简介:AIM:Todefinetheultrasonographicstructureofnormallowereyelidanatomiccompartmentsandtheirspacialrelationshipindynamicmotion.METHODS:Highresolutionultrasound(15MHz)wasperformedonthelowereyelidsof7normalsubjects.Movementsofthelowereyelidanditscompartmentswerevisualizedwithultrasound.Inaddition,themaximalexcursionareaofthelowereyelidfatcompartmentsandretractormotionswasmeasuredbeforeandaftermotion.RESULTS:Theorbicularismusclecouldbeseenasanecholucentstructurebetweenthedermisandtheechodencefatpads.Lowereyelidfatpadseemstobedividedinto2compartmentsasrangeofmotionanddirectionofmovementofeachofthemvaries.Itseemsthatthesecompartmentshavealsodifferentbehavior.Themeasuredprofileareaofthevisiblenormallowereyelidfatpadsduringmovementofglobefromup-gazetodown-gazedecreasedby50%.Orderofmovementoflowereyelidstructuresseemstobeasfollows:afterglobemovementfistweseeretractormovement,anteriororbitalfatpad,thenskinandseptum,andfinallymovementofinferiorfatpad.CONCLUSION:Ultrasoundrepresentsanoninvasivetoolforthevisualizationoflowereyelidmorphology.Expandingitsapplicationcouldhelpusunderstandthecompartmentalchangesinphysiologicaleyelidmovement,inaginganddiseasedstudypopulations,aswellasassessoperativeoutcomes.
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:目的对改良翼状胬肉手术方法进行安全性评估的研究。方法188例翼状胬肉患者随机分为实验组和对照组。实验组接受改良方法进行翼状胬肉手术。对照组按照《眼科手术图谱》传统翼状胬肉切除术方法进行手术。记录所有患者手术时间、术后角膜上皮修复时间。术后每周随访,记录术后1周、2周、3周、4周时结膜充血情况及结膜充血完全消退时间。随访3个月,记录发生角巩膜溃疡、结膜肉芽以及翼状胬肉复发的病例数。结果实验组有96人完成随访,对照组有92人完成随访。实验组患者角膜上皮修复时间为2.42±0.68天,对照组为4.27±1.05天,P〈0.05,差别有统计学意义;实验组结膜充血评分术后1周、2周、3周、4周时分别为3.31±0.47、2.76±0.74、1.89±0.860.94±0.70,对照组分别为3.84±0.37、3.58±0.67、2.93±0.71、1.85±0.78,两两比较P〈0.05,差别有统计学意义。结膜充血消退时间实验组为5.15±0.92周,对照组为7.20±1.08P〈0.05,差别有统计学意义。实验组未发生结膜肉芽,对照组为14例,P〈0.05,差别有统计学意义。实验组发生角巩膜溃疡4例、复发4例,对照组为7例、5例,P〉0.05,差别无统计学意义。结论改良的翼状胬肉手术方法在术后角膜上皮修复时间、术后结膜充血程度、结膜充血消退时间、结膜肉芽发生率上忧于传统手术方法,差别有统计学意义。在角膜溃疡发生率、翼状胬肉复发率上改良手术方法与传统手术差别无统计学意义。
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:目的探讨数字化多媒体系统矫治训练对大龄儿童弱视的治疗效果。方法选取2013年1月至2016年1月我院门诊收治的大龄弱视患儿86例(128眼),作为研究对象。根据患儿治疗方案的差异将其分为观察组与对照组,对照组45例患儿接受常规综合治疗措施,观察组41例患儿接受数字化多媒体系统治疗,比较两组患儿治疗后双眼视功能变化及疗效。结果观察组患儿治疗后总有效率明显高于对照组,并且观察组患者立体视改善率明显高于对照组,P〈0.05,差异具有统计学意义。结论对大龄弱视患儿采取数字化多媒体系统治疗可有效改善患儿弱视症状,提高患儿双眼视功能,缩短患儿视功能障碍治疗时间,具有临床应用及推广价值。
