急进性后极部早产儿视网膜病变的临床进程及疗效观察

目的 描述急进性后极部早产儿视网膜病变(AP-ROP)的临床进程及特征,评价视网膜光凝及冷凝对急进性后极部早产儿视网膜病变的治疗效果.方法 前瞻性、非对比性、连续性病例.2006年1月至2008年6月经检查确诊为急进性后极部ROP的患儿8例16只眼.确诊后24h内行间接眼底镜下行视网膜光凝治疗联合或不联合直视下冷凝治疗.结果 急进性后极部早产儿视网膜病变以病变大部分位于后极部1区,所有象限视网膜血管扩张迂曲,病程进展快,若不及时治疗,迅速发生视网膜漏斗状全脱离为临床特征.本组8例16只眼视网膜光凝和(或)冷凝治疗后,9只眼病变完全退化或控制,占56.2%.7只眼病情未能控制,最终发展为4b至5期视网膜病变.结论 AP-ROP进展快,预后不良,部分患儿虽经严密观察和治疗,病情仍进展.视网膜光凝和(或)冷凝治疗能控制大部分AP-ROP患儿视网膜病变的发展,挽救患儿视功能.临床上需要加强观察和随访,早发现、早诊断、早治疗是减低该病致盲率的惟一方法.     

可溶性fms-样酪氨酸激酶受体-1不同基因片段对视网膜新生血管的抑制作用

Objective To investigate the inhibitory effects of fms-like typrosine kinase receptor sFh-1 on retinal neovascularization (RNV). Methods Recombinant lentivirus sFh-1 ( 2-3 ) and sFh-1 ( 2-4 )expressing the sFh-1 (2-3) and (2-4) immunoglobulin-like regions of sFh-1 were constructed. 96 seven-dayold C57/6J mice were randomly divided into 4 groups with 24 mice in each group. Group 1 : normal control;group 2: experimental control; group 3: sFlt-1(2-3); group 4: sFlt-1(2-4). The mice in group 2-4 were exposed to hyperoxia with (75±2)% O2 for 5 days and then returned to normoxia with 21% O2 ; the mice     

普南扑灵滴眼剂在视网膜脱离手术中的应用

目的　探讨普南扑灵滴眼剂在减轻玻璃体视网膜术 (VRS)和巩膜扣带术 (SBS)后炎症反应的作用。方法　将 82例 (82只眼 )随机分为研究组和对照组 ,研究组 41例 (41只眼 ) ,选用 0 .1%普南扑灵滴眼剂点眼 ,对照组 41例 (41只眼 ) ,选用 0 .0 2 5 %地塞米松滴眼剂点眼。观察指标为眼部疼痛、充血、前房闪辉、角膜炎症、虹膜后粘连。结果　选用 0 .1%普南扑灵滴眼剂的研究组在缓解术后眼部疼痛方面及减轻玻璃体切割术后前房闪辉、虹膜后粘连方面优于对照组 ,差异有显著性 (P <0 .0 5～ 0 .0 1)。结论　普南扑灵能显著的减轻 VRS及 SBS后炎症反应。     

实验性视网膜脱离Na十-K+-转运ATP酶活性及RPE超微结构改变

目的：探讨实验性视网膜脱离(retinal detachment，RD)后视网膜色素上皮(retinal pigment epithelium，RPE)对视网膜下液(subretinal fluid，SRF)的输导功能。 方法：将制作成功的实验性单眼RD 28只家兔随机分为4组，每组7只，每只兔的另眼作为对照。分别取RD部位的RPE-脉络膜组织和对照眼相应部位的组织匀浆，再测定ATP水解产物无机磷含量，以判断ATP酶活性；并作实验和对照眼的两种组织相应部位的RP正电镜观察。 结果：实验眼Na^十-K^+_-转运ATP酶活性为(2.16士1.26)/μmol(mg·h)，对照眼为(4.84±1.59)μmol/(mg·h)，二者差异显著(t＝5.52，P<0.01)；酶活性降低程度随病程延长而减轻(p<0.05)。电镜观察实验眼RD后第2至4周有自脉络膜向视网膜方向的吞饮泡，且随病程延长而增多。 结论；RD发生后RPE的外向输导功能增强，随病程进展，此功能减弱而内向输导功能产生。 （中华眼底病杂志，1997，13：83-85）     

锯齿缘断离术式选择与疗效的关系

报告５０例（５３眼）锯齿缘断离视网膜脱离的临床特点与术式，正确地选择术式视网膜复位率达１００％，其中１次复位率为９０．５７％，讨论了４种术式的适应症，作用原理和复位率。认为正确选择术式与疗效有密切关系。     

Long-term neuroretinal full-thickness transplants in a large animal model of severe retinitis pigmentosa

Background The purpose of this study was to explore neuroretinal transplantation in a large animal model of severe retinitis pigmentosa and to establish graft development, long-term survival, graft-host integration, and effects on the host retina. Methods Rhodopsin transgenic pigs, aged 6 months, received in one eye a fetal full-thickness neuroretinal sheet in the subretinal space by means of vitrectomy and retinotomy. Six months postoperatively, eyes were studied in the light microscope and with immunohistochemical markers. Full-field electroretinography (ERG) was performed at 4 and 6 months. Results Laminated grafts with well-organized photoreceptors, rod bipolar cells, and Müller cells were found in five of six eyes. Neuronal connections between graft and host retina were not seen. In the five eyes containing a graft, the number of surviving rods in the host retina was significantly higher compared with unoperated eyes. The ERG did not reveal any significant difference in b-wave amplitude between operated and control eyes, but the cone-derived response in operated eyes increased significantly from 4 to 6 months while the rod response in control eyes decreased significantly. Conclusions Fetal full-thickness neuroretina can be transplanted safely to an eye with severe retinal degeneration. In their major part, the transplants develop a normal laminated morphology and survive for at least 6 months. Graft and host retinal neurons do not form connections. Retinal function in the host is reduced initially by the surgical trauma, but the presence of a well-laminated graft counteracts this effect and rescues rods from degeneration. Supported by The Foundation Fighting Blindness (grant# C-NC02-798-0078), The Faculty of Medicine, University of Lund, The Swedish Research Council, The Princess Margaretas Foundation for Blind Children, The 2nd ONCE International Award for New Technologies for the Blind.     

