角膜生物参数对青光眼患者眼压测量影响的研究

目的:探讨角膜生物参数对青光眼患者眼压测量的影响。方法:对80例121眼青光眼患者进行眼反应分析仪(ocular response analyzer,ORA)与Goldmann压平眼压计(Goldmann applanation tonometer,GAT)测量,并用先进的OrbscanⅡ眼前节分析系统测量中央角膜厚度(central corneal thickness,CCT)。结果:平均矫正眼压(IOPcc)值17.41±5.62mmHg;平均GAT值15.76±6.06mmHg;IOPcc与角膜滞后性(cornealhysteresis,CH)有相关性(P=0.000;r=-0.236);IOPcc与GAT显著相关(P=0.000;r=0.857);IOPcc与CCT无相关性。结论:对已经诊断的青光眼患者,平均IOPcc值高于平均GAT值;随着CH的降低,IOPcc值有升高的趋势;且IOPcc值不受CCT值的影响。     

非接触式眼压计与Goldmann压平眼压计测量眼压的比较

目的 :比较非接触式眼压计 ( NCT)和 Goldm ann压平眼压计测量眼压的差异。方法 :对 112例 ( 2 2 0眼 )志愿者分别进行 NCT和 Goldmann压平眼压计眼压测量及中央角膜厚度测量 ,并对其中 16 8眼进行自动验光检查。结果 :NCT和 Goldmann眼压计眼压测量值分别为 1.98± 0 .6 9k Pa和 2 .34± 0 .77k Pa。 NCT眼压测量值较 Goldmann眼压测量值偏低 0 .36± 0 .37k Pa( P<0 .0 5 )。眼压在 1.33～ 2 .6 7k Pa内 ,二种眼压计测量眼压值偏差最小。角膜厚度和眼球屈光度与 NCT眼压测量值分别呈明显正相关和负相关。结论 :NCT眼压测量值较Goldmann眼压测量值偏低 ,NCT眼压值为临界眼压时 ,应应用 Goldm ann压平眼压计校正     

眼反应分析仪与非接触眼压计眼压测量的对比观察

目的比较眼反应分析仪(ORA)与非接触眼压计(NCT)测量眼压结果的差异,分析ORA、NCT测量结果与角膜中央厚度(CCT)的关系。方法近视患者57例(114只眼),于准分子激光手术前行ORA测量,得出角膜补偿眼压(IOPcc)和Goldmann相关眼压值(IOPg)两个数值,NCT测眼压3次取平均值。结果 ORA测得IOPcc平均值16.85 mm Hg,IOPpg平均值15.26 mm Hg,NCT眼压计测得平均值15.66 mm Hg;IOPcc>NCT>IOPg。IOPcc、IOPg与NCT所测眼压值比较,差异均有统计学意义(P<0.05)。NCT和IOPg均与CCT呈正相关(r:分别为0.463和0.419,P<0.05);IOPcc与CCT无相关性(r:0.230,P>0.05)。结论 ORA测量屈光不正患者的眼压与NCT测量结果存在一定差异,其中IOPcc不受角膜厚度的影响,在临床运用中准确性较好。     

中央角膜厚度对Goldmann眼压计与非接触式眼压计测量值的影响

目的探讨中央角膜厚度（CCT）对Goldmann眼压计与非接触式眼压计（NCT）眼压测量值的影响。方法分别用Goldmann眼压计与NCT测量83例（83只眼）正常人的眼压,采用光学相干断层扫描仪（OCT）测量CCT。采用配对T检验比较Goldmann眼压计与NCT眼压计眼压测量值的差异,采用线性相关分析方法分析两种眼压计眼压测量值之间的相关关系,并分析CCT对两种眼压计眼压测量值的影响。结果Goldmann眼压计测得的眼压平均值为（13.46±2.93）mmHg,NCT测得的平均值为（12.29±3.47）mmHg,两者之间差异有显著性（t=5.831,P〈0.001）;两种眼压计眼压测量值呈正相关（r=0.852,P〈0.001）。Goldmann眼压计眼压测量值和NCT眼压测量值均与CCT呈正相关,r值分别为0.424（P〈0.001）和0.568（P〈0.001）。Goldmann眼压计眼压测量值与NCT眼压测量值的差值与CCT呈负相关（r=-0.402,P〈0.001）。去除CCT因素影响后,两种眼压计眼压测量值的残差差异无显著性（t=-0.272,P=0.787）。结论Goldmann眼压计与NCT眼压计眼压测量值均受CCT的影响，CCT对NCT眼压测量值的影响更大；两种眼压计眼压测量值的差异可能来源于个体CCT的差异。     

