孔源性视网膜脱离患者视网膜下液蛋白质图谱

运用瑞士产快速液相色谱（ＦＰＬＣ）对孔源性视网膜脱离患者视网膜下液蛋白质进行检测，其结果表明经凝胶作用色谱柱后，视网膜下液蛋白质可分成４个不同分子量级分，即〉７０ＫＤ，〉１０ＫＤ，〈１０ＫＤ及〈１ＫＤ，视网膜下液蛋白质浓度随着ＰＶＲ的加重而中，其蛋白质以１０ＫＤ以上为主要成分占６６．１４～８１．２９％，１０ＫＤ以下蛋白质在样本中的含量所占百分比随ＰＶＲ加重有增加趋势。     

视网膜脱离患者网膜下积液的免疫学检测及其临床意义

检测了21例视网膜脱离患者网膜下积液免疫球蛋白和补体的含量,发现视网膜脱离患者可能在眼局部存有免疫反应,随病程增长,免疫反应加重,高度近视患者易发生免疫反应和发生免疫反应患者手术愈后不理想,并讨论了与网脱范围和裂孔大小、数目的关系。     

不同类型视网膜脱离患者视网膜下积液蛋白质结构分析

为比较不同类型视网膜脱离（ＲＤ）患者视网膜下积液（ＳＲＦ）蛋白质结构的异同,我们用傅里叶拉曼（ＦＴＲａｍａｎ）和傅里叶红外（ＦＴＩＲ）光谱测定不同类型ＲＤ患者血清及ＳＲＦ蛋白质结构。结果发现不同类型ＲＤ患者血清的两种光谱很相似,但的析两各光谱因类型和病程而异。不同类型ＲＤ患者ＳＲＦ不仅有芳香族结构明显改变,而且脂蛋白结构也有改变。     

中药对视网膜脱离术后视网膜下积液的吸收作用

目的 观察健脾益肾、活血利水中药对视网膜脱离术后视网膜下积液、视功能的影响。方法 将153例孔源性视网膜脱离患者于术后随机分为中药组和对照组，观察两组患者术后5天视力及视网膜下积液的变化。结果 中药组术后口服健脾益肾、活血利水中药可促进视网膜下积液的吸收，与对照组比较有统计学意义(P＜0．05)；而且中药组视功能的恢复亦优于对照组(P＜0．05)。结论 健脾益肾、活血利水中药能促进视网膜下积液的吸收及视功能的恢复，是视网膜脱离术后治疗的一个重要方面。     

术前双眼遮盖及体位控制对孔源性视网膜脱离患者视网膜下积液吸收的作用

目的　探讨孔源性视网膜脱离患者术前双眼遮盖对减少视网膜下积液和手术效果的影响。方法　收集2017年4月至12月在安徽医科大学附属省立医院确诊为孔源性视网膜脱离并手术患者197例197眼,随机分为试验组100例100眼、对照组97例97眼,试验组术前给予患者约12 h双眼遮盖并使裂孔保持最低位,对照组未做特殊处理,记录患者年龄、性别、病程、裂孔情况、增生性玻璃体视网膜病变（proliferative vitreoretinopathy,PVR）分级、视网膜脱离等。综合直接眼底镜、间接眼底镜以及B超定量方法综合判断视网膜下积液情况。根据手术适应证,手术方式分为巩膜扣带术和玻璃体切割术,记录每例患者手术方式、时间和术中情况,并随访术后视网膜复位时间及术后视力恢复情况。结果　对照组有4例4眼视网膜下积液减少,试验组有38例38眼视网膜下积液减少,两组比较差异有统计学意义（P<0.05）。试验组行巩膜扣带术患者中视网膜下积液减少（27例27眼）与视网膜下积液未减少（31例31眼）者在术中操作、手术时间、术后视力方面差异均有统计学意义（均为P<0.05）;试验组行玻璃体切割术患者中视网膜下积液减少者（11例11眼）与视网膜下积液未减少者（31例31眼）在手术时间及术后视力等方面差异均无统计学意义（均为P>0.05）。试验组视网膜下积液减少与未减少者之间在PVR分级和年龄方面差异均有统计学意义（均为P<0.05）,Logistic回归分析显示年龄较小和PVC分级较轻是促进视网膜下积液吸收的独立因素（均为P<0.05）。结论　术前双眼遮盖及保持体位控制能够有效减少视网膜下积液,对于PVR较轻的年轻患者更为有效。对于行巩膜扣带术患者能够使手术时间缩短,减少术中操作,患者术后视力恢复也较佳。     

