近视眼神经纤维层光学相干断层扫描检测的临床研究

目的研究人视网膜神经纤维层厚度随近视眼屈光度加深而变化的特点及临床意义。方法将近视眼108例(197眼)和正常对照者42例(60眼)分为低度近视组、中度近视组、高度近视组和正常对照组,应用光学相干断层扫描仪进行以视盘为中心,直径3.46mm圆周的视网膜神经纤维层(retinal nerve fiberlayer,RNFL)厚度测量,计算各组平均RNFL厚度及鼻、颞、上、下4个象限的RNFL厚度,各近视组分别与正常组对比,并进行统计学分析。结果低度、中度近视患者平均RNFL分别为(119.33±37.23)μm、(117.84±36.57)μm,已变薄但与正常人(123.74±35.68)μm无显著差异(P>0.05);高度近视平均神经纤维层厚度为(112.89±37.09)μm明显变薄,与正常人相比有显著性(P<0.01)。近视眼各象限RNFL最早变薄的是鼻侧,低度近视即与正常人有显著性差异(P<0.01)。高度近视眼鼻、下、上方RNFL均明显变薄(P<0.01),而颞侧RNFL反而增厚,与正常人相比差异具有显著性(P<0.01)。结论近视眼中平均RNFL厚度变薄,随着近视度数的加深,近视眼RNFL厚度变薄越来越明显。分区分析上、下、鼻侧变化与平均相一致,而颞侧增厚,这可能是近视眼RNFL的特点。这些特点对临床疾病的诊断具指导意义。     

近视眼视网膜神经纤维层厚度光学相干断层扫描特点

目的:探讨人视网膜神经纤维层(retinal nerve fiber layer,RNFL)厚度随近视眼屈光度及眼轴变化而变化的特点。方法:将近视眼60例108眼分为低、中、高度近视组和正常对照组25例32眼,应用光学相干断层扫描仪(OCT)进行以视盘为中心,直径3.46mm圆周的RNFL厚度测量,研究近视眼平均RNFL厚度与屈光度及眼轴长度的相关性,并计算各组平均RNFL厚度及上、下、鼻、颞4个象限的RNFL厚度,分别比较各近视组与正常组RNFL的差别。结果:近视眼平均RNFL厚度与屈光度呈负相关(r=-0.535,P<0.05),与眼轴成负相关(r=-0.693,P<0.01)。分区分析低度近视组、中度近视组、高度近视组平均RNFL厚度变薄与正常对照组相比有显著统计学差异(P<0.01),近视眼各象限RNFL厚度最早变薄的是鼻侧象限,低度近视组即与正常人有统计学差异(P<0.05),高度近视组上、下、鼻象限RNFL厚度均明显变薄(P<0.01)与正常人相比有显著统计学差异,颞侧象限RNFL反而增厚,但与正常人无统计学差异(P>0.05)。结论:近视眼视网膜神经纤维层厚度随眼轴长度及眼屈光度的增加而减少,分区分析上、下、鼻象限变化与平均相一致,而颞侧增厚,这可能是近视眼RNFL的特点,这些特点对临床疾病的诊断具有指导意义,特别是出现异常数值时,要考虑屈光度及眼轴的影响,综合评价临床意义。     

