玻璃体积血的形态结构与玻璃体的后脱离的图像特征

目的 探讨玻璃体积血的形态结构和治疗特点。方法 对74例（79只眼）增生性糖尿病视网膜病变、视网膜血管炎、视网膜静脉阻塞所致玻璃体积血的临床资料进行比较分析。术前超声检查、术中手术显微镜观察患者的玻璃体形态特点，分析玻璃体与视网膜的关系。结果 所有患者均有不同程度的玻璃体后脱离，根据图像的形态特征可归纳为完全后脱离和部分后脱离两种。部分后脱离又分为“V”型、“L”型及后部玻璃体劈裂型，劈裂型多见于视网膜缺血性疾病的增生期。结论 了解和掌握玻璃体后脱离及玻璃体劈裂的形态特点，可提高手术治疗的成功率并改善其预后。     

玻璃体积血的形态结构与玻璃体后脱离的图像特征

目的探讨玻璃体积血的形态结构和治疗特点.方法对74例(79只眼)增生性糖尿病视网膜病变、视网膜血管炎、视网膜静脉阻塞所致玻璃体积血的临床资料进行比较分析.术前超声检查、术中手术显微镜观察患者的玻璃体形态特点,分析玻璃体与视网膜的关系.结果所有患者均有不同程度的玻璃体后脱离,根据图像的形态特征可归纳为完全后脱离和部分后脱离两种.部分后脱离又分为"V"型、"L"型及后部玻璃体劈裂型,劈裂型多见于视网膜缺血性疾病的增生期.结论了解和掌握玻璃体后脱离及玻璃体劈裂的形态特点,可提高手术治疗的成功率并改善其预后.     

临时人工角膜下行玻璃体切除术

对１０例角膜病变混浊伴玻璃体视网膜病变患者，用临时人工角膜取代混浊角膜，通过睫状体平坦部进行闭合式玻璃体切除即行部分穿透性角膜移植术，可１期手术治疗玻璃体视网膜病变及角膜病变，结果：９获得成功，１例失败，最佳者术后追踪１５个月，达到并保持０．３视力。６例术中联合进行玻璃体腔内多项操作，如气液交换，引出视网膜下液，硅油注入等，使复杂的视网膜脱离能够复位，为盲眼患者恢复光明开辟了新途径。     

玻璃体切割60例临床分析

玻璃体切割６０例临床分析北京交通医院眼科（１００００９）郭纯钢严厉郭春英我院眼科自１９９４年３月开展玻璃体切割手术以来，应用闭合式玻璃体切割手术治疗各种原因所致的玻璃体混浊、增殖性玻璃体视网膜病变６０例，总结报告如下：材料与方法１．所有病例按发病原因...     

玻璃体切割术治疗玻璃体积血的疗效观察

目的观察玻璃体切割术治疗玻璃体积血的疗效。方法分析我院自2004年以来收治的玻璃体积血患者25例（25眼），其中视网膜静脉阻塞（RVO）10例（10眼），糖尿病视网膜病变（DR）8例（8眼），眼外伤5例（5眼），孔源性视网膜脱离（RD）2例（2眼），全部患者均经睫状体平坦部行闭合式巩膜三通道玻璃体切割术，其中20眼联合行视网膜光凝术，3眼联合硅油填充术，5眼行C3F8注气术，5眼联合巩膜外环扎术。结果术后随访6个月以上，25例患者仅1例视力无提高，其余24例术后视力均较术前提高，其中1例DR患者术后发生孔源性视网膜脱离二次玻切术网膜复位。2例DR患者发生视网膜再次出血，予药物治疗，出血渐吸收。结论玻璃体切割术治疗玻璃体积血疗效明显。     

钴源辐照聚乙烯醇制备人工玻璃体的研究

人眼的玻璃体混浊和视网膜脱离都可引起视力下降甚至失明.为了治疗玻璃体混浊及网膜脱离,近百年来人们曾用过多种液体、气体和胶体(如生理盐水、脑脊液、空气、六氟化硫、八氟丁烷、硅油、兔、牛、人尸眼玻璃体、透明质酸…等)取代置换病变的玻璃体和治疗网膜脱离.但     

