糖尿病眼后节病变的超声显示

目的：探讨糖尿病眼后节病变的超声影像特征。方法：对本院行玻璃体切割术的糖尿病患者２１２例（２３６只眼）,术前超声扫描诊断与术中临床所见进行比较,判定超声诊断的准确性。结果：（１）术前超声诊断与术中所见一致的共２２１只眼,占９３．６％;（２）玻璃体出血（ＰＤＲⅣ期）２５只眼占１１．３％;纤维增殖（Ⅴ期）６６只眼占２９．９％;牵拉性视网膜脱离（Ⅵ期）１３０只眼占５８．８％;（３）糖尿病玻璃体出血常合并纤维增殖,在Ｂ超图像上,后极部的厚而广泛的增殖膜最具有代表性;牵拉性视网膜脱离经常发生在视盘周围和上下血管弓,帐篷状、桌盖形及吊床样外观的视网膜脱离为特征性改变。结论：掌握糖尿病眼后节病变的影像特征,对ＰＤＲ进行准确分期,能为玻璃体视网膜手术提供可靠依据     

高频超声对眼内膜状脱离的鉴别诊断

目的：我们采用高频超声对经手术及检眼镜证实的121例，132只眼的 膜状脱离病变进行诊断与鉴别诊断，其中视网膜脱离70只眼，脉络膜脱离8只眼，玻璃体后脱离13只眼，增殖膜17只眼，超声诊断符合率90．15％，结果表明超声应用于眼科诊断视网膜脱离并不困难，但须与玻璃体内的膜状回声进行鉴别。     

彩色多普勒血流显像和多普勒能量图诊断脉络膜脱离的价值

目的 探讨彩色多普勒血流显像(CDFI)和多普勒能量图(CDPI)诊断脉络膜脱离的价值。方法 用彩色多普勒超声对30例脉络膜脱离患者进行检查，在超声检查眼球形态、晶状体、玻璃体及视网膜的基础上，对眼内带状回声行CDFI和CDPI检查，了解其血流情况，并与手术结果对照。结果 30例脉络膜脱离患者，超声诊断符合率为80．0％，超声联合CDFI和CDPI诊断符合率上升为96．7％。脉络膜脱离的CDFI和CDPI声像图特点为血流丰富，血流束呈长条带状或短棒状。4例视网膜脱离3例见血流信号，但不丰富，血流束呈星点状。合并玻璃体积血14例，玻璃体混浊8例及玻璃体增殖机化4例。27例脉络膜脱离超声诊断与临床手术符合。结论 超声联合CDFI和CDPI检查可为脉络膜脱离的诊断和治疗提供有价值的参考。     

视网膜脱离超声诊断价值

目的 探讨Ｂ型超声对视网膜脱离的诊断价值。方法 通过观察眼内膜病变的位置、形态、程度等情况,对７３例经手术治疗证实的视网膜脱离患者进行分析,并作出超声诊断。结果 超声对本病的诊断符合率为９８．６％。视网膜脱离声像图分为两类：①部分性脱离,在玻璃体无回声区见较强带状回声或弧形隆起。②完全性脱离在玻璃体无回声区内眼球轴位层面显示“Ｖ”字形带状回声。结论 Ｂ超对视网膜脱离具有较高的诊断价值,为眼科临床提供了可靠的诊断依据。     

视网膜脱离合并脉络膜脱离的超声表现与临床手术对照

为了探讨视网膜脱离合并脉络膜脱离的超声特点及鉴别诊断，我们应用彩色多普勒超声技术观察并测量视网膜脱离、脉络膜脱离及玻璃体内增殖导致的异常强回声的位置、形态、起止点、张力、运动及血流情况，综合判断与临床手术对照。结果：二维超声诊断与临床手术符合率875％（21／24），不符合率12．5％（3／24），结合彩色多普勒超声其诊断符合率提高到958％（23／24），不符合率下降到4．2％（1／24）。结论：二维彩色多普勒超声可以对视网膜脱离合并脉络膜脱离做出明确诊断，并能对玻璃体增殖性病变进行鉴别。     