视网膜脱离术后顽固性视网膜下积液的治疗

目的：分析视网膜脱离术后顽固性网膜下液的形成原因,并对其治疗方法进行了探讨。方法：对285例视网膜脱离术后出现顽固性网膜下液的23例患者,在常治疗1月无效后,对玻璃体牵引不明显的12例进行药物治疗。其中5例不吸收者行针刺放液和巩膜外环扎,3例行激光堤霸式光凝,11例玻璃体牵引明显者行玻璃体切割术。结果：随访一年,牵引不明显的12例网膜下液在839周内吸收,牵引明显的11例中3例出现复发性网脱,经再次玻璃体切割术后恢复,余网膜均复位良好。结论：研究发现顽固性网膜下液的发生与裂孔的位置,患者年龄,冷凝强弱,玻璃体牵引及巨大裂孔放液位置有关,为减少增殖性玻璃体视网膜病变,尽可能恢复视功能,应针对不同病因及时进行相应的治疗。     

视网膜脱离术后顽固性视网膜下积液的治疗

目的 分析视网膜脱离术后顽固性视网膜下液的形成原因，并对其治疗方法进行了探讨。方法 对285例视网膜脱离术后出现顽固性视网膜下液的23例（23只眼）患者，在常规治疗1月无效后，对玻璃体牵引不明显的12例进行药物治疗，其中5例不吸收者行针刺放液和巩膜外环扎，3例行激光堤坝式光凝，11例玻璃体牵引明显者行玻璃体切割术。结果 随访一年，牵引不明显的12例视网膜下液在8－39周内吸收，牵引明显的11例中3例出现复发性网脱，经再次玻璃体切割术后恢复，余视网膜均复位良好。讨论 顽固性视网膜下液的发生与裂孔的位置、患者年龄、冷凝强弱、玻璃体牵引及巨大裂孔放液位置有关，为减少增生性玻璃体视网膜病变，尽可能恢复视功能，应针对不同病因及时进行相应的治疗。     

孔源性视网膜脱离患者血清及视网膜下液氨基酸谱

目的探讨视网膜脱离患者血清及视网膜下液氨基酸成分及变化。方法应用高效液相色谱对孔源性视网膜脱离患者血清及视网膜下液氨基酸成分进行检查，并配对检查正常人及高度近视患者血清氨基酸。结果各组血清及视网膜下液均可检测出１５种氨基酸；血清谷氨酸浓度正常人＜高度近视患者＜视网膜脱离患者，差异有显著性（Ｐ＜０．０１）；视网膜脱离患者血清蛋氨酸含量较正常人及高度近视患者明显升高（Ｐ＜０．０１）；视网膜脱离患者除天冬氨酸、谷氨酸及精氨酸外余各种氨基酸含量血清明显高于视网膜下液。结论血清及视网膜下液氨基酸检测对探讨视网膜脱离的病因具有临床价值。     

裂孔源性视网膜脱离术后黄斑区视网膜下液及其对预后视力影响

裂孔源性视网膜脱离复位手术成功后,在通过常规检查不能发现显著病变的情况下,部分患者的视力恢复不佳。通过光学断层扫描技术(OCT)的应用,可以发现检眼镜和荧光造影不能发现的黄斑区视网膜下液的存在。本文对视网膜脱离术后黄斑区结构变化与视力预后的结果进行文献回顾,并对这一现象可能发生的原因和对视力的影响进行讨论。     

