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1.
人眼缺血型视网膜中央静脉阻塞组织病理学观察   总被引:4,自引:0,他引:4  
目的 观察视网膜中央静脉阻塞(CRVO)的病理改变,为临床寻找有效的防治方法提供客观的依据。 方法 对11例11只眼缺血型CRVO标本进行组织病理学分析,重点观察视盘和视神经处视网膜中央静脉(CRV)和中央动脉(CRA)的改变。 结果 11只眼CRV在通过筛板区时管腔均变狭窄。其中,5只眼在筛板区和筛板后区CRV内可见机化血栓存在,6只眼在筛板区及其后区CRV内存在血栓机化再通管道,CRV管壁内皮增生,管腔狭窄。11只眼CRA均有明显的动脉硬化改变,管壁增厚,管腔变细;2只眼CRA在筛板区管壁内膜增生,管腔严重狭窄;筛板水平CRA无血栓形成。 结论 在缺血型CRVO发生中,CRV在筛板水平有血栓形成;血栓机化再通的时间及程度,可能决定了CRVO的转归与预后。CRV在巩膜管狭小间隙内受压迫是CRVO的发病机制。 (中华眼底病杂志,2007,23:163-165)  相似文献   

2.
目的靡讨糖尿病视网膜病变(diabetic retinopathy,DR)的发生、发展与眼部血流动力学变化之间的关系。方法:应用彩色多普勒血流成像(color Doppler flow imaging,CDFI)技术检测28例正常人及72例Ⅱ型糖尿病患者视网膜中央动脉(central retinal artery,CRA)、中央静脉(central retinal vein,CRV)的血流速度和阻力指数。结果:糖尿病不伴DK者,CRA血流速度较对照组快(P<0.05).随着视网膜病变程度的加重,CRA血流速度减慢,增殖型DR组CRA血流速度慢于对照组,不伴DR组及单纯型DR组(P均<0. 05);糖尿病患者CRV血流速度较对照组快(P<0.001),且搏动明显.结论:CRA、CRV的血流动力学变化与DR的发生、发展有密切关系。(中华眼底病杂志,1997,13:210-212)  相似文献   

3.
糖尿病视网膜病变视网膜血流动力学变化的超声观察   总被引:2,自引:1,他引:2  
霍豫星 《眼科新进展》2007,27(9):689-690
目的观察糖尿病视网膜病变(diabetic retinopathy,DR)时视网膜中央动脉(central retinal artery,CRA)和视网膜中央静脉(central retinal vein,CRV)血流动力学变化,探讨DR与视网膜血流动力学变化之间的关系。方法应用彩色多普勒超声诊断(color Doppler ultrasoundgraph,CDI)术,对20例34眼正常人(NDR组)与42例60眼DR眼患者(DR组)的CRA和CRV的血流动力学指标进行检测。结果DR组与NDR组相比,CRA的最大收缩期血流速度、舒张末期血流速度和总平均速度、博动指数均降低(P〈0.05),阻力指数增高(P〈0.05);CRV的最高流速、最低流速和平均血流速度均增高(P〈0.05)。结论CDI是评价DR时视网膜血流动力学变化的有效方法。  相似文献   

4.
目的:观察视网膜静脉阻塞患者视网膜中央血管系统的微循环变化。方法:运用超声多普勒技术对视网膜静脉阻塞患者47眼作视网膜中央动脉(CRA)和视网膜中央静脉(CRV)血流速度的检测。结果:患者CRA,CRV的血流速度下降明显(P<0.01),与眼别、年龄、性别无明显差别;舒张末期血流速度(EDV)、收缩期血流加速度(A)反应灵敏,早期 即有变化(P<0.01);收缩期峰值血流速度(PSV)下降则相对滞后;阻力指数(RI)变化不大。部分静脉郁滞性视网膜病变(VSR)患者的各测值以后均回升,而出血性网膜病变(HR)者却不变。早期综合治疗对部分VSR患者的预后有利。结论:血流速度超声检测指数敏感地反映了视网膜微循环情况,可作为病情、预后及疗效观察的参考依据。  相似文献   