青年近视患者神经纤维层厚度的临床研究

目的 探讨青年近视患者的神经纤维层(RNFL)厚度分布特性及其影响因素.方法 横断面研究.选取准分子激光角膜屈光手术前的青年近视患者162例(162眼),平均年龄(27.0±4.6)岁,等效球镜度-0.75～-11.00 D,平均(-4.98±2.64)D.其中,低度近视组54例,平均等效球镜度为(-2.27±0.64)D;中度近视组55例,平均等效球镜度为(-4.54±0.79)D;高度组53例,平均等效球镜度为(-8.19±1.51)D.采用光学相干断层扫描(OCT)仪检查视盘周围神经纤维层厚度,用偏相关分析RNFL厚度与患者年龄、性别、等效球镜度、眼轴、角膜中央厚度及角膜曲率的相关性.结果 本组入选患者视盘周围平均RNFL厚度:全周为(103.6±9.5)μm,上方为(128.7±16.8)μm,鼻侧为(67.8± 16.5)μm,下方为(125.9± 17.2)μm,颞侧为(91.9±16.9)μm.各RNFL厚度参数与年龄、性别、角膜曲率、中央角膜厚度无相关性,全周、上方、鼻侧、下方的平均RNFL厚度与眼轴呈负相关(r=-0.379、-0.297、-0.180 、-0.291,P＜0.05),颞侧的平均RNFL厚度则与眼轴无相关性,鼻侧、下方的平均RNFL厚度与等效球镜度呈负相关(r=-0.233、-0.163,P＜0.05),颞侧平均RNFL厚度与等效球镜度则呈正相关(r=0.159,P＜0.05).结论 青年近视患者视盘周围平均RNFL厚度上方＞下方＞颞侧＞鼻侧,全周、鼻侧、上方、下方平均RNFL厚度随眼轴的增长而变薄,下方和鼻侧RNFL厚度随等效球镜度增加而变薄,颞侧平均RNFL厚度随着等效球镜度增加而增厚.     

高度近视性弱视儿童视盘周围视网膜神经纤维层厚度分析

目的：分析高度近视性弱视儿童视盘周围视网膜神经纤维层厚度特点,并探讨与眼轴、年龄的关系。
　　方法：选择收集2014-01/07间在我院眼科门诊就诊的儿童35例59眼,平均年龄9.59±2.90岁,所有受检眼排除眼底的疾病和眼前节的病变。根据扩瞳验光的结果,分成高度近视性弱视组(22眼)、高度近视组(15眼)、正视眼组(22眼),运用频域OCT对视盘周围视网膜神经纤维层进行检测,通过A超测量出所有受检者眼轴长度。对各组视盘周围各方位视网膜神经纤维层厚度进行比较分析,探讨视盘周围各方位视网膜神经纤维层与眼轴、年龄的关系。
　　结果：高度近视性弱视组视盘颞侧RNFL厚度薄于高度
　　近视组,厚于正视眼组;视盘鼻侧、上方、下方、周围平均RNFL厚度与高度近视组、正视眼组相比均最薄,其中视盘下方及周围平均RNFL厚度与高度近视组相比变薄,有统计学差异(P<0.05),视盘鼻侧、上方、下方、周围平均RNFL厚度与正视眼组相比明显变薄,有统计学差异( P<0.01)。高度近视组视盘颞侧RNFL厚度与正视眼组相比明显增厚,视盘鼻侧、上方、下方、周围平均RNFL厚度与正视眼组相比均明显变薄,有统计学差异(P<0.05)。高度近视性弱视组视盘下方RNFL厚度与眼轴呈负相关性( R=0.474, R2=0.225, F=4.933, P=0.040)。高度近视组视盘上方RNFL厚度与眼轴呈负相关性(R=0.642, R2=0.412,F=9.104,P=0.010)。高度近视性弱视组、高度近视组、正视眼组各方位RNFL厚度与年龄均无明显相关性。
　　结论：高度近视性弱视儿童视网膜结构存在异常。     

Stratus相干光断层扫描仪测量正常人视网膜神经纤维层的厚度

目的建立Stratus OCT测量我国正常人视网膜神经纤维层(RNFL)厚度的正常值,探讨正常人RNFL厚度的变异程度和与年龄及性别的关系。设计前瞻性横断面研究。研究对象10～69岁的正常人。方法用Stratus OCT的扫描程序(Fast RNFL Thickness 3.4)对210例(210眼)正常人进行视乳头环形扫描,测量各象限和平均RNFL厚度值,应用SPSS 11.5软件统计学处理。主要指标RNFL厚度值。结果210例正常人上方象限、颞侧象限、下方象限、鼻侧象限及全周平均的RNFL厚度分别为(145.5±16.8)、(84.2±12.8)、(147.6±15.2)、(84.7±14.2)μm。平均RNFL厚度变异最小,鼻侧RNFL厚度变异最大。除鼻侧象限外,其它各象限及平均RNFL厚度与年龄均呈负相关性。对正常人RNFL厚度无性别差异。结论用Stratus OCT测量的正常人RNFL厚度数值中,平均RNFL厚度变异最小,鼻侧RNFL厚度变异最大;RNFL厚度随年龄增长而变薄。     

