视网膜光凝治疗糖尿病性视网膜病变的临床分析

目的：研究视网膜光凝对糖尿病性视网膜病变的治疗效果。方法对45例糖尿病性视网膜病变患者共计80只患眼,采用视网膜光凝治疗,评价患者视力的变化。结果全部80只患眼中29只患眼视力获得提高,2只患眼视力下降,49例患眼视力没有发生变化;不同病变分期间患者治疗后视力变化差异显著,分期高的患者治疗效果差（ P ＜0．05）。56只黄斑水肿患者中治疗后29只全部消退,24只部分消退,3只无变化;不同黄斑水肿分型患者间水肿消退程度差别具有显著性（ P ＜0．05）。所有接受治疗的患者均未出现严重并发症。结论视网膜光凝治疗能够改善糖尿病性视网膜病变患者黄斑水肿程度,提高患者的视力。     

光学相干断层扫描在糖尿病性黄斑水肿诊断中的应用

糖尿病性视网膜病变(diabetic retinopathy,DRP)分为背景型DRP及增殖型DRP,这两种类型DRP均可引起不同程度黄斑水肿,黄斑水肿是导致糖尿病视网膜病变患者视力下降的主要原因之一,黄斑水肿经激光光凝或玻璃体切割手术后,视功能可得到不同程度的恢复,因此早期发现及治疗黄斑水肿对保护糖尿病视网膜病变患者的视功能极为重要.     

糖尿病性视网膜病变眼底荧光血管造影的分析

目的观察糖尿病性视网膜病变眼底荧光血管造影的特征,探讨糖尿病性视网膜病变分期与黄斑病变发生率的关系.方法对135例(249眼)糖尿病性视网膜病变患者进行眼底荧光血管造影检查.结果199只未经治疗眼中,正常2眼占1%;Ⅰ期63眼占31.7%,其中黄斑区染料积存17眼;Ⅱ期41眼占20.6%,其中黄斑区染料积存17眼;Ⅲ期51眼占25.6%,其中黄斑区染料积存42眼;Ⅳ期34眼占17.1%,其中黄斑区染料积存20眼;Ⅴ～Ⅵ期8眼占4%,其中黄斑区染料积存2眼.糖尿病黄斑病变发生于糖尿病性视网膜病变的不同时期,发病率为55.4%.结论眼底荧光血管造影检查对糖尿病性视网膜病变分期和糖尿病黄斑病变的早期诊断均敏感、可靠,是糖尿病性视网膜病变和黄斑病变的治疗和预后评价的可靠依据.     

Graefe眼科临床和实验文献

对继发于老年性黄斑变性的黄斑中心凹外脉络膜新生血管应用维替泊芬进行光动力治疗,应用经Tenon囊球后注射曲安奈德治疗玻璃体切除术后顽固性糖尿病性黄斑水肿,增殖性糖尿病视网膜病变、增殖性玻璃体视网膜病变和视网膜脱离患者玻璃体腔戊糖素的浓度比较,α-甘露糖苷过多症患者中迟发性视网膜营养不良,伴有眼外肌损伤的外伤性眼球异位入上颌窦1例……     

激光光凝治疗糖尿病性黄斑水肿的研究

黄斑水肿是导致糖尿病性视网膜病变，尤其是非增生性糖尿病视网膜病变患者视力下降最常见、最重要的原因。目前激光光凝术已成为治疗糖尿病性黄斑水肿的常用方法，但激光参数的选择是临床治疗十分重要而又难以统一的问题。我们采用氪黄激光对176例355只眼糖尿病性视网膜病变黄斑水肿进行光凝治疗，旨在对激光参数选择和疗效进行观察，现报道如下。[第一段]     

眼科学文献

曲安奈得用于增生性糖尿病性视网膜病变全视网膜光凝的辅助治疗,玻璃体腔注射曲安奈得后黄斑格栅光凝治疗弥漫性糖尿病性黄斑水肿,从维替泊芬光动力疗法（VIP）试验获得的隐匿性非典型中央凹下脉络膜新生血管的老年性黄斑变性与临床有关的自然病史信息：VIP报道之4,4期早产儿视网膜病变3通道保留晶状体式玻璃体切割术治疗后的视力预后,视神经放射状切开治疗半侧视网膜中央静脉阻塞[编者按]     

