内皮型一氧化氮合酶基因第4内含子中27碱基对重复序列多态性与糖尿病视网膜病变的相关性研究

Objective To investigate the relationship between diabetic retinopathy(DR)and insertion/deletion(a/b)polymorphism of a 27 base pair variable number tandem repeat(VNTR)in intron 4of the endothelial nitric oxide synthase(eNOS)gene.Methods 321 patients of type 2 diabetes mellitus with over 10 years duration(case group)and 146 normal subjects(control group)were enrolled in this study.All the clients are Han Chinese.The case group was divided into DR subgroup(1 54 patients)and non-DR (NDR)subgroup(167 patients)according to the results of indirect ophthalmoscope and fundus fluorescent angiography.The VNTR polymorphism in eNOS gene was determined by polymerase chain reaction(PCR)combined with 8% agarose gel electrophoresis.Then the b,a allele frequency and b/b.a/a.b/a allele frequency of two groups were compared,and its correlation with diseases were analyzed.Results The b allele frequency of the VNTR in intron 4 of eNOS gene in the DR group was significantly higher than that in the NDR group(χ2=4.745,P=0.029;OR=1.685,95% CI=1.050-3.905)and control group(χ2=6.958,P=0.008;OR=1.89l,95% CI=1.172-4.437);b/b allele frequency in the DR group was also significantly higher than that in the NDR group(χ2=4.811,P=0.028;OR=1.790,95% CI=1.060-4.645)and controI group(χ2=5.203,P=0.023;OR=1.859,95% CI=1.087-4.952).Conclusions The b allele and b/b genotype in intron 4 of eNOS gene in the Han Chinese are closely related to DR.     

内皮型一氧化氮合酶基因第4内含子中27碱基对重复序列多态性与糖尿病视网膜病变的相关性研究

目的 观察内皮型一氧化氮合酶(eNOS)基因第4内含子中27碱基对(bp)重复序列(VNTR)的插入/缺失(a/b)多态性与糖尿病视网膜病变(DR)之间的相关性.方法 321例确诊为2型糖尿病且病程在10年以上的患者为病例组,146名健康体检者为正常对照组.所有受检者均为中国汉族.病例组患者根据间接检眼镜及荧光素眼底血管造影检查结果分为DR组和无DR组(NDR组),分别为154、167例.采用聚合酶链式反应(PCR)结合8%聚丙烯酰胺凝胶电泳分离技术检测eNOS基因第4内含子中27 bp VNTR多态性,比较各组间b、a等位基因频率与b/b、a/a、b/a基因型频率,分析其与疾病的相关性.结果 eNOS基因第4内含子中27 bp VNTR b等位基凶频率在DR组显著高于NDR组(x2=4.745,P=0.029;OR=1.685,95%CI=1.050～3.905)和正常对照组(x2=6.958,P=0.008;OR=1.891,95%CI=1.172～4.437);b/b基因型频率在DR组显著高于NDR组(x2=4.811,P=0.028;OR=1.790,95%CI=1.060～4.645)和正常对照组(x2=5.203,P=0.023;OR=1.859,95%CI=1.087～4.952).结论 中国汉族2型糖尿病患者eNOS基因第4内含子b等位基因及b/b基因型与DR发生密切相关.

Abstract：

Objective To investigate the relationship between diabetic retinopathy(DR)and insertion/deletion(a/b)polymorphism of a 27 base pair variable number tandem repeat(VNTR)in intron 4of the endothelial nitric oxide synthase(eNOS)gene.Methods 321 patients of type 2 diabetes mellitus with over 10 years duration(case group)and 146 normal subjects(control group)were enrolled in this study.All the clients are Han Chinese.The case group was divided into DR subgroup(1 54 patients)and non-DR (NDR)subgroup(167 patients)according to the results of indirect ophthalmoscope and fundus fluorescent angiography.The VNTR polymorphism in eNOS gene was determined by polymerase chain reaction(PCR)combined with 8% agarose gel electrophoresis.Then the b,a allele frequency and b/b.a/a.b/a allele frequency of two groups were compared,and its correlation with diseases were analyzed.Results The b allele frequency of the VNTR in intron 4 of eNOS gene in the DR group was significantly higher than that in the NDR group(χ2=4.745,P=0.029;OR=1.685,95% CI=1.050-3.905)and control group(χ2=6.958,P=0.008;OR=1.89l,95% CI=1.172-4.437);b/b allele frequency in the DR group was also significantly higher than that in the NDR group(χ2=4.811,P=0.028;OR=1.790,95% CI=1.060-4.645)and controI group(χ2=5.203,P=0.023;OR=1.859,95% CI=1.087-4.952).Conclusions The b allele and b/b genotype in intron 4 of eNOS gene in the Han Chinese are closely related to DR.     

