简介:目的:研究巩膜扣带术(scleralbuckling,SB)联合玻璃体注气术治疗孔源性视网膜脱离(rhegmatogenousretinaldetachment,RRD)的临床疗效及对患者血清中氨基酸、血管内皮生长因子(vascularendothelialgrowthfactor,VEGF)的影响。方法:回顾性分析我院收治的RRD患者150例150眼临床资料,将仅接受SB的患者81例81眼纳入未注气组,接受SB+玻璃体注气术的患者69例69眼纳入注气组,比较两组患者手术疗效和术前、术后血清中氨基酸、VEGF水平等情况。结果:两组患者术后各时间点视网膜复位率比较,差异均无统计学意义(P>0.05);注气组术后1d眼压明显高于未注气组,差异有统计学意义(P<0.05),两组患者术后5d眼压比较差异无统计学意义(P>0.05);两组患者术后术眼裸眼视力较术前均明显改善,差异有统计学意义(P<0.05);术后5d,两组患者血清中组氨酸、谷氨酸、苯丙氨酸、VEGF水平较术前均显著降低,差异有统计学意义(P<0.05),但组间比较差异无统计学意义(P>0.05);两组患者血清中精氨酸、亮氨酸、异亮氨酸、甘氨酸水平与术前比较,差异无统计学意义(P>0.05);术后1mo,两组患者视功能相关生活质量总分和各维目评分均较术前明显升高,差异有统计学意义(P<0.05),但两组间各评分比较差异无统计学意义(P>0.05);注气组术后并发症总发生率为7.2%(5/69)与未注气组的9.9%(8/81)比较,差异无统计学意义(P>0.05)。结论:SB联合玻璃体注气术有助于RRD患者视功能和眼压的早期恢复,降低血清中组氨酸、谷氨酸、苯丙氨酸、VEGF水平,且安全性较高。
简介:·Glaucomaisoneoftheleadingcausesofvisualimpairmentandblindnessworldwide.Ofknownriskfactorsforglaucoma,anincreasedinintraocularpressureismosthighlycorrelatedwithglaucomatousdamage.Irrespectiveofthecause,apoptosisoftheretinalganglioncellsistheeventualoutcome.Itiswidelyacceptedthatglaucomaisaneurodegenerativediseasethatisstronglycorrelatedwithcentralnervoussystemdisorders,suchasAlzheimer’sdisease.Thesetwodisordersalsosharesomesimilaritiesinpathogenicmechanisms.Recentstudiessuggestthatthetransientreceptorpotentialcanonical6channelcouldworktogetherwithbrain-derivedneurotrophicfactortopromoteneuronsurvivalinbrainandretina.Inthisstudy,weproposethattransientreceptorpotentialcanonical6maycontributetothepathogenesisofhumanglaucomaandbecomeapotentialtherapeutictarget.
简介:目的探讨玻璃体腔注射雷珠单抗辅助23G玻璃体切割治疗增殖期糖尿病视网膜病变的优质护理。方法通过对28例28眼采用玻璃体腔注射雷珠单抗辅助玻璃体切割治疗糖尿病患者并发视网膜增殖期病变存在的主要护理问题,针对患者治疗各阶段,责任护士提供全程、连续、系统的优质护理服务,加强护患沟通,提高护理质量,缩短手术时间,减少并发症的发生。结果24眼一次性手术复位成功(85.7%)术后三个月取出硅油,其中有4例伴有晶状体混浊的同时行晶状体超声乳化联合人工晶体植入术;4例硅油填充下仍然存在下方局限性视网膜增殖,术后三个月取出硅油再次切割增殖膜然后注入C3F8气体填充,随访至气体完全吸收,视网膜复位。结论对玻璃体腔注射雷珠单抗辅助23G玻璃体切割治疗增殖期糖尿病视网膜病变的患者提供优质护理,可缩短手术时间,减少并发症的发生,提高病人及家属的满意度,提升患者的康复效果,是手术取得成功的关键因素。
简介:目的比较周边虹膜切除术与超声乳化联合人工晶状体植入术治疗早期原发性闭角型青光眼的临床效果。方法选择仅局部用药即可控制眼压在正常范围内的早期闭角型青光眼合并白内障患者48例(54眼),应用周边虹膜切除术对28例(32眼)早期闭角型青光眼进行手术治疗,其结果与同类病人(20例22眼)的超声乳化联合人工晶状体植入术治疗结果进行比较。术前,术后一个月内每周一次,半年内每月一次,半年后三个月一次做眼压、裂隙灯检查直至1年。比较两者在术后眼压控制、视力恢复及前房情况,并作统计学分析。结果应用周边虹膜切除术治疗组术后平均眼内压为15.2±3.1mmHg,而同类病人经超声乳化联合人工晶状体植入术治疗后平均眼内压为14.9±2.6mmHg。分别经周边虹膜切除术和超声乳化联合人工晶状体植入术治疗,两类病人眼内压在术后早期无明显差异(P〉0.05)。经超声乳化联合人工晶状体植入术治疗,18眼(81.8%)最佳矫正视力提高,0.4者占63.6%,经周边虹膜切除术治疗术后最佳矫正视力无明显提高,其中8眼视力不增反降,最佳矫正视力0.4者占18.8%,两者差异有显著性(P〈0.05)。经周边虹膜切除术治疗术后中央前房深度无明显变化,而经超声乳化联合人工晶状体植入术治疗术后中央前房深度显著加深,两者差异性明显(P〈0.05)。结论原发性闭角型青光眼早期患者施行超声乳化联合人工晶状体植入术,术后房角显著加宽,中央前房深度显著加深,矫正视力也不同程度提高,且并发症少。
