改良显微小梁切除术治疗葡萄膜炎继发性青光眼

Objective To investigate the effect of trabeculectomy combined with segmental iridectomy, mitomycin C (MMC) and viscoelastic agents usage on the treatment of glaucoma secondary in uveitis. Methods According to the age, degree of inflammation and the condition of Tenon capsule of patients, differ-ent concentration of MMC (0.25-0.33 mg/ml) was used during the operation, with separation of the anterior and posterior synechia, resection of pupillary organization membrane using viscoelastic agents. Segmental iridec-tomy and releasable sutures were also performed on the patients. The visual acuity of preoperation and postoper-ation, intraocular pressure, inflammation and the complication were record. Results Forty-two eyes of 38 cases with glaucoma secondary in uveitis were studied, the mean follow-up time was (12.01±3.56) months. The postoperative visual acuity improved in 14 eyes, didn't change in 28 eyes. The postoperative inflammation of anterior chamber disappeared in 35 eyes, relieved in 7 eyes. And the average postoperative intraocular pres-sure (15.20± 4.64) mmHg was significantly lower than the preoperative intraocular pressure (38.37±12.93) mmHg (t = 8.255, P = 0.000). The total success rate was 92.9%. There were no severe complication. Conclusion Trabeculeetomy combined with MMC, viscoelastic agents usage, separation of anterior and poste-rior syneehia, segmental iridectomy and releasable suture could increase the success rate of operation on pa tients with glaucoma secondary in uveitis, decrease the complication and inflammation reaction of operation, and the recurrence of uveitis.     

绝对期青光眼视网膜神经纤维层活体影像学观察

尽管青光眼是多因素疾病，但最终均为视网膜神经节细胞的凋亡、变性和视神经的损害。Quigiey等的研究表明，青光眼患者的视网膜神经节细胞(RGC)丢失40％左右将出现临床可检测的视野损害。然而，临床绝对期青光眼视功能完全丧失时RGC是否完全丧失?本研究应用光学相干断层扫描仪(optic coherence tomograph，OCT)对绝对期青光眼的视网膜神经纤维层(retinal nerve fiber layer，RNFL)进行了定量观察，以间接了解RGC在绝对期青光眼患者的丢失情况。     

维生素C、维生素E、硒与镉联合作用对LLC-PK1细胞脂质过氧化的影响

[目的]研究氯化镉(CACl2)及其分别与维生素C(VitC)、维生素E(VitE)、硒联合作用对猪肾近曲小管上皮(LLC—PKl)细胞增殖、脂质过氧化及抗氧化酶的影响。[方法]实验设对照组、镉组、镉 Vitc组、镉 VitE组和镉 硒组。以四甲基偶氮唑盐(MTT)比色法检测LIE—PK,细胞活力的变化，黄嘌呤氧化酶法测定超氧化物歧化酶(SOD)活力，以催化还原性谷胱甘肽(GSH)速度表示谷胱甘肽过氧化物酶(GSH—Px)的活力，硫代巴比妥酸法(TBA)测定丙二醛(MDA)含量。[结果]不同浓度cdcl2(0—100μmol／L)作用于LIE—PK1细胞12h，细胞存活率随CAC12浓度升高而下降，呈剂量一反应关系；VitC 镉组、vitE 镉组、硒 镉组分别与单独加镉组相比均可显著提高LIE—PK,细胞存活率；10—40pmol／L(ktCl2作用LLC—PK，细胞12h后的培养液上清MDA含量明显增加，与对照组相比差别有显著性。同时，CuZn-SOD、Mn-SOD、GSH—Px活力较对照组相比显著性升高；硒 镉组细胞培养液上清MDA含量与镉组相比有显著性下降。[结论]镉对LIE—PKl细胞增殖有明显的抑制作用；镉可引起LIE．PK1细胞脂质过氧化，是导致肾细胞毒性机制之一；硒对镉引起的ILC—PK。细胞的脂质过氧化有一定的拮抗作用。     