复杂视网膜脱离视网膜下膜超微结构研究

目的研究复杂视网膜脱离病例中视网膜下膜的超微结构特征,探讨视网膜下膜的细胞成分。方法对21例复杂孔源性视网膜脱离伴视网膜下膜者行玻璃体切割术加视网膜下膜切除术,将所获得的视网膜下膜经处理后于光镜下选择细胞较密集处做超薄切片,染色后行透射电镜观察并摄影。结果复杂视网膜脱离视网膜下膜中,色素上皮细胞多呈散在分布,未见明显基底膜供细胞附着,在条索或片状膜当中的色素上皮细胞形态存在变化。神经胶质细胞胞浆内有较丰富的细胞器和直径约10nm的中间型微丝形成。视网膜下膜的细胞间质含有大量胶原纤维。成纤维细胞形状不规则,活跃,胞浆中见大量直径4～6nm微丝。结论视网膜下膜主要由视网膜色素上皮细胞、神经胶质细胞、成纤维细胞和胶原纤维组成。视网膜下膜中色素上皮细胞、神经胶质细胞和成纤维细胞有转化与增殖能力。     

The subretinal fluid in retinal detachment

Following retinal detachment, subretinal fluid (SRF) fills the neoformed space. Subsequently subretinal and preretinal strands of proliferative tissue begin to form. We have collected the subretinal fluid withdrawn during retinal detachment surgery. We have studied subretinal fluid cytologically to evaluate the number and the type of cells present in the fluid, and by means of transmission electron microscopy. The first cell type to be present in the fluid represented degenerated aspects of pigmented epithelial cells (PECs). Successively, other cell types appeared in the fluid as nerve cells (rods, cones and glial cells), macrophages and well preserved pigmented epithelial cells.Abbreviations PECs pigmented epithelial cells - SRF subretinal fluid     

Shifting subretinal fluid in rhegmatogenous retinal detachment.

In a consecutive series of 470 cases of rhegmatogenous retinal detachment 25 (5%) were found to have shifting subretinal fluid (SRF) at the preoperative examination. The study showed that the association between SRF and rhegmatogenous retinal detachment is unusual but not rare. Shifting SRF was most often associated with aphakic and longstanding retinal detachment, and found in cases in which the retinal holes were small.     

An analysis of subretinal fluid in bullous retinal detachment

A patient with bilateral bullous retinal detachment underwent drainage of the subretinal fluid. The analysis of the subretinal fluid revealed a high protein concentration--17.4 g/dl OD, 27.5 g/dl OS--which was 3-5 times higher than that of the patient's serum. The protein fractionations of the subretinal fluid were almost the same as those of the serum. These findings may well explain the shifting fluid and support the theory that bullous retinal detachment is caused by the breakdown of retinal pigment epithelial function as a barrier between the choroid and retina.     

Endoscopy-guided subretinal fluid drainage in vitrectomy for retinal detachment

PURPOSE: To study the usefulness of endoscopy-guided subretinal fluid drainage in pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD). PARTICIPANTS/METHODS: A prospective non-comparative study of a small number of RRD cases. The study involved examining 10 eyes of 10 patients with RRD that received PPV. Two eyes had hazy corneas, which hindered the observation by surgical microscopy. Fluid-gas exchange was performed and then subretinal fluid was drained through a primary retinal break guided by an endoscope. No drainage retinotomy was made. Each clinical feature was studied and the surgical outcome and complications were evaluated. RESULTS: All eyes had retinal reattachment by a single operation. No serious complication related to surgery was experienced. CONCLUSIONS: Endoscopy-guided subretinal fluid drainage is the safe and effective procedure in PPV for RRD.