眼底血管造影联合频域光相干断层扫描同步检查法对渗出性老年性黄斑变性脉络膜新生血管的诊断价值

Objective To evaluate the diagnostic value of Heidelberg retinal angiography(HRA) combined with optical coherence tomography (OCT) to detect neovascularization (CNV) in exudative age-related macular degeneration (AMD) patients. Methods This is a cross-sectional study of a series of clinical cases. AMD diagnosis was established by international standard vision chart, Slit lamp microscope, direct or indirect ophthalmoscope examination. A total of 50 eyes (42 cases) of exudative AMD received HRA and frequency domain OCT scan. All 50 eyes received fundus fluorescein angiography (FFA) and frequency-domain OCT simultaneously, and among them 15 eyes also received indocyanine green angiography (ICGA) at the same time. FFA and ICGA were carried out by conventional methods, CNV was localized by real-time Localization technology of frequency domain OCT. In the radial and grid-like section from the areas with strong fluorescence, image acquisition settings are 7 μm fault for each frame, 30° intervals for radialsection, 10 vertical and 10 horizontal scan lines for grid-like section. CNV can be divided into 4 types (typical CNV, partial typical CNV, occult CNV, CNV scarring) according to their boundaries demonstrated in FFA. Based on the features of the OCT images, there were 3 types of integrated image (sub-RPE type, sub-retinal type and mixed type). Results CNV was detected in all 50 eyes. There were 4 eyes (8%) of typical CNV, 11 eyes (22%) of partial typical CNV, 32 eyes (64 %, including 27 eyes of RPE detachment and 5 eyes of passive late leakage) of occult CNV and 3 eyes (6%) of CNV scarring. There were 4 eyes (8%) of sub-RPE type (CNV under the RPE light band) , 16 eyes (32%) of sub-retinal type(interrupted light band of RPE and choroid capillary layer) and 30 eyes (60%) of mixed type of integrated image. Conclusion The image integration technology of the HRA and frequency domain OCT system provide a valuable tool to classify and measure CNV, which will benefit the clinical treatment of AMD patients.     

Treatment of retinal vein occlusion in rabbits with Fufang XueShuan Tong

Background Retinal vein occlusion (RVO) is one of the most common causes of visual loss. Many approaches have been tried to treat central retinal vein occlusion (CRVO), and branch retinal vein occlusion(BRVO) with various results. However, there is no definite has been found and limited evidence to support the interventions currently used to treat it. The aim of this study was to assess the effectiveness of the traditional medicine Fufang XueShuan Tong (FXST) in treating experimentally created RVO. Method First, RVO model was induced in forty-four pigmented rabbits through photocoagulation following injection of rose Bengal. The rabbits were divided into four groups based on the dose of FXST administered (212mg/kg,424mg/kg 848mg/kg and control group). The rabbits were observed for four weeks after the procedure, using color fundus photography, fundus fluorescein angiography (FFA ) and electroretinograms (ERG) examination; VEGF, IL-6, NO levels in the vitreous and histopathologic evaluation. Results The obstructed vessels in the treatment groups reopened or anastomosed faster than those in the control group (p<0.05). The amplitude of max b-mave and the oscillatory potential were significantly higher in the treatment groups than in the control group(p<0.01). At both two weeks and four weeks VEGF, IL-6 levels in the vitreous were significantly decreased in the treatment groups(p<0.01), while NO levels were significantly elevated(p<0.01). At the same time, histopathologic evaluation showed different retinal neuroepithelium structures in the different groups, immunoreactivity of VEGF was greater in the control group than in the treatment groups. Conclusion FXST was helpful in reconstructing retina vessels in the RVO model , protecting retina structure and improving visual function, and could inhibit the NV factor.     

玻璃体切割术后中央前房深度的改变

背景：采用A型超声测量法评价玻璃体切割术后中央前房深度的短期改变; 方法：采用前瞻性研究方法,对仅接受单纯玻璃体切割手术的29例患者（29只眼）进行研究,分别在术前和术后1周、1个月、3个月对术眼进行A型超声前房深度测量,并将术后测量数据与术前基线水平进行比较。 结果：29例患者（16例男性和13例女性）符合入选标准并纳入本研究,患者平均年龄50±11 (25-65)岁。23例患者因为玻璃体积血而接受手术,其余6例因特发性视网膜前膜而行玻璃体切割手术。玻璃体积血患者术前平均前房深度为2.98 ± 0.38mm,与对侧眼没有显著性差异(p=0.058)。而在视网膜前膜组,术前平均前房深度（2.94 ± 0.31mm）比其对照组平均深度(2.85 ± 0.28mm）要深,并具有统计学意义(p=0.008)。术后,玻璃体积血组前房深度与术前没有显著性差异;但在视网膜前膜组,术后一周时前房深度仍比术前深 (p=0.034),这种差异在术后一个月和术后三个月时消失(p=0.186 和0.682)。 结论：视网膜前膜形成可能导致前房深度的增加,这种前房深度增加在玻璃体切割术后消失。玻璃体积血后前房深度没有显著变化,玻璃体切割手术亦不影响玻璃体积血眼的前房深度。     

