A 12-year epidemiological review of retinoblastoma in Omani children

AIM: To describe the epidemiology of retinoblastoma (RB) in Omani children. METHOD: The National Cancer Registry, hospital records, and treatment abroad registers were reviewed to identify the characteristics of Omani children diagnosed with RB between 1990 and 2002. RESULTS: Twenty-nine children (12 male and 17 female) were diagnosed with RB. The age-adjusted incidence was 4.04/million/year in children < 15 years and 8.33/million/year in children < 5 years. The mean age at diagnosis was 32.2 months (33.8 months for unilateral RB and 13.2 months for bilateral RB). 75% had unilateral tumors and 25% had bilateral tumors. The five-year survival rate for RB was 89%. None of the patients had a family history of RB. CONCLUSION: The incidence of RB in Oman is at par with other countries. A definite female preponderance exists in the Omani population. The proportion of unilateral RB cases is unusually high among Omani children. The five-year survival rate is almost at par with that reported in the West. Genetic studies and further longitudinal studies of surviving RB cases could further enhance the knowledge of the epidemiology of RB in Oman.     

视网膜母细胞瘤术后存活20年以上的随访观察

为探讨视网膜母细胞瘤（ＲＢ）患者长期存活的有关因素及第二恶性肿瘤发病及遗传性，对１９６０—１９７５年病理确诊的９０例ＲＢ患者及其后代进行随访。随访到５９例，其中存活２０年以上者１６例，存活率为２７．１２％。尚未发现发生第二恶性肿瘤者。随访到ＲＢ患者的后代１４人，除２人因腹泻死亡外，其余经检查均未发现ＲＢ病变。结论：长期存活与病程、病期及是否做放疗有关，未分化型者的预后并不差，只要早期发现，及时治疗仍可长期存活。     

A 12-year epidemiological review of retinoblastoma in Omani children

aim?To describe the epidemiology of retinoblastoma (RB) in Omani children. method?The National Cancer Registry, hospital records, and treatment abroad registers were reviewed to identify the characteristics of Omani children diagnosed with RB between 1990 and 2002. results?Twenty-nine children (12 male and 17 female) were diagnosed with RB. The age-adjusted incidence was 4.04/million/year in children <15 years and 8.33/million/year in children <5 years. The mean age at diagnosis was 32.2 months (33.8 months for unilateral RB and 13.2 months for bilateral RB). 75% had unilateral tumors and 25% had bilateral tumors. The five-year survival rate for RB was 89%. None of the patients had a family history of RB. conclusion?The incidence of RB in Oman is at par with other countries. A definite female preponderance exists in the Omani population. The proportion of unilateral RB cases is unusually high among Omani children. The five-year survival rate is almost at par with that reported in the West. Genetic studies and further longitudinal studies of surviving RB cases could further enhance the knowledge of the epidemiology of RB in Oman.     

双眼异时性视网膜母细胞瘤21例临床分析

目的　通过分析双眼异时性视网膜母细胞瘤（RB）患儿的临床资料,确定高危因素,制订合理的随访计划,从而使肿瘤得以早期发现、早期治疗。方法　回顾性病例分析。收集2014年12月至2019年3月北京儿童医院收治的第一眼确诊为RB后,第二眼发现新发RB的病例共21例,分析双眼确诊间隔时间、发病年龄、首发症状,以及第二眼的确诊方法与肿瘤分期（IIRC）关系等。眼底检查以全身麻醉下间接眼底镜联合RetCam作为常规检查。结果　第一眼发病时患儿的年龄为1~36个月,平均12.2个月,13例年龄≤12个月;第二眼发病年龄为3~84个月,平均25.7个月,19例年龄≤36个月;双眼发病间隔时间为1~48个月,平均13.7个月。第二眼有首发症状者4例,17例（81.0%）在随诊例行检查时发现,无临床症状。第二眼肿瘤分期:A期8例,B期4例,C期1例,D期6例,E期2例。第二眼肿瘤以全身麻醉下间接眼底镜联合RetCam检查发现为主,患者多为早期。结论　第一眼RB发病年龄≤12个月是第二眼发生RB的高危因素,双眼确诊的间隔时间多≤ 36个月;定期、规律随诊和全身麻醉下间接眼底镜联合RetCam检查是早期发现第二眼RB的有效方法。     

