简介:目的比较急性中心性浆液性脉络膜视网膜病变(CSC)的患侧与对侧眼视网膜频域相干光断层扫描(OCT)的图像特征。方法应用频域OCT对30例(60眼)单眼发病急性CSC患者患侧和对侧眼的黄斑部视网膜显微结构进行检测,比较患侧组与对侧组黄斑中心凹外核层厚度、光感受器层(IS/OS层)、视网膜色素上皮(RPE)形态差异。结果所有30例患者患侧眼均有不同程度黄斑部视网膜浆液性脱离,对侧眼中有4眼(13.3%)存在轻度视网膜浆液性脱离;患侧组黄斑中心凹外核层厚度均值为(95.32±24.87)μm,对侧组为(98.80±14.36)μm,两组差异无统计学意义(t=1.627,P=0.110)。患侧组中IS/OS层厚度均匀一致者12眼(40.0%),对侧组20眼(66.7%);患侧组IS/OS层厚度均匀一致伴内外节缺损、不均、凸起增厚者共18眼(60.O%),对侧组共10眼(33.3%),差异有统计学意义(X2=4.28,P=0.038)。患侧组中出现RPE异常者有24眼(80.0%),对侧组中有8眼(26.7%),差异有统计学意义(x。=17.143,P=0.000)。结论频域OCT能清晰显示急性CSC患者的细微病理结构改变,单眼发病CSC患者中一部分对侧眼存在IS/OS层和RPE异常,但是其发生率较患侧眼低。(中国眼耳鼻喉科杂志,2013,13:165—167)
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:·AIM:Toexploretheeffectofimmunizationwithcopolymer-1(COP-1)andretinalstemcells(RSCs)transplantationoninterferon-gamma(IFN-γ)levelsinaratexperimentalglaucomamodel.·METHODS:Anexperimentalglaucomawasinducedbyargonlaserphotocoagulationoftheepiscleralveinsandlimbalplexusintherighteyeofrats.Immediatelyfollowingglaucomainduction,ratswereimmunizedwithCOP-1.RSCswereculturedandtransplantedintravitreallyintotheeyesofglaucomamodelanimals1weekpost-lasertreatment.Sixexperimentalgroupswereused:COP-1/RSC,PBS/RSC,COP-1/PBS,PBS/PBS,glaucomamodelgroup,andanormalcontrolgroup.TheconcentrationofIFN-γinaqueoushumor(AH)andserumwasmeasuredbyenzyme-linkedimmunosorbentassay(ELISA)ineachofthesixgroups.Retinalganglioncell(RGC)survivalwasassessedbyquantifyingapoptosisusingHoechststaining.·RESULTS:ConcentrationsofIFN-γinAHandserumofratsthathadundergoneglaucomainductionwerehigherthanthoseofnon-inducedcontrolrats.TheconcentrationsofIFN-γinAHandserumoftheCOP-1/RSCstreatedgroupweredeterminedtobe2371.9ng/Land710.9ng/L,respectively,whichweresignificantlylowerthanthoseintheothertreatedgroups(P<0.05).Infact,IFN-γlevelsinthedualtreatedgroupwerereducedtobackgroundlevels.TheCOP-1/RSCgrouphadlowernumberofapoptoticRGCsthantheotherthreeexperimentalgroups(P<0.05).·CONCLUSION:ThereducedlevelsofIFN-γinAHandserumoftheCOP-1/RSCgroupmayberelatedtosynergisticeffectsbetweenRSCstransplantationandCOP-1immunemodulation.ItislikelythatthelowerlevelsofIFN-γpreventedRGCsglaucomatousapoptosis.·
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