DNA甲基化在眼科疾病中的研究进展

DNA甲基化作为表观遗传修饰的重要形式,通过调控基因表达,在疾病发生发展中发挥重要作用。近年来,随着DNA甲基化研究的迅速开展、检测技术的不断提升,DNA甲基化修饰已成为探究疾病发病机制及探寻新的治疗方案的重要方法; 眼科不同亚专业疾病在DNA甲基化的基础研究方面也取得了很多突破,包括角膜上皮的修复、结膜上皮的细胞黏附与异常的基质重塑、眼组织纤维化与青光眼、氧化应激和炎症反应与细胞损伤、不同DNA甲基化水平与眼部肿瘤的关系等。本文旨在通过对不同眼科疾病DNA甲基化调控机制的相关研究进行概述,为眼病发病机制的研究、筛查、诊断及预防提供新思路。     

线上教学管理模式在医学院校眼科硕士研究生及住培生教育中的实践及满意度调查

目的 研究线上教学管理模式在医学院校眼科硕士研究生及住培生教育中的满意度.设计问卷调查.研究对象哈尔滨医科大学附属医院2017级和2018级125名专业学位硕士研究生及住培生.方法 介绍哈尔滨医科大学附属医院眼科学专业对硕士研究生及住培学员线上教学的设计与实施方法,通过问卷调查在线教学的质量与学生满意度.主要指标学生满...     

Comparison of articaine and bupivacaine/lidocaine for single medial canthus peribulbar anaesthesia

In a single-centre, randomized, double-blind study, we comparedthe efficacy of 2% articaine with that of a mixture of 0.5%bupivacaine and 2% lidocaine for peribulbar anaesthesia in cataractsurgery, using a single medial canthus injection technique.Eighty-two patients were allocated randomly to receive 7–9 mlof a mixture of 0.5% bupivacaine and 2% lidocaine or an equalvolume of 2% articaine with 1:200 000 epinephrine. Hyaluronidase30 iu ml^–1 was added to both solutions. Thedegree of akinesia was scored 1, 5 and 10 min after theblock, at the end of surgery and at discharge from the day caseunit. Primary outcome measures were the difference in ocularmovement scores 5 min after block and the need for supplementaryinferolateral injections. There was greater akinesia in thearticaine group at 5 min (P=0.01). Ten patients (24%) inthe articaine group and 21 patients (51%) in the bupivacaine/lidocainegroup required a supplementary injection (P=0.02). The mean(SD) volume of local anaesthetic required to achieve adequateblock for surgery was 9.7 (2.1) ml in the articaine group and11.0 (2.2) ml in the bupivacaine/lidocaine group (P=0.01). Therewas a faster offset of akinesia after surgery in the articainegroup (P=0.01). There were no differences between groups inthe incidence of reported pain or of minor complications. Inour study, 2% articaine with 1:200 000 epinephrine wassafe and efficacious for single medial canthus peribulbar anaesthesia. Br J Anaesth 2001; 87: 584–7     

廖品正教授对“活血利水法”在现代眼科临床应用的认识

文章阐述了四川省首届十大名中医廖品正教授对＂活血利水法＂在现代眼科临床应用的认识和治疗经验。     

眼前段光学相干断层扫描仪与超声生物显微镜测量中央前房深度的比较

Objective To compare the difference and repeatability between anterior segment optical coherence tomography (AS-OCT) and ultrasound biomicroscope (UBM) in measuring central anterior chamber depth (ACD). Methods Twenty-nine patients (32 attacked eyes and 23 unaffected fellow eyes) with acute primary angle closure glaucoma (APACG) and 41 patients (74 eyes) with chronic primary angle closure glaucoma (CPACG) were included in this study. AS-OCT and UBM were used to measure the ACD of these APACG and CPACG subjects. Pair sample t test and correlation analysis were introduced to analyze the difference and correlation of the ACD values between the 2 instruments. ACD of one complete randomly selected eye was measured 10 times by the above 2 instruments, respectively, and the repeatability of 2 instruments was analyzed. Results There was no significant difference in ACD values of attacked eyes of APACG between AS-OCT and UBM. In unaffected fellow eyes and CPACG eyes, the ACD values measured by AS-OCT were deeper than that measured by UBM[ (1.923±0.287) mm vs (1.860±0.243) mm, (2.017±0.054) mm vs (1.913±0.052) mm, both P=0.012]. Positive correlation between AS-OCT and UBM in measuring ACD was found (r=0.928, P<0.001). The coefficient of variation of ACD was 0.66% as measured by AS-OCT, and 0.82% as by UBM. Conclusions The ACD measured by AS-OCT can be deeper than that by UBM. Excellent correlation is found between AS-OCT and UBM measurements. AS-OCT appears to be more repeatable in measuring ACD than UBM.     