5.
糖尿病视网膜病变黄斑部脉络膜厚度临床分析   总被引:1,自引:0,他引:1  
目的 观察糖尿病视网膜病变(DR)患者黄斑部脉络膜厚度改变。方法 临床检查确诊的DR患者33例43只眼纳入研究。其中,男性16例20只眼,女性17例23只眼。根据裂隙灯显微镜联合90D前置镜、光相干断层扫描(OCT)检查结果,并依照DR国际分期标准,将患眼分为非增生型DR(NPDR)不伴显著性黄斑囊样水肿(CSME)(NPDR CSME-)组、NPDR伴CSME(NPDR CSME+)组,分别为16、27只眼。选取同期年龄>45岁健康志愿者和血压控制良好且眼底检查正常的高血压患者11例11只眼作为对照组。三组受检者间性别、年龄、眼别、等效球镜度数比较,差异均无统计学意义(χ2=0.562, F=0.580, χ2=0.129, F=0.421;P值均>0.05)。采用Topcon 3D OCT-1000仪分别测量各组黄斑中心凹下(C 0.0 mm),通过黄斑中心凹的水平方向距黄斑中心凹鼻侧(N)、颞侧(T)各500、1000、1500、2000、2500 μm处共11个位点的脉络膜厚度,以及黄斑中心凹视网膜厚度。结果 NPDR CSME+组C 0.0 mm、T 0.5 mm、T 1.0 mm、T 1.5 mm、T 2.0 mm、T2.5 mm、N0.5 mm、N 1.5 mm位点脉络膜厚度较对照组变薄,差异有统计学意义(F=3.459、4.605、5.997、9.096、9.777、11.563、3.765、3.339,P<0.05);N1.0 mm、N 2.0 mm、N 2.5 mm位点脉络膜厚度亦较对照组变薄,但差异无统计学意义(F=2.889、3.157、2.194, P>0.05)。NPDR CSME-组各位点脉络膜厚度与对照组各位点脉络膜厚度比较,差异均无统计学意义(F=2.194、3.157、3.339、2.889、3.765、3.459、4.605、5.997、9.096、9.777、11.563,P>0.05)。NPDR CSME+组T2.5 mm、T 2.0 mm、T1.5 mm位点脉络膜厚度与NPDR CSME-组相同位点脉络膜厚度比较,差异有统计学意义(F=11.563、9.777、9.096,P<0.05);两组其余各位点脉络膜厚度比较,差异均无统计学意义(F=2.194、3.157、3.339、2.889、3.765、3.459、4.605、5.997, P>0.05)。相关性分析结果显示,对照组(r=-0.096)、NPDR CSME-组(r=0.026)、NPDR CSME+组(r=-0.067)黄斑中心凹下处脉络膜厚度与黄斑中心凹视网膜厚度无相关(P>0.05)。结论 NPDR黄斑水肿患者黄斑部脉络膜厚度较正常人变薄。  相似文献   

6.
目的 利用动态对比增强磁共振(DCE-MRI)定量检测实验性糖尿病视网膜病变(DR)血视网膜屏障(BRB)破坏程度,并探讨其可行性。方法 40只鼠龄3周的健康Sprague-Dawley (SD)大鼠随机平均分为实验组和正常对照组,实验组大鼠腹腔注射链脲佐菌素,注射48、72 h后检测大鼠空腹血糖及尿糖,血糖浓度在16.65 mmol/L、尿糖(+++)以上者视为建模成功,并按病程再分为糖尿病2、4、6、8个月,组每组各5只大鼠。正常对照组腹腔注射等体积缓冲液,并根据与实验组大鼠年龄匹配原则再平均分为4组,每组大鼠5只。分别在注射后2、4、6、8个月时利用DCE MRI扫描眼球,计算BRB渗漏速度;戊巴比妥过量麻醉后摘除眼球观察视网膜组织形态。采用SPSS 12.0对数据进行统计学分析。结果  实验组大鼠成模率100%,正常对照组、糖尿病2、4个月组大鼠BRB未见明显渗漏,糖尿病6、8个月组大鼠BRB渗漏速度分别为(0.1399±0.0065)、(0.1816±0.2756) mm3/min,两者之间差异有统计学意义(Z=-2.121,P<0.05)。实验组大鼠病程4个月时出现明显视网膜组织水肿,细胞排列紊乱,随病程延长逐渐加重,出现血管扩张,出血。结论 DCE MRI能够较精确地检测实验性DR的BRB渗漏速度,定量化评价BRB的破坏程度。   相似文献   

7.

