高度近视豹纹状眼底视网膜脉络膜血流改变及相关性分析

目的 观察并定量分析高度近视不同级别豹纹状眼底患者黄斑及视盘区域视网膜、脉络膜血流参数变化。方法 采用横断面临床研究,收集2018年6月～12月在医院就诊的高度近视患者42例(76眼),所有患者均行彩色眼底照相和光学相干断层扫描血管成像(OCTA)检查。应用ETDRS分区,根据脉络膜大血管暴露程度,将受检眼分为0级组、1级组、2级组和3级组。采用OCTA测量黄斑不同区域视网膜浅层毛细血管丛、视网膜深层毛细血管丛(DCP)以及视盘区视乳头层、放射状视盘周围毛细血管层(RPC)血管密度,测量中心凹下脉络膜厚度(SFCT)、脉络膜总面积(TCA)、脉络膜管腔面积(LA)、脉络膜基质面积(SA),并计算脉络膜血管指数(CVI)。统计学采用Kruskal-Wallis H检验、单因素方差分析、Dunnett’s检验及多重线性回归,视网膜、脉络膜血流参数与豹纹状眼底分级的关系采用偏相关分析。结果 各组间黄斑中心凹DCP血管密度、视盘区RPC层血管密度、SFCT、TCA、LA、SA、CVI比较差异有统计学意义(P均<0.05)。豹纹状眼底分级与黄斑中心凹DCP血管密度、CVI呈正相关(r=0....     

光学相干层析血管扫描在视网膜静脉阻塞中的应用

视网膜静脉阻塞(RVO)是眼科临床常见的眼底视网膜血管性疾病。RVO属于视网膜血管性疾病,观察发病后视网膜血管尤其是毛细血管的变化对于视网膜静脉阻塞的治疗以及预后的观察评估有着重要的意义。一直以来,荧光素眼底血管造影(FA)是检查视网膜血管性疾病的金标准,但是FA是一项有创检查,存在有过敏等风险。近年来,光学相干层析扫描血管成像(OCTA)是一种快速、非侵入性的新型血流成像技术,不仅能够定性的分析眼部血管形态,更重要的是能够无创性定量测量眼部血管及血流灌注,同时还能对深部病变进行评估。对OCTA在视网膜静脉阻塞中的应用、优点及局限性进行综述。     

特发性黄斑前膜患者神经节细胞复合体厚度与黄斑部深浅血流密度比值的相关性研究

目的 观察并初步探讨特发性黄斑前膜(iERM)患者神经节细胞复合体(mGCC)厚度与黄斑部深浅血流密度比值(DSFR)的相关性。方法 回顾性非随机对照临床实验研究。纳入武汉大学人民医院确诊为单眼iERM的24例患者为试验组,正常对侧眼为对照组。采用光学相干断层扫描(OCT)测量黄斑中心凹、旁中心凹以及中心凹周围区视网膜厚度,OCT的GCC模式测量mGCC厚度,眼底相干光层析血管成像测量黄斑区浅层视网膜毛细血管丛血流密度和深层视网膜毛细血管丛(DCP)血流密度并计算DSFR。DSFR记录方式为ETDRS-Grid记录法。分析iERM组与对照组上述参数的统计学差异以及相关性。结果 iERM组OCT相关参数、mGCC相关参数与对侧眼对照组相比差异均具有统计学意义(P均<0.05);iERM组旁中心凹深浅血流密度比值(prDSFR)与mGCC平均厚度、上半部分厚度、下半部分厚度均具有显著相关性(r=-0.308,r=-0.263,r=-0.307,P均<0.05)。中心凹深浅血流密度比值与下半部分mGCC厚度具有显著相关性(r=-0.380,P<0.01)。mGCC平均厚度与...     

OCT及OCTA在阿尔茨海默病诊断中的研究进展

阿尔茨海默病是一种进行性且不可逆转的神经系统疾病,由于视网膜和中枢神经系统有相似的胚胎起源和生理特征,眼科检查可提供简单无创的诊断方法。光学相干断层扫描技术(OCT)能够精确地测量视网膜各个组织层面的厚度,以评估视网膜的退行性改变,光学相干断层扫描血管成像(OCTA)可以提供高分辨率三维成像,从而更直观地检测视网膜血管的变化,间接地反映脑神经元和血管的病理特征。就OCT测量视网膜厚度及OCTA测量视网膜血流变化在阿尔茨海默病诊断中的研究进展进行综述。     

相干光层析血管成像术测量视盘旁浅层血管密度在青光眼诊疗中的作用研究进展

相干光层析血管成像术通过对视网膜微血管网络进行分层定量分析,使得青光眼血管变化的临床监测成为可能。近年来,许多研究发现视盘旁浅层毛细血管密度,尤其是放射状视盘周围毛细血管层的血管密度具有较高的青光眼诊断效能,与青光眼性视神经损伤之间的相关性较好,能够辅助青光眼结构和功能检查,从而进一步提高不同类型青光眼在不同阶段的诊治水平。     

