葡萄膜炎患者血清中抗EB病毒抗体的测定及意义

为了解我国葡萄膜炎的发生与ＥＢ病毒感染的关系，我们用免疫酶标法对４２例活动期不同类型葡萄膜炎患者作抗ＥＢ病毒壳抗原（ＶＣＡ）抗体的检测，并以３３例正常人作为对照组。结果发现葡萄膜炎患者血清中抗ＥＢ病毒ＶＣＡ－ＩｇＧ抗体的阳性率及抗体滴度与正常对照组无显著性差异（Ｐ＞０．０５），而患者血清中ＶＣＡ－ＩｇＭ抗体阳性率及抗体滴度明显高于对照（Ｐ＜０．０１）。表明葡萄膜炎患者和对照组以往均感染过ＥＢ病毒，而葡萄膜炎患者新近又重复感染ＥＢ病毒或潜伏感染状态被激活。提示葡萄膜炎的发生与ＥＢ病毒感染可能有关。     

闭角型青光眼患者外周血T细胞亚群的研究

目的利用单克隆抗体技术检测闭角型青光眼（ＡＣＧ）患者外周血Ｔ细胞亚群，以了解ＡＣＧ患者机体的整体免疫平衡状态。方法使用单克隆抗体的碱性磷酸酶抗碱性磷酸酶法（ＡＰＡＡＰ）检测４５例闭角型青光眼（ＡＣＧ）患者外周血Ｔ细胞亚群，并配组对照分析。结果ＡＣＧ组的ＣＤ３＋细胞的百分比数均低于对照组（Ｐ＜０．００５），ＣＤ４＋和ＣＤ８＋细胞的百分比数高于对照组（Ｐ＜０．０１和Ｐ＜０．００１），ＣＤ４＋／ＣＤ８＋的比值低于对照组（Ｐ＜０．００１）。结论ＡＣＧ患者机体存在着自身免疫调节功能的紊乱，且可能是引发疾病发生的一种因素。     

原发性慢性闭角型青光眼黄斑区结构损害的定量研究及相关分析

目的　探讨慢性原发性闭角型青光眼（ｃｈｒｏｎｉｃｐｒｉｍａｒｙａｎｇｌｅ-ｃｌｏｓｕｒｅｇｌａｕｃｏｍａ,ＣＰＡＣＧ）患者黄斑区神经节细胞复合体（ｍａｃｕｌａｒｇａｎｇｌｉｏｎｃｅｌｌｃｏｍｐｌｅｘ,ｍＧＣＣ）厚度变化及与视网膜神经纤维层（ｒｅｔｉｎａｌｎｅｒｖｅｆｉｂｅｒｌａｙｅｒ,ＲＮＦＬ）厚度的相关性。方法　采用ＲＴＶｕｅ１００-２ＯＣＴ检测ＣＰＡＣＧ患者５５例（５５眼）早期、中期及晚期与正常人３０例（３０眼）平均、上方、下方ｍＧＣＣ厚度及平均、上方、下方ＲＮＦＬ厚度,比较组间各检测指标的差异,分析ｍＧＣＣ厚度与ＲＮＦＬ厚度的相关性。结果　早期ＣＰＡＣＧ组、中期ＣＰＡＣＧ组、晚期ＣＰＡＣＧ组平均、上方、下方ｍＧＣＣ厚度值分别为（９５．１５±８．２１）μｍ、（９６．１１±７．７７）μｍ、（９５．０５±９．９４）μｍ,（７６．０４±８．５８）μｍ、（８３．０４±８．７２）μｍ、（７４．１７±９．７１）μｍ,（６４．４０±１０．１３）μｍ、（６８．８３±１３．２６）μｍ、（６３．３４±１２．６１）μｍ。早期ＣＰＡＣＧ组、中期ＣＰＡＣＧ组、晚期ＣＰＡＣＧ组各ＲＮＦＬ及ｍＧＣＣ厚度值均较正常对照组降低,差异均有统计学意义（均为Ｐ＜０．０５）;随着青光眼病情的进展,ＲＮＦＬ厚度及ｍＧＣＣ厚度逐渐变薄,中期ＣＰＡＣＧ组各ＲＮＦＬ及ｍＧＣＣ厚度值均较早期ＣＰＡＣＧ组降低,差异均有统计学意义（均为Ｐ＜０．０５）,晚期ＣＰＡＣＧ组各ＲＮＦＬ及ｍＧＣＣ厚度值均较中期ＣＰＡＣＧ组降低,差异均有统计学意义（均为Ｐ＜０．０５）。ＣＰＡＣＧ患者平均ｍＧＣＣ厚度和平均ＲＮＦＬ厚度、上方ｍＧＣＣ厚度和上方ＲＮＦＬ厚度、下方ｍＧＣＣ厚度和下方ＲＮＦＬ厚度均呈高度正相关（ｒ＝０．９８７、０．９７６、０．９７１,均为Ｐ＝０．０００）。结论　频域ＯＣＴ检测的ＣＰＡＣＧ患者的ｍＧＣＣ厚度随青光眼病情的进展逐渐变薄,与ＲＮＦＬ厚度有良好的相关性。     