三维超声成像对玻璃体带状回声的诊断与鉴别

本文报道三维超声成像在56例玻璃体带状回声的诊断与鉴别上的应用。结果显示：视网膜脱离呈膜样回声，后绿与视乳头相连。玻璃体脱离者见玻璃体形态失常，后界扁平与球壁间有液性暗区分隔。玻璃体出血，机化物呈珊瑚状图像。眼内炎回声杂乱，视网膜增厚或伴有脱离。三维超声图像直观、形象，具有良好立体感，有利于对玻璃体带状回声的诊断与鉴别。     

彩色多普勒血流显像在诊断视网膜脱离中的应用

目的：探讨彩色多普勒血流显像(CDFI)在诊断视网膜脱离中的应用价值。方法：对在我院眼科经眼底(光学)检查，手术及病理证实为视网膜脱离，并曾作二维超声及CDFI检查的患者54例共60只患眼进行回顾性分析。结果：超声诊断网脱患眼57只，完全性网脱15眼，部分性网脱42眼。57只患眼都可见玻璃体内异常光带，其中55眼光带内可显示彩色血流信号，占96％。漏诊3例，诊断符合率95％。结论：单用二维超声对于一些不典型的病变，难以与眼内其它疾病进行鉴别。结合应用CDFI，鉴别视网膜脱离与非视网膜脱离性玻璃体内光带有较高的参考价值。对于病程较长，有血管萎缩的陈旧性视网膜脱离，以及玻璃体内结构异常变化所致二维超声未能显示典型光带的病例，CDFI未必能满意显示血流信号。此种情形不能轻易排除视网膜脱离存在，应重视二维超声表现，密切结合临床，反复仔细观测，以便作出正确诊断。     

彩色多普勒超声对视网膜脱离的诊断价值

目的：探讨彩色多普勒超声对视网膜脱离的诊断价值。方法：应用彩色多普勒超声观察视网膜脱离程度、分型、及血流情况，并做出超声诊断及鉴别诊断。结果：视网膜脱离声像图分为两类：1．部分性脱离：在玻璃体无回声区内见较强的带状回声或弧形隆起；2．完全性脱离：在玻璃体无回声区内见带状强回声呈“V”字形。脱离的视网膜光带上均有血流信号显示。结论：彩色多普勒超声对视网膜脱离有重要的诊断价值，为眼科治疗、评价病程及推断预后提供了可靠的依据。     

超声在增殖型糖尿病视网膜病变玻璃体切割术前的应用价值

玻璃体手术是治疗增殖型糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)所致的玻璃体积血、牵拉性视网膜脱离等并发症的有效方法[1]。但部分糖尿病患者因屈光间质混浊严重妨碍了临床医师在术前对眼底情况的直接观察,超声作为一     

视网膜脱离的超声诊断及鉴别诊断

目的探讨彩色多普勒血流成像(CDFI)在视网膜脱离及相关病变诊断的应用价值.方法应用彩色多普勒超声诊断仪对518例(678只眼)复杂玻璃体视网膜疾病,包括玻璃体积血、玻璃体后脱离、视网膜脱离、脉络膜脱离、糖尿病视网膜等病变进行检查,经手术判定和验证CDFI检查结果的准确性.结果玻璃体内"V"形带状回声与视盘回声相连.带状回声上可探及与视网膜中央动脉相延续的血流信号.脱离的视网膜血流信号为动脉一静脉伴行的血流频谱,与视网膜中央动脉一静脉血流频谱相同.结论CDFI在复杂玻璃体视网膜疾病的诊断方面具有独到优势,综合分析形态改变和血流特征,可显著提高诊断阳性率,其敏感性和准确性较单纯应用二维超声观察形态改变均有极大提高,为临床提供可靠的诊断依据.     

The vitreous and vitreoretinal interface: natural history and associated retinal diseases

Such significant correlations have been found between vitreal changes and retinal breaks that retinal detachment is now considered as a vitreoretinal disease. Concerning this issue, not only the posterior vitreous detachment seems to play an important role in the occurrence of rhegmatogenous retinal detachment but also the vitreoretinal interactions themself seem to be important in the pathogenesis of cystoid and diabetic macular edema, proliferative diabetic retinopathy, age-related macular degeneration, macular pucker, idiopathic macular hole and macular disease associated with optic disk pit. It seemed therefore useful to the author an updated review on alterations of the vitreoretinal interface and associated ocular diseases.     