简介:目的分析个性化角膜切口对白内障术后角膜散光及裸眼视力的影响。方法90例(106眼)白内障患者分为2组,试验组选择位于角膜最大屈光度径线上透明角膜切口,对照组选择11:00处的透明角膜切口,行白内障超声乳化人工晶状体植入术。术前及术后1周、1个月、3个月分别检测患者角膜散光及视力情况。结果术后1个月和3个月试验组裸眼视力分别为(4.9±0.15)、(5.0±0.15),显著优于对照组的(4.8±0.18)、(4.8±0.20),差异有统计学意义(P〈0.05)。术后1个月和3个月试验组角膜散光度分别为(0.78±0.39)、(0.79±0.40),明显低于对照组的(1.53±0.32)、(1.52±0.28),差异有统计学意义(P〈0.05)。结论白内障患者术前大多存在〈1.5D的角膜散光。采用个性化角膜切口可降低白内障手术角膜源性散光,术后视力恢复好,是一种简便、可行的手术切口。(中国眼耳鼻喉科杂志,2013,13:168—169,172)
简介:目的:通过对Q值调整非球面切削与标准化LASIK术后视觉质量的观察来分析Q值引导个性化切削技术的临床效果。方法:对2008-01/05等效球镜低于-12.00D的46例88眼进行非球面切削或标准化LASIK术后进行随访,按术前屈光度数将其分为A组(〈-6.00D)和B组(-6.00~-12.00D)两组,对比各组非球面切削与标准化LASIK术后1mo裸眼视力、Q值、夜间眩光、夜间视物质量及满意率(后3者采取问卷调查)。结果:A、B组内非球面切削与标准化LASIK术后裸眼视力差异无统计学意义(t=1.18,P〉0.05;t=0.62,P〉0.05);A、B组内非球面切削与标准化LASIK术后Q值差异无统计学意义(t=-0.93,P〉0.05;t=-0.372,P〉0.05);A组内非球面切削与标准化LASIK术后眩光、夜间视物质量差异无统计学意义(眩光:χ^2=2.397,P&gt;0.05;夜间视物质量:χ2=1.263,P〉0.05);B组内非球面切削与标准化LASIK术后眩光、夜间视物质量差异有统计学意义(眩光:χ^2=10.85,P〈0.01;夜间视物质量:χ^2=10.85,P〈0.01);术后效果满意率达到98%。结论:非球面切削能明显改善-6.00D以上的术后主观视觉质量。
简介:目的方法结果结论对安徽省两地人群盲和低视力及眼病的流行病学情况进行抽样调查。选择阜阳市颍州区和宣城市绩溪县,采用随机整体抽样方法,对所属居民进行眼部及其他情况的调查。两地的受检人数和受检率分别为3336人(91.40%)和3602人(92.10%),达到抽样调查要求;两地双眼盲、单眼盲、双眼低视力和单眼低视力的患病率分别为1.05%和0.69%、1.71%和1.25%、1.02%和0.97%、0.87%和0.89%;两地盲和低视力的主要原因分别为:白内障、弱视、青光眼和白内障、眼球萎缩/缺如、青光眼;两地主要眼病都为:屈光不正、白内障、翼状胬肉和沙眼;两地的白内障手术率分别为600和278。据不完全资料估计我省盲和低视力的患病率远高于全国平均水平,盲和低视力的高发人群为50岁以上老年人,女性,孤寡,文盲,低收入者,白内障仍是最主要致盲原因,屈光不正/弱视已日益成为影响人民特别是青少年视力的最主要因素,广泛宣传正确用眼方式,推广青少年正确验光配镜方法,提高相关人员验光配镜水平对于有效降低弱视致残率至关重要。
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:目的:探讨规模化白内障手术中高龄及其伴全身疾病患者安全性。方法:回顾性分析"爱心光明行"活动中高龄及其伴全身疾病患者的临床资料。结果:本组高龄伴全身疾病患者213例(90.6%),其中循环系统疾病、代谢性疾病、呼吸系统疾病分别占65.1%,13.6%和11.1%。术前因首次全身疾病评估暂缓手术25例(10.6%),经有效治疗后手术。手术脱残率95.4%,脱盲率84.2%,12例视力〈0.1患者眼底检查均有不同程度的眼底病变。结论:加强术前综合因素评估,充分治疗全身疾病,严格掌握手术适应证,术中监护,操作轻巧,手术时间10~15min,是保证规模化白内障手术中高龄或伴全身疾病患者安全性的有效措施。
简介:目的对临床可疑青光眼患者进行长期的偏振激光扫描仪联合个体化角膜补偿技术(scanninglaserpolarimetrywithvariablecornealcompensation,GDxVCC)随访,分析GDxVCC对该类患者的诊断价值。方法选取门诊可疑青光眼的眼底检查视乳头杯/盘比(C/D)≥0.4,或双眼不对称且C/D差值〉10.2,静态视野检查结果正常患者68例,随访前后均用GDxVCC检查(采用相同的角膜补偿值)。如双跟C/D值相同,随机选取1眼,如C/D值不同,则选取C/D值大的1眼,对结果进行t检验统计学分析。结果随访时间6~30个月,平均(12.5±7.0)个月,眼底C/D值为0.57±0.17。随访前后GDxVCC检查:椭圆平均值分别为50.33±7.72和49.66±8.12,上方平均值为58.72±13.56和58.18±12.01,下方平均值为60.71±11.31和59.13±11.95,神经纤维指数为30.85±19.62和33.03±21.22,差异无统计学意义,但从绝对数值上,椭圆平均值、上方平均值和下方平均值变小,神经纤维指数变大。其中7例(10.3%)诊断为青光眼,21例(30.9%)排除青光眼,40例(58.8%)仍需进一步随访。结论对临床怀疑青光眼的患者应长期进行随访,GDxVCC随访对青光眼的诊断有一定的价值。(中国眼耳鼻喉科杂志,2009,9:92—94)
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.