眼底血管造影联合频域光相干断层扫描同步检查法对渗出性老年性黄斑变性脉络膜新生血管的诊断价值

Objective To evaluate the diagnostic value of Heidelberg retinal angiography(HRA) combined with optical coherence tomography (OCT) to detect neovascularization (CNV) in exudative age-related macular degeneration (AMD) patients. Methods This is a cross-sectional study of a series of clinical cases. AMD diagnosis was established by international standard vision chart, Slit lamp microscope, direct or indirect ophthalmoscope examination. A total of 50 eyes (42 cases) of exudative AMD received HRA and frequency domain OCT scan. All 50 eyes received fundus fluorescein angiography (FFA) and frequency-domain OCT simultaneously, and among them 15 eyes also received indocyanine green angiography (ICGA) at the same time. FFA and ICGA were carried out by conventional methods, CNV was localized by real-time Localization technology of frequency domain OCT. In the radial and grid-like section from the areas with strong fluorescence, image acquisition settings are 7 μm fault for each frame, 30° intervals for radialsection, 10 vertical and 10 horizontal scan lines for grid-like section. CNV can be divided into 4 types (typical CNV, partial typical CNV, occult CNV, CNV scarring) according to their boundaries demonstrated in FFA. Based on the features of the OCT images, there were 3 types of integrated image (sub-RPE type, sub-retinal type and mixed type). Results CNV was detected in all 50 eyes. There were 4 eyes (8%) of typical CNV, 11 eyes (22%) of partial typical CNV, 32 eyes (64 %, including 27 eyes of RPE detachment and 5 eyes of passive late leakage) of occult CNV and 3 eyes (6%) of CNV scarring. There were 4 eyes (8%) of sub-RPE type (CNV under the RPE light band) , 16 eyes (32%) of sub-retinal type(interrupted light band of RPE and choroid capillary layer) and 30 eyes (60%) of mixed type of integrated image. Conclusion The image integration technology of the HRA and frequency domain OCT system provide a valuable tool to classify and measure CNV, which will benefit the clinical treatment of AMD patients.     

国产125I巩膜敷贴器治疗兔眼脉络膜黑色素瘤的有效性及安全性研究

背景 脉络膜黑色素瘤(CM)是成人眼内常见的原发性恶性肿瘤,巩膜表面敷贴放射治疗(EPRT)是一种近距离放射疗法,是多年来治疗CM最常用的方法之一.但该治疗方法的研究与应用目前在国内报道较少,大多数的CM患者需行眼球摘除术. 目的 通过观察兔CM模型眼、正常兔眼经敷贴放射后的反应以及兔全身免疫状态,评价国产125I巩膜敷贴器的有效性及安全性.方法 新西兰大白兔40只,按随机数字表法分成5个组,每组8只兔8只眼(均取右眼).其中放射治疗组1及模型对照组用于评价国产125I巩膜敷贴器的有效性;放射治疗组2、伪放射对照组、正常对照组用于评价国产125I巩膜敷贴器的生物安全性.有效性研究:利用B16F10鼠皮肤黑色素瘤细胞株植入兔眼制作动物模型,造模3周后放射治疗组1模型兔眼放置国产125I巩膜敷贴器进行放射治疗,肿瘤局部照射总剂量为100 Gy,模型对照组不进行治疗.每日间接检眼镜检查,每周行眼底照相、B型超声、彩色超声多普勒检查.安全性研究:放射治疗组2正常兔眼放置巩膜敷贴器,伪放射对照组正常兔眼植入不带放射粒子的敷贴器外壳,正常对照组不作任何干预.放射治疗组2、伪放射对照组于放置敷贴器前及敷贴器取出后3、7、15、30 d抽取外周血,用流式细胞术检测外周血CD4+、CD8+T细胞数量.于放射治疗组1、模型对照组肿瘤种植后6周,放射治疗组2、伪放射对照组、正常对照组观察30 d后耳缘静脉空气栓塞法处死实验兔,对实验眼进行常规组织病理学检查. 结果 放射治疗组1、模型对照组间放置敷贴器前肿瘤的平均高度差异无统计学意义(P=0.550).放置敷贴器1周后,放射治疗组1肿瘤高度明显小于模型对照组,差异有统计学意义(P=0.001);放射治疗组1放置敷贴器2周后肿瘤高度较敷贴前明显缩小,差异有统计学意义(P=0.007).常规组织病理学检查发现,与模型对照组比较,放射治疗组1虽然仍有肿瘤细胞残存,但肿瘤内部血管明显减少且管径较细,肿瘤细胞排列紊乱,部分细胞空泡样变性,色素外露,大量纤维结缔组织增生.安全性研究中,放射治疗组2、伪放射对照组在各时间点CD4+、CD8+、CD4+/CD8+T细胞流式细胞术结果比较,差异均无统计学意义(F分组=0.770、8.110、2.230;P=0.380、0.060、0.140;F时间 =0.770、3.220、4.230;P=0.550、0.170、0.004).放射治疗组2、伪放射对照组表现为角膜、结膜上皮下、巩膜表面慢性炎性细胞浸润,未见巩膜坏死、机化等表现. 结论 国产125I巩膜敷贴器对兔眼CM的疗效确切,对眼部其他组织以及兔全身免疫状态的影响较小.     

