复方樟柳碱治疗外伤性眼底缺血性病变的疗效

目的探讨复方樟柳碱注射液治疗外伤性视神经、视网膜及脉络膜缺血性病变的疗效。方法外伤性视神经、视网膜及脉络膜缺血性病变19例(21眼),双眼外伤2例,单眼伤17例,进行复方樟柳碱注射液治疗,颞部皮下注射,每次2 ml,每天1次,14天为1疗程。结果治疗后视力都有不同程度的提高,损伤严重者提高较少。由治疗前的无光感~0.6增加至数指~1.5(数指/30 cm 2眼,0.1 3眼,0.6 7眼,1.0 6眼,1.5 3眼)。4例合并动眼神经和外展神经损伤所致的斜视恢复正位,复视消失眼球运动自如。结论复方樟柳碱注射液治疗外伤性视神经、视网膜和脉络膜病变有明显效果,对同时合并其他颅神经的损伤也有明显疗效。     

Treatment of ocular inflammation

Acute immunosuppression induced by total body irradiation (TBI) or cyclophosphamide (Cy) treatment, followed by syngeneic bone marrow transplantation (SBMT), was reported to be effective in inducing long-term tolerance in some autoimmune disease models. We examined the efficacy of this approach in the mouse model of experimental auto-immune uveoretinitis (EAU). Development of EAU induced by the interphotoreceptor retinoid binding protein (IRBP) was abolished almost completely by either TBI or Cy treatment, followed by SBMT, instituted one week after priming. In parallel, IRBP-specific delayed-type hyper-sensitivity (DTH) responses and lymph node cell proliferation were strongly suppressed or abolished. However, when these IRBP-immunized, lympho-ablated and BM reconstituted mice were rechallenged with the immunizing antigen seven weeks after the primary immunization, they were not protected from developing disease, despite the fact that DTH and lymph node cell proliferation to the antigen were suppressed relative to controls. TBI treatment appeared somewhat more effective than Cy treatment as judged by its more profound effect on immunological responses. These results demonstrate the ability of acute immunosuppression followed by reconstitution of the immune system to inhibit the development of EAU, although long-term protection from disease was not achieved.     

Treatment of ocular rosacea

Although rosacea is a common entity with significant cosmetic, socioeconomic, and vision-threatening impacts, this disorder remains incurable. Furthermore, until quite recently many of the therapeutic options for rosacea had not been assessed through rigorous clinical testing with meaningful outcome measures. Nonetheless, new medical and surgical interventions that have been validated in well-designed trials hold the promise of treating rosacea more effectively. Furthermore, recent enhancements in our understanding of the cellular and molecular biology offer highly translational insights that will hopefully lead to the development of new treatment options for rosacea. We review the evidence for these therapies and discuss new scientific findings that can be exploited for new therapeutic interventions.     

Treatment difficulties in ocular toxoplasmosis

PURPOSE: To determine the increased incidence of ocular infection with Toxoplasma gondii, the variety of ocular manifestations and therapeutical problems of this potential blind disease. We analyzed 22 patients hospitalized in our clinic in last 2 years at whom clinical diagnosis was confirmed by positive serological tests. Is discussed the correlation between serum level antibody(IgG and IgM) and ocular manifestations and the opportunity of beginning specific treatment depend on these two parameters. CONCLUSIONS: The incidence of ocular toxoplasmosis is increasingly, the ophthalmologist must be open on atypical manifestations of this disease. The treatment remains controversial, we believe that it must be specific and correlated with ocular lesions evolutions and serum antibody level in time.     

Atopic ocular disease

Atopic ocular diseases involve a spectrum of immuno-inflammatory responses. There are minimal pathologic changes with SAC. With PAC, there is increased mast cell activation and late-phase inflammatory cell infiltrate as a consequence of continued allergic stimulation. Associated with the more chronic and severe forms of atopic ocular disorders, GPC, VKC and AKC, there is persistent mast cell, eosinophil, and lymphocyte activation resulting in pathologic changes. Therapeutic intervention for atopic ocular diseases has focused on symptomatic improvement. However, with an increasing understanding of the molecular mechanisms associated with the allergic inflammatory response, experimental studies may facilitate the development of preventative strategies.     

Oxidative stress in ocular disease

The definition of oxidative stress implies increased oxidant production in animal cells characterized by the release of free radicals, resulting in cellular degeneration. The imbalance between excess free radical production and the antioxidant defense causes cellular damage resulting in lipid peroxidation. Oxidative stress is involved in many ocular diseases such as age-related macular degeneration, retinopathy of prematurity, retinal light damage, and cataract. Reactive oxygen species are involved in this process. The pathogenesis of age-related macular degeneration is largely unknown. Excessive light and iron may enhance the progression of this disease. In in vitro study of the ciliary body, gamma irradiation inhibits TPR53BP2 expression associated with apoptotic cell death, and increased BCL2 is evident just after gamma irradiation. Exposure to ultraviolet light has been postulated as a cause of age-related macular degeneration (AMD), perhaps through damage to the retinal pigment epithelium. It seems logical, therefore, to replace the aging, yellowing lens with a blue light-absorbing yellow intraocular lens (IOL) in cataract surgery. The issue of whether cataract surgery is a risk factor for the development or progression of AMD remains controversial. In vivo studies suggest that lipid peroxidation decreases in the vitreous and retina after cataract surgery with or without intraocular lens implantation.     

