巨噬细胞在糖尿病视网膜病变中的作用

糖尿病视网膜病变(diabetic retinopathy,DR)是糖尿病常见且严重的微血管并发症,是视力损害的重要原因之一,其发生和发展是一个多细胞参与,多因素调控的复杂过程.巨噬细胞来源于单核细胞,是视网膜主要的炎性细胞,参与视网膜的许多病理和生理过程.随着越来越多的研究着眼于DR病程中炎症的作用,人们发现巨噬细胞对DR的发病机制研究有着重要意义.     

内分泌激素在早产儿视网膜病变发生中的作用

内分泌激素对机体正常生长发育有明显调节作用,近期研究发现许多激素对视网膜正常血管化和早产儿视网膜病变新生血管的生成具有明显调节作用,从内分泌角度研究早产儿视网膜病变的发病机制,对防治早产儿视网膜病变有重要意义。     

早产儿视网膜病变发病情况分析

目的 分析早产儿视网膜病变(ROP)的发病情况.方法 回顾性分析2005年9月至2008年5月来就诊的胎龄小于36周、体重低于2500g的210例早产儿的眼底筛查情况及高危因素.结果 210例早产儿中,ROP的发生率为12.9%,其中ROP3期以上的发生率为3.8%;低孕周、低体重、出生后吸氧时间过长、严重的新生儿疾病的早产儿ROP发生率高;双生子ROP发生率(20.5%)高于单生子(10.8%),且ROP发生严重.结论 低孕周、低体重、出生后吸氧时间过长、患严重的新生儿疾病、非单生子等是引起早产儿视网膜病变的高危因素.     

感染/炎症在早产儿视网膜病变中的作用

感染/炎症是早产的重要启动因素,同时感染也是早产儿常见的并发症。近来,临床研究提示早产儿视网膜病变(retinopathy of prematurity,ROP)与新生儿或母体的感染/炎症相关;基础研究也发现炎症可影响视网膜血管的正常发育,参与调控视网膜新生血管的形成。了解感染/炎症在ROP中的可能作用,对于ROP的早期诊断和防治有重要意义。本文就感染/炎症与ROP的关系及相关的作用机制进行综述。     

早产儿视网膜病变筛查结果分析

目的 了解早产儿视网膜病变(ROP)的发病情况,并探讨相关危险因素.方法 对符合ROP筛查标准的早产儿201例(402只眼),用间接眼底镜进行眼底筛查,记录眼底检查情况.结果 出生孕周27～ 36周,出生体重750～ 2500g早产儿201例,正压给氧48人次,持续1～17d.鼻导管吸氧53人次,持续1～55d,无1例出现ROP.结论 严格控制吸氧可以控制ROP的发病.     

早产儿视网膜病变与近视

早产儿及低体重儿多发近视眼，尤见于高度近视眼，两者之间的关系以及近视的性质与形成机制，已有一些观察与分析的报道，但看法不一。近年来人们已注意到近视与早产儿视网膜病变的关系，初步肯定两者的相关性，并对其可能机制作了评论，从而为小儿近视的性质及成人近视眼的组成作进一步分析与研究提供了新的依据。     

一氧化氮在早产儿视网膜病变中的作用

目的 研究一氧化氮(NO)在早产儿视网膜病变(ROP)中的作用及其与血管内皮生长因子(VEGF)的相互关系.方法 建立高浓度氧诱导的SD新生鼠ROP模型,腹腔分别注射结构型一氧化氮合酶(cNOS)抑制剂L-NNA 150mg/(kg·d)和诱导型NOS(iNOS)抑制剂L-NIL 25 mg/(kg·d).一段时间后,取新生鼠眼球制备切片计数视网膜新生血管内皮细胞数,Western blot法检测VEGF.结果 氧气组视网膜cNOS活力较空气组显著增高(P＜0.05),iNOS活力明显降低(P＜0.05).L-NNA治疗组与对照组比较,视网膜新生血管内皮细胞数显著减少(P＜0.05),VEGF在高氧期表达增加60.38%,相对低氧期表达减少17.97%,以上指标L-NIL治疗组与对照组差异均无统计学意义(P＞0.05).结论 抑制cNOS产生的NO能减少后者引起的血管活性以及细胞毒性效应,从而减轻对血管内皮细胞的损伤,并且能下调视网膜VEGF的表达.     

