玻璃体积血对兔眼视网膜影响的研究

目的　观察兔眼玻璃体积血后不同时间视网膜电图（electroretinogram,ERG）及超微结构的变化,为玻璃体积血治疗及预后评估提供实验依据。方法　新西兰大白兔32只,右眼均为实验眼,自体全血0.2 mL玻璃体内注射构建玻璃体积血模型,左眼为空白对照眼。随机分为4组,分别于造模后3 d、7 d、14 d及30 d选取一组常规检查后记录ERG的变化,随后处死动物立即摘取眼球制备标本观察超微结构。结果　实验性玻璃体积血3 d后常规ERG波形消失,造模后7 d逐渐出现。强闪光源刺激下,造模后3 d实验眼ERG的b波振幅与a波振幅与对照眼相比均明显降低（均为P＜0.01）。a波振幅在造模后30 d明显恢复,与对照眼无明显差异（P＞0.05）,较造模后14 d差异有统计学意义（P＜0.05）;b波振幅在造模后7 d时开始回升,与对照眼无明显差异（P＞0.05）,较造模后3 d差异有统计学意义（P＜0.05）,造模后14 d及30 d接近正常。扫描电镜显示实验眼造模后3 d无玻璃体后脱离（posterior vitreous detachment,PVD）发生,造模后7 d部分性PVD占1/8,完全性PVD占1/8,造模后14 d部分性PVD占2/8,完全性PVD占5/8,造模后30 d部分性PVD占1/8,完全性PVD占7/8;对照眼各阶段未见PVD发生。结论　玻璃体积血后约1周可轻度可逆地影响视网膜功能并加速导致PVD形成,为实验及临床判断玻璃体积血后视网膜功能变化和临床玻璃体手术治疗的时间窗的选择提供了参考。     

视网膜电图检测对玻璃体手术眼视功能预测的评价

玻璃体切割手术前、术中、术后的ERG改变及各种有关眼部条件对ERG的作用，重点讨论了玻璃体积血、玻璃体切割手术中联合填充物对ERG的影响，并且对手术中的温度、所用灌注液对ERG的影响也作了详细的介绍．我们认为；术前ERG的检测对手术预后的估计有积极的作用。然而术前ERG熄灭的病人，在手术预后方面也必须认真对待． （中华眼底病杂志，1994，10：60-62）     

视网膜电图对玻璃体出血机化和玻璃体手术的意义

报告118例(133眼)由各种疾病引起的玻璃体出血机化患者的视网膜电图(ERG)检查结果,其中31例作了玻璃体手术,结果表明,ERG检查对玻璃体出血机化的患者,能客观地反映其网膜功能,并对玻璃体手术的预后有指导作用。术前ERG检查,a、b波下降越严重,视功能损害显著,术后视力的预后越差,同时证实,玻璃体机化膜是影响a、b波波幅和时间的一个因素。     

双氯芬酸钠兔眼玻璃体内注射对视网膜电图影响的研究

目的：检测不同深度双氯芬酸钠对实验兔视网膜电图的影响。方法：将28只新西兰白兔随机分为7组。将400－1000μg不同剂量的双氯芬酸钠溶液0.1ml分别注入第1－7组家兔右眼玻璃体内。左眼为对照组,均在玻璃体注入0.1ml生理盐水。分别在注药后1,3,7,14,21,28天进行ERG检查。结果：当兔眼玻璃体注入的双氯芬酸钠大于或／和等于700 μg时,ERG检查发现暗适应和明适应b波波幅明显下降。结论：兔眼玻璃体注入的双氯芬酸钠大于或／和等于700μg时,对视网膜有毒性作用。     

