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:目的:本文旨在通过对比白内障患者术后进行的计算机随机点立体视图和TNO立体视觉检查图的检查结果,评价计算机随机点立体视图的实用性及可行性。方法:选择2011-01/06于我院行双眼白内障超声乳化摘除术,双眼间隔1d,并且联合行折叠式人工晶状体植入术的受试者78例作为研究对象,手术均由同一熟练的超声乳化手术医师完成。患者术后定期随访,于术后3mo由同一医师分别使用计算机随机点立体图和TNO立体视检查图检查立体视觉并比较其结果差异。结果:所有受试者均具有不同程度的立体视,由计算机随机点立体图测得黄斑部位立体视患者14例,黄斑中心凹部位立体视患者26例,眼底周边部位立体视38例;TNO立体视觉检查图分别为11例,24例和43例,黄斑立体视、黄斑中心凹立体视随机点检出率较TNO图高,但是两者差异无统计学意义。使用计算机随机点立体图测得的正常与异常立体视结果为32例、46例,使用TNO立体视检查图测得的正常与异常立体视结果为35例、43例,差异无统计学意义。结论:新型计算机随机点立体视图对白内障术后立体视检查的结果与TNO立体图具有较高的一致性,是一种可靠的测量立体视功能的方法,可以用于白内障患者术后立体视觉功能的检测。
简介:目的:观察MoriaM2型90与110μm角膜刀制作角膜瓣在准分子激光角膜原位磨镶术(laserinsitukeratomileusis,LASIK)的疗效和并发症,探讨MoriaM2型90刀头在LASIK中应用的有效性、安全性和优点。方法:选取通过术前检查并自愿行LASIK手术的患者105例202眼,按随机数字表分成两组,使用MoriaM2型90刀头LASIK患者51例98眼,110刀头LASIK患者54例104眼做对照,术后即使用光学相干断层扫描仪(OCT)检测两组角膜瓣厚度,观察两组术后1d;1wk;1,3mo裸眼视力、矫正视力和角膜瓣形态、对合情况、并发症。结果:90刀头组术后角膜瓣厚度为118.3±15.2μm,110刀头组术后角膜瓣厚度为130.5±17.1μm,有显著性差异。90刀头组均未发现层间点状金属碎屑,110刀头组有层间点状金属碎屑个例(12例),有显著性差异。两组角膜瓣形态、对合情况、术后反应、术后裸眼视力相当。结论:应用90刀头LASIK的疗效及并发症和110刀头LASIK相当,但90刀头保留角膜基质床相对较厚,可矫治的屈光度更大,术后层间点状金属碎屑并发症更少,具有更好的安全性和更宽的适应范围。
简介:AIM:Toassesstheeffectivenessofimmunosuppressantsintheprophylaxisofcornealallograftrejectionafterhigh-riskkeratoplastyandnormal-riskkeratoplasty.METHODS:WesearchedtheCochraneCentralRegisterofControlledTrials(CENTRAL),MEDLINE,EMBASE,CNKI,VIPandreferencelistsofarticles.Dateofmostrecentsearch:18June,2011.Allrandomisedcontrolledtrials(RCTs)assessingtheuseofimmunosupressantsinthepreventionofgraftrejection,irrespectiveofpublicationlanguage.Twoauthorsassessedtrialqualityandextracteddataindependently.Onlydichotomousoutcomes(cleargraftsurvival,ratioofimmunereactionsandsideeffects)wereavailableandwereexpressedasrelativerisk(RR)and95%confidenceintervals(CI).RESULTS:Sevenstudieswereincludedinthisreview.Inthecomparingofmycophenolatemofetil(MMF)withplacebo,theresultsshowedMMFcouldsignificantlyreduceimmunereactionscomparedwithplacebo(RR1.0895%Cl0.95to1.21),butnoeffectoncleargraftsurvival(RR1.1195%Cl0.90to1.35).Incleargraftsurvivalandimmunereactions,MMFandcyclosporineA(CsA)showedsimilareffect(RR1.1195%Cl0.90to1.35,andRR1.48,95%Cl0.56to3.93,respectively).Tacrolimus(FK506)andsteroidshowedsimilareffectsoncleargraftsurvivalandimmunereactions(RR0.32,95%CI0.02to6.21,andRR1.00,95%CI0.88to1.14,respectively).Nodrugrelativesideeffecthasbeenfound.CONCLUSION:MMFmayreduceimmunereactionsinbothnormal-riskandhigh-riskrejectionofpenetratingkeratoplasty.CsAandFK506showedsimilareffectsasMMF.However,duetothelackoflargeclinicaltrials,theevidenceremainweak,thequalityofevidenceswereratedasverylowtomoderate.Large,properlyrandomised,placebo-controlled,doublemaskedtrialsareneededtoevaluatetheeffectofimmunosuppressants.
简介:目的观察自制全结膜囊羊膜固定器在重症眼表烧伤行羊膜遮盖手术中应用效果。方法在11例(13眼)眼部重症烫伤患者治疗中采用自制全结膜囊羊膜固定器将羊膜固定于眼表及眼睑皮肤面。根据病情需要更换羊膜,随访3月至3年。结果患者平均手术时间为(8.0±3.0)分钟;眼表组织上皮化时间(13.2±11.3)天。重复手术次数3.5次,患者手术依从性良好,观察病例无角膜穿孔,无睑球粘连。结膜囊狭窄5例,角膜斑翳5例,角膜血管化2例。结论采用自制全结膜囊羊膜固定器手术,缩短手术时间,无创伤,重症烧伤患者可多次重复手术,特别适合重症眼表烧伤早期治疗,减少晚期严重并发症的发生。
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: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