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：AIM:Todeterminewhethersinglenucleotidepolymorphism(SNP)rs641153isassociatedwiththeriskofage-relatedmaculardegeneration(AMD),weperformedasystematicmeta-analysisof15eligiblestudies.SNPinthecomplementfactorB(CFB)geneisconsideredtohavesignificantassociationwithAMDsusceptibility,butthereisgreatdiscrepancyintheseresults.METHODS:TheeligiblestudieswereidentifiedbysearchingthedatabasesofPubMed,EMBASE,andWebofScience.Oddsratios(ORs)with95%confidenceintervals(CIs)wereusedtoassesstheassociation.AlldatawereanalyzedusingStatasoftware.RESULTS:Theassociationbetweenrs641153andAMDriskwasstatisticallysignificantunderthehomozygousmodel(AAvsGG:OR=0.26,95%CI=0.15-0.45,P_h=0.973,/~2=0.0%,fixedeffects),dominantmodel(AA+GAvsGG:OR=0.49,95%CI=0.40-0.59,P_h=0.004,/~2=56.4%,randomeffects)andrecessivemodel(AAvsGA+GG:OR=0.30,95%CI=0.17-0.51,R_n=0.983,I~2=0.0%,fixedeffects).Thesameresultswerealsoobservedinthestratifiedanalysesbyethnicity,sourceofcontrolandsamplesize.CONCLUSION:Ourmeta-analysissuggeststhatrs641153intheCFBgenemayplayaprotectiveroleinAMDsusceptibility,thelateAMDinparticular,bothinCaucasiansandinAsians.

简介：目的：系统评价拉坦前列素（Latanoprost）滴眼液与噻吗心安（Timolol）滴眼液降眼压的有效性和安全性。方法：计算机检索PubMed，Medline，CNKI及中国生物医学文献数据库收录的，并辅以手工检索、因特网搜索的有关拉坦前列素与噻吗心安治疗原发性开角型青光眼和高眼压症的随机对照试验（RCT）。按照纳入和排除标准限定研究对象，通过Jadad评分量表进行文献质量评估后，针对眼压下降比例、药物不良反应2项内容，使用Cochrane协作网提供的RevMan5．0软件进行Meta分析。结果：共纳入9项RCT，合计555例患者。Meta分析结果显示：（1）拉坦前列素滴眼液与噻吗心安滴眼液降眼压效果，在2，6，12wk时差异均有统计学意义（P＜0．01），加权平均差（WMD）分别为：在2wk[WMD＝-0．76，95％CI（-1．32，-0．20）]，在6wk[WMD＝-1．15，95％CI（-1．68，0．63）]和12wk[WMD＝-1．01，95％CI（-1．42，-0．61）]。（2）随访结束时，结膜充血、异物感为拉坦前列素的两种较为常见的不良反应，但其发生率拉坦前列素组与噻吗心安组比较，结膜充血的发生率[OR＝2．25，95％CI（0．99，5．08）]，异物感的发生率[OR＝2．48，95％CI（1．02，6．03）]，显示二者差异均无统计学意义。结论：治疗原发性开角型青光眼和高眼压症，拉坦前列素降眼压效果在用药12wk内较噻吗心安好；两者在12wk内引起结膜充血、异物感、虹膜色素加深、视野损害等的不良反应方面，差异不明显。由于纳入研究的样本量偏小，且方法学质量中等，致使本系统评价结果论证强度不高，因此还需要开展更多的高质量的临床随机对照研究，以便更客观、准确、全面地评价其疗效和安全性。

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:Toinvestigatethelevelsofserumsolubleintercellularadhesionmolecules-1(sICAM-1)andneutrophilicexpressionofCD18inpatientswithvariousstagesofdiabeticretinopathyandtodeterminetheirdifferentexpressionpatterninthedevelopmentofdiabeticretinopathy(DR).·METHODS:LevelsofserumsICAM-1andCD18onthesurfaceofneutrophileweremeasuredin41DRpatients,theywereclassifiedinthreesubgroupsaccordingtothestageofretinopathyasdeterminedbyfund’sophthalmoscopy;10controlsubjectswerealsostudied.sICAM-1weremeasuredbyenzyme-linkedimmunosorbentassayandCD18byflowcytometry.·RESULTS:TheneutrophilicCD18expressionandserumsICAM-1levelwereallsignificantlyelevatedinalldiabeticsubgroupscomparedtocontrolsubjects(P<0.01).ThedifferencesofCD18andsICAM-1amongthediabeticsubgroupsweresignificantinCD18butnotinsICAM-1.TheprogressionofretinopathywasassociatedwithanincreasebothinCD18andinsICAM-1levelsbysimplecorrelationanalysis(β=0.74,P<0.001;β=0.38,P<0.01,respectively).ButstepwisemultipleregressionanalysisrevealedthatonlyCD18wasindependentdeterminantofretinopathy(β=1.04,P<0.01).·CONCLUSION:OurresultsconfirmthecontributionofendothelialandneutrophilicactivationinthedevelopmentofDRasindicatedbyincreasedlevelsofCD18andsICAM-1.However,adirectimplicationofCD18andICAM-1intheprogressionofDRcanbesupportedonlyintheCD18butnotICAM-1.CD18andICAM-1mayplaydifferentroleinthedevelopmentofdiabeticretinopathy.

简介：AIM:Toevaluatetheaccuracyofsphericalequivalent(SE)estimatesofadouble-passsystemandtocompareitwithretinoscopy,subjectiverefractionandatablemountedautorefractor.METHODS:Non-cycloplegicrefractionwasperformedon125eyesof65healthyadults(age23.5±3.0years)fromOctober2010toJanuary2011usingretinoscopy,subjectiverefraction,autorefraction(AutokeratorefractometerTOPCONKR-8100,Japan)andadoublepasssystem(OpticalQualityAnalysisSystem,OQAS,VisiometricsS.L.,Spain).Nineconsecutivemeasurementswiththedouble-passsystemwereperformedonasubgroupof22eyestoassessrepeatability.ToevaluatethetruenessoftheOQASinstrument,theSElaboratorybiasbetweenthedoublepasssystemandtheothertechniqueswascalculated.RESULTS:TheSEmeancoefficientofrepeatabilityobtainedwas0.22D.SignificantcorrelationscouldbeestablishedbetweentheOQASandtheSEobtainedwithretinoscopy(r=0.956,P<0.001),subjectiverefraction(r=0.955,P<0.001)andautorefraction(r=0.957,P<0.001).ThedifferencesinSEbetweenthedouble-passsystemandtheothertechniquesweresignificant(P<0.001),butlackedclinicalrelevanceexceptforretinoscopy;Retinoscopygavemorehyperopicvaluesthanthedouble-passsystem-0.51±0.50Daswellasthesubjectiverefraction-0.23±0.50D;Moremyopicvalueswereachievedbymeansofautorefraction0.24±0.49D.CONCLUSION:Thedouble-passsystemprovidesaccurateandreliableestimatesoftheSEthatcanbeusedforclinicalstudies.Thistechniquecandeterminethecorrectfocuspositiontoassesstheocularopticalquality.However,ithasarelativelysmallmeasuringrangeincomparisonwithautorefractors(-8.00to+5.00D),andrequirespriorinformationontherefractivestateofthepatient.