1例8岁11月龄男性患儿，智力低下，语言落后，1岁9月龄癫痫首次发作，4岁诊断为儿童孤独症，体格检查有特殊面容，视频脑电图示广泛性棘慢波发放。染色体微阵列检测到8q22.2q22.3区域约2.34 Mb片段微缺失，8q22.2q22.3微缺失的病例非常罕见。.

目的 探讨可吸收泪小管栓子VisiPlug植入后对中、重度干眼症病人相关指标的影响.方法 中、重度干眼症病人18例(36眼),给予双眼上下泪小管植入可吸收泪小管栓子VisiPlug,分别于治疗前和治疗后的第1月、1个月、3个月、6个月进行主观症状评分、基础泪液分泌实验、角膜荧光素染色评分、泪膜破裂时间观察和泪河高度检查.结果 无病人出现泪小管栓子脱落,1例病人出现不能耐受的泪溢症状,将下泪小管内的栓子冲洗入泪囊后缓解.治疗后第1周、1个月、3个月、6个月病人主观症状评分、角膜荧光素染色评分、泪膜破裂时间和泪河高度与治疗前比较,差异有显著性(F =26.79～259.18,P＜0.01);治疗后第1、3、6个月与治疗后第1周相比,主观症状评分、角膜荧光素染色评分、泪膜破裂时间比较差异有显著性(P＜0.05);治疗前与治疗后第1周、1个月、3个月、6个月基础泪液分泌测量结果比较差异无显著性(P＞0.05);治疗后第1周、1个月、3个月、6个月泪河高度比较差异无显著性(P＞0.05).结论 可吸收泪小管栓子VisiPlug植入是安全的,并且在未降解期间可以显著改善干眼症病人的相关指标.

病人,男,43岁,因右眼渐进性视物不清1年入院.病人无眼红、眼痛,无异常分泌物,否认有高血压、糖尿病等全身疾病,无手术史、药物过敏史及跟部外伤史.眼科检查:视力OD为0.25,验光视力不提高,眼压2.67 kPa,右眼角膜透明,前房中深,房水清,瞳孔圆,直径约2.5 mm,对光反应存在,晶状体前囊和皮质不均匀混浊,晶状体颞下方悬韧带部分断裂,眼底视盘界清,色正,C/D约0.3,黄斑中心凹光反射存在,A∶V为2∶3.入院诊断为年龄相关性白内障(右)、晶体半脱位(右).

<正>病人,男,51岁。右眼视物变形伴视力下降1个月,于2009年9月29日就诊我院。眼科检查:视力右眼0.5且无法矫正,左眼1.0,双眼前节无明显异常。右眼眼底:黄斑中心凹偏颞侧可见约2.5个视盘直径(DD)大小的近似肾形隆起,呈"灯笼"样外观;左眼底无异常。荧光素眼底血管造影(FFA)示:右眼早期黄斑中心凹偏颞侧范围可见与病灶形态大小完全一致的强荧光,随时限延长荧光增强,并持续到晚期,保持原有形态大小。初步诊断:右眼特发性浆液性色素上皮脱离(IRPED)。给予复方丹参、沃丽汀及维生素药物口服治疗,病情无明显改善,2010年2月右眼视力降至0.2。光相干断层扫描

Objective To investigate the intervention effect of self-made 0.3% Nimodepine(NMD) eye ointment on the apoptosis of rabbit's retinal ganglion cells(RGCs) caused by chronic intraocular hypertension.Methods Forty-eight healthy New-Zealand albino rabbits were randomly assigned to normal control group(16 rabbits) or chronic intraocular hypertension(CIH) group(32 rabbits).The NMD eye ointment was applied on the right eyes of CIH group(group A1),and the left eyes were offered the groundmass of the ointment(group A2).The expression of Caspase-3 in inner nuclear layer(INL) of retina and RGCs in various groups was detected by immunohistochemistry after four weeks.Results Positive expression of Caspase-3 in group A1[(29.45±14.64)/mm2] was lower than that in group A2 [(42.61±23.97)/mm2],the difference between them was significant(t′=2.095,P<0.05).Conclusion Local application of 0.3% NMD eye ointment can down regulate the positive expression of Caspase-3 protein in inner nuclear layer of retina and RGCs under chronic intraocular hypertension.

