高度近视性黄斑出血的荧光素眼底血管造影和靛青绿血管？…

目的 探讨高度近视性黄斑出血及眼底变化特征。方法 对３５例（３７只眼）眼底有黄斑出血的高度近视患者进行眼底彩色照像和荧光素眼底出血管造影（ＦＦＡ）检查，其中８只眼行靛青绿血管造影（ＩＣＧＡ）。结果 高度近视黄斑出血的表现：（１）视网膜下新生血管（ＳＲＮＶ）形成导致的黄斑出血（２３只眼），ＩＣＧＡ显示的ＳＲＮＶ较ＦＦＡ清晰；（２）无ＳＲＮＶ的黄斑出血（１４只眼），在出血下或边缘有漆样裂纹显露者９只眼     

老年黄斑变性的视力与眼底病变及荧光造影的关系

对１５８例（２１３眼）老年黄变性（ＡＭＤ）及早期ＡＭＤ病人的视力，眼诋改变及眼底血管荧光造影（ＦＡ）进行了观察，发现视力≥１．０的病人也有出血，渗出，视网膜下新生血管膜（ＳＲＮＶＭ）视网膜神经上皮或色素上皮脱离（ＲＮＥＤ或ＲＰＥＤ），视力的损害与ＳＲＮＶＭ的部位有关。讨论了视力与眼底改变及ＦＦＡ的关系，并分析了以视力标准划分ＡＭＤ的界限的弊端，提出对视力正常，眼底，ＦＡ及视力功能检测的正常，应诊断     

吲哚青绿血管造影中陈旧性眼底出血的自发荧光分析

目的：观察老年性黄斑变性（Age—relatedmaculardegeneration，AMD）和息肉状脉络膜视网膜病变（Polypoidalchoroidalvasculopathy，PCV）患者眼底陈旧性出血在吲哚青绿血管造影（Indocyaninegreenangiography，ICGA）中的自发荧光表现。方法：对伴有眼底陈旧性出血的AMD和PCV患者共36例（36只眼）行ICGA检查。受试者在进行ICGA检查前．均经过详细的眼底镜检查、眼底彩色照相及荧光素眼底血管造影（Fundusfluoresceinangiography，FFA）检查。结果：眼底陈旧性出血灶ICGA均表现出相应的自发荧光。陈旧性出血灶呈浅灰黄色，其自发荧光的形态大小与眼底彩色图像所示的陈旧性出血灶相一致，边界清晰；造影后期陈旧性出血灶的自发荧光强度最强，与AMD的斑状及焦点状脉络膜新生血管（Choroidal neovasculari zation．CNV）及PCV的息肉状脉络膜血管扩张灶的荧光表现不同。陈旧性眼底出血的自发荧光多与CNV或息肉状病灶重叠或位于其边缘（27只眼，75％）。结论：ICGA中陈旧性眼底出血所致的自发荧光易与CNV及息肉状病灶性强荧光相混淆，将眼底彩色图像与ICGA图像对比分析及掌握其与CNV及息肉状血管扩张灶的不同荧光特性有助于鉴别诊断。     

吲哚青绿眼底血管造影晚期图像反转现象的观察

我们使用德国海德堡眼底血管造影仪（HRA-2）进行吲哚青绿（ICG）眼底血管造影（ICGA）与荧光素眼底血管造影（FFA）同步检查中，发现ICGA晚期出现FFA所没有的红外荧光图像反转现象。我们结合一组急性视网膜色素上皮（RPE）撕裂的病例，重点观察了RPE对ICGA图像反转的影响。     

超广角荧光血管造影在视网膜疾病中的应用研究现状

超广角荧光血管造影（UWFA）是近些年眼底成像领域的一项新技术，该技术同时结合了超广角眼底成像技术和荧光造影的血管显影特点，为临床观察周边视网膜血管结构和功能提供了新途径。目前关于UWFA的研究涉及各类眼底疾病。不仅帮助人们更完整地认识了眼底病变的特征，同时还对疾病的治疗规范、监测及预后评估产生了影响，具有很大的临床及科研价值。本文对近年UWFA技术的更新和新的研究成果作一综述。     