运用OCT及OCTA观察硅油对视网膜脉络膜的影响

硅油作为一种玻璃体替代物被广泛应用于复杂性玻璃体视网膜疾病的手术治疗中。虽然硅油的安全性和有效性已被广泛认可,但其在眼内的填充仍可引起眼前段及眼后段的多种并发症。近年来,随着光学相干断层扫描(OCT)及光学相干断层扫描血管成像(OCTA)的出现和应用,有关硅油填充对视网膜脉络膜影响的研究更为深入。论文主要就运用OCT及OCTA观察硅油填充术后视网膜脉络膜血流及结构的改变进行综述。     

遗传性出血性毛细血管扩张症治疗进展

遗传性出血性毛细血管扩张症是常染色体显性遗传性血管发育异常的一种疾病,主要表现反复鼻出血、黏膜毛细血管扩张和动静脉畸形。本文综合国内外治疗方面的最新研究进展,为遗传性出血性毛细血管扩张症提供新的治疗策略。     

25例虹膜新生血管发生原因探讨

目的 分析25例(28眼)虹膜新生血管生长原因,探讨消除虹膜新生血管的有效方法。 方法 回顾性分析2014年9月至2016年7月期间临床发现虹膜新生血管的患者25例(28眼)眼部相关检查资料,记录治疗方法及病情变化,分析虹膜新生血管发生的原因及治疗效果。 结果 25例(28眼)治疗前裂隙灯下均可见虹膜新生血管;17例(20眼,71.4%)存在视网膜缺血表现,包括FFA可见视网膜新生血管或大片非灌注区,或存在大量的玻璃体积血及纤维血管增殖膜;8例(8眼,28.6%)缺乏视网膜缺血相关表现。治疗后3个月,FFA显示25例(28眼)均未见视网膜新生血管;20例(23眼,82.1%)虹膜新生血管消退,5例(5眼,17.9%)虹膜新生血管未完全消退。 结论 眼前部缺血也是虹膜新生血管发生的原因之一;全视网膜光凝术是针对视网膜缺血的治疗手段,不能消除全部的虹膜新生血管,抗VEGF药物注射对虹膜新生血管有很好的疗效。     

光学相干断层扫描血管成像在年龄相关性黄斑变性诊治中的应用进展

年龄相关性黄斑变性(age-related macular degeneration, AMD)是与氧化应激、补体失调和年龄相关性黄斑病变易感因子2等位基因的多态性等多种机制有关的一组年龄相关性黄斑疾病,近年来AMD的发病率有明显增加的趋势。影像学技术的发展为AMD患者的进一步研究提供了条件,荧光素眼底血管造影(fluorescein angiography, FFA)一直是AMD诊断的金标准,但是作为一种侵入性的检查方法,FFA无法显示病变的断层结构;光学相干断层扫描可以显示视网膜的断层结构,但是无法显示血流形态。光学相干断层扫描血管成像(optical coherence tomography angiography, OCTA)实现了对视网膜及脉络膜各层血流和结构的无创可视化,在显示各层视网膜及脉络膜血管的血流状态及结构方面展现出独一无二的优势,已经成为研究AMD发病机制及诊治中不可或缺的利器。论文对OCTA在AMD诊治中的应用进行综述。     

光学相干断层扫描血管成像在年龄相关性黄斑变性诊治中的应用进展

年龄相关性黄斑变性(age-related macular degeneration, AMD)是与氧化应激、补体失调和年龄相关性黄斑病变易感因子2等位基因的多态性等多种机制有关的一组年龄相关性黄斑疾病,近年来AMD的发病率有明显增加的趋势。影像学技术的发展为AMD患者的进一步研究提供了条件,荧光素眼底血管造影(fluorescein angiography, FFA)一直是AMD诊断的金标准,但是作为一种侵入性的检查方法,FFA无法显示病变的断层结构;光学相干断层扫描可以显示视网膜的断层结构,但是无法显示血流形态。光学相干断层扫描血管成像(optical coherence tomography angiography, OCTA)实现了对视网膜及脉络膜各层血流和结构的无创可视化,在显示各层视网膜及脉络膜血管的血流状态及结构方面展现出独一无二的优势,已经成为研究AMD发病机制及诊治中不可或缺的利器。论文对OCTA在AMD诊治中的应用进行综述。     

Chloroaluminum sulfonated phthalocyanine versus dihematoporphyrin ether: early vascular events in the rat window chamber.

The development of a simple and well-tolerated rat window chamber has allowed direct comparison of the vascular effects of two photosensitizers, chloroaluminum sulfonated phthalocyanine (CASP) and dihematoporphyrin ether (DHE). CASP and DHE were given 4 days after the implantation of the window chamber. Photodynamic therapy (PDT) with CASP was performed 24 hours after intravenous injection (10 mg/kg) with light at 675 nm (power density 200 mW/cm2, incident energy 100 J). DHE was given in a similar fashion (5 mg/kg intraperitoneally; light at 630 nm with matching power density and energy settings 24 hours after injection). Using videomicroscopic and integrating sphere measurements, marked differences were noted in the vascular effects of these photosensitizers. DHE caused immediate hemorrhage and disruption of the postcapillary venules, while CASP induced vascular spasm starting 4 hours after the completion of PDT. Forty-eight hours after PDT, both systems demonstrated a loss of chamber-induced neovascularization.     