CRISPR-Cas9基因编辑技术在眼科疾病中的应用

规律成簇间隔短回文重复（clustered regularly interspaced short palindromic repeat,CRISPR）及相关核酸内切酶9（CRISPR associated protein,Cas9）技术是一种由RNA指导核酸内切酶的基因编辑技术。该技术以其操作简便、基因敲除效率高、靶向精准、周期短等特点迅速被用于多个物种的基因组编辑及疾病基因治疗中。本文旨在对CRISPR-Cas9技术在构建眼科疾病模型和治疗眼科疾病中的应用进展进行综述。     

重视眼底影像学检查方法的合理应用

眼底检查有多种方法,从早期的检眼镜、荧光素眼底血管造影到近十年出现的各种影像学检查方法,包括相干光断层扫描、海德堡共焦激光眼底断层扫描等.由于每种检查方法的特点与功能不同,因此不可相互取代.如果将多种影像学检查方法有机地结合应用,则可显著提高眼底疾病的诊断和治疗水平.如果临床医师对各种影像学检查方法认识不足或缺乏经验,就会出现选择不当的问题,最终不能为临床诊断提供可靠的依据.针对上述问题,笔者就眼底影像学检查方法的合理应用提出了一些看法,旨在提高眼科医师合理应用眼底影像学检查方法的水平.     

Comparison of articaine and bupivacaine/lidocaine for sub-Tenon's anaesthesia in cataract extraction

Background. Articaine is the most widely used local anaestheticfor dental anaesthesia in Germany, Italy and The Netherlandsand has recently been introduced and licensed for dental usein the UK. We have previously shown articaine to be superiorto a standard mixture of bupivacaine 0.5%/lidocaine 2% for peribulbaranaesthesia. Sub-Tenon’s anaesthesia arguably providesa safer method of anaesthetic delivery for cataract surgery.A blunt cannula is used in this technique, thus greatly reducingthe risk of globe perforation, intrathecal injection and sight-threateningperiocular haemorrhage. Methods. We compared articaine and bupivacaine/lidocaine forsub-Tenon’s anaesthesia in cataract surgery. Results. Sub-Tenon’s anaesthesia using articaine 2% resultedin a more rapid onset of motor block compared with a bupivacaine/lidocaine(P=0.0076). Ocular movement scores were significantly lowerfrom 2 min after injection until the end of surgery (P=0.031ANOVA). Conclusion. Articaine 2% is safe and effective for sub-Tenon’sanaesthesia and is a suitable alternative to the traditionalbupivacaine 0.5%/lidocaine 2% mixture. Br J Anaesth 2004; 92: 228–30     

Single injection peribulbar anaesthesia. Total upper eyelid drop as an end-point marker

A prospective, observer blinded study on 51 patients undergoing cataract surgery was conducted to assess Total Upper Eyelid Drop as a new end-point marker to single injection peribulbar block. At present, no such clinical marker exists to stop clinicians injecting more than necessary volumes of local anaesthetic and therefore to prevent dangerous increases in intra-ocular pressure. Using this technique, satisfactory ocular akinesia was achieved in 90% of eyes 10 min after injection. Operating conditions were satisfactory in 98% of cases. The mean (range) volume injected was 9.1 (4-15) ml. The mean increase in intra-ocular pressure immediately after injection was 6.9 mmHg, decreasing to 0.7 mmHg after 5 min without the application of ocular compression. We found a negative correlation between the increase in intra-ocular pressure and the volume of injection (p < 0.002), which has never previously been reported. We conclude that Total Upper Eyelid Drop is a reliable endpoint marker for producing satisfactory operating conditions for cataract surgery while minimising increases in intra-ocular pressure and its use may therefore avoid the risks associated with ocular compression.     

频域光相干断层扫描：眼底影像检查技术的新时代

光相干断层扫描（OCT）技术从时域转入频域,使得图像的清晰度增加,分辨率提高。能够更好地观察视网膜各层组织结构及病理改变,并对病变进行三维立体重建,使得黄斑视网膜外界膜、视细胞内外段等改变清晰可见,不仅为临床诊断提供了更为详尽的图像信息,而且还有助于更加深入全面的了解眼底疾病的特征及病理机制,引领我们进入了一个眼底疾病观察的新时代。在应用过程中,需要了解OCT图像不同色彩表达的意义,重视随诊时图像采集部位的一致性。提倡通过频域OCT技术直接地对病变进行动态观察以及对多种眼底影像检查资料进行整合分析是今后眼底影像检查的发展方向。