盐酸哌唑嗪点眼房水葡萄膜巩膜途径的形态观察

目的观察兔眼房水葡萄膜巩膜途径的形态，探讨选择性α１受体阻断剂盐酸哌唑嗪（ｐｒａｚｏｓｉｎ，ＰＺ）点眼对该途径的形态学影响。方法前房注入微量示踪剂异硫氰酸荧光素牛血清白蛋白（ｆｌｕｏｒｅｓｃｅｉｎｉｓｏｔｈｉｏｃｙａｎａｔｅ－ｂｏｖｉｎｅｓｅｒｕｍａｌｂｕｍｉｎ，ＦＩＴＣ－ＢＳＡ）于ＰＺ点眼后２，４，６，８，１０，１２ｈ各处死家兔２只，摘除双侧眼球作冰冻切片，荧光显微镜下观察并确定睫状体、脉络膜上腔、前后巩膜和脉络膜的荧光强度等级。光镜下观察其组织结构变化。结果ＰＺ点眼后眼压出现有统计学意义的下降。ＰＺ点眼后葡萄膜巩膜途径各部位的荧光强度均比对照组显著增强，光镜观察仅见ＰＺ组睫状肌细胞间隙扩大。结论ＰＺ点眼可使眼压下降，点眼后促进房水从葡萄膜巩膜途径排出，房水由睫状肌细胞间隙到脉络膜上腔后，主要经前巩膜排出，后巩膜及脉络膜排出较少。     

匹罗卡品对兔眼葡萄膜巩膜途径作用的形态学研究

目的：从形态学方面探讨匹罗卡品对兔眼葡萄膜巩膜途径的作用。方法：通过前房内注入微量示踪剂异硫氰酸荧光素牛血清白蛋白（Fluorescein isothiiocyanate-bovine serum albumin,FITC-BSA),匹罗卡品点眼后2,4,6,8,10和12h各处死家兔2只,摘除眼球作冰冻切片,于荧光显微镜下观察并确定睫状体、脉张膜上腔、前、后巩膜和脉络膜的荧光强度等级,并于光镜下观察其组织结构改变。结果：匹罗卡品点眼后眼压下降,点眼后睫状体、脉络膜上腔和前巩膜荧光强度均显著减弱,后巩膜、脉络膜无明显变化。光镜观察见睫状肌细胞间隙缩小。结论：匹罗卡品通过收缩睫状肌而减少房水从葡萄膜巩膜途径排出。     

眼调节对葡萄膜巩膜房水外流途径影响的形态学观察

目的　通过形态学观察探讨眼调节对葡萄膜巩膜房水外流途径的影响。方法　14只健康日本大耳白兔,10只（20眼）用于荧光显微镜观察,4只（8眼）用于光镜观察,按用药方法不同各分为调节状态组和非调节状态组。所有白兔双眼分别采用5 g·L^-1硝酸毛果芸香碱滴眼液和10 g·L^-1盐酸环喷托酯滴眼液模拟眼调节态和非调节态,测量滴眼前及末次滴眼后30 min的眼压,于滴眼后30 min将5 μL异硫氰酸荧光素标记牛血清白蛋白（FITC-BSA）注入前房,于前房注射后0.5 h、1.5 h、2.5 h、3.5 h、4.5 h各处死2只白兔,摘取双眼作冰冻切片,于荧光显微镜下观察调节态和非调节态葡萄膜巩膜途径的房水荧光强度及其分布形态;于滴眼后30 min处死4只白兔,摘取双眼通过HE染色和抗平滑肌抗体染色在普通光镜下观察兔眼睫状肌形态、肌间隙。结果　调节状态组基线眼压（19.13±1.75）mmHg（1 kPa=7.5 mmHg),毛果芸香碱模拟眼调节后眼压下降,滴眼后眼压为（16.56±1.67）mmHg,差异有统计学意义（t=9.37,P=0.00)。调节状态组睫状体、脉络膜上腔和前巩膜荧光强度较非调节状态组均显著减弱（均为P<0.05）,而两组间后巩膜、脉络膜差异均无统计学意义（均为P＞0.05）。光镜观察见非调节状态组放射肌区域有明显肌间隙,而在调节状态组未发现此间隙。结论　眼调节可通过收缩睫状肌从而减少房水从葡萄膜巩膜房水外流道排出。     