Electron microscopic study of vascular regeneration in rat tracheal mucosa following physical curettage.

Transmission and scanning electron microscopic studies were made of regeneration of the vascular network of rat tracheal mucosa on 30 min to 8 hr after the mechanical curettage. The vascular network casts were made by infusion of Mercox resin through the aortic arch for scanning electron microscopy. At 30 min after curettage, vascular thromboses were observed, and terminal blind branches were formed in the injured blood vessels areas through SEM observation. Diapedesis of leukocytes appeared at 30 min after curettage from intact venules at the wound margins. Recovery from the loss of endothelial cells began at 30 min after curettage. At 3 hr after curettage, vascular indentation (protrusion) and vascular process (bud-like process) were developed from intact venules at the wound margins. It is concluded that the formation of thrombus and terminal blind branch vessels constitute the initial reparative reactions of the injured vascular network and that new vessels then begin to form by outgrowth of protrusions and bud-like processes from intact venules at the wound margins.     

Effects of endothelial cell growth factor on vascular compromised skin flaps.

Angiogenic growth factors have the potential to accelerate vascularization in soft tissue. This study explored the vascular effects of endothelial cell growth factor (1800 micrograms/mL) with heparin (7 micrograms/mL) in gelatin sponge (Gelfoam) in two settings of vascular compromise. On days 2 and 3 ligated skin flaps in the rabbit ear model, peripheral neovascularization, and flap viability were quantitatively documented by digital angiographic analysis and by polar planimetry. The mean flap viability of the treated flaps was two times greater than their controls in the day 2 (N = 24) and day 3 ligation groups (N = 22). The angiograms among the treated flaps in the day 2 ligation group also demonstrated a quantitative increase in vascularization compared with their controls. These results suggest a provocative means for accelerating neovascularization and enhancing viability to vascular compromised skin flaps.     

Hereditary hemorrhagic telangiectasia/avastin

This is the first scientific report of hereditary hemorrhagic telangiectasia (HHT) epistaxis treatment by intranasal spraying of the vascular endothelial growth factor (VEGF) inhibitor bevacizumab (Avastin). Epistaxis in patients with HHT is a morbid, mortal condition that is difficult and unpleasant to manage. Nasal telangiectasia growth is modulated by VEGF, which is elevated in HHT patients. Bevacizumab is a VEGF inhibitor that diminishes epistaxis when administered intravenously or injected locally, or as reported here when sprayed topically onto the nasal mucosa. Laryngoscope, 2010     

载siIKKβ脂质纳米粒的制备及其对巨噬细胞再极化的作用

目的 构建负载siRNA-IKKβ的阳离子脂质纳米粒并探索其调节巨噬细胞再极化从而抑制脉络膜新生血管(CNV)的能力。 方法 使用薄膜分散法制备阳离子脂质纳米粒;通过琼脂糖凝胶电泳筛选最佳基因纳米粒负载比,使用透射电子显微镜和马尔文粒度仪对其进行表征;qRT-PCR检测M2型巨噬细胞中IKKβ及巨噬细胞极化表型相关分子mRNA的表达;Western Blotting检测M2型巨噬细胞内IKKβ蛋白的沉默情况;激光诱导建立小鼠CNV模型并给药;Western blotting检测给药后CNV病灶内巨噬细胞表型的变化;OCTA检测载基因纳米粒对CNV的治疗效果。 结果 成功制备负载siIKKβ的阳离子脂质纳米粒LNs-siIKKβ,最佳负载比下粒径为(133.3±0.62)nm,Zeta电位为(6.72±0.17)mV;在体外,LNs-siIKKβ抑制M2型巨噬细胞内IKKβ的表达,巨噬细胞产生由M2向M1表型转变的趋势;体内给药后,CNV病灶处巨噬细胞产生由M2向M1表型转变的趋势,且对CNV的生成具有一定的抑制作用;生物安全性良好。 结论 构建的负载siIKKβ阳离子脂质纳米粒能够在体外及体内CNV病灶处将M2再极化为M1并能抑制CNV的生成。     

Utilizing angiogenic agents to expedite the neovascularization process in skin flaps

The revascularization of a skin flap after flap transposition is an important step in flap survival. This study investigates the efficacy of certain angiogenic agents to expedite the neovascularization process and to increase the viability of skin flaps. Eighty-four island skin flaps were designed on the auricles of 42 New Zealand White rabbits to achieve 90% necrosis over a 7-day period. Thirty-six flaps were treated with Endothelial Cell Growth Supplement (ECGS) or Endothelial Cell Growth Factor (ECGF) at several concentrations topically or immersed in Gelfoam. The remaining flaps were used as normal saline controls. Flap viability and peripheral neovascularization were documented by polar planimetry, angiography, and histological analysis. The flap viability of the ECGS-Gelfoam -treated flaps was 100% greater than their normal saline-Gelfoam controls (p = .021). Flap angiograms demonstrated increased vascular ingrowth among the treated flaps compared to the controls. This study suggests that angiogenic agents can expedite flap neovascularization and have the potential to increase flap viability.