二步法激光诱导脉络膜视网膜静脉吻合术治疗兔视网膜中央静脉阻塞的疗效

目的:评价二步法激光诱导脉络膜视网膜静脉吻合术(laser-inducedchorioretinalvenousanastomosis,LCRVA)治疗视网膜中央静脉阻塞(centralretinalveinocclusion,CRVO)的可行性及有效性。方法:青紫蓝兔22只44眼,光动力学方法建立兔双眼的CRVO模型。任选1眼作为治疗眼,先后用倍频Nd:YAG激光器和YAG激光器分别在选定部位击破Bruch膜及相邻的静脉壁,以建立视网膜静脉与脉络膜血管之间的吻合通道;另1眼作为对照。在治疗后4mo行眼底荧光素血管造影(fundusfluoresceinangiography,FFA)以及组织病理学检查,通过组间的对比来评价LCRVA治疗CRVO的疗效。结果:有34眼(77%,15只兔双眼,4只兔单眼)一次性建立了CRVO模型。对其中的17眼行LCR-VA,每眼击射2个点。经FFA证实,有8眼(47%)中的11个点(32%)存在功能性吻合。术后4mo,通过对各组的FFA及组织病理切片对比发现,吻合成功眼的视网膜病变严重程度明显比CRVO组轻。结论:二步法LCRVA治疗CRVO是可行及有效的,旁路引流通路的建立可以延缓CRVO病情的进展。     

视网膜电图在视网膜中央静脉阻塞分型中的应用价值

我们选择不同的刺激条件，对32例早期视网膜中央静脉阻塞(central retinal vein occlusion,CRVO)患者进行视网膜电图(electroretinogram,ERG)的检测．缺血型CRVO13例的a、b波潜伏期延长，b波振幅明显下降：非缺血型CRVO19例的a、b波潜伏期延长，b波振幅表现为轻度降低、升高或正常．提示b波振幅和b/a是区分缺血型与非缺血型CRVO的最敏感指标．我们还探讨了ERG在早期CRVO分型中的应用价值。 （中华眼底病杂志，1994，10：7-10）     

双眼视网膜静脉阻塞

报告23例双眼视网膜静脉阻塞，占同期收治视网膜静脉阻塞病例的5.85%.其中男性18例，女性5例，平均年龄55.4岁．双眼视网膜中央静脉阻塞(CRVO)2例；1眼CRVO，另1眼视网膜半侧静脉阻塞(HRVO)2例；1眼CRVO，另1眼视网膜分支静脉阻塞(BRVO)6例；双眼BRVOl3例。中央和视网膜半侧静脉阻塞14眼，分支静脉阻塞32眼．缺血型19眼，占41%；非缺血型27眼，占59%。双眼发病间隔平均3年零5个月。双眼与单眼发病的危险因素比，统计学差异无显著性。 （中华眼底病杂志，1994，10：174-175）     

脉络膜视网膜重度激光损伤的ERG研究

用Q—开关红宝石激光多脉冲辐照法制作39只青紫蓝灰兔脉络膜视网膜玻璃体出血模型,从视网膜电图的角度研究脉络膜视网膜重度激光损伤对视觉电生理的影响。结果:动物眼经激光辐照损伤后四档强度ERG的a、b波振幅分别下降至原来的1/2～1/3,峰潜时明显提前。单眼激光损伤后,对侧非辐照眼a、b波振幅分别降低至原来的92.6%、87.5%。激光辐照后一定时期ERG振幅有一定程度恢复。     

视网膜中央静脉阻塞对侧眼视网膜电图的观察

本文对31例单眼视网膜中央静脉阻塞（centralretinalveinocclusion，CRVO）患者正常眼底的对侧眼进行了暗视ERGa、b波及OPs各子波峰时值、波幅和OP总合波幅的观察，结果表明，ERG的a、b波及OPs各子波峰时值均延迟，ERGb波波幅异常者占32％，其中b波超高者占29％，b波降低者占3％，OPs主要表现为O2波波幅的降低，异常率42％，异常率随着年龄的增大而增加。在OPs异常的患者中绝大多数存在着血液粘稠度的增高及血脂异常。提示O2波是观察视网膜血液循环障碍的敏感指标。全身因素可以同时影响双眼视网膜功能。     

