甲状腺相关眼病图形视觉诱发电位的研究

目的了解图形视觉诱发电位(P-VEP)在甲状腺相关眼病视神经病变(DON)早期诊断中的应用价值.方法随机选取39例甲状腺相关眼病(TAO)和30例正常对照进行P-VEP检查.结果P-VEP的改变主要为P1振幅(PA)的降低(P＜0.05).结论P-VEP比较敏感地反映TAO视神经功能的变化,可作为DON早期诊断的敏感指标.     

弱视患者P-VEP,P-ERG的变化

目的:观察弱视患者P-VEP,P-ERG的变化.方法:采用系统(RETIscan3.15version)对80例弱视患者及76个正常人进行P-VEP,P-ERG检查,主要观测潜时,幅值,潜时差,并用SPSS11.0系统进行统计学分析.结果:弱视组的P-VEP,P-ERG的潜时,幅值,潜时差与正常对照组间均有明显差异(P＜0.05).结论:弱视患者的视觉电生理有明显的变化,且视觉电生理检查对弱视的诊断及治疗提供了客观易行的依据.     

The surgical management of the lid changes of Graves' disease

There are three areas of surgical intervention available to patients with the eye changes of Graves' disease-lids, extraocular muscles, and orbital decompression. The lid changes may be managed by lateral tarsorrhaphy, levator tenotomy, recession of the levator with or without graft, "tenotomy" of the retractors of the lower lid, or recession with graft. The success of these procedures is dependent on proper patient selection and surgical execution, and when these are achieved, definite benefits result.     

The pattern-evoked electroretinogram (PERG): Age-related alterations and changes in glaucoma

Pattern-onset electroretinograms (PERGs) were studied in 147 normal subjects of different ages (14-79 years) and in 110 eyes of 65 patients with glaucoma or ocular hypertension. The responses showed an increase (P less than 0.001) in peak latency with increasing age and a decrease (P less than 0.001) in amplitude which approximately parallels the loss of ganglion cells estimated by other authors. Many glaucoma eyes showed a loss of the normally present spatial tuning. In the age group above 50 years 50% of the onset responses were significantly diminished and the peak latencies were not significantly different. A negative correlation (P less than 0.001) was found between the size of the PERG and the cup/disc ratio and a positive correlation (P less than 0.001) with the area of the neuroretinal rim of the optic disc. The PERG decreased (P less than 0.01) with increasing visual field losses.     

Prevention of Graves' Orbitopathy: Early Diagnosis of Thyroid-Associated Orbitopathy in Graves' Disease

Abstract

Primary signet ring cell carcinoma of the eyelid (PSCE) is a very rare tumour. Only a few cases having been reported to date. The majority of patients have been middle-age to elderly men. Different treatment modalities have been applied in cases of PSCE. Here, we report a case of PSCE in a man treated with orbital exenteration and radiotherapy.     

Ocular surface changes in Graves’ophthalmopathy

Many patients with Graves’ophthalmopathy(GO)suffer from dry eye syndrome(DES),and this is one of the most common reasons of eye discomfort in patients with GO.The prevalence of DES in patients with GO is significantly higher than normal subjects.The ocular surface changes involving changes in tears,cornea,conjunctiva and glands occur in GO patients.However,the mechanism of how DES occurs in GO still remains unclear.In this review,the ocular surface changes were illustrated and analyzed the reasons for high prevalence of DES in GO patients.     

准分子激光角膜切削术后视觉诱发电位的改变

目的：探讨准分子激光光学屈光性角膜切削术（PRK）手术过程中，激光发射时的冲击力等对视网膜及视神经的影响。方法：随机抽取在我院行PRK手术者38人，76眼，术前3天内及术后第3天行P－VEP检查，对比两者P100的波幅及潜伏时的变化。结果：手术后P100的波幅较前明显提高（P＜0．01），而潜伏时无差异（P＞0．1），结论：从P－VEP的角度看，PRK对视网膜及视神经无任何损害。     

Early detection of changes in visual function in diabetes mellitus

Psychophysical measurements were performed with a view to providing an assessment of early neural functional integrity in the presence of no or minimal diabetic retinopathy (DR). The investigations were carried out on a normal group and a number of age- and sex-matched non-insulin dependent diabetic groups with different levels of DR. Results were considered in terms of the presence of functional changes relative to the severity of DR and the duration of diabetes. Significant deficits were found for visual acuity (VA), contrast sensitivity (CS) and colour vision. Both CS and colour vision measurements differentiated between non-diabetics and those with diabetes but without DR. However, none of the tests reliably distinguished diabetics without DR from those with early retinal changes although VA and colour vision (especially along a blue-yellow colour axis) were sensitive to more substantial retinal changes. This finding suggests such tests may be useful as screening tests for more advanced levels of background DR.     

