高度近视眼荧光素眼底血管造影与吲哚青绿血管造影分析

目的 探讨高度近视眼荧光素眼底血管造影（fundus fluorescein angiography，FFA）和吲哚青绿血管造影（indocyanine green angiography，ICGA）同步检查的影像学特征及其临床意义。 方法 随机选择屈光状态-6 D以上的高度近视患 者30例57只眼，进行FFA和ICGA同步检查，对比分析其FFA和ICGA检查图像。 结果 57只眼中FFA显示早期背景 荧光减弱25只眼，晚期显示新生血管形成10只眼，漆纹样裂纹形成40只眼；ICGA显示睫状后短动脉8只眼，背景荧光减弱35 只眼，脉络膜新生血管形成8只眼，漆纹样裂纹形成52只眼。 结论 高度近视眼的FFA和ICGA 检查的影像学特征主要表现为背景荧光减弱，漆纹样裂纹及脉络膜新生血管形成。FFA 和ICGA 同步检查能更全面地了解高度近视患者眼底视网膜与脉络膜的病理变化，有助于全面地了解病情和指导进一步治疗。 （中华眼底病杂志，2003，19：87-89）     

高度近视眼的吲哚青绿血管造影

目的探讨高度近视眼的吲哚青绿血管造影(indocyanine green angiography,ICGA)图像特征。方法对27例(54只眼)高度近视眼患者分别进行检眼镜、眼底彩色照相、共焦激光荧光素及吲哚青绿(indocyanine green ,ICG)同步血管造影。结果ICGA显示19只眼有漆裂纹,其中10只眼见漆裂纹中间有点、片状脉络膜新生血管(choroidal neovascularization,CNV), 占52．6%。而荧光素眼底血管造影(fundus fluorescein angiography,FFA)仅7只眼有明 显的漆裂纹。ICGA与FFA均显示14只眼有多灶性萎缩,ICGA显示3只眼伴有粗大的脉络膜血管 。结论ICGA可更清楚地显示高度近视眼的脉络膜视网膜的变性萎缩、漆裂纹及并发的CNV,有助于预后的评价。(中华眼底病杂志,2001,17:201-203)     

漆样裂纹性高度近视黄斑出血的眼底特征及视力预后

目的 探讨不伴脉络膜新生血管(CNV)的高度近视黄斑出血的眼底改变特征和视力预后。方法 对37例(38眼)不伴CNV的高度近视黄斑出血患者行眼底彩色照相和荧光素眼底血管造影(FFA)及矫正视力的随访观察，其中11例(11眼)行吲哚菁绿血管造影(ICGA)检查。结果84．2％的患眼在出血吸收后于原出血下方可见新的漆样裂纹形成；行ICGA的11只患眼中，7眼(63．6％)于ICGA可透过出血发现呈弱荧光条索的早期漆样裂纹。81．6％的患眼于出血吸收后视力均有明显增进。结论 不伴CNV的高度近视黄斑出血与新漆样裂纹形成相关，建议称之为漆样裂纹性黄斑出血。大部分患眼视力预后良好。     

高度近视黄斑病变分类及眼底血管造影特征分析

目的探讨高度近视黄斑病变的类型及荧光素眼底血管造影（fundus fluorescein angiography，FFA）特征。方法对诊断为高度近视黄斑病变的88例（125眼）患者行眼底彩色照相及FFA，分析其图像特征。结果高度近视黄斑病变根据其FFA表现可分为6种类型：（1）漆样裂纹性黄斑病变：25例36眼，占28．8％；（2）新生血管性高度近视黄斑病变．22例32眼。占25．6％；（3）漆样裂纹性黄斑出血：12例16眼，占12．8％；（4）高度近视性Fuchs斑：9例12眼，占9．6％；（5）高度近视性黄斑萎缩：14例23眼，占18．4％；（6）高度近视性黄斑裂孔：6例6眼，占4、8％．结论根据高度近视黄斑病变的FFA进行分类有助于明确病变性质、判断预后及指导治疗。【眼科新进展2007；27（2）：113-115】     

