视网膜静脉阻塞与凝血因子XII的相关研究

目的通过观察视网膜静脉阻塞患者静脉血中凝血圈子XII（FXII）的活性，研究它与视网膜静脉阻塞（RVO）是否相关。方法以随机方式收集我院门诊眼科常规检查眼底正常的正常人25例（25只眼），RVO患者25例（25只眼），按RVO发病年龄分为450岁和〉50岁两组，根据RVO位置，将RVO病例组分为视网膜中央静脉阻塞（CRVO）、视网膜半侧静脉阻塞（HRVO）、视网膜分枝静脉阻塞（BRVO）三型。所有研究对象均在空腹抽取静脉血2．7ml，一期法测定FXII活性，常规测定凝血功能（APTT）。统计学方法采用Spssl3．0软件包，对两组资料采用（Fisher—test）检验与t检验。结果两组资料特征差异（年龄、性别）统计学上无显著性差异（P〉0．05）；试验组的FXII缺乏发生率虽然比对照组高，但两组比较统计学上差异无显著性（P=0．12），试验组的APTT低于对照组，两组比较统计学上差异有显著性（P=0．02）。结论本研究进一步证实了易栓危险因素（凝血因子XII）的缺乏与视网膜静脉阻塞的发生、发展之间存在内在的相关性。     

眼压和轴长在视网膜中央静脉阻塞中的意义

目的　探讨眼压和轴长在视网膜中央静脉阻塞中的意义。方法　应用TX- 10眼压计对4 6例(46只眼) CRVO患者的眼压进行测量。并使用A型超声仪对其中16例CRVO眼轴进行测量,对照组与病例组年龄和性别相配,例数相等。结果　36例CRVO阻塞眼眼压较对侧眼有不同程度降低。CRVO阻塞眼眼压显著低于对侧眼及正常对照眼(P <0 .0 1)。CRVO阻塞眼轴长显著短于对侧眼及正常对照眼(P <0 .0 1)。结论　CRVO可引起眼压降低,短眼轴是CRVO的危险因素。     

视网膜静脉阻塞荧光素眼底血管造影观察

目的观察视网膜静脉阻塞（RVO）的荧光素眼底血管造影（FFA）的图像特征,加深对RVO病变的认识,探讨FFA在RVO的应用。方法对我院自2006年1月至2009年12月经临床诊断为视网膜中央静脉阻塞（CRVO）和视网膜分支静脉阻塞（BRVO）患者298例（298只眼）的FFA检查结果进行回顾性分析。结果 RVO患者共298例（298只眼）。CRVO者97只眼,占32.55%;BRVO者201只眼,占67.45%。其中颞上分支静脉阻塞117只眼,占分支静脉阻塞的58.21%;半侧静脉阻塞12只眼,占5.97%。有视网膜新生血管形成32只眼,占10.74%;黄斑囊样水肿者104只眼,占35.14%;视网膜毛细血管无灌注区形成者139只眼,占46.64%。78.86%的病例发病年龄在50岁以上。结论 BRVO发病率高于CRVO;BRVO中以颞上分支静脉阻塞最常见;视网膜新生血管形成和黄斑囊样水肿是RVO的两个主要并发症。FFA对RVO的诊断、分类分型、指导治疗有重要的意义。     