伊朗 Graves 眼病的临床特点

目的:研究分析伊朗 Graves 眼病患者的临床特点.方法:回顾分析 2003/2005 年确诊为 Graves 眼病的103例患者临床资料.结果:在103例 Graves 眼病患者中,48例(46.6%)为男性,55例(53.3%)为女性(男女比例为1.1).年龄18-73(平均45)岁,95例(92.2%)表现为甲状腺机能亢进,3例(2.9%)表现为原发性甲状腺机能减退,5例(4.8%)甲状腺机能正常.出现眼部症状的时间为2～95 (平均3.2)mo,而表现出甲状腺功能障碍的时间为6～180(平均39.4)mo.12例患者单眼发病,90例(87%)患者有眼睑退缩,80例(77.6%)患者表现出眼球突出,其中30例(29%)伴有局限性眼外肌运动障碍;CT扫描显示70例患者中有52例(74%)有眼外肌肥大.6例患者(5.8%)有视神经功能障碍,22例患者(21%)表现出Graves眼病相关的青光眼.其中7例(6.7%)为正常眼压青光眼.结论:本组病例中眼睑退缩是Graves眼病最常见的临床表现.未来需要更大范围的病例研究,以评价分析Graves眼病在伊朗人群中的发病率以及不同人种之间临床表现差异.     

Clinical features of Graves'' ophthalmopathy in Iran

AIM: To determine the clinical characteristics of a prospective study of patients with Graves' ophthalmopathy(GO). · METHODS: We reviewed clinical manifestations, and medical records of 103 patients in whom GO was diagnosed between 2003 and 2005. · RESULTS: Among 103 patients with GO, 48 (46.6%) male and 55 (53.3%) female, with mean age of 45 (range; 18-73) years, 95 (92.2%) patients had Graves' hyperthyroidism, 3 (2.9%) had primary hypothyroidism, and 5 (4.8%) were euthyroid. The mean duration of ocular symptoms was 13.2 (range 2-95) months while the mean duration of dysthyroid symptoms was 39.4 (range 6-180) months. Unilaterality occurred in 12 patients. Eyelid retraction was presented in 90 patients (87%), whereas the approximate frequency of exophthalmos was 77.6% (80 patients); restrictive extraocular myopathy, 29% (30 patients); evidence of extraocular enlargement on CT-scan in 52 patients of 70 patients (74%) that was evaluated, and optic nerve dysfunction, 5.8% (6 patients). 22 (21%) patients had glaucoma associated with GO that 7 (6.7%) of them were normal-tension glaucoma. · CONCLUSION: Eyelid retraction was the most common clinical sign of GO in our patients. Larger prospective studies are suggested to evaluate both the prevalence and possible racial difference in its clinical presentation in Iranian population.     

Wilson 病的眼部表现

目的 探讨Wilson病(WD)眼部表现的情况.方法 采用非随机回顾性系列病例研究.对2002年1月至2006年4月在中山大学附属第一医院住院的52例Wilson病患者的家族史、临床表现及实验室检查等临床资料进行分析,按照临床表现将其分为无症状筛查组、仅有肝脏病变组、仅有神经病变组及混合组(兼有肝脏和神经病变)4组.结果 52例患者中男性32例,女性20例,比例为1.6∶1.0.年龄4～53岁,平均(20±1)岁,其中41例(78.8%)在10～30岁之间.14例(26.9%)有家族史,3例(5.8%)有可疑家族史.无症状筛查组2例(2/52,3.8%),其中1例(1/2)K-F环阳性;12例(12/52,23.1%)仅有肝脏病变,其中7例(7/52,13.5%)K-F环阳性;11例(11/52,21.2%)仅有神经病变患者全部K-F环阳性(11/11,100%);27例(27/52,51.9%)兼有肝脏和神经病变,其中26例(26/27,96.3%)K-F环阳性.共45例(45/52,86.5%)K-F环阳性,7例(13.5%)无K-F环.1例(1.9%)有"向日葵"样白内障,1例(1.9%)有眼球震颤.51例(98.1%)铜蓝蛋白降低,51例(98.1%)24 h尿铜排泄量大于正常.结论 K-F环是常见的WD特征性的临床表现,多见于有神经病变的患者.     