2型糖尿病患者糖尿病视网膜病变不同时期外周血内皮祖细胞的数量变化

Objective To observe the amount of endothelial progenitor cells(EPCs)at different stages of diabetic retinopathy(DR)in patients with type 2 diabetes mellitus(DM).Methods Sixty patients with type 2 DM were divided into no DR(NDR)group,non-proliferative DR(NPDR)group and proliferative DR(PDR)group according to the examination of fundus and fundus fluorescein angiography,20patients in each group.Twenty healthy people were collected as the control group.6 ml blood samples were taken from all the subjects,and then the EPCs contents in peripheral blood were detected by flow cytometry.Results The EPCs contents in peripheral blood of the control,NDR,NPDR and PDR group were(0.0179±0.0047)% ,(0.0151±0.0086)% ,(0.0123±0.1137)% ,(0.0316±0.0294)% .The EPCs contents in peripheral blood of the PDR group was significantly higher than those in others(χ2=43.780,P＜0.05);the EPCs contents in peripheral blood of the NDR and NPDR group were slightly lower than that in the control group(χ2=5.244,P=0.73);the EPCs contents in peripheral blood of the NPDR group was lower than that in the NDR group(χ2=6.0 1 6,P=0.12).Conclusion The EPCs contents in peripheral blood decreases in NDR,NPDR patients,while significantly increases in PDR patients.     

2型糖尿病患者糖尿病视网膜病变不同时期外周血内皮祖细胞的数量变化

Objective To observe the amount of endothelial progenitor cells(EPCs)at different stages of diabetic retinopathy(DR)in patients with type 2 diabetes mellitus(DM).Methods Sixty patients with type 2 DM were divided into no DR(NDR)group,non-proliferative DR(NPDR)group and proliferative DR(PDR)group according to the examination of fundus and fundus fluorescein angiography,20patients in each group.Twenty healthy people were collected as the control group.6 ml blood samples were taken from all the subjects,and then the EPCs contents in peripheral blood were detected by flow cytometry.Results The EPCs contents in peripheral blood of the control,NDR,NPDR and PDR group were(0.0179±0.0047)% ,(0.0151±0.0086)% ,(0.0123±0.1137)% ,(0.0316±0.0294)% .The EPCs contents in peripheral blood of the PDR group was significantly higher than those in others(χ2=43.780,P＜0.05);the EPCs contents in peripheral blood of the NDR and NPDR group were slightly lower than that in the control group(χ2=5.244,P=0.73);the EPCs contents in peripheral blood of the NPDR group was lower than that in the NDR group(χ2=6.0 1 6,P=0.12).Conclusion The EPCs contents in peripheral blood decreases in NDR,NPDR patients,while significantly increases in PDR patients.     

2型糖尿病患者糖尿病视网膜病变不同时期外周血内皮祖细胞的数量变化

目的 观察2型糖尿病患者糖尿病视网膜病变(DR)不同时期外周血内皮祖细胞(EPCs)的数量变化.方法 临床确诊为2型糖尿病的60例患者纳入研究.根据眼底及荧光素眼底血管造影(FFA)检查结果,将患者分为无视网膜病变(NDR)组、非增生型DR(NPDR)组及增生型DR(PDR)组,每组各20例.选择同期门诊体检正常者20名作为对照组.抽取所有受检者晨起空腹静脉血6 ml,采用流式细胞仪检测,并比较4组受检者外周血EPCs数量的变化情况.结果 对照组、NDR、NPDR及PDR组受检者外周血EPCs数量分别为(0.0179±0.0047)%、(0.0151±0.0086)%、(0.0123±0.1137)%、(0.0316±0.0294)%;PDR组受检者外周血EPCs数量较其他3组高,差异有统计学意义(x2=43.780,P＜0.05);NDR、NPDR组受检者外周血EPCs数量略低于对照组,差异无统计学意义(x2=5.244,P=0.73);NPDR组受检者外周血EPCs数量低于NDR组,但差异也无统计学意义(x2=6.016,P=0.12).结论 NDR、NPDR患者外周血EPCs数量降低,PDR患者外周血EPCs数量显著增高.

