高度近视泪膜稳定性观察

目的观察高度近视患者的泪膜状态。方法选择80眼高度近视患者(屈光度为-6．00～-18．75D)作为实验组，选择80眼屈光度正常者为正常对照组(屈光度 0．50～-0．50D)，分别观察两组泪膜形态及侵犯性泪膜破裂时间(BUT)。结果①高度近视患者泪膜形态中流水样及大理石型所占比例高于正常对照组。②高度近视患者泪膜破裂时间低于正常对照组。结论高度近视对泪膜的稳定性有明显影响。     

Deep sclerectomy with collagen implant in patients with glaucoma and high myopia

PURPOSE: To study prospectively the success rate and complications of deep sclerectomy with collagen implant (DSCI), a nonpenetrating filtration procedure, in patients with glaucoma and high myopia. SETTING: Glaucoma Unit, H?pital Ophtalmique Jules Gonin, Lausanne, Switzerland. METHODS: This nonrandomized prospective trial comprised 21 eyes of 21 highly myopic patients with medically uncontrolled primary or secondary open-angle glaucoma. Visual acuity, intraocular pressure (IOP), and slitlamp examinations were performed before as well as 1 and 7 days and 1, 3, 6, 9, 12, 18, 24, 30, 36, 42, 48, 54, 60, and 66 months postoperatively. Visual field examinations were repeated every 6 months. Exclusion criteria were known allergy to collagen, advanced lens opacity, and eye surgery or laser trabeculoplasty fewer than 6 months before enrollment. RESULTS: The mean follow-up was 44.0 months +/- 17.1 (SD). The mean preoperative IOP of 26.4 +/- 5.9 mm Hg dropped to 10.4 +/- 6.1 mm Hg at 48 months. Eighty-one percent of patients achieved an IOP below 21 mm Hg with or without medication at 48 months. Thirty-eight percent had an IOP below 21 mm Hg without medication. The mean number of medications per patient was reduced from 2.30 +/- 0.85 to 0.86 +/- 0.91. CONCLUSIONS: Deep sclerectomy with collagen implant provided reasonable control of IOP in patients with glaucoma and high myopia over a long-term follow-up. There were relatively few postoperative complications.     

近视眼巩膜胶原的研究现状

病理性近视常引致视功能不可逆性损害。通过对实验性近视眼和人类近视眼研究发现,巩膜胶原变化与该病发生、发展关系密切。本文就胶原结构、力学特性、近视眼及后巩膜加固术后胶原变化等方面进行综述。     

近视患者Corvis ST角膜生物力学参数与眼部其他生物测量参数的相关分析

目的　分析近视患者Corvis ST测得的角膜生物力学参数与眼部其他生物测量参数的相关性。方法　收集自2019年3月至12月于西安交通大学第一附属医院眼科就诊,拟行角膜屈光手术的192例近视患者的临床资料,全部选择右眼进行研究;年龄18～51岁,Corvis ST测得的眼压为13~17 mmHg（1 kPa=7.5 mmHg）,等效球镜度（SE）为-1.50～-11.62 D。研究纳入Corvis ST测量的角膜变形基础参数包括:第一次压平速率（A1V)、第一次压平长度（A1L)、第一次压平时间(A1T)、第二次压平速率（A2V)、第二次压平长度(A2L)、第二次压平时间(A2T)、最大压陷时间（HCT）、最大压陷曲率半径（HCR）、最大压陷时两峰间距离（PD）;整合参数包括:2 mm处变形幅度的比值（DA 2 ratio）、综合半径（IR）、最薄点厚度/厚度变化率（ARTh）、第一次压平时角膜硬度参数（SP-A1）、Corvis生物力学指数（CBI）和生物力学/断层扫描地形图指数（TBI）。眼部其他生物测量参数包括:中央角膜厚度（CCT）、SE、眼轴长度（AL）、平均角膜前表面曲率（Km)、角膜水平直径（CD）。使用Spearman相关分析方法评估Corvis ST角膜生物力学参数与眼部其他生物测量参数的相关性。结果　CCT与除HCT之外的其他Corvis ST角膜生物力学参数均相关（均为P<0.05）;SE与A2L、A2V、PD、HCR、DA 2 ratio、IR均相关（均为P<0.05）;AL与A2T、HCT呈负相关,与A2V、PD呈正相关（均为P<0.05）;Km与PD、HCR、A2L均呈负相关（均为P<0.05）;CD仅与A1V、ARTh、CBI存在弱的相关性（均为P<0.05）;CBI仅与CCT、CD相关（均为P<0.05）;TBI仅与CCT相关（P<0.001）。结论　近视患者Corvis ST角膜生物力学参数与眼部其他生物测量参数存在相关性,在临床应用这些数据时需要综合考虑。     