视网膜静脉阻塞与血液中血小板相关参数及高密度脂蛋白胆固醇和低密度脂蛋白胆固醇水平之间的关系

目的　探讨视网膜静脉阻塞（retinal vein occlusion,RVO）与血液中血小板相关参数及高密度脂蛋白胆固醇（HDL-C)和低密度脂蛋白胆固醇（LDL-C)水平之间的关系。方法　选取我院2017年5月至2019年8月收治的113例113眼RVO患者作为研究对象。将研究对象中30例 30眼视网膜中央静脉阻塞(CRVO)患者作为CRVO组，将其余83例83眼视网膜分支静脉阻塞(BRVO)患者作为BRVO组。此外，将研究对象按年龄分为年轻组（≤50岁）和老年组（>50岁），分别为23例和90例；选取同期排除眼底病的患者112例112眼作为对照组。抽取各组患者空腹外周静脉血9 mL，采用Sysmex^@XN血液分析仪测定患者血液中血小板相关参数，包括:血小板计数(PLT）、血小板压积(PCT)、大型血小板比率（P-LCR)、血小板分布宽度（PDW)和血小板平均体积（MPV)等。采取终点法测量患者血液中HDL-C和LDL-C含量。结果　CRVO组、BRVO组及对照组患者血小板相关参数中PLT和PCT，差异均无统计学意义（均为P＞0.05）。BRVO组和CRVO组MPV均较对照组高，差异均有统计学意义(均为P<0.05)。CRVO组PDW较对照组高，差异有统计学意义（P<0.05）,但BRVO组与CRVO组和对照组比较，差异均无统计学意义（均为P＞0.05）。CRVO组和BRVO组P-LCR含量较对照组高，差异均有统计学意义（均为P<0.05）；BRVO组P-LCR与CRVO组比较，差异无统计学意义（P＞0.05）。BRVO组患者血液中HDL-C含量比对照组降低，差异有统计学意义（P<0.05），而CRVO组与对照组和BRVO组间差异均无统计学意义（均为P＞0.05）。三组间LDL-C含量比较，差异均无统计学意义（均为P＞0.05）。年轻组患者PLT较老年组高，差异有统计学意义（P<0.05）；年轻组和老年组患者PCT、MPV、PDW、P-LCR以及HDL-C、LDL-C含量比较，差异均无统计学意义（均为P＞0.05）。结论　人体血液中血小板相关参数及HDL-C水平与RVO的发病存在密切关系。     

视网膜静脉阻塞与凝血因子Ⅻ的相关研究

目的 通过观察视网膜静脉阻塞患者静脉血中凝血因子Ⅻ(FⅫ)的活性,研究它与视网膜静脉阻塞(RVO)是否相关.方法 以随机方式收集我院门诊眼科常规检查眼底正常的正常人25例(25只眼),RVO患者25例(25只眼),按RVO发病年龄分为≤50岁和>50岁两组,根据RVO位置,将RVO病例组分为视网膜中央静脉阻塞(CRVO)、视网膜半侧静脉阻塞(HRVO)、视网膜分枝静脉阻塞(BRVO)三型.所有研究对象均在空腹抽取静脉血2.7 ml,一期法测定FⅫ活性,常规测定凝血功能(APTT).统计学方法采用Spss13.0软件包,对两组资料采用(Fisher-test)检验与t检验.结果 两组资料特征差异(年龄、性别)统计学上无显著性差异(P>0.05);试验组的FⅫ缺乏发生率虽然比对照组高,但两组比较统计学上差异无显著性(P=0.12),试验组的APTT低于对照组,两组比较统计学上差异有显著性(P=0.02).结论 本研究进一步证实了易栓危险因素(凝血因子Ⅻ)的缺乏与视网膜静脉阻塞的发生、发展之间存在内在的相关性.     

轴长在视网膜分支静脉阻塞中的意义

目的评价眼轴长度（简称轴长）在视网膜分支静脉阻塞(branch retinal vein occlusion,BRVO)中的意义。方法34例BRVO和34例选自白内障摘除而年龄和性别相配的对照病例，做了轴长的对比研究，轴长应用A型超声测量。结果BRVO组患眼和对侧眼的轴长比较无统计学差异(P＞0.20)；BRVO组患眼轴长平均(23.16±0.82)mm，对照组眼的轴长平均(23.78±1.06)mm，两者差异无显著(P＞0.10)。结论作为远视眼依轴长测定结果并不是BRVO发病的一种危险因素。(中华眼底病杂志,1998,14:12-13)     

视网膜静脉阻塞的危险因素分析

目的 分析视网膜中央静脉阻塞(central retinal vein occlusion,CRVO)和视网膜分支静脉阻塞(branch retinal vein occlusion,BRVO)的危险因素;并对CRVO和BRVO危险因素进行直接比较.方法 对46例CRVO(CRVO组)、33例BRVO(BRVO组)与79例老年性白内障或屈光不正患者(对照组)行危险因素和血脂谱分析,并对比观察.结果 多元线性回归分析结果显示:高同型半胱氨酸血症(P＜0.000 1)、高总胆固醇(P=0.003 0)、高脂蛋白a(P =0.027 0)、高血压(P =0.022 0)、短眼轴(P ＜0.000 1)与CRVO显著相关;而高同型半胱氨酸血症(P＜0.0001)、高总胆固醇(P =0.008 0)、高血压(P=0.002 0)、高体质量指数(P=0.004 0)、短眼轴(P=0.001 0)与BRVO相关.一元线性回归分析示CRVO和BRVO上述危险因素比较没有明显差别.结论 CRVO、BRVO危险因素包括系统(高血脂、高血压、高同型半胱氨酸)和眼部(短眼轴)的多种因素,但是这些危险因素在CRVO和BRVO之间没有显著差异.     

