目的 通过对比577nm阈下微脉冲激光与传统激光治疗中心性浆液性脉络膜视网膜病变(CSC)的效果,评价577nm阈下微脉冲激光在治疗CSC中的疗效及安全性.方法 回顾性分析经荧光眼底血管造影(FFA)和相干光断层扫描(OCT)检查确诊为CSC且病史＜3个月的CSC患者35例(35只眼),17只眼给予577nm阈下微脉冲激光治疗(微脉冲组),18只眼给予传统激光治疗(传统组),观察治疗前及治疗后1、3个月两组的最佳矫正视力(BCVA)及黄斑区视网膜下液吸收情况.结果 治疗后1个月的BCVA微脉冲组由治疗前的0.66±0.20提高到1.08 ±0.22,差异有统计学意义(P＜0.01),传统组由治疗前的0.67±0.14提高到1.05±0.16,差异有统计学意义(P＜0.01),两组比较差异无统计学意义(P＞0.05).治疗后1个月,微脉冲组有14只眼(82.4％),传统组有15只眼(83.3％)黄斑区视网膜下液消失,黄斑中心凹视网膜厚度恢复正常,两组比较差异无统计学意义(P＞0.05).治疗3个月所有患眼视网膜下液完全吸收,无一患眼复发.结论 在CSC治疗上,577 nm阈下微脉冲激光与传统激光具有同样良好疗效,但577 nm阈下微脉冲激光安全性更好,是值得推荐的治疗方法.

目的 分析息肉状脉络膜血管病变(PCV)的临床误诊原因,以作出正确诊断.方法 回顾分析31例经吲哚青绿血管造影(ICGA)确诊为PCV患者的眼底、荧光素眼底血管造影(FFA)、相干光断层扫描(OCT)、B超改变情况.结果 误诊为湿性年龄相关性黄斑病变5例,误诊为慢性中心性浆液性脉络膜视网膜病变3例,误诊为孔源性视网膜脱离1例.结论 提高对PCV的全面认识,掌握其眼底、FFA、OCT、B超特征性改变,可降低临床误诊率.

目的：探讨术前眼位注视训练在铁质角膜异物剔除术患者中的应用效果。方法选取我院行铁质角膜异物剔除术患者182例，按随机数字表随机分为对照组和观察组各91例，对照组给予常规治疗和护理；观察组在术前常规治疗和护理基础上给予术前眼位注视训练。观察比较两组患者术中眼球旋转偏移发生率、头面部偏移发生率、手术时间、一次手术成功率及角膜损伤发生率。结果观察组术中眼球旋转偏移、头面部偏移发生率及角膜损伤发生率均低于对照组（P＜0．01）；观察组手术时间短于对照组，一次手术成功率高于对照组，差异均有统计学意义（P＜0．01）。结论术前眼位注视训练可降低患者术中眼球旋转偏移和头面部偏移发生率，缩短手术时间，提高一次手术成功率，减少角膜损伤发生率，并且其操作方法简单，值得临床推广应用。

Objective To investigate the morphological characteristics of pathological myopia using fundus fluores -cein angiography ( FFA) , indocyanine green angiography ( ICGA) and optical coherence tomography ( OCT) .Methods We studied 28 cases (31 eyes) of pathological myopia with macular hemorrhage .FFA, ICGA, and OCT examinations were performed to characterize the morphological changes in these patients .Results Uncomplicated macular hemorrhage was i-dentified in 15 eyes (48.4%).Among these eyes, FFA showed masked fluorescein in the bleeding region .Striated bands of fluorescein could be observed in 8 eyes (53.5%).ICGA showed similar masks at initial phase and fluorescein bands at later phases.OCT revealed high reflection in neurosensory retina (9 eyes, 60%) or in RPE (4 eyes, 26.7%).There was no retina edema.Choroid appeared to be continuous .In 2 eyes, OCT were completely normal.Another group of eyes ex-hibited choroidal neovascularization (CNV;n=16, 51.6%).FFA identified overt CNV in 14 eyes (87.5%) and occult CNV in 2 eyes (12.5%), while ICGA detected scattered CNV in 14 eyes (87.5%) and in two eyes there was no fluores-cein leakage .OCT showed discontinuation and spindle or round shaped high reflection within RPE in 14 eyes.In 2 other eyes, RPE discontinuation was also found along with irregular thickened RPE and neurosensory retina edema .Conclusion Pathologicsl myopia can present with two different types of pathological changes , uncomplicated macular hemorrhage and choroidal neovascularization .Different morphological characters can be identified through FFA , ICGA and OCT examina-tions.