目的:探讨并发糖尿病视网膜病变(DR)的2型糖尿病患者与健康人群脉络膜血管指数(CVI)的差异及特点。

方法:选取2017-01/12于我院就诊的并发DR的2型糖尿病患者68例68眼作为DR组,同时纳入同期体检的无糖尿病病史健康人群34例34眼作为对照组。通过频域相干光层析深度增强成像术(EDI-OCT)获取受检者黄斑中心凹下脉络膜厚度(SFCT)、黄斑中心凹处视网膜厚度(CRT),并将黄斑区图像进行二值化处理,采用图像分析软件计算黄斑区脉络膜总面积(TCA)、血管区面积(LA)及间质区面积(SA),计算CVI。

结果:对照组和DR组受检者TCA(0.53±0.14mm2 vs 0.49±0.15mm2)、LA(0.35±0.09mm2 vs 0.32±0.10mm2)、SA(0.17±0.05mm2 vs 0.17±0.06mm2)及SFCT(347.9±76.9μm vs 325.9±92.9μm)均无差异(P>0.05),但DR组患者CVI明显低于对照组(64.33%±3.25% vs 67.04%±2.46%,P<0.001),二者临界值为63.59%。

结论:CVI可以直观反映脉络膜内部结构的变化,较SFCT更加稳定可靠,合并DR的2型糖尿病患者其CVI较健康人群降低。  相似文献   


8.
目的 观察婴儿视网膜黄斑区形态及视网膜各层厚度变化。方法 随机选取新生儿重症监护病房中的婴儿58例86只眼纳入研究。根据不同矫正胎龄对婴儿进行分组。其中,矫正胎龄<32周组10例14只眼;33~36周组26例39只眼;37~41周组12例18只眼;≥42周组10例15只眼。随机选择无器质性眼病的成人12名22只眼作为成人组。所有婴儿及成人均行便携式光相干断层扫描(OCT)检查。着重观察婴儿黄斑区形态。同时,测量婴儿及成人黄斑中心凹及距中心凹750、1500 μm处旁中心凹的神经上皮层、内层视网膜、外层视网膜、神经纤维层、节细胞层、内丛状层、内核层、外丛状层、外核层厚度。分析视网膜各层厚度与矫正胎龄的相关性。结果 婴儿早期的黄斑中心凹凹陷浅,随着矫正胎龄增长凹陷逐渐加深并接近成人形态。婴儿外层视网膜结构较内层完善,随着矫正胎龄的增长逐渐出现外界膜、光感受器内外节连接(IS/OS)、光感受器外节/视网膜色素上皮(OS/RPE)层。外界膜、IS/OS、OS/RPE层最早出现时间分别为矫正胎龄32+6、35、47+6周。RPE层、脉络膜血管层厚度均随矫正胎龄增长逐渐增厚。婴儿组、成人组之间距中心凹750 μm处内层视网膜、1500 μm处神经纤维层和中心凹及距中心凹750、1500 μm处节细胞层厚度比较,差异无统计学意义(P>0.01)。其他视网膜各层厚度在婴儿组及成人组间,以及在不同矫正胎龄组组内间差异均有统计学意义(P<0.01)。相关性分析发现,除节细胞层外,其他视网膜各层厚度均与矫正胎龄有相关性(P<0.05)。结论 婴儿早期的黄斑中心凹凹陷浅,随着矫正胎龄增长凹陷逐渐加深并接近成人形态。婴儿早期黄斑区外层视网膜逐渐增厚,其中以内外核层增减变化最为明显。视网膜各层随着矫正胎龄增长逐渐增厚,但发育速度并不完全一致。  相似文献   

