玻璃体切除术前视觉电生理测定的意义

目的对玻璃体视网膜病变患者于玻璃体切除术前行视觉电生理测定，以探讨其对患者预后的诊断价值。方法对因眼外伤、视网膜脱离、视网膜血管疾患等导致玻璃体出血或混浊的８２例患者在玻璃体切除术前行视网膜电图（ｅｌｅｃｔｒｏｒｅｔｉｎｏｇｒａｍ，ＥＲＧ）及视诱发电位（ｖｉｓｕａｌｅｖｏｋｅｄｐｏｔｅｎ－ｔｉａｌ，ＶＥＰ）测定，并与术后两周的视力进行比较分析。结果８２例中，玻璃体切除术前ＥＲＧ测定值正常者６例，轻、中度降低者３７例，严重降低或记录不到者３９例；在后者中，术后视力无改善或减退者分别为２３例及６例，与正常ＥＲＧ者术后４例进步、２例不变者比较，差异有显著性。术前ＥＲＧ随不同病因有所区别。对术后视力差者的术前ＥＲＧ及ＶＥＰ也作了分析。结论玻璃体切除术前行视觉电生理测定有助于对患者术后的视力改变及疗效进行预后评估。     

ERG及VEP对白内障术后视力的预测

目的：探讨ERG及VEP对白内障术后视力的预测作用。方法：应用ERG及VEP对259只白内障眼进行检查并与术后视力进行分析，结果：259只眼中VEP表现为潜伏期延长66眼，P100及N75振幅降低73只眼，正常183只眼，ERG潜伏期管迟66眼，振幅降低67眼，结论：VEP及ERG潜伏期延迟，振幅降低，术后视力差，它们能较好的预测白内障的术后视力。     

增殖型糖尿病视网膜病变玻璃体切割手术后的视力及影响因素

作者分析增殖型糖尿病视网膜病变(proliferative diabetic retinopathy，PDR)合并严重玻璃体出血、黄斑部视网膜前出血、牵拉性视网膜脱离、牵拉性视网膜脱离并发孔源性视网膜脱离共81只眼进行玻璃体切割手术的结果。83.9%的患眼手术后视力获得不同程度的改善，PDR的严重程度对手术后视力有一定的影响，V期患者手术后出血率较高。虹膜红变的发生率与PDR的严重程度无关，但晶体切割眼的虹膜红变发生率高于有晶体眼。手术后视网膜脱离和出血不吸收均可导致虹膜红变的发生。 （中华眼底病杂志，1995，11：216-218）     

严重PDR玻璃体切除术和全视网膜光凝的视力对比

目的：观察严重增殖性糖尿病视网膜病变（proliferative diabetic retinopathy,PDR）患者玻璃体手术和全视网膜光凝的视力对比。方法：将我院93例严重PDR患者随机分为两组,一组接受玻璃体切除＋剥膜＋全视网膜光凝＋黄斑光凝;另一组接受全视网膜光凝＋黄斑光凝,随访1a。结果：术后1a,第一组,视力提高12眼（27.9%）,不变11眼（25.6%）,下降20眼（46.5%）。第二组,提高14眼（28.0%）,不变24眼（48.0%）,下降12眼（24.0%）。两组间视力提高比例无差异。但不变和下降比例差异有显著意义。结论：对于严重的PDR患者,玻璃体切除术可能会带来更高视力下降的风险。     

Ⅱ型增殖性糖尿病视网膜病变患者行玻璃体切除地机与术后视力 …

探讨Ⅱ型增殖性糖尿病视网膜病变合并严重玻璃本出血或合并血管纤维增殖引起的视网膜牵拉性视网膜脱离情况下,进行玻璃全切除术的手术时机。     

眼外伤玻璃体切除术前ERG及VEP检查对术后视力预测价值

目的 观察闪光视网膜电图（flicker electroretinogram,F-ERG）及闪光视诱发电位（flicker visual evoked potential,F-VEP）测定对眼后段外伤玻璃体切除术后视力预测价值。方法 对42例（42只眼）眼后段外伤伴玻璃体混浊或积血的患者在玻璃体切除术前两周内行F-VEP及F-ERG检查,并分析其与术后1个月最佳矫正视力的关系。结果 F-ERG检查正常或轻度异常25只眼,术后视力提高23只眼（92．0％）,中度异常或重度异常和记录不到波形17只眼,术后视力提高7只眼（41．2％）。F-VEP检查正常或轻度异常27只眼,术后视力提高24只眼（88．9％）,中度异常或重度异常和记录不到波形15只眼,术后视力提高5只眼（33．3％）。F-VEP及F-ERG均正常或轻度异常的18只眼,术后视力均提高,且术后视力均恢复至0．1以上。F-VEP及F-ERG均重度异常或记录不到波形的2只眼,术后视力1只眼下降,1只眼不变。结论 眼外伤玻璃体切除术前联合检测F-VEP及F-ERG对术后视力预测有重要意义。     

