AIM:To assess the gap between the peak of the base curve to the surface of the cornea,as well as examines the correlation between the thickness of the tear film and the fitting of the orthokeratology lens through optical coherence tomography(OCT),providing an intuitive and quantitative clinical evaluation method for the fitting of the orthokeratology lens. METHODS:Myopia patients who fitted orthokeratology at our hospital from January to December 2023 were included.Examinations,including naked vision,slit lamp,non-contact intraocular pressure,ocular fundus,eye position,corneal diameter,corneal topography,tear film rupture time,optometry,etc.,were performed on all patients before fitting.The trial lens parameter was selected according to the examination results,and fluorescein staining was performed to evaluate lens fitting state after patients adapted to wearing glasses.According to the performance of fluorescein staining,the inspected eyes are divided into three groups:lens loose group,lens fitting group,and lens tight group.In addition,the tear film thickness of three groups of subjects was measured by OCT,and the differences between the three groups of data were evaluated. RESULTS:A total of 49 myopic patients(77 eyes)were included.The average sphere degree was-3.10±1.25 D,the average cylinder degree was-0.43(-0.75,0)D,the average horizontal keratometry(HK)was 42.48±0.81 D,and vertical keratometry(VK)was 42.98(42.25,43.50)D.There were 21 cases(34 eyes)in the lens fitting group,with 13 cases of bilateral eyes,8 cases of one eye,14 cases(22 eyes)in the lens loose group,with 8 cases of bilateral eyes,6 cases of one eye,and 14 cases(21 eyes)in the lens tight group,with 7 cases of bilateral eyes,7 cases of one eye.There was no statistical difference in the main basic data of the subjects in the three groups(all P＞0.05).OCT showed that the tear film thickness of the lens fitting group,the lens loose group,and the lens tight group was 231.18(219.0,243.0),220.41(214.0,224.3),and 249.00(241.5,258.0)μm,respectively,and there was statistical significance in the thickness among the three groups(P＜0.05). CONCLUSION:OCT can serve as a safe and reliable method for measuring the tear film thickness,which can help evaluate the suitability of orthokeratology and provide a non-invasive,more intuitive,and quantitative evaluation method for the fitting and evaluation of orthokeratology.

AIM:To evaluate the changes of macular retinal vessel density after the first intravitreal anti-vascular endothelial growth factor(VEGF)injection for macular edema secondary to retinal vein occlusion. METHODS: A retrospective case control series, 23 cases with RVO secondary macular edema were included from April 2018 to July 2018. They were treated with 0.5mg/0.05mL intravitreal injection of conbercept. To compare the best corrected visual acuity(BCVA)before and after treatment. Optical coherence tomography angiography(OCTA)images was obtained, central macular thickness(CMT)and vessel length density and perfusion density in the superficial retinal capillary plexus were measured before and after intravitreal injection.RESULTS: The mean interval between baseline and follow up was 1mo. The improvement of BCVA, the decreased value of average central macular thickness after treatment were better than before(P<0.05). The vessel length density and perfusion density at the central, inner and full region in the superficial retinal capillary plexus was not significantly different after intravitreal injection(P>0.05).CONCLUSION: The average BCVA and the mean CMT of patients with RVO secondary macular edema after treatment was significantly better, and it is not progressive macular ischemia in the short-term after a single intravitreal injection of an anti-VEGF agent.

目的 观察采用自拟化瘀明目汤联合针刺疗法治疗糖尿病性黄斑水肿(DME)的临床疗效.方法 将符合相应标准的78例DME患者按就诊顺序随机分为联合组与基础组各39例,基础组给予患者单纯的玻璃体内药物注射治疗,联合组在除基础组治疗外,给予患者自拟化瘀明目汤联合针刺疗法进行治疗;两组治疗均15 d为1个疗程,共治疗2个疗程.结果 从视力、视网膜厚度、综合疗效、中医疗效等几方面比较,联合组均优于基础组(P<0.05).结论 采用自拟化瘀明目汤联合针刺疗法治疗DME的临床疗效显著.

