巩膜扣带术联合氪多波长激光光凝治疗视网膜脱离

目的 评价巩膜扣带术后限期应用双目间接眼底镜激光光凝封闭裂孔治疗视网膜脱离的疗效。方法 回顾性分析在我院行巩膜扣带术后接受氪激光光凝治疗的孔源性视网膜脱离患者39例(39只眼)的临床资料。结果 术后随访3～6个月，39只眼中，视网膜一次性复位36只眼(92．3％)。结论 巩膜扣带术后限期经光导双目间接眼底镜激光光凝治疗孔源性视网膜脱离，简便快捷、安全可靠，减少了术后并发症，是治疗孔源性视网膜脱离的有效方法之一。应用宽环扎，能更好的缓解玻璃体牵引；采用光导间接眼底镜进行光凝，可以减轻患者不适、对创口无污染、不压迫眼球。     

玻璃体内注射康柏西普联合周边视网膜选择性光凝治疗视网膜静脉阻塞继发黄斑水肿的疗效及安全性

目的　观察玻璃体内注射康柏西普联合周边视网膜选择性光凝治疗视网膜静脉阻塞继发黄斑水肿的疗效及安全性。方法　选择２０１４年３月至２０１５年３月于我院眼科就诊的视网膜静脉阻塞继发黄斑水肿患者２６例２６眼,予以玻璃体内注射康柏西０．５ｍｇ。１周后,根据ＦＦＡ结果,对于周边视网膜存在无灌注区的患者,联合周边视网膜选择性光凝;分别于术后１个月、２个月、３个月进行复查,若黄斑水肿无明显减轻或复发［黄斑中心凹视网膜厚度（ｃｅｎｔｒａｌｍａｃｕｌａｒｔｈｉｃｋｎｅｓｓ,ＣＭＴ）＞２２５μｍ或ＣＭＴ增厚＞１００μｍ］,行重复注射;对比分析患眼治疗前后最佳矫正视力（ｂｅｓｔ-ｃｏｒｒｅｃｔｅｄｖｉｓｕａｌａｃｕｉｔｙ,ＢＣＶＡ）、ＣＭＴ的变化并观察有无眼部或全身并发症。结果　治疗前患眼ＢＣＶＡ为０．０９±０．０５,治疗后１周、１个月、２个月、３个月时ＢＣＶＡ分别为０．１６±０．０６、０．２５±０．０７、０．２１±０．０７、０．２０±０．０８,各时间点与治疗前相比,差异均有统计学意义（ｔ１周＝９．３９２,ｔ１个月＝１４．４４０,ｔ２个月＝９．２９５,ｔ３个月＝６．７０９,均为Ｐ＜０．０５）;治疗前患眼ＣＭＴ为（６０８．５０±１１９．４５）μｍ,治疗后１周、１个月、２个月、３个月ＣＭＴ分别为（３６４．３５±８４．３３）μｍ、（２７９．１２±７９．７３）μｍ、（３０８．００±７７．９０）μｍ、（３２６．７７±９１．７８）μｍ。复查各时间点与术前相比,差异均有统计学意义（ｔ１周＝１１．１２４,ｔ１个月＝１４．６６７,ｔ２个月＝１４．１７６,ｔ３个月＝１３．４３４,均为Ｐ＜０．０５）;随访期间,２６眼均未发生与药物、玻璃体内注射相关的局部及全身的严重不良反应。结论　玻璃体内注射康柏西普联合周边视网膜选择性光凝治疗视网膜静脉阻塞继发黄斑水肿具有较好的疗效及安全性,可以减轻黄斑水肿,提高患者的视力。     

Intravitreal bevacizumab for exudative retinal detachment post laser therapy for retinopathy of prematurity

Retinopathy of prematurity (ROP), a leading cause of pediatric blindness, predominantly affects premature and low-birth-weight infants. Although many cases are self-limiting, a minority progress to retinal detachment despite treatment. Exudative retinal detachments, although uncommon, have been reported after conventional laser therapy.^{1, 2 and 3} We report 2 cases of exudative retinal detachment after laser therapy for prethreshold and threshold ROP that responded favourably to a series of intravitreal bevacizumab injections.     