Cirrus HD OCT检测近视眼视网膜神经纤维层厚度的研究

目的：应用Cirrus HD OCT检测近视眼视网膜神纤维层厚度,探讨近视眼神经纤维层厚度分布特点及其与屈光度的关系。 方法：将近视眼106例196眼分为低、中、高度近视组和正常对照组38例60眼,应用Cirrus HD OCT进行以视盘为中心,直径3.46 mm圆周的RNFL厚度测量,计算各组平均、各象限及各钟点RNFL厚度,各近视组分别与正常对照组对比,研究近视眼RNFL厚度与屈光度的关系。 结果：各近视组平均、上方象限及下方象限RNFL厚度较正常对照组变薄,其中中度、高度近视与正常对照组相比有统计学差异（ P〈0.05）,鼻侧象限RNFL厚度变薄,无统计学显著性差异（ P〉0.05）,颞侧象限RNFL厚度增加,有统计学差异（ P〈0.05）;各近视组2：00,6：00,12：00位RNFL厚度较正常对照组变薄,有统计学差异（ P〈0.05）,8：00,9：00,10：00位RNFL厚度较正常对照组增加,有统计学差异（ P〈0.05）,中、高度近视1：00,5：00位厚度较正常对照组变薄,有统计学差异（P〈0.05）。 结论：近视眼平均、上方及下方象限、2：00,6：00,12：00位RNFL厚度较正常对照组变薄,颞侧象限、8：00,9：00,10：00位RNFL厚度较正常对照组相比明显增加,这是近视眼RNFL厚度的特点,当临床出现RNFL厚度异常时,应考虑屈光度的影响,综合评价其临床意义;近视眼7：00,8：00,10：00,11：00位RNFL厚度与正常对照组相比均未变薄,出现异常变薄时,应考虑青光眼可能。     

OCT检测儿童青少年近视眼视网膜神经纤维层厚度的临床研究

目的：探讨8~17岁儿童青少年近视眼视网膜神经纤维层( retinal nerve fibre layer,RNFL)厚度临床变化特点,为儿童青少年青光眼的诊断提供依据,避免漏诊及误诊。方法：将8~17岁儿童青少年99例165眼按屈光度分为正常对照组、低度近视组、中度近视组及高度近视组,应用Cirrus HD OCT分别对4组研究对象进行以视盘为中心,直径为3.46 mm圆周的RNFL厚度测量,分别得出各组平均、各象限、各钟点RNFL厚度。将各近视组与正常组RNFL厚度进行比较,观察近视眼RNFL厚度变化特点。
　　结果：各近视组与正常组相比,平均RNFL厚度均变薄,高度近视组差异有统计学意义(P<0.05),上、下、鼻侧象限RNFL厚度均变薄,颞侧象限厚度均变厚;中度、高度近视组,上方、下方象限厚度变薄,差异有统计学意义(P<0.05),颞侧象限厚度均变厚,差异有统计学意义( P<0.05);1：00,5：00,6：00,12：00位RNFL厚度变薄,差异有统计学意义( P<0 .05),8：00,9：00,10：00位RNFL厚度增加,差异有统计学意义(P<0.05),低度近视3：00位RNFL厚度增加,差异有统计学意义( P<0 .05)。
　　结论：儿童青少年近视眼与正常眼相比,Avg(平均RNFL厚度),S(上方象限 RNFL 厚度),I(下方象限 RNFL 厚度),1：00,5：00,6：00,12：00位RNFL厚度变薄,且随着屈光度增加其RNFL厚度变薄, T (颞侧),8：00,9：00,10：00位RNFL厚度变厚,且随着屈光度增加其RNFL厚度变厚。在对近视眼进行 RNFL 厚度测量时,发现有异常RNFL厚度变化时,应该考虑到屈光度的影响,综合评价其临床意义,以免造成对青光眼的误诊。对于青光眼诊断效能最高的颞下(7：00~8：00位)、颞上(10：00~11：00位) RNFL并未出现变薄,当对儿童青少年近视眼进行RNFL厚度测量时,如果出现上述方位的 RNFL 厚度变薄,应考虑青光眼的可能性,以免漏诊。     

