人工晶体眼的视网膜脱离

为分析人工晶体植入后的视网膜脱离的特殊性,对我院自９１年到９６年收治的人工晶体眼视网膜脱离４２例４４眼进行临床观察,并对其特殊性予以分析和讨论。结果：人工晶体眼视网膜脱离有发展快,裂孔难以寻找,增殖的后囊膜和人工晶体遮挡视路使检查很困难等特点,并易发展为复杂性视网膜脱离,治愈率为８０％。结论：在置入人工晶体时要尽量减少对手术眼的损伤,一旦发生视网膜脱离,要加大检查力度,尽早采取传统的视网膜脱离手术和现代玻璃体手术,以增加其疗效。     

Intraoperative retinal light damage reflected in electrophysiologic data

In a series of 30 unilaterally pseudophakic patients, electroretinograms and electrooculograms were recorded 6 months postoperatively. The unoperated on fellow eyes served as controls High intraoperative retinal light exposure (3.4–7.3 mW/cm², Zeiss OPMI 6 operating microscope) caused a substantial reduction of electrophysiologic potentials. Light protection prevented deterioration of electroretinogram and electro-oculogram potentials; reducing the bulb voltage, tilting the axis of illumination, filtering short wavelengths and the use of light shields resulted in 4-log-unit lower intensities (0.8–3.7 W/cm²).Abbreviations ACL anterior chamber lens - ECCE extracapsular cataract extraction - ICCE intracapsular cataract extraction - PCL posterior chamber lens     

Liposomally-entrapped ganciclovir for the treatment of cytomegalovirus retinitis in AIDS patients

Treatment of retinitis by cytomegalovirus (CMV) in AIDS patients requires frequent repetitive injections of intravitreal ganciclovir (GCV). This study was undertaken to establish experimentally whether the intravitreal application of liposomally-entrapped GCV could prolong intraocular therapeutic levels when compared with the intravitreal injection of free GCV, and the clinical effectiveness of this approach in AIDS patients. Intraocular concentration of GCV was determined by means of an ELISA test in rabbit vitreous 2, 3, 7, and 14 days after a single intravitreal injection of either different doses of the free drug (0.2–20 mg) or 1 mg of liposomally-entrapped GCV. After 72 h, only the vitreous of rabbits injected with doses of free GCV greater than or equal to 5 mg showed therapeutic levels of the drug; no GCV was detected after 72 h with any of the doses applied. Moreover, the microscopic study revealed GCV-induced damage in retinal structures in the animals injected with a free GCV dose greater than or equal to 15 mg. Intravitreal injection to rabbits of 1 mg of liposomally-encapsulated GCV showed no retinal toxicity at any of the time points studied, and therapeutic levels were detected up to 14 days after injection (4.67 ± 0.39 g/ml). Five AIDS patients suffering CMV retinitis were injected with 0.5 mg of liposomally-entrapped GCV (2 mg of lecithin). Complete remission of the CMV retinitis was observed already at the third injection of 0.5 mg GCV (one per week) and relapse did not occur during the 2–4 month follow-up of the patients. In view of the results presented, it can be concluded that intravitreal injection of liposomally-encapsulated GCV increases the time period required for reinjections in the treatemnt of CMV retinitis.Abbreviations AIDS acquired immunodeficiency syndrome - AZT zidovudine - CMV cytomegalovirus - GCV ganciclovir     

Cell Survival in the Uncrossed Projection of the Mammalian Retina is Independent of Birthdate

Naturally occurring cell loss in the retinal ganglion cell population of one eye can be interrupted by removal of the other eye in newborn rodents. Many of the rescued retinal ganglion cells which project ipsilaterally reside in the nasal retina, that part of the retina normally giving rise to primarily crossed optic axons. Their naturally occurring elimination has been attributed to their hypothesized late neurogenesis and the consequent delayed time of arrival of their axons in the target visual nuclei, thereby placing them at a competitive disadvantage with other, early arriving, optic axons. By combining the technique of tritiated thymidine autoradiography with the retrograde axonal transport of horseradish peroxidase in rats that had been enucleated on the day of birth, we report here that rescued cells in the nasal retina which project ipsilaterally are generated at the same time as their neighbours in the temporal retina. Time of genesis does not distinguish them; consequently, their axons should not differ in their arrival times within the target visual nuclei. Since their only obvious anomaly is one of pathway choice at the optic chiasm, their place of arrival, rather than their time, may ultimately determine their naturally occurring elimination.     

