Pissarro,dacryocystitis, and the development of modern lacrimal surgery

The co-founder of French Impressionism, Camille Pissarro, suffered from chronic dacryocystitis for at least fifteen years. This kept him from working for long periods of time, and when he was able to work, influenced his method of painting. Pissarro just missed the modern period of lacrimal surgery, and was treated by conservative methods.     

直接检眼镜和彩色眼底照像及FFA在DME诊断中的应用研究

目的:探讨直接检眼镜、彩色眼底照像及眼底荧光血管造影(fundus fluorescein angiography,FFA)在糖尿病视网膜病变黄斑水肿(diabetic macular edema,DME)中的诊断价值。方法:对50例100眼糖尿病视网膜病变患者散瞳后进行直接检眼镜、彩色眼底照像及FFA检查,以FFA为金标准,并将其分别与直接检眼镜及眼底照像结果进行一致性比较。结果:患者50例100眼中发现黄斑水肿45眼(45%),其中,直接检眼镜、眼底照像及FFA对黄斑水肿的检出分别为10眼(10%),35眼(35%),45眼(45%)。直接检眼镜与FFA的诊断吻合程度较差(K=0.239,P=0.00),而眼底照像与FFA的诊断吻合程度较高(K=0.794,P=0.00),具有显著统计学意义。结论:直接检眼镜、彩色眼底照像及FFA三种方法对诊断黄斑水肿都有一定的吻合性,但眼底照像与FFA的吻合程度更高,因此,对于一些无条件开展FFA检查的基层医院,眼底照像更为适用。     

Selected abstracts of the Joint Meeting of the Belgian Ophthalmological Society,The Dutch Ophthalmological Society,and the Netherlands Ophthalmic Research Institute,Antwerp, 21 January 1995

After glaucoma filtering surgery subconjunctival injection of human recombinant tissue plasminogen activator may promote the function of glaucoma filter bleb and increase outflow facility. It can also increase postoperativae complications, such as corneal damage. The aim of our research was to determine corneal endothelial permeability (Pac) in subjects with glaucoma filter bleb protected by a plasminogen activator (Actilyse, Boehringer) when haemorrhagic clots obstructing a glaucoma filtering site had occurred. Two weeks, three months and six months after goniotrephining with scleral cover, in groups with and without subconjunctival injection of 25 mg human tissue plasminogen activator, Pac was calculated. In both groups, no significant differences in the level of Pac measured by fluorophotometry were found.     

泪道插管圈套器的制作及其在泪道插管挂线扩张器植入术中的应用

目的自主设计制作一种取材、制作简易的泪道插管圈套器,用于辅助泪道阻塞再通术、泪小管断裂吻合术时协助泪道插管、挂线或扩张器的植入。方法随机选择慢性鼻泪管阻塞或合并慢性泪囊炎、急性外伤后泪小管断裂、鼻腔泪囊吻合术后吻合口狭窄阻塞患者206例,其中慢性鼻泪管阻塞或合并慢性泪囊炎者198例,鼻腔泪囊吻合术后吻合口狭窄阻塞者2例,泪小管断裂者6例;男性38例,女性168例;年龄5～82岁,平均年龄为（48.0±5.8）岁。用自制泪道插管圈套器辅助泪道插管完成泪道挂线,并观察评价其耗时、成功率及并发症。具体方法：用一根内置有钢丝的硬脊膜外导管,将其分成两段,有标记刻度带侧孔的头部一段作为泪道插管;另一段硬脊膜外导管的两端绞合,制成带柄的长轴约为7～8cm、短轴约为5～6cm的类椭圆形环状圈（取名为泪道插管圈套器）。在泪道插管前将泪道插管圈套器的环状段预先从前鼻孔向后部鼻腔插入,使环状段放置于鼻腔至鼻咽部内,再行上或下泪点泪道插管,插入泪道达鼻泪管下鼻道开口以下,穿入预先放置于下鼻道至后鼻孔区域的圈套器圆环中;继之牵引圈套器拉出前鼻孔,将套取的泪道插管牵引拉出前鼻孔;再将丝线固定于泪道插管头端,随后泪道插管逆行退出泪道,丝线即随泪道插管退出而穿入泪道完成泪道挂线术。最后可再与其他各种泪道扩张器连接完成泪道扩张器植入。结果用泪道插管圈套器圈套拉出泪道插管的206例完成泪道挂线的成功率为100%,平均时间92s。自制泪道插管圈套器辅助泪道插管完成泪道挂线术中部分病例有泪道和鼻腔少量出血,全部在5min内自止;术中术后无泪小点及泪小管撕裂或其他并发症。结论泪道插管圈套器可以简单有效地辅助完成硬脊膜外导管泪道插管、挂线或扩张器植入,使泪道插管、挂线或扩张器植?     