简介:AIM:Toestimatetheprevalenceandriskfactorsforvitreousfloatersinthegeneralpopulation.·METHODS:Anelectronicsurveywasadministeredthroughasmartphoneappaskingvariousdemographicandhealthquestions,includingwhetherusersexperiencefloatersintheirfieldofvision.Multivariatelogisticregressionanalysiswasusedtodetermineriskfactors.·RESULTS:Atotalof603individualscompletedthesurvey,with76%reportingthattheyseefloaters,and33%reportingthatfloaterscausednoticeableimpairmentinvision.Myopeswere3.5timesmorelikely(P=0.0004),andhyperopes4.4timesmorelikely(P=0.0069)toreportmoderatetoseverefloaterscomparedtothosewithnormalvision.Floaterprevalencewasnotsignificantlyaffectedbyrespondentage,race,gender,andeyecolor.·CONCLUSION:Vitreousfloaterswerefoundtobeaverycommonphenomenoninthisnon-clinicalgeneralpopulationsample,andmorelikelytobeimpairinginmyopesandhyperopes.
简介:目的探讨一种规范化的的高度近视白内障超声乳化方式,总结手术注意点。方法选取高度近视白内障患者91例(91眼)均予以超声乳化联合人工晶体植入术治疗并总结。结果所有病例的术后裸眼视力均优于术前裸眼视力。术后第1天裸眼视力≥0.2共72眼(79.12%),≥0.5共37只眼(40.66%);术后3月裸眼视力≥0.2共85只眼(93.41%),≥0.5共42只眼(46.15%)。最佳矫正视力≥0.2共89只眼(97.80%),最佳矫正视力≥0.5共72只眼(79.12%)。术前散光度平均1.10D±0.78D,术后3月散光度平均1.25D±0.72D。术后散光度与术前散光度比较,差异无显著性(t=1.166,P=0.261)。无瞳孔严重变形、视网膜脱离、囊样黄斑水肿、瞳孔夹持、青光眼以及顽固性葡萄膜炎等并发症。结论低能量,高负压,低灌注,连续环形撕囊,双手劈核技术对于高度近视白内障患者更加安全有效。
简介:AIM:ToidentifythegeneticdefectinaChinesefamilywithbilateralprogressivechildhoodposteriorcataract.METHODS:Atwo-generationfamilywasrecruitedinthisstudy.Familyhistoryandclinicaldatawererecorded.AllreportedcandidategenesassociatedwithcongenitalposteriorcataractwerescreenedbydirectDNAsequencing.·RESULTS:Allaffectedindividualspresentedposterioropacitiesinthelens.Directsequencingofthecandidategenesshowedaheterozygousc.2668C>TvariationinEPHA2gene,whichresultedinthereplacementofargininebycysteineatcodon890(p.R890C).Thismutationwasfoundintwoaffectedindividuals,butwasnotobservedin200normalcontrols.·CONCLUSION:Wereportanovelmutation(p.R890C)intheEPHA2receptortyrosinekinasegene.ThefindingexpandsthemutationspectrumofEPHA2inassociationwithposteriorcataract.
