卵磷脂络合碘治疗中心性浆液性脉络膜视网膜病变

目的　观察卵磷脂络合碘治疗中心性浆液性脉络膜视网膜病变的疗效。方法　 4 2例经临床及荧光素血管造影 (FFA)确诊为中心性浆液性脉络膜视网膜病变患者随机分为两组 ,治疗组 2 3例 ,用卵磷脂络合碘 ,1 5mg/次 ,3次 /d ,共 2个月 ;对照组 19例 ,用肌苷片 ,2 0 0mg/次 ,3次 /d ,共 2个月。观察治疗前后视力、眼底变化、视野及FFA改变。结果　 1例淘汰。有效率治疗组 90 9% ,对照组 36 8% (P <0 0 1)。结论　卵磷脂络合碘对中心性浆液性脉络膜视网膜病变有明显疗效。     

532nm绿激光治疗中心性浆液性脉络膜视网膜病变疗效观察

目的观察以532nm绿激光眼底光凝治疗为主,辅以营养神经中西药物治疗中心性浆液性脉络膜视网膜病变(central serous chorioretinopathy,CSC)的治疗效果。方法2000年1月～2005年12月末在我院眼科门诊及住院治疗,采用532nm绿激光眼底光凝治疗为主的综合治疗CSC204例(209眼)为激光组,仅采用药物治疗的CSC47例(48眼)为对照组;治疗后观察眼底情况和视力变化。随访时间≥3月。结果激光组治疗后1月和3月时临床治愈分别为172眼(81.3%)和198眼(94.7%);对照组治疗1月和3月时临床治愈分别为12眼(25%)和30眼(62.5%)。激光组在治疗后1个月(χ2=63.01,P<0.001)和3个月时(χ2=40.52,P<0.001)的疗效明显优于对照组。激光组治疗后1月和3月时平均视力分别为0.9±0.33和0.97±0.13,均较治疗前平均视力0.57±0.3有明显提高(u=10.7,P<0.01和u=16.3,P<0.01);对照组治疗1月和3月时平均视力分别为0.70±0.28和0.82±0.23,也均较治疗前平均视力0.55±0.32有明显提高(u=2.44,P<0.05和u=4.75,P<0.01),但治疗后1月和3月时激光组的平均视力明显高于对照组(u=4.31,P<0.01和u=4.36,P<0.01)。激光组眼底光凝治疗后2周时155眼黄斑区水肿消退(74.1%),治疗后4周时192眼黄斑区水肿消退(91.9%);7眼进行了补充光凝;随访3～18个月,眼底检查未提示复发。对照组在治疗后6～9月复发10例(20.8%)。结论眼底激光光凝术治疗CSC操作简便且疗效确切,少有复发,疗效明显优于单纯药物治疗组。波长为532nm的绿激光在屈光间质透过率高,易被视网膜色素上皮吸收,而被黄斑部叶黄素吸收少,在眼内和视网膜内散射更低,所以该波长激光也常被用来治疗视网膜裂孔,较其他波长的眼底激光治疗器更为高效、安全。     

中心性浆液性脉络膜视网膜病变129例荧光素眼底血管造影分析

目的 分析中心性浆液性脉络膜视网膜病变(CSC)的临床特征和荧光素眼底血管造影(FFA)的检查结果.方法 回顾性分析129例(132只眼)CSC患者的视力,男女发病比例,FFA的表现及病变分型.结果 CSC患者中男性比女性患病率高(8.21∶1),根据FFA检查结果表现可将眼底荧光渗漏分为7种类型,患者视力与渗漏点位置及浆液性视网膜脱离范围相关.结论 FFA检查可明确诊断CSC,清晰显示病变类型,并且可以指导治疗、判断预后.     