目的 相干光断层扫描(OCT)观察鼠眼短暂缺血后的视网膜改变.方法 选取实验动物12只,随机作为鼠眼短暂缺血组和正常对照组(各6只),行OCT检查以观察鼠眼短暂缺血与正常鼠眼的视网膜改变.结果 短暂缺血组的6只大鼠鼠眼均显示视网膜厚度增加,神经上皮层的反射性增强;OCT检查显示鼠眼短暂缺血组平均视网膜厚度为(205.50±9.95).μm,正常鼠眼组为(186.17±3.49)μm,两者差异有统计学意义(t =4.489,P＜0.01).结论 构建了鼠眼短暂缺血视网膜改变的实验模型,并由OCT观察改变情况,对今后利用动物进行相关研究具有重要意义.

Objective To evaluate the safety and efficacy of double using triamcinolone acetonide (TA) and indocyanine green(ICG) during vitrectomy with internal limiting membrane (ILM) peeling for idiopathic macular hole(IMH).Methods Pars plana vitrectomy with ILM peeling was performed in 26 eyes of 26 patients.TA and ICG were used respectively to identify posterior vitreous cortex and ILM.Finally,16％ C3 F8 was tamponaded.Results Anatomic closure of the macular hole was achieved in 23 patients,withdrawed in 2 cases and failed in 1 patient with small hole near ora serrata who underwent the surgery with silicone oil tamponaded finally.Visual acuity improved in 21 eyes,remained unchanged in 2 eyes,decreased in one eye.Conclusion The injection of TA makes the posterior vitreous cortex visualized clearly in all patients.Upon the injection of ICG,the ILM can be successfully removed in all patients.Double visualization of the posterior vitreous cortex and ILM using TA and ICG during vitrectomy may be safe and effective.

【Objective】 To observe the histo pathological changes of the whole retinal vasculature in rats of transient cerebral ischemia with Exogenous kallikrein.In order to furnish some evidence for clinic Ophthalmology.【Methods】 They were randomly divided into 3 groups:exogenous kallikrein treated group,ischemia group,sham operation group,exogenous kallikrein(1.6×10-2PNAU/Kg) and the same dose of saline were given daily through caudal vein injection for 10 days in exogenous kallikrein treated group and ischemia group respectively,then the histopathology were examined with each group.【Results】 Radial incomplete perfusion showed that retinal vasculation and cytoplasmic vacuolation was localized within ganglion cell layer of the retina.The above changes had improved in exogenous kallikrein treated group than ischemia group.【Conclusion】 As a selective cerebral capillary vasodilator,Exogenous kallikrein had possibly improved injured retina of transient cerebral ischemia in rats.It help us to prevent from visual dysfunction.

OBJECTIVE To improve the diagnosis and treatment of painful ophthalmoplegia syndrome. METHODS Forty cases with painful ophthalmoplegia syndrome diagnosed clinically were collected and their modes of onset,the involvement of the cranial nerves and the results of the special examinations were analysed. RESULTS The main manifestations were syndrome of multiple cranial nerves impairment for this group of patients. Cerebrospinal fluid and neural imaging examinations might be abnormal. CONCLUSIONS Differential diagnosis must be done for the patients with headache or single ophthalmoplegia. Building up correct diagnostic course is the key to reduce an erroneous or losable diagnosis.

目的探讨0.25%硝酸银溶液治疗急性结膜炎的护理效果。方法将240例急性结膜炎患者随机分为用0.25%硝酸银溶液洗眼的治疗组(120例196眼)和单用0.9%生理盐水溶液洗眼的对照组(120例194眼)。3d后,比较2组患者的疗效和治愈时间。结果治疗组与对照组相比,治疗组患者疗效优于对照组患者(p<0.05),治愈时间也较对照组患者短(p<0.05)。结论用0.25%硝酸银溶液治疗急性结膜炎能明显改善患眼症状,缩短疗程,配合相应的护理措施,效果满意,值得临床推广。

Objective The purpose of this study was to determine which aeroallergens were prevalent in patients with allergic conjunctivitis in Guangdong and provide basis for the prevention of all allergic conjunctivitis. Methods A total of 138 cases were determined as allergic conjunctivitis based on history and manifestation in Affiliated Second Hospital of Guangzhou Medical University. The patients underwent the intradermel skin test including 17 aeroallergens. Results In the 138 passmuster exples, the positive rate of D. farinae was the highest one( 122/138, 88.41% ), and then was house dust(88/138, 63. 71% ), Amaranthus spinosus ( 87/138, 63. 04% ), cockroach ( 79/138, 57. 24% ), autumn pollen ( 75/138, 4. 35% ), polymat aterial(75/138, 4. 35% ), lkworm chrysalis( 74/138, 53.62% ) and bee( 65/138, 47. 10% ), etc. Conclusion D. farinae and house dust are the most prevalence allergen in Guangdong area. This result is helpful for prevention of allergic conjunctivitis.

