视网膜色素变性的视网膜电图观察

<正>视网膜色素变性(RP)是一种有明显遗传倾向的进行性视网膜变性类疾病,随着病变的进展,视功能越来越差,呈现视力的减退,视野向心缩小,最终导致失明。本文对96例188只眼RP患者的视网膜电图(ERG)进行分析,报告如下。1对象与方法1.1对象:随机检测了门诊检查确诊的96例188只眼RP患     

糖尿病早期的倍频视野变化研究

目的检测糖尿病患者的中心视野,探讨倍频视野计在糖尿病性视网膜病变(DR)早期诊断中的价值。方法对尚无眼底改变的2型糖尿病患者20例、健康人群20名、DR20例分别做倍频视野检查,分析其视野变化。结果糖尿病患者的视野敏感度较健康组下降(P<0.01),且下降程度随DR的出现而加重。结论糖尿病患者在未出现视网膜病变之前视网膜神经感觉功能已经下降,倍频视野检查可以作为一个监测早期糖尿病性视网膜神经病变的敏感指标。     

糖尿病患者中心视野早期光敏感度分析

目的评价视野检查在糖尿病视网膜病变早期诊断中的作用.方法采用HQDS-Ⅱ型视野分析仪对51例(100只眼)眼底正常的糖尿病患者(糖尿病组)及46例(92只眼)正常人(对照组)进行中心30度视野检查和分析.结果糖尿病组视野光敏感度较对照组平均降低7dB,中心视野的三个区域内的平均光敏感度与对照组的平均光敏感比较,差异有显著性(P＜0.01);糖尿病组视野平均光敏感度与糖化血红蛋白显著相关(r=-0.643,P＜0.05),而与空腹血糖不相关(r=-0.324,P＞0.05).结论糖尿病患者在出现视网膜病变之前视网膜神经感觉功能已受到了损害;这些损害与血视网膜屏障的破坏等形态学病损并不相关,但与糖代谢障碍有关.电脑视野检查在糖尿病视网膜病变的早期诊断中有一定的临床价值.     

sE-选择素和sICAM-1与糖尿病性视网膜病变的相关性研究

目的检测糖尿病性视网膜病变患者血清中sE-选择素和sICAM-1的水平,研究sE-选择素和sICAM-1在糖尿病性视网膜病变发生、发展中的作用及其二者之间的关系。方法选择糖尿病性视网膜病变患者50例;无糖尿病性视网膜病变的2型糖尿病患者100例;年龄、性别相当的正常对照组50例。空腹抽静脉血,采用酶联免疫吸附法(ELISA法)对sE-选择素和sICAM-1进行检测,比较各组之间统计学差异以及sE-选择素和sICAM-1之间的相关性。结果糖尿病性视网膜病变组(A组)和无糖尿病性视网膜病变组(B组)sE-选择素和sICAM-1与对照组(C组)比较均有显著性差异(P<0.01);糖尿病性视网膜病变组(A组)与无糖尿病性视网膜病变组(B组)比较,差异有显著性意义(P<0.01)。糖尿病性视网膜病变组中sE-选择素和sICAM-1呈正相关(r=0.836,P<0.001)。结论 sE-选择素和sICAM-1的测定或许有助于糖尿病性视网膜病变的早期诊断,可能对糖尿病视网膜病变发生和发展有提示意义。     

糖尿病视网膜病变早期视觉对比敏感度变化

目的探讨糖尿病视网膜病变患者早期视觉对比敏感度的变化,为早期的诊断治疗提供临床依据。方法对我院收治的90例2型糖尿病合并视网膜病变的患者、90例2型糖尿病不合并视网膜病变的患者以及随机选取90例正常人进行视网膜的对比敏感度检测,将分辨光栅和方向的对比度进行对比。结果糖尿病患者与正常对照组比较,在0.5、5、10、20、40周/每度视角时,差异均具有统计学意义(P<0.05);黄斑水肿组与无黄斑水肿组比较,空间频率在5、10、20、40处,差异具有统计学意义(P<0.05)。结论糖尿病合并视网膜病变的患者的视觉对比敏感度有所下降,在诊断和治疗方面具有指导作用。     