视网膜母细胞瘤综合治疗的预后及其相关因素

目的：研究视网膜母细胞瘤（RB）患儿综合治疗的预后并探讨其相关临床因素。 方法：回顾性系列病例研究。分析在深圳市眼科医院进行综合治疗的65例（92眼）RB患儿的临床资料。综合治疗的方法为以化疗为主联合局部治疗（光凝或冷冻）+眼球摘除治疗。不同结局相关临床因素的比较采用独立样本t检验,其余指标采用Fisher's精准检验。 结果：所有RB患儿的总生存率为92%,不同分期生存率差异无统计学意义。所有患儿总的保眼率为51%,E期和其他4期之问保眼率差异均有统计学意义(P<0.01)。高风险D、E期RB患儿共60例,采用化疗联合局部治疗保眼的共42例,D期18例中11例保眼成功,E期24例中4例保眼成功。治疗成功与失败患儿的初诊时间和随访时间差异无统计学意义。根据眼内肿瘤的位置将42例患儿分为3组,分析显示即周边部（包括中周部）与后极部、后极部+周边部保眼率差异有统计学意义(P=0.009、0.021)。42例患儿中4例死亡,均为肿瘤位置处于后极部的患儿,后极部与后极部+周边部2组之间病死率差异有统计学意义( P=0.045)。 结论：综合治疗提高了RB患儿的生存率,但患儿的生存率和保眼率与其临床分期及肿瘤所处的位置高度相关。     

视网膜母细胞瘤细胞分化程度对扩散和 存活预后的影响

目的探讨视网膜母细胞瘤（retinoblastoma,RB）细胞分化程度对扩散和存活预后的影响。方法对156份RB眼球标本 进行组织病理学观察，根据肿瘤细胞分化程度将其分为分化型与未分化型，注意有无肿瘤细 胞的扩散，并统计两型发生扩散的比率。对随访到的82例RB患者进行死亡率统计。用检验的方法比较两型间死亡率和扩散发生率。记录扩散部位与死亡率之间的关系、死者生前眼球摘除术后平均存活时间。结果分化型RB　17例17只眼，发生肿瘤细胞局部扩散8只眼，占47.06%；未分化型137例139 只眼，发生局部扩散66只眼，占47.48%。两型间发生扩散的比率差异无显著性意义（P>0.05）。随访到的患者中，分化型RB死亡率27.27%，未分化型RB死亡率22.54%，二者比较差异亦无显著性意义（P>0.05）。眶内和巩膜侵犯者死亡率100%，视神经侵犯Ⅳ级者死亡率62.50%，葡萄膜侵犯者死亡率22.22% 。眼球摘除术后生存时间为5～41个月，平均21.92个月。结论分化型与未分化型RB的存活预后及局部扩散比率差异无显著性意义。发生扩散的RB，无论是分化型还是未分化型其预后均取决于扩散的程度以及是否进行积极治疗。(中华眼底病杂志,2001,17:18-20)     

视网膜母细胞瘤的遗传学特征及临床筛查与治疗

视网膜母细胞瘤(RB)是儿童最常见的眼内恶性肿瘤,多发于婴幼儿,可损害患儿视力、眼球,甚至危及生命。其发生和发展与基因组和表观基因组有很大关系,遗传性RB占所有病例的45%。RB的治疗和预后取决于疾病的初始阶段,当疾病被早期诊断和治疗时,存活率超过95%,当RB在晚期发生眼外播散时,存活率低于50%。因此RB的治疗重点是通过早期肿瘤的监测和预防挽救患儿生命,其次要目标是保存眼球,并最大水平地保留视力。对RB遗传学的研究有助于通过基因筛查、监测查找特异性靶点,对提高患儿的生存率、研究RB靶向治疗十分必要。     

