青光眼住院病人的疾病构成特点

目的 探讨青光眼住院病人疾病构成的特点,为青光眼的防治研究提供新的流行病学资料.方法 选择2006年1月至2009年12月在眼科住院的青光眼患者1294例进行统计学分析.结果 原发性闭角型青光眼(PACG)、原发性开角型青光眼(POAG)、继发性青光眼(SG)、先天性青光眼(CG)各占青光眼住院病人总数的72.95%、6.18%、19.94%和0.93%.四年来青光眼住院病人疾病构成无明显改变.结论 青光眼住院病人构成与其他研究结果不完全一致.原发性青光眼也是我院青光眼的主要类型,其中PACG占第1位,但POAG的构成仍然较低.

Abstract：

Objective To analyze the characteristics of proportion in hospitalized patients with glaucoma.Methods Of 1294 cases in our Department of Ophthalmology from January 2006 to December 2009were included.Results 72.95% of the case were primary angle-closure glaucoma (PACG),while 6.18%,19.94% and 0.93% of them were primary open angle glaucoma (POAG),secondary glaucoma (SG) and congenital glaucoma (CG) respectively.There were no change in proportion of hospitalized patients with glaucoma in our department.Conclusions Compared with the constitutive portions of hospitalized patients with glaucoma in other hospitals,the results are not all the same in our department.Primary glaucoma is also the main part,with PACG constituting the greatest part.However,POAG still constitute the small part.     

华西医院青光眼住院患者构成及其变化

目的:比较近年青光眼患者在青光眼类型、发病年龄和性别分布的差异,并与以往的资料作比较,以了解青光眼内部构成的变化趋势,为青光眼的防治研究提供新的流行病学资料。方法:收集华西医院眼科2009-01/12所有青光眼住院患者病历共577例,根据出院诊断分为原发性闭角型青光眼(PACG),原发性开角型青光眼(POAG),先天性青光眼,继发性青光眼,并将其与1978-01/1981-12,以及2001-01/2002-12青光眼住院患者971例进行比较。结果:2009年间,原发性青光眼占当年青光眼住院患者总数的60.2%所占比例下降;POAG占原发性青光眼的27.4%,在原发性青光眼中的构成比有所上升;PACG中位数年龄为62.8,总体有所增大,POAG中位数年龄为48,无明显变化;POAG中女性患者比例增加;2009年继发性青光眼占当年青光眼住院患者总数的33.4%,比例显著较往年增加。结论:POAG在原发性青光眼中的构成比有所上升,继发性青光眼患者显著增加。     

混合型青光眼住院病人的致病机制构成分析

目的 分析混合型青光眼(mixed glaucoma,MG)住院病人的致病机制.方法 收集 2005年~2009年连续住院患者MG 109只眼(76例)的临床资料,结合眼压、C/D、视野、前房角镜及超声生物显微镜(ultrasound biomicroscopy,UBM)等临床资料,分类分析其混合致病机制的构成.结果 (1)本组病例存在12个致病机制类型:原发性开角型青光眼(primary open-angle glaucoma,POAG、原发性闭角型青光眼(primary angle-closure glaucoma,PACG)、先天性青光眼、新生血管性青光眼、青睫综合征及以下因素:晶状体膨胀或脱位、睫状体囊肿、糖皮质激素、眼外伤或眼内手术、虹膜炎、Fuchs综合征和剥脱综合征继发性青光眼.(2) 本组病例存在7类混合机制致病:POAG合并PACG35只眼,占32.1%;PACG合并继发性闭角型青光眼32只眼(29.4%);PACG合并继发性开角型青光眼13只眼(11.9%);POAG合并继发性开角型青光眼11只眼(10.1%);POAG合并继发性闭角型青光眼10只眼(9.2%);先天性青光眼合并继发性青光眼5只眼(4.6%)及不同类型的继发性青光眼合并存在3只眼(2.8%).结论 注意对青光眼发病机制的全面分析,避免明确一种青光眼致病病机制而忽略混合致病机制的存在,以便采取恰当全面的治疗方案;UBM的应用有助于MG致病机制的分析;POAG 合并PACG是MG的主要类型.     

保定地区青光眼患病率现状调查分析

目的：调查分析保定地区青光眼患病率现状。

方法：于2017-05/12采取整群抽样法选择保定地区市民4 960名进行青光眼排查,分析各类青光眼发病率以及发病年龄、性别分布情况,比较已诊断和新诊断青光眼患者眼部病变情况。

结果：青光眼患病率为2.72%(135/4960),其中原发性闭角型青光眼(primary angle-closure glaucoma,PACG)、原发性开角型青光眼(primary open angle glaucoma,POAG)、先天性青光眼(congenital glaucoma,CG)、继发性青光眼(secondary glaucoma,SG)患病率依次为51.85%、20.00%、17.04%、11.11%,男、女构成比例依次为1：1.92、3.50：1、2.83：1、1：1.14,青光眼患者的男女比例相比较,差异无统计学意义(P>0.05); 40岁以上PACG、POAG、SG、CG构成比例依次为95.71%、51.85%、52.17%、0,≤49岁、50～69岁、≥70岁各年龄段的PACG、POAG、SG、CG构成比依次为1：5.63：2.13、4.5：1.25：1、4.67：2：1、15：0：0,差异具有统计学意义(P<0.05); 已诊断、新诊断青光眼患者视野改变、眼压>21mmHg发生情况相比较,差异无统计学意义(P>0.05); 新诊断青光眼患者单眼低视力、单眼盲发生率比已诊断青光眼患者低,视神经改变发生率比已诊断青光眼患者高,差异具有统计学意义(P<0.05)。