Abstract：

Objective To observe the amount of endothelial progenitor cells(EPCs)at different stages of diabetic retinopathy(DR)in patients with type 2 diabetes mellitus(DM).Methods Sixty patients with type 2 DM were divided into no DR(NDR)group,non-proliferative DR(NPDR)group and proliferative DR(PDR)group according to the examination of fundus and fundus fluorescein angiography,20patients in each group.Twenty healthy people were collected as the control group.6 ml blood samples were taken from all the subjects,and then the EPCs contents in peripheral blood were detected by flow cytometry.Results The EPCs contents in peripheral blood of the control,NDR,NPDR and PDR group were(0.0179±0.0047)% ,(0.0151±0.0086)% ,(0.0123±0.1137)% ,(0.0316±0.0294)% .The EPCs contents in peripheral blood of the PDR group was significantly higher than those in others(χ2=43.780,P＜0.05);the EPCs contents in peripheral blood of the NDR and NPDR group were slightly lower than that in the control group(χ2=5.244,P=0.73);the EPCs contents in peripheral blood of the NPDR group was lower than that in the NDR group(χ2=6.0 1 6,P=0.12).Conclusion The EPCs contents in peripheral blood decreases in NDR,NPDR patients,while significantly increases in PDR patients.     

Role of Smad4 from ocular surface ectoderm in retinal vasculature development

AIM: To investigate the association between a set of six candidate genes and the risk of diabetic retinopathy (DR) in an urban community cohort of Chinese patients with type 2 diabetes mellitus (T2DM). METHODS: A population-based cross-sectional study. The diabetic subjects were recruited from an urban community in Beijing and categorized into groups of proliferative diabetic retinopathy (PDR), non-proliferative diabetic retinopathy (NPDR), or diabetic without any retinopathy (DWR) based on the fundus photography and duration of diabetes. Six candidate genes, including advanced glycation end product specific receptor (AGER), aldose reductase (AKR1B1), inducible nitric oxide synthase (iNOS), pigment epithelium derived factor (PEDF), tumor necrosis factor-alpha (TNF-α), and paraoxonase 1 (PON1), were chosen based on Meta-analysis of genetic association studies for DR and biochemical pathways implicated in DR progression. The allele and genotype distribution of 21 functional single-nucleotide polymorphisms (SNPs) in those 6 candidate genes were investigated using MassARRAY genotyping system. RESULTS: Among 1461 diabetic patients recruited from community, 569 were selected in following genotyping analysis, including 97 patients with PDR, 217 with NPDR, and 255 with DWR. For the promoter variant rs1051993 in AGER gene, the distribution of allele and genotype in PDR group differed from that in DWR group (allele: P=0.011; genotype: P=0.01). Compared with DWR, patients with PDR had lower frequencies of heterozygous genotype GT (9.8% for DWR, 1% for PDR, OR: 0.10, 95%CI: 0.01-0.72) and minor allele T (4.9% for DWR, 0.5% for PDR, OR: 0.10, 95%CI: 0.01-0.75). In multivariate model, the distribution of genotype for rs1051993 in PDR group was significantly different from that in DWR group (GT vs GG: OR=0.07, 95%CI: 0.01-0.61, P<0.001). No association with DR was observed in other genotyped SNPs. CONCLUSION: The data suggested a significant association of the promoter variant rs1051993 in AGER gene with PDR in Chinese cohort with T2DM.     

Association of candidate gene polymorphisms with diabetic retinopathy in Chinese patients with type 2 diabetes

AIM: To investigate the association between a set of six candidate genes and the risk of diabetic retinopathy (DR) in an urban community cohort of Chinese patients with type 2 diabetes mellitus (T2DM). METHODS: A population-based cross-sectional study. The diabetic subjects were recruited from an urban community in Beijing and categorized into groups of proliferative diabetic retinopathy (PDR), non-proliferative diabetic retinopathy (NPDR), or diabetic without any retinopathy (DWR) based on the fundus photography and duration of diabetes. Six candidate genes, including advanced glycation end product specific receptor (AGER), aldose reductase (AKR1B1), inducible nitric oxide synthase (iNOS), pigment epithelium derived factor (PEDF), tumor necrosis factor-alpha (TNF-α), and paraoxonase 1 (PON1), were chosen based on Meta-analysis of genetic association studies for DR and biochemical pathways implicated in DR progression. The allele and genotype distribution of 21 functional single-nucleotide polymorphisms (SNPs) in those 6 candidate genes were investigated using MassARRAY genotyping system. RESULTS: Among 1461 diabetic patients recruited from community, 569 were selected in following genotyping analysis, including 97 patients with PDR, 217 with NPDR, and 255 with DWR. For the promoter variant rs1051993 in AGER gene, the distribution of allele and genotype in PDR group differed from that in DWR group (allele: P=0.011; genotype: P=0.01). Compared with DWR, patients with PDR had lower frequencies of heterozygous genotype GT (9.8% for DWR, 1% for PDR, OR: 0.10, 95%CI: 0.01-0.72) and minor allele T (4.9% for DWR, 0.5% for PDR, OR: 0.10, 95%CI: 0.01-0.75). In multivariate model, the distribution of genotype for rs1051993 in PDR group was significantly different from that in DWR group (GT vs GG: OR: 0.07, 95%CI: 0.01-0.61, P<0.001). No association with DR was observed in other genotyped SNPs. CONCLUSION: The data suggest a significant association of the promoter variant rs1051993 in AGER gene with PDR in Chinese cohort with T2DM.     