Fine needle aspiration biopsy (FNAB) for retinoblastoma

PURPOSE: To determine the incidence of diagnostic fine needle aspiration biopsy (FNAB) in eyes with retinoblastoma (RB) as well as its indications and potential complications. METHODS: A retrospective study by survey was designed and a questionnaire inquiring on FNAB use in RB diagnosis during the past 15 years was submitted to 12 high-volume ocular oncology clinics. RESULTS: A total of 3,651 patients with RB have been diagnosed and treated in 12 clinics since 1985. During the same period, eight biopsies were obtained for diagnostic purposes and six of these proved to be RB by cytology; the other two showed inflammatory cells and benign retinal cells. The median age for the biopsied patients was 46 months; 6 of the biopsied children were older than 4 years of age. The average age at the time of biopsy was 46 months. Most of the cases were biopsied with clinical diagnosis of uveitis/endophthalmitis through the limbus and pars plana with 25- and 27-gauge needles. Five of six cases of RB had enucleation and one patient had cryotherapy and I-125 brachytherapy after FNAB. The average follow-up time for biopsy-proven RB cases was 10.8 years with no recurrent disease. CONCLUSION: The results of this survey suggest that FNAB indication for RB diagnosis is rare; the majority of cases can be diagnosed and treated by ocular oncologists without invasive procedures.     

P53蛋白及P21蛋白在视网膜母细胞瘤表达的研究

目的：探讨P53和P21在视网膜母细胞瘤发生中的作用,及其与预后的关系。方法：应用抗人P53,P21抗体,采用链霉素亲生物素蛋白一过氧化霉（SP）免疫组化方法。对30例RB常规石蜡标本进行P53和P21蛋白的测定,结果：P53和P21在RB中的阳性表达率分别为60％和80％,P53的表达与临床分期有关（P＜0．05）,P53和P21的表达均与生存时间有关,P53阳性组生存时间低于P53阴性组（P＜0．05）,P21阳性组生存时间高于P21阴性组（P＜0．01）,P53阳性组的2年生存率低于P53阴性组,而P21阳性组的2年生存率高于P21的阴性组,结论：在RB的发生中P53和P21起着重要的作用,P53和P21的表达可以作为临床预后的一个参考指标。     

视网膜母细胞瘤患者全身化学药物治疗联合眼部治疗的临床疗效观察

目的：观察视网膜母细胞瘤（RB）患者全身化学药物治疗（化疗） 联合眼部治疗的 临床效果。 方法：回顾分析37例56只眼行全身化疗联合眼部治疗的RB患 者的生存率、眼球保留 率以及病情得到良好控制的情况。病情得到良好控制的标准为：（1）眼部肿瘤缩小乃至消 失，肿瘤病灶呈软乳酪样改变或出现钙化和瘢痕化；（2）眼球摘除者未出现眼眶肿瘤复发 ；（3）临床检查未见肿瘤转移。所有患者均至少有一只肿瘤眼分期为Ⅲb期或以上并接受化 疗。根据肿瘤对化疗的反应情况，一般接受6轮全身化疗，每轮化疗间隔3~4周。化疗药物组 成为：长春新碱、环磷酰胺、依托泊甙(VP16)、卡铂。另外,根据情况分别联合激光光凝、 冷冻、经瞳孔温热疗法（TTT）、钌¹⁰⁶放射敷贴器局部放射治疗以及眼球摘除等眼部 治疗。 治疗和观察时间2~59个月，平均观察时间为35个月。 结果：除1例双眼发 病患者眼球摘除手术 后失访外，观察期内30例患者存活，占83.3%；6例患者死亡，占16.6%。30例存活患者的45 只肿瘤眼中，肿瘤分期为I-Ⅱ期(早期)、Ⅲ-Ⅳ期(中期)和Ⅴ期(晚期)者眼球保存率分 别为100%（10只眼）、7 0.0%（10只眼）和14.3%（21只眼），随访期内病情均得到良好控制。6例死亡患者均为肿瘤 分期Ⅳ期 以上，最终死于肿瘤脑转移。 结论：全身化疗联合多种眼部治疗可以有效地治疗RB。     