玻璃体切除治疗无严重增殖性玻璃体视网膜病变的视网膜脱离

目的:探讨后段玻璃体切除术(PPV)在非严重性增殖性玻璃体视网膜病变(PVR)性视网膜脱离中的作用。方法:研究15眼有裂孔边缘卷曲的PVR—B级网脱,11眼裂孔在赤道后的PVR—C1或C2级网脱及28眼眼底可视度差的网脱共54眼,用玻璃体切除治疗的效果。结果:一次手术成功率为76％,总成功率96％。术后视力提高43眼(79.6％),不变9眼(16.7％),变坏2眼(3.7％)。结论:PPV是治疗一些非复杂性网脱的有效及安全的方法。眼科学报1998;14:97—99。     

玻璃体切除治疗出血性玻璃体视网膜疾病

目的探讨玻璃体切除术对出血性玻璃体视网膜疾病的临床效果。方法对39例(40眼)玻璃体积血施行三通道经睫状体平坦部玻璃体切除术,联合膜剥离,水下透热,眼内光凝(或经巩膜冷凝),并根据病情选用眼内长效填充材料。结果视网膜静脉阻塞15眼,外伤性玻璃体积血9眼,视网膜孔源性玻璃体积血6眼,珠网膜下腔出血合并玻璃体积血(Terson综合症)4眼,静脉周围炎(Eales病)5眼,老年性黄斑变性1眼。术后随访2~40月,平均(12±3.4)月,40眼视力均有不同程度的提高,0.05以上者33眼(82.50%),与术前相比差异有统计学意义(P<0.05),视力0.2~0.8者26眼占65.00%。结论出血性玻璃体视网膜疾病经药物治疗无效,B超探示出现玻璃体后脱离或B超显示伴有牵引性视网膜脱离者,玻璃体切除术是消除玻璃体积血并使视网膜复位的有效方法。     

玻璃体切除治疗复发性出血性玻璃体视网膜疾病

目的探讨玻璃体切除术对复发性出血性玻璃体视网膜疾病的临床效果。方法对43例(44眼)玻璃体积血施行三通道经睫状体平坦部玻璃体切除术,联合膜剥离,水下透热,眼内光凝(或经巩膜冷凝),并根据病情选用眼内长效填充材料。结果视网膜静脉阻塞18眼,外伤性玻璃体积血9眼,视网膜裂孔致玻璃体积血6眼,静脉周围炎5眼,增生性糖尿病视网膜病变3眼,蛛网膜下腔出血合并玻璃体积血(综合症)2眼,老年性黄斑变性1眼。术后随访2～24月,44眼视力均有不同程度的提高,随访视力较术前相比差异有统计学意义(P<0.05),视力0.05以上者36眼(81.82%),0.2～0.8者27眼(61.36%)。结论复发性出血性玻璃体视网膜疾病经药物治疗无效,B超显示出现玻璃体后脱离或B超显示伴有牵引性视网膜脱离者,玻璃体切除术是消除玻璃体积血并使视网膜复位的有效方法。     

晶状体超声乳化吸出玻璃体切除治疗合并白内障的玻璃体视网膜病变的效果评价

目的探讨玻璃体视网膜病变合并白内障的玻璃体手术中,同期行超声乳化白内障吸出术的效果及并发症。方法回顾性分析合并有白内障的玻璃体视网膜病变30例（30眼）。实行玻璃体切除联合超声乳化吸出人工晶状体植入术观察术后视力改善情况及术中术后并发症。结果术后随访3～24个月,25眼（83.33%）术后均有不同程度视力改善,视力不变者3眼,视力下降者2眼。影响视力提高的主要原因为不同类型的黄斑病变。并发症主要有角膜水肿、一过性高眼压、术后炎症反应、后囊浑浊,均可治愈。结论超声乳化白内障吸出玻璃体切除联合术治疗合并不同程度白内障的玻璃体视网膜病变是安全有效的方法,它有利于患者视力改善,避免玻璃体切除术后并发白内障再次手术。玻璃体切除联合白内障手术不会明显增加手术并发症。     

