视网膜母细胞瘤的CT表现及临床价值

目的 探讨视网膜母细胞瘤的CT表现在其诊断、鉴别诊断中的价值。方法 回顾分析27例经病理或临床证实的视网膜母细胞瘤的CT表现。结果 视网膜母细胞瘤CT表现：27例均以眼球后部软组织肿块为特征，其中24例(25只眼)肿块内伴钙化；3例肿块无钙化，可见斑点状、斑片状低密度坏死及囊变。结论 CT可以显示肿瘤的形态、大小、内部特征及累及范围，有助于诊断和鉴别诊断。     

眼球内视网膜母细胞瘤CT表现分析

目的:加深对眼球内视网膜母细胞瘤CT表现的认识。方法:眼球内视网膜母细胞瘤20例24只眼,均做眼眶轴位CT平扫,详细分析观察其CT表现。结果:视网膜母细胞瘤24只眼均表现为球内肿块伴钙化;按视网膜母细胞瘤生长模式分类,内生性者7只眼,外生性14只眼,混合性3只眼;伴有视网膜脱离17只眼,其中14只眼为外生性,3只眼为混合性。结论:根据CT表现可对视网膜母细胞瘤进行分类,有利于临床选择治疗方案。     

拟似视网膜母细胞瘤的内因性眼内炎

拟似视网膜母细胞瘤的内因性眼内炎［英］／ＳｈｉｅｌｄｓＪＡ…∥Ｒｅｔｉｎａ．－１９９５，１５（３）．－２１３～２１９作者报告６例儿童感染性眼内炎，仅表现有白瞳孔的眼症状，极少有严重的全身感染性病变，初诊均误诊为视网膜母细胞瘤（ＲＢ），经详细检查最后确...     

浸润性视网膜母细胞瘤一例

视网膜母细胞瘤以其特有的发病年龄,瞳孔白光反射(猫眼),眼底镜检查见到肿块,B超、CT检查提示实质性肿块及瘤内钙化等特点,一般不难诊断.但如缺乏上述特征,如患儿发病年龄大,眼内无肿块,B超与CT检查无钙化,此时诊断较为困难.弥漫性浸润性视网膜母细胞瘤凶瘤细胞沿着视网膜呈浸润性生长而不形成肿块,绝大多数患者也无钙化,使诊断难度加大.我们曾于2005年收治1例浸润性视网膜母细胞瘤患儿,现回顾分析其早期诊断问题,以总结其经验与教训.     

以眼内炎为首发症状的弥漫浸润型视网膜母细胞瘤1例

弥漫浸润型视网膜母细胞瘤是视网膜母细胞瘤中一种少见的病理类型，发病率约为视网膜母细胞瘤的1％～2％，通常会由于检查不到明显的肿块而误诊为内源性眼内炎，本文报道1例以眼内炎为首发症状的弥漫浸润型视网膜母细胞瘤，并对其组织病理进行探讨。     

视网膜母细胞瘤的超声诊断分析

　　目的　分析视网膜母细胞瘤（RB）的超声诊断价值。方法　162例经手术及病理检查证实为RB患者的210只眼纳入研究。对其超声检查、计算机断层扫描(CT)检查、临床和病理学检查资料进行回顾性分析,分相RB的超声特征以及与病理诊断的符合率。结果　RB的超声表现均以眼球后段实质性肿块为特征,呈球形、半球形及不规则形,甚至充满整个眼球。149例197只眼肿块内有钙化,占病例数的92.0%;13例13只眼肿块中无钙化,但超声高度怀疑为RB,占病例数的8.0%。超声诊断与病理诊断符合率为92.0%。所有患眼肿块内均见与视网膜中央血管相延伸的彩色血流信号。CT检查发现145例167只眼肿块内有斑片状、块状钙化。CT诊断与病理诊断符合率为89.5%。结论　超声检查可以显示肿瘤的形状、大小、内部特征及眼眶内累及范围,在RB诊断中有重要应用价值。      

眼球摘除病例的临床病理分析

本文对摘除后经病理检查的２７１只眼球的疾病进行了分析，摘除的眼球中最多的疾病是视网膜母细胞瘤１１１例；其次有：眼外伤５５例，眼内炎３２例和绝对期青光眼２４例等。对其年龄，性别，眼别和病因等进行了分析。     

视网膜母细胞瘤眼外蔓延

总结 1979年 7月～ 1999年 9月经病理组织学确诊为视网膜母细胞瘤眼外蔓延患者 18例。眼外蔓延的发生率约占同期视网膜母细胞瘤的 2 0 %。其发生眼外蔓延与就诊时间早晚、病程长短和治疗是否及时有关。早期临床诊断比较困难 ,影像学检查对发现肿瘤眼外蔓延有帮助。视网膜母细胞瘤眼外蔓延的治疗主要是眶内容摘除术 ,术后联合应用化疗和放疗     

RetCamⅡ早产儿眼底筛查仪在婴幼儿眼病筛查中的应用价值

目的探讨RetCamⅡ早产儿眼底筛查仪在婴幼儿各种眼病筛查中的应用价值,了解婴幼儿眼病的发病情况。方法收集2009年7月到2010年3月在我院行RetCamⅡ眼底检查的婴幼儿,记录其出生胎龄、出生体重、年龄、家族疾病史等临床资料。结果共有32例婴幼儿完成眼部检查,其中,双眼角膜白斑1例、双眼颞侧巩膜化角膜1例、瞳孔区出血1例（1只眼）、先天性白内障3例（3只眼）、小儿黄疸2例（2只眼）、先天性脉络膜缺损1例（1只眼）,双眼视网膜母细胞瘤2例、视神经胶质瘤术后视神经前新生血管1例（1只眼）、双眼先天性色素不均1例、双眼视网膜出血1例。其中1例双眼视网膜母细胞瘤患儿行RetCamⅡ荧光素眼底血管造影检查。结论 RetCamⅡ不仅可用于早产儿视网膜病变的筛查,并且可用于婴幼儿的眼病筛查、术后复查、眼底荧光血管造影等,可提高婴幼儿眼病的诊断率,有利于其早期发现,早期治疗。     

诊断非典视网膜母细胞瘤的临床线索

视网膜母细胞瘤是儿童期最常见的眼内恶性肿瘤。典型病例如年龄在3岁以下，有白瞳或斜视，眼底检查见到视网膜肿块，B超及CT检查有实质肿块并有钙化等，依靠这些临床资料诊断一般不难。但不典型病例，如发病年龄大于5岁，眼部主要表现为葡萄膜炎，B超及CT未探及眼内肿块亦无钙化，这时诊断遇到极大困难。对这些不典型病例是否存在一些临床线索，让我们怀疑或考虑到视网膜母细胞瘤的可能性，采取进一步措施及早诊断，从而挽救或延长患者生命。本文就此问题结合临床病例进行探讨。     

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.