卵磷脂络合碘治疗中心性浆液性脉络膜视网膜病变的临床疗效观察

目的：比较卵磷脂络合碘与传统方法治疗中心性浆液性脉络膜视网膜病变的临床疗效。方法：将80例中心性浆液性脉络膜视网膜病变患者随机分为两组,各40例。对照组给予常规治疗,肌苷400mg／次,3次／d;维生素B1 10mg／L次,3次／d;复方丹参滴丸9粒／次,3次／d。治疗组在常规治疗基础上,加用卵磷脂络合碘片1．5mg／次,3次／d。两组均治疗2个月观察治疗前后视力和眼底变化及视野和FFA改变。结果：对照组和治疗组总有效率分别为52．5％和72．5％（P〈0．05）。结论：卵磷脂络合碘是治疗中心性浆液性脉膜视网膜病变的有效药物。     

中药合并激光治疗中心性浆液性脉络膜视网膜病变疗效观察

目的探讨中药合并激光治疗中心性浆液性脉络膜视网膜病变疗效。方法选取32例中心性浆液性脉络膜视网膜病变患者,随机分为治疗组和对照组两组,每组16例,对照组采用激光,治疗组采用激光联合中药治疗,观察疗效,比较视力变化及复发率。结果治疗组与对照组比较,治疗后2周视力显著升高,两组比较,差异有统计学意义(P<0.05);治疗组患者自觉症状轻者,显著增多,自觉症状中、重者显著减少,两组比较,差异有统计学意义(P<0.05);痊愈率显著升高,好转率、复发率显著下降,两组比较,差异有统计学意义(P<0.05)。结论中药合并激光治疗中心性浆液性脉络膜视网膜病变,能够快速减轻症状,提高视力,减少复发,起到良好临床效果。     

中心性浆液性脉络膜视网膜病变患者应用高压氧联合卵磷脂络合碘治疗的研究

目的分析中心性浆液性脉络膜视网膜病变(CSC)患者应用高压氧联合卵磷脂络合碘治疗的临床疗效及安全性。方法随机选取2012年12月~2013年12月本院诊治的98例(108眼)中心性浆液性脉络膜视网膜病变患者,按照随机双盲法分为两组,对照组49例予以高压氧治疗,研究组49例在对照组基础上联合卵磷脂络合碘治疗,分析两组患者视力恢复及不良反应情况。结果两组患者治疗后视力均明显恢复,且研究组患者的视力明显优于对照组,比较差异均具有统计学意义(P<0.05),研究组治疗后复发情况明显少于对照组,比较差异具有统计学意义(P<0.05);同时,两组患者的不良反应情况比较差异不明显,且均经临床对症治疗后缓解。结论应用高压氧联合卵磷脂络合碘治疗中心性浆液性脉络膜视网膜病变的临床疗效显著,且用药过程安全可靠。     

Morphologic changes and visual outcomes in resolved central serous chorioretinopathy treated with ranibizumab

Context: Central serous chorioretinopathy (CSC).

Objective: To evaluate the effect of intravitreal ranibizumab injection and the correlation between foveal morphologic changes and visual outcomes in patients with resolved CSC.

Materials and methods: We measured outer nuclear layer (ONL) thickness, outer layer (OL) thickness and evaluated the integrity of the photoreceptor inner-outer segment (IS/OS) junction, the status of the external limiting membrane (ELM) at the central fovea using spectral-domain optical coherence tomography (OCT) in 35 eyes of 35 patients with resolved CSC. The eyes were divided into two groups: The initial medical treatment administered to Group1 (n?=?17) then received intravitreal ranibizumab injections, Group 2 (n?=?18) received medical treatment. Group 3 was composed of normal eyes (n?=?20, as a control). We also investigated a correlation between the ONL thickness and best corrected visual acuity (BCVA).

Results: The mean age was 45.7?±?7.2 (ranged from 27 to 55 years). The mean follow-up period was 14.2 months (minimum 6, maximum 24 months). The mean ONL and OL thickness in Group 1 were significantly thinner than Group 3 (p?r?=?0.681, p?=?0.001). Thirty-tree patients had improvement in BCVA after treatment. Discontinuity of the IS/OS junction was found in 15 eyes (88.2%) in Group 1, in 5 eyes (27.7%) in Group 2 and in no eyes in Group 3.