眼化学性烧伤综合治疗临床分析

目的探讨眼化学性烧伤综合治疗的效果。方法对眼化学性烧伤48例（79眼）进行综合治疗，包括：彻底冲洗结膜囊、清除附着致伤物、中和毒素、散瞳、局部和全身应用维生素C、抗生索及手术等。结果Ⅰ度烧伤49眼经治疗后视力均恢复至0．8以上；结膜光洁，角膜透明。Ⅱ度烧伤17眼，视力恢复至0．3者2眼，0．4～0．6者6眼，0．7，1．0者9眼；角膜薄翳3眼，角膜血管增生1眼。Ⅲ度烧伤7眼，视力恢复至0．05者2眼，0．1～0．3者5眼；角膜薄翳3眼、角膜白斑4眼，角膜血管增生3眼。Ⅳ度烧伤6眼，视力恢复至光感Ⅰ眼，〉光感-0．02者4眼，0．05者1眼；角膜血管性浑浊，结膜增厚5眼，角膜白斑1眼，结膜囊变窄2眼。结论眼化学烧伤综合治疗可取得较好效果。     

Radiotherapy-induced ocular surface disease

Today radiation is routinely used as a therapeutic modality for select tumors of the orbit, adnexa, paranasal sinus, and nasopharynx. Despite significant improvements in mechanisms of delivery and protective shielding, acute and chronic complications of radiation can affect different segments of the eye. In this report, we provide an overview of ocular damage secondary to radiotherapy. We identify the characteristic clinical changes and underlying pathophysiologic mechanisms involving the ocular surface and provide a rational approach to their prevention and treatment.     

B- and T-lymphocytes in ocular disease

Ocular inflammatory diseases and ocular adnexal lymphoid tumors have become less obscure and intimidating by virtue of our ability to study the infiltrates in these various diseases for their B-lymphocyte and T-lymphocyte composition. Comparisons are also possible between lymphocytic profiles in the peripheral blood and the precise composition of the in situ infiltrates within the ocular tissue themselves. The availability of monoclonal antibodies, which can determine T-lymphocytic subsets such as T-helper cells and T-suppressor/cytotoxic cells, natural killer cells, and monocytes-histiocytes, has provided a powerful technology for the delineation of the distinctive immune composition of the inflammatory infiltrates, as well as any possible disturbances in T-cell immunoregulation. B-lymphocytes produce immunoglobulins, which may be misdirected as autoantibodies in local or systemic autoimmune diseases. Immunoglobulin-mediated and therefore B-cell derived conditions include vasculitis, progressive cicatricial ocular pemphigoid, Mooren's corneal ulcer, scleritis, and hay fever and vernal conjunctivitis. Other diseases in which B-lymphocytes, their immunoglobulin products or immune complexes formed with presently unknown antigens are potentially at fault are chronic non-specific uveitis; iridocyclitis in Behcet's syndrome; Fuch's heterochromic syndrome, ankylosing spondylitis, and Reiter's syndrome; Graves' disease; and idiopathic inflammatory orbital pseudotumor and myositis. T-cells do not produce immunoglobins, but rather secrete lymphokines or interact directly with receptors or determinants on viruses or target tissues (eg. immunosurveillance against neoplasia); it is possible that some autoimmune diseases are the result of neo-antigens on the surfaces of host tissues that have been coded for by a cryptic inciting virus. T-cell diseases include phlyctenulosis graft rejections, graft versus host disease, and possibly sympathetic ophthalmia and temporal arteritis. Natural killer cells are involved in many of the same diseases as cytotoxic T-cells, except that the former require no period of sensitization (natural immunity), whereas cytotoxic T-cells must undergo an antigen-specific blast transformation (acquired immunity of the delayed hypersensitivity type). In many diseases in which B-cell derived auto-antibodies are at fault, there may be local tissue or systemic T-cell imbalances, with a reduction in T-suppressor cells and a relative augmentation in T-helper cells, thereby facilitating production of misdirected auto-antibodies.(ABSTRACT TRUNCATED AT 400 WORDS)     

Diverse ocular manifestations in Boeck disease

The clinical picture of sarcoidosis varies widely; in many cases there are few symptoms. In cases where the initial symptoms of sarcoidosis are ocular the diagnosis can only be established if systemic disease is considered in differential diagnosis. Five cases with ocular manifestation and unusual findings or development are described.