频域-OCT观测原发性闭角型青光眼患者视盘形态、视网膜神经纤维层及神经节细胞复合体的临床意义

目的　应用频域-ＯＣＴ观测原发性闭角型青光眼（ｐｒｉｍａｒｙａｎｇｌｅｃｌｏｓｅｄｇｌａｕｃｏｍａ,ＰＡＣＧ）患者视盘形态、视网膜神经纤维层（ｒｅｔｉｎａｌｎｅｒｖｅｆｉｂｅｒｌａｙｅｒ,ＲＮＦＬ）及黄斑区神经节细胞复合体（ｇａｎｇｌｉｏｎｃｅｌｌｃｏｍｐｌｅｘ,ＧＣＣ）,分析其与视野平均缺损（ｍｅａｎｄｅ-ｖｉａｔｉｏｎ,ＭＤ）的相关性。方法　选取３５例６０眼ＰＡＣＧ患者,根据视野损害程度分为早期及中晚期２组,与３３例正常人进行频域-ＯＣＴ对比检查。测量视盘形态学参数、整体平均ＲＮＦＬ厚度（ＲＮＦＬ-Ａｖｇ）、上方平均ＲＮＦＬ厚度（ＲＮＦＬ-Ｓｕｐ）、下方平均ＲＮＦＬ厚度（ＲＮＦＬ-Ｉｎｆ）、整体平均ＧＣＣ的厚度（ＧＣＣ-Ａｖｇ）、上方平均ＧＣＣ厚度（ＧＣＣ-Ｓｕｐ）、下方平均ＧＣＣ厚度（ＧＣＣ-Ｉｎｆ）,并分析青光眼患者组视野ＭＤ与ＲＮＦＬ、ＧＣＣ的相关性。结果　视盘各形态学参数在各期ＰＡＣＧ组与正常对照组间的差异具有统计学意义（视盘面积Ｆ＝１４．２９、Ｐ＝０．０００;视杯面积Ｆ＝１１．３１、Ｐ＝０．０００;盘沿面积Ｆ＝６．２７、Ｐ＝０．００２;盘沿容积Ｆ＝１０．４１、Ｐ＝００００;视神经盘容积Ｆ＝３．５３、Ｐ＝０．０３４;视杯容积Ｆ＝１０．９９、Ｐ＝０．０００;杯盘比Ｆ＝８．６４、Ｐ＝０．０００;杯盘纵比Ｆ＝３．１４、Ｐ＝００４８;杯盘横比Ｆ＝４．２０、Ｐ＝０．０１２）。其中视盘面积差异表现为两个ＰＡＣＧ组均较正常对照组大,而两个ＰＡＣＧ组间差异无统计学意义;其他各参数表现为:中晚期ＰＡＣＧ组的视杯面积、视杯容积、杯盘比均比正常对照组显著增大;而盘沿面积、盘沿容积和视神经盘容积均比正常对照组显著减小。增大及缩小的程度与正常对照组比较,差异均具有统计学意义,变化符合ＰＡＣＧ神经损害的特点;而早期ＰＡＣＧ组在上述参数中与正常对照组之间的差异均无统计学意义（均为Ｐ＞０．０５）。对ＲＮＦＬ及ＧＣＣ的分析中,ＰＡＣＧ组与正常对照组间的差异具有统计学意义（ＲＮＦＬ-ＡｖｇＦ＝９．７９、Ｐ＝０．０００;ＲＮＦＬ-ＳｕｐＦ＝６．４８、Ｐ＝０００２;ＲＮ-ＦＬ-ＩｎｆＦ＝７．５４、Ｐ＝０．００１;ＧＣＣ-ＡｖｇＦ＝６．６２、Ｐ＝０．００２;ＧＣＣ-ＳｕｐＦ＝５．６９、Ｐ＝０．００５;ＧＣＣ-ＩｎｆＦ＝６．４５、Ｐ＝０．００３）。组间两两比较发现:中晚期ＰＡＣＧ组上述各参数与正常对照组的差异具有统计学意义（均为Ｐ＜０．０５）;而早期ＰＡＣＧ组各参数与正常对照组间的差异无统计学意义（均为Ｐ＞０．０５）。中晚期ＰＡＣＧ组ＲＮＦＬ和ＧＣＣ均与ＭＤ呈明显的正相关（ｒ＝０．６８９５,Ｐ＝０．００１;ｒ＝０５２７１,Ｐ＝０．０１０）;早期ＰＡＣＧ组ＲＮＦＬ及ＧＣＣ与ＭＤ无相关性（ｒ＝－０．２０８４、Ｐ＝０．２４４;ｒ＝０．２００１、Ｐ＝０２８１）。结论　频域-ＯＣＴ是一种比较敏感的能够观察到视网膜结构改变的检查方法,但其对于早期青光眼的诊断仍具有局限性。     