麻风病眼部病变-1 004例麻风病患者的研究

目的：探讨麻风病患者的眼部病变的流行病学和眼部疾病类型。 方法：眼科医生历经3a就各自治疗中心的麻风病患者进行了检查,记录视力后,手电筒和放大镜观察眼前节,Schiotz眼压计测量眼内压,tropicamide眼水散大瞳孔后,直接眼底镜检查眼底。 结果：麻风病患者1004例中,530例属瘤性麻风,413例属结核样型麻风,61例属界限类麻风,606例（60.3%）患者出现了与麻风病有关的眼部损害,其中,角膜改变（81.1%）最多见,其次是眼睑改变（42.1%）,在这些患者中,还发现了可引起潜在性的视力损害的疾患,如兔眼症（17.3%）、角膜知觉麻痹（36.1%）、虹膜睫状体炎（17.3%）,无1例患者出现与麻风病有关的眼底改变,177例（17.6%）麻风病患者患有白内障,169例（16.8%）因麻风病而失明,慢性虹膜睫状体炎及其并发症是失明患者最常见的病因。 结论：60.3%的麻风病患者发现了眼部改变,其中2/3患者伴有角膜损害,它是最常见的及对视力危害最大的疾患,16.8%的患者因麻风病而失明,早期发现麻风病患者的眼部损害和早期治疗潜在性的视力损害及白内障可降低麻风病患者的致盲率。     

慢性结膜炎患者泪液中腺病毒与单纯疱疹病毒的检测

目的 探讨慢性结膜炎患者泪液标本中腺病毒和单纯疱疹病毒的表达情况.方法 实验研究.2008年11月至2009年6月期间,在北京大学第三医院、北京大学眼科中心门诊采集81例临床确诊为慢性结膜炎(成人组66例、儿童组15例)、9例急性病毒性结膜炎及30例健康者的双眼泪液标本,采用聚合酶链反应(PCR)法特异性检测腺病毒及单纯疱疹病毒核酸的存在情况,并对PCR阳性结果结合临床症状和体征进行分析.采用两个样本例数的卡方检验.结果 在慢性结膜炎患者中,腺病毒阳性率为32.1%(26/81),单纯疱疹病毒阳性率为30.9%(25/81).在慢性结膜炎的儿童组患者中腺病毒阳性率为33.3%(5/15),单纯疱疹病毒阳性率为13.3%(2/15).成人组中腺病毒的阳性率为31.8%(21/66),单纯疱疹病毒阳性率为34.8%(23/66).在既往有急性结膜炎病史的患者中腺病毒的阳性率为61.5%(16/26),与既往无急性结膜炎病史的患者比较,差异有统计学意义(χ2=16.884,P＜0.01).单纯疱疹病毒阳性率为42.3%(11/26),与既往无急性结膜炎病史的患者比较,差异有统计学意义(χ2=5.351,P=0.021).正常阴性对照组病毒检测阳性率均为0%(0/30),阳性对照组即急性病毒性结膜炎组腺病毒阳性率为100.0%(9/9).81例慢性结膜炎患者中腺病毒和(或)单纯疱疹病毒阳性者为37例.病毒检测阳性的患者中64.9%(24/37)的患者出现眼红症状,56.8%(21/37)的患者出现眼痒症状,32.4%(12/37)的患者兼有眼红和眼痒,73.0%(27/37)的患者临床体征表现有下睑滤泡.结论 慢性结膜炎患者中腺病毒和单纯疱疹病毒的表达占有相当的比例,既往有明确感染史的患者病毒阳性率明显高于无既往感染史患者.     

High incidence of autoimmune disease in Japanese patients with ocular adnexal reactive lymphoid hyperplasia

PURPOSE: To determine the incidence of autoimmune disease in Japanese patients with ocular adnexal lymphoid proliferations. DESIGN: Case series study. METHODS: The authors investigated the incidence of autoimmune disease in 88 patients with primary ocular adnexal lymphoid proliferations. Southern blot analysis was used to determine the presence of B-cell clonality in reactive lymphoid hyperplasia (RLH) associated with autoimmune disease. RESULTS: Histopathologic analysis indicated that 15 (17%) patients had RLH, 62 (70%) patients had mucosa-associated lymphoid tissue lymphoma (MALToma), and 11 (13%) patients had primary lymphomas. The incidence of autoimmune disease was seven (47%) of 15 patients with RLH, two (3%) of 62 patients with MALToma, and zero (0%) of 11 patients with primary lymphoma. B-cell clonality was detected in one (14%) of seven RLH patients with autoimmune disease. CONCLUSIONS: Ocular adnexal RLH with or without B-cell clonality is highly associated with autoimmune disease.     