视网膜色素变性多焦视网膜电图研究

目的 :采用多焦视网膜电图 (mfERG)评价视网膜色素变性 (RP)患者视网膜功能的改变。方法 :用VERIS4 2视诱发反应图像系统测试6例RP患者及6例正常对照者的mfERG。刺激阵列由103个六边形组成 ,刺激野半径23°,记录时间为4min ,分别记录总体反应、6个环行视网膜区域的一阶反应的振幅密度及潜时并行组间比较。结果 :RP组除中央5度外 ,其余各部视网膜的潜时均较正常对照组延长 ,且有显著性差异。RP组视网膜各局部振幅密度均明显下降。结论 :mfERG可准确反应视网膜各局部功能 ,RP患者除中央5度外视网膜各局部视敏度明显下降     

正常人视网膜电图研究

<正> 视网膜电图(Electroretinosram,ERG)是视觉电生理检测技术之一,是视网膜对视觉刺激所产生的综合电位反应,对视网膜病变具有重要诊断价值。近年临床应用日益广泛。本研究采用脉冲氙灯闪光全视野刺激和信号叠加平均技术记录闪光ERG(F—ERG),现将初步结果报告如下。材料和方法一、仪器设备:检查是在安静的P—22型双层铜丝网屏蔽室内进行。仪器系日本光电公司产MEB—5100型诱发电位记录仪,刺激源为SLS—3100型     

糖尿病致早期的视网膜神经退行性病变的临床诊治

目的：对早期糖尿病患者出现视网膜病变的原理进行认识,掌握此病变的临床诊断与治疗。方法：通过对本院临床工作中124例早期糖尿病患者的眼病症状和治疗方案进行研究总结。结果：67例患者治疗后病情好转出院,54例患者长期入院并巩固治疗,3例因多器官衰竭和并发症死亡。结论：做到及时临床检查发现病情,早期糖尿病视网膜病变可控可治。     

浅谈OCT在青光眼早期诊断中的应用及护理

<正>青光眼是一组以视神经萎缩和视野缺损为共同特征的疾病,病理性眼压升高是其主要危险因素。随着病情进展,可进一步出现不可逆的视盘凹陷、萎缩,其防治的关键在于早期检测、早期诊断、早期治疗。目前认为视野缺损是青光眼诊断的金标准,然而有研究表明,青光眼患者在临床上检测到视野缺损时,视网膜神经纤维层(RNFL)已缺失40%~50%。因此,早期发现RNFL缺失对诊断早期青光眼十     

图形视网膜电图与图形视觉诱发电位联合诊断原发性开角型青光眼

目的观察图形视网膜电图（PERG）与图形视觉诱发电位（PVEP）检查在原发性开角型青光眼诊断中的应用价值。方法用图形视网膜电图和图形视觉诱发电位联合检查32例（32眼）原发性开角型青光眼的视功能。结果图形视网膜电图的异常率是81．25％,图形视觉诱发电位的异常率是68．75％,93．75％的受检眼有一项或两项的检查项目异常。结论图形视网膜电图和图形视觉诱发电位联合检查将更有助于原发性开角型青光眼的早期诊断。     

Stargardt病的电生理特征

6例(12眼)Stargardt病者,眼底表现为黄斑变性伴有散在于黄斑区的黄色斑点(8眼);黄斑萎缩无黄色斑点(2眼)。极轻微的黄斑变性伴视网膜黄色斑点(2眼)。应用视网膜电流图和图形视网膜电流图对Stargardt病的电生理特征进行观察分析。结果显示,明适应与暗适应视网膜电流图b波振幅中度异常,4眼正常,且平均值正常。图形视网膜电流图全部低于正常。视觉电生理结果显示,主要病变位于视网膜色素上皮-光感受复合体。图形视网膜电流图可反映黄斑功能,为本病提供了敏感、客观,和早期诊断依据。     

Toxic optic neuropathy following ingestion of homeopathic medication Arnica-30

We report a case of acute, bilateral and severe vision loss after inadvertent consumption of a large quantity of the homoeopathic medication Arnica-30. Severe vomiting which required hospitalization preceded visual symptoms. In the acute stage, pupillary responses to light were absent and fundus examination was normal. Vision loss followed a fluctuating course, with profound loss noted after 6 weeks along with bilateral optic disc pallor. Neuro-ophthalmic examination and detailed investigations were performed, including magnetic resonance imaging, electroretinography (ERG) and visual evoked potentials (VEP). Ocular coherence tomography (OCT) showed gross thinning of the retinal nerve fiber layer. While a differential diagnosis of posterior ischemic optic neuropathy was kept in mind, these findings supported a diagnosis of bilateral toxic optic neuropathy. Arnica-30 is popularly used to accelerate wound healing, including after oculoplastic surgery. While homeopathic medicines are generally considered safe due to the very low concentrations involved, Arnica-30 may be neurotoxic if consumed internally in large quantities.     