Discussion: We demonstrated that prolonged serous detachment results in photoreceptor cell loss (apoptosis) and thinning of the ONL. Thinning of the ONL correlates with poorer vision, which has been found by other investigators. Furthermore, vascular endothelial growth factor (VEGF) may be neuroprotective to the photoreceptors which might explain the additional thinning in the patients treated with ranibizumab. This raises the possibility that treatment with VEGF inhibitors may be unfavourable to patients with CSC, even though it speeds recovery and vision does improve.

Conclusion: Intravitreal ranibizumab injection leads to thinning of the ONL and the OL in patients with resolved CSC. The ONL thickness reduction and discontinuity of the IS/OS junction results in poor visual prognosis in resolved CSC eyes.     

迈之灵片联合卵磷脂络合碘片治疗中心性浆液性脉络膜视网膜病变的疗效观察

目的探讨迈之灵片联合卵磷脂络合碘片治疗中心性浆液性脉络膜视网膜病变的临床疗效。方法选取2013年1月—2016年1月在咸阳市第一人民医院接受治疗的中心性浆液性脉络膜视网膜病变患者78例为研究对象,按照治疗方法的差别分成对照组和治疗组,每组各39例。对照组口服卵磷脂络合碘片,1片/次,3次/d。治疗组在对照组基础上口服迈之灵片,2片/次,3次/d。两组患者均治疗2个月。观察两组的临床疗效,比较两组患者的视力情况。结果治疗后,对照组和治疗组的总有效率分别为79.49%、94.87%,两组比较差异有统计学意义(P0.05)。治疗后,两组患者的视力情况均明显提高,同组治疗前后差异有统计学意义(P0.05);且治疗组这些观察指标的改善程度明显优于对照组,两组比较差异具有统计学意义(P0.05)。结论迈之灵片联合卵磷脂络合碘片治疗中心性浆液性脉络膜视网膜病变具有较好的临床疗效,能改善视力,具有一定的临床推广应用价值。     

迈之灵治疗中心性浆液性脉络膜视网膜病变

目的:探讨迈之灵治疗中心性浆液性脉络膜视网膜病变(CSC)的临床效果及光学相干断层成像(OCT)的运用价值。方法:33例(36眼)临床诊断为CSC的病人随机分为2组,芦丁组15例(15眼),迈之灵组18例(21眼),分别给予迈之灵和复方芦丁片口服,2片,每日3次,均4wk为一个疗程,随访12wk。比较2组在治疗前后logMAR对数视力变化,并通过OCT检查,比较治疗前后视网膜神经上皮和(或)色素上皮脱离程度的变化。结果:治疗wk2,迈之灵组视力改善优于芦丁组,差异有显著意义(P<0.05);治疗wk4和wk12,2组无显著差异(P>0.05)。治疗wk2和wk4,迈之灵组视网膜脱离面积减小(116347±s88445)和(171104±120636)μm2,减小幅度大于芦丁组(53858±46561)和(85486±114607)μm2,差异有显著意义(P<0.05),治疗wk12时2组间无显著差异(P>0.05)。2组均无不良反应。结论:迈之灵治疗CSC,可缩短病人主观视力改善及黄斑部水肿消退的时间。OCT能客观、定量地进行黄斑部微结构的测量和分析,对CSC治疗效果的评价有一定价值。     

急性中心性浆液性脉络膜视网膜病变的诊治分析

目的：探讨支持营养疗法治疗急性中心性浆液性脉络膜视网膜病变（CSC）的临床效果。方法选取在本院就诊的急性CSC患者69例作为研究对象,根据是否治疗分为试验组和对照组,试验组36例（36眼）给予支持营养疗法,对照组33例（33眼）未做任何治疗,分析和比较两组的恢复情况。结果试验组治疗后1个月的视力与对照组比较,差异有统计学意义（P〈0.05）;治疗1周、3个月的视力与对照组比较,差异无统计学意义（P〉0.05）。试验组治疗后1周、1个月视网膜厚度比对照组薄,差异有统计学意义（P〈0.05）。结论支持营养疗法应用于急性CSC患者,可以促进其早期病情的恢复,提高其生活质量。     