Application of Lutein and Zeaxanthin in nonproliferative diabetic retin

AIM: To compare serum Lutein and Zeaxanthin (L/Z) concentrations between patients with nonproliferative diabetic retinopathy (NDR) and normal subjects, and to explore the effect of L/Z supplementation on serum L/Z level and visual function in NDR patients METHODS: Subjects were divided into three groups: 30 NDR patients supplied with Lutein 6mg/d and Zeaxanthin 0.5mg/d for three months (DR Group), 30 NDR patients without L/Z supplementation (DR Control Group) and 30 normal subjects (Control Group). Serum L/Z concentrations were measured by liquid high-resolution chromatography (HPLC). Visual acuity was recorded at baseline, 1 month, 2 months and 3 months post initial supplementation. Serum L/Z concentration were measured at baseline, 1 month and 2 months post initial supplementation. Contrast sensitivity (CS) and fovea thickness were recorded at baseline and 3 months post initial supplementation. RESULTS: Mean serum lutein concentrations in DR group were 0.0686±0.0296μg/mL and zeaxanthin concentration was 0.0137±0.0059μg/mL. The L/Z level of DR group was significantly lower compared to the control group( lutein: 0.2302±0.1308μg/mL,zeaxanthin: 0.0456±0.0266μg/m,P = 0.000). The concentration of lutein and zeaxanthin in the DR control group at base line was 0.0714±0.0357μg/mL and 0.0119±0.0072μg/mL, respectively. There was no significant change of L/Z concentration in the DR control group during the study. Serum L/Z concentrations of DR group increased significantly after supplementation（F=109.124,P=0.000;F=219.207,P=0.000）.Visual acuity improved significantly after medication. Compared with pre-medication, the average CS values of 1.5cpd, 3cpd and 6cpd after three months increased significantly (P=0.030,0.013,0.008) and the foveal thickness decreased. (P=0.05) CONCLUSION: Serum L/Z concentrations in DR patients are significantly lower than those in normal subjects, and L/Z intake can improve the visual acuity, CS and macular edema in DR patients, suggesting that L/Z supplementation might be targeted as potential potential therapeutic agents in treating NDR.     

A single nucleotide polymorphism in the IL1RL1 gene is associated with Behcet’s disease in a Chinese Han population

AIM: To explore the association of single nucleotide polymorphisms (SNPs) in the IL33/IL1RL1 gene region with the susceptibility to Behcet’s disease (BD) in a Chinese Han population. METHODS: A total of eight SNPs in the candidate gene region (rs11792633, rs7025417, rs10975519 and rs1048274 in IL33; rs2310220, rs12712142, rs13424006 and rs3821204 in IL1RL1) were genotyped in783 BD patients and 701 healthy controls by the Sequenom Mass Array iPLEX platform. RESULTS: A statistically significant association was observed between IL1RL1 rs12712142 and BD patients. The frequency of IL1RL1 rs12712142 variant allele A was significantly lower in BD patients than that in controls (OR=0.8, 95%CI: 0.69-0.94, Pc=0.039); the genotype distribution (Pc=0.043) and additive and dominant genetic model analyses (OR=0.8, 95%CI: 0.69-0.94, Pc=0.040 and OR=0.72, 95%CI: 0.58-0.88, Pc=0.011) also indicated a strong association between rs12712142 and BD patients. CONCLUSION: This is the first study to reveal the association between IL1RL1 rs12712142 variant allele A and the decreased risk of BD in the Chinese Han population, indicating a protective role of IL1RL1 in the pathogenesis of BD.     