中央角膜厚度及屈光度对压平眼压计测量值的影响

目的 探讨中央角膜厚度(CCT)以及屈光状态对Goldmann压平眼压计(GAT)测量值的影响.方法 应用OCT3测量正常人121例(199只眼)与近视患者81例(159只眼)的CCT,用Goldmann压平眼压计测量眼压,比较两组之间CCT和眼压测量值的差异,分析CCT与眼压测量值的关系.结果 正视组平均CCT值为(525.05±32.83)μm,眼压的均值为(12.91±2.26)mmHg;近视组平均CCT值为(524.85±29.76)μm,眼压的均值为(14.23±2.54)mmHg;两组的CCT值比较差异无显著性(t=-0.600,P=0.952),两组的眼压值比较差异有显著性(t=-5.139,P＜0.001).高度近视眼CCT偏薄,眼压随屈光度数较少而增加,近视组眼压与屈光度相关(r=-0.296,P＜0.001),屈光度数每增加-4.05D,眼内压升高1 mmHg.正视组(r=0.317,P＜0.001)和近视组(r=0.341,P＜0.001)的眼压与CCT相关,眼压校正公式分别为1 mmHg/45.45 μm、1 mmHg/34.48 μm.结论 CCT可以影响Goldmann压平眼压计测量值,屈光状态也可以影响眼压值,高度近视眼的眼压建议用从近视人群中获得的眼压校正公式校正.     

五种眼压计测量眼压的一致性比较及其与角膜生物力学的相关性

目的 比较非接触眼压计（气流眼压）、Goldmann压平眼压计（压平眼压）、Icare pro回弹眼压计（回弹眼压）、Tono-pen AVIA眼压计（笔式眼压）和可视化角膜生物力学分析仪（生物力学眼压）测量眼压的一致性,进一步分析眼压和角膜生物力学的相关性。设计 诊断方法评价。研究对象 健康志愿者44例。方法 同一医师每天同一时段分别应用上述五种眼压计测量受试者的左眼眼压。将眼压与中央角膜厚度、角膜第一压平时间进行Pearson相关分析。主要指标 眼压值、眼压差值的平均值、相关系数。结果 压平眼压、气流眼压、回弹眼压、笔式眼压和生物力学眼压5种眼压结果分别为（15.9±3.3）mmHg、（14.8±2.9）mmHg、（16.9±3.3）mmHg、（14.7±2.5）mmHg和（16.1±3.0）mmHg。其中,气流眼压、笔式眼压较压平眼压低（P=0.01,0.00）。气流眼压、回弹眼压、笔式眼压、生物力学眼压均与压平眼压正相关（r=0.63、0.37、0.63、0.55,P均＜0.05）;Bland-Altman分析两种测量方式眼压差值平均值分别为：气流眼压与压平眼压：-1.1 mmHg [95%一致性界限（95% LoA）为-6.4,4.2],笔式眼压与压平眼压：-1.2 mmHg（95% LoA -6.3,3.9）,回弹眼压与压平眼压：1.0 mmHg（95% LoA为-6.2,8.3）,生物力学眼压与压平眼压：0.3 mmHg（95% LoA为-5.6,6.2）。所有研究对象中央角膜厚度（550.5±29.2）μm,角膜第一压平时间（7.63±0.36）ms。笔式眼压和中央角膜厚度呈正相关（r=0.40,P=0.01）。五种测试的眼压均与角膜第一压平时间呈正相关（r=0.53,0.64,0.55,0.46,0.99;P均＜0.05）。结论 Icare pro和Corvis ST测量眼压与Goldmann眼压计无明显差异,气流眼压、笔式眼压较压平眼压略低,Corvis ST与Goldmann眼压一致性最好。角膜第一压平时间是影响眼压测量结果的重要因素,时间越长,眼压测量值越高。（眼科, 2020, 29： 365-369）     

