明显变化,视网膜的光敏度不变.结论 微视野检查能客观评估TTT治疗CNV的疗效.     

EFFECT OF FUNDUS PIGMENT ON RESPONSE OF RABBIT RETINA TO TRANSPUPILLARY THERMOTHERAPY

Objective To study the effect of fundus pigment on the response of the retina to transpupillary thermotherapy （TTT）. Methods The retina were irradiated with 810 nm diode laser in 16 eyes of 8 pigmented rabbits and 12 eyes of 6 albino rabbits. The spot size was 1.2 mm; the duration was 60 s; and powers were 50, 80, 150 and 300 mW for pigmented rabbits and 800, 1 200 and 1 500mW for albino rabbits. All of the eyes were followed up with ophthalmolscope. The fundus was photographed and examined histologically with optic microscope immediately and 1 month after TTT respectively. Results The changes of the fundus and the histological examination were not significant immediately and 1 month after TTT in 50 mW group of pigmented rabbit and 800 mW of albino rabbit. Grey spot on the retina was observed on the fundus in 80 mW group of pigmented rabbit and 1 200 mW of albino rabbit immediately after TTT. The structure of the retina remained intact and subretinal fluid was observed histologically. Grey spot was still visible on the fundus, though the fluid was absorbed after 1 month. As the power of diode laser was increased to 150 mW for pigmented rabbits and 1500 mW for albino rabbit, fundus white spots were observed and the outer retina was destroyed while photoreceptors existed immediately after TTT. Pigmentation was found in white lesions and the fibrous proliferation was found in choroid 1 month after TTT. Prominent white spot was seen on the fundus immediately after laser irradiation of 300 mW in pigmented rabbits and the structure of the retina was obscured. One month after TTT, dense pigmentation appeared at laser lesions. The retina was thinner. There was prominent fibrous proliferation in the choroid. Conclusion The fundus pigment seems to play an important role in the response of the retina to TTT. The reaction of the retina is in proportion to the intensity of laser.     

色素上皮衍生因子与眼部新生血管性疾病

色素上皮衍生因子 (pigmentepithelium derivedfac tor ,PEDF)主要来源于眼部的色素上皮细胞 ,具有抗血管新生和神经营养的双重功效。最早是由胎儿视网膜色素上皮细胞的培养液中分离出来的。目前研究认为PEDF是最有效的内源性眼部新生血管抑制剂 ,对新生血管的形成起着重要的调控作用。我们就PEDF的生物学特性、表达部位、调节机制、抗血管新生的作用机理以及PEDF与眼部新生血管性疾病的研究进展作一综述。     

激光诱导小鼠脉络膜新生血管模型中CD105的表达

目的通过激光诱导C57BL／6J小鼠CNV动物模型，观察CD105在新生血管组织中的表达。方法二极管激光诱导生成小鼠脉络膜新生血管，激光后1周和4周以免疫组化观察CD105的表达。结果激光后1周，视网膜下新生血管形成，CD105表达于CNV组织。激光后4周，当血管形成趋于静止时，CD105表达明显减弱。结论研究提示CD105在脉络膜新生血管形成过程中可能起重要作用。