近视及近视性弱视儿童视网膜神经纤维层OCT检测及分析

目的分析近视及近视性弱视儿童视网膜光学相干断层扫描（OCT）各项指标的变化,研究近视及近视性弱视儿童的视网膜结构的变化特征。方法对52只眼近视性弱视组和32只眼单纯近视组行视网膜OCT检查,记录黄斑中心凹中心视网膜厚度和视盘上方、下方、鼻侧、颞侧及平均视网膜神经纤维层（RNFL）厚度,并与32只眼正常对照组进行比较。结果近视性弱视组和正常对照组比较,视盘下方和视盘周围平均RNFL厚度变薄,且有统计学意义（P〈0.05）,而视盘上方、颞侧和鼻侧RNFL厚度和黄斑中心凹中心视网膜厚度均无显著差异（P〉0.05）。单纯近视组和正常对照组比较,视盘周围RNFL厚度和黄斑中心凹视网膜厚度均无显著差异（P〉0.05）。近视性弱视组高度近视儿童的视盘上方、下方、鼻侧和视网膜平均RNFL厚度较健眼变薄（P〈0.05）,而颞侧和黄斑中心凹中心视网膜厚度无明显变化（P〉0.05）,单纯近视组中高度近视儿童的视盘颞侧RNFL层厚度和黄斑中心凹中心视网膜厚度增加明显（P〈0.05）。结论近视及近视性弱视儿童的视网膜结构存在异常。     

轻度帕金森病患者视网膜神经纤维层厚度变化的特点分析

目的：：观察轻度帕金森病( Parkinson’s disease,PD)患者视网膜神经纤维层( retinal nerve fiber layer,RNFL)厚度变化的特点。方法：采用光学相干断层扫描( optical coherence tomography,OCT)对我院门诊诊断为早期PD的15例15眼患者和18例18眼正常对照者进行以视盘中心为圆心、直径为3.46 mm的环形扫描。扫描分为颞侧、上方、鼻侧、下方、颞下、颞上、鼻下、鼻上8个象限进行。对比分析两组受检者8个象限的视网膜神经纤维层( retinal nerve fiber layer,RNFL)厚度及平均RNFL厚度。结果：正常对照组颞侧、上方、鼻侧、下方、颞下、颞上、鼻下、鼻上RNFL厚度和平均RNFL厚度分别为83.2±17.5,132.7±17.4,83.7±22.3,141.5±15.3,117.9±24.5,120.8±21.2,110.2±27.7,109.6±20.6,109.9±8.5μm,早期PD患者颞侧、上方、鼻侧、下方、颞下、颞上、鼻下、鼻上RNFL厚度和平均RNFL厚度分别为68.7±13.5,128.1±25.3,76.5±17.8,128.6±13.2,103.3±14.1,102.6±23.7,96.6±15.0,101.2±20.9,102.3±11.9μm。两组比较,下方、颞侧、颞下、颞上RNFL厚度和平均RNFL厚度差异有统计学意义(t=2.595,2.700,2.153,2.330,2.131;P=0.014,0.011,0.040,0.026,0.041)。结论：早期PD患者下方、颞侧、颞下、颞上及平均RNFL厚度较正常者明显变薄。     

LASIK术前近视眼神经纤维层厚度光学相干断层扫描分析

目的:探讨近视眼视网膜神经纤维层(retinal nerve fiber layer,RNFL)厚度的变化。方法:随机抽取准分子激光原位角膜磨镶术(LASIK)术前的近视眼患者53例106眼和正常对照组53例106眼利用光学相干断层扫描仪(OCT)进行以视盘为中心,3.4mm为半径的RNFL测量,计算上、下、鼻、颞四个象限及平均RNFL厚度,分别与正常组比较,并进行统计学分析。结果:近视组与正常对照组平均RNFL厚度相比变薄且有显著性差异(P<0.05)。近视组上方、下方、鼻侧象限RNFL厚度与正常组相比变薄且有显著性差异(P<0.05),颞侧象限亦变薄但无显著性差异(P>0.05)。结论:近视眼上方、下方、鼻侧象限及平均RNFL厚度变薄,鼻侧RNFL厚度差异明显,且具有显著性差异。     