对眼科学中有关医学影像诊断内容进行讲授,增加医学影像专业学生学习眼科学的积极性,在学期初和学期末对学生进行问卷调查、分析结果并提出了在医学影像专业学生中更好地开展眼科学教学的方法.

目的 探讨早产儿缺氧缺血性脑病的高压氧(HBO)治疗效果及其视网膜病变(retinopathy of prematurity,ROP)的预防措施.方法 采用婴儿高压氧舱,对早产儿、低体重儿矫正胎龄至满40周,体重在2.5 kg以上后行HBO治疗,严格掌握适应证和禁忌证,早产儿HBO治疗的压力、浓度、时间要与足月儿进行区分,实行HBO治疗前、治疗期间、治疗后均需作眼底追踪检查.结果 38例早产儿、低体重儿经过HBO治疗,4～9 个月复查头颅CT或MRI,治愈32例,占82.1%;有效6例,占15.4%.眼底检查无一例发生早产儿视网膜病变.结论 在严格掌握适应证、治疗方案,定期进行眼底检查的情况下,HBO治疗是有效安全的。

OBJECTIVE:To study the microsurgical procedures for the treatment of large primary pterygium and their therapeutic effects. To observe the recurrence rate, the changes of visual acuity after microsurgery and the pathological relationships between pterygium and cornea/sclera under the surgical microscope.METHODS:Forty-six eyes of forty-one patients with pterygium which invading the cornea over the pupil border were included. Pterygium was dissected by various methods under surgical microscope. The pathological relationship between the pterygium and cornea/sclera was observed. The lengths of the pterygium head and its three parts were measured. Degenerative Tenon's capsule was removed totally and the wound was covered by rotated conjunctival flaps. These patients were followed-up for 12.0 - 50.2 months (median: 22.4 months). Changes in visual acuity and recurrence rate after operation were observed.RESULTS:The average length of the total pterygium heads was (6.3 +/- 0.4) mm. The head was divided into three parts: the apical, loose and adhesive parts. The apical part was located at the top of the pterygium head with a length of (1.7 +/- 0.4) mm. The tissue of apical part was compact, hard, translucent and adhered to the cornea tissue. The adhesive part was a band in front of the anterior border of the limbus and paralleled to the limbus. The width of adhesive part was (0.9 +/- 0.1) mm and was tightly adhered to the cornea. The loose part lied between the apical and the adhesive part. The length of which was (3.6 +/- 0.4) mm and could be separated from the cornea easily. The neck and the body parts of pterygium could be separated easily from the limbus and sclera. Non-corrected visual acuity averaged 0.3 (ranged from finger count to 0.7) before the operation and averaged 0.7 (ranged from finger count to 1.5) 1 month postoperatively (Wilcoxon signed rank test u = 5.435, P < 0.01). Pterygium relapsed in 5 eyes with a recurrence rate of 11% (5/46).CONCLUSIONS:There is a regular pathological relationship between the pterygium and the cornea/sclera under surgical microscope, which is fundamental for the microsurgery of the pterygium. Extensively degenerated Tenon's capsule should be removed totally and the defect should be covered by rotated conjunctival flaps. The recurrence rate is low and the visual acuity increases significantly after the operation.

Objective:To evaluate the therapeutic efficacy of hydrophilic soft corneal contact lens in ocular surface trauma.Methods: 26 eyes in 26 cases of ocular surface trauma registered to our in-patient and clinic departments between 2001 and 2005,including chemical and thermal burns,mechanical corneal trauma and corneal laceration,were treated with continuous use of soft corneal contact lens and antibiotic eye-drops.Results: All patients were cured except for 5 Ⅳ° ocular chemical or thermal burns.The rate of curing was 80.8%.Conclusion: Soft corneal contact lens appeared to be a safe and effective treatment in ocular surface trauma.