合并近视的原发性开角型青光眼眼血流动力学研究

目的：利用彩色多普勒血流显像研究合并近视的原发性开角型青光眼（Ｐｒｉｍａｒｙ Ｏｐｅｎａｎｇｌｅ Ｇｌａｕｃｏｍａｗｉｔｈ Ｍｙｏｐｉａ,ＭＰＯＡＧ）眼部血流动力学变化。方法：对３８ 例６３ 只合并近视（平均－６．９２ ±３ ．７９Ｄ）高眼压性（ 平均眼压３２ ．００±９．３６ｍｍＨｇ）ＰＯＡＧ、３２ 例５１ 只单纯原发性开角型青光眼（Ｓｉｍｐｌｅ Ｐｒｉｍａｒｙ Ｏｐｅｎａｎｇｌｅ Ｇｌａｕｃｏｍａ,ＳＰＯＡＧ） 、１５ 例３０ 只正常眼分别测量眼动脉、视网膜中央动脉、睫状后动脉的收缩期血流峰值速度（ＰＳＶ） 、舒张末期血流速度（ＥＤＶ） 、阻力指数（ＲＩ） 。结果：①与正常组比较：ＭＰＯＡＧ组及ＳＰＯＡＧ组视网膜中央动脉及睫状后动脉的ＲＩ升高（ Ｐ＜０．０５,Ｐ＜０ ．０１） ;ＭＰＯＡＧ 组眼动脉的ＥＤＶ值减低（Ｐ＜０．０５） 。②与ＳＰＯＡＧ 组比较：ＭＰＯＡＧ组眼动脉ＥＤＶ值明显减低（Ｐ＜ ０．０１）。结论：ＭＰＯＡＧ 患者眼部血流速度减低,血管阻力升高,有血流灌注不足的表现。提示眼压及血管因素在高眼压性ＭＰＯＡＧ 的视功能损害中均起着重要作用。     

枯草热结膜炎泪液免疫球蛋白及补体C3检测

目的 探讨枯草热结膜炎局部体液免疫状态及其在发病机理中所处的地位。方法 采用双盲法对枯草热结膜炎泪液中ＩｇＧ、ＩｇＡ、ＩｇＭ及补体Ｃ３进行检测及分析。结果 枯草热结膜炎组ＩｇＧ及补体Ｃ３明显高于对照组（Ｐ〈０．０１）;ＩｇＡ、ＩｇＭ次之（Ｐ〈０．０５）。结论 ＩｇＧ等免疫球蛋白在枯草热结膜炎发病中占有重要地位,补体源炎症介质可能参与局部炎症反应。     