视网膜母细胞瘤经眼动脉灌注化学药物治疗与经静脉全身化学药物治疗后摘除眼球的组织病理学特征研究

目的探讨视网膜母细胞瘤(RB)经眼动脉灌注化学药物治疗(IAC)或经静脉全身化学药物治疗(IVC)后摘除眼球的临床组织病理学特征。 方法收集首都医科大学附属北京儿童医院眼科2020年1月至2022年3月期间经IAC或IVC治疗后行眼球摘除术的19例(19只眼)RB病例。其中,男性10例(10只眼),女性9例(9只眼);年龄4~45个月,平均年龄(24.7±11.9)个月。根据治疗手段不同分为IAC治疗组和IVC治疗组。记录患者的治疗方法、临床分期(cTNM)、组织病理学分期(pTNM)、组织病理学特征及组织病理学高危因素(HRF),以例数(眼数)和百分比进行描述。 结果采用IAC疗法治疗者8例(8只眼),占42.11 %(8/19),采用IVC疗法治疗者11例(11只眼),占57.89%(11/19)。采用AJCC第8版TNM分期法进行分期,其中IAC治疗组cT2期、cT3期及cT4期分别有4例(4只眼)、3例(3只眼)及1例(1只眼),分别占50.00%(4/8)、37.50%(3/8)及12.50%(1/8),pT1期、pT2期及pT3期分别有5例(5只眼)、1例(1只眼)及2例(2只眼),分别占62.50%(5/8)、12.50%(1/8)和25.00%(2/8);IVC治疗组cT2期、cT3期及cT4期分别有1例(1只眼)、9例(9只眼)及1例(1只眼),分别占9.09%(1/11)、81.82%(9/11)和9.09%(1/11),pT1期、pT2期及pT3期及pT4期分别有1例(1只眼)、6例(6只眼)、3例(3只眼)和1例(1只眼),分别占9.09%(1/11)、54.55%(6/11)、27.27%(3/11)、9.09%(1/11)。全部19例(19只眼)经IAC与IVC治疗的RB组织病理学检查显示肿瘤有不同程度的钙化、出血及坏死,IAC治疗组和IVC治疗组发生脉络膜广泛性萎缩患者分别有8例(8只眼)和2例(2只眼),分别占100%(8/8)和18.18%(2/11),IAC治疗组和IVC治疗组发生血管壁均质性增厚改变者分别有8例(8只眼)和1例(1只眼),分别占100%(8/8)和9.09%(1/11)。全部19例(19只眼)中肿瘤存在HRF者7例(7只眼),占36.84%(7/19)。其中,HRF在cT2期、cT3期及cT4期者分别有1例(1只眼)、4例(4只眼)及2例(2只眼),分别占14.29%(1/7)、57.14%(4/7)及100.00%(2/2)。IAC治疗组和IVC治疗组存在HRF者分别为2例(2只眼)和5例(5只眼),分别占25.00%(2/8)和45.45%(5/11)。 结论IAC治疗后特征性组织病理学改变为脉络膜广泛性萎缩、血管壁呈均质性增厚改变。cTNM分期较高的患者存在组织病理学高危因素风险可能增加。     

Squamous cell carcinoma of the conjunctiva: clinicopathological features in 287 cases