颈动脉斑块与心脑血管阻塞性疾病关系的临床探讨

目的 探讨颈动脉斑块与心脑阻塞性疾病及视网膜中央动脉阻塞(CRAO)的关系。方法 1995年10月至2002年7月采用彩色多普勒超声对我院心脑血管疾病患者149例行颈动脉检查。结果 检出颈动脉斑块者74例，未检出斑块者75例。有斑块者较无斑块者颈动脉内膜中层厚度明显增加(P＜0．01)。结论 颈动脉斑块严重程度的增加，其内膜中层厚度亦呈增厚趋势。前者是造成脏器梗死的重要原因之一。颈动脉斑块的检测和治疗可作为心脑血管及CRAO疾病的重要预防措施。     

视网膜脱离复位动物模型的建立

目的探索在兔眼建立视网膜脱离(retinal detachment,RD)复位模型的方法.方法 20只成年健康有色兔(40只眼)随机分为正常组和模型组,每组10只.模型组兔眼用自制的注射针头直视下经玻璃体腔在视网膜下注入透明质酸钠造成视网膜脱离,术后观察眼底情况2～4周.结果模型组10只兔有19只眼成功建立视网膜脱离模型,12～14天后,有18只眼视网膜复位.结论此法可以快速有效地建立一致性较强的视网膜脱离复位动物模型,有助于研究视网膜脱离及其复位的病理改变,影响因素及其治疗方法.     

准分子激光术前的眼底病变分析及处理

目的分析近视眼行准分子激光术前眼底病变病情及治疗方法.方法对730例(1460只眼)LASIK术前患者行散瞳眼底检查并作详细眼底检查记录.结果1460只眼中152只眼有干性视网膜裂孔(占10.4%),其中有2只眼伴视网膜浅脱离,36只眼同时伴有严重视网膜变性.152只眼干性视网膜裂孔和2只眼视网膜浅脱离行氩激光光凝治疗.结论近视眼LASIK术前常规散瞳检查眼底对发现病变并及时治疗是非常必要的,同时提出眼底病变光凝的指征.     

灯盏花中单体成分对体外培养大鼠视网膜神经细胞的影响

目的:考察咖啡酸、东莨菪内酯、野黄芩苷对体外培养视网膜神经细胞存活的影响,探讨灯盏花中具视神经保护作用的有效成分。方法:采用胰酶消化法将18只出生2-3d的乳鼠视网膜制成细胞悬液,接种于经多聚鸟氨酸(HA)和层粘连蛋白(LN)包被的96孔板中。于培养3d后,分别加入PBS液及不同含量的咖啡酸、东莨菪内酯、野黄芩苷溶液继续培养2d,采用MTT比色法测量其存活细胞的吸收值,同时对部分细胞行Nissel体染色检查。结果:Nissel体染色检查结果表明,培养5d的存活细胞大部分均为神经细胞。与空白对照组比较,咖啡酸含量在3.9-1000μg·mL^-1、东莨菪内酯、野黄芩苷含量在250-1000μg·mL^-1时,其吸收值均明显增加(P<0.05,P<0.01),且有一定的量效关系。结论:咖啡酸、东莨菪内酯、野黄芩苷三者均能促进体外培养的视网膜神经细胞存活,且咖啡酸活性最强。     

视网膜脱离复位术后屈光改变的临床研究

目的　了解视网膜脱离复位术后屈光状态的改变及恢复情况。方法　收集 39例 (39只眼 )手术复位成功的孔源性视网膜脱离患者 ,于术前及术后 1周、1、3、6月分别进行检影验光 ,A超测量眼轴长度 ,角膜曲率计检查 ,观察动态变化情况。结果　术前本组孔源性视网膜脱离中 ,近视眼占 82 .0 5 %。 >4 .0 D者占 6 9.2 3% ,眼轴长度>2 6 mm者占 6 9.2 3%。 3例环扎术后 ,全部眼轴加长 ,近视度加深。术后 1周及 1月时 ,散光值 >2 .0者为 12 .82 % ,术后 3个月逐渐减少。放射状加压术后散光值更大 ,差异有显著性 (P <0 .0 5 ) ,但 6个月内能恢复原状。结论　术前眼轴越长 ,近视度越高 ,发生孔源性视网膜脱离机会越多。环扎术后 ,眼轴变长 ,近视度加深 ,且半年内无明显改善。环形加压术或放射状加压术后早期 ,近视度数降低 ,向远视方向改变 ,从 +0 .5 D～ +5 .0 D不等 ,1月时最为明显。放射状加压术更易引起角膜曲率改变 ,散光值更大。但这种屈光改变是暂时性的 ,术后 6个月逐渐恢复原状 ,并趋于稳定。临床上适宜于视网膜脱离复位术后 6个月重新验光配镜。     

光学相干断层扫描技术诊断RPE脱离

目的:观察黄斑区视网膜色素上皮(RPE)脱离的光学相干断层扫描(OCT)图像特征。方法:并发黄斑区RPE脱离的眼底病病例共48例(52眼),进行黄斑区OCT检测,观察其图像特征,并结合FFA结果进行分析。结果:根据形态特征,RPE脱离可分为两种,浆液性RPE脱离和出血性RPE脱离。前者见于部分中心性浆液性脉络膜病例(16例)、特发性浆液性RPE脱离(7例)、部分视网膜下新生血管病变的病例(10例),后者仅见于部分视网膜下新生血管病变的病例(16例)。结论:OCT能够直观形象地显示RPE脱离的形态特征,准确地测量RPE脱离的范围大小。