单眼视网膜静脉阻塞患者对侧眼黄斑区血流密度和中心凹无血管区面积观察

目的:观察单眼视网膜静脉阻塞(RVO)患者对侧眼黄斑区血流密度和黄斑中心凹无血管区(FAZ)面积。方法:回顾性病例对照研究。2018年5~11月在长沙爱尔眼科医院临床确诊为单眼RVO的78例患者78只对侧眼纳入研究。其中,男性44例,女性34例;平均年龄(53.17±10.12)岁。视网膜中央静脉阻塞(CRVO)42例(CRVO组),视网膜分支静脉阻塞(BRVO)36例(BRVO组)。选取年龄和性别与RVO患者相匹配的33名正常健康者42只眼作为对照组。其中,男性17例22只眼,女性16例20只眼;平均年龄(53.48±10.84)岁。3组受检眼均行OCT血管成像检查,以仪器自带软件自动识别以黄斑中心凹为中心的直径6 mm区域及FAZ,自动测量黄斑区浅层和深层血流密度及FAZ面积。对比分析3组受检眼黄斑区浅层、深层血流密度和FAZ面积。结果:与对照组比较,CRVO组(t=-4.26、-4.93)、BRVO组(t=-4.79、-4.74)受检眼黄斑区浅层及深层血流密度均降低,差异均有统计学意义(P<0.05)。CRVO组、BRVO组受检眼黄斑区浅层及深层血流密度降低幅度分别为4.13%、5.51%及3.50%、4.58%,深层血流密度的降低幅度较浅层更大。CRVO组受检眼FAZ面积较对照组减小,差异有统计学意义(t=-3.43,P<0.05)。BRVO组与对照组受检眼FAZ面积比较,差异无统计学意义(t=-0.10,P>0.05)。结论:单眼RVO患者对侧眼黄斑区血流密度较正常健康眼降低,黄斑区深层血流密度的降低幅度较浅层更大。与正常健康眼比较,单眼CRVO患者对侧眼FAZ面积减小,单眼BRVO患者对侧眼FAZ面积无明显变化。     

视网膜静脉阻塞激光光凝的时机选择

目的：观察激光光凝治疗不同病程的视网膜静脉阻塞(retinal vein occlusion,RVO)的临床疗效,探讨RVO激光光凝治疗的时机,为临床选择RVO光凝治疗时机提供依据。

方法：回顾性分析视网膜激光光凝治疗的RVO患者103例103眼,按发病时间将患者分为3组, A组46眼,病程≤1mo,其中视网膜分支静脉阻塞(branch retinal vein occlusion,BRVO)28眼,视网膜中央静脉阻塞(central retinal vein occlusion,CRVO)18眼; 缺血型RVO 30眼,非缺血型RVO 16眼。B组38眼,1mo<病程<3mo,其中BRVO 22眼,CRVO 16眼; 缺血型RVO 26眼,非缺血型RVO 12眼。C组19眼,病程≥3mo,其中BRVO 7眼,CRVO 12眼; 缺血型RVO 15眼,非缺血型RVO 4眼。随访3mo,观察光凝治疗后各组患者的视力变化差异、视网膜出血、眼部新生血管、黄斑中心凹厚度下降值。

结果：不同病程RVO光凝治疗后患者的最佳矫正视力提高率,视网膜出血、黄斑水肿吸收情况,黄斑中心凹厚度降低量,早期组优于晚期组,非缺血型RVO优于缺血型RVO,激光光凝治疗效果BRVO优于CRVO且差异具有统计学意义(P<0.05)。