原田氏病临床与眼底荧光血管造影分析

目的探讨原田氏病的临床表现、药物治疗与荧光眼底血管造影特点。方法观察１５例（２８眼）原田氏病的临床表现并行眼底彩色照相和眼底荧光血管造影（ｆｕｎｄｕｓｆｌｕｏｒｅｓｃｅｉｎａｎｇｉｏｇｒａｐｈｙ，ＦＦＡ）结果１５例（２８）眼原田氏病主要表现为视力下降、头痛、颈强、听力下降等症状。眼底为视乳头水肿、视网膜水肿，周边视网膜浆液性脱离或晚霞状眼底，相应的ＦＦＡ检查结果为，急性期：眼底后极部及周边的“密集针尖状”荧光素渗漏；恢复期：眼底后极部弥散性色素上皮萎缩性高荧光，脉络膜大血管显露。甲基强的松龙冲击治疗后，１５例（２８眼）治疗后视力明显提高（Ｐ＜０．０５）。讨论ＦＦＡ造影和糖皮质激素合理应用对原田氏病诊断及预后具有价值。     

50岁以上患者视网膜色素上皮脱离的眼底特征分析

目的 探讨50岁以上患者视网膜色素上皮脱离（PED）的眼底改变特征。 方法 回顾分析2001年10月至2004年8月经荧光素眼底血管造影（FFA）确诊为PED的31例（34只眼）50岁以上连续性病例，眼底改变的特征，患者均进行眼底彩色照相、FFA及吲哚青绿血管造影（ICGA）检查。 结果 31例34只PED患眼中，FFA显示浆液性PED18只眼，占52.9%，血液性PED8只眼，占23.5%，浆液血液性PED 8只眼，占23.5%。ICGA结果显示，12只眼（35.3%）伴发脉络膜新生血管（CNV）,17只眼（50.0%）伴发息肉状脉络膜血管病变（PCV），1只眼（2.9%）同时伴发CNV及PCV，4只眼（11.8%）不伴有脉络膜血管性病变。 结论 50岁以上患者PED可发生于CNV、PCV及无脉络膜血管性病变患眼，其中PCV患眼最常见。 (中华眼底病杂志, 2006, 22:224-227)     

视网膜色素上皮与新生血管的形成

新生血管的形成是许多眼底疾病的一个共同环节。视网膜色素上皮（ＲＰＥ）与新生血管的发生有着密切的关系。通过阐述视网膜色素上皮对新生血管发生的４个步骤，即血管外膜的降解、血管内皮细胞的迁移、血管内皮细胞的增生及新生血管成熟等的影响，回顾了视网膜色素上皮在眼底新生血管发生中的作用。阐明其在何种情况下促进新生血管的发生，或何种情况抑制新生血管的发生，以期为眼底新生血管疾病的治疗寻找出路     

双侧进行性闭塞性视网膜血管炎

报告１０例特殊类型的视网膜血管炎，其特征为双眼底血管呈进行性闭塞，由周边向后极进展，晚期并发玻璃体出血（６只眼）和新生血管性青光眼（５只眼）等。视力≤０．０５者１０只眼（５０％），氩激光光凝治疗似可延缓其进程，对眼底表现、荧光血管造影、鉴别诊断及治疗也进行了讨论。     

脉络膜黑色素瘤的三种影像学检查对比分析

目的通过对比超声、磁共振成像及眼底血管造影三种影像学检查方法对脉络膜黑色素瘤的诊断结果与病理诊断的一致性，探讨脉络膜黑色素瘤影像学检查的合理应用方法，提高脉络膜黑色素瘤的确诊率。设计回顾性病例系列。研究对象疑诊为脉络膜黑色素瘤的26例（28眼）患者。方法对26例（28眼）疑诊为脉络膜黑色素瘤患者术前进行眼B超和（或）彩色超声多普勒血流成像（CDFI）、磁共振成像（MRI）、荧光素眼底血管造影（FFA）和（或）吲哚青绿血管造影（ICGA）检查，结合病理诊断，应用SPSS12．0软件对影像学检查结果与病理诊断的一致性进行统计学分析。主要指标眼部超声、MRI、眼底血管造影的表现及肿瘤病理诊断。结果三种影像学检查结果与病理诊断的一致性由好到差依次为：MRI（r=0．494，P=0．010）、超声检查（k=0．348，P=0．050）、眼底血管造影（k=0．140，P=0．463）；超声检查对脉络膜黑色素瘤诊断的敏感度和特异度分别为95．2％和33．3％，MRI的敏感度和特异度分别为85．7％和66．7％，眼底血管造影的敏感度和特异度分别为76．2％和40．0％。联合MRI和眼底血管造影或三种影像学检查的诊断结果与病理诊断的一致性最好（k=0．886，P=0．000），其对脉络膜黑色素瘤诊断的敏感度和特异度分别为100％和83．3％。结论三种影像学检查联合是目前除病理外敏感性和特异性最佳的诊断方法，优于单独应用以及其他两两组合。     

