光化学法诱导家兔视网膜中央动脉阻塞

目的 建立家兔视网膜中央动脉（ＣＲＡ）主干阻塞的动物模型。方法 手术暴露出０视网膜中央动脉后,采用光化学法造模,随后对模型进行荧光眼底照相及电镜检查。结果 视网膜中央动脉内血栓形成,阻塞血管腔。视网膜的节细胞层及神经纤维层在缺血６ｈ后均出现变性、坏死的改变。结论 采用光化学方法,可以成功复制出视网膜中央动脉主干阻塞模型,且缺血达６ｈ后视网膜节细胞层及神经纤维层可发生不可逆性损伤。     

倍频532激光激发孟加拉红建立色素兔视网膜静脉阻塞模型

目的探讨光化学法诱导色素兔视网膜静脉阻塞模型的方法和特点。方法将16只健康青紫蓝兔随机分为A、B两组,每组8只。经兔耳缘静脉注入孟加拉红(50 mg/kg)后应用倍频532激光光凝视网膜静脉,A组激光能量150 mW光凝双侧视网膜静脉主干15点后,300 mW再照射15点;B组激光能量150 mW光凝双侧视网膜静脉主干40点后,300 mW再照射40点。分别于术前和光凝后15 m in、1 d、3 d、7 d、14 d、21 d、28 d行眼底照相和眼底荧光造影检查,并于光凝后1 d时两组各处死1只动物,其余于光凝后28 d处死,摘除眼球行光学显微镜检查。结果两组均成功诱导视网膜静脉阻塞模型,光凝后第1天B组产生视网膜动、静脉阻塞。光凝后第7天,A组阻塞静脉全部再通,B组有部分阻塞静脉再通。病理检查结果显示:光凝后第1天,两组视网膜静脉内均见血栓形成;光凝后第28天,B组视盘周围视网膜萎缩,结构不清。结论利用孟加拉红光化学法制作兔视网膜静脉阻塞模型操作简便,随着局部视网膜静脉接受光凝次数的增加,视网膜动脉亦可出现阻塞现象。     

视网膜动脉阻塞的病因分析

本文报道２３例经眼底血管荧光造影检查确诊为视网膜动脉塞病人。其发病原因以５０岁以上、患有高血压动脉硬化及视网膜动脉硬化为多见，其次为眼挫伤，大量饮酒和球后注射强的松龙药物所少见。     

视网膜静脉阻塞合并动脉阻塞二例报告

视网膜静脉阻塞（ＲＶＯ）是临床上常见的眼底血管病，而合并动脉阻塞（ＲＡＯ）者却很少见，国内未见专题报道。我院１９９４～１９９６年经治初诊ＲＶＯ共１０８例（发病率约为万分之九），其中发现合并动脉阻塞者２例，约占ＲＶＯ病例的１．８５％，现分析报告如下。病...     

视网膜中央动脉阻塞合并静脉阻塞1例

1　临床资料　　患者谷银山 ,男 ,4 8岁。因右眼不明诱因突然失明伴眼胀疼 5d,于 1 999年 4月 2 6日来我院就诊。查体 :视力右眼光感 ( -) ,左眼 0 .5,矫正视力 1 .5,左眼正常。右眼结膜充血 ,角膜透明 ,前房深浅尚可 ,闪辉 ( )瞳孔直接对光反射消失 ,散瞳查眼底 :乳头境界不清 ,视网膜中央静脉及周围小静脉均呈紫黑色 ,视网膜动脉明显变细 ,无节段或腊肠样改变 ,视网膜水肿呈灰白色 ,整个网膜可见散在点状及小片状出血 ,黄斑区水肿 ,中反射消失。初步诊断 :视网膜血性病变 (右眼 ) ,给予强的松30 mg,每日三次 ,先锋霉素 IV0 .2 5,每日四…     

视网膜中央动脉阻塞的治疗

视网膜中央动脉阻塞 ,使其所供应的区域发生急性缺血 ,能引起瞬间失明 ,是一种严重的致盲性疾病 ,因其治盲率高 ,故发病后应立即抢救 ,否则将导致永久失明。我科自 1992年以来 ,救治视网膜动脉阻塞患者 35例 ,报告如下。1　临床资料本组 35例 ,36只眼。其中 ,男性 2 0例 ,女性 15例。年龄最小 42岁 ,最大 75岁 ,平均 5 6 .5岁。右眼发病 2 5例 ,左眼发病 10例 ,双眼发病 1例。发病时间至就诊时间 ,最短者 3ｈ ,最长者 7ｄ ,平均 2 .7ｄ。就诊视力 :无光感者 2 0例 ,光感、手动者10例 ,指数 6例。诊断标准 :①视力突然下降至光感或手动 ;②眼…     

复方樟柳碱治疗视网膜中央动脉阻塞

视网膜中央动脉阻塞是眼科急诊之一。对视力损害很严重，且预后不理想。2001年2月～2003年1月，我们两所医院共收治15例(15只)眼患，采用复方樟柳碱治疗，疗效良好，报告如下。     

视网膜动脉阻塞的临床治疗分析

视网膜中央动脉及其分支属于末梢动脉.除了视网膜睫状动脉以外,它是供应视网膜内层营养的唯一血管,血液供给障碍都可导致视网膜缺血缺氧,严重损害视功能.视网膜中央动脉的阻塞引起视网膜急性缺血,视力严重下降,是导致盲目的 急症之一.故应早期诊断,立即抢救.如果有视网膜睫状动脉时,尚可保留一定的中心视力.     