金雀异黄素对视网膜中央静脉阻塞动物模型中闪光视网膜电图的影响

目的评价金雀异黄素（Gen）对兔视网膜中央静脉阻塞（CRVO）后视网膜细胞功能下降是否具有改善作用。方法采用氩激光直接光凝法封闭兔眼视网膜静脉建立CRVO模型成功后1周,将兔分为两组：Gen治疗组6只和DMSO组6只。Gen治疗组兔连续4天玻璃体腔内注射浓度为150μmol／l的Gen 0．1ml,DMSO组兔连续四天玻璃体腔内注射DMSO0．1ml。兔光凝前、光凝后1周、2周行闪光视网膜电流图检查（flash electrorefinogram,FERG）测定视网膜细胞功能。结果（1）激光封闭视网膜静脉可建立兔CRVO模型;（2）Gen治疗组FERG—a、FERG—b波潜伏期较用药前明显缩短（P〈0．05）,DMSO组的FERG与用药前无统计学差异。结论激光封闭致兔视网膜中央静脉阻塞的动物模型是成功的,Gen可改善部分视网膜功能。     

视网膜电流图振荡电位的计算机处理及临床应

目的研究视网膜电流图(electroretinogram,ERG)振荡电位(oscillatory potentials, OPs)的提取和分析方法及其临床应用。方法测试了40只(40例)正常对照眼、33只(33例)糖尿病视网膜病变(diabetic retinopathy,DR)患眼、9只视网膜中央静脉阻塞(central retinal vein occlusion,CRVO)患眼和9只视网膜分支静脉阻塞(branch retinal vein occlusion,BRVO)患眼的振荡电位。用快速傅里叶变换计算OPs的10～290Hz频谱,计算频谱的功率总和以及最大功率。通过快速傅里叶逆变换用110～250Hz频谱成分重构时域的OPs。测量重构的OPs4个子波的潜伏期、振幅和振幅总和。结果与正常对照组比较,早期DR患眼140～210Hz振幅谱、功率总和以及最大功率下降,4个子波的潜伏期延长,振幅和振幅总和下降;CRVO患眼150～180Hz振幅谱、功率总和以及最大功率下降,第1到第3个子波的潜伏期延长,振幅和振幅总和下降;BRVO患眼功率总和以及最大功率下降,第2和第3个子波的潜伏期延长、第1到第3个子波的振幅和振幅总和下降。结论该文阐述的OPs分析方法可为DR、CRVO和BRVO的诊断提供有效的客观指标。     

外伤性低眼压视网膜电图的改变

目的 观察外伤性低眼压后视网膜电图 (ERG)的变化，探讨可能的改变机制。 方法 兔眼40只，伤前测量眼压后20只实验眼制作外伤性低眼压的兔眼模型，20只对照眼行晶状体囊外摘除术，伤后分别于2、4、8、16周测量眼压。进行暗适应ERG检查。 结果 伤后2周，实验组ERG b波的振幅高于伤前，约为伤前的2.5倍，到伤后16周下降至伤前1.5倍。 结 论 外伤性低眼压后ERG b波振幅高于正常，可能与低眼压造成视网膜血液循环淤滞，代谢产物淤积有关。 （中华眼底病杂志，2004，20：189-191）     

视网膜电流图振荡电位的计算机处理及临床应用

目的：研究视网电流图（electroretinogram,ERG)振荡电位（oscillatory potentials,OPs)的提取和分析方法及其临床应用。方法：测试了40只（40例）正常对照眼33只（33例）糖尿病视网膜病变（diaetic retinopathy,DR)患者、9只视网膜中央静脉阻塞（central retinal vein occlusion,CRVO)患者和9只视网膜分支静脉阻塞（branch retinal vein occlusion,BRVO)患眼的振荡电位,用快速傅里叶变换计算OPs的10－290Hz频谱,计算频谱的功率总和以及最大功率,通过快速傅里叶逆变换用110－250Hz频谱成分重构时域的OPs,测量重构的OPs4个子波的潜伏期、振幅和振幅总和。结果：与正常对照组比较,早期DR患眼140－210Hz振幅谱、功率总和以及最大功率下降,4个子波的太期延长,幅和振幅总和下降,CRVO患眼150－180Hz振幅谱、功率总和以及最大功率下降,BRVO患眼功率总和以及最大功率下降,第2和第3个子波的潜伏期延长,第1到第3个子波的振幅和振幅总和下降。结论：该文阐述OPs分析方法可为DR、CRVO和BRVO的诊断提供有效的客观指标。     