激光光凝治疗黄斑水肿

应用氩绿激光治疗视网膜血管性疾病所致黄斑水肿50例,73只眼。治疗后,有20.5％(15/73)的患眼视力提高2行以上,76.8％(56/73)的患眼视力保持稳定。局部性和/或非囊样黄斑水肿患眼的视力预后较好,水肿易于吸收。弥漫性和/或囊样黄斑水肿患眼的视力预后较差,水肿较难吸收。术前视力可影响预后。对激光光凝治疗本病的疗效、影响因素、激光治疗技术及其机理,也进行了讨论。     

Retinal slip during active head motion and stimulus motion

Gaze control in various conditions is important, since retinal slip deteriorates the perception of 3-D shape of visual stimuli. Several studies have shown that visual perception of 3-D shape is better for actively moving observers than for passive observers watching a moving object. However, it is not clear to what extent the improved percept of 3-D shape for active observers has to be attributed to corollary discharges to higher visual centers or whether the improved percept might be due to improved gaze stabilization during active head movements. The aim of this study was to measure binocular eye movements and to make a quantitative comparison of retinal slip for subjects instructed to fixate a visual stimulus in an active condition (subject makes an active head movement, object is stationary) and in a passive condition (the stimulus moves, the subject is stationary) for various movement frequencies, viewing distances, and stimulus diameters. Retinal slip remains below the acuity threshold of about 4 deg/s in active conditions, except for the highest frequency tested in this study (1.5 Hz) for nearby targets (0.25 cm). Retinal slip exceeds this threshold for most passive conditions. These results suggest that the enhanced performance in the visual perception of 3-D shape during active head movements can, at least partly, be explained by better fixation by actively moving observers.     

Retinal projections to the lateral posterior-pulvinar complex in intact and early visual cortex lesioned cats

In intact cats, it is generally considered that the lateral posterior-pulvinar complex (LP-pulvinar) does not receive direct retinal terminals, with the exception of the retino-recipient zone known as the geniculate wing. There is, however, some evidence that early lesions of the visual cortex can occasionally induce the formation of novel retinal projections to the LP nucleus. Given the importance of knowing the connectivity pattern of the LP-pulvinar complex in intact and lesioned animals, we used the B fragment of cholera toxin, a sensitive anterograde tracer, to reinvestigate the retinal projections to the LP-pulvinar in normal cats and in cats with early unilateral lesions of the visual cortex (areas 17 and 18). Immunohistochemical localization of the toxin was performed to show the distribution and morphology of retinofugal terminals. A direct bilateral but predominantly contralateral retinal projection reached the caudal portion of LPl and LPm in the form of patches located mainly along its dorsomedial surface and many scattered terminals. The distribution of retinal projections to LP-pulvinar in intact and operated cats did not differ. Contrary to what had been previously reported, we found no evidence for lesion-induced sprouting of retinal axons in these higher-order thalamic nuclei. Retinal input to the LP-pulvinar might modulate visual responses driven by primary visual cortex or superior colliculus.     

Displaced retinal ganglion cells project to the accessory optic system in the chameleon ( Chamaeleo calyptratus)

Retinal ganglion cells were successfully labelled in the chameleon by retrograde axonal transport of dextran amines that were applied to the nucleus of the basal optic root (nBOR) in an in vitro preparation. Labelled ganglion cells were restricted to the contralateral eye. Many cells were completely stained including their dendritic trees. With few exceptions, all cells had displaced somata that were located at the inner margin of the inner nuclear layer. The labelled ganglion cells had two to six primary dendrites that branched frequently and formed large unistratified dendritic trees within sublamina 1 of the inner plexiform layer. There was extensive overlap of the dendritic trees of neighbouring cells leading to an estimated coverage factor of 2-4. The dendritic field areas varied in size according to the retinal position of the cells and were highest in the central retina around the fovea with a maximum of 0.14 mm(2) and reached a second maximum at the retinal margin with values of 0.08-0.1 mm(2). The smallest dendritic areas (0.04-0.06 mm(2)) were measured midway between the fovea and retinal margin. The size of the soma area was not correlated to the dendritic field size and increased from 100 to 150 microm(2) near the fovea to 150-300 microm(2) at the retinal margin. There was no evidence for a retinotopic organisation of ganglion cell fibres within the nBOR. All cells were of uniform morphology that was identical to the type of nBOR-projecting displaced ganglion cell (DGC) described previously for the bird retina. Similar to birds, the labelled DGCs were the only source of retinal projection to the nBOR. A small fraction of cells had orthotopic somata located in the ganglion cell layer but were otherwise identical to the labelled DGCs. The similarity of chameleon nBOR-projecting ganglion cells to those described in avian retinas mirrors the close phylogenetic relationship of birds and lizards.