Comparative antiproliferative and cytotoxic profile of bevacizumab (Avastin), pegaptanib (Macugen) and ranibizumab (Lucentis) on different ocular cells

Aim To compare the antiproliferative and cytotoxic properties of bevacizumab (Avastin), pegaptanib (Macugen) and ranibizumab (Lucentis) on human retinal pigment epithelium (ARPE19) cells, rat retinal ganglion cells (RGC5) and pig choroidal endothelial cells (CEC). Methods Monolayer cultures of ARPE19, RGC5 and CEC were used. Bevacizumab (0.1–0.3 mg/ml), pegaptanib (0.025–0.08 mg/ml) or ranibizumab (0.04–0.125 mg/ml) diluted in culture medium were added to the cells. Expression of VEGF-receptors (VEGFR1 and VEGFR2) and von Willebrand factor (a marker for endothelial cells) were analysed by immunohistochemistry. CEC cells were stimulated with VEGF. Cellular proliferative activity was monitored by BrdU-incorporation into cellular DNA. For cytotoxicity assays cells were grown to confluence and then cultured in a serum-depleted medium to ensure a static milieu. MTT-test was performed after one day. Results CEC and ARPE19 cells stained positively for VEGFR1 and VEGFR2. More than 95% of the CEC cells were positive for von Willebrand factor. Ranibizumab reduced CEC cell proliferation by 44.1%, bevacizumab by 38.2% and pegaptanib by 35.1% when the drugs were used at their established clinical doses. The differences, however, between the three drugs in respect to cell growth inhibition were not statistically significant. Only a mild antiproliferative effect of bevacizumab or pegaptanib on ARPE19 cells could be observed. Ranibizumab did not alter ARPE19 cell proliferation. No cytotoxicity on RGC5, CEC and ARPE19 cells could be seen. Conclusions Bevacizumab, pegaptanib and ranibizumab significantly suppress choroidal endothelial cell proliferation. However, when used at the currently established doses none of the drugs was superior over the others in respect to endothelial cell growth inhibition. The biocompatibility of all three drugs — including the off-label bevacizumab — seems to be excellent when used at the currently recommended intravitreal dose. This work is presented on behalf of the Tuebingen Bevacizumab Study Group.     

Intravitreal use of bevacizumab (Avastin) for choroidal neovascularization due to ARMD: a preliminary multifocal-ERG and OCT study

Purpose To evaluate by MFERG and OCT the macular function before and after intravitreal use of bevacizumab (Avastin) in eyes suffering from CNV due to ARMD. Methods Eighteen eyes with subfoveal CNV due to ARMD were studied before and after intravitreal use of bevacizumab with MFERG and OCT. The post treatment follow up was three months. Results Before treatment, OCT shows an increase of the retinal thickening of the fovea and the electrical response densities in the fovea and parafovea were decreased in all patients. Three months after treatment, OCT showed a real resolution of the subretinal fluid. The electrical responses in the fovea and parafovea remained the same or slightly improved in some cases. The intraocular pressure remained normal and no inflammation was observed. Conclusion The intravitreal use of bevacizumab may provide anatomical correlates that support the concept of disease amelioration but the functional improvement of the macula three months after treatment is not obvious. However the method is promising and needs further evaluation.     