单纯玻璃体腔注气治疗高度近视黄斑裂孔视网膜脱离的临床疗效:北京同仁眼科中心的结果

目的探讨单纯玻璃体腔注气治疗高度近视合并黄斑裂孔视网膜脱离的疗效。设计前瞻性随机对照研究。研究对象北京同仁医院24例(24眼)屈光度超过–6.0D黄斑裂孔视网膜脱离患者。方法随机分为单纯C3F8注气组(A组)14例、玻璃体切割联合C3F8注气组(B组)10例。手术前后检查矫正视力、眼压、裂隙灯显微镜、眼底、眼部超声波和相干光断层扫描(OCT)。术后平均随诊(27.3±12.8)个月。主要指标视网膜复位例数,术后视力,手术费用。结果术后最后随诊时,单纯C3F8注气组、玻璃体切割联合C3F8注气组间手术复位率分别为28.6%(4/14例)和20%(2/10例),视力改善≥2行例数亦分别为4例和2例(P均=1.00)。两组间手术费用比较有显著性差异(P=0.000)。结论单纯玻璃体腔C3F8注气治疗高度近视合并黄斑裂孔视网膜脱离是一种可供选择的经济、有效的手术方式。     

兔葡萄膜黑色素瘤模型建立方法的实验研究

目的建立兔眼脉络膜黑色素瘤动物模型,观察肿瘤的生长特性。设计实验研究。研究对象新西兰大白兔20只（20跟）。方法将培养的B16F10鼠皮肤黑色素瘤细胞悬液种植到C57BL／6黑鼠大腿内侧皮下,7～12天孵育成直径10mm团块后制成肿瘤碎片,种植到新西兰大白兔右眼脉络膜上腔,自种植之日起予环孢霉素A20mg／kg肌肉注射以抑制淋巴细胞免疫功能。每周行间接检眼镜、眼底照相、B超、彩色超声多普勒观察并记录兔眼底肿瘤大小、形状、眼部其他组织的改变以及肿瘤内部血液供应情况。观察6周后眼球摘除,行HE染色组织病理学检查。主要指标肿瘤最大基底径、高度、细胞类型、肿瘤内血管分布情况以及眼部其他组织肿瘤浸润情况。结果除1只（5％）兔因呕吐物窒息死亡外,余19只兔19眼（95％）肿瘤存活并迅速生长。其中1眼（5％）自种植4周开始肿瘤自行萎缩,第6周12眼（60％）肿瘤充满玻璃体腔。2周、3周、4周B超测量肿瘤平均最大基底径分别为3．1mm、6．1mm、12．2mm,平均高度分别为2．2mm、2．7mm、8．5mm。HE染色示肿瘤以梭形细胞为主,排列规则紧密,部分坏死,血管充盈。18眼（90％）均可见眼部其他组织受肿瘤细胞浸润,3跟（15％）肿瘤突破巩膜向球外蔓延。结论B16FIO鼠皮肤黑色素瘤细胞株兔眼脉络膜上腔种植后肿瘤迅速生长,模型建造成功率高。f跟科,2010,19：130—134）     