中心性浆液性脉络膜视网膜病变频域光相干断层扫描与时域光相干断层扫描图像比较

Objective To compare difference of the cross-sectional pathological imaging and quantitative measurement of central serous chorioretinopathy (CSC) between time-and fourier-domain optical coherence tomography (OCT). Methods Consecutive 26 patients (26 eyes) with unilaterial CSC were subsumed. Bilateral eyes of all the patients underwent time-and fourier-domain OCT. Horizontal and vertical line scanning and radial six-line scanning protocols were used for time-domain OCT examination; horizontal and vertical high resolution five-line scanning and macular cube scanning protocols were used for fourier-domain OCT examination. The characteristics of OCT images, retinal segmentation and the quantitative measurement were compared between these two methods. Results Fourier-domain OCT could yield the three-dimensional images of surface of inner limiting membrane (ILM) and RPE. The band of external limiting membrane (ELM) of normal subjects and CSC patients, and the inner segment and outer segment (IS/OS) of normal subjects could be clearly shown by fourier-domain OCT. However, the band of IS/OS disappeared in 65.4 % of the CSC patients. The outer boundary of retina was defined in front of the retinal pigmental epithelia (RPE) by fourier-domain OCT. The foveal thickness of normal subjects and CSC patients was (180. 50 ±12.69) and (158. 41 ± 34.20) μm, respevtively. The height of detachment of neuralepithelial layer was (245.84± 154.61) μm measured by fourier-domain OCT. The band of IS/OS of normalsubjects could be clearly shown by time-domain OCT. However, the band of IS/OS disappeared in 73.4%of the CSC patients, which showed no difference with fourier-domain OCT (Z=-0. 108, P=0. 914). Theouter boundary of retina was defined in front of the IS/OS band by OCT. The foveal thickness of normal subjects was (141.16±12.75) μm, which was thinner than that measured by fourier-domain OCT (t= 20. 671,P= 0. 000). The foveal thickness and the height of detachment of neural epithelial layer was (146.40± 36.28) μm and (240. 32±156. 82) μm measured by time-domain OCT, respectively, which showed no significant difference with which measured by fourier-domain OCT (t value was from 0. 026 to 1. 517, P value was from 0. 144 to 0. 980). Conclusions Fourier-domain OCT yields better visualization of intraretinal layers and more accurate definition of outer boundary of retina than time-domain OCT. Thus the measurements by fourier-domain OCT were more accurate. Moreover, three-dimensional images of CSC shown by fourier-domain OCT enable the comprehensive observation of pathological morphology and location.     

眼前段异物的超声生物显微镜图像特征及其诊断价值

[目的]探讨眼前段异物的UBM图像特征及其应用价值.[方法]应用UBM对39例(39只眼)可疑眼前段异物患者进行检查,分析UBM图像特征,并进行定量测量,同时进行常规X线检查.[结果]UBM显示39例患者均有眼前段异物存留,而X线照片则仅提示27例异物存留.异物的UBM图像均显示为高强反射特征,其中22例同时具有"慧尾征"的超声伪影;异物最大直径为3.93 mm,最小直径为0.21 mm,平均0.94±O.69 mm.39例患者通过异物磁吸术或联合眼内手术取出异物;其中铁异物26例,铜异物3例,铝异物1例,石头异物5例,玻璃异物2例,睫毛异物1例,植物花刺1例.[结论]眼前段异物UBM图像呈高强反射特征,部分同时具有"慧尾征"超声伪影.UBM能准确地判断异物的位置、大小及其与周围组织的关系;对眼前段异物的诊断优于X线检查;为异物的术前定位及手术方式的选择提供客观依据.     

闭合性眼外伤致黄斑裂孔的光相干断层扫描图像分析

Objective To observe the features of the images of optical coherence tomograpy (OCT) in patients with traumatic macular hole (TMH), and detect the clinical significance of OCT. Methods Consecutive 74 patients (74 eyes) diagnosed with TMH by examinations of visual acuity, slit lamp, and direct or indirect ophthalmoscopy underwent optical coherence tomography (OCT), The analysis software of OCT was used to make the quantitative measurements of TMH. And the TMH were classified according to the morphological characteristics of the images of OCT. 50°color fundus photography was performed on the patients after OCT. The relationship of TMH with the average visual acuity, disease duration, average neuroepithelial thickness on the margin of hole, and the base diameter and the apex diameter of macular hole were retrospectively analyzed. Results The characterisctics of the images of 74 cases (74 eyes) of TMH were classified into 5 types: macular holes with symmetric edema of the neurosensory retina at the margin in 27 eyes (36.5%), macular holes with asymmetric edema of the neurosensory retina at the margin in 12 eyes (16.2%), macular hole with full-thickness defect of neurosensory retina without edema or detachment at the margin in 14 eyes (18.9 %), macular hole with localized detachment of the neurosensory retina at the margin without edema in 17 eyes (23.0 %), and macular hole with thinning neurosensory retina in 4 eyes (5. 4 %).There was no significant difference of visual acuity among different types of TMH (F=1. 574, P=0. 191).The visual acuity was positively related with the marginal retinal thickness (r=0. 342, P=0. 003), but not related to age, diameter of macular hole or the disease duration(r value was from-0. 022 to-0. 134, P value was from 0. 863 to 0. 261). The disease duration of Type IV TMH was shorter than that of other TMH types. In the patients with the disease duration over 90 days, Type I TMH was predominant. The average retinal thicknesses at the margin of the hole showed significant differences among different TMH types (F= 13.921, P= 0.000). Conclusions TMH could be divided into 5 types according to the characteristics of images of OCT; the clinical characteristics of different types of TMH varies.     

不同药物诱导小鼠胸腺萎缩模型的对比研究

目的:对比研究地塞米松、氢化可的松、聚肌胞苷酸以及苯甲酸雌二醇分别诱导的小鼠胸腺萎缩模型.方法:将55只雌性ICR小鼠分为5组,除对照组外分别给予地塞米松磷酸钠、氢化可的松、聚肌胞苷酸与苯甲酸雌二醇建立模型.观察其胸腺指数、脾脏指数、血细胞变化、血浆中MDA与GST水平、胸腺病理学检测、胸腺细胞凋亡以及相关蛋白的表达情...