中心性浆液性脉络膜视网膜病变的三维光学相干断层扫描的临床分析

中心性浆液性脉络膜视网膜病变(central serous chorioretinopathy,CSC)属于一种常见的脉络膜、视网膜病变,其病因不明,多发于20～50岁的中青年,单眼或双眼均可发病,男性较女性多见。CSC是一种易复发的自限性疾病,多次反复发作可导致视觉功能的下降。传统的荧光血管造影(fundus fluorescein angiography,FFA)虽能确诊本病,但为创伤性检查,可重复性差,并有可能出现严重过敏现象,在临床应用中受到一定限制,而三维光学相干断层扫描(3D-optical     

弥可保治疗中心性浆液性脉络膜视网膜病变的临床观察

目的 评价弥可保治疗中心性浆液性脉络膜视网膜病变(central serous chorioretinopathy,CSC)的疗效.方法 经临床检查和眼底血管荧光造影诊断为CSC的患者86例(86眼),分为弥可保治疗组和对照组各43例(43眼),并对治疗前后的眼底、视力及眼底血管荧光造影等进行比较.结果 弥可保治疗组总有效率为55.9%,视力提高率69.8%,血管造影荧光素渗漏消失率53.5%;对照组分别为23.3%、30.2%和25.6%.两者差异有统计学意义(P＜0.05).结论 弥可保治疗CSC可快速修复其视网膜外层组织.     

Usefulness of optical coherence tomography to detect central serous chorioretinopathy in monkeys

Many systemic drugs can induce ocular toxicity and several ocular side‐effects have been identified in clinical studies. However, it is difficult to detect ocular toxicity in preclinical studies because of the lack of appropriate evaluation methods. Optical coherence tomography (OCT) is useful because it can provide real‐time images throughout a study period, whereas histopathology only provides images of sacrificed animals. Using OCT alongside histopathology, attempts were made to find effective approaches for screening of drug‐induced ocular toxicity in monkeys. Such approaches could be used in preclinical studies prior to human trials. Six male cynomolgus monkeys (Macaca fascicularis Raffles) were orally administered one of six candidate MAPK/ERK kinase (MEK) inhibitors. Central serous chorioretinopathy, a known side‐effect of such inhibitors, was identified in four monkeys by OCT. Artifacts generated during tissue processing meant that histopathology could not detect edematous changes. Thus, OCT is a useful tool to detect ocular toxicity which cannot be detected by histopathology in preclinical studies. Copyright © 2014 John Wiley & Sons, Ltd.     

曲克芦丁联合卵磷脂络合碘治疗中心性浆液性脉络膜视网膜病变的疗效观察

目的 探讨曲克芦丁片联合卵磷脂络合碘片治疗中心性浆液性脉络膜视网膜病变的临床疗效.方法 选择2018年12月—2019年12月在南阳市眼科医院治疗的60例中心性浆液性脉络膜视网膜病变患者,随机分组法分成对照组和治疗组,每组各30例.对照组口服卵磷脂络合碘片,3 mg/次,3次/d;治疗组在对照组基础上给予口服曲克芦丁片...     

甲钴胺联合卵磷脂络合碘治疗中心性浆液性脉络膜视网膜病变的疗效观察

目的 探讨甲钴胺联合卵磷脂络合碘治疗中心性浆液性脉络膜视网膜病变的临床疗效。方法 选取2019年5月—2022年5月在中国人民解放军海军军医大学第一附属医院治疗的120例中心性浆液性脉络膜视网膜病变患者。随机分对照组和治疗组,每组各60例。对照组口服卵磷脂络合碘片,2片/次,3次/d。在对照组的基础上,治疗组口服甲钴胺片,0.5 mg/次,3次/d。两组用药7周。观察两组患者临床疗效,比较治疗前后两组患者症状缓解时间,视力改善情况,血清全血黏度（WBV）、血浆黏度（PV）、黄斑中心凹厚度（CMT）和视网膜下积液（SRF）指标水平及不良反应。结果 治疗后,治疗组临床总有效率（98.33%）明显高于对照组（83.33%,P＜0.05）。治疗后,治疗组症状缓解时间均明显早于对照组（P＜0.05）。治疗后,两组患者标准对数视力表值比治疗前明显升高（P＜0.05）,且治疗组的视力改善情况明显高于对照组（P＜0.05）。治疗后,两组患者WBV、PV、CMT、SRF指标均明显下降（P＜0.05）,且治疗组患者的指标水平明显低于对照组（P＜0.05）。治疗组不良反应发生率（6.67%）明显低于对照组（15.06%,P＜0.05）。结论 甲钴胺联合卵磷脂络合碘治疗中心性浆液性脉络膜视网膜病变效果确切,可改善眼底血液微循环,纠正眼底状态,有效提高患者视力。     