正常及光感受器损伤兔眼视网膜下芯片植入后的电生理结果

目的 观察视网膜下芯片所引起的光感受器损伤及正常兔眼的电生理改变。 方法 青紫蓝兔共30只，其中22只兔NaIO3生理盐水溶液静脉 注入后眼光感受器受到损伤。将一个由90个微光电二极管组成的阵列和相连电极构成的直径约3mm的芯片通过巩膜切口植入4只正常及22只注药后光感受器损伤兔右眼的视网膜下腔或脉络膜中，左眼为对照眼 ；分别检测芯片眼及对照眼局部闪光视觉诱发电位（F-VEP）、局部闪光视网膜电图（F-ERG）、全视野闪光VEP及全视野闪光ERG。另外4只兔双眼摘作病理检查。 结果 22只色光感受器损伤兔中有11只芯片眼的局部ERG主波振幅明显大于对照眼；4只正常兔中，2只芯片眼的局部ERG主波振幅大于对照眼。1只芯片眼表面视网膜出现破孔不能引出任何波。局部VEP及全视野闪光VEP重复性较差，全视野闪光ERG未见明确差别。 结论 植入的芯片在受到光刺激 后可刺激局部视网膜并引起局部视网膜的电活动。 (中华眼底病杂志, 2006, 22: 324-327)     

Strabisme Alternant - Etude clinique - traitement

The author defines motor and sensory alternation: the term alternation should not be used in isolation, it should always be accompanied by the name of the parameter concerned. Sensory alternation is always found together with motor alternation but the reverse is not true.The examining criteria for a diagnosis of sensory alternation are given, sensory alternation must not be confused with alternating inhibition. Working from clinical observations of cases of motor alternating strabismus, the author selects 2 types of binocular sensory relations which allow one to differentiate between:- cases of primary alternating strabismus- cases of secondary alternating strabismusThese forms will develop in different ways; in both cases a cure is possible providing that the right treatment is prescribed and once prescribed carefully followed, etc. It is always a case of serious forms of strabismus whose developmental period is spread over several years.According to the authors, the frequency of cases of true primary strabismus is from 1–3%, the frequency of cases of secondary alternating strabismus varies according to the type of therapy practised on cases of monocular strabismus with amblyopia. These latter will become cases of alternating strabismus under the influence of certain types of therapy carried out over several years (penalization, rocking, alternated occlusion, etc...).Experimental data on kittens confirm clinical data; kittens placed in abnormal environments during the sensitive period will show modification in the distribution of cortical cells and the absence of binocular cells (either because the excitation of the two eyes was not simultaneous, or not identical: artificial strabismus, occlusion, opaque glasses). This disturbances become irreversible after a certain period of exposure (a function of age, length of exposure, etc...).It is thus necessary to bear in mind: 1) the iatrogenic risks of certain orthoptic treatments, 2) the necessity for a binocular form of treatment as soon as possible, as once a certain stage is passed, cortical plasticity diminishes and the elaboration of normal binocular relations becomes impossible.

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Effects of Adenosine Agonists on Intraocular Pressure and Aqueous Humor Dynamics in Cynomolgus Monkeys

The effects of single or multiple topical doses of the relatively selective A₁adenosine receptor agonists (R)-phenylisopropyladenosine (R-PIA) and N⁶-cyclohexyladenosine (CHA) on intraocular pressure (IOP), aqueous humor flow (AHF) and outflow facility were investigated in ocular normotensive cynomolgus monkeys. IOP and AHF were determined, under ketamine anesthesia, by Goldmann applanation tonometry and fluorophotometry, respectively. Total outflow facility was determined by anterior chamber perfusion under pentobarbital anesthesia. A single unilateral topical application of R-PIA (20–250 μg) or CHA (20–500 μg) produced ocular hypertension (maximum rise=4.9 or 3.5 mmHg) within 30 min, followed by ocular hypotension (maximum fall=2.1 or 3.6 mmHg) from 2–6 hr. The relatively selective adenosine A₂antagonist 3,7-dimethyl-1-propargylxanthine (DMPX, 320 μg) inhibited the early hypertension, without influencing the hypotension. Neither 100 μg R-PIA nor 500 μg CHA clearly altered AHF. Total outflow facility was increased by 71% 3 hr after 100 μg R-PIA. In conclusion, the early ocular hypertension produced by topical adenosine agonists in cynomolgus monkeys is associated with the activation of adenosine A₂receptors, while the subsequent hypotension appears to be mediated by adenosine A₁receptors and results primarily from increased outflow facility.