简介:·Thisisacasepresentationofaverybizarreopenglobetraumawithanteriorsegmentforeignbody-fishinghookstuckinthecorneaandiris.Complicationsduetothiskindofeyetraumamightbeveryhazardousandwithseriousimpactonvisualfunction.Wearerepresentingourapproachandexperienceofthreestepmanagementofthiskindofeyeinjury:first-extracttheforeignbody,closeandreconstructtheeyeball,second-fightinflammation,andthird-restorethevisualfunctionbycataractsurgery.·
简介:AIM:Toevaluatetheefficacyandsafetyofcornealcollagencrosslinking(CXL)topreventtheprogressionofpost-laserinsitukeratomileusis(LASIK)cornealectasia.·METHODS:Inaprospective,nonrandomized,single-centrestudy,CXLwasperformedin20eyesof11patientswhohadLASIKformyopicastigmatismandsubsequentlydevelopedkeratectasia.Theprocedureincludedinstillationof0.1%riboflavin-20%dextranesolution30minutesbeforeUVAirradiationandevery5minutesforanadditional30minutesduringirradiation.Theeyeswereevaluatedpreoperativelyandat1-,3-,6-,and12-monthintervals.Thecompleteophthalmologicexaminationcompriseduncorrectedvisualacuity,bestspectacle-correctedvisualacuity,endothelialcellcount,ultrasoundpachymetry,cornealtopography,andinvivoconfocalmicroscopy.·RESULTS:CXLappearedtostabiliseorpartiallyreversetheprogressionofpost-LASIKcornealectasiawithoutapparentcomplicationinourcohort.UCVAandBCVAimprovementswerestatisticallysignificant(P<0.05)beyond12monthsaftersurgery(improvementof0.07and0.13logMARat1year,respectively).Meanbaselineflattestmeridiankeratometryandmeansteepestmeridiankeratometryreduction(improvementof2.00and1.50diopters(D),respectively)werestatisticallysignificant(P<0.05)at12monthspostoperatively.At1yearafterCXL,meanendothelialcellcountdidnotdeteriorate.Meanthinnestcorneapachymetryincreasedsignificantly.·CONCLUSION:Theresultsofthestudyshowedalong-termstabilityofpost-LASIKcornealectasiaaftercrosslinkingwithoutrelevantsideeffects.Itseemstobeasafeandpromisingproceduretostoptheprogressionofpost-LASIKkeratectasia,therebyavoidingordelayingkeratoplasty.
简介:Thedamageofhumancornealcellsencounterwiththeproblemofavailabilityofcornealcellsforreplacement.Limitationofthesourceofcornealcellshasbeenrealized.Anattemptofdevelopmentofcornealepithelial-likecellsfromthehumanskin-derivedprecursor(hSKPs)hasbeenmadeinthisstudy.Combinationofthreeessentialgrowthfactors:epidermalgrowthfactor(EGF),keratinocytegrowthfactor(KGF)andhepatocytegrowthfactor(HGF)coulddemonstratesuccessfullyinductionofhSKPstodifferentiationintocornealcells.Theinducedcellsexpressedtheappearanceofmarkersofcornealepithelialcellsasshownbythepresenceofkeratin3(K3)byantibodylabelandWesternblotassay.TheK3geneexpressionofinducedhSKPscellsasshownbyreversetranscription-polymerasechainreaction(RT-PCR)technologywasalsodemonstrated.ThepresenceofthesemarkersatbothgeneandproteinlevelscouldleadtoourconclusionthatthedirectionaltransdifferentiationofhSKPscellsintocornealepithelialcellswassuccessfullydoneunderthiscellinductionprotocol.Thefindingshowsanewlyavailablestemcellsourcecanbeobtainedfromeasilyavailableskin.Cellsfromautologoushumanskinmightbeusedforcornealdisordertreatmentinfutureclinicalapplication.