9.
目的;观察高三尖杉酯碱(homoharringtonine,HHT)对视网膜母细胞(retinoblastoma,RB)细胞系HXO—RB44:细胞的杀伤作用及其诱导的细胞死亡形式。 方法:用MTT法测定肿瘤细胞存活率,提取药物作用后的细胞核DNA进行琼脂糖凝胶电泳。 结果:HHT在10-9mol/L~10-4mol/L浓度范围对HXO-RB44具有较强的杀伤作用(P<0.05)。10-6mol/L的HHT与HXO-RB44作用48小时后,核DNA发生有规律的裂解,琼脂糖凝胶电泳呈典型DNA梯度。 结论:HHT诱导RB发生程序性死亡(programmedcelldeath,PCD),其诱导活性呈较强的浓度和时间依赖性。 (中华眼底病杂志,1997,13:70-72)  相似文献   

10.
目的 观察玻璃体腔注射抗血管内皮生长因子单克隆抗体ranibizumab(IVR)辅助微创玻璃体视网膜手术(VRS)治疗严重增生型糖尿病视网膜病变(PDR)的临床效果。方法 回顾性非随机临床对照研究。临床确诊为严重PDR的60例患者70只眼纳入研究。依据手术前是否行IVR治疗将患者分为IVR组和对照组。IVR组31例35只眼,对照组29例35只眼。IVR组于手术前3~4 d玻璃体腔注射10 mg/ml的ranibizumab 0.05 ml(含ranibizumab 0.5 mg),然后行23G微创VRS。对照组直接行23G微创VRS。手术后随访3~12个月,平均随访时间(4.5±1.8)个月。对比分析两组患者最小分辨角对数(logMAR)最佳矫正视力(BCVA)、眼压、黄斑中心凹视网膜厚度(CRT)和视网膜复位及手术后并发症的发生情况。结果 IVR组患者均未发生与注射及药物相关的局部及全身不良反应。手术后1周,1、3个月,IVR组玻璃体积血(VH)发生率分别为8.6%、0.0%、0.0%,对照组VH发生率分别为28.6%、17.1%、8.6%。两组手术后各时间点VH发生率比较,手术后1周及1个月之间差异有统计学意义(χ2=4.63、4.56,P<0.05),手术后3个月之间差异无统计学意义(χ2=0.24,P>0.05)。IVR组、对照组手术后平均logMAR BCVA分别为0.81±0.40、1.05±0.42,均较手术前提高。IVR组、对照组手术前后平均logMAR BCVA比较,差异有统计学意义(t=12.78、4.39,P<0.05)。IVR组手术后平均logMAR BCVA较对照组提高,两组手术后平均logMAR BCVA比较,差异有统计学意义(t=-2.36,P<0.05)。IVR组、对照组手术后平均CRT分别为(297.6±79.8)、(347.6±85.0) μm,两组平均CRT比较,差异有统计学意义(t=-2.53,P<0.05)。IVR组、对照组手术后视网膜复位率分别为97.1%、94.3%,两组视网膜复位率比较,差异无统计学意义(χ2=0.35,P>0.05)。IVR组、对照组一过性高眼压发生率分别为14.3%、34.3%,两组间一过性高眼压发生率比较,差异有统计学意义(χ2=4.79,P<0.05)。IVR组、对照组视网膜前膜、新生血管性青光眼等并发症发生情况比较,差异也无统计学意义(χ2=0.97、0.51,P>0.05)。结论 IVR辅助23G微创VRS治疗严重PDR能提高患者视力,降低手术后VH发生率,减小CRT。  相似文献   

