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:目的研究玻璃体切割术对晶体完整者角膜内皮细胞的早期影响。方法122例(131眼)行玻璃体切割术,其中无眼内充填46例(47眼),C3F8充填36例(38眼),硅油充填40例(46眼),分别在术前、术后1天、3天、5天和15天测量眼压、角膜内皮细胞密度、六角形细胞比例和变异系数。结果与术前相比,无眼内充填者眼压无明显改变,术后1天角膜六角形细胞百分数下降;C3F8充填术后1天眼压升高,角膜六角形细胞百分数术后1、3天下降;硅油充填术后1、3天眼压升高,角膜六角形细胞百分数术后1、3、5天下降;眼压升高与六角形细胞百分数下降显著相关。结论对于晶体完整者,玻璃体切割术后早期角膜内皮形态会受到一定的影响,可能主要由眼压及手术操作所致,在将眼压控制后,短期内即可恢复正常。
简介:目的分析儿童呼吸道异物的流行病学特征,减少儿童呼吸道异物的发生。方法回顾分析2010~2012年在本院经硬性支气管镜手术治疗的1085例呼吸道异物患儿的临床资料。结果1085例患者中,3岁以下的男性患儿占58.17%;城乡比为1∶2.52;冬春季节发病人数占总发病人数的61.05%;83.59%的患儿在患病24h后获得有效诊治,其中右侧支气管异物46.57%;坚果类食物占所有吸入异物种类的79.94%;进食哭闹占所有诱发因素的78.43%。结论儿童呼吸道异物的发生具有明显的性别、年龄、城乡、季节分布特征,以坚果类食物为主,常由进食哭闹诱发。依据流行病学特征制订干预策略将有助于降低该类意外事件的发生。
简介:目的通过对上海市北新泾社区糖尿病患者眼部病变的流行病学调查,了解糖尿病患者盲与低视力的情况。方法对上海市长宁区北新泾社区糖尿病患者进行视力损伤眼病的流行病学调查,内容包括:问卷调查询问一般状况和生活习惯;全身情况的检查:血压、血糖;眼部检查:日常生活视力、小孔镜视力、裂隙灯检查、眼底镜检查、自动验光仪验光、免散瞳眼底照相机眼底照相。结果应有590人进行调查,实际调查共535人,其中盲的患病率为1.12%,低视力的患病率为9.91%。导致盲的首要病因是糖尿病视网膜病变,其次是白内障和其他视网膜病变,导致低视力首要病因是白内障,其次是屈光不正和糖尿病视网膜病变。结论北新泾地区糖尿病患者防盲工作重点是糖尿病视网膜病变、白内障以及屈光不正的防治。
简介:糖尿病性视网膜病变(diabeticretinopathy,DR)是糖尿病微血管病变在眼部的表现,是〈75岁成年人的首要致盲眼病。定期随访检查糖尿病患者的眼底及控制血糖、血压、血脂都有助于降低因视网膜病变而致失明的发生率,但其机制仍不明确。蛋白质组学及其相关技术的发展为蛋白质水平上研究DR的病理生理机制提供了强有力手段,该技术可以一次性研究大量蛋白质。比较蛋白质组学研究结果表明DR并不是由单一蛋白质启动的疾病,而是多种蛋白质共同参与的病理过程。目前,绝大多数鉴定出的差异性蛋白质其功能都不太明确,而且各蛋白质之间存在着复杂的网络调节关系。我们就其在DR蛋白质组学方面的研究进展作一综述。
简介:AIM:ToevaluatethecornealendothelialcelldensityandmorphologyinChinesepatientswithpseudoexfoliationsyndrome(PEX).·METHODS:Medicalrecordsof16patients(20eyes)withPEXwhopresentedtoourinstitutionbetweenJuly2008andJune2010wereretrospectivelyreviewed.Thirteeneyeshadcombinedglaucoma.Theinformationoffiveapparentlynormalfelloweyesinthesepatientswasalsorecorded.Lefteyesof20patientswithbilateralsenilecataractsbutnoothereyediseasewereincludedascontrols.Specularmicroscopywasperformedinalleyestoanalyzeforcornealendothelialcelldensityandmorphology.Celldensity,coefficientofvariationincellsize,andpercentageofhexagonalcellsincornealendotheliumwereevaluated.·RESULTS:ThemeancornealendothelialcelldensityinthePEXeyeswas2298±239cells/mm2,significantlylowerthanthatinthecataracteyes(2652±18cells/mm2,P=0.026),buttherewerenosignificantdifferencesincoefficientofvariationofcellsizeandfrequencyofhexagonalitybetweenthesetwogroups.NosignificantdifferencesinthethreeparameterswerefoundbetweentheapparentlynormalfelloweyesandthePEXeyesorthecataracteyes,orbetweenthePEXeyeswithandwithoutglaucoma.·CONCLUSION:CornealendothelialcelldensitymaydecreaseinChinesepatientswithPEX.ThedevelopmentofglaucomainPEXeyesdoesnotseemtoberelatedwiththechangeincornealendothelialcelldensityormorphology.