Ophthalmopathy in childhood Graves' disease

AIMS: To study the ocular manifestations and their severity in children with Graves' disease. METHODS: All patients with Graves' disease having regular follow up in a paediatric endocrine clinic were recruited for the study. A comprehensive ophthalmic assessment including ocular motility, exophthalmometry, intraocular pressure (IOP), slit lamp, and fundus examinations was performed. RESULTS: 83 patients (72 female, 11 male) aged 16 years or below were examined. All are Chinese. Ocular symptoms occurred in 12 patients. Ocular signs of ophthalmopathy were documented in 52 patients (62.7%). Most of them presented with eyelid abnormalities such as lid oedema, lid lag, and lagophthalmos, whereas lower lid retraction was the commonest clinical sign noted (38.6%). Diffuse conjunctival injection was found in four patients (4.8%). 10 patients (12.0%) had mild proptosis of less than 3 mm. Only one patient (1.2%) had limited extraocular motility in extreme gaze. Punctate epithelial corneal erosions were reported in 11 patients (13.3%). CONCLUSIONS: This is the largest series on the ocular complications of childhood Graves' disease in the literature. Although 52 patients (62.7%) were identified with positive ocular changes, none of them had visual threatening complications or debilitating myopathy.     

A clinical analysis of Graves' ophthalmopathy and ophthalmic Graves' disease]

Clinical analysis of 29 cases of Graves' ophthalmopathy and 71 cases of ophthalmic Graves' disease showed that both identities had common ocular features of lid retraction, upper lid lag and exophthalmos, while Graves' ophthalmopathy tended to occur in later life, with longer morbid course, marked systemic symptoms and binocular involvement in contrast to ophthalmic Graves' disease. The clinical and differential diagnoses and treatment of the maladies were discussed.     

图形视觉诱发电位鉴别伪盲的临床应用研究

目的　用图形视觉诱发电位（ｐａｔｔｅｒｎｖｉｓｕａｌｅｖｏｋｅｄｐｏｔｅｎｔｉａｌ,Ｐ-ＶＥＰ）来评价客观视力以及用来鉴别伪盲的临床应用价值。方法　取志愿受检者１５８例（１５８眼）患黄斑病变或视神经病变眼,其中６５眼为黄斑病变组（Ａ组）,９３眼为视神经病变组（Ｂ组）,通过多元回归分析Ｐ-ＶＥＰ波幅和潜伏期与最佳矫正视力的关系。由此得出最佳关系方程,进而得出１５８眼Ｐ-ＶＥＰ推算视力（ＰＶＥＰ-ＶＡ）,以及５３只伪盲眼（包括２１眼黄斑病变及３２眼视神经病变）的ＰＶＥＰ-ＶＡ,最后用受试者工作特征曲线（ＲＯＣ曲线）得出可接受ＰＶＥＰ-ＶＡ及主观视力差值范围,从而鉴别伪盲。结果　在１５′视角黑白棋盘格刺激下引出的Ｐ-ＶＥＰ波形,该波形的Ｐ１００波幅（记录为Ａｍｐ１５′）与主观视力的相关性最好,Ａｍｐ１５′与主观视力显著相关（Ａ组:Ｐ＝０．０１６;Ｂ组:Ｐ＜０．０００１）。Ａｍｐ１５′的对数［ｌｏｇ（Ａｍｐ１５′）］与主观视力（ｌｏｇＭＡＲ）的回归方程为:Ａ组:ｙ＝１．８６７－１．１００ｘ,Ｐ＜０．０００１,Ｂ组:ｙ＝１．５０２－０．７９９ｘ,Ｐ＜０．０００１［ｘ为ｌｏｇ（Ａｍｐ１５′）,ｙ为ｌｏｇＭＡＲ］。利用回归曲线和ＲＯＣ曲线可以得到Ａ组辨别伪盲的截断值为０．３９７２时,其诊断敏感性为７３．３％,特异性为６８．０％;Ｂ组辨别伪盲的截断值为０．４１５０,其诊断敏感性为９０．５％,特异性为６７．５％。结论　Ｐ-ＶＥＰ的Ａｍｐ１５′用来判断客观视力最有效,对于鉴别伪盲也很有意义。     

Orbital compliance in Graves' eye disease

Thirty-three patients with Graves' eye disease (GED) and 68 normal subjects had their orbital compliance measured by determining the force generated on retropulsing the eye and also estimated on digital retropulsion, and their eye position determined with an exophthalmometer. Patients with compressive optic neuropathy showed significantly higher mean forward force on retropulsion than other Graves' eye disease patients or normal subjects, supporting the theory that the tissue is compressed in these orbits. There is a suggestion that orbital compliance testing of a GED patient without compressive optic neuropathy may be of value in predicting the risk of the patient developing compressive optic neuropathy. There is no association between the force on ocular retropulsion and the exophthalmometer reading. The digital estimation of the resistance to retropulsion did not reliably suggest the measured forces.     

Upgaze intraocular pressure changes and strabismus in Graves' ophthalmopathy.

Graves' thyroid ophthalmopathy primarily affects women in their third through sixth decade. Sixty-seven patients with clinical myopathic ophthalmic Graves' disease examined (by SCB) between 1982 and 1989 were measured for changes in upgaze intraocular pressure and strabismus. Special attention was paid to "masquerade" symptoms, including pseudosuperior oblique palsies and cyclotorsions. Any correlation between the extent of hypertropia on muscle exam and upgaze intraocular pressure changes is examined. Data suggest that significant changes in introcular pressure in upgaze correlate with more severe extraocular muscle involvement, may represent progression to muscle fibrosis, and occur uniformly in our study of patients who progress to require inferior rectus recession.