目的:探讨背部俞穴拔罐治疗小儿痰湿蕴肺型咳嗽的临床疗效.方法:选取2014年9月～2015年9月于我院门诊治疗的小儿痰湿蕴肺型咳嗽患者100例,随机双盲分为两组,对照组50例接受常规治疗,拔罐组50例在常规治疗的同时加用背部俞穴拔罐治疗,观察比较两组治疗总有效率及治疗后各时间段的症状总积分、呼吸道疾病发作次数、不良反应情况.结果:拔罐组治疗总有效率为100.00％,显著高于对照组的84.00％,差异具有统计学意义(P＜0.05).治疗后d3、d5及d7、d10,拔罐组症状总积分情况均优于对照组,差异具有统计学意义(P＜0.05).治疗后1个月,拔罐组在观察期内发生呼吸道痰病的次数明显少于对照组,差异具有统计学意义(P＜0.05).两组临床试验均未出现不良反应.结论:背部俞穴拔罐治疗小儿痰湿蕴肺型咳嗽,可有效改善临床症状,减少发生呼吸遥疾病次数,疗效显著,安全性高,值得深入研究.

目的：探讨中医配合激光治疗糖尿病性黄斑水肿的疗效及对血清 HbA1C 、尿白蛋白及血脂水平影响探究。方法：将我院治疗的102例糖尿病性黄斑水肿患者分为治疗组和对照组。治疗组患者采用中医配合激光手术治疗，对照组仅采用激光手术治疗。分别检测两组患者治疗后血清 HbA1C 、尿白蛋白及血脂水平，比较两组患者疗效差异。结果：治疗前两组患者血清 HbA1C 、尿白蛋白及血脂水平没有明显差异（ P ＞0．05）；治疗后治疗组患者血清HbA1C 、尿白蛋白及血脂水平明显低于对照组（ P ＜0．05）。治疗组患者的治疗效果显著优于对照组（ P ＜0．05）。结论：中医配合激光治疗糖尿病性黄斑水肿能够有效调节血清HbA1C 、尿白蛋白和血脂水平，疗效显著。

目的：探讨尿白蛋白和血脂水平与激光后持续性黄斑水肿的相关性。方法收集2012年1月至2014年5月眼科和内分泌科就诊的糖尿病性黄斑水肿患者102例。给予对症治疗和密切护理，择期行激光光凝治疗。治疗后随访观察持续性黄斑水肿患者（试验组），观察黄斑水肿消退患者（对照组）。治疗后检测2组患者尿白蛋白和血脂水平差异，比较其临床相关性。结果试验组总胆固醇（TC）（6汉．90±1．45）μg／ml和三酰甘油（TG）（2．90±1．40）μg／ml明显高于对照组TC（5．80±1．31）μg／ml和TG（1．90±1．12）μg／ml（ P <0．05）；试验组尿微量白蛋白（69．39±14．36）μg／ml水平明显高于消退组（19．65±5．12）μg／ml。结论较高水平的尿白蛋白和血脂与糖尿病黄斑水肿患者经激光治疗后持续性黄斑水肿的发病率呈正相关。

光相干断层扫描（optical coherence tomography，OCT）是一种高分辨率的横截面断层影像学检查方法，能在活体显示生物学组织的细微结构。自1994年 OCT 正式应用于眼科临床以来，该技术快速发展，尤其在黄斑部疾病的诊断、疗效判定、术后观察随访中具有较高的应用价值。目前临床普遍使用的频域 OCT 仪探测波段普遍在850 nm 左右，受光源波长的限制以及光感受器和视网膜色素上皮细胞层的散射，其对更深层次的脉络膜显像不清晰，而光相干断层深度增强成像技术（enhanced depth imaging spectral-domain opical coherence to-mograthy，EDI SD - OCT）也备受关注，其探测波段在1050 nm，对脉络膜能够进行较清晰的成像。下面介绍 OCT 技术在几种黄斑病变中的临床应用。

目的：探讨两种不同手术方式治疗眼外伤继发青光眼的临床疗效。方法选取我院202例眼外伤继发青光眼患者，随机将患者分为A组和B组，分别采用小梁切除术和周围虹膜切除术进行治疗，术后对两组患者进行为期3个月的随访，记录每月眼压和视力的变化。结果两组患者术后眼压和视力恢复情况均较好，差异无统计学意义（P＞0.05）。结论眼外伤继发青光眼病因复杂，明确致病机制，针对性采取治疗是取得疗效的重要环节，对继发青光眼病因和治疗方式的进一步研究对于改善患者眼压和视力具有重要的意义。

本文为一误诊病例,将痛性眼肌麻痹伴慢性闭角型青光眼误诊为:1.左眼动眼神经麻痹;2.左眼青光眼,文中讨论了痛性眼肌麻痹,分析了误诊原因.