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）     

大量玻璃体积血对兔视网膜电图检查的影响

目的研究大量玻璃体积血对兔眼视网膜电图检查的影响。方法(1)用物理学方法测量血液对白色闪光的透过率;(2)在经玻璃体气体压缩术形成的兔眼玻璃体腔中注入0.5ml自体血，利用强闪光视网膜电图(electrical resistance gauge,ERG)技术和光强度振幅曲线的计算分析ＥＲＧ的变化；测定玻璃体切除术消除积血前后ERG。结果随着浓度和厚度的增加，血液对光线的透过率呈指数下降趋势。玻璃体积血使常规ERG检查波形消失，用增强3.5log单位的强闪光刺激可以引出ERG波形。玻璃体切除术后ERGb波可逐渐恢复。结论血液对白色闪光有较强的吸收能力，光线被玻璃体内积血吸收可以导致常规ERG波形消失，此时应用强闪光ERG可以测得接近于正常的ERGb波最大反应，提示视网膜功能并未因玻璃体大量积血而发生不可逆病变。玻璃体切除术清除积血后，ERG波形缓慢恢复。(中华眼底病杂志,1998,14:104-107)     

兔眼玻璃体视网膜界面结构与相关生理参数

目的:观测兔眼正常玻璃体视网膜界面(VRI)基本的结构及相关生理。方法:新西兰大白兔20只,应用皮肤及角膜接触镜电极作为记录电极,测定其视网膜电图(ERG),记录其b波振幅(bA)值,并对其中4只眼的VRI结构进行组织病理学检查。结果:正常的VRI包括紧密相邻的玻璃体后皮质(PVC)和视网膜内界膜(ILL),并有其各自的特点;两种记录电极得到的正常兔眼双侧ERG的bA值无统计学差异(P>0.05)。结论:正常兔眼VRI的基本结构由PVC与ILL组成;ERG的bA值能较好地反映视网膜的生理功能。     

过氟丙烷对兔眼视觉电生理和超微结构的影响

目的研究玻璃体腔中过氟丙烷气体对兔眼电生理和视网膜结构的影响。方法８只兔眼玻璃体内注入Ｃ３Ｆ８０．３ｍｌ，观察了术后ｄ３和ｄ７ＥＲＧ－ｂ波和视觉层诱发电位（ｖｉｓｕａｌｅｖｏｋｅｄｐｏｔｅｎｔｉａｌ，ＶＥＰ）的振幅以及视网膜结构的变化。结果在注气后ｄ３视网膜电流图（ｅｌｅｃｔｒｏｒｅｔｉｎｏｇｒａｍ，ＥＲＧ）－ｂ波明显降低（Ｐ＜０．０５），ｄ７恢复正常（Ｐ＞０．０５），ＶＥＰ振幅无明显变化（Ｐ＞０．０５），在ｄ４气体可达到最大膨胀体积，膨胀的气体形成一个占据８０％以上玻璃体腔的空腔，玻璃体被压缩成一薄层附于视网膜表面，２只眼晶体轻度混浊，视网膜无明显结构损害。结论玻璃体内注入Ｃ３Ｆ８可形成一个较大的空腔，为进行玻璃体内药物灌注和玻璃体大量积血等实验提供了良好的实验模型。     

玻璃体切除术治疗人工晶状体眼视网膜脱离

目的 探讨玻璃体切除术治疗人工晶状体眼视网膜脱离（ｔｒｔｉｎａｌ ｄｅｔａｃｈｍｅｎｔ,ＲＤ）的效果。方法 对３２例（３２只眼）植入人工晶状体后ＲＤ患眼行玻璃体除术,其中首次治疗采用玻璃体切除术１１只眼（３４．４％）,巩膜扣带术失败后再行玻璃体切除术２１只眼（６５．６％）,玻璃体切除术中联合硅油充填１０只眼（３１．３％）,玻璃体切除术同时行人工晶状体取出１２只眼（３７．５％）。术后随诊６个月至５年     