BACKGROUND: Squamous cell carcinoma is the most frequently encountered malignant tumour of the conjunctiva. The objective of this study was to describe the clinicopathological features of patients with squamous cell carcinoma of the conjunctiva seen at a large ophthalmologic hospital in Mexico City. METHODS: We reviewed the clinical and pathological files of all patients with documented squamous cell carcinoma of the conjunctiva seen at the hospital between 1957 and 1996. RESULTS: A total of 287 cases (286 patients) were reviewed. The mean age of the patients was 60.4 (range 12 to 99) years; 55% were male. The clinical diagnosis was accurate in 41% of cases. Typical keratinized squamous cell carcinoma of the conjunctiva accounted for 98% of the lesions, and there were small numbers of histologic variants: lymphoepithelioma-like carcinoma (three cases), spindle cell carcinoma (two cases) and mucoepidermoid carcinoma (one case). Evidence of local extension of the tumour was found in 150 patients (52%), with the cornea being most frequently involved (108 cases [38%]). Regional metastasis was found in two patients, to a submandibular lymph node in one and to a preauricular lymph node in the other. The most common form of treatment was local resection (258 cases [90%]). The mean length of follow-up was 7.7 (range 2 to 24) months. The recurrence rate was 5.2%. INTERPRETATION: We report a large series of patients with squamous cell carcinoma of the conjunctiva. The incidence of local extension was high. Three cases of lymphoepithelioma-like carcinoma, a variant not previously reported in the conjunctiva, were encountered and were confirmed by immunohistochemical reactions.     

Bilaterality of idiopathic macular holes

Background: There has been wide variation in estimates of the incidence of bilateral idiopathic macular holes in the literature. This report of a large series of patients with macular holes provides further information regarding incidence of bilaterality, interval between onset in the first and the second eye, and visual outcome. Methods: A retrospective chart review was done of 550 patients with idiopathic macular holes examined at the Bascom Palmer Eye Institute between 1968 and 1994. The incidence of bilaterality was estimated from 365 patients in whom the fellow eye was normal at the initial examination. The rate of onset in the fellow eye was evaluated by survival analysis. Mean follow-up was 31 months (median 17 months). Results: Patients with incomplete macular holes (stage 1, aborted stage 1, lamellar) or full-thickness holes had a 19% incidence of bilaterality at 48 months follow-up. In the subset of 32 patients with full-thickness macular holes in the first eye, 13% developed full-thickness holes in the fellow eye within 48 months. The median interval between the onset in the first and in the second eye was 17.5 months. Visual acuity was excellent and stable in eyes with aborted stage 1 and lamellar holes. The visual acuity in the first eye with full-thickness macular hole decreased to 20/200 or worse in 79% of cases within 36 months' follow-up. Conclusions: The incidence of bilaterality and poor visual function in the majority of full-thickness idiopathic macular holes by 3 years' duration should be considered when advising patients and planning management.     

66例视网膜母细胞瘤患儿临床资料分析

目的观察西南地区视网膜母细胞瘤(RB)患眼的临床特点。方法回顾性临床研究。2010年1月至2017年12月在四川大学华西医院眼科检查确诊的RB患儿66例82只眼纳入研究。患儿均行眼部B型超声、眼眶CT或MRI检查,行广角数码视网膜成像系统检查10例。组织病理学检查确诊29例,临床症状结合影像学检查确诊37例。根据肿瘤是否侵及眼眶和视神经分为眼外期和眼内期;后者根据国际眼内期RB分期标准分为A^E期。根据不同分期行相应治疗。回顾分析患儿基本情况、就诊年龄、病程、就诊原因、分期、治疗方案和保眼率。结果66例患儿来自四川、云南、贵州省分别为56、2、2例,西藏自治区6例。可明确常住地43例,其中来自农村27例(62.8%)。男性38例(57.6%);单、双眼分别为50(75.8%)、16(24.2%)例。初诊51例(77.3%),复诊15例(22.7%)。初诊51例中,平均就诊年龄(20.9±14.4)个月;单、双眼患儿平均就诊年龄分别为(23.2±14.7)、(11.2±7.6)个月。可明确病程及就诊原因41例,患儿平均病程(90.6±115.2)d。瞳孔区发白32例(62.7%),眼部红肿4例(9.8%),其他原因5例(12.2%)。复诊15例中,平均就诊年龄为(63.6±46.8)个月;平均病程(32.8±45.5)个月。复发、手术后并发症分别为5(33.3%)、3(20.0%)例;瞳孔区发白4例(26.7%);眼球突出、眼部红肿分别为2(13.3%)、1(6.7%)例。82只眼中,入院治疗50只眼;其中,初诊37只眼,复诊13只眼。初诊37只眼中,眼内期31只眼(83.8%),包括A^C期5只眼(13.5%)、D^E期26只眼(70.3%);眼外期6只眼(16.2%)。A^C期5只眼均行激光光凝和(或)冷冻联合全身化学药物治疗(化疗);D期4只眼行眼动脉介入化疗;其余D^E期22只眼、眼外期6只眼中,行眼球摘除、眶内容物剜除手术分别为19(51.3%)、2(5.4%)只眼,放弃治疗7只眼(18.9%)。复诊13只眼中,既往已行眼球摘除6只眼(46.2%),其中手术后复发5只眼;眼外期4只眼(30.8%);D^E期3只眼(23.1%)。行眶内容物剜除、眼球摘除手术分别为5(38.5%)、4(30.8%)只眼;行眼整形手术1只眼(7.7%);放弃治疗3只眼(23.1%)。入院治疗患儿保眼率为18.0%,眼内期保眼率29.0%,眼外期保眼率0.0%。结论西南地区RB患儿就诊时病程长、分期晚、保眼率低。     

