血栓通联合等容血液稀释对视网膜静脉阻塞患者视网膜微循环的影响

目的 :探讨血栓通 (PNS)、等容血液稀释 (IHD)及二者结合治疗视网膜静脉阻塞 (RVO)对视网膜微循环的影响。方法 :采用PNS ,IHD及PNS +IHD随机对照治疗RVO患者 73例 ,观察治疗前后视网膜微循环时间 (RCT)和视网膜出血、水肿、毛细血管渗漏及黄斑囊样水肿 (CME)、无灌注区面积等的改变。结果 :与另两种方法比较 ,PNS +IHD使RCT ,尤其非缺血型和分支静脉阻塞患者RCT缩短更明显 ,视网膜出血、水肿、毛细血管渗漏及CME消退更快 ,并使病程小于两周的早期患者无灌注区发生率减低 ,缺血型者无灌注区边缘毛细血管充盈增加 ,但无灌注区面积无显著缩小。结论 :PNS结合IHD能显著缩短RVO患者RCT ,促进视网膜出血、水肿和毛细血管渗漏及CME的消退 ,可能还有减少早期患者无灌注区形成的作用。     

复杂原发性视网膜脱离的综合疗法

目的：探讨综合疗法对原发性视网膜脱离的手术效果及并发症。方法：采用环扎巩膜外势压及眼内注气等综合疗法。结果：治疗成功率由８５％提高到９０％。结论：综合疗法治疗原发性视网膜脱离是一种行之有效的方法。     

Immunohistochemistry of anterior proliferative vitreoretinopathy

Anterior proliferative vitreoretinopathy is characterized by epiretinal proliferation that extends anteriorly over the vitreous base, and may, in addition to the cells usually contributing to proliferative vitreoretinopathy, also contain cells of ocular structures located in that area. We examined 11 complete globes with aPVR that were enucleated after previous severe trauma or perforating injuries (n=8) and complicated retinal detachment (n=3) by a panel of immunohistochemical markers. We found presence of RPE, glial cells, macrophages and fibrocytes, as consistently reported in PVR membranes. In addition, T-cell lymphocytes were present in 6 of the cases, and cells expressing the common leucocyte antigen on 8 cases. Cells staining positive for the intracytoplasmic contractile filament-smooth muscle actin were present in 5 cases and cells staining for desmin in one case. Collagen type IV was part of most of the membranes, and vessels with leakage of plasma factors were present in more than half of the cases.This paper was presented in part at the First Annual Meeting of the European Community Ophthalmic Research Association (ECORA), Bonn, Germany, 6.10.1993.     

Steps to optimize transscleral photocoagulation

Background: In transscleral photocoagulation, the desired effect is coagulation of parts of the ciliary body or of the peripheral retina. However, the application is often limited by the unwanted effect of coagulation of the sclera. to reduce this effect, the ratio of incident radiation flux to radiation flux transported through the sclera (and able to coagulate the target tissue) should be minimized by the incident beam characteristics.Methods: Monte Carlo simulations for the radiation transport problem of multiple scattering in the sclera were used to calculate the ratio of transported to incident radiation for different parameter settings of beam diameters, optical thicknesses of the sclera and beam angles. To verify the theoretical calculations, an simple optical device utilizing a bulb instead of a laser source was constructed and applied to enucleated porcine eyes.Results: The theoretical calculations showed that the ratio of incident to transported radiation flux can typically be decreased by a factor of three by increasing the beam radius from 0.35 mm (as used in state-of-the-art laser devices) to 2 mm. This was confirmed by the experiments. Coagulations of the ciliary body or of the peripheral retina were possible with power densities an order of magnitude below the values normally applied with laser sources.Conclusion: To improve transscleral photocoagulation, beam diameters should be increased.     

Shiva-1: in vitro and in vivo tests of the effects of a novel,synthetic, lytic peptide on ocular cells

An investigation was undertaken to determine the toxicity of an intravitreal injection of a novel peptide drug, Shiva-1, in rabbits. The drug, a synthetic peptide modeled after lytic peptides secreted by certain insects, has antiproliferative and antibacterial properties. Initial in vitro experiments showed that the drug, at a concentration of 100 M, was toxic to both Y-79 retinoblastoma cells and human retinal pigment epithelial cells. A wide range of doses (6–1200 g) was injected into the rabbit vitreous in an attempt to determine the maximum tolerated dose. Retinal toxicity was evaluated clinically, by electroretinography, and by light microscopy. Some localized toxicity was evident at 200 g; all doses of 240 g and above were toxic. While the drug appears to exhibit a narrow range between effective and toxic doses, the results suggest that this and other peptides of similar design merit further investigation for the treatment of proliferative and infectious diseases of the eye.Supported in part by U.S. Public Health Service grants EY07541 and EY02377 from the National Eye Institute, the National Institutes of Health Services, Bethesda, MD, USA     

Diabetic retinal photographic screening: a model for introducing audit and improving general practitioner care of diabetic patients in a rural setting

ABSTRACT: This paper describes the addition of diabetic retinal screening using retinal photography to an existing immunisation audit by a General Practitioner (GP) Network in a semi-rural area 60-min drive from central Wellington, New Zealand. The employment of a nurse-facilitator who visited practices to assist the setting up of diabetic registers and the subsequent auditing of patterns of referral for retinal photography was seen as a first step in a process that would lead to audit of the care of diabetic patients by GPs in the Network. This should lead to a measurable improvement in health-care delivery to diabetic patients in this area and is a model that could be adapted by any group of rural or semirural GPs within a defined geographical area.     

裂孔源性视网膜脱离手术中不放液的选择与疗效分析

目的：探讨视网膜裂孔冷凝、巩膜环扎、外加压、手术中不放液治疗裂孔源性视网膜脱离（ＲＲＤ）的手术适应证及疗效。方法：对７８例（８０眼）ＲＲＤ采用视网膜裂孔冷凝、巩膜环扎、外加压、术中不放液的手术方法,并对治疗结果进行分析。结果：８０眼ＲＲＤ一次手术成功率为９３．８％,视网膜下液（ＳＲＦ）在术后１～２ｄ吸收为５１．３％,３～７ｄ吸收为３５％,术后视力明显提高。结论：ＲＲＤ术中不放液为手术步骤的重要改进。因其可保持眼内液体及眼压相对稳定,手术成功率高,并发症少,适应证可适当放宽。     

Histological measurement of human retinal thickness

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六氟化硫气体治疗黄斑裂孔视网膜脱离

目的： 探讨六氟化硫（ＳＦ６） 气体治疗黄斑裂孔视网膜脱离的价值。方法： 采用１００ ％ ＳＦ６ 气体玻璃体腔内注射３３ 例（３３ 眼） ,术后病人采取俯卧位１ 周。结果：３１ 例患者视网膜复位,中心暗区消失,视力均有不同程度的提高。结论：ＳＦ６ 气体治疗黄斑裂孔视网膜脱离,简便易行,成功率高,术后视功能恢复好