Distribution,markers, and functions of retinal microglia

Retinal microglia originate from hemopoietic cells and invade the retina from the retinal margin and the optic disc, most likely via the blood vessels of the ciliary body and iris, and the retinal vasculature, respectively. The microglial precursors that appear in the retina prior to vascularization are major histocompatibility complex (MHC) class I- and II-positive and express the CD 45 marker, but lack specific macrophage markers. They differentiate into ramified parenchymal microglia in the adult retina. A second category of microglial precursors, which do express specific macrophage markers, migrate into the retina along with vascular precursors. They appear around blood vessels in the adult retina and are similar to macrophages or cells of the mononuclear phagocyte series (MPS). Microglia are distributed in the outer plexiform layer (OPL), outer nuclear layer (ONL), inner plexiform layer (IPL), ganglion cell layer (GCL), and nerve fiber layer (NFL) of the primate retina. The pattern of microglial distribution in the avascular retina of the quail indicates that blood vessels are not responsible for the final location of microglia in the retina. In the human retina, microglia express MHC class I, MHC class II, CD 45 , CD68, and S22 markers. In the rat and mouse retina, OX 41 , OX 42 , OX 3 , OX6, OX18, ED1, Mac-1, F 4 /80, 5 D 4 anti-keratan sulfate, and lectins are used to recognize microglia. Microglial cells play an important role in host defense against invading microorganisms, immunoregulation, and tissue repair. During neurodegeneration, activated microglial cells participate in the phagocytosis of debris and facilitate regenerative processes. In autoimmune disease, microglia have dual functions: initiating uveoretinitis, but also limiting subsequent inflammation. Retinal microglia may be associated with vitreoretinopathy, diabetic retinopathy, glaucoma, and age-related macular degeneration. The goal of this article was to review the present knowledge about retinal microglia and the function of retinal microglia in pathological conditions.     

视网膜血管瘤增殖一年龄相关性黄斑变性的特殊类型

本文总结了年龄相关性黄斑变性的特殊类型—视网膜血管瘤增殖(RAP)的临床和造影表现及分期。RAP是起源于黄斑旁视网膜深层毛细血管的、以伴发多灶小片视网膜内出血及盘变前期即有视网膜-脉络膜血管吻合(RCA)形成为特征的新生血管性AMD。     

Long Noncoding RNA 3632454L22Rik Contributes to Corneal Epithelial Wound Healing by Sponging miR-181a-5p in Diabetic Mice

PurposeThis work explores the abnormal expression of long noncoding RNAs (lncRNAs), microRNAs (miRNAs) and messenger RNAs (mRNAs) in diabetic corneal epithelial cells (CECs) and constructs an associated competitive endogenous RNA (ceRNA) network. Moreover, we revealed that Rik may exert advantageous effects on diabetic corneal epithelial wound closure by sponging miR-181a-5p.MethodsWe obtained the profiles of differentially expressed lncRNAs (DELs) of CECs of type 1 diabetic versus control corneas by microarray and summarized the differentially expressed miRNAs (DEmiRs) and differentially expressed genes (DEGs) data by published literature. Subsequently, the ceRNA network was constructed using bioinformatics analyses. The levels of lncRNA ENSMUST00000153610/3632454L22Rik (Rik) and miR-181a-5p were verified. The localization of Rik was identified with fluorescence in situ hybridization (FISH), and dual-luciferase assays proved the targeted relationship between Rik and miR-181a-5p. Furthermore, we validated the functional impact of Rik in vitro.ResultsOverall, 111 upregulated and 117 downregulated DELs were detected in diabetic versus control CECs. The level of Rik located in both the cytoplasm and the nucleus was clearly downregulated, whereas miR-181a-5p was upregulated in vitro and in vivo in the diabetic group versus the control group. Rik can act as a ceRNA to bind to miR-181a-5p, thus promoting diabetic corneal epithelial wound healing in vitro.ConclusionsThis work investigated the expression profile of DELs and constructed ceRNA networks of diabetic CECs for the first time. Furthermore, we revealed that Rik may positively impact diabetic corneal epithelial wound healing by sponging miR-181a-5p, providing a novel potential therapeutic target of diabetic keratopathy (DK).     

30天连续配戴硬性透氧性角膜接触镜的安全性研究

目的为了评价Menicon Z硬性接触镜30 d连续配戴的安全性与有效性,进行了两个为期一年的临床比较试验.方法分别选用了可以7 d连续配戴的Hydrogel材料的Acuvue(1)及可以30 d连续配戴的Si H材料的Focus Night & Day(2)软性接触镜作为对照镜片.结果临床试验(Ⅰ)中,317人参加了Menicon Z组群,313人参加了Acuvue组群.Menicon Z组群有258人(占81.4%)完成了为期一年的试验,而Acuvue组群仅有210人(占67.1%).Acuvue组群中比较常见的副作用为浸润性角膜炎与细菌性结膜炎.相比之下,Menicon Z组群常见的不适症状是由异物飞入角膜造成角膜上皮擦伤所致的.各有50人参加了临床试验(Ⅱ)的Menicon Z组群与Night & Day组群.Menicon Z组群有35人(占70.0%)完成了为期一年的试验,Night & Day组群有33人(占66.0%).Menicon Z组群中常见的副作用表现为3～9点角膜染色,Night & Day组群为接触镜相关性充血、接触镜性角膜周边溃疡、乳头性结膜炎、角膜上方弓状损伤与细菌性角膜炎.结论Menicon Z 30 d连续配戴具有安全性.     