Corvis ST评估不同程度近视成年患者的眼角膜生物力学参数及其与年龄、近视程度的相关性

目的 应用Corvis ST评估不同近视程度成年患者的角膜生物力学及及与年龄、近视程度的相关性。方法 横断面研究。收集2021年1月至8月在佛山市第二人民医院眼科门诊就诊的拟行屈光手术的近视患者101例(101眼，右眼)。根据等效球镜屈光度(SE)分为轻度近视组(SE>-3.00 D)组(12眼)、中度近视组(-6.00 D相似文献   

Biochemical parameters and prediction of the development of glaucoma in patients with progressive myopia

Examinations were made in 3 groups of patients aged 15 to 27 years: 1) patients with rapidly progressive high-grade myopia; 2) those with slowly progressive high-grade myopia; 3) healthy individuals (controls). Groups 1 and 2 patients had elevated levels of lactic and pyruvic acids along with the decreased activity of the antioxidant system in the tear. Thus, a combination of indicators, such as a rise in hypoxia index by more than 1.0 and a decrease in the lacrimal fluid content of superoxide dismutase by more than 40%, may be a predictor of glaucoma in persons with rapidly progressive high-grade myopia.     

近视患者晶状体参数与眼部解剖特征参数的关系

目的：了解行有晶状体眼后房型人工晶状体植入术的近视患者晶状体参数与其眼部解剖特征参数的关系。

方法：回顾性研究。收集2022-06/2023-06在无锡华厦眼科医院行有晶状体眼后房型人工晶状体植入术的近视患者46例46眼。术前评估眼部解剖特征参数包括角膜中央厚度(CCT)、前房深度(ACD)、眼轴长度(AL)等前后径,水平角膜直径(WTW)、水平沟到沟直径(STS_H)、水平角到角直径(ATA_H)等水平径,以及垂直沟到沟直径(STS_V)、垂直角到角直径(ATA_V)等垂直径,晶状体参数包括水平晶状体矢高(CLR_H)、垂直晶状体矢高(CLR_V)、水平晶状体厚度(LT_H)、垂直晶状体厚度(LT_V),并分析上述参数的差异性、一致性及相关性。

结果：除WTW与STS_V、STS_H与ATA_V无显著差异(均P>0.05)外,其余水平径与垂直径眼部解剖特征参数均有差异(P<0.05); CLR_H与CLR_V有显著差异(P<0.01),但LT_H与LT_V无差异(P>0.05)。Bland-Altman一致性分析结果显示,水平径、垂直径眼部解剖特征参数一致性较差; CLR_H与CLR_V一致性较差; LT_H与LT_V一致性较好,其差值的95%一致性界限(LoA)为-0.21-0.28 mm,95% LoA线外点比例为4.35%。Pearson相关性分析结果显示,水平径与垂直径眼部解剖特征参数间均有相关性(P<0.01),前后径参数均无相关性(P>0.05); 除CLR_H与LT_H、LT_V无相关性外,其余晶状体参数均有相关性(P<0.05); AL与水平径和垂直径眼部解剖特征参数均具有相关性(P<0.05),但与晶状体参数均无相关性(P>0.05)。多元线性回归分析显示,LT=0.419+0.017×年龄-0.548×ACD+0.371×ATA_H+0.884×CLR_V,CLR_H=-0.443+0.809×CLR_V,CLR_V=-0.092-0.200×ATA_H+0.560×CLR_H(校正R²=0.458、0.482、0.589)。