简介:AIM:Toinvestigatethespecialtyoftranscranialsurgerythroughpterionalapproachforremovalofcranio-orbitaltumors,introducetheophthalmologicalexperiencesofenteringtheorbittoreducetheincidencerateofassociatedcomplicationsofthisoperation.·METHODS:Weperformedaretrospectiveanalysisofaseriesof37casesinvolvingpatientswhounderwenttranscranialsurgerythroughpterionalapproachfortreatmentofcranio-orbitaltumorsinourdepartmentinthepast8years.Pterionapproachcraniotomywasperformedtoallpatients.Afterremovingtumorsintheskullbytheneurosurgeon,ophthalmologistremovedtumorsinorbit.Wetookmeasuresbelowtodecreasecomplications,includinggroundingopticcanalthroughanabrasivedrillingwhennecessary,hangingvariousextraocularmusclestobeexposedforprotection,refrigeratingbyrefrigerationheadstoremovetumors,atlastsewinguporbitseptumaftersurgery.·RESULTS:Tumorswereremovedcompletelyin32cases,andincompletein5casesduetoextensiveinvasionintothecavernoussinusorsphenoidsinus.Ofallthecases,benigntumorsweredemonstratedin28cases(75.6%,28/37)andmalignantin9(24.3%,9/37).Themostcommonlesiontypewasmeningiomain11cases(29.7%,11/37).Extraocularmuscles(EOM)impairment,occurringin21cases(56.7%,21/37),wasthemostfrequentpostoperativecomplication.Themostseriousconsequencewasvisionlossoccurredin4cases(10.8%,4/37).Othercomplications,suchas11casesoftransientblepharoptosis29.7%(11/37),5casesofmydriasisin13.5%(5/7);2casesofcerebrospinalrhinorrheain5.4%(2/37).·CONCLUSION:Cranio-orbitaltumorscanberemovedcompletelyusingtranscranialapproach,andthepterionalapproachoffersexcellentexposure.Cooperationofinterdisciplinaryteamofneurosurgeonsandophthalmologistsconducestofulluseofrespectiveprofessionaladvantages.Theexperienceofophthalmicoperationtechnologycandecreaseoccurrenceofocularcomplicationsaftersurger
简介:AIM:Toassesstheawarenessofeyecomplicationsandtheprevalenceofretinopathy,inthefirstvisittoeyeclinic,amongtype2diabeticpatientsattendingatertiarymedicalcentreinKualaLumpur,Malaysia.METHODS:Aninvestigator-administeredquestionnairewasgivento137patientswithdiabetesundergoingfirsttimeeyescreeningintheeyeclinic.Thiswasfollowedbyadetailedfundusexaminationbyaseniorophthalmologisttoassessforpresenceofretinopathy.RESULTS:Almost86%ofrespondentswereawareofdiabeticeyecomplications,especiallyinpatientswhohadachievedtertiaryeducationallevel(96.3%).Themajorityofthepatients(78.8%)werereferredbytheirphysiciansandonly20.4%cameontheirowninitiative.Manyofthepatients(43.8%)didnotknowhowfrequenttheyshouldgoforaneyecheck-upand72.3%didnotknowwhattreatmentswereavailable.Lackofunderstandingondiabeticeyediseases(68.6%)wasthemainbarrierformostpatientsfornotcomingforeyescreeningearlier.Despiteahighlevelofawareness,only21.9%hadrecordedHbA1clevelof<6.5%while31.4%wereundertheerroneousassumptionofhavingagoodbloodsugarcontrol.Atotalof29.2%haddiabeticretinopathyintheirfirstvisiteyetesting.CONCLUSION:Inthepresentstudy,29.2%oftype2diabeticpatientshadretinopathyintheirfirsttimeeyetesting.Althoughtheawarenessofdiabeticeyecomplicationswashighamongfirsttimeeyescreeningpatients,theappropriateeyecare-seekingbehaviorwascomparativelylessandshouldberectifiedtopreventtheriseofthissightthreateningeyedisease.