The influence of age on the electroretinogram and visual evoked potential

Changes in the ERG and VEP across the life span were investigated. The dark adapted and scotopic ERGs both showed a progressive increase in the implicit times of the A and B waves and a reduction in the amplitude of the AB configuration. There was also an increase in the implicit times of the oscillatory potentials of the photopic ERG.The flash and pattern onset-offset VEP both showed changes in waveform with age whilst the waveform of the pattern reversal VEP was constant. The amplitudes of the components of the flash and pattern reversal VEP were very high in the teenage group, but once reduced, were constant from the twenties onwards, showing no further consistent age changes.The latencies of the components of the pattern VEPs showed an increase with age which could be accounted for by the reduction in retinal illuminance due to the decrease in pupil diameter with age. However, the increase in the latency of the flash major positive (P2) component was greater than that expected from the decrease in retinal illuminance alone, suggesting that this is due to neural factors.     

诊断性玻璃体切割判断眼外伤无光感眼视力预后

目的：通过对眼外伤后无光感眼行诊断性玻璃体切割术,判断伤情,决定具体的手术方式。 方法：对8例8眼眼外伤视力无光感的患者行2期玻璃体切割术。 结果：术后无光感5眼,1眼FC,1眼HM,1眼0.05。术中改术式为眼内容剜除+羟基磷灰石义眼台植入2眼,1眼4mo后眼球摘除,3眼硅油眼。 结论：诊断性玻璃体切割可估计眼外伤伤情、决定术式。     

Detecting color vision in a malingerer

A patient describing himself as totally color blind was ordered by the judicial system to have his color vision investigated in order to establish his suitability for military service. Basic clinical (Farnsworth Panel D-15, Moreland and Rayleigh anomaloscope equations), electroretinographic (ERG) and psychophysical techniques (spectral sensitivities) were applied to determine the extent of his color discrimination performance and cone function. These standard procedures were complemented by a test for cone interaction (transient tritanopia) and by newly developed cone-isolating flicker large-field ERG recordings. The patient's data consistently indicate the function as well as the functional interaction of the middle-wavelength-sensitive (M-) and the short-wavelength-sensitive (S-) cones. But the function of the long-wavelength-sensitive (L-) cones was completely absent. Hence the patient was correctly demonstrated to be a protanope. This study establishes that standard classical procedures, in combination with newly developed and easy to apply psychophysical and ERG ones, which can be reliably used to assess true color discrimination performance, in difficult cases of malingering.     

Vigabatrin; its effect on the electrophysiology of vision

Vigabatrin is known to induce visual field defects in approximately one third of patients treated with the drug. It is apparent from electrophysiological studies that the cause of this defect is at retinal level probably as a result of the build up of GABA. Studies of electrophysiological retinal parameters such as the EOG and photopic, scotopic and 30-Hz flicker ERG have revealed changes in Arden Index, photopic a and b wave latency and amplitude, changes in oscillatory potentials, and changes in latency and amplitude of the 30Hz response. However, many of these changes such as the Arden Index, oscillatory potentials, latency and amplitude of photopic b wave appear to be related to current anti-epileptic drug treatment rather than visual field defects. Certain parameters, particularly the amplitude of the 30-Hz flicker response, do appear to correlate with the severity of the field defect. Paediatric patients treated with the drug at age 9 years or below cannot reliably perform visual field perimetry. To identify these patients a special VEP H-Stimulus has been developed to produce separate responses from central and peripheral field stimulation by alternating at slightly separate rates. Forty-five healthy children between ages 3 and 10 years have been used to develop a normal database. This technique has a sensitivity of 75% and a specificity of 87.5% in identifying the field defect and may be used in children with epilepsy from age 3 upwards.     