早产儿视网膜病变研究进展

早产儿视网膜病变(retinopathy of prematurity,ROP)是早产儿尤其是伴有低体重儿发生的一种视网膜毛细血管发育异常化的双侧性眼病,表现为视网膜缺血、新生血管形成和增生性视网膜病变,重者可以引起视网膜脱离而导致永久性失明。近年来,随着围产医学的进步,早产儿成活率逐渐增加,相应ROP发生率也呈增加趋势。由于其后果严重,对患儿及其家庭造成巨大伤害,ROP也日益引起人们的重视。目前ROP的确切病因仍未明确,真正的发病机制尚不十分清楚,亦缺乏有效的预防措施。本文从ROP的发病因素、发病机制及干预措施三方面对其新近研究进展作一综述。     

汕头市早产儿视网膜病变筛查结果分析

目的：了解汕头地区早产儿视网膜病变( retinopathy of prematurity, ROP)发病情况,探讨适合汕头地区的 ROP筛查标准。
　　方法：对2011-01/2014-12在汕头4家医院NICU住院的1813例出生体重≤2000 g的低出生体重儿或胎龄≤34周的早产儿采用双目间接眼底镜和(或)广角数码儿童成像系统( RetCamⅡ)进行ROP筛查,所有患儿随访至视网膜完全血管化或病变退化。
　　结果：发现ROP 202例388眼,占筛查总例数11.14%。其中重症ROP(阈值前期Ⅰ型或阈值期)43例85眼,占筛查总例数2.37%。出生体重<1500 g新生儿408例,重症ROP 34例67眼,占全部重症 ROP 病例的79.07%。GEE模型分析结果表明,低出生体重、小胎龄及吸氧是ROP的高危因素。
　　结论：汕头地区ROP检出率11.14%,但重症ROP检出率较低,主要发生于出生体重<1500 g低出生体重儿和出生胎龄≤34周的早产儿。低出生体重、小胎龄及吸氧是ROP的高危因素。     

Profile of asymmetrical retinopathy of prematurity in twins

Background:

In twin births, both babies have the same gestational age and pre-natal conditions. However, twins may develop a varied retinopathy of prematurity (ROP) course depending on birth weight and other systemic factors.

Objective:

To study the profile of asymmetric ROP in twins

Design:

Retrospective study

Setting:

Tertiary ROP referral eye hospital.

Materials and Methods:

The profile of 56 pairs of twins with ROP were studied and analyzed for differences in zone or need for treatment, while studying possible causes for the varied outcome.

Results:

In 45 pairs of twins (80%) the disease progressed identically in both eyes, while in 11 pairs (20%) the ROP showed differences in zone or need for treatment. Four of these pairs were discordant. In 3 of these 4 pairs, the heavier birth weight twin had a more severe ROP course.

Conclusions:

Twins can present with asymmetric ROP course, and it is therefore essential to examine both twins as per screening protocols.     

未成熟儿视网膜病变危险因素分析

目的分析未成熟儿视网膜病变(retinopathy of     

早产儿视网膜病变治疗方法及疗效分析

早产儿视网膜病变(retinopathy of prematurity,ROP)曾称为晶状体后纤维增生症,是婴幼儿致盲的重要原因之一,常发生于有高浓度吸氧史的早产儿或发育迟缓的低体重儿。随着低体重新生儿治疗成活率的提高,ROP患儿亦日益增加。早发现、早治疗是避免ROP患儿发生视网膜脱离,视力永久丧失的重要手段,目前治疗方法主要有视网膜冷凝治疗、视网膜光凝治疗、巩膜扣带术、玻璃体切割手术治疗等方法,药物及基因疗法尚处于动物实验阶段。     

The role of hyperoxia in the aetiology of retinopathy of prematurity

Oxygen in excess is toxic to living tissues and a capacity to neutralise its harmful potential is a requirement for survival. Experimental and circumstantial clinical evidence suggests that the requisite protective mechanisms are insufficiently advanced in the retinal vasculature of the premature neonate, such that babies of very low birth weight are vulnerable to even minor hyperoxia. Sustained hyperoxia produces degenerative effects on the developing endothelium with the result that the newest vessels at the retinal periphery are obliterated. Factors other than the level of inspired oxygen per se may serve to increase the risk of retinopathy by raising the rate of delivery of hyperoxygenated blood.     