结论：RVO早期激光光凝干预治疗,可以加速视网膜出血、黄斑水肿吸收,有效保护患者现有视力、促进远期视力提高,具有一定临床实用意义。     

量化OCTA在视网膜静脉阻塞中的应用

目的:应用光学相干断层扫描血管成像技术(OCTA)测量视网膜静脉阻塞(RVO)患者黄斑区血流密度、黄斑中心凹无血管区(FAZ)面积和黄斑中心凹视网膜厚度。方法:选取RVO患者30例30眼,视网膜中央静脉阻塞(CRVO)和视网膜分支静脉阻塞(BRVO)患者各15例,双眼接受OCTA检查,获取黄斑中心3mm×3mm大小范围的血流密度、FAZ面积、黄斑中心凹视网膜厚度,以及双眼最佳矫正视力(BCVA)。比较患眼与健眼上述指标的变化及其与BCVA的相关性。结果:CRVO患者患眼黄斑区视网膜浅层毛细血管网(SVN)、深层毛细血管网(DVN)总血流密度较健眼降低[SVN:(43.07±4.95)%vs(50.09±2.86)%,DVN:(45.89±4.12)%vs(53.29±2.62)%,均P<0.01],与BCVA呈负相关(r_s=-0.6、-0.5,均P<0.05)。BRVO患者患眼SVN、DVN总血流密度较健眼降低[SVN:(45.62±3.04)%vs(52.10±2.98%),DVN:(49.21±3.80)%vs(55.52±3.33%),均P<0.01],与BCVA呈负相关(r_s=-0.5、-0.5,均P<0.05)。BRVO患眼病变区域与患眼未病变区域、健眼对应区域比较,SVN、DVN血流密度均下降(均P<0.01);患眼未病变区域DVN血流密度较健眼相应区域下降[(56.86±1.95)%vs(58.15±2.24)%,P=0.02];患眼病变区域DVN血流密度与BCVA呈负相关(r_s=-0.6,P=0.01)。CRVO、BRVO患眼SVN的FAZ面积较健眼明显扩大(CRVO:0.515±0.26mm²vs 0.27±0.08mm²,P<0.01;BRVO:0.376±0.12mm²vs 0.261±0.07mm²,P<0.01),且均与BCVA呈正相关(CRVO:r_s=0.6,P=0.01;BRVO:r_s=0.5,P=0.01)。CRVO、BRVO患眼黄斑中心凹视网膜厚度均较健眼增加(CRVO:431.2±191.3μm vs 235.5±18.2μm,P<0.01;BRVO:373.2±188.7μm vs 233.8±13.7μm,P=0.01),均与BCVA呈正相关(CRVO:r_s=0.9,P=0.01;BRVO:r_s=0.6,P=0.01)。结论:OCTA可作为测量RVO患者黄斑区血流密度、FAZ面积及黄斑中心凹视网膜厚度的有效工具。     

眼压在视网膜静脉阻塞中的意义

目的:探讨眼压在视网膜静脉阻塞中的意义。方法:应用TX-F眼压计对23例23眼,视网膜静脉阻塞(retinal vein occlusion,RVO)患者的眼压进行测量。对照组与病例组年龄和性别相配,例数相等。结果:18例RVO阻塞眼眼压较对侧眼有不同程度降低。RVO阻塞眼眼压显著低于对侧眼及正常对照眼(P<0.01)。结论:RVO可引起患者眼压降低。     

Central corneal thickness in congenital glaucoma

PURPOSE: The aim of this study was to compare central corneal thickness between eyes with congenital glaucoma and normal fellow eyes in unilateral glaucoma or less affected fellow eyes in bilateral glaucoma. METHODS: Eyes of consecutive phakic children with congenital glaucoma and previous glaucoma surgery were examined under chloral hydrate. Complete ophthalmologic examination, central corneal thickness (CCT), axial length, and corneal diameter measurements were performed. Patients were included in the study if presented with intraocular pressure (IOP) less than 21 mm Hg and no biomicroscopic signs of corneal edema. RESULTS: Nine patients were included in the study. The mean CCT in the more affected eye/glaucomatous eye was 522.3 +/- 65.2 microm and in the less affected eye/healthy eye was 579.7 +/- 44.5 microm. This difference was statistically significant (P = 0.0013). CONCLUSION: CCT was significantly thinner in glaucomatous eyes than in normal fellow eyes in phakic children with congenital glaucoma. This finding may be another confounding factor when measuring IOP in these patients.     