结论：水平径、垂直径眼部解剖特征参数不可互相替代; CLR_H、CLR_V不可互相替代,而LT_H、LT_V可互相替代。部分晶状体参数、WTW、STS、ATA与ACD相关,而年龄、ACD、ATA_H、CLR_V是LT的影响因素。     

Measurement of anterior segment parameters in Saudi adults with myopia

Purpose

To measure anterior segment parameters of the eye in myopic Saudi population using Pentacam.

Morphological parameters of the optic disc in patients with primary open angle glaucoma and low myopia

PURPOSE: To compare the morphological parameters of the optic disc in patients with low myopia and primary open angle glaucoma (POAG) and in patients with glaucoma without refractive errors. MATERIAL AND METHODS: 53 patients, aged 33-88 (56.2 +/- 11.9) with POAG were qualified for our study. The group was divided into two: first group consisted of 14 patients--11 women and 3 men, aged 41-83 (58.2 +/- 10.9) comprising 28 eye balls with low myopia (-0.5 Dsph to -3.5 Dsph) and POAG. The second group consisted of 38 patients: 24 women and 14 men, aged 33-80 (51.0 +/- 13.4) comprising 71 eye balls including 43 emetropic eyes, 26 eyes with hyperopia (+0.5 Dsph to +3.0 Dsph) and 2 eyes with astigmatism. All patients demonstrated early changes in visual field 1-2 stage due to the Aulhom classification. The measurements of the morphological parameters of the optic disc were made with confocal scanning laser ophthalmoscopy using Heidelberg Retina Tomograph--HRT II with glaucoma software. We analyzed the following parameters: optic disc area, cup area, rim area, cup/disc ratio, linear c/d ratio, mean cup depth, maximum cup depth. The statistical analysis was made using Kolomogarow-Smirnow test. RESULTS: All analyzed parameters were higher in patients with low myopia and POAG than in patients with only POAG. The results in both groups were different but still no statistically significant. CONCLUSIONS: Low myopia has an influence on the optic disc morphology in patients with POAG.     

雷珠单抗和PDT治疗病理性近视合并黄斑CNV的疗效比较

目的：比较抗血管内皮生长因子(VEGF)与光动力疗法(PDT)对病理性近视(PM)并发黄斑脉络膜新生血管(CNV)的治疗效果。

方法：将临床上经FFA、ICGA及OCT确诊为PM合并黄斑CNV的患者43例45眼纳入观察,其中抗VEGF组20例22眼行玻璃体腔注射雷珠单抗治疗,PDT组23例23眼行PDT治疗。治疗后每月复查一次,随访12mo,根据复诊情况,按需行重复治疗。以末次随访为疗效判定时间点,记录并分析患者治疗前后ETDRS视力和视野变化。以ETDRS视力表记录最佳矫正视力(BCVA),测定中心10°视野平均缺损(MD)并比较。

结果：治疗前两组基线ETDRS视力及中心视野MD比较,差异均无统计学意义(P>0.05)。治疗后12mo,抗VEGF组ETDRS视力39.23±20.06字母,较治疗前明显提高5.88±9.03字母(P<0.05); PDT组ETDRS视力37.38±16.95字母,较治疗前提高0.33±6.94字母(P>0.05)。治疗后12mo,抗VEGF组中心10°MD较治疗前明显下降(P<0.05),PDT组MD较治疗前无明显改变(P>0.05)。