Lat-B对家兔房水葡萄膜巩膜引流通路的影响

目的:研究Lat-B对家兔眼内压、葡萄膜巩膜通路的影响。方法:兔眼局部应用Lat-B,BSS和DMSO,于用药前1h及用药后1,2,3,4,5,6,24h测量眼压后部分免疫荧光组通过前房内注入微量示踪剂异硫氰酸荧光素牛血清白蛋白(fluorescein isothiocyanate bovine serum albumin,FITC-BSA),于点眼后2,4,6,8,10h各处死家兔2只,摘除双侧眼球作冰冻切片,于荧光显微镜下观察并确定睫状体、脉络膜上腔、前、后巩膜和脉络膜的荧光强度等级。结果:Lat-B滴眼后处理眼眼压不同时间点与滴眼前比较眼压呈下降趋势,差异有显著性(P<0.05),1h即可引起眼压降低,24h仍有效,BSS组与DMSO组未引起眼压下降;葡萄膜巩膜途径通路3组之间在睫状体、脉络膜上腔、前、后巩膜和脉络膜的荧光强度,各部位均为Lat-B组最强,Lat-B与BSS组和DMSO组相比差异均有显著性(P<0.05),BSS组和DMSO组相比差异无显著性。结论:Lat-B能够有效降低眼压,1h即可起效,且24h仍有效。Lat-B可以增加葡萄膜巩膜途径通路的房水流出率,具有治疗青光眼的应用前景,尤其是正常眼压性青光眼、开角性青光眼。     

盐酸哌唑嗪对脱交感家兔眼葡萄膜巩膜途径的形态学研究

目的：从形态学探讨盐酸哌唑嗪（PZ）对脱交感家兔眼（FSRE）葡萄膜巩膜途径（FU）的作用。方法：家兔作单侧颈交感神经节切除术后第14日在手术侧点PZ滴眼液,通过前房内注入异硫氰酸荧光素牛血清白蛋白,PZ点眼后每2h各处死家兔2只,于荧光显微镜下观察FU各部位的荧光强度等级。结果：PZ点眼后FSRE眼压下降,但降压幅度低于正常家兔眼;点眼后FU各部位的荧光强度均稍强于对侧眼的相应部位。结论：PZ增加FU排出的作用在FSRE明显减弱,其作用部分依赖于交感神经活性,尚有未通过交感活性的其它机制。     

哌唑嗪点眼对脱交感兔眼葡萄膜巩膜房水流出量的影响

目的　探讨哌唑嗪（ＰＺ） 对脱交感眼的降眼压机理。 方法　制作家兔单侧颈上交感神经节切除模型,交感神经节切除侧之兔眼点用０ ．１ ％ ＰＺ,用示踪剂异硫氰酸荧光素牛血清白蛋白（ＦＩＴＣＢＳＡ） 对正常对照组和脱交感组（ＳＣＧ 组）兔眼进行前房灌注,测定葡萄膜巩膜房水流出量。 结果　脱交感眼葡萄膜巩膜房水流出量为（０ ．２４５ ±０ ．００９）μｌ／ｍｉｎ ,比正常对照组显著增加（ Ｐ＜ ０ ．０１） 。 结论　葡萄膜巩膜途径房水排出增加是脱交感眼ＰＺ 降眼压的机理     

盐酸哌唑嗪点眼对葡萄膜巩膜房水流出量的影响

目的探讨盐酸哌唑嗪（ＰＺ）点眼对葡萄膜巩膜房水流出量的影响。方法用示踪剂异硫氰酸荧光素牛血清白蛋白（ＦＩＴＣＢＳＡ）对兔眼进行前房灌注，测定对照组和ＰＺ点眼组双眼前葡萄膜、前巩膜、后葡萄膜、后巩膜、视网膜和残余液体的前房水再现量，计算葡萄膜巩膜流出量。结果ＰＺ组双眼葡萄膜巩膜流出量显著高于对照组，ＰＺ点眼侧显著高于对侧眼。对照组和ＰＺ组双眼的前房水再现量均以前葡萄膜、前巩膜和残余液体为多。结论家兔ＰＺ点眼后增加葡萄膜巩膜途径房水流出量，房水主要由前巩膜排出。科     