系统性红斑狼疮眼底病变评估和分型

目的 分析系统性红斑狼疮患者的眼底表现特征.方法 对27例(54眼)眼底有病变的系统性红斑狼疮患者行荧光素眼底血管造影检查并与眼底检查结合进行综合分析.对患者的系统性红斑狼疮活动性指数(systemic lupus erythematosus disease activity in-dex,SLEDAI)进行计算,并采用SPSS 19.0中的t检验进行统计分析.结果27例患者的眼底表现可以分为4种类型,即毛细血管阻塞型(14例28眼)、动脉阻塞型(6例11眼)、静脉阻塞型(6例7眼)和脉络膜血管阻塞型(1例2眼).24例患者进行了SLEDAI评分.5例动脉阻塞型患者的SLEDAI为(25.6±2.2)分,显著高于其他患者的SLEDAI评分(18.2±2.9)分(P＜0.05).结论 不同血管阻塞的分型有助于了解系统性红斑狼疮患者的眼底病变情况,并可能与疾病活动程度相关.动脉阻塞型的SLEDAI评分高于其他类型.     

Platelet aggregation,disc haemorrhage and progressive loss of visual fields in glaucoma

Platelet aggregationin vitro, deterioration of visual field defects (VFD) and the prevalence of disc haemorrhages (DH) were assessed in 49 patients with primary open angle glaucoma (POAG) and compared with the findings for 67 individuals with suspected glaucoma (GS) in a seven-year follow-up study (range 5.8 to 8.2 years). The percentage patients with spontaneous platelet aggregation (SPA) was higher for POAG patients with visual field deterioration (60%) than both POAG patients without progressive loss of visual fields (12.5%; P<0.005) and those with suspected glaucoma (22.4%; P<0.005). The occurrence of DH was higher among POAG patients with progressive loss of visual field (28%) compared to the GS group (8.4%; P<0.025) and the group of patients consisting of POAG patients without deterioration of VFD and GS (9.9%; P<0.05). DH also occurred more often in patients with low tension glaucoma (41.6%) than in the remaining POAG patients (13.5%; P<0.05). No relation between the patients with SPA and the patients with DH was observed.Abbreviations NPB normal platelet behavior - SPA spontaneous platelet aggregation - DH disc haemorrhage     

成人重症肌无力眼肌型的临床特征

目的：分析成人重症肌无力眼肌型（OMG）患者的临床特征。方法：回顾性系列病例研究。收集2016年6月至2019年10月暨南大学附属第一医院眼科收治的40例成人OMG患者的病例资料,并对病程、性别比例、眼部表现、复视特征、眼外肌麻痹情况和辅助检查结果等进行分析。结果：40例成人OMG患者中男女比例为1∶1。病程中位数6个月（范围：1个月～10年）。27例表现为单纯复视（68%）,9例表现为单纯上睑下垂（22%）,4例表现为复视合并上睑下垂（10%）。31例复视患者中,水平复视20例（64%）,垂直复视11例（35%）,所有复视患者均表现为双眼多条眼外肌呈不同程度麻痹。31例复视患者中主要受累眼外肌分布：外直肌16例（52%）,上直肌6例（19%）,内直肌4例（13%）,下直肌3例（10%）,上斜肌1例（3%）,下斜肌1例（3%）。辅助检查显示新斯的明试验阳性32例（80%）,乙酰胆碱受体抗体阳性4例（10%）,合并胸腺异常5例（13%）,肌电图异常2例（5%）,合并甲状腺异常19例（48%）。结论：成人OMG临床表现多以水平复视为首发症状,其中外直肌受累较为常见。     

Polymerase chain reaction analysis of aqueous humour samples in necrotising retinitis

Aim: To evaluate the diagnostic value of polymerase chain reaction (PCR) performed on aqueous humour for the detection of viral DNA in patients with necrotising herpetic retinitis. METHODS: The clinical features and laboratory results of 22 patients (29 eyes) presenting with necrotising herpetic retinitis between March 1999 and June 2001 were reviewed retrospectively. Aqueous humour was obtained after anterior chamber paracentesis and PCR was performed in all cases. RESULTS: Viral DNA was detected in the aqueous humour of 19 patients (86.4%). Epstein-Barr virus (EBV) seroconversion was evidenced in one additional patient. In the acute retinal necrosis (ARN) group (n = 19), varicella zoster virus (VZV) DNA was identified in six patients, herpes simplex virus 1 (HSV-1) DNA in two patients, herpes simplex virus 2 (HSV-2) DNA in four patients, and cytomegalovirus (CMV) genome in four patients. In the progressive outer retinal necrosis (PORN) group (n = 3), VZV DNA was detected in all patients. No sample was positive for more than one virus. CONCLUSIONS: PCR analysis of aqueous humour in patients with clinical features of necrotising viral retinitis can provide specific aetiological orientation and the method appears to be safe and highly sensitive.