早产儿视网膜病变模型研究进展

目前,早产儿视网膜病变(retinopathy of prematurity,ROP)已经成为世界范围内儿童致盲的重要原因,约占儿童致盲原因的6%～18%。防治ROP以改善早产儿的生存质量已成为全球关注的焦点。因此,建立合适的视网膜新生血管动物模型已成为探讨视网膜新生血管的发生机制并评估其药物治疗效果的重要手段。本文对用各种模型模拟ROP的发生过程进行综述。     

Management of retinopathy of prematurity

Seventeen patients with symmetrical stage 3 retinopathy of prematurity (ROP) and plus disease as described in the International Classification of ROP had one eye randomized to cryotherapy and the other to control. Seventy-seven percent of the patients were under 1000 grams at birth and females outnumbered males by a 2 to 1 ratio. The average chronologic age at which cryotherapy was performed was three months. Twelve of seventeen treated eyes (71%) showed resolution of the ROP and 10 of 17 untreated eyes (59%) became significantly worse. However, only five patients had improvement in the treated eye and progression in the untreated eye, a number too small to provide statistical significance. Six eyes with Stage IV ROP were operated by encircling scleral buckling techniques because of total retinal detachment secondary to peripheral traction and cicatrization arising from the ridge. In five patients the unoperated eye had already developed a retrolental membrane, and in one patient bilateral detachments were present. Five of the six operated retinas were reattached.     

早产儿视网膜病变发病因素探讨

目的探讨致早产儿视网膜病变(ROP)发生的可能危险因素。方法对43例早产儿伴发疾病、生后血气指标、就诊时间、给氧治疗等方面进行回顾性分析。结果43例早产儿中只一例发生ROP,此例与其它病例相比,只是同时伴发四种疾病,其余在治疗、血气检验、给氧等方面无明显不同。结论ROP的发生除吸氧外,是否与机体状况(同时伴发多种疾病)、出生后环境、伴发病治疗效果、种族、地理和基因等哪一个或哪几个因素有着密切相关,还有待于深入探讨。     

The progress of prophylactic treatment in retinopathy of prematurity

Retinopathy of prematurity (ROP) is a retinal vascular disorder frequently found in premature infants. Different therapeutic strategies have been developed to treat ROP. However, there are still many children with ROP suffering by severe limitations in vision or even blindness. Recently, ROP has been suggested to be caused by abnormal development of the retinal vasculature, but not simply resulted by retinal neovascularization which takes about 4 to 6wk after birth in premature infants. Thus, instead of focusing on how to reduce retinal neovascularization, understanding the pathological changes and mechanisms that occur prior to retinal neovascularization is meaningful, which may lead to identify novel target(s) for the development of novel strategy to promote the healthy growth of retinal blood vessels rather than passively waiting for the appearance of retinal neovascularization and removing it by force. In this review, we discussed recent studies about, 1) the pathogenesis prior to retinal neovascularization in oxygen-induced retinopathy (OIR; a ROP in animal model) and in premature infants with ROP; 2) the preclinical and clinical research on preventive treatment of early OIR and ROP. We will not only highlight the importance of the mechanisms and signalling pathways in regulating early stage of ROP but also will provide guidance for actively exploring novel mechanisms and discovering novel treatments for early phase OIR and ROP prior to retinal neovascularization in the future.     

The retinopathy of prematurity: medicolegal aspects

The incidence of medicolegal claims based on retinopathy of prematurity (ROP) diminished in the 1960s after the role of oxygen was presumed to be understood. It has since increased again for a number of reasons. More very premature infants are being saved. The causes of ROP are multifactorial, not well understood, and the role of oxygen as a significant factor is not always clear. Moreover, the risk/benefit ratio of supplemental oxygen is not always easy to evaluate. The morphologic features of ROP are common to a number of disorders, which may be misdiagnosed as ROP. In the series of 500 medicolegal claims that I have studied, no ophthalmologists have been sued in cases concerning ROP. However, they are routinely called as expert witnesses and it is to guide them in that role that I am reviewing the subject.