遵义市汉族居民Eales病人类白细胞抗原基因多态性和结核感染的相关性研究

目的 探讨遵义市汉族Eales病与人类白细胞抗原(HLA)-A/B、HLA-DRB/DQB基因多态性和结核感染的相关性.方法 采用聚合酶链反应序列特异引物法(PCR-SSP)检测Eales病组、肺结核组、正常对照组HLA-A/B、HLA-DRB/DQB共59个等位基因分布频率,计算各组间优势比(OR)及95%可信区间(CI);对Eales病组与肺结核组的HLA-A*02基因分布频率做相关分析.Eales病组为临床确诊的Eales病患者47例;肺结核组为痰结核菌培养确诊肺结核并排除眼部疾病的患者36例;正常对照组为与研究组患者年龄、性别、民族等因素无差异的100名健康人.Easle病组中,资料完整的39例Eales病患者根据病史及纯结核菌素试验(PPD)检查结果分为4组,a组为既往或现在患肺结核患者,12例;b组为无结核感染患者,27例;c组为PPD检查阳性者,27例;d组为PPD阴性者,12例.结果 Eales病组HLA-A*02(OR=9.719,OR 95%CI为4.377～21.580,P=0.000)、HLA-B*07(OR=11.605,OR 95%CI为2.397～56.191,P=0.001)基因分布频率高于正常对照组,差异有统计学意义,HLA-A*11基因分布频率低于正常对照组,差异有统计学意义(OR=0.495,OR 95%CI为0.245～1.000,P=0.048).肺结核组HLA-DRB*16(OR=5.215,P=0.049)、HLA-A*02(OR=18.87,P=0.000)基因分布频率高于正常对照组,差异有统计学意义,HLA-A*24基因分布频率低于正常对照组,差异有统计学意义(OR=5.690,P=0.015).a组与b组,c组与d组比较:HLA-A*02、HLA-A*11、HLA-B*07基因分布频率差异无统计学意义.在Eales病组、肺结核组、正常对照组间,HLA-A*02、HLA-A*24、HLA-B*07、HLA-DRB*16基因总体分布频率比较,差异均有统计学意义,进一步行x2分割法在Eales病组、肺结核组间两两比较,肺结核组HLA-A*24基因分布频率低于Eales病组,差异有统计学意义(x2=7.289,P=0.007),而HLA-A*02基因分布频率无统计学意义(OR=0.515,P=0.202).Eales病组与肺结核组HLA-A*02基因相关性比较,差异无统计学意义(列联系数0.412,P=0.064).结论 Eales病可能存在遗传易感性,HLA-A*02和HLA-B*07可能是遵义市汉族Eales病患者的遗传易感基因,而HLA-A*11可能是保护基因;HLA-DRB*16和HLA-A*02可能是遵义市汉族肺结核病的易感基因,而HLA-A*24可能是保护基因.HLA-A*02可能是遵义市汉族人群中Eales病和肺结核病共同的易感基因.

Abstract：

Objective To analyze the relationship of human leukocyte antigen alleles (HLA-A/B,HLA-DRB/DQB) polymorphism and Eales disease, tuberculosis infection in a Han population in Zunyi city of China. Methods The subjects were analyzed by case-control study, which consisted of three groups including Eales disease group (47 patients), pulmonary tuberculosis group (36 patients) and normal control group (100 healthy people). Thirty-nine patients in Eales disease group who had complete history were divided into 4 subgroups according to the history and tuberculin PPD test. Twelve patients with past or present pulmonary tuberculosis were in group A, 27 patients without pulmonary tuberculosis were in group B, 27 patients with positive PPD test were in group C, and 12 patients with negative PPD test were in group D. Fifty-nine alleles of HLA-A/B and HLA-DRB/DQB were analyzed by polymerase chain reaction with sequence-specific primers (PCR-SSP) in all subjects. Odds ratios between each group (OR) and 95%confidence interval (CI) were calculated; Frequency distribution of HLA-A * 02 gene were analyzed for the group A and the TB group. Results The frequency distribution of HLA-A* 02 (OR=9. 719, OR 95% CI:4. 377-21. 580, P=0. 000) and HLA-B* 07 (OR= 11. 605, OR 95% CI: 2. 397-56. 191, P=0. 001) alleles in Eales disease group were obviously higher than that in normal control group, but frequency distribution of HLA-A * 11 (OR = 0. 495, OR 95% CI: 0. 245-1. 000, P= 0. 048) in Eales disease group was obviously lower than that in normal control group. There was no significant difference in frequency distribution of HLA-A * 02, HLA-A * 11 and HLA-B* 07 alleles between groups A and B, and between groups C and D (P＞0. 05). The distribution frequency of HLA-A * 02, HLA-A * 24, HLA-B * 07 and HLA-DRB * 16alleles among Eales disease group, pulmonary tuberculosis group and control group was statistically different (P＜0. 05). The frequency distribution of HLA-A * 24 alleles in pulmonary tuberculosis group was lower than that in Eales disease group (x2 = 7. 289, P = 0. 007), but the frequency distribution of HLA-A * 02 alleles had no significant difference (OR=0. 515, P=0. 202) between two groups. Conclusions The alleles of HLA-A * 02 and HLA-B * 07 may be genetic predisposing genes of Eales disease, but HLA-A * 11 alleles may be protective gene in population of Han nationality from Zunyi city. The alleles of HLA-DRB * 16 and HLA-A * 02 may be genetic predisposing genes of pulmonay tuberculosis. The alleles of HLA-A * 02 may be a common susceptible gene for Eales disease and pulmonary tuberculosis. HLA-A * 11 and HLA-A * 24 alleles were protective genes of Eales disease and pulmonary tuberculosis respectively.     