三维光学相干断层扫描测量视网膜神经节细胞复合体厚度对原发性开角型青光眼诊断的意义

目的　应用三维光学相干断层扫描（ｏｐｔｉｃａｌｃｏｈｅｒｅｎｃｅｔｏｍｏｇｒａｐｈｙ,ＯＣＴ）测量原发性开角型青光眼（ｐｒｉｍａｒｙｏｐｅｎａｎｇｌｅｇｌａｕｃｏｍａ,ＰＯＡＧ）患者的黄斑区各部位神经节细胞复合体（ｍａｃｕｌａｒｇａｎｇｌｉｏｎｃｅｌｌｃｏｍｐｌｅｘ,ｍＧＣＣ）厚度,评价其在ＰＯＡＧ诊断中的意义。方法　选取早期ＰＯＡＧ患者３０例（３０眼）,中晚期ＰＯＡＧ患者３０例（３０眼）,以正常人３０例（３０眼）作为对照,应用Ｔｏｐ-ｃｏｎ３ＤＯＣＴ-２０００测量并记录所有受试者的视盘周围各部位视网膜神经纤维层（ｐｅｒｉｐａｐｉｌｌａｒｙｒｅｔｉｎａｌｎｅｖｅｒｆｉｂｅｒｌａｙｅｒ,ｐＲＮＦＬ）和ｍＧＣＣ［包括黄斑区视网膜神经纤维层（ｍａｃｕｌａｒｒｅｔｉｎａｌｎｅｖｅｒｆｉｂｅｒｌａｙｅｒ,ｍＲＮＦＬ）、黄斑区神经节细胞层＋内丛状层（ｇａｎｇｌｉｏｎｃｅｌｌｌａｙｅｒｗｉｔｈｔｈｅｉｎｎｅｒｐｌｅｘｉｆｏｒｍｌａｙｅｒ,ＧＣＩＰ）、神经节细胞复合体（ｇａｎｇｌｉｏｎｃｅｌｌｃｏｍｐｌｅｘ,ＧＣＣ）］厚度,并对所有数据进行统计分析,应用受试者工作特征曲线下面积（ａｒｅａｕｎｄｅｒｔｈｅｒｅｃｅｉｖｅｒｏｐｅｒａｔｉｎｇｃｈａｒａｃｔｅｒｉｓｔｉｃｃｕｒｖｅ,ＡＵＲＯＣ）评价各参数对ＰＯＡＧ的诊断效力。结果　早期、中晚期ＰＯＡＧ患者各部位的ｐＲＮＦＬ厚度及ｍＧＣＣ厚度值随着青光眼的严重程度逐渐变薄。早期ＰＯＡＧ患者与正常人相比,除了ｍＲＮＦＬ厚度和部分ｐＲＮＦＬ厚度（鼻侧和颞侧）参数差异无统计学意义（均为Ｐ＞０．０５）外,其余的各项参数间差异均有统计学意义（均为Ｐ＜０．０５）。中晚期ＰＯＡＧ患者与正常人相比、早期ＰＯＡＧ患者与中晚期ＰＯＡＧ患者相比,各项参数间差异均有统计学意义（均为Ｐ＜０．０５）。早期ＰＯＡＧ患者ｍＲＮＦＬ、ＧＣＩＰ、ＧＣＣ、ｐＲＮＦＬ平均值的ＡＵＲＯＣ值分别为０．６４１、０．７３１、０．７２４、０．７７５;中晚期为０．９３１、０．８３０、０．９１５、０．９４７。早期ＰＯＡＧ患者ｍＲＮＦＬ、ＧＣＩＰ、ＧＣＣ最小值的ＡＵＲＯＣ值分别为０．６７４、０．７４６、０．７３２,中晚期为０．９４２、０．８４１、０．９２８,均高于其平均值的ＡＵＲＯＣ值。除了鼻侧及颞侧ｐＲＮＦＬ厚度参数外,其余各项参数均能有效地诊断ＰＯＡＧ,差异均有统计学意义（均为Ｐ＜０．０５）。结论　ｍＧＣＣ厚度参数与ｐＲＮＦＬ厚度参数对ＰＯＡＧ的诊断效力相当,可作为ＰＯＡＧ诊断的一个新指标。     