糖尿病黄斑水肿不同顺序激光治疗分析

目的 观察不同顺序黄斑格栅光凝联合全视网膜光凝治疗糖尿病视网膜病变黄斑水肿的临床疗效.方法 将58例(102眼)糖尿病视网膜病变弥漫性黄斑水肿患者随机分二组,给予不同顺序黄斑格栅光凝和全视网膜激光光凝治疗,比较二组术后1,3个月视力和黄斑水肿消退情况.结果 二组患者术后1个月视力、黄斑水肿差异均有统计学意义;术后3个月视力、黄斑水肿差异无统计学意义.结论 先行黄斑格栅光凝再行全视网膜光凝治疗糖尿病视网膜病变黄斑水肿能更早消除黄斑水肿,提高患者视力.     

激光光凝治疗中心性浆液性脉络膜视网膜病变远期疗效

目的观察中心性浆液性脉络膜视网膜病变（CSC）及视网膜激光光凝后的变化情况。方法对符合激光光凝治疗的120例中心性浆液性脉络膜视网膜病变患者,观察记录其激光光凝后3年视网膜发生的变化。结果对120例中心性浆液性脉络膜视网膜病变患者行视网膜激光光凝治疗,98例1次性激光封闭渗漏点成功,占82％,22例行2次激光光凝后封闭渗漏点成功,6例演变为黄斑变性（其中湿性黄斑变性5例,干性黄斑变性1例）,其年龄均在45岁以上。结论98例1次性激光封闭渗漏点成功者的吲哚青绿血管造影术,均看到与渗漏点相对应的脉络膜局部的毛细血管小叶的高通透性,表明存在CSC复发的病理基础。另外,当激光光凝的能量过大时,可导致视网膜下的bruch膜破裂,从而使视网膜下出血和新生血管生成,是否也是黄斑变性形成的原因,值得我们继续观察研究。     

糖尿病性视网膜黄斑水肿氪黄激光治疗的临床分析

目的分析氪黄激光治疗糖尿病性视网膜病变黄斑水肿的临床疗效,并探讨氪黄激光治疗黄斑水肿的时机. 方法对50例68眼非增殖期糖尿病性视网膜病变黄斑水肿患者,根据FFA提示黄斑水肿的形态及范围,分别行氪黄激光黄斑部视网膜局部光凝术或“C”形格珊状光凝术. 结果术后视力提高者45眼（66.2%）,不变者18眼（26.5%）,下降5眼（7.3%）,黄斑水肿完全消退者28眼（41.2%）,部分消退者32眼（47.1%）,不变者8眼（11.8%）. 结论氪黄激光光凝为治疗糖尿病性视网膜病变黄斑水肿的安全有效方法.建议对非增殖期糖尿病性视网膜病变黄斑水肿患者及早行氪黄激光治疗.     

氩绿激光治疗糖尿病性黄斑病变的临床观察

目的探讨氲绿激光治疗糖尿病性黄斑病变的对改善视力及黄斑水肿的疗效。方法将对糖尿病性黄斑病变患者按病程分成两组：增殖前期；增殖期。并行眼底荧光血管造影确定视网膜血管渗漏点(区)。对局部渗漏点氩激光点状光凝，弥漫性渗漏区采用格栅样光凝。随访12个月，观察比较两组光凝前后视力及黄斑水肿、渗漏的变化．并进行统计学分析。结果氩绿激光治疗糖尿病性黄斑病变86例136眼，87．50％的眼别提高或保存现有视力，其中对增殖前期的疗效为优；87．95％的黄斑水肿完全或部分消退．增殖前期的黄斑水肿消退尤为明显。两组的视力改善和黄斑水肿消退比较均有统计学意义。结论氩绿激光光凝是治疗糖尿病性黄斑病变的有效手段，有助于提高或保存现有视力．疗效与病变程度有关．早期治疗效果较好。     