11.
PURPOSE: To study the luminal characteristics of the central retinal vessels of young humans where the vessels pass through the anterior optic nerve. METHODS: Serial sections of nine central retinal arteries (CRAs) and 13 central retinal veins (CRVs) from 12 eyes of 12 young donors (aged 20-29 years) without known ocular disease or anatomic malformation were examined by image analysis to determine their luminal dimensional differences right at, anterior to, and posterior to the lamina cribrosa. RESULTS: The average values of the mean area of the CRAs in the prelaminar, laminar, and retrolaminar portions were 16.5 x 10(3) microm2, 17.2 x 10(3) microm2, and 15.2 x 10(3) microm2, and mean perimetric lengths were 541 microm, 528 microm, and 492 microm, respectively. Differences were detected in perimetric length and theoretical luminal area between the laminar and retrolaminar portions, but not the prelaminar and laminar portions. The average values of the mean area of the CRVs in the prelaminar, laminar, and retrolaminar portions were 24.6 x 10(3) microm2, 13.3 x 10(3) microm2, and 7.8 x 10(3) microm2, and mean perimetric lengths were 689 microm, 544 microm, and 411 microm, respectively. There were marked differences between the prelaminar and laminar values and between the laminar and retrolaminar values in terms of the perimetric lengths and theoretical luminal areas. CONCLUSIONS: The results suggest that the resistance of blood flow in CRAs decreases when the blood enters the eye. The gradual constriction of CRVs from the prelaminar to the retrolaminar portion may act as a throttle mechanism in controlling the outflow of the blood and in maintaining the patency of the retinal venules and capillaries.  相似文献   

12.
目的探讨视网膜静脉阻塞(retinalveinocclusion,RVO)患者视网膜中央动脉(centralreti-nalartery,CRA)和视网膜中央静脉(centralretinalvein,CRV)血流动力学特征及其意义。方法使用ATL-HDI3000彩色多普勒诊断仪,检测RVO患者患眼48只、对侧临床健康眼39只及正常对照眼40只的CRA收缩期峰值血流速度(peaksystolicvelocity,PSV)、舒张末期血流速度(end-diastolicvelocity,EDV)和血管搏动指数(pulsatilityindex,PI),CRV最大血流速度(maximunvelocity,Vmax)。结果RVO患眼、对侧临床健康眼CRA的PSV和EDV均显著低于正常对照眼,RVO患眼PI显著高于正常对照眼;RVO患眼CRA的PSV显著低于RVO对侧临床健康眼,RVO患眼PI显著高于RVO对侧临床健康眼;RVO患眼、对侧临床健康眼CRV的Vmax均显著低于正常对照眼。结论RVO患眼和对侧临床健康眼血流动力学异常。彩色多普勒成像技术可作为其早期诊断的重要手段  相似文献   

13.
Pathological changes in the optic disc and anterior part of the optic nerve of monkeys were studied 5 hours and several days after occlusion of the temporal short posterior ciliary arteries. Ischaemic vacuolation of neural tissue was observed in some of the animals studied and was restricted to the lamina cribrosa and the immediately retrolaminar portion of the optic nerve. Axonal swelling and organelle aggregation were demonstrated in the prelaminar region, and autoradiography after intravitreal injection of tritiated leucine revealed an associated obstruction of rapid and slow orthograde axoplasmic transport. The experimental findings correlate with those seen clinically in acute ischaemic optic neuropathy. The pale swelling of the optic disc in this condition represents an accumulation of axoplasmic debris in retinal ganglion-cell axons owing to obstruction of axoplasmic transport at the lamina cribrosa; it is thus equivalent to a 'cotton-wool spot' of the disc.  相似文献   