原发性闭角型青光眼患者虹膜生物学结构特点

目的　观察原发性闭角型青光眼（ｐｒｉｍａｒｙａｎｇｌｅｃｌｏｓｕｒｅｇｌａｕｃｏｍａ,ＰＡＣＧ）患者虹膜生物学结构特点。方法　采用眼前段光学相干断层扫描仪（ａｎｔｅｒｉｏｒｓｅｇｍｅｎｔｏｐｔｉｃａｌｃｏ-ｈｅｒｅｎｃｅｔｏｍｏｇｒａｐｈｙ,ＡＳ-ＯＣＴ）,获取ＰＡＣＧ组与对照组眼前段图像,采用中山房角分析软件（Ｚｈｏｎｇｓｈａｎａｎｇｌｅａｎａｌｙｚｅｐｒｏｇｒａｍ,ＺＡＡＰ）对图片进行分析,对比ＰＡＣＧ组与对照组虹膜结构参数的差异。结果　ＰＡＣＧ组患者前房浅、眼轴短、晶状体厚、房角窄及前房宽度小,与对照组相比差异均有显著统计学意义（均为Ｐ＜０．００１）。ＰＡＣＧ组虹膜厚度ＩＴ７５０为（０．４８±０．１５）ｍｍ,对照组为（０．４３±０．１８）ｍｍ,ＰＡＣＧ大于对照组;ＰＡＣＧ组虹膜厚度ＩＴ２０００为（０．５２±０．１４）ｍｍ,对照组为（０．４７±０．１６）ｍｍ;ＰＡＣＧ组虹膜面积为（１．５６±０.２８）ｍｍ２,对照组为（１．５０±０．２８）ｍｍ２;ＰＡＣＧ组虹膜弯曲距离为（０．３１±０．１７）ｍｍ,对照组为（０.２５±０．１２）ｍｍ;ＰＡＣＧ组瞳孔直径（４．０９±１．７１）ｍｍ,对照组为（４．４８±１．７１）ｍｍ;两组间虹膜厚度、虹膜面积、虹膜弯曲距离、瞳孔直径差异均有显著统计学意义（均为Ｐ＜０．００１）。结论　与对照组相比,ＰＡＣＧ患者虹膜厚、面积大、虹膜弯曲距离大,虹膜结构参数可能参与ＰＡＣＧ发病。     

恶性青光眼的临床特征和危险因素分析

目的　探讨原发性闭角型青光眼（ｐｒｉｍａｒｙａｎｇｌｅｃｌｏｓｕｒｅｇｌａｕｃｏｍａ,ＰＡＣＧ）患者行手术治疗后发生恶性青光眼的临床特征以及相关的危险因素。方法　回顾性分析我院收治的２３８６例（２８９７眼）ＰＡＣＧ行手术治疗患者的临床资料,按术后是否发生恶性青光眼分为恶性青光眼组与非恶性青光眼组,探讨恶性青光眼组患者的临床特征,并采用Ｌｏｇｉｓｔｉｃ回归方法对ＰＡＣＧ患者术后发生恶性青光眼危险因素进行分析。结果　ＰＡＣＧ患者手术后恶性青光眼的发生率为２．９３％。恶性青光眼组患者的女性比例、行小梁切除术比例、术前眼压、晶状体厚度、房角完全闭合比例均显著高于非恶性青光眼组（均为Ｐ＜０．０５）,前房深度、眼轴长度均显著低于非恶性青光眼组（均为Ｐ＜０．０５）。两组间的年龄、病程、血压、相对晶状体位置等临床参数比较,差异均无统计学意义（均为Ｐ＞０．０５）。女性、年龄４５～６０岁、小梁切除术、术前眼压＞３０ｍｍＨｇ（１ｋＰａ＝７．５ｍｍＨｇ）、前房深度＜１．８ｍｍ、晶状体厚度＞４．５ｍｍ、眼轴长度＜２２ｍｍ、房角完全闭合是ＰＡＣＧ患者术后发生恶性青光眼的危险因素,其中,短眼轴、术前持续高眼压、房角完全闭合３个因素是ＰＡＣＧ患者术后发生恶性青光眼的独立危险因素。结论　性别、年龄、眼压以及患者自身的眼球解剖结构是ＰＡＣＧ术后发生恶性青光眼的易感因素,需引起临床研究者的重视。     