视网膜中央动脉阻塞的急救治疗

目的探讨视网膜中央动脉阻塞的急救治疗方法。方法回顾性分析自2007年以来,98例临床确诊视网膜中央动脉阻塞的患者(104只眼)的临床资料,应用临床常用的7种治疗方法,观察患者视力恢复情况。结果视网膜中央动脉阻塞经过短期治疗后,视力可部分恢复,与就诊时间和就诊时的疾病严重程度有关。     

大剂量尿激酶冲击溶栓治疗视网膜中央动脉阻塞

目的 评价大剂量尿激酶冲击溶栓治疗视网膜中央动脉阻塞的疗效及安全性。方法 对19例病人在发病6h内经静脉给予溶于100ml 5％～10％葡萄糖液的150万U尿激酶进行溶栓治疗。2h后进行眼底荧光造影，观察溶栓及视力恢复情况。结果 19例中，10例视力恢复至0，5以上，4例0．2～0．5，3例0．05～0．1，2例病人治疗前无光感，治疗后无改善、经荧光造影证实10例血管完全再通，再通率52．6％，无严重并发症，结论 大剂量尿激酶冲击溶栓治疗视网膜中央动脉阻塞完全有效，其治疗效果大大好于传统治疗方法。     

Central retinal artery occlusion following peribulbar anesthesia for pterygium excision

Pterygium is a common ocular surface pathology in tropical environments. In the early stages, it may be managed medically with topical anti-inflammatory agents and ocular lubricants. However as the disease progresses, surgical excision becomes necessary and several anaesthetic methods may be used to assist this. We share our experience of a 30-year old woman who underwent uneventful pterygium excision using peribulbar lignocain injection with adrenaline. She developed sudden blindness due to central retinal artery occlusion with macular infarction. While peribulbar anaesthesia is generally safe, a remote risk of retinal vascular accident exists and its routine use should be done with caution. Where possible topical anaesthesia with or without intra-lesional injection be employed.     

Sequential bilateral central retinal artery occlusion as the primary manifestation of systemic lupus erythematosus

Bilateral central retinal artery occlusion (CRAO) has been rarely reported as the primary manifestation in patients with systemic lupus erythematosus (SLE). The severe retinal vaso-occlusive diseases usually cause devastating and permanent damage to visual function in spite of vigorous treatment. A 42-year-old Chinese woman presented with abrupt bilateral vision loss. The diagnosis of bilateral CRAO was suggested by the ocular presentation and fluorescein angiography. Laboratory studies showed positive results of antinuclear antibody, anti-Ro/SSA anti-La/SSB; decreased levels of C3, C4 complement and normal levels of antiphospholipides antibodies (APAs). Her visual acuity deteriorated despite systemic steroid and immunosuppressant treatment. Severe vaso-occlusive retinopathy may be an earlier manifestation of SLE without elevated level of APAs.

     

Fundus artery occlusion caused by cosmetic facial injections

Background With the increasing popularity of cosmetic facial filler injections in recent years, more and more associated complications have been reported. However, the causative surgical procedures and preventative measures have not been studied well up to now. The aim of this stady was to investigate the clinical characteristics and visual prognosis of fundus artery occlusion resulting from cosmetic facial filler injections. Methods Thirteen consecutive patients with fundus artery occlusion caused by facial filler injections were included. Main outcome measures were filler materials, injection sites, best-corrected visual acuity （BCVA）, fundus fluorescein angiography, and associated ocular and systemic manifestations. Results Eleven patients had ophthalmic artery occlusion （OAO） and one patient each had central retinal artery occlusion （CRAO） and anterior ischemic optic neuropathy （AION）. Injected materials included autologous fat （seven cases）, hyaluronic acid （five cases）, and bone collagen （one case）. Injection sites were the frontal area （five cases）, periocular area （two cases）, temple area （two cases）, and nose area and nasal area （4 cases）. Injected autologous fat was associated with worse final BCVA than hyaluronic acid. The BCVA of seven patients with autologous fat injection in frontal area and temple area was no light perception. Most of the patients with OAO had ocular pain, headache, ptosis, ophthalmoplegia, and no improvement in final BCVA. Conclusions Cosmetic facial injections can cause fundus artery occlusion. Autologous fat injection tends to be associated with painful blindness, ptosis, ophthalmoplegia, and poor visual outcomes. The prognosis is much worse with autologous fat injection than hyaluronic acid iniection.     