巩膜扣带术联合氩激光光凝治疗视网膜脱离

目的探讨巩膜扣带术联合氩激光光凝治疗视网膜脱离的疗效及适应证范围。方法对1996年～2002年8月在我院行巩膜扣带术后接受氩激光光凝治疗的视网膜脱离患者386例392只眼进行回顾性分析。结果术后随访3～6个月,392只眼中,视网膜完全复位377只眼(96.8%),术后矫正视力>0.05者341只眼(87%),最佳矫正视力为1.0。结论将巩膜扣带术中冷凝改为术后氩激光光凝,可简化术中操作,减少视网膜和脉络膜血管的损伤及术后并发症的发生,是治疗视网膜脱离的有效方法之一。     

巩膜扣带术联合氩激光光凝治疗视网膜脱离

目的 探讨将巩膜扣带术中冷凝改为术后氩激光光凝封闭裂孔,治疗视网膜脱离（retinal detachment,RD)的疗效及适应证范围。方法 回顾性分析1999年12月至2000年4月,在我院行巩膜扣带术接受氩激光光凝治疗的RD患者35例（38只眼）的临床资料。结果 术后随访3－6个月,38只眼中,视网膜完全复位36只眼（94．7％）。术后视力≥0。05者31只眼（86．1％）,最佳矫正视力为1．0。结论 将巩膜扣带术中冷凝改为术后氩激光光凝,可简化术中操作,减少视网膜和脉络膜血管的损伤及术后并发症的发生,是治疗RD的有效方法之一。     

巩膜扣带术联合激光光凝术治疗视网膜脱离的效果观察

目的 观察巩膜扣带术联合激光光凝术治疗非复杂性孔源性视网膜脱离的疗效。方法 回顾性分析2003年1月-2005年9月我院行巩膜扣带术联合激光光凝术治疗的非复杂性孔源性视网膜脱离27例（28眼）。术后随访3-6月,观察视网膜复位情况,视力及并发症。结果 视网膜复位27眼（96.43%）,视力提高25眼,视力无改变2眼,下降1眼。结论 巩膜扣带术联合激光光凝术治疗非复杂性孔源性视网膜脱离效果满意。     

A case of retinal detachment in retinitis pigmentosa

PURPOSE: To report case of retinitis pigmentosa in association with rhegmatogenous retinal detachment. METHODS: An eight year old boy complained of a sudden visual loss. The patient had night blindness, bone spicule-like hyperpigmentation, pale optic disc in both eyes, and the retina was totally detached in the right eye. RESULTS: He was initially treated with conventional scleral buckling surgery, then pars plana vitrectomy with silicone tamponade was performed and retinal reattachment was established. After the phacoemulsification combined with silicone oil removal the final visual acuity of counting fingers was obtained. CONCLUSIONS: The association of retinitis pigmentosa and rhegmatogenous retinal detachment is uncommon in young patients.     

Giant retinal tears, retinal detachment and retinitis pigmentosa

A patient with retinitis pigmentosa and sensorineural deafness presented with bilateral giant retinal tears and a unilateral retinal detachment. The peripheral visual field loss could have been erroneously ascribed to the primary retinal dystrophy. A retinal detachment must be considered in patients with a sudden loss of visual acuity or field even if they have a primary retinal dystrophy.     

玻璃体内注射康柏西普联合手术及全视网膜光凝治疗新生血管性青光眼

目的　观察玻璃体内注射康柏西普联合复合式小梁切除术或青光眼引流阀植入术及全视网膜光凝治疗新生血管性青光眼的临床效果。方法　对１７例（１７眼）新生血管性青光眼患者行玻璃体内注射康柏西普眼用注射液０．０５ｍＬ（１０ｇ·Ｌ－１）,待新生血管消退后行复合式小梁切除术或青光眼引流阀植入术及全视网膜光凝,术后平均随访３个月。结果　所有患者治疗后眼压控制完全成功者１０眼（５８．８２％）,部分成功者７眼（４１．１８％）。末次随访时７眼（４１．１８％）矫正视力提高,８眼（４７．０６％）视力稳定,２眼（１１．７６％）视力降低。所有患者均未出现与玻璃体内注射药物相关并发症。结论　玻璃体内注射康柏西普联合手术及激光治疗新生血管性青光眼是安全有效的。     

Exudative retinal detachment following grid laser photocoagulation in a patient with hemiretinal vein occlusion

PURPOSE: To report a patient with unilateral hemiretinal vein occlusion and macular edema who developed exudative macular detachment after grid laser application. METHODS: Clinical examinations, fundus photography and fluorescein angiography. RESULTS: Severe macular edema and exudation. CONCLUSIONS: This case illustrates a previously unreported complication of grid laser application for macular edema in retinal vein occlusion.     