曲安奈德预防术后增殖性玻璃体视网膜病变临床观察

目的：评价曲安奈德（triamcinolone acetonidem,TA）在预防玻璃体切除术后增殖性玻璃体视网膜病变（proliferative vitreoretinopathy,PVR）发生过程中的安全性和有效性。方法：2004-03／2004-10行玻璃体手术治疗视网膜脱离患者75例78眼,分为治疗组与对照组各39眼。治疗组术中玻璃体腔内注入TA0．5-1mL（4mg）,对视网膜表面残存的玻璃体进行标识,将黏附曲安奈德的玻璃体皮质完全剥除。手术结束玻璃体腔内再注入TA0．1mL4mg）。对照组未用TA。平均随访6．8mo,两组结果进行对比分析。结果：治疗组与对照组术后PVR发生率分别是8％和28％,有显著性差异（P〈0．05）。治疗组术后视网膜脱离复发率5％,对照组为20％,有显著性差异（P〈0．05）。术后2mo眼压≥21mmHg分别是31％和13％,有显著性差异（P〈0．05）。两组手术前后视力的变化无差异。未见明显与药物有关的眼部并发症。结论：曲安奈德可以帮助显示透明的玻璃体皮质,容易辨认和剥除,提高手术安全性及成功率。有抗炎和抗增殖的作用,可以预防PVR的发生。     

透明质酸酶在玻璃体手术中的应用研究进展

透明质酸酶可使透明质酸水解成双糖化合物,并离解细胞间质屏障,使玻璃体液化,是目前辅助玻璃体切割手术最有应用潜力的酶之一.透明质酸酶的相关研究有可能为玻璃体手术带来新的进展.现就透明质酸酶应用于玻璃体手术的研究背景、实验研究进展、临床应用情况、主要优点和主要并发症及尚待解决的问题作一扼要综述.     

The effect of a moderate level of hypoxia on human color vision

This study reports the effect of a moderate level of hypoxia on human color discimination. We found a generalized loss of color vision affecting both red-green and blue-yellow discrimination at an altitude of 12,000 feet. Although the residual color discrimination at this altitude was within age-matched, sea-level norms, a statistically significant increase over sea level error scores was measured on the Farnsworth-Munsell 100-Hue test and the Pickford-Nicolson anomaloscope. An analysis of psychophysical and electrophysiological studies indicates that hypoxia acts by depressing retinal ganglion cell activity and that it can affect photopic visual processes as well as scotopic vision. We conclude that studies evaluating man's visual performance at altitude must consider post-receptoral processes.     

Implications of inherited color vision deficiency on occupations: A neglected entity!

Purpose:To highlight the plight of individuals with congenital color vision deficiency (CVD).Methods:This is a retrospective study in which 191 electronic medical records of individuals with the diagnosis of inherited CVD, who visited the eye institute, between January 2010 and January 2021 were included. The inclusion criteria included diagnosis based on the failure in pseudoisochromatic plates (Ishihara / Hardy, Rand and Rittler (HRR) and age range between 18 and 35 years. The patient’s medical history, age, gender, type of defect, and preference for colored contact lenses was noted. Medical records were excluded if the participant had any other ocular pathology apart from congenital CVD.Results:At least 30% (57/191) of the individuals explicitly requested for color vision examination for a job-related purpose. Amongst them, the most common jobs aspired were army (~25%; [14/57]) followed by police (21%; [12/57]). There was only 2.6% (5/191) of individuals in which the type of CVD (protan/deutan) was classified. Only 5.2% of them (10/191) sought an X-Chrome contact lens trial.Conclusion:This study reported the occupational setbacks experienced by individuals with CVD. This study highlights the need to identify CVD at a younger age, thereby avoiding occupational-related setbacks later in life.     

玻璃体腔内注射贝伐单抗对增生性糖尿病视网膜病变玻璃体手术的影响

目的:评估术前1wk玻璃体腔内注射贝伐单抗对增生性糖尿病视网膜病变(PDR)玻璃体手术(PPV)的效果。方法:对46例PDR患者进行回顾性研究,46例患者随机分为玻璃体手术(PPV)组(n=28)和IVB组(n=18,PPV术前注射贝伐单抗)。玻璃体术前1wk注射贝伐单抗,比较两组间视力,医源性视网膜裂孔发生率,术中和术后出血情况。结果:术后1mo,PPV组和IVB组视力都明显提高(82.1%对88.9%)(P<0.01),两组间并无明显差异。医源性视网膜裂孔发生率PPV组18例,IVB组4例(64.3%对22.2%)(P<0.05)。术中出血PPV组28例,IVB组7例(100%对39%)(P<0.01),术后出血PPV组9例,IVB组0例(32.1%对0)(P<0.01)。结论:术前注射贝伐单抗可以减少增生性糖尿病视网膜病变玻璃体手术中医源性视网膜裂孔、术中出血和术后出血发生率。