眼冲击伤早期视网膜电图的变化

本文探讨了眼冲击伤早期视网膜电图（ERG）的变化。实验动物为成年家兔，用BST－Ⅲ型生物激波管造成轻度和重度的眼冲击伤，冲击波超压峰值分别为429±38．8kPa和834±16．47kPa。于伤前和伤后0．5h，3h，6h和24h；临床观察并检测伤眼和对侧健眼的ERG变化。结果提示：伤后轻、重伤两组伤眼的a波和b波波幅值均明显下降，a波峰潜时延长；2组健服的a、b波幅值也有下降。表明眼冲击伤后早期，伤眼的伤情不论轻重，视功能的障碍均是严重的，并影响对侧眼。     

Nonrecordable Electroretinogram in Vitreous Hemorrhage

A 32-year-old male sustained a dense vitreous hemorrhage following a scleral buckle procedure for a traumatic retinal detachment in his right eye. The bright-flash ERG was nonrecordable on two occasions. At pars plana vitrectomy, a dense vitreous hemorrhage was removed, and the retina was noted to be attached. The patient sub-sequently regained good vision with progressive recovery of the ERG over several months. Although a nonrecordable bright-flash electroretinogram is usually a reliable indication of a detached or severely impaired retina, recordings should be interpreted with caution in cases of dense vitreous hemorrhage, particularly if ocular penetration has occurred.     

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。     

兔眼玻璃体内注入脂质体的观察

应用离心、加温和冷藏试验证实自制脂质体具有较良好的稳定性。经眼压、眼底镜、裂隙灯、眼电生理、光镜和电镜等检查,表明这种脂质体能安全用于眼内,是较为理想的眼内药物载体。     

实验性急性高眼压对兔视网膜电图的影响

目的：检测家兔实验性急性高眼压不同压力状态下视网膜电图的变化。方法：采用视电生理检测仪测定家兔实验前,30mmHg(1mmHg=0.133kPa),60mmHg,90mmHg和120mmHg前房高压灌注45min及恢复正常眼压4h的视网膜电图（Flash Electroretinogram FERG)和振荡电位（Oscillatory Potentials,OPs)。结果：对照组和30mmHg组视电生理检测在实验前后无差异。60mmHg组在高压持续45min后,b波和OPs波振幅下降,4h后恢复正常。90mmHg和120mmHg组在高压45min后,FERG波形消失。4h后有不同程度恢复。结论：随着实验性高眼压压力的升高,家兔视网膜功能损伤加重,恢复能力减弱。     

马蹄形裂孔视网膜脱离玻璃体手术治疗的技术及其效果

目的探讨马蹄形裂孔视网膜脱离玻璃体手术治疗的要点及其影响因素。方法回顾性研究玻璃体手术治疗马蹄形裂孔视网膜脱离患者110例(110眼)的临床结果,对术中处理裂孔边缘粘连牵引、重水应用、气液交换吸出网膜下液、激光或冷凝封闭裂孔、惰性气体充填等技术进行分析和比较性研究。结果1.行施玻璃体手术后裂孔封闭视网膜脱离复位一次性成功者共93例(84.6%)。其中5例因裂孔封闭不全随即再次手术治愈。12例在随访中发现有新裂孔形成,视网膜再脱离,7例接受再次手术治愈。2例激光光凝治愈。2.术中42例用重水压平视网膜行裂孔边缘处膜切除,其中35例治愈(83.3%);68例直接行膜切除松解牵引灶,其中58例治愈(85.3%)。二者无统计学差异(x2=0.072P>0.05)。3.在裂孔处行气液交换内放液,其中47例全气液交换40例治愈(85.1%);63例行部分气液交换以裂孔贴附为准,其中53例治愈(84.1%)。二者无统计学差异(x2=0.13P>0.05)。4.气液交换后用激光封闭裂孔34例,其中24例治愈(70.58%),用巩膜外冷凝法76例,其中69例治愈(90.78%)。二者相比冷凝的效果好(x2=5.48P<0.05)。结论马蹄形裂孔视网膜脱离采用玻璃体手术重点在切除裂孔边缘粘连牵引,应用重水和气液交换以裂孔贴附为度。冷凝比激光封闭的效果要好。     