AGE-RELATED MACULAR DEGENERATION: CURRENT ASPECTS OF PATHOGENESIS AND TREATMENT

About 1.1 million people are estimated to have age-related macular degeneration in West Germany. Anatomical aspects of the normal macula and physiological ageing processes in the retina will be discribed including alterations in the choroid, in Bruch‘s membrane, the pigment epithelium and the sensory retina. Risk factors for the development of age-related macular degeneration are age per se, perhaps ethnologic characteristics, ocular characteristics, and perhaps environmental factors. The histopathology...     

Sympathetic ophthalmia and subretinal neovascularization

We report a case of sympathetic ophthalmia with subretinal neovascularization of the macula. The subretinal neovascularization developed after penetrating trauma to the fellow eye. The occurrence of subretinal neovascularization in sympathetic ophthalmia is not surprising since disintegrative changes and breaks in Bruch's membrane have been reported in sympathetic ophthalmia. Subretinal neovascularization has also been reported in Vogt-Koyanagi-Harada syndrome, which is histopathologically similar to sympathetic ophthalmia.     

视网膜后膜的超微结构观察

在34例视网膜脱离伴增殖性玻璃体视网膜病变的慢性病例中，观察到12例视网膜后膜，占35.3%.其中对1例经玻璃体手术切除的标本进行了透射电镜检查。神经胶质细胞、视网膜色素上皮细胞及大量胶原纤维是后膜的主要细胞或间质成分。 （中华眼底病杂志，1994，10：165-166）     

Changes in Müller cell plasma membrane specializations during subretinal scar formation in the rabbit.

The aim of this study was to identify changes in Müller cell plasma membrane specializations during experimentally induced subretinal gliosis in rabbits. When rabbits are dosed with sodium iodate, large expanses of retinal pigment epithelium and photoreceptors are destroyed. They are replaced by a subretinal scar consisting mainly of the ascending processes of Müller cells. These processes transform from the slender, highly polarized structures seen in normal animals into irregular processes that form a glia limitans along the basement membrane of the pigment epithelium, left bare following its degeneration. As the scar processes extend through the subretinal space and contract this basement membrane, they undergo dramatic changes in shape that are especially apparent in three-dimensional computer reconstructions of serial thick sections examined by high-voltage electron microscopy. Other changes involve the intercellular junctions and apical microvilli normally associated with the external limiting membrane. These structures become scattered over the surfaces of the ascending processes and are eventually lost. Loss of microvilli is associated with disappearance of immunostaining for a specific glycoconjugate normally associated with the microvillar plasma membrane. The observations document profound changes in Müller cell structural and functional polarity during subretinal scar formation.     

Surgical management of bilateral exudative retinal detachment associated with central serous chorioretinopathy

PURPOSE: To report a case of bilateral bullous exudative retinal detachment in central serous chorioretinopathy (CSC) which was attached by vitrectomy and internal drainage of the subretinal fluid. METHODS: A 47-year-old man affected by bilateral atypical CSC with a bullous retinal detachment with subretinal exudate. A fluorescein angiogram (FAG) showed multiple points of leakage and staining of subretinal fibrosis. A tentative diagnosis of Vogt-Koyanagi-Harada (VKH) syndrome was made and the patient was treated with systemic corticosteroids and immunosuppressive agents. However, the subretinal fluid was not absorbed. He was then treated with vitrectomy and internal drainage of subretinal fluid. RESULTS: The retina was attached successfully in both eyes. Visual acuity improved to 20/50 in his left eye but did not improve in the right eye due to subretinal fibrotic scarring and atropic changes on the macula. CONCLUSIONS: Our case suggests that the surgical management of bullous exudative retinal detachment is safe and necessary.     