巩膜扣带术联合532间接眼底镜激光治疗孔源性视网膜脱离

目的 探讨将巩膜扣带术中冷凝改为间接眼底镜激光光凝封闭裂孔，治疗孔源性视网膜脱离的疗效和适应证范围。方法回顾性分析2003年12月～2005年4月在我院行巩膜扣带术接受532间接眼底镜激光光凝治疗RD患者26例（26眼）的临床资料。结果术后随访3～6个月，26眼中视网膜全部复位。结论将巩膜扣带术中的冷凝改为532间接眼底镜激光光凝可减少视网膜和脉络膜损伤及术中并发症发生，是治疗RD的有效方法之一。     

Intravitreal triamcinolone and laser photocoagulation for retinal angiomatous proliferation

BACKGROUND: Recently, the entity of retinal angiomatous proliferation (RAP) as a subtype of exudative age-related macular degeneration was described, but no treatment options have been established as yet. The only two therapeutic modalities being discussed are surgical lysis of the feeding arteriole and draining venule, and the use of photodynamic therapy combined with intravitreal triamcinolone injection. AIM: To examine focal laser treatment of early extrafoveal intraretinal neovascularisation of RAP. METHODS: Prospective case series. We included 13 consecutive patients with an extrafoveal RAP stage I lesion. All patients underwent a complete ophthalmic examination, including fluorescein angiography and optical coherence tomography (OCT) III before treatment and at 2 weeks, 1, 2 and 4 months afterwards. In cases with marked macular oedema (>350 mum retinal thickening in OCT III, r = 12), intravitreal injection of 4 mg triamcinolone was given before focal laser treatment to reduce the oedema. RESULTS: This case series indicates anatomical improvement or stabilisation in patients with an extrafoveal RAP lesion after treatment. Initial visual acuity ranged from 0.1 to 0.6 on the Snellen chart. By calculating logarithmic values, visual acuity was seen to be improved in five cases (2 to 5 log lines), deteriorated in four cases (-2 to 5 log lines) and stabilised in four cases (-1 to +1 log line change). Exudation on fluorescein angiography was stopped in 11 cases. CONCLUSIONS: This preliminary case series suggests laser photocoagulation combined with prior intravitreal triamcinolone injection as a viable treatment option for RAP stage I. In cases with marked macular oedema, intravitreal triamcinolone injection improved visual acuity. For long-term stabilisation, additional laser treatment is mandatory. These preliminary results warrant a more detailed prospective clinical trial.     

玻璃体内注射雷珠单抗联合激光光凝治疗Coats病的疗效观察

目的 观察玻璃体内注射雷珠单抗联合激光光凝治疗Coats病的效果.方法 选择自2012年8月至2015年12月经眼底荧光血管造影及光学相干断层扫描诊断为Coats病的患者18例(18眼)为研究对象,所有患者先接受玻璃体内注射雷珠单抗,1周后在眼底荧光血管造影引导下行视网膜激光光凝术,必要时进行重复治疗.术后对最佳矫正视力及黄斑中心凹视网膜厚度(central macular thickness,CMT)进行观察,随访时间为16 ～ 24个月,平均18.8个月.结果 雷珠单抗的平均注射次数为2.6次,激光光凝次数为1.8次.术前最佳矫正视力为(0.81±0.28) LogMAR,末次随访时最佳矫正视力为(0.76±0.37) LogMAR(P=0.396).视力提高大于0.3 LogMAR者3例(16.7％),视力改变在0.3 LogMAR以内者13例(72.2％),视力下降大于0.3 LogMAR者2例(11.1％).术前CMT为(341.11±67.97) μm,末次随访时为(277.83±51.59) μm(P=0.030).末次随访时最佳矫正视力与术前最佳矫正视力显著相关(r =0.817,P＜0.001).伴有黄斑中心凹下硬性渗出的患眼末次随访时最佳矫力较不伴有硬性渗出者差(P =0.044).结论 玻璃体内注射雷珠单抗联合激光光凝是治疗Coats病的有效方法,可以稳定视力,降低CMT.术后视力与术前视力及黄斑中心凹下硬性渗出有关.     

原发性视网膜色素变性合并视网膜脱离的手术治疗

目的观察不同手术方法治疗原发性视网膜色素变性合并视网膜脱离的临床效果。方法选取1999年1月至2009年1月在我院确诊为原发性视网膜色素变性合并视网膜脱离患者8例（11只眼）,其中6只眼给予巩膜外加压术,5只眼行玻璃体切除手术治疗。术后随访1个月至1年,平均6个月,随访患者视力、眼压及视网膜复位情况。结果11只眼术后视力均有不同程度提高;术后高眼压1只眼;除1只眼经巩膜外加压术失败后行玻璃体切除术联合硅油填充术外,视网膜均保持复位。结论对于原发性视网膜变性合并视网膜脱离可根据不同的病例特点选择合理的手术方式,能有效改善患者的视力,获得比较满意的临床疗效。