AIM:To research the influences of leech extracting solution on expression of thrombin receptor-1 in cultured human retinal pigment epithelial(RPE) cells.·METHODS:After RPE cells were treated by leech extracting solution alone or leech extracting solution with thrombin,flourescence expression of PAR-1 was mea-sured by immumofluorescence method.·RESULTS:Flourescence integral optical density(IOD) of PAR-1 displayed that thrombin group: compared with normal control group,IOD decreased (P<0.01);leech extract group: compared with normal control group,IOD increased(P<0.01);leech extracting solution with thrombin group:compared with thrombin group,IOD significantly increased (P<0.01). ·CONCLUSION:Leech extracting solution seems to be a competitive inhibitor of thrombin during PAR-1 activation in hRPE cells.It can inhibit the activation of PAR-1 induced by thrombin in human RPE cell membrane and interrupt PAR-1-mediated cell signal transduction.

Objective To investigate the effects of leech percolate on cell division cycle of culturedhuman retinal pigment epithelium (hRPE)cells induced by thrombin.Exploring mechanism of leech percolateon preventing and curing PVR.Methods (1)Human retinal pigment epithelium(hRPE)cells were cultured invitro with digest culture method. (2)The selected concentrations of leech percolate (128mg/ml,64mg/ml,32mg/ml,16mg/ml and 8mg/ml)were based on the previous experiments.With or without 0.5NIHU/mlthrombin, hRPE cells were treated with leech percolate by various concentrations for 24hrs, and the effects ofcell division cycle of leech percolate were studied with Flow Cytometer (FCM). (3)With or without0.5NIHU/ml thrombin, hRPE cells were treated with 64mg/ml leech percolate at different times(6hr, 12hr,24hrand 48hr), and the effects of cell division cycle of leech percolate were treated with FCM.Results (1)Therewas a general tendency that leech percolate of the selected concentrations arrested hRPE cells on G0/G1 phaseand 64mg/mi leech percolate inhibited 77.9% hRPE cells on G0/G1 phase and made hRPE cells on S phaseless especially. (2)During the period of 6hrs and 48hrs the longer the treat time of 64mg/ml leech percolate, themore the RPE cells arrested on G0/G1 phase.Conclusion The results approve leech percolate can inhibitproliferation of human RPE cells cultured in vitro.Its mechanism may be that leech percolate could act on celldivision cycle and arrest RPE cells on G0/G1 phase to make proliferation power of hRPE cells lower.

视网膜色素变性(retinitis pigmentosa,RP)是一组由遗传因素引起的进行性营养不良性退行性视网膜病变.它被认为是单基因遗传病.临床上主要分为典型性视网膜色素变性和非典型性视网膜色素变性,典型性视网膜色素变性的眼底表现是首先在赤道部发现骨细胞样色素沉着,以后逐渐向后极部和周边发展.而非典型性视网膜色素变性又可分为:①无色素性视网膜色素变性;②白点状视网膜色素变性;③结晶样视网膜色素变性;④中心性和旁中心性视网膜色素变性;⑤象限性视网膜色素变性;⑥单侧性视网膜色素变性[1];其各自的临床表现又与典型RP不同.一般情况下,同一家族中若多人同患本病,其临床表现大多较为相近.而本报道的特点是在父母为表兄妹近亲结婚的家系中发现4姐妹(亲姐妹)同为视网膜色素变性患者,但4人的眼底表现各不相同,所属的视网膜色素变性类型也不相同.

Although vitreoretinal surgery has made the greater success on the treat of PVR, it cannot arrest and may stimulate the move and proliferation of RPE cells. All these would induce recrudescence of PVR. RPE cell is an important kind of cells to reduce PVR, and so it is important to study drugs on inhibiting proliferation of RPE cells. The research of effects of drugs on RPE cell dividing cycle arrest is reviewed here. The inhibition of proliferative vitreoretinopathy (PVR) by RPE cell cycle arrest is prospected.