眼球创伤超声检测的临床应用价值

目的探讨眼球创伤的眼部超声表现及眼球超声检测的临床应用价值。方法对我院眼球创伤病例的超声检查结果及其临床资料进行回顾性分析,总结眼球创伤的眼部超声表现,与手术及眼科专科检查结果进行对比分析。结果眼部创伤伤情不一,超声阳性表现混杂,轻者可仅表现为一种异常,严重者可合并出现多种异常。超声可以对眼球壁完整性、晶体脱位、玻璃体浑浊、病理膜的鉴别诊断等提供重要诊断信息;对角膜损伤、前房出血等,常规超声检查容易漏诊。结论超声检查对于眼球创伤的伤情判定具有重要的临床应用价值。     

Diabetic retinopathy--pathophysiological knowledge and modern treatment methods

Diabetic retinopathy (DR) leads to visual impairment in the majority of patients suffering from diabetes mellitus for more than 20 years. Endothelial damage, capillary dropout, and vasoproliferative activity of various growth factors are some of the complex pathophysiologic events that lead to retinal damage. Insufficient blood glucose control and arterial hypertension are the leading risk factors for the progression of DR. Adequate therapeutic measures depend on timely and regular ophthalmologic examination. Laser photocoagulation prevents severe visual loss in about 50% of cases with proliferative DR and high risk factors as defined by the Diabetic Retinopathy Study Group. Dosage of laser treatment depends on the stage and severity of DR and requires appropriate experience of the surgeon. Introduction of modern vitreoretinal surgery has yielded considerable progress in the management of vitreous hemorrhages (VH) and tractional retinal detachment in advanced stages of proliferative DR. Results of vitrectomy in 765 cases with proliferative DR are presented. Visual loss can be prevented in over 70% of cases with simple VH without retinal detachment and limited neovascularization, but in only about 30% of cases of VH complicated with retinal traction detachment and extensive vasoproliferation.     

彩色多普勒超声对糖尿病增殖性视网膜病变的诊断价值

目的探讨超声对糖尿病增殖性视网膜病变的诊断价值。方法68例（107只眼）糖尿病患者和60例（60只眼）健康对照组,分析其眼声像图特点。结果107只患眼,检出玻璃体出血32只眼,玻璃体机化膜61只眼,玻璃体下出血14只眼,玻璃体后脱离22只眼,视网膜脱离13只眼;视网膜中央动脉收缩末期和舒张末期血流速度较对照组降低（P〈0．05）,超声诊断符合99只眼,误诊7只眼,漏诊1只眼。结论超声在糖尿病增殖性视网膜病变的诊断中具有重要的价值。     

High vitreous concentration of vascular endothelial growth factor in diabetic patients with proliferative retinopathy using statins

Background. Vascular endothelial growth factor (VEGF) plays an important role in the development of diabetic retinopathy. Previous studies have suggested that angiotensin‐converting enzyme (ACE) inhibitor therapy may reduce vitreous VEGF concentration in diabetic retinopathy. Also HMG CoA reductase inhibitors (statins), known for their beneficial effects on vascular endothelium, might influence vitreous VEGF concentration in diabetic retinopathy.

Aim. Vitreous VEGF concentration of diabetic patients with proliferative retinopathy using statin therapy and/or ACE inhibitor therapy was studied.

Methods. Fifty diabetic patients with proliferative diabetic retinopathy, 21 diabetic control patients without proliferative retinopathy, and 43 non‐diabetic control subjects underwent vitrectomy. Vitreous samples were collected at the beginning of surgery, and VEGF concentration was assessed using a chemiluminescent VEGF immunoassay.

Results. Vitreous VEGF concentration was significantly higher in diabetic patients with proliferative retinopathy using statins than in those not using statins. The diabetic patients with proliferative retinopathy were divided into subgroups according to use of ACE inhibitor and/or statin medication. These groups did not differ significantly in concentration of vitreous VEGF.

Conclusions. Statin therapy is associated with high vitreous VEGF concentration in diabetic patients with proliferative retinopathy. In contrast to previous reports, ACE inhibitor use did not significantly influence vitreous VEGF concentration in these patients.     