甲状腺相关眼病是眼科临床常见眼眶病病因之一,患病率在眼眶疾病中居首位[1].近年来,随着人们对甲状腺相关眼病的认识,早期诊断多无困难,但个别病例由于症状不典型,或医生经验不足,未详细询问病史,或未作相关检查等,造成误诊.现将我院或他院初诊误诊病人10例分析如下.

Objective To investigate the fundus features,fluorescein angiography (FFA) character-istics and the main complications of angioid streaks.Methods Nine patients (18 eyes) with bilateral angioid streaks were examined by the routine ophthalmological examination and FFA.Color fundus photographs were also taken.Results ① Fundus findings:angioid streaks were visualized in the posterior pole of 18 eyes and the streak colors ranged from brown in the early phases to orange in severe stages.The macular areas of 11 eyes (61.1%) were involved and 8 eyes (44.4%)had subretinal hemorrhages either with or without neovascularization.② FFA:streaks were hyperfluorescent in 14 eyes,hypofluorescent areas between hyperfluorescent edges in 4 of the 18 eyes.In most cases hyperfluorescent were seen in macular of late venous and late phase of FFA.FFA confirmed the presence of well-defined choroidal neovascularization(CNV) in 8 eyes.5 eyes presented classic and 3 occult CNV.Conclusion In all eyes,angioid streaks were well visualized.FFA results may contributes to the diagnosis,treatment and prognosis for patients with angioid streaks.

我院自1997年始行活动性羟基磷灰石义眼台(HA)植入术22例,效果较好,现报告如下. 1 临床资料

随着白内障摘除联合人工晶状体植入术的普及和术后大量抗生素、糖皮质激素的应用,真菌性眼内炎的发生率呈现逐渐增高的趋势.

Objective To observe the effect of trabeculectomy with adjustable sutures in patients with glaucoma. Methods Adjustable sutures combined with traditional trabeculectomy were applied to the operation for glaucoma. Results The intraocular pressure was controlled postoperatively and there were no significant differences as compared with traditional trabeculectomy(t=1.946,P0.05). Shallow anterior chamber could be observed to have lower incidence than that of ordinary and recovered rapidly by adjusting the sutures. The difference was significant(χ 2=11.148,P0.05). Conclusion Trabeculectomy with accommodative suture can lower the complications of the operation by adjusting the filtration of aqueous humor.

目的讨论白内障囊外摘除术后囊破裂的术中处理方式及效果.方法对37例(37只眼)白内障囊外摘除术后囊破裂的病例进行回顾性分析.结果后囊中央裂口＜5mm,周边缺损＜120°者18只眼;后囊缺损而前囊膜周边完整者8只眼,常规法植入人工晶体,术后反应轻微.后囊破裂超过上述范围11只眼,玻璃体处理后行双侧晶体襻悬吊术,术后反应重.术后裸眼视力0.1～0.3者5只眼,0.3～0.5者4只眼,＞0.5者28只眼.结论根据后囊破裂的程度和部位,采取正确的处理方式,可以取得较好的临床效果.

Objective To study the induction of anterior chamber associated immune deviation (ACAID) of rabbits.Methods Soluble corneal classified antigens were prepared by glycine method, ACAID was induced by injecting glycine into anterior chamber(AC) of rabbits in different groups. The ear swelling and pathological results of the spleen were investigated. Results Corneal epithelium, endothelium, stroma and the whole corneal soluble antigens could induce ACAID .The induced concentration was 2.0g/L, and the success rate was 90%, 100%, 80% and 100%, respectively. Conclusion Corneal soluble antigen can induce ACAID of rabbits.