正确认识和掌握高度近视黄斑病变的诊疗方法,减少高度近视患者视功能损害

以近视眼中心凹劈裂、黄斑裂孔及黄斑裂孔性视网膜脱离、近视性脉络膜新生血管为代表的高度近视黄斑病变是影响高度近视患者视功能的主要原因之一.光相干断层扫描检查有助于提升高度近视黄斑病变的认知水平.选择合适的手术时机,解除玻璃体后皮质和内界膜对视网膜的牵拉,有利于恢复视网膜的弹性,使近视眼中心凹劈裂消失.促进黄斑裂孔的闭合和视网膜复位;而抗新生血管药物与光动力疗法和(或)糖皮质激素联合应用,则是治疗近视性脉络膜新生血管的发展方向.正确认识和掌握高度近视黄斑病变的诊疗方法 和时机,采取针对性的干预措施.使其能够得到合理有效的治疗,是进一步减少高度近视患者视功能损害的关键.     

去炎松对玻璃体切除兔眼视网膜电图和超微结构的影响

3组12只兔双眼行玻璃体切除术，分别于一眼玻璃体内注入0.5、1.0，2.0mg去炎松悬液，另一眼注入眼用平衡盐液．观察术后28天内眼底及ERGb波和28天时视网膜结构的变化．注入各剂量的去炎松在28天时均未完全吸收，0.5、1 .0mg组用药眼ERGb波在各时间点与对照眼及术前无显著差异(P>0.05)；2.0mg组用药眼较术前无显著差异(P>0.05)，较对照眼有轻度升高(t=3.3589，P>0.05)．光镜及电镜下视网膜结构无损害．表明玻璃体切除后使用有效剂量的去炎松对视网膜仍是安全的． （中华眼底病杂志，1996，12：105-107）     

Coats病19例临床病理观察

目的：观察Coats病的临床及病理改变。 方法：复习本院眼科病理室1959—1994年经病理学证实的19例Coats病患者的临床资料和病理切片。 结果：男14例，女5例，年龄为1~18岁，10岁前发病者男性明显多于女性，随年龄增长，性别差异逐渐减少。病理改变主要是视网膜外层血管扩张充血，血管壁厚薄不均及结缔组织增生。晚期病例眼底多见视网膜脱离隆起，表面有血管改变和出血，视网膜下液中有泡沫细胞和胆固醇结晶，有的病例视网膜外层有钙化及骨化。 结论：Coats病是视网膜血管病变引起的视网膜多种病理变化，视网膜下液细胞学检查可作为本病与视网膜母细胞瘤鉴别诊断的可靠方法。 （中华眼底病杂志，1996，12：157-159）     

后巩膜加固术治疗高度近视黄斑裂孔性视网膜脱离

目的：探讨改进的后巩膜加固术对高度近视黄斑裂孔性视网膜脱离的治疗效果。 方法：1993年3月至1995年11月对住院的20例高度近视黄斑裂孔性视网膜脱离患者的20只眼，采用后巩膜加固术治疗，有关临床资料进行回顾分析。 结果：眼轴可对比的14只眼，术前与出院时的均值为28.22mm与26.87mm，17只眼视网膜复位，获得0.02一0.2的矫正视力，3只眼失败，增殖性玻璃体视网膜病变(proliferative vitreous retinopathy，PVR)加重。 结论：后巩膜加固术可有效治疗无严重PVR的高度近视黄斑裂孔所致的视网膜脱离，不必采用视网膜粘连法以尽量保存残留的中心视力。 （中华眼底病杂志，1996，12：214-216）     