视网膜下人工假体植入后视网膜变化的研究进展

视网膜下人工假体是目前关于视网膜色素变性和老年性黄斑变性等视网膜外层退行变性疾病研究中的一种新的治疗方法。它旨在利用植入的微电极器替代变性的光感受器细胞,经光-电信号转换,对视网膜内层残留的双极细胞和神经节细胞产生电刺激,进而通过正常的视路在大脑视皮质诱发视觉反应,从而达到恢复视力的目的。然而视网膜下假体植入后视网膜的结构、功能及蛋白表达等可发生一些变化,有学者还发现视网膜下假体植入后一段时间内视网膜的结构和功能得到改善,推测可能有保护作用的参与,但其来源尚不完全明了。本文主要就视网膜下人工假体植入后视网膜的变化作一综述。     

Idiopathic macular hole with extensive subretinal fluid: clinical and optical coherence tomography features before and after surgery

PURPOSE: To report clinical and optical coherence tomography (OCT) features in patients with idiopathic macular hole and extensive subretinal fluid (extending at least 1 disk diameter from the center of the hole). DESIGN: Retrospective, consecutive, noncomparative case series. METHODS: The case records of two patients with idiopathic macular holes with extensive subretinal fluid were reviewed. RESULTS: Both patients presented with reduced visual acuity (20/200 and 20/400). OCT demonstrated attachment of the posterior hyaloid to the inner retina, a full-thickness macular hole, cystoid macular edema (CME), and extensive subretinal fluid. After surgery, both patients achieved macular hole closure and improvement in visual acuity (20/60 and 20/30). Postoperatively, OCT showed a normal foveal contour, complete hole closure, and resolution of the CME and subretinal fluid. CONCLUSIONS: In patients with macular hole and extensive subretinal fluid, improved visual acuity and hole closure can be achieved. Preoperative OCT in these patients demonstrates vitreoretinal interface abnormalities, CME, and extensive subretinal fluid. These changes resolve postoperatively.     

Aging macular degeneration. Clinical features of treatable disease

Argon laser treatment reduces visual loss in patients with aged macular degeneration and extrafoveal subretinal neovascular membranes (SRNVM). Ophthalmologists must now educate patients concerning the symptoms of subretinal neovascularization and give them an Amsler grid. If a patient develops symptoms he should be examined promptly. High quality fluorescein angiograms and meticulous contact lens examinations of the macula should be performed to detect subtle neovascularization. Ophthalmologists must be familiar with the clinical and fluorescein angiographic changes of drusen, retinal pigment epithelial atrophy, and retinal pigment epithelial detachments in order to differentiate them from subretinal neovascular membranes.     

MASSIVE CHOROIDAL HAEMORRHAGE AS A COMPLICATION OF KRYPTON RED LASER PHOTOCOAGULATION FOR DISCIFORM DEGENERATION

A 78-year-old man with perifoveal subretinal neovascularization originally treated with krypton red laser was re-treated. An attempt was made to produce a "chalky white" burn at the site of the neovascular frond. Immediately after a bum, a brisk choroidal haemorrhage followed, apparently from a ruptured choroidal vessel. Bleeding occurred subretinally and into the vitreous, blinding the patient. While the krypton red laser carries advantages over the argon laser in the treatment of subretinal neovascular fronds, this case indicates that hard burns with the krypton laser carry a risk of massive subretinal haemorrhage.     

Decompensation of the retinal pigment epithelium and occult choroidal neovascularization: indications for treatment

Degenerative changes in the retinal pigment epithelium (RPE) may compromise the patient's visual acuity before the development of frank choroidal (subretinal) neovascularization. A decompensation of the barrier function of the RPE may permit accumulation of subretinal fluid and sub- or intraretinal hard, yellow exudate. Laser treatment may control this inimical process which threatens or impairs vision and may prevent or delay its progression.