Spectral domain optical coherence tomography–based prevalence of hydroxychloroquine maculopathy in Indian patients on hydroxychloroquine therapy: A utopia of underdiagnosis

BackgroundSpectral domain optical coherence tomography (SD-OCT) detects early structural damage to macula in patients on Hydroxychloroquine (HCQ) therapy. The current screening protocols emphasize concurrent use of both SD-OCT and Visual field analysis (VFA) which detects functional damage to detect Hydroxychloroquine maculopathy. However, VFA is a time-consuming and subjective test which is often neglected. This study gives the prevalence of Hydroxychloroquine maculopathy using SD-OCT alone which often fails to detect macular damage in peri-foveal and extra-foveal area of the retina.MethodsThree hundred thirty four eyes of 167 patients taking systemic Hydroxychloroquine were studied with SD-OCT macular cube 512 x 128 to diagnose structural macular damage to detect prevalence of Hydroxychloroquine maculopathy.ResultsOut of 167 patients, only four patients showed features suggestive of Hydroxychloroquine maculopathy. One patient had ELM loss, two had para-foveal and one had peri-foveal IS-OS disruption. The SD-OCT gave prevalence as 2.4%.ConclusionSD-OCT alone can underdiagnose burden of Hydroxychloroquine maculopathy (prevalence = 2.4%) when compared to studies which use both SD-OCT and Visual field analysis (prevalence = 7.5%).     

阿奇霉素的不良反应

文章对近年来有关阿奇霉素不良反应的文献资料进行归纳，其主要不良反应包括胃肠道反应、过敏反应。其中过敏性休克的发生高于预期；其他少见的不良反应包括白细胞减少症、肝损害、听力损伤、低血压和血小板减少伴皮下出血等。     

三七总皂甙及抗坏血酸对大鼠视网膜光化学损伤的防护作用

目的：评介三七总皂甙及抗坏血酸防护视网膜光化学损伤的效果。方法：本实验于光照前２４ｈ及光照前立即给大鼠腹腔注射三七总皂甙及抗坏血酸,进行光损伤的防护研究,以视网膜光镜形态,外核层厚度及丙二醛含量检测作为评判分析指标。     

激光医学与组织修复

激光在医学领域应用广泛。在组织修复方面,弱激光可通过生物刺激作用促进细胞生长;激光经光致聚合封闭创面,并通过光致氧化作用有效控制创面感染;点阵式激光能够促进瘢痕重塑。相信随着研究的深入和治疗方法的不断优化,激光在组织修复方面的应用将越来越广泛。     

原花青素对小鼠视网膜光化学损伤的保护作用

目的观察原花青素对视网膜光化学损伤后感光细胞的保护作用。方法24只昆明小鼠随机分为3组：A组为正常对照组;B组为光化学损伤模型对照组;C组为原花青素给药组。C组在造模前三天开始灌胃给原花青素混悬液（400mg/kg/d）,B和C组先暗适应12小时,然后在自制的光损伤箱内光照12小时,连续光照3天。在造模后第7天,将每组的8只小鼠进行光镜观察视网膜形态学,并采用计算机图像分析技术,对各实验组小鼠视网膜厚度及视网膜外核层厚度进行定量测量。结果光照第7天后,三组视网膜厚度和视网膜外核层厚度相比均具有显著性差异（p〈0.01）。结论原花青素对视网膜光化学损伤具有一定的保护作用。     

激光医学与组织修复

激光在医学领域应用广泛。在组织修复方面,弱激光可通过生物刺激作用促进细胞生长;激光经光致聚合封闭创面,并通过光致氧化作用有效控制创面感染;点阵式激光能够促进瘢痕重塑。相信随着研究的深入和治疗方法的不断优化,激光在组织修复方面的应用将越来越广泛。 更多还原     

Systolic blood pressure,choroidal thickness,and axial length in patients with myopic maculopathy