Closed Vitrectomy in the Management of Diabetic Traction Retinal Detachment

One hundred and seventy-four instances of diabetic traction retinal detachment in which the patient underwent closed vitrectomy during the period of January 1970 to December 1978 and had adequate follow-up ranging from six months to five years are reported. As a rule, eyes with vision better than 20/200, or with inaccurate light projection, or with no response to electrophysiologic tests were excluded. The surgical technique avoided stripping of vitreous membranes. Closed vitrectomy was combined with scleral buckling in eyes with retinal breaks, and with scleral resection in eyes with incomplete section of traction membranes. Anatomic improvement was noted in 75.3% of the eyes; vision improved in 64.9% of the eyes; new or recurrent vitreous hemorrhage was observed in 43.1%; corneal decompensation in 51.8%, rubeosis iridis in 23.0%, phthisis bulbi in 9.2%, iatrogenic retinal break in 8.6%, postoperative rhegmatogenous retinal detachment in 5.2%, and iatrogenic cataract in 4.6%.     

Central Retinal Artery Occlusion and Retinal Tolerance Time

Transient central retinal artery occlusion (CRAO) was produced in 63 eyes of rhesus monkeys by lateral orbitotomy and temporary clamping of the central retinal artery (CRA) for between 15 and 270 minutes. Thirty-three eyes were examined at regular intervals for 12 to 22 weeks. Color fundus photography, fluorescein fundus angiography, electroretinography (ERG) and visual evoked response (VER) were performed before and during clamping of the CRA as well as periodically after unclamping. All the eyes were examined by light and/or electron microscopy. This study revealed that the retina suffered irreparable damage after ischemia of 105 minutes, but recovered well after ischemia of 97 minutes. As a general rule, the monkey retina can tolerate up to 100 minutes of ischemia but not more.     

正常眼和老年黄斑变性眼的局部视网膜电图

以全视野亮背景及４５′视角的红色闪光作刺激，采用带中孔的角膜接触镜电极，记录了局部视网膜电图。测得２２只正常眼的黄斑中心对盲点区的局部ＥＲＧ振幅之比值为３．５４±１．３５，而３１只老年黄斑变性眼的比值是１．３９±０．５４，两者差异显著（Ｐ＜０．０１），两组全视野明适应ＥＲＧ间无意义，表明此法建立的局部ＥＲＧ记录技术对早期老年黄斑变性病人具有一定诊断价值。     

ERG findings in patients using hydroxychloroquine

PURPOSE: To examine the electroretinographic findings derived by full-field electroretinography (ERG) and multifocal electroretinography (mfERG) in patients taking HCQ for different periods of time, including those without clinically visible evidence of toxicity. METHODS: The records for 26 consecutive patients (51 eyes, age 19-79) who had used HCQ for 1-30 years and who had an ERG and/or mfERG were reviewed. RESULTS: The patients fell into 5 groups, according to the results from their electrophysiological and clinical evaluation: no abnormalities (n = 13), cone b-wave delay (n = 2), decreased ERG amplitude (n = 6), borderline toxicity (n = 2) and toxicity (bull's-eye maculopathy; n = 3). Oscillatory potential (OP) amplitudes were decreased in many of the patients, even in the absence of any other clinical or ERG abnormality. MfERGs were normal in these patients without other abnormalities, but showed a bull's eye pattern of damage in a patient with clear toxicity. The full-field ERG parameters (including OPs) showed little relationship to the duration of HCQ usage or the cumulative dose. CONCLUSIONS: A substantial subgroup of patients showed varying degrees of diffuse ERG abnormality despite having no clinical signs (visual or fundus changes) of toxicity, and despite a range of cumulative doses. The mfERG showed toxicity, but its sensitivity in detecting early change remains to be determined. Further work is needed in order to separate pharmacological actions of the drug, retinopathy from the systemic disease, and potential toxic effects.