折叠式人工玻璃体球囊植入在玻璃体视网膜疾病治疗中的应用

目的　探讨折叠式人工玻璃体球囊(foldable capsular vitreous body，FCVB)治疗玻璃体视网膜疾病的临床效果。方法　回顾性分析2017年9月至2019年1月行玻璃体切割联合FCBV植入术的43例（43眼）患者的临床资料。术后随访6个月，观察术后视力、眼压、视网膜复位情况和FCBV状态。结果　术后6个月，43例视力无明显变化，手术前后差异无统计学意义（P=1.000）。术后6个月，4例眼压降低，39例眼压正常，手术前后差异有统计学意义（P=0.002）。眼底照相、B超、OCT检查结果显示:所有患者视网膜复位良好，FCVB在玻璃体内均匀地支撑视网膜。双眼外观对称，眼球活动正常。随访期末1例眼球轻微萎缩、1例出现角膜血管化，经治疗后情况好转。结论　在患者6个月的植入期内，FCVB是安全、有效的玻璃体替代物，可以维持眼球形态和稳定眼压。     

人眼后皮质前玻璃体囊袋的光相干断层扫描影像特征观察

目的观察人眼后皮质前玻璃体囊袋(PPVP)的OCT影像特征。方法回顾性临床研究。2012年5月至2017年2月于成都市第三人民医院眼科行OCT检査发现PPVP的受检者107名173只眼纳入研究。行频域OCT(SD-OCT)、扫频光源OCT(SS-OCT)检査分别为103、70只眼。SD-OCT检査采用德国Heidelberg公司Spectralis OCT仪进行。SS-OCT检查采用日本Topcon公司DRI OCT仪的玻璃体增强扫描模式。观察PPVP不同类型OCT成像差异以及影像特征。结果所有受检眼SD-OCT.SS-OCT检查均可见PPVP结构清晰,表现为黄斑区前弱反射船形腔隙,前界为玻璃体胶原,后界为玻璃体皮质;PPVP鼻侧存在一弱反射的无凝胶区域(Martegiani区),两者之间存在连接通道。其形态特点两种检查方式所见相似,但SS-OCT对PPVP的成像更清晰。结论人眼PPVP的OCT影像特征为黄斑区前弱反射船形腔隙,前界为玻璃体胶原,后界为玻璃体皮质;其鼻侧存在Martegiani区。     

桃红四物汤联合银杏酮酯滴丸治疗老年出血性玻璃体混浊的临床疗效研究

目的:探究桃红四物汤联合银杏酮酯滴丸治疗老年出血性玻璃体混浊的临床疗效。方法:收集2016年12月-2018年12月我院收治的老年出血性玻璃体混浊患者67例,共67眼,根据随机对照表分为对照组和试验组,其中试验组34例,对照组33例,对照组予以银杏酮酯滴丸;试验组在对照组的基础上联用桃红四物汤。两组均服用30 d。治疗结束后对比分析两组患者临床疗效、出血吸收时间、血液流变学及视网膜中央动脉血流动力学。结果:治疗后两组患者高切全血粘度、低切全血粘度、纤维蛋白原、阻力指数(Resistance Index,RI)低于治疗前,收缩期峰值速度(Peak Systolic Velocity,PSV)、舒张末期血流速度(End Diastolic Velocity,EDV)高于治疗前,差异具有统计学意义(P<0.05);治疗后试验组临床总有效率、PSV、EDV高于对照组,出血吸收时间、高切全血粘度、低切全血粘度、纤维蛋白原、RI低于对照组,差异具有统计学意义(P<0.05)。结论:桃红四物汤联合银杏酮酯滴丸治疗老年出血性玻璃体混浊临床疗效显著,适宜临床应用推广。     

可注射水凝胶治疗眼科疾病的研究进展

眼部结构的特殊性使眼科疾病的治疗面临很多阻碍。水凝胶作为一种具备多维应用潜能的高分子材料,有着可控的力学性能及生物性能,是组织工程、生物工程等领域的研究热点。水凝胶良好的透明性、安全性、兼容性也提示了水凝胶在眼科领域广阔的研究前景。目前已应用于眼科的水凝胶有人工泪液、药物载体、黏附剂等。本综述介绍了可注射水凝胶在制作、性能及应用方面的特点,概述了可注射水凝胶作为药物载体、组织黏附剂、空间填充剂以及细胞载体在眼科疾病中的应用进展及挑战,特别介绍了可注射水凝胶近年来在角膜外伤、青光眼、白内障、视网膜脱离及年龄相关性黄斑变性等疾病治疗方面的研究。     

玻璃体后脱离与高度近视眼的关系

论述了玻璃体后脱离的病因、发病机制、分类和临床特点,并揭示了玻璃体后脱离与高度近视眼的关系。     

MYD88 L265P mutation in intraocular lymphoma: A potential diagnostic marker

Purpose:Vitreoretinal lymphoma (VRL) is the most common intraocular lymphoma (IOL). This can be either primary or secondary to the central nervous system lymphoma. The diagnosis of primary intraocular lymphoma (PIOL) currently relies on clinical diagnosis and cytological analysis of the vitreous or subretinal biopsy. Although most cases are diagnosed without much issue, the limited amount of vitreous fluid, subjectivity in cytological reporting, and special expertise in ocular pathology make the diagnosis challenging. MYD88 L265P mutation has been implicated to have diagnostic utility in PIOL. In this study, we screened consecutive vitreous biopsies for the presence of MYD88 L265P mutation to understand its diagnostic utility compared to conventional cytological analysis.Methods:Cytological analysis and MYD88 L265P mutation by PCR-based sequencing and restriction fragment length polymorphism (RFLP) were carried out on consecutive vitreous and subretinal biopsies collected from 21 patients. The diagnostic utility of the cytology and MYD88 L265P mutation analysis were compared.Results:Out of the 21 patients, 15 had clinical suspicion of having PIOL. Out of these suspected cases of PIOL, nine were confirmed on follow-up, while six were diagnosed as other intraocular pathologies. Diagnostic utility of MYD88 L265P mutation analysis revealed a sensitivity of 88.9%, specificity of 91.6%, positive and negative predictive value of 88.9% and 91.7%, respectively. Diagnostic accuracy of 90.5% was achieved with the mutation analysis that shows the superiority of MYD88 in both ruling in and ruling out PIOL. The diagnostic utility of MYD88 L265P mutation was superior to conventional cytological analysis.Conclusion:The analysis of MYD88 L265P mutation is reliable and efficient in the diagnosis of PIOL.