Subretinal delivery of erythropoietin alleviates the N-methyl-N-nitrosourea-induced photoreceptor degeneration and visual functional impairments: an in vivo and ex vivo study

Retinitis pigmentosa (RP) is a heterogeneous group hereditary retinal disease that is characterized by photoreceptor degeneration. The present study sought to explore the therapeutic effects of erythropoietin (EPO) on the N-methyl-N-nitrosourea (MNU)-induced photoreceptor degeneration. The MNU-administered mouse or normal control received a subretinal injection of EPO (at the dose of 10U). Twenty-four hours after EPO injection, the retinal EPO levels of experimental animals were quantified. Subsequently, the experimental animals were subjected to optokinetic tests, ERG examination, SD-OCT examination, histology assessment, and immunohistochemistry evaluation. The retinal superoxide dismutase (SOD) activity, malondialdehyde (MDA) content, and expression levels of several apoptotic factors were also quantified. The subretinal injection of EPO up-regulated the retinal EPO level in the retinas of MNU-administered mice. The optokinetic tests and ERG examination suggested the visual functional impairments in MNU-administered mice were ameliorated after EPO treatment. The SD-OCT and histological examination suggested the morphological devastations in MNU-administered mice were alleviated after EPO treatment. The cone photoreceptors in MNU-administered mice were protected from the MNU-induced detrimental effects. Moreover, the EPO treatment rectified the apoptotic abnormalities in MNU-administered mice, and enhanced the expression level of Foxo3, a critical mediator of autophagy. The EPO treatment also mitigated the MDA concentration and enhanced the retinal SOD activity, thereby counteracting the retinal oxidative stress in MNU administered mice. In ophthalmological practice, the subretinal delivery of EPO is a feasible therapeutic strategy to alleviate photoreceptor degeneration. These findings would enrich our pharmacological knowledge about EPO and shed light on the development of an effective therapy against RP.     

血清AFP、GPC3、TGF-β1单独及联合检测对原发性肝癌的诊断价值分析

目的探讨血清中AFP、GPC3、TGF-β1三种肿瘤标志物在原发性肝癌中的诊断价值及联合检测的意义。方法检测了60例原发性肝癌、30例良性肝病(慢性乙型肝炎)和30例正常体检者血清中AFP、GPC3、TGF-β1的含量并进行相关分析。结果原发性肝癌患者血清AFP、GPC3和TGF-β1水平及阳性率均明显高于良性肝病组及正常对照组(P<0.05);联合检测的敏感性和诊断准确性均比单项检测高。结论联合检测血清中的AFP、GPC3及TGF-β1对原发性肝癌的诊断具有重要价值。     

自动视野计测量结果的影响因素分析与护理干预

目的 为了提高自动视野计检查结果的准确性,为疾病的早期诊断和监测病情的发展提供可靠的依据.方法 回顾分析我科在2005年1月～10月应用OCULUS自动视野计为215例患者进行检查,并向患者介绍视野计的检查方法,分析了影响检查结果准确性的因素.结果 患者的文化程度、理解能力和配合程度、瞳孔大小、学习效应及训练因素等均可影响检查的准确性.结论 通过采取有效的护理措施,提高检查结果的准确性和可靠性.     

Ocular adverse effects of Topiramate: Two case reports

Topiramate, an antiepileptic drug is reported to cause various ocular adverse effects like acute onset myopia, glaucoma. Visual field defect is an uncommon, serious treatment emergent adverse effect. We are reporting two cases of suspected topiramate induced visual field defects.Both the cases were on topiramate for more than 6 months as add-on therapy at daily doses ranging from 100-150mg. The presenting complaints were insidious onset visual disturbances. Diagnosis was based of temporal association with drug intake, clinical examination and investigations. Automated perimetry revealed bilateral superior quadrantic and arcuate field defects in the two cases respectively. Marked improvement with drug dechallenge was noted which was also corroborated by perimetry. Using Naranjo's ADR Probability Scale, both cases revealed a "probable" association with topiramate. This report intends to improve awareness amongst clinicians to facilitate early diagnosis and intervention.     