高度近视眼底后极部病变的临床研究

本文对104例(188眼)高度近视(-6.00D以上)眼底后极部病变进行临床研究表明,后巩膜葡萄肿是本病眼底的一种基础性病变,发生率为77.36％,分为黄斑型,盘周型,盘-斑型。脉络膜视网膜萎缩分为三期:色素上皮萎缩,脉络膜毛细血管萎缩,脉络膜大中血管萎缩。其发生与眼轴变长,近视加重及年龄增长正相关。漆纹样裂纹是导致黄斑出血和视网膜下新生血管的重要因素,它与Fuchs斑关系密切。后巩膜葡萄肿是本病进展阶段的主要早期体征。脉络膜视网膜萎缩则是本病变性阶段的重要标志。上述病变对患者视功能构成进行性损害。     

高度近视性黄斑出血的临床表现与荧光素眼底血管造影

目的 观察和探讨高度近视性黄斑出血的临床特点。方法 对确诊为高度近视性黄斑出血的60例患者(65只眼)做视力、眼底、荧光素眼底血管造影(fundus fluorescein angiography,FFA)等检查,平均追踪时间15个月。结果 做FFA检查的65只眼中有62只眼（95%）伴有漆裂样纹。其中54只眼为单纯型黄斑出血，出血多在1—3个月吸收，预后较好；另外11只眼为脉络膜新生血管膜型，视力预后较差。结论 高度近视性黄斑出血可分为单纯型和脉络膜新生血管膜型。前者出血吸收快，后者视力预后较差。     

高度近视性黄斑出血的临床观察

目的：观察高度近视性黄斑出血的临床特点和探讨其治疗方法。方法：对确诊为高度近视黄斑出血的28列32眼分别作视力、矫正视力、眼前节、眼底、A／B超、眼底彩照和眼底荧光血管造影（fundus fluorecein angiography,FFA)等检查,给予中西药物治疗,随访观察2－26个月（平均16个月。）结果：经FFA检查32眼中28眼（87．5％）为单纯型黄斑出血,其中25眼（89．3％）伴有漆裂样纹。出血经治疗多在15天至2个月吸收。另外4眼FFA显示为脉络膜新生血管出血,最终均因反复出血,后巩膜葡萄肿和脉络膜萎缩而预后较差。结论：高度近视性黄斑出血分单纯型和脉络膜新生血管型,前者出现吸收快,后者反复出血严重损害中心视力而预后不良。     

渗出型老年黄斑变性的吲哚菁绿血管造影图像特征

目的 探讨渗出型老年黄斑变性(AMD)吲哚菁绿血管造影(ICGA)与荧光素眼底血管造影(FFA)比较的图像特征。方法 对52例65眼渗出型AMD患者进行了眼底彩色照相、FFA和ICGA检查。结果 渗出型AMD的65眼中，ICGA诊断为典型性脉络膜新生血管(CNV)有33跟．占50．8％，FFA诊惭为典型性CNV有8眼，占11．6％；FFA诊断为隐匿性CNV的35眼中，ICGA诊断为边界清楚或久清楚的斑状CNV有22眼；合并黄斑出血39眼中，FFA不能发现的CNV而ICGA能发现共5眼；FFA诊断为痕痕染色的7眼中，有2眼有ICGA中发现CNV；ICGA发现CNV的供养血管(feeding vessel)有3眼。结论 ICGA比FFA发现CNV诊断率高，准确地显示黄斑出血所掩盖的CNV，ICCA有助丁发现CNV的供养血管。     

黄斑部出血的鉴别诊断

目的 分析黄斑部出血的病因及眼底血管造影在诊断中的作用.方法 对142例152只眼黄斑部出血患者的眼底荧光血管造影和吲哚青绿血管造影,结合病史、临床检查结果进行分析:结果90例98只眼黄斑部出血患者的眼底血管造影结果显示有脉络膜新生血管(CNV),其中老年黄斑变性湿性型39例44只眼,中心性渗出性脉络膜视网膜病变(特发性CNV)23例23只眼,高度近视22例25只眼,息肉状脉络膜血管病变4例4只眼,多灶性脉络膜炎1例1只眼,诊断不明1例.在非脉络膜新生血管所致的52例54只眼中,高度近视漆裂纹出血17例19只眼,视网膜大动脉瘤12例12只眼,黄斑区小分支静脉阻塞8例8只眼,黄斑前膜5例5只眼,脉络膜外伤4例4只眼,脉络膜血管瘤4例4只眼,诊断不明2例.结论 眼底血管造影对黄斑部出血疾病病因的鉴别诊断有重要价值,对治疗有指导意义.     