原发性青光眼合并2型糖尿病患者房水及血液中MMP-2及TIMP-2的表达

目的　探讨基质金属蛋白酶２（ｍａｔｒｉｘｍｅｔａｌｌｏｐｒｏｔｅｉｎａｓｅ-２,ＭＭＰ-２）及金属蛋白酶２组织抑制因子（ｔｉｓｓｕｅｉｎｈｉｂｉｔｏｒｏｆｍｅｔａｌｌｏｐｒｏｔｅｉｎａｓｅ-２,ＴＩＭＰ-２）与原发性青光眼合并２型糖尿病的关系。方法　研究对象分Ａ组、Ｂ组、Ｃ组、Ｄ组、Ｅ组、Ｆ组６组,每组３０眼。Ａ组为原发性开角型青光眼（ｐｒｉｍａｒｙｏｐｅｎａｎｇｌｅｇｌａｕｃｏｍａ,ＰＯＡＧ）组,Ｂ组为原发性闭角型青光眼（ｐｒｉｍａｒｙａｎｇｌｅｃｌｏ-ｓｕｒｅｇｌａｕｃｏｍａ,ＰＡＣＧ）组,Ｃ组为ＰＯＡＧ合并２型糖尿病组,Ｄ组为ＰＡＣＧ合并２型糖尿病组,Ｅ组为糖尿病性白内障组,Ｆ组为年龄相关性白内障组。采用酶联免疫吸附试验检测各组房水及血清中ＴＩＭＰ-２及ＭＭＰ-２的含量,并计算ＴＩＭＰ-２／ＭＭＰ-２值。结果　在６组研究对象的房水中,ＭＭＰ-２浓度在Ａ组为（２４．９２±６．６２）μｇ?Ｌ－１、Ｂ组为（３６．８０±１５．０７）μｇ?Ｌ－１、Ｄ组为（２８.４４±５．７８）μｇ?Ｌ－１,均较Ｆ组的（２２．８７±３.５４）μｇ?Ｌ－１显著升高（均为Ｐ＜０．０５）;同时房水中ＴＩＭＰ-２浓度在Ａ组为（４３.９２±１９．５７）μｇ?Ｌ－１、Ｂ组为（７６．１３±２７．６７）μｇ?Ｌ－１、Ｄ组为（６１．９２±６．５１）μｇ?Ｌ－１,也均较Ｆ组的（２２.４８±３．５６）μｇ?Ｌ－１显著升高（均为Ｐ＜０．０５）。Ａ、Ｂ、Ｃ、Ｄ组房水中ＴＩＭＰ-２／ＭＭＰ-２值较Ｅ组和Ｆ组显著提高,约为其２倍,但Ａ组、Ｂ组、Ｃ组、Ｄ组间ＴＩＭＰ-２／ＭＭＰ-２值无显著性差异。在６组研究对象的血清中,Ａ组ＭＭＰ-２和ＴＩＭＰ-２浓度最高,分别为（３９６．７５±４９．３０）μｇ?Ｌ－１和（３３７．６７±６２．７８）μｇ?Ｌ－１,其余各组间ＭＭＰ-２和ＴＩＭＰ-２浓度无显著性差异。６组研究对象血清中ＴＩＭＰ-２／ＭＭＰ-２值无明显差异。结论　原发性青光眼患者中ＴＩＭＰ-２／ＭＭＰ-２值均存在失衡,说明ＭＭＰ-２的活性变化及ＴＩＭＰ-２／ＭＭＰ-２值与ＰＯＡＧ和ＰＡＣＧ的发病密切相关,但２型糖尿病对原发性青光眼的病程进展无明显影响。     

Anticardiolipin antibodies and occlusive vascular disease of the eye: Prospective study

There is a recognized association between the presence of anticardiolipin antibodies and vascular occlusive disease. The purpose of our study is to detect the presence of high titers of anticardiolipin antibodies (ACA) in the serum and to correlate the titers with the severity of the vascular disease in patients with occlusive ocular vascular disease. 82 patients were included in a prospective study; 25 patients with anterior ischaemic optic neuropathy, 36 with retinal vein occlusion and 21 with retinal artery occlusion. ACA (IgG and IgM isotypes) were measured by ELISA in the sera of all patients. The group of the patients (group A) was compared to an age-matched control group of 79 healthy individuals (group B). IgG isotype (but not IgM) titers of ACA were found significantly higher in group A (P < 0; 0.001). In patients with titers of ACA (IgG isotype) > 100 units we noted a higher incidence of a more severe disease (recurrency, involvement of both eyes or extraocular manifestations) especially among those with anterior ischaemic optic neuropathy and secondarily in those with retinal artery occlusion. Our results suggest that the association between high titers of ACA and occlusive vascular disease of the eye concerns only the IgG isotype. In addition, the detection of high titers of IgG/AGA in patients could be a useful marker for disease severity and prognosis and this observation seems to be more explicit in cases with arterial occlusive disease than in cases with venous occlusive disease. This revised version was published online in July 2006 with corrections to the Cover Date.     