Objective To investigate the methods of phacoemulsification and intraocular lens implantation(PHA +IOL)for cataract with small pupil,synechia and atouic iris(SPSAI)after glaucoma trabeculectomy,which is simple, save and faster recovery of visual acuity.Methods Fifty eyes of forty-five patients with SPSAI cataract after trabeculecto- my were divided into A and B groups according their operating methods and analyzed retrospectively.There were 31 eyes of 27 patients in group A,the treatment method of SPSAI was small segmental iridectomy and coreoplasty(SSIC).There were 19 eyes of 18 patients in group B,the treatment method of SPSAI was stretching and dilating the pupil(SDP)to 4～5mm. The visual acuity,the pupil' s situations were observed at the first,seventh and thirtieth days after operation.The operative procedures were recorded.Results The different of visual acuity of the two groups was significant statistically at the first day after operation,namely the recovery of the visual acuity of the patients of group A was faster than that of group B(u= 2.38,P＜0.05).Compared with SDP,SSIC had no laceration of posterior lens membrane,much less bleeding,shorter operating time and better recovery of the pupils.Conclusion PHA+IOL for the cataract with SPSAI after glancoma trab- eculectomy,compared with SDP,SSIC made the operation simple and save,the recovery of the visual acuity was faster.

Objective:In order to find the characteristic of ocular symptom in ischemic stroke of the aged,the changes of vision,visual field and fundus in 45 patients were analysed. Methods:The examination of vision,visual Field and fundus was carefully recorded. Results:Ischemic stroke of posterior circulation(64.4%) was dominant in all patients. The rate of visual impairment was 69.7% and visual field defects were in oculus unitas,HR、SMD and DR were 63.6%、40.9% and 27.2% respectively in the changes of fundus. Conclusion:The cause of the visual impairment was the changes of fundus,but not ischemic stroke. It is suggested that for the patients with ocular symptom,especially those with normalilty of visual acuity,a close observation including examination of ophthalmology should be made. It was significant value for the prevention,treatment and prognosis that the ocular changes could be discovered earlily.

Objective To improve diagnoses and treatment of painful ophthalmoplegia syndrome and study possible etiology of the syndrome.Methods Eighteen cases with painful ophthalmoplegia syndrome diagnosed clinically were collected and their modes of onset,the involvement of the cranial nerves and the results of the special examinations were analyzed.Results The syndrome of multiple cranial nerves with ophthalmopathy were found.Cerebrospinal fluid and neuroimaging examinations may be abnormal.Conclusion The patients with headache or sigle ophthalmoplegia must be diagnosed with exclusion.Possible etiology of the syndrome is nonspecific inflammatory with immune reaction,besides,satisfactory effect of adrenocorticotrophic hormone is acquired after corticosteroid treatment has no effect.

Objective:To observe the changes in the function of tear film after laser in situ keratomileusis(LASIK) for myopia.Methods: One hundred myopic patients (186 eyes) treated with LASIK were evaluated for tear flow(Schirmer I test),tear break-up time(BUT) tests and fluorescein staining scores before operation and at l week,l month and 3 month intervals after the operation.Results:(1) the mean values of Schirmer I were(15.89±6.70) mm preoperatively;(12.08±7.30)mm,(10.43±5.52)mm,(11.56±6.82)mm at l week,l month and 3 months postoperatively(P<0.05).(2) The mean BUT were(12.83±5.04) seconds preoperatively,(9.07±6.40) seconds,(8.74±7.56) seconds and(10.23±5.76) seconds at l week,l month and 3 months postoperatively(P<0.05).(3) The FL staining was intensified at l week postoperatively as compared with before operation.Conclusion: LASIK caused a decrease in tear film stability and tear secretion early stage after operation,probably due to decreased corneal sensation after LASIK.

大鼠眼部及其周围组织详细结构未见文献的详细报道或描述,我们在超声介导放射性微粒植入近距离治疗眼部肿瘤研究这一课题项目中,发现大鼠的眼部组织解剖结构与人类大有不同.在动物实验中,研究其组织解剖结构及手术穿刺针的安全进路及出血表现,这些实验材料,未见既往有文献报道.

目的应用异丙酚,水合氯醛,氯胺酮等三种常用动物实验麻醉药对小白鼠的麻醉效果比较分析。研究三种麻醉药对小白鼠的致死量,麻醉起效时间及麻醉维持时间。方法随机采购实验动物养殖基地实验用健康小白鼠200只,每只体重约50g,使用市售异丙酚,水合氯醛,氯胺酮三种麻醉药对小白鼠分组、分批不同剂量注射麻醉,观察记录麻醉后的各种数据。结果异丙酚,水合氯醛,氯胺酮三种常用动物实验麻醉药对小白鼠的麻醉效果不同。其麻醉致死量、麻醉起效时间、麻醉维持时间差异有统计学意义。结论麻醉对动物实验成功与否起关键作用,采用正确的麻醉剂量是动物实验成功的先决条件。