近视及散光眼LASIK后非接触眼压计测量值的影响因素及其预测

目的 比较近视和(或)散光患者在LASIK手术前后非接触眼压计测量结果的差异及其影响因素,并得到预计眼压的计算公式.方法 对2005年12月至2006年11月在北京协和医院准分子激光手术中心行初次准分子激光原位角膜磨镶术(LASIK)矫正近视和(或)散光的患者进行回顾性研究,共93例(183只眼),采用非接触眼压计(NCT)测量术前和术后2周、1个月、3个月的眼压值,计算眼压变化值并分析其与各种变量之间的相关性,应用多元线性回归从相关变量得到术后预计的测量眼压值及眼压变化值.结果 患者术后3个月眼压较术前平均下降(5.74±2.03)mmHg,其变化与性别、年龄均不相关,但与术前屈光度有明显的关系.多元线性回归分析得到术后实际测量的眼压与术前眼压呈正性相关,而与手术切削量呈负相关(R2=0.442,P<0.001),术后预计测量眼压=5.175+0.411×术前眼压-0.0205×切削量,手术后眼压测量下降值0.589×术前眼压+0.0205×切削量-5.175.结论 通过术后实际测量眼压值与预测值比较,可以及时发现高眼压的患者,避免低估眼压以致漏诊青光眼而造成患者视功能损失.虽然可以通过预测公式来判断实际测量眼压值是否在正常范围.但更有效的方法是使用不受角膜变化影响的眼压计测定眼压.     

Assessing hydroxychloroquine toxicity by the multifocal ERG

Twenty patients on Plaquenil treatment were evaluated for retinal toxicity using the (EOG) and the mfERG. Group 1 comprises 15 patients (30 eyes) with normal EOG. From these patients 11 (22 eyes) showed normal RRD of mfERG in area 1 and area 2. The rest four patients (8 eyes) the RRD were reduced. Six months after interruption of HC, the mfERG improved in three cases. Group 2 comprises 5 patients (10 eyes) with subnormal EOG. Four (8 eyes) of these showed a decrease of RRD of the mfERG in area 1 and 2. In the rest one (2 eyes) the RRD were normal. Six months after interruption of HC the mfERG and the EOG improved in 2 cases. These results postulate that the mfERG may be used as an alternative method, perhaps more sensitive, for the detection of the HC retinopathy and the follow up of the patients on hydroxychloroquine.     

糖尿病患者的视网膜电图分析

目的分析糖尿病(DR)患者视网膜电图(F-ERG)的振幅、峰潜时、OPS总和振幅及其与病程的相关性.方法将53例102眼糖尿病患者分为三组(NDR、BDR、PDR),并采用美国UATA-2000型视觉电生理仪对53DR例进行F-ERG检查,主要分析其a、b波峰潜时、振幅、OPS总和振幅.结果随着DR病情的加重,ERG及OPS无波的情况所占比例增大.a波峰潜时BDR组和正常组比较差异有极显著性(P<0.01),BDR组和DM无DR组比较差异有显著性(P[WTBZ〗<0.05);a波振幅正常对照组与其他各组比较差异均有极显著性(P<0.01).b波振幅正常对照组与BDR、PDR间以及DM无DR组与BDR、PDR组间均有极显著性差异(P<0.01).OPS总和振幅除了BDR与PDR间外,其他各组比较差异均有极显著性(P<0.01).结论OPS、ERG之a、b波振幅,尤其是b波振幅,可以作为早期诊断DR患者以及估计预后的敏感指标;良好的血糖控制,可以延缓DM的病情发展.