复明中药治疗视神经疾病的疗效观察

视神经疾病,尤其是视神经萎缩是一种危害视功能的严重疾病,夏德昭用弯针接力针刺法治疗视神经萎缩收到较好的效果,但有些患者不能坚持治疗。我们应用复明中药治疗视神经疾病,并观察患眼用药后视力、色觉、视野、P-VEP 以及患眼眼动脉血流速度的变化,观察疗效并了解该药的作用机理。     

活血化瘀治疗内眼出血临床体会

活血化瘀治疗内眼出血临床体会四川省荣经县医院（６２５２００）严康平活血化瘀疗法是祖国医学治疗疾病的重要方法之一，．治疗诸多疾病，都有着良好的效果尤其对内眼疾病的治疗效果明显。活血化瘀疗法，包括活血和化瘀两个相辅相存的方面，化瘀必须活血，活血才能化瘀。...     

外伤性眼内出血的中药治疗

目的 观察中药对外伤性眼内出血的治疗效果。方法 对28例外伤性眼内出血的住院患者在进行相关眼部损伤治疗的前提下，应用中药分期治疗观察1－4周。结果 治愈23例，好转5例，治愈率82．14％，总有效率100％。治疗期间无并发症或再出血发生。结论 活血化淤中药对外伤性眼内出血的吸收具有确切疗效。     

中药为主治疗缺血性视神经病变疗效观察

目的 评价以中药为主治疗缺血性视神经病变的疗效。方法 对23例26只眼缺血性视神经病变患者辨证分型为肝肾不足、气滞血瘀、阴虚阳亢，以中药为主进行治疗。治疗过程配合神经营养及血管扩张剂药物，对无效者加激素类药物综合治疗。结果 治疗观察时间1个月，追踪随访时间1年，疗效良好19只眼，占73%；有效5只眼，占19%；无效2只眼；占0.7%。结论 中药为主治疗缺血性视神经病变疗效显著。副作用小，复发者少，是治疗本病较理想的方法。     

中西医结合治疗婴幼儿复发性麦粒肿

目的观察中药配合西医物理、药物疗法治疗婴幼儿复发性麦粒肿的疗效。方法给予患有复发性麦粒肿的婴幼儿局部应用抗生素眼水，给予患儿局部湿热敷，已成脓者，给予切开排脓，肉芽形成者予以切除；配合中药清脾散加减内服，来治疗婴幼儿复发性麦粒肿。结果12例患者16眼，痊愈10例14眼，有效1例1眼，无效1例1眼，治愈率为86．7％，有效率达93．8％。结论在婴幼儿复发性麦粒肿的治疗方面，中西医结合治疗疗效较为确切。     

羊膜移植在20例眼表疾病中的应用

目的：研究羊膜移植在眼表疾病中的疗效。方法：曾经历过眼睑缝合、角膜接触镜等各种方法治疗的20例20眼接受羊膜移植。结果：在术后平均20d内,第一次羊膜移植后有10眼（50％）治愈,1眼（10％）复发。结论：羊膜移植有助于眼表疾病的治疗。     

凉血化瘀中药治疗特发性脉络膜新生血管临床观察

目的:通过临床病例,观察凉血化瘀中药治疗特发性脉络膜新生血管(idiopathic choroidal neovascularization,ICNV)的疗效。方法:对46例46眼确诊的ICNV病变患者服凉血化瘀中药治疗,服中药3mo,总观察时间9mo。观察比较治疗前后最佳矫正视力(best corrected visual acuity,BCVA)、荧光眼底血管造影(fundus fluorescein angiography,FFA)和光学相干断层扫描(optic coherent tomography,OCT)图像。结果:末次随访时,中药治疗46眼中,视力平均提高0.21,较治疗前有统计意义;FFA检查发现:显效(CNV闭合)34眼(73.9%),有效(CNV部分闭合)7眼(15.2%),进步(CNV小部分闭合)4眼(8.7%),无效(CNV扩大)0眼,较治疗前显著改善。OCT检查发现:CNV型别由治疗前活动期38眼(82.6%)、中间期8眼(17.4%),转变为有效(瘢痕期)38眼(82.6%),进步(中间期)6眼(13.1%),无效(活动期)2眼(4.4%),具有统计学意义。结论:中药凉血化瘀可以促进ICNV中CNV闭合。     

羊膜移植在20例眼表疾病中的应用(英文)