非穿透性小梁手术对葡萄膜巩膜房水流出量的影响

目的探讨非穿透性小梁手术（nonpenetrating trabecular surgery，NPTS）对葡萄膜巩膜房水流出量的影响，从房水动力学的角度揭示NPTS降眼压的机制。方法用示踪剂异硫氰酸荧光素牛血清白蛋白（fluoresceinisothiocyanate—bovine serum albumin：FITC—BSA）于术后7d分别对手术后的兔眼模型组和正常兔眼组进行前房持续灌注30min，灌注毕处死家兔，摘除双侧眼球，并将组织分离为前巩膜、后巩膜、前葡萄膜、后葡萄膜、视网膜和残余液体等6种组织。测定每种组织的荧光强度，计算葡萄膜巩膜流出量（uveoscleral outflow，Fu）。结果实验组葡萄膜巩膜流出量明显高于正常组，两组前房水再现量均以前葡萄膜、前巩膜和残余液体为多，实验组术后葡萄膜巩膜通道各组织房水再现量与正常组相比差异有统计学意义（p〈0．001）。结论非穿透性小梁手术能增加葡萄膜巩膜途径房水流出量，房水主要由前巩膜排出。     

葡萄膜巩膜途径降眼压机制治疗青光眼的研究进展

房水排出障碍导致的眼压升高是引起青光眼发病的主要原因,而降眼压仍是目前青光眼治疗的主要方法。房水外流主要通过传统的小梁网途径和非传统的葡萄膜巩膜途径,通过非压力依赖性的葡萄膜巩膜途径降低眼压以治疗青光眼越来越受到重视。本文综述了应用药物和手术从葡萄膜巩膜途径降眼压机制治疗青光眼的研究进展。     

兔眼非穿透性小梁切除术后早期葡萄膜巩膜途径的组织病理学改变

目的:观察兔眼非穿透性小梁切除术(nonpenetratingtabecularsurgery,NPTS)后房水葡萄膜巩膜引流途径的组织病理学改变,进一步阐明其降压机制。方法:8只家兔,随机选1眼作NPTS即A组(n=8),另1眼为正常对照即B组(n=8)。术后观察眼压,1wk后处死家兔摘除眼球分别行HE染色、SMA免疫组化染色,光镜下观察葡萄膜巩膜途径的各组织结构改变。结果:A组术前、术后1wk时眼压差别有显著性(P<0.01);光镜观察见A组房水池底部巩膜纤维间隙疏松、睫状体微小脱离,SMA免疫组化显示睫状肌细胞间隙无明显改变。结论:NPTS后房水池底部巩膜纤维间隙增大和/或睫状体微小脱离是葡萄膜巩膜途径引流量增强的组织解剖基础。     

Possibilities and prospects of therapy and prevention of corneal dystrophies

Therapeutic approaches in corneal dystrophies should aim at long-term avoidance of recurrences. At the moment, this goal can only be achieved by transplantation of healthy corneal cells. In dystrophies of keratocytes and/or endothelial cells this can be realized by conventional penetrating keratoplasty. In epithelial dystrophies, however, simultaneous transplantation of limbal stem cells is necessary. Optimal HLA-matching strategies and immunosuppressive medication are major means to prevent immunological destruction of these.     

外源性VEGF及Ang-1对大鼠CNV的作用及机制探讨

目的:研究细胞因子VEGF,Ang-1对大鼠脉络膜新生血管的形成、分化以及成熟过程的影响及机制。方法:采用激光光凝诱导建立大鼠CNV动物模型后,分别在不同时期玻璃体腔注射VEGF,Ang-1,通过其眼底荧光造影与病理切片的变化观察上述因子的作用。结果:血管生成素-1组比对照组晚期渗漏明显减少,VEGF组较对照组晚期渗漏明显增加;组织病理切片显示实验组瘢痕形成,VEGF组和对照组可见肉芽组织。结论:血管生成素-1能有效抑制脉络膜新生血管的生成,促进新生的脉络膜新生血管成熟,促进瘢痕形成。     