超选眼动脉化疗治疗视网膜母细胞瘤的临床观察

目的:通过对视网膜母细胞瘤(retinoblastoma,RB)患者实施眼动脉化疗,观察化疗效果及副反应。方法:根据RB最新国际分期,对11例11眼A~D期RB患者,通过股动脉插管至眼动脉,使用马法兰(melphalan)经眼动脉灌注,对RB患者实施动脉化疗。结果:所选患者共实施眼动脉灌注化疗23次,随访3~12mo,其中8例肿瘤明显缩小、钙化,2例病情进展,实施眼球摘除,1例失访。除部分患者术后短暂的恶心、呕吐、发热,没有出现死亡、中风、骨髓抑制等严重并发症。结论:所选患者中,A、B、C期9例,7例有效,1例继续进展,1例失访,有效率88%;2例D期患者1例有效,1例继续进展,有效率50%。     

Primary orbital melanoma: a case series and literature review

Primary orbital melanoma (POM) is a very rare condition. We report further four cases and review all previously reported cases. We present a multicentre retrospective review of patients with POM. Clinical, radiological, surgical, histological, and follow-up data is presented. Four patients with POM were identified between 2000 and 2013. All presented with proptosis and diplopia without reduced vision. Two had known pre-existing blue cell naevi. All were stage T1N0M0. All underwent exenteration with adjuvant radiotherapy. All are disease free at follow-up durations of 24–151 months. The present three cases and review of all cases in the literature suggest a higher likelihood of disease-free survival from primary exenteration (7/8 disease-free survival, 1/8 death from metastatic disease) than wide local excision (7/16 disease-free survival, 9 recurrence or metastasis of whom 4 died). Adjuvant radiotherapy may additionally improve outcomes.     

Prognostication in eye cancer: the latest tumor,node, metastasis classification and beyond

The tumour, node, metastasis (TNM) classification is a universal cancer staging system, which has been used for five decades. The current seventh edition became effective in 2010 and covers six ophthalmic sites: eyelids, conjunctiva, uvea, retina, orbit, and lacrimal gland; and five cancer types: carcinoma, sarcoma, melanoma, retinoblastoma, and lymphoma. The TNM categories are based on the anatomic extent of the primary tumour (T), regional lymph node metastases (N), and systemic metastases (M). The T categories of ophthalmic cancers are based on the size of the primary tumour and any invasion of periocular structures. The anatomic category is used to determine the TNM stage that correlates with survival. Such staging is currently implemented only for carcinoma of the eyelid and melanoma of the uvea. The classification of ciliary body and choroidal melanoma is the only one based on clinical evidence so far: a database of 7369 patients analysed by the European Ophthalmic Oncology Group. It spans a prognosis from 96% 5-year survival for stage I to 97% 5-year mortality for stage IV. The most accurate criterion for prognostication in uveal melanoma is, however, analysis of chromosomal alterations and gene expression. When such data are available, the TNM stage may be used for further stratification. Prognosis in retinoblastoma is frequently assigned by using an international classification, which predicts conservation of the eye and vision, and an international staging separate from the TNM system, which predicts survival. The TNM cancer staging manual is a useful tool for all ophthalmologists managing eye cancer.     