眼底血管造影联合频域光相干断层扫描同步检查法对渗出性老年性黄斑变性脉络膜新生血管的诊断价值

Objective To evaluate the diagnostic value of Heidelberg retinal angiography(HRA) combined with optical coherence tomography (OCT) to detect neovascularization (CNV) in exudative age-related macular degeneration (AMD) patients. Methods This is a cross-sectional study of a series of clinical cases. AMD diagnosis was established by international standard vision chart, Slit lamp microscope, direct or indirect ophthalmoscope examination. A total of 50 eyes (42 cases) of exudative AMD received HRA and frequency domain OCT scan. All 50 eyes received fundus fluorescein angiography (FFA) and frequency-domain OCT simultaneously, and among them 15 eyes also received indocyanine green angiography (ICGA) at the same time. FFA and ICGA were carried out by conventional methods, CNV was localized by real-time Localization technology of frequency domain OCT. In the radial and grid-like section from the areas with strong fluorescence, image acquisition settings are 7 μm fault for each frame, 30° intervals for radialsection, 10 vertical and 10 horizontal scan lines for grid-like section. CNV can be divided into 4 types (typical CNV, partial typical CNV, occult CNV, CNV scarring) according to their boundaries demonstrated in FFA. Based on the features of the OCT images, there were 3 types of integrated image (sub-RPE type, sub-retinal type and mixed type). Results CNV was detected in all 50 eyes. There were 4 eyes (8%) of typical CNV, 11 eyes (22%) of partial typical CNV, 32 eyes (64 %, including 27 eyes of RPE detachment and 5 eyes of passive late leakage) of occult CNV and 3 eyes (6%) of CNV scarring. There were 4 eyes (8%) of sub-RPE type (CNV under the RPE light band) , 16 eyes (32%) of sub-retinal type(interrupted light band of RPE and choroid capillary layer) and 30 eyes (60%) of mixed type of integrated image. Conclusion The image integration technology of the HRA and frequency domain OCT system provide a valuable tool to classify and measure CNV, which will benefit the clinical treatment of AMD patients.     

眼底血管造影联合频域光相干断层扫描同步检查法对渗出性老年性黄斑变性脉络膜新生血管的诊断价值

Objective To evaluate the diagnostic value of Heidelberg retinal angiography(HRA) combined with optical coherence tomography (OCT) to detect neovascularization (CNV) in exudative age-related macular degeneration (AMD) patients. Methods This is a cross-sectional study of a series of clinical cases. AMD diagnosis was established by international standard vision chart, Slit lamp microscope, direct or indirect ophthalmoscope examination. A total of 50 eyes (42 cases) of exudative AMD received HRA and frequency domain OCT scan. All 50 eyes received fundus fluorescein angiography (FFA) and frequency-domain OCT simultaneously, and among them 15 eyes also received indocyanine green angiography (ICGA) at the same time. FFA and ICGA were carried out by conventional methods, CNV was localized by real-time Localization technology of frequency domain OCT. In the radial and grid-like section from the areas with strong fluorescence, image acquisition settings are 7 μm fault for each frame, 30° intervals for radialsection, 10 vertical and 10 horizontal scan lines for grid-like section. CNV can be divided into 4 types (typical CNV, partial typical CNV, occult CNV, CNV scarring) according to their boundaries demonstrated in FFA. Based on the features of the OCT images, there were 3 types of integrated image (sub-RPE type, sub-retinal type and mixed type). Results CNV was detected in all 50 eyes. There were 4 eyes (8%) of typical CNV, 11 eyes (22%) of partial typical CNV, 32 eyes (64 %, including 27 eyes of RPE detachment and 5 eyes of passive late leakage) of occult CNV and 3 eyes (6%) of CNV scarring. There were 4 eyes (8%) of sub-RPE type (CNV under the RPE light band) , 16 eyes (32%) of sub-retinal type(interrupted light band of RPE and choroid capillary layer) and 30 eyes (60%) of mixed type of integrated image. Conclusion The image integration technology of the HRA and frequency domain OCT system provide a valuable tool to classify and measure CNV, which will benefit the clinical treatment of AMD patients.     

miRNA在葡萄膜黑色素瘤诊断中的应用

葡萄膜黑色素瘤是成年人最常见的原发性眼内恶性肿瘤,其诊断方法是通过间接检眼镜所见结合彩色超声、磁共振成像等影像学检查,患者就诊时往往已发展到晚期.葡萄膜黑色素瘤的治疗包括激光光凝治疗、放射治疗、肿瘤局部切除和眼球摘除,均未明显提高患者的生存率.微小RNA是一种长约21～25个核苷酸的RNA,参与了包括个体发育、细胞凋亡、细胞增生与分化、肿瘤发生等生命过程.所以miRNA可作为葡萄膜黑色素瘤新的分子标志物,其检测可能对诊断疾病及判断预后提供有价值的依据,为针对目标微小RNA进行基因治疗提供理论依据.