Detection and discrimination of the direction of motion in central and peripheral vision of normal and amblyopic observers

This paper describes the "motion" properties of the amblyopic fovea and compares them to the normal periphery. Specifically, thresholds for detection of the displacement of a grating pattern, and for discrimination of displacement direction were measured. The main findings of these experiments were: in the central vision of both normal and amblyopic observers, unreferenced displacement are detected with an accuracy equal to the observer's grating acuity; in the normal periphery, unreferenced motion thresholds fall off at a slower rate than does grating acuity; in amblyopic eyes, displacement thresholds are most elevated centrally; the addition of an abutting reference improves detection of motion for the normal fovea and in anisometropic amblyopes, but elevates motion thresholds in both the normal periphery and in the fovea of amblyopes with strabismus. The adequacy of the normal periphery as a model for the central vision of amblyopes is discussed.     

增生型糖尿病视网膜病变患者血浆和玻璃体中VEGF和低密度脂蛋白受体相关蛋白6的表达及其相关性

目的　通过定量检测血管内皮生长因子（ｖａｓｃｕｌａｒｅｎｄｏｔｈｅｌｉａｌｇｒｏｗｔｈｆａｃｔｏｒ,ＶＥＧＦ）和低密度脂蛋白受体相关蛋白６（ｌｏｗｄｅｎｓｉｔｙｌｉｐｏｐｒｏｔｅｉｎｒｅｃｅｐｔｏｒ-ｒｅｌａｔｅｄｐｒｏｔｅｉｎ６,ＬＲＰ６）在增生型糖尿病视网膜病变（ｐｒｏｌｉｆｅｒａｔｉｖｅｄｉａｂｅｔｉｃｒｅｔｉｎｏｐａｔｈｙ,ＰＤＲ）患者血浆和玻璃体中的表达水平,并探究其相关关系,为ＰＤＲ的防治提供依据。方法　选择ＰＤＲ患者６０例,非增生型糖尿病视网膜病变（ｎｏｎｐｒｏｌｉｆｅｒａｔｉｖｅｄｉａｂｅｔｉｃｒｅｔｉｎｏｐａｔｈｙ,ＮＰＤＲ）患者６２例,单纯性糖尿病患者（对照组）５５例。ＥＬＩＳＡ检测各组血浆和玻璃体中ＶＥＧＦ、ＬＲＰ６浓度,并对三组检测指标进行统计学比较。结果　ＰＤＲ组血浆和玻璃体ＶＥＧＦ浓度显著高于对照组和ＮＰＤＲ组,差异均有统计学意义（均为Ｐ＜０．０５）。对照组和ＮＰＤＲ组差异具有统计学意义（Ｐ＜０．０５）。ＰＤＲ组玻璃体中ＬＲＰ６浓度高于ＮＰＤＲ组和对照组,差异均具有统计学意义（均为Ｐ＜０．０５）。ＮＰＤＲ组和对照组玻璃体中ＬＲＰ６差异具有统计学意义（Ｐ＜０．０５）。各组血浆中ＬＲＰ６浓度差异无统计学意义（Ｐ＞０．０５）。ＰＤＲ组血浆和玻璃体中ＶＥＧＦ浓度呈显著正相关（ｒ＝０．６０,Ｐ＜０．０５）。结论　ＰＤＲ患者血浆和玻璃体中ＶＥＧＦ与ＬＲＰ６水平能较好反映视网膜新生血管活动情况,检测血浆和玻璃体中ＶＥＧＦ与ＬＲＰ６水平可为早期诊断ＰＤＲ提供理论依据。     

息肉状脉络膜血管病变的诊治现状与进展

息肉状脉络膜血管病变(polypoidal choroidal vasculopathy,PCV)是一组常见的视网膜疾病,有色人种多见,在我国主要患者群以60岁左右为主,且女性较多见,该病目前发病原因不明且尚无特效药,眼底镜下可见橘红色病灶、出血及渗出,结合吲哚菁绿血管造影(indocyanine green angiography,ICGA)可做出诊断,近几年对其治疗的主要手段有光动力疗法(photodynamic therapy,PDT)、玻璃体腔抗VEGF药物注射疗法、针对并发症的手术治疗及其联合治疗,本文将对息肉状脉络膜血管病变的诊疗展开综述,对其未来的研究方向进行展望.     