兔视网膜中蛋白激酶C的定位研究

目的：证实兔视网膜中有α、β和γ三种蛋白激酶C(protein kinase C，PKC)亚型的分布。方法；采用免疫组织化学技术，以抗PKC同功酶I(α)、Ⅱ(β)、Ⅲ(γ)单克隆抗体对兔视网膜进行PKC同功酶定位研究。 结果：兔视网膜中有PKC-α、PKC-β和PKC-γ的阳性免疫反应。PKC-α免疫反应主要呈现在内核层的双极细胞；PKC-β免疫反应主要呈现在神经节细胞层的神经节细胞；PKC-γ则在神经节细胞层、内网状层以及光感受器的外节呈弥漫性弱阳性染色。 结论：作为中枢神经系统的一部分，视网膜可以同时存在PKC-α、PKC-β和PKC-γ三种亚型。 （中华眼底病杂志，1996，12：242-244）     

病理性近视黄斑劈裂光相干断层扫描图像分型及其对临床的指导意义

病理性近视黄斑劈裂光相干断层扫描(OCT)的类组织学分型可以分为单纯外层劈裂、外层和中层劈裂、外层和内层劈裂、多层劈裂4种情况.以彻底清除玻璃体后皮质及后部血管弓内的内界膜为重点的玻璃体视网手术是治疗病理性近视黄斑劈裂的主要选择.其中,单纯外层劈裂合并中心凹脱离者,手术后视功能改善较明显;而多层劈裂者视功能改善有限或不改善.合理剥除后皮质与内界膜起始点,应在未发生内层劈裂处.正确认识和了解病理性近视黄斑劈裂的OCT分型.对于选择玻璃体视网膜手术方式和判断治疗预后有积极意义.     

前后段联合手术及硅油填充治疗高度近视黄斑孔视网膜脱离的疗效观察

目的 观察前后段联合手术及硅油充填治疗高度近视黄斑孔视网膜脱离临床疗效.方法 回顾分析前后段联合手术及硅油充填治疗高度近视黄斑孔视网膜脱离患者48例48只眼的临床资料.患者均有高度近视史,视网膜脱离以后极部为主.裂隙灯前置镜和(或)光相干断层扫描(OCT)检查均发现黄斑裂孔.均行白内障超声乳化或抽吸联合玻璃体切割硅油充填,41例行内界膜(ILM)剥离,23例植入人工晶状体(10L).硅油取出的时间距第一次手术时间为3.5～48.0个月.取硅油前均行OCT检查.取硅油后随访观察均1年以上.结果 除5例外,其他患者手术后1周,前置镜检查均不能看到黄斑孔边缘;视力均有不同程度的提高.48例患者全部已取硅油.取硅油前OCT检查,黄斑孔愈合呈U型8例,V型为6例,W型为23例;未闭合11例.未闭合的11例经取硅油与膨胀气体充填后全部复位,其中,U型2例,W型9例.32例W型愈合者中2例患者在取油后13、38个月后出现视网膜脱离复发.最终黄斑裂孔U型和V型愈合者16例,占33.3%;W型愈合者32例,占66.7%.视网膜复位率为100.0%.结论前后段联合手术及硅油充填是治疗高度近视黄斑孔视网膜脱离的有效方法 ;OCT检查是确定黄斑孔是否封闭的客观标准.     

病理性近视黄斑裂孔患者黄斑区视网膜前膜的组织学观察

目的 观察病理性近视内界膜表面结构的组织学变化与黄斑裂孔发生发展的关系.方法 同顾分析行玻璃体切割手术的病理性近视黄斑裂孔患者34例34只眼的临床资料.患眼屈光度均超过-6.00 D,眼轴26.00～33.12 mm,平均眼轴长度27.74 mm.5只眼为黄斑裂孔无视网膜脱离(黄斑裂孔组),29只眼为黄斑裂孔合并后极部视网膜浅脱离(视网膜脱离组).对入选患眼行睫状体平坦部三切口的玻璃体切割手术,手术中观察Weiss环以判断玻璃体后脱离程度,获取34只眼的视网膜前膜及19只眼的内界膜组织标本,行苏木精-伊红(HE)及醋酸铀-枸橼酸铅双染色,采用光学及透射电子显微镜观察.结果 玻璃体切割手术中,5只眼出现Weiss环,24只眼的视网膜表面有多层玻璃体组织残留.光学显微镜观察发现,内界膜表面的视网膜前膜主要由玻璃体胶原纤维.星形胶质细胞及细胞外基质组成.透射电子显微镜观察发现,19只眼的内界膜标本中,5只眼可她内界膜一玻璃体胶原纤维-细胞的"三明治"样结构,1只眼可见内界膜损伤、表面组织牵引和星形胶质细胞移行.结论病理性近视玻璃体后界面劈裂、内界膜表面组织结构的变化是黄斑裂孔发生发展直至视网膜脱离的重要原因.     

