航空旅行后急性玻璃体后脱离合并玻璃体积血一例

患者,女,39岁,航空旅行后突发右眼视物不清伴黑影遮挡1 d。于2016年1月29日来温州医科大学附属眼视光医院就诊。既往史：右眼近视（-5.50 D）,否认糖尿病、高血压、眼部及其他手术史。眼科检查：右眼裸眼视力（UCVA）0.1,左眼UCVA 0.6;右眼眼压（IOP）10.3 mmHg（1 mmHg=0.133 kPa）,左眼IOP 10.8 mmHg。右眼眼前节未见异常,散瞳后见玻璃体局限的团块状积血,遮盖上方视盘（见图1A）,未见视网膜血管阻塞、出血及视网膜裂孔等。辅助检查：B超显示右眼视乳头表面高回声（见图1B）;OCT显示右眼玻璃体积血（见图1C）。诊断：右眼急性玻璃体后脱离（Posterior vitreous detachment,PVD）,玻璃体积血,近视。治疗方案：给予云南白药胶囊口服,忌剧烈运动。1周后复诊,右眼UCVA提高至0.15,右眼IOP 15.2 mmHg。眼底照相及OCT均提示玻璃体积血部分吸收（见图2）,再次详细检查眼底,未见视网膜裂孔。1个月后复查,右眼玻璃体积血已完全吸收,右眼UCVA提高至0.2。     

美容激光致单眼玻璃体积血一例

患者,女,39岁,因“右眼固定性视物黑影1个月,视物模糊2周”于2016年11月1日来湖北恩施土家族苗族自治州中心医院眼科就诊。患者为美容院工作人员,自述于1 个月前在激光美容治疗结束时不慎被激光扫射到右眼,当时感右眼刺痛,持续性上方眉弓前方固定黑影。受伤半月余后无其他诱因下突感右眼视力骤降,视物不清症状逐渐加重。自述来我院就诊前未接受任何治疗。无高血压、糖尿病等全身疾病。眼科检查：视力右眼0.02,左眼1.0,右眼眼前节未见异常,裂隙灯前置镜检查见玻璃体血性混浊,下方见大量血凝块形成,隐约可见上方视网膜平伏（见图1A）。入院诊断：右眼玻璃体积血。     

Vitreous fluorophotometry in patients with cone-rod dystrophy.

Eight patients with cone-rod dystrophy were examined by means of vitreous fluorophotometry. The data in three patients with an early stage of retinitis pigmentosa (rod-cone dystrophy) served for comparison. In contrast with the abnormal findings on vitreous fluorophotometry in patients with an early stage of retinitis pigmentosa the value of vitreous fluorophotometry in cone-rod dystrophy was within the normal range in all patients except the two with advanced stages of this disease. Our results suggest that, although both diseases are based on diffuse dystrophy of photoreceptors, and the final stages of the two diseases may show several similar features, the process of breakdown of the blood retinal barrier differs greatly in the two diseases.     

Vitreous fluidity in myopia.

Forth-eight eyes were examined to determine if degeneration and liquification of the vitreous could be determined by vitreous movement in subjects with myopia compared with subjects who had either emmetropia or hypermetropia. The difference in duration of vitreous movement for the myopes was significantly greater than that for nonmyopes (p less than 0.05).     

Clinical Case Notes

The visual field can be affected by disorders involving any part of the visual pathway, from the retina to the striate cortex. The pattern of visual field damage can indicate the location of the disorder. The case is presented here of an 8-year-old girl with congenital glaucoma. Initial perimetry appeared consistent with glaucomatous field loss; however, this evolved into a homonymous quadrantanopia, indicating the presence of a cerebral lesion as the cause. Computed tomography and magnetic resonance imaging scans detected a large middle cranial fossa arachnoid cyst. Postoperatively there was resolution of the visual field defects secondary to the arachnoid cyst. The pattern of field loss was pivotal in this patient's management. Attention must be paid when caring for the patient with a chronic disease to ensure that concurrent conditions are diagnosed.     

Vitreous wick syndrome.

A 67-year-old man had vitreous wick syndrome after an uncomplicated intracapsular cataract extraction with a sector iridectomy in the left eye. The intraocular infection cleared with antibiotic therapy including intravitreal antibiotic injection, but a residual anterior cyclitic membrane and shallow anterior chamber persisted. An anterior vitrectomy was performed later in the course of treatment after the intraocular infection subsided, to relieve the shallow anterior chamber, prolonged hypotony, and ciliary body detachment. Final visual acuity was 6/15+(20/50+) in the left eye.     

Vitreous fluorophotometry in diabetes mellitus.

Vitreous fluorophotometry has proved to be a useful method to evaluate the integrity of the blood-ocular barrier to fluorescein in clinical and experimental diabetes mellitus. Diabetic patients with or without background retinopathy had increased vitreous accumulation of fluorescein after intravenous injection when compared with age-matched controls. Streptozotocin-induced diabetes in rats increase vitreous fluorescein levels. In the rat, this abnormality was reversed with insulin therapy and with pancreatic islet transplantation. The breakdown of the blood-ocular barrier to fluorescein appears to be the earliest detectable ocular abnormality of diabetes.     

Vitreous cutter in anterior segment surgery.

Experience has been gained in operating upon a variety of anterior segment disorders using a Grieshaber vitreous cutter. The results and complications are briefly discussed.