简介：视网膜脱离是常见的致盲性疾病,光感受器细胞损伤严重影响着患者的视力。以往认为光感受器细胞最常见的损害方式是坏死和凋亡,而坏死性凋亡作为可调控的细胞死亡形式,近年来也得到了广泛关注。自噬是促进细胞生存的重要代谢机制,在一定程度可以抑制细胞的凋亡和坏死,但是目前研究细胞自噬和细胞坏死性凋亡的文章甚少,其中的作用机制也尚未明确。本文就坏死性凋亡和自噬在视网膜脱离中的机制和相互关系作一综述。

简介：目的：利用频域三维相干光学断层扫描（threedimensionalfrequencydomaincoherentopticaltomography,3D-OCT）评估准分子激光原位角膜磨镶术（laserinsitukeratomileusis,LASIK）对视网膜神经纤维层厚度（retinalnervefibrelayerthickness,RNFLT）的影响。方法：对83例83右眼接受LASIK治疗的受试者分别于术前及术后1d;1wk;1,3mo行3D-OCT检查,测量视乳头上方、下方、鼻侧、颞侧及12个钟点位RNFLT,利用重复测量方差分析及配对t检验对术前及术后的数据统计学处理。结果：术前及术后各时间点行重复测量方差分析显示,视乳头下方、颞侧、5：00～11：00位RNFLT均值无显著差异（P〉0.05）,而视乳头上方、鼻侧、1：00～4：00位、12：00位RNFLT有显著差异（P〈0.05）;进一步对术前及术后各时间点视乳头上方、鼻侧、1：00～4：00位、12：00位RNFLT分别行配对t检验得出,术后1d时视乳头上方、鼻侧及1：00～4：00位、12：00位RNFLT较术前变薄,差异有统计学意义（P〈0.05）,术后1wk;1,3mo时以上各方位RNFLT较术前比较均无统计学差异（P〉0.05）。同时表明RNFLT变薄与屈光度及激光时间成正相关。结论：LASIK术后早期上方及鼻侧RNFLT变薄,但术后1wk恢复至正常水平,LASIK手术对RNFLT无长远影响。

简介：AIM:Tofindouttheoutcomeoflaserphotocoagulationinclinicallysignificantmacularedema(CSME)byopticalcoherencetomography(OCT).·METHODS:Itwasaprospective,non-controlled,caseseriesstudyenrolling81eyesof64patientswithCSMEbetweenAugust2008andJanuary2010.AllpatientsreceivedmodifiedgridphotocoagulationwithfrequencydoubledNd:YAGlaser.Eachpatientwasevaluatedintermsofbest-correctedvisualacuity(BCVA)andregressionorprogressionofmaculopathyafterlasertherapyat1,3and6months.Spearman’scorrelationtestwasusedtoshowthecorrelationbetweenBCVAandtotalmacularvolume(TMV).Analysisofvariance(ANOVA)wasusedtocompareamonggroupsandindependentt-testwasusedtocompareineachgroup.·RESULTS:ThereishighcorrelationbetweenBCVAandTMV(P≤0.001).BCVAimprovedin50.6%,remainedstaticin39.5%anddeterioratedin9.9%patientsafter6monthoftreatment.TheBaselineTMV(meanandSD)were9.26±1.83,10.4±2.38,11.5±3.05,8.89±0.75and9.47±1.98mm3fordifferentOCTpatterns,ST(spongelikethickening),CMO(cystoidmacularedema),SFD(subfovealdetachment),VMIA(Vitreomacularinterfaceabnormality)andaverageTMVrespectively(P=0.04).After6monthsoflasertreatment,themeanTMVdecreasedfrom9.47±1.98mm3to8.77±1.31mm3(P=0.01).InSTtherewassignificantdecreaseinTMV,P=0.01,Furtherwithinthesegroupsat6months,theyweresignificantlydifferent,P=0.01.·CONCLUSION:OCTshowedthedifferentmorphologicalvariantofCSMEwhiletheresponseoftreatmentisdifferent.TMVdecreasedthemostandhenceshowedtheimprovementinvisionafter6monthsoflasertreatment.IntheeraofAntivascularendothelialgrowthfactors(VEGFs),efficacyoflaserseemstobeinshadowbutitisstillfirstlineoftreatmentindevelopingnationlikeNepalwhereantiVEGFsmaynotbeeasilyavailableandaffordable.