眼球壁异物X线、B超和CT定位诊断的评价

目的 分析X线、B超和CT对眼球壁异物定位的准确性,探讨较可靠的球壁异物定位方案。方法 对1993年6月～2000年12月间入院治疗的236例眼球壁异物进行临床回顾分析。以异物的术中定位为“金标准”分析B超、X线和CT对眼球壁异物的诊断阳性率,以及X线、CT对异物的空间定位准确性。并分析辅助检查准确性与异物大小、位置的关系。结果 X线、B超和CT判断异物与球壁关系的准确性依次为:CT>B超>X线;对异物是否穿出球壁的判断以CT最为灵敏,而B超的误诊率最低。结论 推荐X线作为眼球异物诊断的筛选方法,当定位片提示异物位于眼球壁附近时,应首选CT做进一步的确认;CT联合B超诊断眼球壁异物是目前最佳的诊断方法组合。     

Psychophysical relationships among mechanisms sensitive to pattern,motion and flicker

Sensitivity to drifting gratings was measured both before and after adaptation to a uniform flickering field. In the first experiment, it was found that viewing uniform flicker with one eye impaired sensitivity for drifting gratings presented to the same or contralateral eye. Likewise, adaptation to drifting gratings increased flicker detection thresholds. In the second experiment, temporal tuning of the adaptation effect was determined by adapting observers to several different flicker frequencies and testing with gratings of different drift rate. The data suggested the existence of broadly tuned temporal channels which respond to both flicker and motion. In a third experiment, spatial tuning of uniform flicker adaptation was evaluated by employing test gratings of different spatial frequency. The threshold elevation curves were low-pass in shape and exhibited an upper cut-off at 3–4 c/deg. Moreover, the 3–4 c/deg limit was found even when observers explicitly set thresholds for detecting temporal change. The results of the three experiments are consistent with the view that the human visual system contains separate sustained and transient mechanisms. Contrary to previous suggestions that the two systems play specialized roles in perception, however, our data indicate that both transient and sustained mechanisms can signal motion.     

白内障摘出人工晶状体植入联合光学虹膜切除术的临床应用

目的:应用小切口非超声乳化白内障摘出+人工晶状体植入联合虹膜光学切除术(以下简称三联术)的方法治疗角膜混浊合并白内障,并评价其疗效。方法:选择角膜白斑、斑翳合并白内障患者13例18眼,根据角膜混浊程度、部位,设计虹膜光学切除部位。为患者施行三联手术治疗,观察术后视力恢复的情况,随访1～3mo。结果:术前视力:光感～数指12眼,<0.1者4眼,0.1～0.2者2眼。术后1wk,裸眼视力>0.3者12眼,>0.1者5眼,无改善者1眼。3mo后最佳矫正视力0.6,0.2～0.3以上的视力14眼,大部分视力不同程度的提高,全部脱盲。结论:小切口非超声乳化白内障摘出+人工晶状体植入联合虹膜光学切除术,可以一次性解决眼前段屈光间质混浊。与传统穿透性角膜移植联合白内障摘除术相比,三联术简化了手术操作,减少了角膜移植术后排斥反应等并发症,根据角膜混浊的程度、部位患者视力获得不同的恢复。三联术操作简单,安全性高,低成本低风险,值得推广。     

Primary central nervous system angiitis, amyloid angiopathy, and Alzheimer's pathology presenting with Balint's syndrome

We report a patient who presented with Balint's syndrome as a manifestation of primary central nervous system angiitis. Clinical findings included simultanagnosia, optic ataxia, and optic apraxia. Pathologic evaluation demonstrated amyloid angiopathy and Alzheimer's plaques. The presence of primary central nervous system angiitis along with amyloid angiopathy and Alzheimer's plaques may not be coincidental. Angiitis may be a foreign body reaction to A4 amyloid deposition.     

益视汤对脾气虚证兔视网膜脱离复位后视网膜组织形态的影响

目的:观察中药益视汤对脾气虚证兔视网膜脱离(retinaldetachment,RD)自动复位后视网膜组织结构恢复的影响。方法:将健康成年新西兰灰兔26只随机分为脾气虚型RD自动复位组(A组)、益视汤治疗组(B组)及空白对照组(C组),采用耗气破气加饥饱失常法建立脾气虚证动物模型,在显微镜下行视网膜下注射透明质酸钠术建立视网膜脱离自动复位动物模型,用光学显微镜分别观察比较术后10,20,30d视网膜组织结构的变化。结果:B组较A组兔视网膜组织结构紊乱明显改善,细胞水肿变性明显减轻。结论:益视汤能减轻脾气虚证对视网膜脱离自动复位后各层组织细胞的不良影响。