BDNF对急性高眼压后大鼠视网膜三种钙结合蛋白表达的影响

目的：检测外源性BDNF对急性高眼压后大鼠视网膜Parvalbumin（PV），calbindin D-28k（CB）和calretinin（CR）表达的影响。方法：72只SD大鼠随机分成高眼压组、溶媒预处理高眼压组和BDNF预处理高眼压组，每组动物左眼制作急性高眼压模型，右眼为正常对照，动物分别存活1、3、7或14d。用免疫组化方法检测视网膜PV、CB和CR的表达变化。结果：溶媒预处理高眼压组中PV、CB和CR的表达与高眼压组相似。高眼压组中，随着再灌时间延长，内层视网膜中PV和CB标记的神经元数先下调再逐渐恢复，而CR标记的神经元数逐渐减少；再灌1d时PV和CR具有从内核层到内网层的重新分布。在BDNF预处理高眼压组，PV、CB和CR标记的神经元数在再灌1d、7d和14d时与高眼压组比较无明显差异，但在再灌3d时，明显高于后者（P〈0．05）。结论：BDNF预处理对急性高眼压后视网膜的保护作用可能与其再灌早期上调钙结合蛋白的表达有关。     

聚甲基丙烯酸羟乙酯水凝胶人工晶状体材料的合成与性能

以甲基丙烯酸羟乙酯为原料,过硫酸铵/偏重亚硫酸钠为引发体系,二甲基丙烯酸三乙二醇酯为交联剂,采用溶液聚合法制备了聚甲基丙烯酸羟乙酯水凝胶(PHEMA)人工晶状体材料。系统考察了聚合反应时间、温度及引发剂和交联剂的用量等对该水凝胶材料机械强度、平衡水含量(EWC)的影响,并对PHEMA水凝胶的结构和光学性能进行了表征。实验结果表明,PHEMA水凝胶的最佳合成条件为:引发剂0.5wt%,交联剂1.0wt%,反应温度40℃,反应时间36h。在此条件下制备的PHEMA水凝胶的拉伸强度达到0.57MPa,邵氏A硬度为23.0,平衡含水量超过40%,透光率≥97%。     

白内障晶状体上皮细胞及晶状体纤维超微结构的观察

应用胎儿晶状体发育的超微结构为形态学依据,观察老年性、外伤性、先天性白内障晶状体的超微结构.结果:老年性白内障晶状体上皮多数细胞膜破裂,作者首先发现其原因是相邻细胞顶部的紧密连结缺失,房水侵入所致.胞质中线粒体空泡化,内质网扩张、脱粒.晶状体纤维膨胀、崩溃.细胞之间的各种连结消失.外伤性白内障除具有白内障特点外,胞质中出现大量溶酶体、残体.1例先天性白内障,上皮细胞发育尚好,晶体纤维不发育.     

人工晶体植入前后视觉诱发电位的临床分析

目的:(1)探讨白内障囊外摘除术前术后及人工晶体植入术后视觉诱发电位幅值及潜时变化特征;(2)探讨白内障囊外摘除术术前P—VEP,F—VEP,F—ERG联合预测的必要性。方法:采用重庆泰克医电仪器公司产TEC—100C视觉电生理仪。对白内障患者实行分组测量。术前均测F—ERG,P—VEP,部分病例增测F—VEP。结果:114例术前F—ERG正常,P—VEP测量其P_(100)波幅值潜时均异常:P_(100)波幅值降低,潜时延长,术后及人工晶体植入后幅值,潜时都有所改善,而并发性白内障,代谢性白内障变化不明显。结论:据视觉诱发电位的变化,老年性白内障组,外伤性白内障组术后应及时装入人工晶体,并发性白内障组,代谢性白内障组装入人工晶体临床意义不大。术前联合测试(VEP ERG)对视力预后、以及眼底病变的定量诊断意义重大。     

Ectopia lentis in Loeys‐Dietz syndrome type 4

Loeys‐Dietz syndrome is a heritable disorder of the connective tissue leading to multisystem involvement including craniofacial features, skeletal abnormalities, cutaneous findings and early‐onset and aggressive disease of the aorta and its branches. There are multiple types of Loeys‐Dietz syndrome related to pathogenic variants in TGFBR1, TGFBR2, SMAD3, TGFB2, and TGFB3. Individuals with Loeys‐Dietz syndrome may be misdiagnosed as having Marfan syndrome due to shared phenotypic features and aortic root dilation. However, ectopia lentis has been an important discriminating feature, being unique to Marfan syndrome and not reported to be associated with Loeys‐Dietz syndrome. We report the case of a 46‐year‐old woman with Loeys‐Dietz syndrome type 4 due to a pathogenic variant in TGFB2 who was diagnosed with ectopia lentis at age 44. The patient underwent whole exome sequencing and no other pathogenic variants were found to explain the ectopia lentis. Our findings indicate that ectopia lentis may be an uncommon finding in Loeys‐Dietz syndrome type 4 and emphasize the importance of genetic testing in familial thoracic aortic aneurysm disease.     