简介:目的为了进一步了解永康市常见致盲眼病情况,更好的开展防盲治盲工作,为政府部门制订防盲计划提供决策依据。方法从2015年7月至2016年7月,我院采用流行病学描述性研究的方法,按1979年全国第二届眼科学术会议提出的WHO标准进行。对象当地城乡常住人口60岁以上不特定人群为主要对象,随机对永康市两个街道、四个乡镇、80余个行政村(自然村)、两所中学、八所小学、两个养老院共一万人次的致盲眼病,进行了流行病学抽样调查研究。结果第一位致盲眼病是白内障;第二位是外伤性陈旧性角膜病变;第三位是全身性基础性疾病引起的眼病,如高血压、糖尿病性眼病变。结论以上眼病是我市当前主要的致盲眼病,是现阶段防盲治盲的重点所在。
简介:目的调查上海市奉贤区奉城镇60岁以上老年人群干眼的患病率及相关影响因素。方法2013年6~12月对上海市奉贤区奉城镇60岁以上人群采用随机整群分组抽样法,进行问卷调查,对有阳性症状的受检者做裸眼视力、裂隙灯、基础泪液分泌试验(SⅠt)、泪膜破裂时间(BUT)、角膜荧光素染色(FL)、睑板腺功能检查。结果随机抽取受检者2387例,实际受检者2058例,应答率为86.2%。受检者中干眼患者295例,患病率为14.3%,女性患病率为18.0%(208/1153),男性患病率为9.6%(87/905),女性高于男性(χ^2=29.22,P〈0.05);80岁以上人群的干眼患病率为21.3%,70~79岁为15.8%,60~69岁为9.2%(χ^2=36.61,P〈0.005)。结论上海市奉贤区奉城镇60岁以上人群中,女性的干眼患病率高于男性。干眼患病率随年龄增长而升高,眼干涩、视疲劳、异物感为最常见症状,局部及全身多种因素均影响干眼的发生。干眼的社区防治对郊区眼病防治工作有着重要的意义。
简介:AIM:Todescribethedesignandpreliminaryresultsofthehospitalbasedepidemiologicalstudyfordiabeticretinopathy(HBESDR),anongoingepidemiologicalstudytoestimatetheprevalenceofdiabeticretinopathy(DR)andtoelucidatetheclinical,anthropometric,biochemicalandanyotherriskfactorsassociatedwithdiabeticretinopathy.METHODS:Totally2000diabeteswillberecruitedfromtheDiabeteseyeclinicintheFirstAffiliatedHospitalofChinaMedicalUniversity.AllsubjectsunderwentbloodsugarestimationandOralGlucoseToleranceTesttodiagnosediabetes.Alldiabeteswouldundergocompletequestionnaire,acomprehensiveeyeexamination.Bloodandurinewouldbecollectedforbiochemicalinvestigations.AllfundusphotographsforanyDRwillbegraded.Participantswhoneedtreatmentwillbesenttotheophthalmicclinicandfollow-upintervalprogramforallsubjectswillbesuggested.Acomputerizeddatabaseiscreatedfortherecords.RESULTS:Todate,1174diabeteshavebeenrecruited,therewere350(29.81%)DRinalldiabetes,mostofthemwerewithmildnon-proliferativediabeticretinopathy(NPDR)(139,39.71%);71(20.29%)moderateNPDR,66(18.86%)severeNPDR,74(21.14%)proliferativediabeticretinopathy(PDR).Females,longerdurationofdiabetes,familyhistoryofdiabetesandhypertensionhadastatisticallysignificantincreaseinriskofanyDR.CONCLUSION:ThestudyisexpectedtoprovideanestimateoftheoverallprevalenceofDRandtheprevalencewithdifferentdurationofdiabetesandalsoabetterunderstandingoftheriskfactorsassociatedwithDR.
简介:AIM:Toevaluatetheepidemiologic,anatomic,andclinicalfeaturesofopenglobeinjuriesinchildren.METHODS:Themedicalfilesofpatientsundertheageof16whohadbeenoperatedforanopenglobeinjuryatAkdenizUniversityHospital’sDepartmentofOphthalmologywereretrospectivelyevaluated.RESULTS:Atotalof90patientswereevaluatedinthisstudy.Amongthesepatients,26(28.9%)werefemaleand64(71.1%)weremale.Themeanageofthepatientswas7.7±4.2years.Themale/femaleratiowasobservedtoincreasewithincreasingage(P=0.006,P=7.48).Injuriesweremostlikelytooccurinspringandautumn(P=0.028).Thetimeintervalbetweentheinjuryandthesurgicalrepairwas9.36±27.4h.Forty(44.4%)oftheinjuriesoccurredinthehome,27(30%)occurredintheyard,and21(23.3%)happenedwhileplayinginthestreet.Themostcommoncausesofinjuryweresharpmetalobjects(P<0.001).Injurytothecorneaoccurredin47(52.2%)ofthepatients(P<0.001).Themostcommoncomplicationtooccurwascataractformation.Additionaloperationswerenecessaryfor37(41.1%)ofthepatients.Thefinalvisualacuitywascorrelatedwithboththeinitialvisualacuityofthewoundedeyepriortosurgeryandthelengthofthewound(P<0.001,r=0.502andP<0.001,r=-0.442,respectively).CONCLUSION:Openglobeinjuriesthataresufferedinchildhoodgenerallyoccureitherathome,intheyard,oronthestreet,withsharpmetalobjectsbeingthemostcommoncauseofinjury.Theinitialvisualacuityandthelengthofthewoundarethemostimportantdeterminantsofthefinalvisualacuity.