单眼视网膜静脉阻塞患者对侧眼黄斑功能的多焦视网膜电图检测

目的 观察单眼视网膜静脉阻塞(RVO)患者对侧眼黄斑功能的变化.方法 对比分析24例经荧光素眼底血管造影(FFA)确诊为单眼RVO患者的24只对侧眼及18位正常受试者18只正常眼的多焦视网膜电图(mfERG)检测结果,比较两组受试者黄斑功能的差异.采用罗兰RETIsean电生理仪记录mfERG,将记录图形分别按照6个同心圆和4个象限对P1、N1波的振幅密度及潜伏期进行比较和分析.结果 RVO患者对侧眼在中心第1、2环处P1、N1波的振幅密度显著低于正常眼,差异有统计学意义(t=4.520,2.147;P＜0.05);其它各环、各象限振幅密度及潜伏期在两组间均未见明显差异(P＞0.05).结论 与正常眼相比,RVO患者对侧眼黄斑中心凹视功能受损.     

Tono-Pen versus Goldmann tonometry after excimer laser photorefractive keratectomy

PURPOSE: To compare intraocular pressure (IOP) measurements by the Tono-Pen 2 tonometer and Goldmann applanation tonometer (GAT) in post-photorefractive keratectomy (PRK) patients. SETTING: Refractive Surgery Center, Assaf Harofeh Medical Center, Zerifin, Israel. METHODS: In 18 patients, IOP was measured by GAT and then by Tono-Pen 2 tonometer 2 to 18 months following PRK (mean 6.6 months +/- 5.1 [SD]). Photorefractive keratectomy had been performed in 1 eye of each patient; the fellow eyes served as controls. Corneal curvature and thickness were evaluated. Ten of the 18 patients were treated with topical steroids. RESULTS: In the post-PRK eyes, mean GAT IOP was 1.8 +/- 3.1 mm Hg lower than mean Tono-Pen IOP (P = .012); there was no significant IOP difference in the control (fellow) eyes. In steroid-treated post-PRK eyes, mean GAT IOP (12.2 mm Hg) was 2.2 +/- 1.3 mm Hg lower than mean Tono-Pen IOP (14.4 mm Hg) (P = .0007). Mean Tono-Pen IOP in steroid-treated post-PRK eyes was 4.3 +/- 3 mm Hg higher than in the fellow eyes (P = .0014); mean GAT IOP was only 2.3 +/- 3.5 mm Hg higher (P = .04). In post-PRK eyes without topical steroid treatment, mean GAT IOP was 2.0 +/- 1.18 mm Hg lower than in the fellow eyes (P = .001); there was no significant difference in Tono-Pen IOP. There was a negative correlation between the difference in IOP values (Tono-Pen minus GAT) and corneal curvature in post-PRK eyes (r = 0.76, P = .0108, n = 15). CONCLUSIONS: The Tono-Pen tonometer appeared to be less affected than the GAT by the relative flattening, thinning, and anterior stromal decreased rigidity of the central cornea that occur following PRK. Post-PRK steroid-induced IOP elevation may be masked by the artifactual decrease in GAT IOP.     

Comparison between Glaucomatous and Non-glaucomatous Eyes with Unilateral Retinal Vein Occlusion in the Fellow Eye

Purpose

To evaluate and compare the clinical and angiographic characteristics of retinal vein occlusion (RVO) in glaucomatous and non-glaucomatous eyes with unilateral RVO in the fellow eye.

Methods

Twenty-one glaucomatous eyes (GL group) and 25 age-matched non-glaucomatous eyes (non-GL group) with unilateral RVO in the fellow eye were included in this study. Fluorescein angiographic images were assessed in both groups by 3 retina specialists in order to determine the RVO occlusion site. The occlusion site was divided into 2 types: arteriovenous (AV)-crossing and non-AV-crossing (optic cup or optic nerve sited). The clinical characteristics and prevalence of AV-crossing and non-AV-crossing RVO were compared between the 2 groups.