复方樟柳碱联合卵磷脂络合碘片对中心性浆液性脉络膜视网膜病变的临床观察

目的 探讨复方樟柳碱联合卵磷脂络合碘片对中心性浆液性脉络膜视网膜病变的疗效。方法 选取60例中心性浆液性脉络膜视网膜病变患者,按随机数字表法分为两组,对照组（29例）口服卵磷脂络合碘片1.5 mg/次,3次/d;观察组在对照组基础上静脉推注复方樟柳碱注射液2 mL,1次/d,两组均治疗14 d。观察并记录两组疗效,视力水平,光敏感度及治疗期间不良反应,评价复方樟柳碱联合卵磷脂络合碘片治疗中心性浆液性脉络膜视网膜病变的疗效。结果 治疗后,观察组患者治疗有效率为93.5%,对照组患者治疗有效率为79.3%,观察组有效率明显高于对照组（P<0.05）;治疗前两组视力水平无统计学差异,治疗后两组时间视力水平均明显提高且观察组视力更好（P<0.05）;治疗前,两组光敏感度无统计学差异,治疗后2、4周,两组光敏感度均明显提高,且观察组光敏感度值更高（P<0.05）。治疗期间,两组不良反应率无统计学差异。结论 复方樟柳碱联合卵磷脂络合碘片对中心性浆液脉络膜视网膜病变具有较好疗效,能够提高患者视力,改善眼部光敏感度,用药具有安全性,值得临床推广使用。     

Effects of chronic smoking on central corneal thickness,endothelial cell,and dry eye parameters

Objective: To evaluate the effect of chronic cigarette smoking on dry eye parameters, endothelial cells, and corneal thickness.

Design: Prospective cross-sectional case series.

Methods: In this cross-sectional study, 49 eyes of 49 chronic smokers (smoker group) and 53 eyes of 53 age-matched, healthy non-smokers (non-smoker group) were enrolled. All participants underwent measurements of tear breakup time (TBUT), central corneal thickness (CCT) measurements with contact pachymeter and the Schirmer test with anesthesia. Corneal endothelial cells were evaluated by non-contact specular microscopy and photographed for analysis of cell density and hexagonality and the coefficient of variation in cell size.

Results: The mean Schirmer score and TBUT value were significantly lower in the smoker group compared to the non-smoker group (p?=?0.015) and p?p?>?0.05). However, a lower percentage of endothelial hexagonal cells were observed in smokers than non-smokers (p?Discussion and conclusion: Our results suggest that cigarette smoking seems to affect the Schirmer score, TBUT value, and hexagonal cells of the corneal endothelium.     

Effects of cigarette smoking on psychopathology scores in patients with schizophrenia: An experimental study

Cigarette smoking and/or nicotine administration have been shown to transiently ameliorate several psychophysiological deficits in patients with schizophrenia such as indicators of deficient sensory gating and attention, but acute effects of smoking on positive and negative symptoms in schizophrenia have not been evaluated in experimental paradigms. The current study assessed whether smoking of cigarettes, after 6–12 h abstinence, transiently alters the expression of negative and/or positive symptoms in patients with schizophrenia who have a history of regular smoking. In a double‐blind, placebo controlled study patients with schizophrenia participated in two sessions in which they smoked either cigarettes moderately high in nicotine content or denicotinized cigarettes. They were interviewed pre‐and postsmoking to obtain ratings of PANSS and SANS scales, and had blood pressure and pulse serially recorded before and after smoking. Pulse rate and blood pressure were slightly higher after smoking in the high nicotine cigarette session. Negative symptom scores on both scales were significantly lower after cigarette smoking compared to same‐day predrug baseline, but there were no differences in active versus denicotinized cigarette drug effects. These results suggest that acute smoking of cigarettes reduces negative symptoms in patients with schizophrenia in this experimental paradigm. Future work needs to identify the mechanism responsible for this behavioral effect.     