视网膜内界膜剥离手术治疗高度近视黄斑裂孔视网膜脱离的疗效观察

目的 观察视网膜内界膜剥离治疗高度近视黄斑裂孔视网膜脱离的疗效. 方法 回顾分析25例25只眼高度近视黄斑裂孔伴视网膜脱离患者的临床资料.根据治疗方法 分为2组,A组为单纯玻璃体切割手术,13例13只眼;B组为玻璃体切割手术加吲哚青绿染色内界膜剥离,12例12只眼.所有患者行惰性气体填充,手术后保持面朝下体位7～15 d.观察最佳矫正分辨角对数(LogMAR)视力,检查眼底,光相干断层扫描(OCT)、B型超声检查视网膜复位及黄斑裂孔闭合情况,比较两组间疗效差异.手术后随访6～18个月,平均随访时间10个月. 结果 A组13只眼中,7只眼手术后视网膜复位,占53.8%;B组12只眼中,11只眼手术后视网膜复位,占91.7%.B组视网膜复位率明显优于A组(X2=4.427,P=0.046);25只眼中,手术后黄斑裂孔闭合者17只眼,占68.0%.其中,A组13只眼中,6只眼黄斑裂孔闭合,占A组患者的46.2%;B组12只眼中,11只眼黄斑裂孔闭合,占B组患者的91.7%.两组患者手术后黄斑裂孔闭合率比较,差异有统计学意义(X2=5.940,P=0.020).A组手术后最佳矫正LogMAR视力提高平均0.32,与手术前比较,差异有统计学意义(Z=-2.045,P=0.041),B组手术后最佳矫正LogMAR视力提高平均0.53,与手术前比较,差异有统计学意义(Z=-2.481,P=0.012).两组间手术后视力差异无统计学意义(U=51.5,P=0.16). 结论玻璃体切割联合视网膜内界膜剥离手术可能通过完全解除玻璃体黄斑牵引、增加视网膜顺应性而提高高度近视黄斑裂孔视网膜脱离的治疗效果.显著增加视网膜复位率及黄斑裂孔闭合率.     

高度近视黄斑部视网膜劈裂和非裂孔性视网膜脱离

目的 观察高度近视黄斑部视网膜劈裂(MRS)和非裂孔性视网膜脱离(MRDH)的临床表现和影像学特征.方法 高度近视患者186例349只眼中合并MRS和MRDH的19例24只眼纳入研究.所有患者均进行了主觉验光、双目间接检眼镜、裂隙灯显微镜联合Goldmann三面镜检查,以及眼底照相、A/B型超声和光相干断层扫描(OCT)检查.结果 349只眼中后极部存在MRS和(或)MRDH 24只眼,占6.9%.眼底检查结果 显示.所有患跟均有后巩膜葡萄肿(PS),占100.0%;玻璃体黄斑牵引条带(VMT)2只眼.占8.3%;黄斑部局限性视网膜浅脱离2只眼,占8.3%;黄斑全层裂孔1只眼,占4.2%.B型超声检查结果 显示,所有患眼均伴有PS,占100.0%;黄斑部局限性视网膜浅脱离7只眼,占29.2%,脱离的视网膜与PS锥顶形成弓样结构;VMT条带2只眼,占8.3%.OCT检查结果 显示,黄斑部外层视网膜劈裂(ORS)22只眼,占91.7%,其中合并黄斑部内层视网膜劈裂(IRS)8只眼,占黄斑部ORS的36.4%.MRDH 5只眼,占20.8%,其中合并ORS 3只眼,占MRDH的60.0%;单纯性MRDH 2只眼,占MRDH的40.0%,其中合并VMT 1只眼.VMT 13只眼,占54.2%;黄斑囊样水肿(CME)3只眼,占12.5%;黄斑板层裂孔4只眼,占16.7%.结论 MRS和MRDH是伴有PS的高度近视眼的常见并发症.与常规眼底检查和B型超声相比,OCT是发现MRS和MRDH的更为有效的检查手段.