简介:<正>DearSir,IamDr.Sheng-LiMi,fromtheBiomanufacturingengineeringlaboratory,GraduateSchoolatShenzhen,TsinghuaUniversity,Shenzhen,China.Iwritetopresentacasereportofnocardiabrasiliensisinapatientwithdiabetes.Nocardiaispartofagroupofaerobicactinomycetes,widelydistributedinsoil.Nocardiaasteroidsandnocardiabrasiliensisarethemostcommonhumanpathogens.Humansinfectedbynocardiaasteroidsthroughtherespiratorytractmainlysufferfromprimarysuppurativepulmonaryconditions.Infectionofnocardiabrasiliensisoftenoccursintheadvancedstagesofaprogressivediseaseorimmunedisorder,especiallyCushingsyndrome,diabetes,orinpatientsusingcorticosteroids,immunosuppressiveagentsandbroad-spectrumantibioticsforlongtime[1].Toourknowledge,thereportsofnocardiakeratitiswasveryrare
简介:AIM:Toexaminetheexpressionofsurvivinandvascularendothelialgrowthfactor(VEGF)duringthedevelopmentofretinalneovascularization(NV)inamousemodel.·METHODS:Awell-characterizedmurinemodelofretinalNVwasusedtostudytheexpressionofsurvivinandVEGF.NVoftheretinawasinducedinmicebyexposureto75%O2frompostnataldayP7toP12,followedbyreturntoroomairfromP12toP17.ExpressionofsurvivinandVEGFproteinwasanalyzedbyImmunohistochemistry.Inaddition,mousemodelofproliferativeretinopathywasanalyzedbyretinalfluoresceinangiographyandquantificationanalysis.·RESULTS:Thenormalmicehadbothsuperfiekalanddeepvascularlayersthatextendedfromtheopticnervetotheperiphery.Inintraocularpressure(IOP)micewerecharacterizedbyrepresentatypicalpatternofpathologicalretinalNV.Therearelessorlittlenucleiofnewvesselsvascularendothelialcellbreakingthroughtheinnerretinalthaninretinopathyofprematurity(ROP)mice,largeclustersofbloodvesselswereadherenttotheinternallimitingmembrane(ILM)(0.27±0.20vs23.38±1.027,t=9.454,P<0.001).DuringtheangiogenicperiodfromP13toP17,survivinandVEGFproteinexpressionincreasedinexperimentalretinascomparedwithcontrolsamples(2.56±0.46vs3.34±0.40,t=17.43,P<0.01:2.18±0.75vs4.34±0.25,t=19.61,P<0.01).ProteinlevelsofVEGFandsurvivnhassignificantlypositivecorrelation(P<0.05,r=0.411).·CONCLUSION:CorrelationwasmadeattheproteinlevelsofsurvivinexpressioncomparedwiththatofVEGFinamurinemodelofretinalNV,whichsuggestsatemporalroleforsurvivinandVEGFinnewvesselformationinresponsetohypoxicstimulation.
简介:AIM:Toestablishanuntransfectedhumancornealstromal(HCS)celllineandcharacterizeitsbiocompatibilitytoacellularporcinecornealstroma(aPCS).·METHODS:PrimaryculturewasinitiatedwithapurepopulationofHCScellsinDMEM/F12media(pH7.2)containing20%fetalbovineserumandvariousnecessarygrowthfactors.Theestablishedcelllinewascharacterizedbygrowthproperty,chromosomeanalysis,tumorigenicityassay,expressionofmarkerproteinsandfunctionalproteins.Furthermore,thebiocompatibilityofHCScellswithaPCSwasexaminedthroughhistologicalandimmunocytochemistryanalysesandwithlight,electronmicroscopies.·RESULTS:HCScellsproliferatedtoconfluence2weekslaterinprimarycultureandhavebeensubculturedtopassage140sofar.AcontinuousuntransfectedHCScelllinewithapopulationdoublingtimeof41.44hoursatpassage80hasbeendetermined.Resultsofchromosomeanalysis,morphology,combinedwiththeresultsofexpressionofmarkerproteinandfunctionalproteinssuggestedthatthecellsretainedHCScellproperties.Furthermore,HCScellshavenotumorigenicity,andwithexcellentbiocompatibilitytoaPCS.·CONCLUSION:Anuntransfectedandnon-tumorigenicHCScelllinehasbeenestablished,andthecellsmaintainedpositiveexpressionofmarkerproteinsandfunctionalproteins.Thecellline,withexcellentbiocompatibilitytoaPCS,mightbeusedforinvitroreconstructionoftissue-engineeredHCS.
