简介：目的探讨当前医改新形式下可行的白内障防盲治盲干预策略,解决大量积存的白内障致盲患者。方法成立白内障筛查工作队伍,以社区（村）居委会为单位,为50岁以上的村民进行免费白内障筛查,并专车接送分批组织患者来院接受手术,依托基本医疗保险,医院给予全免（选择硬性人工晶状体的患者）或部分免除（选择不同软性人工晶状体的患者）患者自付、自费这一部分的费用。结果中山市2008年8月16日率先在沙溪镇圣狮村建立了白内障无障碍示范村,中山市白内障无障碍市的创建工作由此以圣狮村为模式拉开了序幕,2009年9月中山市通过了全国白内障无障碍市的验收。结论在医改新形式下依托基本医疗保险,医院给予全免或部分免除患者自付、自费这一部分费用的白内障防盲治盲干预策略有助于解决我国目前各地区积存的大量白内障患者,在初期的实践过程中取得了良好的社会效益。另一方面也间接推动了社会基本医疗保险的普及,使广大患者实实在在的享受到了社会福利的好处。

简介：AIM:Topresentretinalmicrostructure,metabolismandfunctionabnormalitiesinthecourseofmultipleevanescentwhitedotsyndrome(MEWDS)byHeidelbergspectralismodalityimagingplatformandobserveitsoutcomebyEDI-SD-OCTandtwowavelengthautofluorescence.METHODS:Acaseofmultipleevanescentwhitedotsyndromeina23-year-oldfemalepresentedinitiallywitha15-dayhistoryoffloatersandacentralscotomaintherighteye.Toestablishthediagnosis,multimodalityimagingwasperformed,namely,bluelight-fundusautofluorescence(BL-FAF,excitation488nm,emission>500nm),near-infraredfundusautofluorescence(NIR-FAF,excitation787nm,emission>800nm)usingaconfocalscanninglaserophthalmoscope,fundusfluoresceinangiography(FFA),indocyaninegreenangiography(ICGA),spectrum-domainenhancedepthimagingopticalcoherencetomography(SD-EDI-OCT),multifocalelectroretinography(mf-ERG)andfundusphotograghwereperformedandfollowedupattheeighthmonthafterinitiallyvisiting.RESULTS:Opticalcoherencetomography(OCT)showedatransientdisruptionofthefovealphotoreceptoroutersegmentsincorrespondencetofovealgranularity.NIR-FAFshowedhypoautofluorescentareas,≤40μminsize,mostlyconcentratedaroundtheposteriorpoleanditstemporalsidelessthanthatinBL-FAF.Mf-ERGshowpinnacledisappearedinfoveaandmaculaandresponsesdecreasedmarkedlycomparedwiththefolloweye.Attheeighthmonthfollowup,hyperfluorescenceinBL-FAFweredisappear,while,NIR-FAFHypofluorescentspotsinearlystageofsuchlesionwerereduced.ButOCTdemonstratedthestructurewasrecoveredinresidualHypofluorescentareainNIR-FAF.Thesubfovealchoroidalthicknesswasdecreasedfrom372μmto307μmslightlyandcostlinewasrecovered.CONCLUSION:MEWDSisabenignself-healingdiseaseandthereisnopathologicalevidencetoinvestigatethenaturalcourseofsuchdisease.SD-OCTallowshighlydetailedimagesapproachinghistopathologytocertifythemicrostructura

简介：AIM:ToinvestigatetheeffectofintravitrealinjectionofDL-alpha-aminoadipicacid(DL-α-AAA)onocularrefractivestateandretinaldopamine,transforminggrowthfactor-β2(TGFβ2),vasoactiveintestinalpolypeptide(VIP)inguineapigform-deprivedmyopia.METHODS:Four-week-oldpigmentedguineapigswererandomlyassignedto4groups:normalcontrol,deprivation,deprivationplusDL-α-AAA,deprivationplussaline.Formdeprivationwasinducedwiththeself-madetranslucenteyeshields,andlastedfor14days.8μgDL-α-AAAwasinjectedintothevitreouschamberofdeprivedeyes.Thecornealradiusofcurvature,refractionandaxiallengthweremeasured.Retinaldopaminecontentwasevaluatedbythehigh-performanceliquidchromatographywithelectrochemicaldetection,andTGFβ2andVIPproteinweredetectedbyWesternblotting.RESULTS:Fourteendaysofeyeocclusioncausedtheaxiallengthtoelongateandbecomemyopicintheform-deprivedeyes,withthedecreaseofretinaldopamineandtheincreaseofTGFβ2andvasoactiveintestinalpolypeptide(VIP)protein.IntravitrealinjectionofDL-α-AAAcouldinhibitthemyopicshiftfrom(-3.65±1.06)Dto(-1.48±0.63)D,P<0.01duetogogglesoccludingandcausethedecreaseofretinalTGFβ2proteininthedeprivedeyes.However,intravitrealinjectionofDL-α-AAAhadnosignificanteffectonretinaldopamineandVIPproteinindeprivedeyes.RetinalTGFβ2proteincorrelatedhighlywiththeocularrefraction(y=-3.34+0.31/x,F=74.75,P<0.001)andaxiallength(y=8.39-0.02/x,F=48.32,P<0.001)indifferenttreatmentgroups.·CONCLUSION:IntravitrealinjectionofDL-α-AAAiseffectivelyabletosuppressthedevelopmentofformdeprivationmyopia,whichmaybeassociatedwithretinalTGFβ2proteininguineapigs.