原发性青光眼基础临床研究进展与发展趋势

青光眼是全球第二大致盲眼病、不可逆性盲最主要的原因.青光眼的流行病学、发病机制、早期诊断、基础与临床研究、致病基因筛选及视功能测定、视神经损伤与保护等问题尚处于探讨阶段.因此,有必要回顾国内近年来青光眼的基础与临床研究进展情况,分析青光眼研究领域存在的问题,明确今后青光眼的研究方向,进一步推动青光眼的基础与临床研究深入发展.文中就近年来原发性青光眼的流行病学状况、基础研究、视功能检测、临床治疗方法的研究进展做一综述.     

原发性婴幼儿型青光眼的研究

原发性婴幼儿型青光眼是儿童致盲的主要原因之一，本文从概念、分类、流行病学、病理和发病机理、临床表现、检查方法、鉴别诊断及治疗等方面对这一疾病给予全面系统的描述。对先天性青光眼的认识具有一定的意义。     

原发性婴幼儿型青光眼的研究

原发性婴幼儿型青光眼是儿童致盲的主要原因之一，本文从概念，分类，流行病学、病理和发病机制，临床表现，检查方法，鉴别诊断及治疗等方面对这一疾病给予全面系统的描述，对先天性青光眼的认识具有一定的意义。     

原发性闭角型青光眼流行病学研究进展

青光眼是全球第二大致盲眼病、不可逆性盲最主要的原因。原发性闭角型青光眼(PACG)是亚洲、特别是东亚、中国人中最常见的青光眼类型。随着社会、经济、环境的变化以及诊疗手段的进步,青光眼的流行病学特点不断变化;不同的青光眼诊断标准和分类系统也会导致不同的流行病学调查结果;流行病学的特征又指导着临床干预措施;这一切都密切相关,因此,PACG流行病学状况对青光眼的防治有着重要的意义。本文就国内外PACG流行病学相关研究进展作一综述。     

我国原发性青光眼流行病学研究进展

青光眼是不可逆盲的主要病因。随着社会、经济、环境的变化以及诊疗手段的进步,青光眼的流行病学特点也在不断的变化。由于不同的青光眼诊断标准和分类系统可以导致不同的流行病学调查结果,而流行病学的特征又指导着临床的干预措施。因此青光眼流行病学状况对青光眼的防治有着重要的意义。本文就我国原发性青光眼流行病学相关研究进展作一综述。     

全国青光眼规范诊疗学习班将在北京举办

中国医师协会和北京协和医院眼科联合举办的“全国青光眼规范诊疗学习班”将于2004年11月中旬在北京举办，会期5天，会务费860元，学习期满授予国家Ⅰ类继续教育学分10分。授课内容：青光眼的临床及进展、青光眼的流行病学、青光眼的遗传、原发性闭角型青光眼的早期诊断和治疗、原发性开角型青光眼的早期诊断和治疗、青光眼手术治疗及其进展、先天性     

全国青光眼规范诊疗学习班将在北京举办

中国医师协会和北京协和医院眼科联合举办的“全国青光眼规范诊疗学习班”将于2004年11月中旬在北京举办，会期5天，会务费860元，学习期满授予国家Ⅱ类继续教育学分10分。授课内容：青光眼的临床及进展、青光眼的流行病学、青光眼的遗传、原发性闭角型青光眼的早期诊断和治疗、原发性开角型青光眼的早期诊断和治疗、青光眼手术治疗及其进展、先天性青光眼的临床及进展、继发性青光眼的临床及进展、青光眼的药物治疗及进展、青光眼的激光治疗及进展、青光眼手术并发症     

时讯

全国青光眼规范诊疗学习班将在北京举办中国医师协会和北京协和医院眼科联合举办的“全国青光眼规范诊疗学习班”将于 2 0 0 4年 11月中旬在北京举办 ,会期 5天 ,会务费 86 0元 ,学习期满授予国家Ι类继续教育学分 10分。授课内容 :青光眼的临床及进展、青光眼的流行病学、青光眼的遗传、原发性闭角型青光眼的早期诊断和治疗、原发性开角型青光眼的早期诊断和治疗、青光眼手术治疗及其进展、先天性青光眼的临床及进展、继发性青光眼的临床及进展、青光眼的药物治疗及进展、青光眼的激光治疗及进展、青光眼手术并发症及处理、青光眼的视野检…     

儿童青光眼及其治疗的研究进展

儿童青光眼是指发生在从出生到18岁、多种原因引起的不同类型青光眼所组成的一组疾病.这组疾病在诊断和治疗上存在相当难度,严重危害儿童视力.目前,药物治疗只能采用成年人抗青光眼药物,但药物副作用明显大于成年人;手术治疗的效果并不理想,同时存在一系列并发症、再手术和晚期失败的可能性.本文着重叙述原发性先天性青光眼、先天性白内障术后继发性青光眼和Sturge-Weber综合征继发青光眼这三种常见类型的儿童青光眼的临床特点、临床表现、治疗措施和研究进展.     