简介:AIM:ToIntroduceanewspecializedvisualacuitychartforamblyopicchildrenaged3-5yearsoldanditsclinicalapplications.METHODS:ThenewvisualacuitychartandnotationsweredesignedbasedonWeber-Fechnerlaw.Theoptotypeswereredagainstawhitebackgroundandwerespeciallyshapedfourbasicgeometricsymbols:circle,square,triangle,andcross.Aregulargeometricprogressionoftheoptotypesizesanddistributionwasemployedtoarrangein14lines.Theprogressionrateoftheoptotypesizebetweentwolineswas1.2589andthetestingdistancewas3m.VisualacuityscorecouldberecordedaslogMARnotationordecimalnotation.Agestratifieddiagnosticcriteriaforamblyopiaestablishedbyconsensusstatementondiagnosisofamblyopia(2011)amongmembersoftheStrabismusandPediatricOphthalmologyGroup,OphthalmologySociety,ChineseMedicalAssociation(SPOGOSCMA)wereillustratedinthenewvisualacuitychart.RESULTS:Whenassessingvisualacuityinchildrenaged3-5yearsold,thisnewvisualacuitychartthatconsistsoffoursymmetricalshapes(triangle,square,cross,andcircle)overcameaninabilitytorecognizethelettersofthealphabetanddifficultiesindesignatingthedirectionofblackabstractsymbolssuchasthetumbling’E’orLandolt’C’,whichthesubjectswerepronetoloseinterestin.Thevisualacuityscoremayberecordedindifferentnotations:decimalacuityandlogMAR.Thesetwonotationscanbeeasilyconvertedeachotherintheneweyechart.Themeasurementsofthisnewchartnotonlyshowedasignificantcorrelationandagoodconsistencywiththeinternationalstandardlogarithmicvisualacuitychart(r=0.932,P<0.01),butalsoindicatedahightest-retestreliability(89%ofretestscoreswerewithin0.1logMARunitsoftheinitialtestscore).CONCLUSION:Theresultsofthisstudysupportthevalidityandreliabilityofdistancevisualacuitymeasurementsusingtheneweyechartinchildrenaged3to5yearsoverawiderangeofvisualacuities,andtheneweyechartisgreatforearl
简介:AIM:Toaddressissuesininteroperabilitybetweendifferentfundusimagesystems,weproposedawebeyepicturearchivingandcommunicationsystem(PACS)frameworkinconformancewithdigitalimagingandcommunicationinmedicine(DICOM)andhealthlevel7(HL7)protocoltorealizefundusimagesandreportssharingandcommunicationthroughinternet.METHODS:Firstly,atelemedicine-basedeyecareworkflowwasestablishedbasedonintegratingthehealthcareenterprise(IHE)EyeCaretechnicalframework.Then,abrowser/serverarchitectureeye-PACSsystemwasestablishedinconformancewiththewebaccesstoDICOMpersistentobject(WADO)protocol,whichcontainsthreetiers.RESULTS:Inanyclientsysteminstalledwithwebbrowser,clinicianscouldlogintheeye-PACStoobservefundusimagesandreports.Multipurposeinternetmailextensions(MIME)typeofastructuredreportissavedaspdf/htmlwithreferencelinktorelevantfundusimageusingtheWADOsyntaxcouldprovideenoughinformationforclinicians.Somefunctionsprovidedbyopen-sourceOviyamcouldbeusedtoquery,zoom,move,measure,viewOICOMfundusimages.CONCLUSION:Suchwebeye-PACSincompliancetoWADOprotocolcouldbeusedtostoreandcommunicatefundusimagesandreports,thereforeisofgreatsignificanceforteleophthalmology.