结论：对PM并发CNV的治疗,玻璃体腔注射雷珠单抗较PDT治疗能更好地改善患者的黄斑视功能。     

A comparative analysis of hemodynamic parameters within the evaluation of the glaucomatous process in patients with myopia

One hundred and eighty (180) persons (363 eyes), mean age 63.7 +/- 5.2, mean follow-up--6.1 +/- 1.2, were investigated. Control group 1 comprised 46 patients (92 eyes) with emmetropia and different-degree myopia; control group 2 had 74 persons (148 eyes) with primary open-angle glaucoma (POAG). The main group had 60 patients (119 eyes) with POAG combined with myopia. The ocular hemodynamics parameters were found to reliably differ, in patients with myopia, without glaucoma and with the anterior-posterior eye axis of 25 mm, from the similar parameters in persons with emmetropia. The process aggravates in myopic patients with glaucoma due to reliably worsened ocular hemodynamics parameters and due to a higher intraocular pressure without any reliably changing systemic hemodynamics. The measuring of ophthalmoplethysmography parameters could be handy in examining the POAG patients with myopia in order to detect if glaucoma is progressing or not.     

青年近视人群屈光度与眼球生物学参数的相关性

目的:通过测量青年近视人群等效球镜度(SE)、眼轴(AL)、眼压(IOP)、中央角膜厚度(CCT)、前房深度(ACD)以及平均角膜曲率(Km),探讨屈光度与眼球生物学参数的关系。方法:回顾性分析2017-03/2019-07在兰州华厦眼科医院就诊的近视患者1619例1619眼的术前检查资料,根据SE将其分为低、中、高、超高度近视组。收集术前SE、AL、IOP、CCT、ACD、Km等眼球生物学参数,并分析其相关性。结果:低、中、高、超高度近视组SE分别为-2.38±0.49、-4.60±0.82、-7.40±1.08、-11.58±1.23D,AL分别为24.55±0.72、25.68±0.77、26.75±0.64、28.00±0.56mm,IOP分别为14.68±3.18、14.78±2.81、15.19±2.66、15.70±2.68mmHg,ACD分别为3.41±0.24、3.34±0.25、3.32±0.25、3.24±0.27mm,Km分别为42.96±1.22、43.02±1.43、43.29±1.47、43.56±1.47D,四组患者AL、IOP、ACD、Km均有明显差异(P<0.001),而CCT无明显差异(P>0.05)。SE值与AL、IOP、CCT、Km呈正相关性(r=0.851、0.104、0.066、0.157,均P<0.001),与ACD呈负相关性(r=-0.129,P<0.001)。结论:随着屈光度的增加,近视患者AL增长,Km增高,IOP增高,CCT增高,ACD变浅。     

Evaluation of spectral domain optical coherence tomography parameters in discriminating preperimetric glaucoma from high myopia

AIM: To evaluate the diagnostic ability of macular ganglion cell-inner plexiform layer (GCIPL) thickness obtained by spectral-domain optical coherence tomography (SD-OCT) in discriminating non-highly myopic eyes with preperimetric glaucoma (PPG) from highly myopic healthy eyes. METHODS: A total of 254 eyes, including 76 normal controls (NC), 116 eyes with high myopia (HM) and 62 non-highly myopic eyes with PPG were enrolled. The diagnostic ability of OCT parameters was accessed by the areas under the receiver operating characteristic (AUROC) curve in two distinguishing groups: PPG eyes with non-glaucomatous eyes including NC and HM (Group 1), and PPG eyes with HM eyes (Group 2). Differences in diagnostic performance between GCIPL and RNFL parameters were evaluated. RESULTS: The minimum (AUROC curve of 0.782), inferotemporal (0.758) and inferior (0.705) GCIPL thickness were the top three GCIPL parameters in discriminating PPG from non-glaucomatous eyes, all of which had statistically significant lower diagnostic ability than average RNFL thickness (0.847). In discriminating PPG from HM, the best GCIPL parameter was minimum (0.689), statistically significant lower in diagnostic ability than average RNFL thickness (0.789) and three other RNFL thickness parameters of temporal and inferotemporal clock-hour sectors. CONCLUSION: The minimum GCIPL thickness is the best GCIPL parameter to detect non-highly myopic PPG from highly myopic eyes, whose diagnostic ability is inferior to that of average RNFL thickness and RNFL thickness of several temporal and inferotemporal clock-hour sectors. The average RNFL thickness is recommended for discriminating PPG from highly myopic healthy eyes in current clinical practice in a Chinese population.     