目的:研究羊膜移植在眼表疾病中的疗效。方法:曾经历过眼睑缝合、角膜接触镜等各种方法治疗的20例20眼接受羊膜移植。结果:在术后平均20d内,第一次羊膜移植后有10眼(50%)治愈,1眼(10%)复发。结论:羊膜移植有助于眼表疾病的治疗。     

激光联合中药治疗糖尿病性视网膜病变的临床观察

目的:比较中药、光凝及二者结合治疗糖尿病性视网膜病变的疗效。方法 :14 6例 ( 2 10眼 )DR患者作观察。 5 1例 ( 79眼 )根据辨证论治分型予以中药 ;42例 ( 6 3眼 )做视网膜光凝 ;43例 ( 6 8眼 )光凝结合中药治疗。结果 :光凝结合中药治疗组患者视力提高优于中药组、光凝组 ;眼底出血、水肿、渗出吸收时间缩短 ;新生血管退缩较完全。结论 :光凝结合辨证论治口服中药治疗效果最好     

小切口非超声乳化IOL植入术联合除风益损汤治疗白内障

目的:探讨小切口非超声乳化人工晶状体(intraocular lens,IOL)植入术联合除风益损汤治疗白内障的疗效及安全性.方法:将在我院接受小切口非超声乳化IOL植入术治疗的120例120眼白内障患者随机分为对照组(57例57眼)与中药治疗组(63例63眼),对照组术后主要是常规抗感染以及对症支持治疗,中药治疗组术后则是在对照组基础上再使用除风益损汤.术后1wk观察患者前房纤维蛋白渗出程度和视力情况,术后6mo观察患者疗效.结果:中药治疗组术后1wk前房纤维蛋白渗出程度显著低于对照组,差异有统计学意义(P＜0.05).术后1wk,中药治疗组视力显著高于对照组,差异有统计学意义(P＜0.05).经疗效评价,术后6mo,对照组无效26眼(45.6％),有效10眼(17.5％),显效21眼(36.8％);中药治疗组无效6眼(9.5％),有效17眼(27.0％),显效40眼(63.5％),中药治疗组治疗效果显著优于对照组,差异有统计学意义(P＜0.05).结论:小切口非超声乳化IOL植入术联合除风益损汤治疗白内障的疗效确切,安全性好.     

明目中药活性单体的研究现状

中医中药是祖国传统医药学的瑰宝,随着传统中药的标准化和国际化进程的推进,中药的有效单体亟待明确与开发.目前,国内外学者对中药的活性单体成分研究报道逐渐增多,但单体数量庞杂,缺少系统性归纳.本文对2015版《中国药典》第1部中记载的对眼部有治疗作用的56种中药中已知的相关药理作用与其对应的活性组分或单体进行归纳总结,并将这些具有眼部治疗作用的中药材中含有的主要成分或单体按照治疗眼部疾病的作用机制,从抗病原微生物、抗炎及免疫调节、抗氧化应激损伤、神经保护、血管保护作用几个方面分类阐述其最新的眼科研究进展,以期为致力于眼科疾病治疗及中药开发研究的科研人员提供一定的参考.     

Difference in response to botulinum toxin type A treatment between patients with benign essential blepharospasm and hemifacial spasm

Background: Botulinum toxin (BTX) is the first‐line treatment in managing benign essential blepharospasm (BEB) and hemifacial spasm (HFS). We wished to assess the difference in duration of effect and the number of BTX treatments required to treat patients with BEB and HFS. Methods: A prospective study of patients attending the BTX clinic in Manchester Royal Eye Hospital over 6 months. All treatments were administered by a single experienced ophthalmologist. A questionnaire was completed for each patient. In patients with BEB where the BTX was injected bilaterally, one side was randomized to compare with HFS patients. Patient demographics, cumulative dose of BTX, duration of BTX effect with patient satisfaction and the number of previous BTX injections were recorded. Results: Sixty‐four patients were included in the study. The mean age was 60.8 years. Among them, 30 patients had BEB and 34 had HFS. Patients with HFS received a lower mean dose of BTX than patients with BEB (12.23 units vs. 16.2 units). The patients with HFS had a longer duration of effect than patients with BEB, with fewer BTX treatments. Of all patients, 90% with HFS and BEB were satisfied with the effect of their last BTX injection. Three unsatisfied patients in the BEB group were referred on for surgical management of their disorder. Conclusions: We have shown that patients with BEB have a shorter duration of effect with BTX and require more frequent BTX treatments than patients with HFS, highlighting that facial dystonias in patients with BEB is more challenging to manage.     