简介：目的：观察早期衰老大鼠视网膜色素上皮-光感受器细胞复合体超微结构的变化。方法：取3月龄及12月龄大鼠视网膜,制成半薄切片,透射电镜下观察视网膜色素上皮-光感受器细胞复合体超微结构的变化。结果：12月龄大鼠视网膜中出现视网膜色素上皮细胞（retinalpigmentepithelium,RPE）凋亡和RPE-光感受器细胞复合体的退行性改变。结论：视网膜色素上皮-光感受器细胞复合体的退行性改变是视网膜衰老的早期表现。

简介：目的：探讨眼附属器B细胞非霍杰金淋巴瘤（B—cellnon-Hodgkinlymphoma，NHL）中Skp2，p27和PTEN的表达。方法：收集1995年到2011年青岛大学附属医院眼科石蜡包埋标本，用免疫组化法分别检测眼附属器B细胞NHL（n=30）标本中Skp2，p27和PTEN的表达，以眼部反应性淋巴组织增生（n=10）作为对照组。以患者的年龄、性别、发病部位，病理类型作为眼附属器B细胞NHL的的分类标准。结果：Skp2，p27和PTEN的表达与患者的年龄、性别、发病部位无关，而与病例类型有关。眼附属器B细胞NHLSkp2表达率与眼部反应性淋巴组织增生相比显著增高。p27，PTEN表达率与反应性淋巴组织增生相比显著降低。随眼附属器B细胞NHL病理分级的提高，Skp2的表达显著增高，p27和PTEN的表达显著降低。在黏膜相关淋巴组织结（mucosa—associatedlymphoidtissue，MALT）外边缘区B细胞淋巴瘤（diffuselargeB—celllymphoma，DLBCL）中，Skp2分别与p27，VFEN成负相关，p27和PTEN成正相关。结论：Skp2的表达升高，p27，PTEN蛋白的缺失以及可能与眼附属器B细胞NHL的发生有关；其中在MALT外边缘区DLBCL中，三种蛋白存在相关性。联合三种蛋白的检测眼附属器B细胞NHL的不同病理类型有重要意义。

简介：AIM:Topresenttheoutcomeofmodifiedgridlaserphotocoagulation(GLP)indiffusediabeticmacularedema(DDME)ineyeswithoutextrafovealand/orvitreofovealtraction.METHODS:InclusioncriteriafortheretrospectivestudywereDDMEeyesofpatientswithtypeⅡdiabetesmellitusthathad≥4monthsoffollow-upfollowingGLP.Onlyoneeyeperpatientwasanalyzed.Using3-Dspectral-domainopticalcoherencetomography(3-DSDOCT),eyesthathadeitherextrafovealorvitreofovealtraction,orhadbeenpreviouslytreatedbyanintravitrealmedication(s)wereexcluded.TreatedDDMEeyesweredividedinto4groups:A)'Classic'DDMEthatinvolvedthecentralmacula;B)edemadidnotinvolvethemacularcenter;C)eyesassociatedwithcentralepiretinalmembrane(ERM);D)DDMEthatwasassociatedwithmacularcapillarydropout≥2disc-diameter(DD).RESULTS:GLPoutcomein35DDMEeyesafter4-24(mean,13.1±6.9)monthswasasfollows:GroupA)18eyeswith'classic'DDME.Followingoneor2(mean,1.2)GLPtreatments,best-correctedvisualacuity(BCVA)improvedby1-2Snellenlinesin44.4%(8/18)ofeyes,andworsenedby1linein11.1%(2/18).Centralmacularthickness(CMT)improvedby7%-49%(mean,26.6%)in77.8%(14/18)ofeyes.CausesofCMTworsening(n=4)werecommonlyexplainable,predominantly(n=3)associatedwithemergenceofextrafovealtraction,5-9monthspost-GLP.GroupB)GLP(s)inDDMEthatdidnotinvolvethemacularcenter(n=6)resultedinimprovedBCVAby1-2linesin2eyes.However,thecentralmaculabecameinvolvedintheedemaprocessaftertheGLPin3(50%)eyes,associatedwithanemergenceofextrafovealtractioninoneoftheseeyes4monthsfollowingtheGLP.GroupC)GLPfailedinall5eyesassociatedwithcentralERM.GroupD)GLPwasofpartialbenefitin2of6treatedeyeswithmacularcapillarydropout≥2DD.CONCLUSION:EyeswithDDMEthatinvolvedthemacularcenterwerefoundtoachievefavourableoutcomesafterGLP(s)duringmid-termfollow-up,unlesscomplicatedpre-GLPorpost-GLPbyvltreoretinalinterfaceabnormalities,oftenextrafovealtra