巩膜胶原交联疗法治疗进行性近视的研究进展

胶原交联是指胶原分子内部和胶原分子间通过共价键结合实现提高胶原纤维的张力和稳定性的目的 .胶原交联被广泛应用于其他行业,近期研究表明胶原交联可改变巩膜的生物力学性质,使其抗牵拉能力增强,从而阻止进行性近视的发展恶化,有望成为治疗进行性近视的新疗法,本文对进行性近视巩膜胶原的特点、传统治疗方法及巩膜胶原交联疗法的研究现状做一阐述.     

近视与眼动参数变化的研究进展

近视的发病率有逐渐增加趋势,在人群中出现明显的低龄化且进展迅速.其有效的预测及控制方法并不十分明确.与其他眼球屈光状态相比,在近视的发生与发展中,多个眼动参数值与近视存在相关性.本文对近视发生与发展过程中出现相关改变的眼动参数包括调节幅度、调节灵敏度、调节滞后、强直调节、相对性调节、调节与辐辏、眼轴与角膜曲率半径比、隐斜视等进行综述.     

Phacoemulsification of cataract in patients with high myopia

We conducted a study for the purpose of developing a phacoemulsification technique for patients with high myopia optimized for the specificity of myopic eye. The study involved 124 (165 eyes) patients with high myopia and cataract. The lens density in operated patients was of degrees II-IV according to Buratto. The anterior-posterior axis of the eyeball ranged from 26.5 to 34.00 mm. the patients were shared between the experimental (92 eyes) and control (73 eyes) groups with respect to a used surgical technique. A modified procedure was applied in the experimental groups and the basic technique was used in the control group. The time of lens extraction, the volume of used irrigation liquid and the frequency rate of intra- and postoperative complications were the criteria in efficiency evaluation. The study showed the modified surgical procedure of phacoemulsification to ensure a better visualization, to reduce the load on the lens ligamentous apparatus and to facilitate, as much as possible, manipulations made on the lens nucleus of myopic eye; it also cuts the time of cataract lens extraction, which ensures a less volume of used irrigation liquid.     

Evaluation of visual field parameters in patients with chronic obstructive pulmonary disease

Purpose: To evaluate the effects of chronic obstructive pulmonary disease (COPD) on retina and optic nerve. Methods: Thirty-eight patients with COPD and 29 healthy controls, totally 67 subjects, were included in the study. Visual evoked potentials (VEP) and visual field assessment (both standard achromatic perimetry (SAP) and short-wavelength automated perimetry (SWAP)) were performed on each subject after ophthalmological, neurological and pulmonary examinations. Results: Mean deviation (MD), pattern standard deviation (PSD) and corrected pattern standard deviation (CPSD) were significantly different between patient and control groups as for both SAP and SWAP measurements (p?=?0.001, 0.019, 0.009 and p?=?0.004,0.019, 0.031, respectively). Short-term fluctuation (SF) was not statistically different between the study and the control groups (p?=?0.874 and 0.694, respectively). VEP P100 latencies were significantly different between patients with COPD and the controls (p?=?0.019). Conclusion: Chronic obstructive pulmonary disease is a systemic disease, and hypoxia in COPD seems to affect the retina and the optic nerve.