中药单体对眼部新生血管性疾病治疗作用的研究现状

概述中药单体在眼部新生血管性疾病中的应用现状。通过检索近十余年来国内外相关研究文献,进行归纳和总结,概述中药单体抑制眼内新生血管的研究进展,阐述中医药在眼内新生血管研究领域具有的潜在优势,为眼部新生血管性疾病的研究及治疗提供新的思路和参考。     

The evaluation of light sensitivity in benign essential blepharospasm

PURPOSE: To test light sensitivity thresholds rigorously in patients with benign essential blepharospasm (BEB) compared with patients who have known light sensitivity (migraineurs) and to normal control subjects. DESIGN: Prospective, observational, case control study. METHODS: We recruited a total of 87 subjects into each of three groups: BEB, migraine, and normal control subjects. A modified slit-lamp chin rest, heat shield, light meter, and halogen light that was modulated by a rheostat were used to measure light sensitivity thresholds. Participants were tested without spectacles, with gray-tinted spectacles, and with FL-41-tinted spectacles. RESULTS: Light discomfort thresholds for subjects with BEB were significantly lower compared with normal control subjects (P < or = .009) and similar to the migraine group. Both gray and FL-41-tinted lenses improved light sensitivity thresholds in all groups (P < or = .0005). There was no observed difference in the improvement in light sensitivity when the gray and FL-41-tinted lenses were compared. CONCLUSION: Patients with BEB are considerably more sensitive to light than control subjects and as sensitive to light as patients with migraine. Physicians who care for patients with BEB should consider using tinted lenses to help ameliorate symptoms.     

Medical Cannabis,a Beneficial High in Treatment of Blepharospasm? An Early Observation

The objective of this study was to observe the effect of medical cannabis in benign essential blepharospasm (BEB) as an adjunct to botulinum toxin. A retrospective chart review was performed on patients certified for medical cannabis use for BEB from September 2015 to May 2016. Patient demographics and responses, cannabis history, and severity indices were collected. Ten patients were certified for medical cannabis use. Five met the inclusion criteria, which was any patient with a diagnosis of BEB receiving standard botulinum toxin treatment who had started medical cannabis treatment by a registered distributor within the state, and was contactable by phone. Four patients discontinued use. Three out of four patients (75%) reported symptomatic improvement. Medical cannabis is an accepted therapy for muscle spastic disorders. Its potential as an adjunctive therapy for BEB remains unknown, and further investigations would be of benefit.     

Benign essential blepharospasm among residents of Olmsted County,Minnesota, 1976 to 1995: an epidemiologic study

PURPOSE: To describe the incidence, patient demographics, and response to treatment of benign essential blepharospasm (BEB) in a population-based cohort. METHODS: In this epidemiologic study, we searched the Rochester Epidemiology Project database for patients diagnosed with blepharospasm or related disorders between 1976 and 1995. The incident rate denominator was based on a linear interpolation of decennial census data from Olmsted County. The 95% confidence interval for the incidence rate was based on the Poisson distribution. RESULTS: Olmsted County residents (n = 295) were diagnosed with blepharospasm or related disorders between 1976 and 1995. Of these, 8 patients met the criteria for BEB. The calculated incidence rate of BEB is 1.2 persons per 100,000 population per year (95% CI, 0.37 to 2.02). At the time of BEB diagnosis, the median patient age was 61.5 years, and symptoms had been present for a median of 24 months. Four patients were men and 4 were women. Four of the 8 patients had Meige syndrome. Three of 4 patients treated with oral medications reported symptomatic improvement. Botulinum toxin injection was offered to all patients, but only 4 elected treatment. All who were treated with botulinum toxin had temporary symptomatic improvement. No patient underwent surgical treatment for BEB. Two patients had resolution of symptoms within the follow-up period. CONCLUSIONS: BEB is a rare disorder. In this small, population-based sample, women and men were affected with equal frequency, and half of patients had lower facial dystonia (Meige syndrome). Only half of patients with BEB elected botulinum toxin injections, and none required surgery. Disease remission occurred in 2 of 8 patients.     