眼外伤患者行视觉电生理检查的临床意义

目的：探讨眼外伤患者行视觉电生理检查的临床意义。方法：选择41例单眼外伤患者进行视网膜电流图（ERG）和视觉诱发电位（VEP）联合检测,比较外伤眼与正常眼的检测结果差异。结果：外伤眼P-EVPP100波幅和F-EVPP100波幅均较正常眼增加（P〈0.05）,P-EVP潜伏期均较正常眼明显延长（P〈0.05）,外伤眼F-ERGa、b波幅均较正常眼明显增大（P〈0.05）。结论：眼外伤患者行视觉电生理检查有助于早期诊断和预后评价。     

原发性青光眼合并白内障手术方式临床评价

目的探讨原发性青光眼合并白内障手术方式临床效果。方法本组53例63眼,根据房角粘连情况将38例48眼闭角青光眼合并白内障患者分为：房角粘连关闭≤180°12眼,采用超乳联合房角分离术;180°〈房角粘连关闭≤270°20眼,采用超乳联合房角分离、虹膜周边切除术;房角粘连关闭〉270°16眼,采用超乳、房角分离联合小梁切除术（简称三联）,15例开角型青光眼合并白内障,视力低于0.4者,行超乳联合小梁切除术,随访3个月-5年,对比术前、术后的视力、眼压、前房深度及前房角变化。结果 29眼急性闭角型青光眼和19眼慢性闭角型青光眼术后眼压控制在正常范围,视力恢复良好;6只慢性闭角型青光眼房角粘连〉2/3,术后近期眼压控制好,术后1.8-2.0年眼压再次增高,药物效果好,眼压控制在正常范围。15例开角型青光眼合并白内障者,术后视力均提高,术后眼压12眼控制正常范围,3眼术后近期眼压控制好,1.0-1.5年眼压再次增高,药物控制眼压良好。结论对于原发性闭角型青光眼合并白内障患者,根据房角关闭情况：行超乳联合房角分离术、虹膜周边切除术超乳联合小梁切除术（三联术）,开角性青光眼合并白内障患者,超乳联合小梁切除术可有效控制眼压,但仍需长期随访。     

高度近视对原发性开角型青光眼临床诊断的影响

目的探讨高度近视对原发性开角型青光眼（primary open angle glaucoma，POAG）各种诊断指标的影响，以便提高POAC的早期诊断率，减少漏诊的发生率。方法对25例38眼高度近视合并POAG的各项指标进行回顾性分析？结果只有8眼（21．05％）表现为典型的青光眼视杯，其余均不典型。弥漫性视神经纤维层缺损18眼（47，37％）；9眼（23．68％）不易辨认视神经纤维层。12眼表现为晚期青光眼性视野损害（31．58％），31眼（81.58％）眼压〉21mmHg。结论高度近视可影响POAG的典型体征包括眼压、眼底及视野？认识高度近视合并POAG时的临床特点，有利于提高临l床医师对该病的警觉性及早期诊断水平.     

Potential implications for pathophysiology in a type 1 diabetic patient affected by Stargardt disease

PURPOSE/METHOD: To present a 35-year-old woman affected by type 1 diabetes mellitus, Stargardt maculopathy and fundus flavimaculatus. To our knowledge, this association is unusual and not yet described in the ophthalmic literature. RESULTS/CONCLUSIONS: Visual acuity was reduced to < 20/200 in both eyes, color vision was absent and computerized perimetry showed an absolute central scotoma. Pattern visual evoked potentials and electroretinogram (ERG) (scotopic, photopic and flicker) were considerably reduced in amplitudes. Full-field ERG was within normal limits whereas oscillatory potentials were reduced in number and amplitude. Fluorescein angiography confirmed the diagnosis of Stargardt maculopathy and fundus flavimaculatus but no diabetic retinopathy was clinically evident. Potential interactions between the diabetic microangiopathy and the retinal degenerative disorder are hypothesized and discussed.