简介：目的观察Ex-press青光眼引流器植入术治疗难治性青光眼患者的疗效及安全性。方法选取2015年月—520177月我院难治性青光眼患者74例（74眼）,依据治疗方案不同分组,各37例（37眼）。观察组行Ex-press青光眼引流器植入术,对照组行小梁切除术。统计对比两组手术成功率及并发症发生情况。结果观察组手术成功率.49%（32/较对8637）照组59.46%（22/37）高,且并发症发生率18.92%（7/37）较对照组40.54%（15/37）低,差异有统计学意义（P〈0.05）。结论Ex-press青光眼引流器植入术应用于难治性青光眼治疗中,可进一步提高治疗效果,且安全性较高。

简介：AIM:Toinvestigatetheaccuracyofintraocularpressure(IOP)asmeasuredbyaReichertOcularResponseAnalyzer(ORA),aswellastherelationshipbetweencentralcornealthickness(CCT)andIOPasmeasuredbyORA,Goldmannapplanationtonometry(GAT),anddynamiccontourtonometry(DCT).·METHODS:Atotalof158healthyindividuals(296eyes)werechosenrandomlyformeasurementofIOP.AfterCCTwasmeasuredusingA-ultrasound(A-US),IOPwasmeasuredbyORA,GAT,andDCTdevicesinarandomizedorder.TheIOPvaluesacquiredusingeachofthethreetonometrieswerecompared,andtherelationshipbetweenCCTandIOPvalueswereanalyzedseparately.TwoIOPvalues,Goldmann-correlatedIOPvalue(IOPg)andcorneal-compensatedintraocularpressure(IOPcc),weregotusingORA.ThreegroupsweredefinedaccordingtoCCT:1)thincornea(CCT<520μm);2)normal-thicknesscornea(CCT:520-580μm);and3)thickcornea(CCT>580μm)groups.·RESULTS:Innormalsubjects,IOPmeasurementswere14.95±2.99mmHgwithORA(IOPg),15.21±2.77mmHgwithORA(IOPcc),15.22±2.77mmHgwithGAT,and15.49±2.56mmHgwithDCT.Meandifferenceswere0.01±2.29mmHgbetweenIOPccandGAT(P>0.05)and0.28±2.20mmHgbetweenIOPccandDC(P>0.05).TherewasagreatercorrelationbetweenIOPccandDCT(r=0.946,P=0.000)thanthatbetweenIOPccandGAT(r=0.845,P=0.000).DCThadasignificantcorrelationwithGAT(r=0.854,P=0.000).GATwasmoderatelycorrelatedwithCCT(r=0.296,P<0.001),whileIOPccshowedaweakbutsignificantcorrelationwithCCT(r=0.155,P=0.007).TherewasastrongnegativecorrelationbetweenCCTandthedifferencebetweenIOPccandGAT(r=-0.803,P=0.000),withevery10increaseinCCTresultinginanincreaseinthisdifferenceof0.35mmHg.Thethickcorneagroup(CCT>580μm)showedtheleastsignificantcorrelationbetweenIOPccandGAT(r=0.859,P=0.000);whilethethincorneagroup(CCT<520μm)hadthemostsignificantcorrelationbetweenIOPccandGAT(r=0.926,P=0.000).ThecorrelateddifferencesbetweenIOPccan