视网膜分支静脉阻塞致视网膜脱离1例

视网膜脱离(retinal detachment)是视网膜的神经上皮层与色素上皮层的分离,两层之间有一潜在间隙,分离后间隙内所潴留的液体称为视网膜下液.按病因可分为孔源性、牵拉性和渗出性视网膜脱离.脱离后的视网膜得不到脉络膜的血液供应,色素上皮层游离、萎缩、脱离,部分无法正常工作,大脑接受从眼部传来的图像不完整或全部缺失,导致视力部分或完全丧失.现报道视网膜分支静脉阻塞导致视网膜大面积脱离1例.     

中西医结合治疗急性视网膜中央动脉阻塞疗效观察

目的探讨中西医结合疗法在急性视网膜中央动脉阻塞治疗中的作用。方法对36例视网膜中央动脉阻塞患者,采用眼科常规药物治疗及中西医结合综合治疗;对照组33例患者仅行眼科常规药物治疗,将两组的疗效进行对比观察。结果两组治疗后视力均明显改善,但治疗组优于对照组（P〈0.05或P〈0.01）。与治疗前比较,两组治疗后全视网膜及中央视网膜平均光敏感度均明显提高。结论中西医结合综合治疗法治疗视网膜中央动脉阻塞,其疗效明显优于眼科常规药物治疗。     

Multimodal magnetic resonance imaging for assessing lacunar infarction after proximal middle cerebral artery occlusion in a canine model

Background  A new lacunar infarction model was recently established in beagle dogs through proximal middle cerebral artery (MCA) occlusion by thrombus. This study aimed to characterize the model by multimodal magnetic resonance imaging (MRI) and to investigate its potential role for the future stroke research.

Methods  The left proximal MCA was embolized with an autologous thrombus in six beagles. Diffusion-weighted imaging (DWI) and T2-weighted imaging (T2WI) were performed every half hour during the first six hours after occlusion, followed by three time points at 12 hours, 24 hours, and one week. Perfusion-weighted imaging (PWI) and magnetic resonance angiography (MRA) were carried out at six hours, 24 hours and one week. The PWI-DWI mismatch ratio was defined as (PWI-DWI)/DWI ischemic volume.

Results  Lacunar infarcts induced by MCA occlusion were located in the left caudate nucleus and internal capsule. All the lesions could be detected within two hours by DWI. Lesion volume on DWI increased in a time dependent manner, from (87.19±67.16) mm³ at one hour up to (368.98±217.05) mm³ at 24 hours (P=0.009), while that on PWI gradually decreased from (7315.00±2054.38) mm³ at six hours to (4900.33±1319.71) mm³ at 24 hours and (3334.33±1195.11) mm³ at one week (P=0.002). The mismatch ratio was 41.93±22.75 at six hours after ischemia, showing “extensive mismatch”, and decreased to 18.10±13.74 at 24 hours (P=0.002). No MCA recanalization was observed within 24 hours after MCA occlusion.

Conclusions  Lacunar infarction induced by proximal MCA occlusion could be detected early by DWI and was characterized by extensive PWI-DWI mismatch. Multimodal MRI is useful to demonstrate the natural evolution of PWI-DWI mismatch. This ischemic model could be further used for investigating early thrombolysis in lacunar stroke showing extensive mismatch.

     

增强型体外反搏联合药物治疗视网膜中央动脉阻塞的疗效

目的 探讨增强型体外反搏(EECP)联合药物治疗视网膜中央动脉阻塞( CRAO) 的疗效。方法 选择2020年5月—2021年5月我院诊治的视网膜中央动脉阻塞患者共48例（48眼）作为观察对象,根据治疗方法分为观察组22例（22眼）和对照组26例（26眼）,另选取我院同期体检的健康人群20例（20眼）作为阴性对照组。观察组进行4个疗程的EECP联合药物治疗;对照组予单纯药物治疗;阴性对照组予单纯4个疗程EECP治疗。根据治疗前后患者视力、黄斑区血流密度、颈内动脉舒张期末血流速度（EDV）、收缩期峰值血流速度（PSV）及阻力指数（RI）等指标变化,评价及比较疗效。结果 观察组总有效率高于对照组（χ2=7.968,P＜0.05）。观察组视力治疗后较治疗前显著提高,差异有统计学意义（P＜0.05）,对照组视力治疗后无明显提高,差异无统计学意义（P＞0.05）。病程越短,EECP联合药物治疗效果越好,两者呈高度负相关（r=-0.837,P＜0.05）。阴性对照组治疗后颈内动脉各项血流动力学指标较治疗前明显增加,治疗后RI较治疗前明显减小,差异有统计学意义（P＜0.05）;治疗后黄斑区血流密度各项指标较治疗前明显增加,差异有统计学意义（ P＜0.05）。观察组治疗后EDV与PSV较治疗前明显增加,治疗后RI较治疗前明显减小,差异有统计学意义（P＜0.05）。对照组治疗前后EDV、PSV及RI均无明显改善,差异无统计学意义（P＞0.05）。观察组治疗后黄斑区SCP与DCP血流密度较治疗前明显增加,差异均有统计学意义（P＜0.05）。对照组治疗前后黄斑区SCP与DCP血流密度无明显变化,差异无统计学意义（P＞0.05）。结论 EECP联合药物治疗视网膜中央动脉阻塞,可显著提高CRAO患者的临床疗效,可在临床推广应用