亚太地区青光眼的流行病学

原发性开角性青光眼是亚太地区第二主要的永久盲目原因.所以确定与开角性青光眼相关的流行病学和其危险因素是非常重要的.青光眼视神经损害的危险性随着年龄和眼内压的升高而增加.本文强调了我们对几个开角青光眼危险因素的研究:1.眼压升高;2.近视眼;3.怀疑视神经杯盘比增大;4.伴有视盘出血的视杯;5.视神经纤维缺损.被认为是具有原发性青光眼危险因素一般的和系统状态为:1.青光眼家族史;2.年龄增长;3.糖尿病;4.如视网膜中央静脉阻塞等的心血管状态;5.讨论青光眼对甲状腺素和皮质类固醇高反应的内分泌失调.     

Strabisme Alternant - Etude clinique - traitement

The author defines motor and sensory alternation: the term alternation should not be used in isolation, it should always be accompanied by the name of the parameter concerned. Sensory alternation is always found together with motor alternation but the reverse is not true.The examining criteria for a diagnosis of sensory alternation are given, sensory alternation must not be confused with alternating inhibition. Working from clinical observations of cases of motor alternating strabismus, the author selects 2 types of binocular sensory relations which allow one to differentiate between:- cases of primary alternating strabismus- cases of secondary alternating strabismusThese forms will develop in different ways; in both cases a cure is possible providing that the right treatment is prescribed and once prescribed carefully followed, etc. It is always a case of serious forms of strabismus whose developmental period is spread over several years.According to the authors, the frequency of cases of true primary strabismus is from 1–3%, the frequency of cases of secondary alternating strabismus varies according to the type of therapy practised on cases of monocular strabismus with amblyopia. These latter will become cases of alternating strabismus under the influence of certain types of therapy carried out over several years (penalization, rocking, alternated occlusion, etc...).Experimental data on kittens confirm clinical data; kittens placed in abnormal environments during the sensitive period will show modification in the distribution of cortical cells and the absence of binocular cells (either because the excitation of the two eyes was not simultaneous, or not identical: artificial strabismus, occlusion, opaque glasses). This disturbances become irreversible after a certain period of exposure (a function of age, length of exposure, etc...).It is thus necessary to bear in mind: 1) the iatrogenic risks of certain orthoptic treatments, 2) the necessity for a binocular form of treatment as soon as possible, as once a certain stage is passed, cortical plasticity diminishes and the elaboration of normal binocular relations becomes impossible.

---

     

Effects of Adenosine Agonists on Intraocular Pressure and Aqueous Humor Dynamics in Cynomolgus Monkeys

The effects of single or multiple topical doses of the relatively selective A₁adenosine receptor agonists (R)-phenylisopropyladenosine (R-PIA) and N⁶-cyclohexyladenosine (CHA) on intraocular pressure (IOP), aqueous humor flow (AHF) and outflow facility were investigated in ocular normotensive cynomolgus monkeys. IOP and AHF were determined, under ketamine anesthesia, by Goldmann applanation tonometry and fluorophotometry, respectively. Total outflow facility was determined by anterior chamber perfusion under pentobarbital anesthesia. A single unilateral topical application of R-PIA (20–250 μg) or CHA (20–500 μg) produced ocular hypertension (maximum rise=4.9 or 3.5 mmHg) within 30 min, followed by ocular hypotension (maximum fall=2.1 or 3.6 mmHg) from 2–6 hr. The relatively selective adenosine A₂antagonist 3,7-dimethyl-1-propargylxanthine (DMPX, 320 μg) inhibited the early hypertension, without influencing the hypotension. Neither 100 μg R-PIA nor 500 μg CHA clearly altered AHF. Total outflow facility was increased by 71% 3 hr after 100 μg R-PIA. In conclusion, the early ocular hypertension produced by topical adenosine agonists in cynomolgus monkeys is associated with the activation of adenosine A₂receptors, while the subsequent hypotension appears to be mediated by adenosine A₁receptors and results primarily from increased outflow facility.