结论：保定地区青光眼患病率为2.72%,其中以PACG患病率最高,其他依次为POAG、SG、CG,其发病率与性别无关,除CG发生于特定人群外,50～69岁为PACG高发阶段,POAG、SG患病率随年龄的增加而降低,青光眼新诊断患者的眼盲率较低,但病情进展程度较为严重。     

青光眼住院手术患者的构成及变化趋势分析

目的分析青光眼住院手术患者的内部构成比及其性别、年龄分布,为青光眼的防治研究提供流行病学参考。方法回顾分析浙江大学医学院附属第二医院眼科2001年1月至2008年12月期间青光眼住院手术患者资料,统计住院手术患者的年龄、性别分布及各种类型青光眼的构成比,分析其内部构成比及变化趋势。结果原发性青光眼、继发性青光眼和先天性青光眼患者数各占青光眼总数的61.82%、31.01%和7.16%。住院手术患者中,原发性闭角型青光眼（PACG）患者男：女=1：2.05;原发性开角型青光眼（POAG）患者男：女=2.41：1;继发性青光眼（SG）患者男：女=1.94：1;先天性青光眼（CG）患者男：女=1.45：1。40岁以下原发性青光眼手术患者以POAG患者多于PACG,而40岁以上则相反。结论 PACG是青光眼住院手术患者的主要类型。40岁以上人群中,PACG可能是青光眼防治的重点,而40岁以下人群的防治重点则可能是POAG。     

原发性开角型青光眼一家系

原发性开角型青光眼（ primary open-angle glaucoma, POAG ）是一种多基因遗传性疾病,13％～47％的患者有阳性家族史。现将POAG一家系8例患者,报告如下。     

原发性青光眼视野缺损的严重性和空间分布-一项原发性开角型青光眼与原发性闭角型青光眼的比较

目的：比较原发性开角型青光眼(POAG)与原发性闭角型青光眼(PACG)视野缺损的特点。     

早期诊断原发性开角型青光眼的客观检查

通过与经典的静态视野检查法相比较,探讨原发性开角型青光眼(primary open angle glaucoma,POAG)的客观检查的可行性和敏感度,提高原发性开角型青光眼的早期诊断率。     

晶状体摘出术:降低眼压的新途径？

晶状体超声乳化摘出术治疗原发性闭角型青光眼（primary angle-closure glaucoma,PACG）可以有效加深前房,扩大房角,降低眼压（intraocular pressure,IOP）;研究表明晶状体摘出术对于原发性开角型青光眼（primary open-angle glaucoma,POAG）、剥脱性青光眼等也可以有效地降低IOP。关于透明晶状体摘出术作为PACG治疗的方式一直存在着过度医疗等争议,但随着研究的不断深入,透明晶状体摘出术的安全性和有效性逐渐被证实。     

青光眼住院患者的疾病构成及民族特点流行病学调查

目的:了解青光眼住院患者的病型构成、性别、年龄分布、族别(维吾尔族)及其变化特点,为青光眼的防治研究提供新的流行病学资料。方法:选取2005-01/2010-01在本院眼科住院的青光眼手术患者2953例,根据出院诊断分为包括急性型与慢性型闭角型青光眼(PACG),原发性开角型青光眼(POAG),先天性青光眼(CG)和继发性青光眼(SG)。统计住院患者的年龄、性别、民族分布,分析其内部构成及变化趋势。结果:PACG,POAG,CG,SG各占青光眼总数的54.6%,15.2%,2.3%,27.9%。PACG的构成比逐年(63.1%～54.1%)下降,POAG的构成比在2007-01/2008-01达高峰(21.0%),CG的构成比平稳,SG的构成比(23.9%～33.5%)逐年增高;维吾尔族患者在闭角型青光眼中所占百分比逐年增高(23.0%～35.3%),在开角型青光眼中所占百分比亦逐年增高(7.9%～26.7%),在CG中所占百分比波动较大,在SG中所占百分比平稳。<40岁的维吾尔族男性患者在闭角型、开角型青光眼中,所占百分比逐年增高,<40岁的维吾尔族女性患者开角型青光眼中,所占百分比逐年增高,在闭角型青光眼中,所占百分比有下降趋势;≥40岁的维吾尔族女性患者在闭角型青光眼中,所占百分比逐年增高。结论:闭角型青光眼仍然是我国青光眼的主要类型,SG的防治研究不容忽视,在新疆维吾尔族住院患者的青光眼构成比逐渐增加,≥40岁的维吾尔族女性人群应特别注意闭角型青光眼的筛查,但开角型青光眼的防治研究不能忽视,<40岁的维吾尔族男、女性群体均是开角型青光眼防治的重点。     

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.