胎盘早剥的B超诊断及声像图分析

胎盘早剥是妊娠晚期严重的并发症,其发病率为0.46~2.14%[1]。往往起病急,进展快,如诊断和处理不及时,可危及母婴生命。本文总结了我院1999年3月~2005年7月产前经B超检查并经剖宫产及分娩证实的胎盘早剥43例,通过产前超声所见与产后检查胎盘剥离面的凝血块压迹对照分析,探讨胎盘     

玻璃体内膜样病变超声诊断价值

目的 探讨超声对玻璃体内膜样病变的诊断价值.方法 回顾性分析声像图上表现为玻璃体内膜样病变的63只眼的超声资料,并与手术结果对照.结果 63只眼中,视网膜脱离28只,脉络膜脱离4只,玻璃体机化膜20只,玻璃体后脱离9只,永存原始玻璃体增生症2只.超声诊断与手术结果符合者59只,符合率93.7%.结论 超声对玻璃体内膜样病变有较高的诊断率.     

非外伤性玻璃体积血的病因分析

【目的】分析非外伤性玻璃体积血的病因。【方法】对2008年1月至2011年11月期间住院的96例（100只眼）出现玻璃体积血的非外伤患者的出血原因及治疗情况进行回顾性分析。【结果】本组非外伤性玻璃体积血患者的出血原因为视网膜静脉阻塞（RVO）54只眼（占54％）,增生性糖尿病视网膜病变（PDR）18只眼（占18％）,年龄相关性黄斑变（EAMD）10只眼（占10％）,视网膜大动脉瘤破裂6只眼（占6％）,视网膜裂孔或脱离6只眼（占6％）。【结论】RV0、PDR、EAMD是非外伤性玻璃体积血的主要原因。     

常见眼内疾病的三维超声表现初探

目的探讨眼内常见疾病的三维超声图像特征表现。方法应用三维超声重建技术对常见眼内疾病进行三维超声成像并描述其成像特征。图像采集方式为无定位系统的自由臂扫查，扫查时间为3～5S。结果48只患眼中46只获得较为满意的三维图像，患眼内视网膜脱离、脉络膜脱离、玻璃体内机化物的立体形态及范围，晶状体脱离及玻璃体内异物的空间位置，球内肿瘤的立体结构、表面及内部的特征均清晰可见。结论三维超声不但具有采集时间短的优点，而且所重建图像形象、直观、立体感强、空间位置关系明确，同时可观察到病变的表面及内部的细微结构特征，弥补了二维超声的不足，为眼内疾病的诊断提供了更多的信息。     

Deficit of somatostatin-like immunoreactivity in the vitreous fluid of diabetic patients: possible role in the development of proliferative diabetic retinopathy

OBJECTIVE: To evaluate the vitreous levels of somatostatin-like immunoreactivity (SLI) in patients with proliferative diabetic retinopathy (PDR). RESEARCH DESIGN AND METHODS: A total of 14 diabetic patients with PDR, in whom a vitrectomy was performed, were included in the study. Sixteen nondiabetic patients, with other conditions requiring vitrectomy, served as a control group. Both venous blood and vitreous samples were collected at the time of vitreoretinal surgery. Patients in whom intravitreous hemoglobin was detectable were excluded. In addition, a correction for plasma levels of SLI and intravitreal proteins was performed. SLI was measured by radioimmunoassay and vitreous hemoglobin by spectrophotometry. RESULTS: SLI in the vitreous fluid was significantly lower in diabetic patients than in the control group (68 +/- 18.7 vs. 193.6 +/- 30.8 pg/ml, P < 0.01). The vitreous SLI-to-plasma SLI ratio was strikingly higher in nondiabetic subjects than in diabetic patients with PDR (5.3 [1.2-71.1] vs. 0.6 [0.03-4.1], P < 0.01). After correcting for total vitreous protein concentration, SLI (pg/mg of proteins) remained significantly higher in nondiabetic control subjects than in diabetic patients with PDR (186 [51-463] vs. 7.5 [0.8-82], P < 0.0001). Remarkably, intravitreous levels of SLI were higher than those obtained in plasma in nondiabetic control subjects (193.6 +/- 30.8 vs. 43.5 +/- 10.7 pg/ml, P < 0.0001). Finally, a lack of relationship between plasma and vitreous levels of SLI was observed in both diabetic patients with PDR and nondiabetic control subjects. CONCLUSIONS: The significantly higher SLI in the vitreous fluid than in plasma detected in nondiabetic control subjects supports the concept that somatostatin plays a relevant role in retinal homeostasis. In addition, the intravitreous deficit of SLI observed in diabetic patients with PDR suggests that it might contribute to the process of retinal neovascularization.