泪腺炎症及淋巴细胞增生性病变的CT及磁共振成像诊断

目的研究泪腺炎症及淋巴细胞增生性病变的CT和MRI表现及其诊断价值。设计回顾性病例系列。研究对象泪腺炎症及淋巴细胞增生性病变患者46例。方法回顾分析46例经病理学或临床证实的泪腺炎症及淋巴细胞增生性病变患者的CT及MRI影像资料。主要指标病变形态、信号(密度)、累及范围。结果46例患者中炎性假瘤32例,表现为泪腺体积增大,CT示泪腺呈均匀等密度,MRI T_1WI及T_2WI呈等或低信号,1例可见多发囊变,MRI增强扫描病变强化明显。Mikulicz病4例,均为双侧泪腺弥漫增大,CT呈均匀等密度,MRI T_1WI及T_2WI均呈低信号,增强后呈明显均匀强化。反应性淋巴细胞增生5例,表现为泪腺体积增大,CT呈均匀等密度,MRI T_1WI、T_2WI呈低或等信号,1例T_2WI呈高信号,增强扫描呈明显强化。非典型性淋巴细胞增生1例,CT表现为双侧泪腺弥漫性增大,密度均匀。泪腺淋巴瘤4例(B细胞淋巴瘤3例,组织细胞肉瘤1例),表现为双侧泪腺弥漫性增大。结论泪腺炎症及淋巴细胞增生性病变的影像表现相似,CT及MRI有助于病灶与泪腺上皮性肿瘤的鉴别,并可准确显示病变累及范围。(眼科,2007,16:308-311)     

论数字眼视光学的方法和意义

利用数字化技术的优势,结合一些成熟的数理理论（如传递函数、积分变换等）和信息学的新技术（如机器视觉、数据挖掘、数字三维模型等）,对眼视光学基础理论和临床应用的研究方法、手段进行提升和改进,使之更加定量化、模型化、数字化,从而可以取得一些新的成果和突破.     

CT-scan and intraocular tumours: detection and assessment of size and extrascleral growth of uveal melanomas

Twenty-two patients, who were suspected of an intraocular tumour, were examined with the high resolution thin slice CT-scan (1.5 or 3 mm slices). The final diagnosis in 14 cases was an uveal melanoma, and in 3 cases in which an uveal melanoma was suspected a chorioretinal haemorrhage, an exudative macular degeneration type Junius Kuhnt and an intrascleral foreign body were respectively found. In 2 cases intraocular metastases were demonstrated, and in 2 other cases malignant lymphomata. One patient had a haemangioma. In 10 of the 14 patients with uveal melanomata enucleation was performed and 4 were treated by ruthenium application. The CT-scan was compared with ultrasonographic, operative and histological findings. From the study it appears that the CT-scan is useful for screening uveal melanomas. It is however difficult to distinguish the uveal melanoma from a secondary retinal detachment; differentiation from an exudative macular degeneration was not possible. The size of the tumour was only represented correctly on the CT-scan in half the cases. CT examination fails to demonstrate or exclude epi-and extrascleral growth. The multiple metastases and the haemangioma could only be seen with difficulty on the CT-scan; the latter was however clearly visible after the injection of contrast. The foreign body could be clearly seen without contrast.     

Objective and subjective evaluation of cyclovergence and cyclofusion

There is a marked dispersion in the measured results of the angle formed by the intersection of the optic disc-center-meridian with the horizontal meridian, when the cycloposition of the eyes is determined through evaluation of the position of the optic disc (with fundus photographs or indirectly with perimetry).Values of the angle ranging from 0° at 12° are still physiological. Inside this dispersion, individual right-left asymmetries of less than 4° with photography and of less than 7° with monocular perimetry are still normal as well. Positional differences of less than 4° in sequential testings are also in a physiological range.The motor behaviour of both eyes during cyclofusion is evaluated by means of a perimetrical analysis of the blind spot at the phase-difference haploscope. Various sensory and motor adaptation phenomena are detected by comparing objective and subjective findings in patients with cyclotropia. These phenomena are discussed in detail.