Increase of erythrocyte aggregation in retinal vein occlusion

Erythrocyte aggregation is one of the principal determinants of blood viscosity at low shear rates (low flow). Anatomical and hemodynamical characteristics make retinal venous circulation particularly dependent on hemorheological factors. Erythrocyte aggregation and other laboratory parameters (haematocrit, fibrinogen, plasma proteins, clotting) were measured in 85 patients presenting with retinal vein occlusion and 64 controls matched for age, sex and vascular risk factors (hypertension, diabetes, smoking). Statistical analysis of the results demonstrated a significant difference between the retinal vein occlusion group an the control group for erythrocyte aggregation (p less than 0.001 for the aggregation index at 10 sec and for the threshold of dissociation). The fibrinogen level, haematocrit and plasma proteins (albumin, IgA, IgG, IgM, total proteins, 2-macroglobulin) were similar in the two groups. No statistically significant difference for erythrocyte aggregation was observed between occlusions of the venous branch and occlusions of the central retinal vein or between ischaemic and non-ischaemic forms. These results suggest that raised erythrocyte aggregation mainly explains the increase in blood viscosity previously demonstrated, and could play a role in the constitution of retinal vein occlusion.     

Antiphospholipid antibodies in ocular arterial and venous occlusive disease

PURPOSE: It was the aim of this study to evaluate antiphospholipid antibodies (APA), i.e. lupus anticoagulants (LA) and anticardiolipin (ACA) IgG and IgM, in ophthalmic occlusive disease. METHODS: Over a 3.5-year period, APA were evaluated in 368 patients. RESULTS: Eighty-six patients (23.4%), compared to 5% in the general population, tested positive for APA. APA did not differ significantly between patients with venous (20.6%) or arterial (25.5%) occlusive disease. This included 93 patients with central retinal vein occlusion (18% APA positive), 67 with retinal branch vein occlusion (24% APA positive), 41 with central retinal artery occlusion (22% APA positive), 53 with retinal branch artery occlusion (32% APA positive), 71 with anterior ischemic optic neuropathy (23% APA positive), 12 with posterior ischemic optic neuropathy (33% APA positive) and 31 patients with amaurosis fugax (23% APA positive). Excluding patients with accepted main risk factors, APA were positive in 15.3% of 85 patients. CONCLUSION: The high APA prevalence confirms its relevance in ocular occlusive disorders.     

Axial length and hyperopia in eyes with retinal vein occlusions

We performed a prospective study in order to elucidate thepredisposing role of axial length and hyperopia in retinal veinocclusions. The study group comprised 39 patients with unilateralcentral retinal vein occlusion (CRVO), 50 patients with unilateralbranch retinal vein occlusion (BRVO), 13 patients with unilateralhemispheric retinal vein occlusion (HRVO) and 45 controleyes.The axial length of affected eyes was compared to fellow eyesand control eyes in each subgroup of patients with retinal veinocclusion. No statistical difference was noted for any of thesubgroups (p > 0.05). Hyperopia was detected in 12 of 39 eyes(31%) with CRVO, 14 of 50 eyes (28%) with BRVO, 4 of 13 eyes(31%) with HRVO and 15 of 45 eyes (33%) in the control group.No statistically significant difference was discovered (p> 0.05).In the light of our study, we believe that axial length andhyperopia may not be risk factors in retinal vein occlusions, incontrast to common belief.     

A prospective study of xenon arc photocoagulation for central retinal vein occlusion.

Twenty patients with central retinal vein occlusion were randomly divided into two groups in a prospective study to evaluate the effects of xenon are photocoagulation in central retinal vein occlusion. The patients in one group were treated with 360 degrees scatter xenon photocoagulation and the others received no treatment. The average follow-up was 18 months. There were no cases of rubeosis or neovascular glaucoma in the treated group. Two patients in the untreated group developed rubeosis with subsequent neovascular glaucoma. There was no significant difference in the visual prognosis or in fundus neovascularization between the groups.     

Risk factors for retinal vein occlusions. A case-control study.