病理性近视的相干光断层扫描

目的研究病理性近视的相干光断层扫描(OCT)的图像特征。方法对100例(195只眼)高度近视患者行OCT检查。患者年龄16～76岁。屈光度数-6．00～-36．00D。结果OCT检查正常者7只眼(3．6％),视网膜色素上皮及脉络膜毛细血管光带不均匀和薄变者161只眼(82．6％),黄斑全层裂孔21只眼(10．8％),其中合并视网膜脱离10只眼(5．1％),黄斑限局性视网膜浅脱离24只眼(12．3％),其中合并视网膜劈裂7只眼(3．6％),黄斑脉络膜新生血管膜19只眼(9．7％),Fuchs斑9只眼(4．6％),厚的黄斑出血3只眼,黄斑前膜18只眼(9．2％),常合并有视网膜水肿。黄斑视网膜神经上皮薄变5只眼(2．6％),漆裂纹3只眼(1．5％)。结论与裂隙灯全视网膜显微镜检查比较,OCT在观察视网膜色素上皮和脉络膜毛细血管改变,确诊黄斑裂孔,发现小的神经上皮脱离和劈裂,诊断黄斑前膜,神经上皮薄变等方面均有优越性。但对薄的黄斑出血及小色素点不能分辨,对厚出血与色素难以分辨,因而也有其局限性。     

Strabisme Alternant - Etude clinique - traitement

The author defines motor and sensory alternation: the term alternation should not be used in isolation, it should always be accompanied by the name of the parameter concerned. Sensory alternation is always found together with motor alternation but the reverse is not true.The examining criteria for a diagnosis of sensory alternation are given, sensory alternation must not be confused with alternating inhibition. Working from clinical observations of cases of motor alternating strabismus, the author selects 2 types of binocular sensory relations which allow one to differentiate between:- cases of primary alternating strabismus- cases of secondary alternating strabismusThese forms will develop in different ways; in both cases a cure is possible providing that the right treatment is prescribed and once prescribed carefully followed, etc. It is always a case of serious forms of strabismus whose developmental period is spread over several years.According to the authors, the frequency of cases of true primary strabismus is from 1–3%, the frequency of cases of secondary alternating strabismus varies according to the type of therapy practised on cases of monocular strabismus with amblyopia. These latter will become cases of alternating strabismus under the influence of certain types of therapy carried out over several years (penalization, rocking, alternated occlusion, etc...).Experimental data on kittens confirm clinical data; kittens placed in abnormal environments during the sensitive period will show modification in the distribution of cortical cells and the absence of binocular cells (either because the excitation of the two eyes was not simultaneous, or not identical: artificial strabismus, occlusion, opaque glasses). This disturbances become irreversible after a certain period of exposure (a function of age, length of exposure, etc...).It is thus necessary to bear in mind: 1) the iatrogenic risks of certain orthoptic treatments, 2) the necessity for a binocular form of treatment as soon as possible, as once a certain stage is passed, cortical plasticity diminishes and the elaboration of normal binocular relations becomes impossible.

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Effects of Adenosine Agonists on Intraocular Pressure and Aqueous Humor Dynamics in Cynomolgus Monkeys

The effects of single or multiple topical doses of the relatively selective A₁adenosine receptor agonists (R)-phenylisopropyladenosine (R-PIA) and N⁶-cyclohexyladenosine (CHA) on intraocular pressure (IOP), aqueous humor flow (AHF) and outflow facility were investigated in ocular normotensive cynomolgus monkeys. IOP and AHF were determined, under ketamine anesthesia, by Goldmann applanation tonometry and fluorophotometry, respectively. Total outflow facility was determined by anterior chamber perfusion under pentobarbital anesthesia. A single unilateral topical application of R-PIA (20–250 μg) or CHA (20–500 μg) produced ocular hypertension (maximum rise=4.9 or 3.5 mmHg) within 30 min, followed by ocular hypotension (maximum fall=2.1 or 3.6 mmHg) from 2–6 hr. The relatively selective adenosine A₂antagonist 3,7-dimethyl-1-propargylxanthine (DMPX, 320 μg) inhibited the early hypertension, without influencing the hypotension. Neither 100 μg R-PIA nor 500 μg CHA clearly altered AHF. Total outflow facility was increased by 71% 3 hr after 100 μg R-PIA. In conclusion, the early ocular hypertension produced by topical adenosine agonists in cynomolgus monkeys is associated with the activation of adenosine A₂receptors, while the subsequent hypotension appears to be mediated by adenosine A₁receptors and results primarily from increased outflow facility.