14.
PURPOSE: To investigate morphologic changes in the posterior segment of the eye and optic nerve head (ONH) in rhesus monkeys with experimental glaucoma, and to evaluate the effect of age and vascular disease on the glaucomatous damage. METHODS: This study was conducted in 36 eyes of rhesus monkeys 11 to 24 years of age. Experimental glaucoma was produced by laser photocoagulation of the anterior chamber angle in 28 eyes, and the remaining 8 eyes served as the nonglaucomatous group. Of the 28 glaucomatous eyes, 19 belonged to animals with experimental atherosclerosis and chronic arterial hypertension (A-H group); the remaining 9 had no A-H (non-AH group). Among the 8 eyes without glaucoma, 5 belonged to A-H animals and the remaining 3 to animals without A-H. All eyes underwent IOP measurements and fundus photography before laser photocoagulation and serially thereafter for 4 to 60 months (median 22.5 months). After enucleation, eyes were fixed in formalin for light microscopic studies. Morphologic abnormalities were evaluated and graded. Correlation analyses between morphologic parameters and clinical data were performed. RESULTS: The highest IOP ranged from 44 to 80 mmHg, but during the follow-up period median IOP was mostly 28 mmHg (mean 27+/-4.8 mmHg). On histopathologic examination, the eyes showed moderate to severe atrophy of the temporal peripapillary choroid (67%), choriocapillaris (70%), and RPE (12%); axonal atrophy in the retinal nerve fiber layer (85%), prelaminar region (69%), lamina cribrosa (66%), and retrolaminar region (82%); fibrous septal thickening in the lamina cribrosa (77%) and retrolaminar region (86%); bowing backward of the lamina cribrosa (77%); overall tissue atrophy in the prelaminar region (81%); and retinal ganglion cell atrophy (74%). The data showed a positive correlation between the ONH damage and atrophic changes in the temporal peripapillary choroid, and suggested greater damage in animals with A-H than in those without A-H. CONCLUSION: Vascular disease may influence glaucomatous damage in the ONH, as damage in the ONH was greater in animals with A-H than in those without A-H. A similar relationship also may exist between age and glaucomatous damage, but this needs to be investigated further in a larger study. It is postulated that the bowing back of the lamina cribrosa seen in optic disc cupping is produced by retrolaminar septal fibrosis and axonal loss. Although elevated IOP no doubt played an important role, the data suggest that the glaucomatous changes that were observed in this study are not simply mechanical in nature (due to the raised IOP), but may represent a multifactorial phenomenon.  相似文献   

15.
Microangioarchitecture of optic papilla   总被引:4,自引:0,他引:4  
Two hundred postmortem normal human eyes of 100 cases were studied by four methods to investigate the microangioarchitecture of the optic papilla. The following results have been obtained. The Zinn's circle is important to the blood supply of the optic papilla. It gives off tributaries to the papillar prelaminar and laminar layers and pial vessel network at the retrolaminar portion. The blood supply of the prelaminar layer comes directly from the branches of the short posterior ciliary arteries and Zinn's circle, while the choroidal vessels contribute only a few branches to this area. The above two results are not consistent with Hayreh's idea. Between the central retinal artery system and short posterior ciliary artery system, there are anastomoses at the pial vessel network and in the optic nerve at the retrolaminar portion, but none is found, obviously, in the intraocular portion of the optic nerve. The microangioarchitecture of the optic papilla is accommodated to the nerve in which it resides. The most superficial vessels are radiating, those in the prelaminar and laminar layers are lamellar, and those in the retrolaminar portion are an interwoven network. The caliber of the capillary at the prelaminar and laminar layers is the narrowest, therefore, an ischemic change easily takes place right here.  相似文献   

16.
We examined three patients with optic disc edema and peripapillary hemorrhages. Each was found by standard echography to have calcified nodules within the retrobulbar portion of the optic nerves. These nodules were located approximately 2 mm posterior to the lamina cribrosa. Each patient had unilateral congestion of the optic nerve head with dilated, tortuous retinal veins that appeared much like a partial central retinal vein occlusion; one patient subsequently developed optic atrophy. The central location of the calcifications within the anterior aspect of the optic nerves suggests that each nodule may have been situated within the central retinal vein or artery. Calcifications within the retrolaminar space may be associated with some etiologies of unilateral congestion of the optic nerve head.  相似文献   

17.
陈锋  李润春 《眼科研究》1999,17(6):488-490
目的 探讨视网膜静脉阻塞(RVO)血流动力学改变。方法 经散瞳眼底检查及眼底荧光血管造影确诊为RVO病例52例,健康对照组52例,使用Acuson 128XP/ 10型彩色电脑声像仪,测定也视网膜中央动脉(CRA)、中央静脉(CRV)及眼动脉(OA)的收缩期最大血流速度(Vmax)、舒张期末最小血流速度(Vmin)及阻力指数(RI)。结果 RVO患者CRV和Vmax及Vmin均明显低于健眼(P〈0.  相似文献   

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