我国近五年眼底病临床与基础研究新进展

近5年我国眼底病的临床治疗与基础研究均取得了较大进步,积累了丰富的临床经验和大量的研究资料。临床方面,脉络膜新生血管膜的光动力疗法、经瞳孔温热疗法等在我国逐步开展,玻璃体手术及眼内注射曲安奈德治疗黄斑水肿,放射状视神经切开术治疗视网膜中央静脉阻塞,早产儿视网膜病变综合防治,眼内肿瘤综合治疗及玻璃体视网膜手术技术和设备更新等方面均进展较快。基础研究方面,我国学者在糖尿病视网膜病变、视网膜母细胞瘤、增生性玻璃体视网膜病变、视网膜色素上皮细胞、视网膜移植、眼底病基因治疗等多个研究领域均取得了显著成绩,标志着我国眼底病的临床与基础研究水平基本与罔际接轨,部分研究成果已达到国际先进水平。     

中药单体治疗青光眼的研究进展

青光眼(glaucoma)是一组进行性视神经损害,导致视力损伤的疾病,是人类首要不可逆致盲性眼病,病理性眼压升高是其危险因素。临床上常用降眼压类与保护视神经类药物治疗,以对症治疗为主,疗效不理想。中药单体兼有中药与化药双重优势,我国传统中药与中药单体在青光眼治疗,特别是视神经保护方面具有独特优势,可供研发的空间很大。本文综述了代表性组方与单味中药,尤其是代表性中药单体在青光眼治疗中的应用与机制,以期为青光眼临床治疗与新药研发提供参考。     

Central corneal thickness and related factors in an elderly American Chinese population

Background: To assess central corneal thickness and related factors in an elderly American Chinese population residing in San Francisco. Design: Cross‐sectional community based study. Participants: American Chinese aged 40 years and older were enrolled using random cluster sampling and volunteer screening in the Chinatown district of San Francisco. Methods: The following data were obtained: central corneal thickness by ultrasound pachymetry, intraocular pressure by Goldmann applanation tonometry, axial length by A‐scan biometry, refractive status and corneal curvature by autorefractor. History of systemic and ocular diseases was collected via standard questionnaire. Main Outcome Measures: Central corneal thickness. Results: Of 311 eligible subjects, 274 consented to study participation, and 228 phakic eyes were analyzed. Mean corneal thickness was 524.1 ± 31.1 µm, 545.5 ± 30.9 µm and 538.9 ± 31.8 µm in the sampling cluster, volunteer group and all subjects, respectively. A multiple linear regression model showed corneal thickness to be negatively associated with age (standardized regression coefficient [SRC] = ?0.21; P = 0.016) and corneal curvature (SRC = ?0.19; P = 0.018) but positively correlated with intraocular pressure (SRC = 0.20; P = 0.023). Conclusions: The distribution of central corneal thickness among this American Chinese population is similar to that reported in studies from East Asia. The independent factors associated with thinner corneas included older age, lower intraocular pressure and greater corneal curvature. While descendents of Chinese immigrants in America have, on average, thicker corneas than their ancestors, this phenomenon is potentially impacted by the level of intraocular pressure.     

激素性高眼压与TIGR/MYOC基因突变的关系

目的研究准分子激光术后使用激素类滴液引起眼压升高的患者和小梁网糖皮质激素诱导反应蛋白(trabecularmeshwork induced glucocorticoid response protein,TIGR/MYOC)基因编码区的突变情况并初步探讨这类疾病在基因水平的发病机制。方法选取在我院进行准分子激光术后常规使用激素类滴眼液导致眼压升高患者30例,抽取外周静脉血2mL。用酚-氯仿法提取全基因组DNA,然后应用聚合酶链式反应(polymerase chain reaction,PCR)扩增TIGR/MYOC基因3个外显子(7对引物)的各个片段;采用ABI-3730自动测序仪对扩增的PCR产物进行双向测序;对PCR产物测序结果及突变片段进行初步分析。结果 30例患者中有1例发现MYOC基因致病突变Arg342Lys,即2271G→A;6例发现有2271杂合突变;5例发现有同一种同义突变Glu352Glu即2302G→A。PCR产物测序共发现2个序列突变即编码区突变点Arg342Lys和同义突变点Glu352Glu。结论初步实验结果显示,MYOC基因编码区突变点Arg342Lys和此处杂合突变可能与激素性高眼压的发生有一定的联系。