Effects of acute paroxetine treatment on the consumption of cigarette smoking and caffeine in depressed patients

In the present study, we examined the effects of acute treatment with paroxetine on the consumption of cigarette smoking and caffeine in 65 patients who met the DSM-IV criteria for major depressive disorder (M/F: 28/37, age: 48 +/- 15 years). Plasma levels of cotinine or caffeine were analysed using high-performance liquid chromatography (HPLC). The amount of cigarette smoking and plasma levels of cotinine, but not caffeine, decreased 4 weeks after paroxetine treatment. There was no difference between smokers and nonsmokers with respect to their response to paroxetine treatment. In addition, plasma 3-methoxy-4-hydroxyphenylglycol (MHPG) levels in responders to paroxetine treatment was higher than those in nonresponders, and there was a negative correlation between the changes in plasma MHPG levels and the changes in Hamilton rating scale for depression (Ham-D) scores before and 4 weeks after paroxetine administration. These results suggest that paroxetine has the potential to reduce the amount of cigarette smoking in depressed smokers, and we reconfirmed our previous results that depressed patients with higher plasma MHPG levels had better response to paroxetine treatment than those with lower plasma MHPG levels using larger depressed samples.     

The prevalence of 4G/5G polymorphism of plasminogen activator inhibitor-1 (PAI-1) gene in central serous chorioretinopathy and its association with plasma PAI-1 levels

Context: Central serous chorioretinopathy (CSCR) is a poorly understood disease and the choroidal circulation abnormality induced by the plasminogen activator inhibitor type 1 (PAI-1) seems to be associated with the pathogenesis. There are many reports indicating that 4G/5G polymorphism of the PAI-1 gene is a risk factor for several diseases related to the elevated serum levels of PAI-1.

Objective: To evaluate the 4G/5G polymorphism of the PAI-1 gene and its association with serum levels of PAI-1 in acute CSCR patients.

Materials and methods: Sixty CSCR patients and 50 healthy control patients were included. The PAI-1 4G/5G was genotyped using the polymerase chain reaction–restriction technique. Serum PAI-1 level was measured using enzyme-linked immunosorbent assay. Demographic data consisting of age, sex, body mass index (BMI) as well as genotype disturbances and serum PAI-1 levels were compared between the groups. Statistical significance for differences in the serum PAI-1 levels of each group with different genotypes was also analyzed.

Results: The CSCR group consisted of 40 male (66.7%) and 20 female (33.3%) patients with a mean age of 46.7?±?8.39 years. The control group consisted of 32 male (64%) and 18 female (36%) healthy subjects with a mean age of 45.8?±?8.39 years. There was no statistically significant difference between the groups in terms of age, sex and BMI. In the CSCR group the genotype frequencies were 4G/4G: 30% (n?=?18), 4G/5G: 50% (n?=?30), 5G/5G: 20% (n?=?12) and in the control group genotype frequencies were 34% (n?=?17), 42% (n?=?21) and 24% (n?=?12), respectively. There was no statistically significant difference in the distribution of genotypes among the groups (chi-squared, p?=?0.70). The CSCR group had a significantly higher serum PAI-1 concentration than the control group (p?=?0.001). In both groups the mean plasma PAI-1 concentration did not vary significantly among the different genotypes (p?>?0.05).

Discussion and conclusion: Although our results demonstrated that the patients with acute CSCR have higher serum PAI-1 concentrations than the controls, no significant difference was found in the genotype disturbances of the PAI-1 gene between the groups. The current study indicates that 4G/5G polymorphism in the promoter of the PAI-1 gene cannot be considered a risk factor for the elevated serum PAI-1 levels and consequent development of CSCR.