角膜补偿眼压（IOPcc）和5种眼压校正公式所得校正眼压的一致性及IOPcc、模拟Goldmann眼压与眼球各参数的相关性分析

目的　比较眼反应分析仪测得的角膜补偿眼压（corneal-compensated intraocular pressure,IOPcc）和Sirius眼前节分析系统内置的5种眼压校正公式所得校正眼压的一致性,分析IOPcc、模拟Goldmann眼压（Goldmann-correlated intraocular pressure,IOPg）与眼球各参数的相关性。方法　选取2016年11月至2017年3月在我院眼科中心行近视激光治疗的患者90例90眼,年龄18～37（24.47±5.57）岁。应用Sirius眼前节分析系统对所有患者按常规方法测量3次,选择最佳测量结果作为各参数最终结果。应用眼反应分析仪测量患者的角膜生物力学参数。根据眼反应分析仪测量的IOPg输入Sirius眼前节分析系统内置的5种眼压校正公式进行计算,得到的校正眼压分别记录为Dresdner校正眼压、Ehlers校正眼压、Kohlhaas校正眼压、Orssengo/Pye校正眼压和Shah校正眼压。将所得的5种校正眼压和非接触性眼压计眼压与眼反应分析仪测得的IOPcc进行一致性分析。对IOPcc、IOPg与角膜滞后量、角膜阻力因子、眼球各参数进行相关分析。结果　Kohlhaas校正眼压和IOPcc比较差异有统计学意义（P<0.05）。Dresdner校正眼压、Orssengo/Pye校正眼压与IOPcc的一致性较好,95%一致性界限分别为 （-2.09～2.55）mmHg、（-2.38～2.37）mmHg;其中Dresdner校正眼压与IOPcc的95%一致性界限宽度最窄。IOPcc与角膜滞后量、角膜阻力因子以及眼球各参数均无相关性,而IOPg与角膜阻力因子、中央角膜厚度、角膜体积呈正相关关系 （均为P<0.05）。结论　Dresdner校正眼压、Orssengo/Pye校正眼压与IOPcc的一致性较好;眼球大部分参数对IOPcc影响小。     

角膜厚度对两种眼压测量方法的影响

目的　比较非接触眼压计 (non -contacttonometer ,NCT)和Goldmann压平眼压计测量眼压的差异 ,并分别探讨中央角膜厚度 (centralcornealthickniss ,CCT)对这两种测量方法的影响。方法　对 1 0 8例拟接受PRK或LASIK手术的患者行CCT ,NCT和Goldmann压平计眼压测量。结果NCT和Goldmann压平眼压计测得的眼压均值具有显著性差异 (F =89 .70 4 4,P <0 . 0 1 )。CCT与NCT和Goldmann压平眼压计测量值呈正相关 ,相关系数分别是r =0. 4 96 0 (t =8 .356 3,P <0 .0 0 1 )和r =0 . 2 1 1 3(t =3. 1 6 2 3,P <0 .0 0 1 )。结论　NCT和Goldmann压平眼压计测量眼压值有差异 ,NCT测量值大于Goldmann压平眼压计 ,CCT对NCT的影响大于Goldmann压平眼压计。     

Goldmann压平眼压计与非接触式眼压计测量眼压的对比研究

目的:比较Goldmann压平眼压计(Goldmannapplanationtonometer,GAT)与非接触眼压计(non-contacttonometer,NCT)测量眼压的差异,以评价NCT与GAT测量的相关性。方法:对265例志愿者(529眼)分别采用Goldmann压平眼压计与非接触眼压计测量眼压。结果:非接触眼压计的测量结果低于Goldmann压平眼压计,且差异有显著性(19.13vs23.43,t=22.644,P<0.01),随眼压值的升高,两者相差幅度增大,差异在眼压〉30mmHg时更为明显,但相关系数逐渐变小。结论:非接触眼压计眼压测量值较Goldmann眼压测量值偏低,非接触眼压计眼压值为临界眼压时,需应用Gold-mann压平眼压计校正,以便及时发现病理性眼压升高,避免青光眼的漏诊和失治。     

一种新型凸面眼压计的设计原理及研制

目的为获得眼压测量的更大精确性,设计并研制一架新型凸面眼压计。方法根据Goldmann压平眼压计的基本原理,将Goldmann压平眼压计测压头的平面改成曲率半径为7.8mm的凸面,并在凸面中央刻一个3.06mm直径的圆形刻线,作为压迫角膜固定面积的标志。其测量方法与Goldmann压平眼压计相同。用本眼压计对55例(109只眼)进行了初步眼压测试,并与Goldmann压平眼压计进行对照。结果凸面眼压计的平均眼压为(16.08±5.13)mmHg,Goldmann压平眼压计平均眼压为(14.96±4.27)mmHg,t值=0.28,P>0.05,两者差异无显著统计学意义;r=0.82,两者有较好的正相关。结论本眼压计有较高的准确性,可用作临床眼压测量。     

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.

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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.