The authors conducted a case-control study of risk factors for retinal vein occlusions using 87 patients with vein occlusions, chosen randomly from photographic files from their institution between 1985 and 1990, and a control group of 85 subjects 38 years of age (the youngest individual in the vein occlusion group) or older, who were randomly selected from the records of two general ophthalmologists in the authors' department. Certain risk factors for retinal vein occlusion were highly significant when subjects with retinal vein occlusion were compared with the control group. These risk factors included systemic hypertension (odds ratio [OR], 3.86; 95% confidence interval [Cl], 2.08 to 7.16), open-angle glaucoma (OR, 2.89; 95% Cl, 1.38 to 6.05), and male sex (OR, 2.61; 95% Cl, 1.43 to 4.79). Race, presence of diabetes mellitus, history of coronary artery disease or stroke, and family history of diabetes, glaucoma, coronary artery disease, or stroke were not significant risk factors in the population studied. Logistic analysis of the risk factors showed no interactions. Risk factors for branch retinal vein occlusion and central retinal vein occlusion were identical.     

彩色多普勒对视网膜静脉阻塞血流动力学分析

目的 探讨视网膜静脉阻塞（ＲＶＯ）血流动力学改变。方法 经散瞳眼底检查及眼底荧光血管造影确诊为ＲＶＯ病例５２例,健康对照组５２例,使用Ａｃｕｓｏｎ １２８ＸＰ／ １０型彩色电脑声像仪,测定也视网膜中央动脉（ＣＲＡ）、中央静脉（ＣＲＶ）及眼动脉（ＯＡ）的收缩期最大血流速度（Ｖｍａｘ）、舒张期末最小血流速度（Ｖｍｉｎ）及阻力指数（ＲＩ）。结果 ＲＶＯ患者ＣＲＶ和Ｖｍａｘ及Ｖｍｉｎ均明显低于健眼（Ｐ〈０．     

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。     

光凝预防视网膜中央静脉阻塞新生血管性青光眼

目的 评价广泛视网膜光凝预防缺血犁视网膜中央静脉阻塞新牛血管性青光眼的临床效果.方法 为前瞻性随机对照临床研究,共60例(60只眼)经眼底荧光素血管造影证实的缺血型视网膜中央静脉阻塞患者,随机分组,A组30例(30只眼)用药物治疗;B组30例(30只眼)除用药物治疗外,还用氪黄激光进行广泛视网膜光凝(激光波长568nm,功率100～300mw,光斑直径300～500μm,曝光时间0.1s,光凝872-1207点,光斑反应Ⅲ级).随访时间为治疗后1个月、3个月、半年、1年、2年和3年.结果 A组失访7例,B组失访9例;A组23例(23只眼)治疗前平均视力为0.097±0.038,治疗后平均视力为0.102±0.066,两者比较无显著差异(t=0.901,P>0.05);B组21例(21只眼)治疗前平均视力为0.094±0.034,治疗后平均视力为0.10l±0.043,两者比较无显著差异(t=0.887,P>0.05);A组和B组的治疗前平均视力比较无显著筹异(t=0.672.P>0.05);A组和B组的治疗后平均视力比较也无显著筹异(t=0.488,P>0.05);A组发生新生血管性青光眼7例.占30.4%,B组发生新牛血管性青光眼1例,占4.8%,两组比较有显著差异(x2=4.864,P<0.05).结论 氪黄激光广泛视网膜光凝能有效预防缺血型视网膜中央静脉阻塞新生血管性青光眼的发生,但不能提高视力.     

Four cases of normal-tension glaucoma with disk hemorrhage combined with branch retinal vein occlusion in the contralateral eye

PURPOSE: To report four cases of normal-tension glaucoma with disk hemorrhage in one eye and branch retinal vein occlusion in the contralateral eye. DESIGN: Observational case series. METHODS: Four cases of normal-tension glaucoma with disk hemorrhage in one eye and branch retinal vein occlusion in the contralateral eye were detected within a 1-year period. RESULTS: Mean patient age was 57 +/- 10 years. Three patients had systemic hypertension, two bilateral normal-tension glaucoma, and all four bilateral peripapillary atrophy. There was no significant difference in intraocular pressure between the disk hemorrhage eyes and the contralateral eyes with branch retinal vein occlusion. CONCLUSION: Some normal-tension glaucoma patients with disk hemorrhage may have a pathogenic mechanism in combination with branch retinal vein occlusion.