Results

The mean baseline intraocular pressures of the RVO eye and the fellow eye did not differ between the 2 groups (RVO eye: 14.3 ± 2.5 mmHg [non-GL group], 15.5 ± 3.9 mmHg [GL group], p = 0.217; fellow eye: 14.4 ± 2.5 mmHg [non-GL group], 15.7 ± 3.7 mmHg [GL group], p = 0.148). The prevalence of systemic disease did not differ between the 2 groups (e.g., diabetes mellitus and hypertension, p = 0.802 and 0.873, respectively). AV-crossing RVO was significantly more frequent in the non-GL group (19 eyes; 76%) than in the GL group (4 eyes, 19%, p < 0.001).

Conclusions

Non-AV-crossing RVO, i.e., optic cup- or optic nerve-sited RVO, is more frequently associated with glaucomatous changes in the fellow eye. Therefore, this type of RVO should be monitored more carefully for indications of glaucoma in the fellow eye.     

Acute primary angle closure in an Asian population: long-term outcome of the fellow eye after prophylactic laser peripheral iridotomy

PURPOSE: To study the long-term outcome of fellow eyes of Asian patients with acute primary angle closure (APAC) who underwent prophylactic laser peripheral iridotomy (LPI). DESIGN: Retrospective, noncomparative, interventional case series. PARTICIPANTS: Ninety-six consecutive patients with APAC at presentation to one Singapore hospital from January 1990 through December 1994. METHODS: The presenting features of the fellow eye were recorded, and the subsequent long-term intraocular pressure (IOP) outcome after LPI was analyzed. All fellow eyes were initially treated with pilocarpine 2% eyedrops four times daily before LPI, which was performed within 1 week of presentation. For any eye, a rise in IOP during follow-up was defined as a rise in IOP requiring treatment by medication or surgery. MAIN OUTCOME MEASURES: Incidence of acute angle closure and IOP. RESULTS: The mean follow-up period was 50.8 months (range, 9-99 months). Of the 96 patients, 15 patients had bilateral APAC, and APAC developed in one fellow eye before LPI could be performed. The remaining 80 fellow eyes were studied. No cases of APAC developed after prophylactic LPI. Seventy-one fellow eyes (88.8%) were successfully treated with LPI alone without the need for additional glaucoma treatment in the long term. Seven eyes (8.8%) had IOPs of 21 mmHg or less on presentation, but a rise in IOP developed on follow-up despite the presence of a patent LPI. Two fellow eyes (2.5%) had signs of preexisting chronic angle closure glaucoma at presentation and required further glaucoma treatment even after LPI. There were no significant complications from the procedure in any of the fellow eyes studied. CONCLUSIONS: In this Asian population with APAC, prophylactic LPI is safe and effective in preventing acute angle closure in fellow eyes. In addition, prophylactic LPI prevents long-term rise in IOP in 88.8% of fellow eyes (with approximately 4 years of follow-up). However, because a small proportion of fellow eyes did experience a rise in IOP within the first year, despite the presence of a patent LPI, close monitoring is still advised in the follow-up of fellow eyes of patients with APAC.     

The role of axial length in central and branch retinal vein occlusion

BACKGROUND AND OBJECTIVE: To assess whether the axial length is a local risk factor in central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO). PATIENTS AND METHODS: The axial lengths of affected and fellow eyes of 19 patients with CRVO and 27 with BRVO and of their controls were measured with A-scan ultrasonography. The control group consisted of 17 individuals for CRVO and 25 for BRVO matched in age, sex and the prevalence of hypertension and diabetes in patient groups. The results of measurements in affected, unaffected and control eyes were compared. RESULTS: The mean axial length was different among the affected and unaffected eyes in patients with CRVO and their controls (P < .05). The affected eyes had significantly shorter axial length compared to the fellow and control eyes (P < .01 and P < .01, respectively). In the BRVO group, the mean axial length did not differ among affected, unaffected and control eyes (P > .05). CONCLUSIONS: Our study demonstrates a significantly shorter axial length in eyes with CRVO and not significantly shorter axial length in those with BRVO. The shorter axial length could be an additional risk factor in the pathogenesis of CRVO.     