Long-term outcome of systemic cyclosporine treatment following penetrating keratoplasty

PURPOSE: To perform a retrospective study to evaluate the long-term outcome of systemic cyclosporine treatment as an adjunct to topical corticosteroid treatment after penetrating keratoplasty (PKP). METHODS: Twenty-six high-risk patients (27 eyes) who received systemic cyclosporine following PKP for an average of 5.4 months were compared with another series of 57 patients (57 eyes) who did not receive cyclosporine after PKP. RESULTS: Endothelial rejection developed in 2 cases during cyclosporine treatment and in 6 cases after discontinuation. The rate of rejection-free graft survival was similar between the treated and the control groups. The control group showed a significantly higher rate of graft survival than the treated group. As side effects in the treatment group, transient elevation in blood urea nitrogen or creatine developed in 7 cases. Increase in glutamate oxaloacetate transaminase (GOT) or glutamate pyruvate transaminase (GPT) developed in 4 cases. Severe side effects were absent throughout the series in both groups of patients. CONCLUSION: Systemic cyclosporine treatment for several months did not reduce the incidence of rejection nor improve the rate of graft clarity in the long term in high-risk patients after PKP.     

异位中心凹内层黄斑前膜分期方案对患者术后视力预后的评估

目的　探究异位中心凹内层（EIFL）分期方案对特发性黄斑前膜（IMEM）手术患者视力预后的评估。方法　本研究纳入确诊为单眼IMEM的79例患者,术后随访6个月以上。所有患者均接受23 G玻璃体切割术,剥除黄斑前膜（MEM）及内界膜,联合超声乳化白内障吸出及人工晶状体植入术。分析患者术前和术后不同EIFL分期与患者最佳矫正视力（BCVA）的差异,以及术前不同EIFL分期与BCVA的相关性。结果　根据EIFL分期方案,2期患者15眼（19.0%）,3期患者54眼（68.4%）,4期患者10眼（12.7%）。与3期、4期患者相比,2期患者术前和术后BCVA均较好（P=0.224、P<0.001）。术后6个月,所有EIFL分期患者的BCVA较术前均有明显提高（均为P<0.05）。EIFL分期与患者术前BCVA、CFT均呈正相关（均为P<0.001）,与患者术后6个月BCVA、CFT也呈正相关（均为P<0.001）。术后6个月,46.7%的2期患者中心凹恢复正常形态,3期患者中5.6%改善为2期,4期患者100.0%黄斑区视网膜结构稍改善。随访期间,所有患者均未见明显眼部或全身不良反应。结论　EIFL分期方案是评估IMEM手术视力预后的一种简便、快捷、重复性好的方法,有利于患者手术时机的选择。相比3期、4期患者,2期IMEM手术可显著改善患者视力,并增加解剖结构恢复的机会。     

视网膜母细胞瘤增殖细胞核抗原的免疫组织化学研究

目的：研究视网膜母细胞瘤(retinoblastoma，RB)细胞的增殖活性与RB组织学分型和浸润能力的关系。 方法：应用链霉亲和物素蛋白-生物素酶标免疫组织化学方法(LSAB法)对48例RB组织中增殖细胞核抗原(proliferating cell nuclear antigen，PCNA)的表达进行分析。 结果：12例分化型RB组织平均PCNA标记指数(labelling index，L1)明显低于36例未分化型(P<0.05)；22例视神经浸润组RB组织平均PCNA LI明显高于26例视神经未浸润(P<0.05)。表明PCNA LI与RB组织学分型及浸润能力相关。 结论：测定PCNALI对于判断RB的组织学特性和生物学行为具有一定意义。 （中华眼底病杂志，1997，13：10-11）