BackgroundIn the population-based Shihpai Eye Study, patients aged >65 years with myopic maculopathy were found to have higher systolic blood pressure. This finding deserved further exploration because this is the only correctable factor for preventing maculopathy in patients with high myopia. Therefore, we investigated the association between myopic maculopathy and systolic blood pressure, as well as other ocular parameters in this study.MethodsA clinic-based, retrospective cross-sectional study at a medical center was conducted between February 2011 and October 2012. Patients with high myopia were included and medical charts were reviewed. High myopia was defined as axial length ≥26.5 mm in at least one eye. Myopic maculopathy was defined as the presence of lacquer cracks, focal areas of deep choroidal atrophy, diffuse chorioretinal atrophy, and macular choroidal neovascularization or geographic atrophy in the presence of high myopia. Systolic blood pressure measurements were collected, and fundus photography and optical coherence tomography were performed. Subfoveal choroidal thickness (SFCT) shown on optical coherence tomography was measured and recorded.ResultsThe medical records of 187 high-myopic patients (87 without and 100 with maculopathy) were reviewed. Patients with maculopathy were older (56.96 years vs. 42.95 years, p < 0.01), had longer axial length (29.96 mm vs. 27.31 mm, p < 0.01), thinner SFCT (49.71 μm vs. 155.77 μm, p < 0.01), higher systolic blood pressure (132.28 mmHg vs. 125.31 mmHg, p < 0.05), greater prevalence of hypertension (31% vs. 16%, p < 0.05), and longer history of hypertension (2.34 years vs. 0.59 years, p < 0.01) compared to patients without maculopathy. After multivariate adjustment, SFCT and axial length were the only significant factors for maculopathy.ConclusionThinner SFCT and longer axial length are significant risk factors for myopic maculopathy. Unlike previous epidemiological surveys, results of this clinic-based study suggested that systolic blood pressure is not a significant factor for maculopathy.     

Photochemically induced focal cerebral infarction in rat and its pathological observation]

Cerebral infarction in Wistar rats was induced by photochemical method. A photochemical reaction was produced by the photosensitive agent rose bengal under the effects of green light (560 +/- 60 nm). This reaction released free radicals which may damage the endothelium of cerebral vessels and induce platelet aggregation, and then may cause thrombosis in cerebral parenchymal vessels. There were typical changes of thrombosis and ischemic necrosis in the irradiated region of the cerebrum under light and electron microscopy. Serial pathologic findings suggested that the critical phase of progressive necrosis lies at the time of 1-6 hours after cerebral ischemia induced photochemically. Therefore, effective protection of the brain is important in the early stage of cerebral ischemia.     

水飞蓟宾-磷脂酰胆碱复合物对小鼠急性肝损伤保护作用的量效关系

目的　观察不同剂量水飞蓟宾 -磷脂酰胆碱复合物 (SPC)对四氯化碳 (CCl4)所致小鼠急性肝损伤的影响。方法　雌性小鼠随机分组给药后测定血清中谷丙转氨酶 (ALT)和谷草转氨酶 (AST)活性 ,取肝组织作病理学检查。结果　不同剂量的水飞蓟宾 -磷脂酰胆碱复合物均可明显降低CCl4所致小鼠血清中ALT和AST活性升高 ,并与剂量呈正相关。SPC组肝组织变性、坏死的程度亦明显减轻 (P <0 .0 0 1,P<0 .0 1,P<0 .0 5 )。结论　SPC对CCl4所致小鼠急性肝损伤具有明显的保护作用 ,高、中、低剂量组间降酶作用呈明显的量效关系。     

23例少年型黄斑营养不良及黄色斑点状眼底病变的眼底荧光血管造影观察

本文报告23例(46眼)Stargardt病及黄色斑点状眼底病变的眼底荧光血管造影所见。单纯黄斑变性16例,中心凹周围有斑点的黄斑变性5例,黄斑变性伴后极部弥散性黄色斑点1例。无黄斑变性的后极部弥散性黄色斑点1例,黄斑变性区表现为密集点状透见荧光,夹杂点状遮蔽荧光。大多数斑点呈透见荧光,少数呈遮蔽荧光.4例显示脉络膜湮没征象。所有病例均未见荧光素渗漏。本病具有典型的荧光征象,眼底荧光血管造影检查对于早期诊断具有十分重要的意义。