Specular microscopy of hard contact lens wearers

Wide-field specular microscopy, slit-lamp examination, and pachometry were performed on 22 successful hard contact lens wearers and 22 controls matched for age, race, sex, and refractive error. A minimum of 600 cells per control and 1200 per contact lens wearer were manually digitized from the specular photomicrographs. Frequency distributions of cell areas were compared between the two groups using the parameters of mean, median, standard deviation, coefficient of variation, skewness and kurtosis. Slit-lamp examination was normal and there was no significant difference in corneal thickness between the patient group and the control group. Comparison of mean, median, and standard deviation also revealed no significant difference, but skewness (P less than .001), kurtosis (P less than .001) and coefficient of variation (P less than .004) were greater in the hard contact lens wear group. Hard contact lens wearing time correlated with increasing pleomorphism (P less than .05). Specular microscopy also revealed morphologic changes including deep stromal striae, intra- and extracellular "blackout" areas, and clustering of extremely small and large cells. The possible relationship between endothelial hypoxia and structural stromal changes are discussed.     

角膜塑形镜控制中小学生近视有效性和安全性Meta分析

目的 系统评价角膜塑形镜对中小学生轻中度近视延缓的有效性和安全性。方法 检索The Cochrane Library、PubMed、EMbase、CBM、CNKI、WanFang Data和VIP等数据库,语言限定为中英文。采用Cochrane手册提供的偏倚风险评价工具和改良JADAD评分量表评价纳入文献质量;采用漏斗图检测纳入文献的发表偏倚;采用RevMan5.4软件进行Meta分析。结果 共有12篇文献符合纳入排除标准,包含1 908例研究对象。Meta分析结果显示: 佩戴角膜塑形镜后,裸眼视力有所提高[1年:MD=0.40,95%CI(0.05～0.74),P=0.02];角膜曲率有所下降[1年:MD=-3.21,95%CI=(-3.64～-2.79),P＜0.01];屈光度增长得到了有效控制[1年:MD=-3.19,95%CI=(-4.42～-1.95),P＜0.01;2年:MD=-3.61,95%CI=(-5.78～-1.43),P＜0.01];眼轴增长有所控制[1年:MD=-0.73,95%CI=(-1.43～-0.03),P=0.04;2年:MD=-1.15,95%CI=(-2.25～-0.06),P=0.04];眼轴变化量有所下降[1年:MD=-0.42,95%CI=(-0.64～-0.21),P＜0.01;2年:MD=-0.53,95%CI=(-0.96～-0.11),P=0.01]。结论 角膜塑形镜能够延缓中小学生轻中度近视的进展,且较为安全。     

儿童白内障摘除人工晶体植入术的临床分析

目的：评价儿童白内障摘除人工晶体植入术后的临床疗效。讨论儿童白内障手术治疗的时机、方式、屈光度的选择和术后处理。方法：23例34只眼施行后房型人工晶体植入术,其中26只眼为先天性白内障,8只眼为外伤性白内障。结果：术后矫正视力满意。但术后葡萄膜反应及后囊膜混法严重。结论：儿童白内障摘除后植入人工晶体是恢复视力的最好方法。     

高度近视白内障超声乳化及人工晶体植入的疗效

目的 :评价高度近视白内障超声乳化及人工晶体植入术的临床疗效。方法 :对眼轴 >2 6mm的 38例、5 2眼高度近视并发白内障患者 (Ⅰ级核 5眼 ,Ⅱ级核 2 1眼 ,Ⅲ级核 2 6眼 )行超声乳化及人工晶体植入术。患者平均 5 7 4岁 (5 2～ 73岁 ) ,平均眼轴长度 2 7 2± 1 5 6mm(2 6 1～ 2 9 2mm) ,平均人工晶体屈光度 (8 2 3±4 76 )D( 2～ 15 )D。结果 :术后 1周裸眼及矫正视力≥ 0 3者 38眼 (73 1% )。并发症主要包括后囊膜破裂 2眼 (3 85 % ) ,轻度角膜水肿 7眼 (13 5 % )。术后视力差的主要原因是高度近视视网膜病变。结论 :超声乳化及人工晶体植入术是高度近视并发白内障患者的理想术式 ,术者操作技巧是手术成功的关键