视网膜电图明视负向反应在视网膜静脉阻塞中的变化

目的 观察视网膜静脉阻塞(RVO)患者视网膜电图(ERG)明视负向反应(PhNR)的变化特点.方法 对间接检眼镜、荧光素眼底血管造影(FFA)检查确诊的RVO患者30例30只患眼以及对侧健康眼进行视力、视野、闪光ERG(FERG)检查,同时选取与其性别、年龄相匹配的正常人25例50只眼作为正常组进行FERG检查.所有检查均按常规方法进行.RVO患者中,视网膜中央静脉阻塞(CRVO)患者14例14只眼、视网膜分支静脉阻塞(BRVO)患者16例16只眼.根据其病史及FFA检查结果,将其按病程时间划分为小于1个月、1～3个月、大于3个月组;另外再根据RVO分型标准及具体检查结果,将RVO患者分为缺血型和非缺血型.对比分析RVO患眼与对侧健康眼以及正常眼PhNR振幅变化及ERG其他参数指标,包括振荡电位(Ops),视锥细胞反应(Cone-a、Cone-b),视杆细胞反应(Rod-b),暗适应眼的最大反应(Max-a、Max-b),30 Hz闪烁光反应(30 Hz)的差异以及PhNR振幅变化与RVO疾病缺血类型、病程的关系.结果 PhNR振幅在CRVO患眼为(28.20±5.80)μV,BRVO患眼为(36.96±4.71)μV,对侧健眼为(61.25±3.93)μV,正常眼为(59.33±16.92)μV.CRVO组与对侧健眼、正常组比较,差异有统计学意义(F=10.69,9.80;P＜0.001),BRVO组与对侧健眼、正常组比较,差异有统计学意义(F=9.69,9.75;P＜0.001).CRVO组中缺血型PhNR值为(22.77±5.73)μV,非缺血型为(36.63±12.91)μV,二者差异有统计学意义(t=6.54,P＜0.01);BRVO组缺血型PhNR值为(32.39±13.22)μV,非缺血型为(46.73±10.43)μV,二者差异无统计学意义(t=2.12,P＜0.05);病程小于1个月组CRVO与BRVO分别为(24.58±4.60)、(27.94±15.73)μV,1～3个月组分别为(50.39±13.80)、(58.69±12.43)μV,大于3个月组为(25.40±19.94)、(34.48±16.72)μV,CRVO中1～3个月组与大于3个月组差异有统计学意义(F=4.30,P＜0.01).结论 RVO患眼的PhNR振幅较对侧健康眼以及正常对照眼明显降低,缺血型较非缺血型降低,随病程变化呈现下降、上升、下降的变化趋势.     

The effect of trabeculectomy on the intraocular pressure of the unoperated fellow eye

PURPOSE: To investigate the intraocular pressure (IOP) changes in the unoperated fellow eye in patients who underwent trabeculectomy. MATERIALS AND METHODS: IOP changes in the unoperated fellow eyes of 107 patients who underwent trabeculectomy in 1 eye for high-tension glaucoma (48 primary open-angle glaucoma, 43 pseudoexfoliative glaucoma, and 16 narrow-angle glaucoma) were evaluated during the early postoperative period. All IOP measurements were recorded during the postoperative first 3 months and compared with preoperative values. RESULTS: Mean preoperative IOP levels were 37.0 +/- 10.0 mm Hg in the operated eyes and 15.1 +/- 3.1 mm Hg in the fellow eyes. Mean IOPs in the unoperated eyes on the postoperative first-day, first- and second-week, and first- and third-month visits (17.1 +/- 5.7, 17.5 +/- 5.1, 18.5 +/- 5.4, 18.6 +/- 5.1, and 19.0 +/- 5.9 mm Hg, respectively) were significantly different compared with the preoperative levels for each period of time (P < 0.01). Eight fellow eyes underwent operations for uncontrolled glaucoma before month 3. Among the remaining 99 eyes, higher postoperative IOP values were measured in 33 (33%) eyes at all postoperative visits compared with the preoperative IOP levels. A consistent IOP rise equal to or higher than 5 mm Hg was detected in 12 eyes (12%) and a consistent IOP elevation of 30% or more was found in 14 eyes (14%) during the postoperative first 3 months. Contralateral IOP elevation was not correlated with patient age, type of glaucoma, or preoperative antiglaucomatous medications prescribed to the operated or fellow eyes. CONCLUSION: After filtration surgery, IOP of the unoperated fellow eye should also be monitored closely in order not to overlook a possible insidious rise, especially in glaucomatous eyes that were previously under good medical control.