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.

目的 比较巩膜扣带术和玻璃体切除术两种术式对孔源性视网膜脱离患者视网膜复位率、血清氨基酸与血管内皮生长因子(VEGF)变化.方法 回顾性分析我院以孔源性视网膜脱离为第一诊断的病例资料60例(60只眼),依据术式分为两组,A巩膜扣带术组,B玻璃体切除术组.记录两组术前和术后不同时间点手术复位率、血清中氨基酸表达水平及VEGF等变化情况.结果 应用相干光层析成像术(OCT)记录视网膜复位情况:术后1周A组神经上皮下积液15例,B组5例;术后1个月A组10例,B组0例;术后3个月A组2例,B组0例;最佳矫正视力(BCVA)两组患者复位术后均较术前明显提高,有统计学差异(P<0.05),两组间比较,患者术后各时间点的BCVA差异无统计学意义(均P>0.05);术后1周,两组患者血清中谷氨酸、苯丙氨酸、组氨酸及VEGF水平较术前均显著降低,差异有统计学意义(P<0.05),与巩膜扣带术比较,玻璃体切除术组中谷氨酸、苯丙氨酸、组氨酸及VEGF水平降低,差异有统计学意义(P<0.05).结论 玻璃体切除术能够早期降低谷氨酸、苯丙氨酸、组氨酸及VEGF水平及视网膜复位率增加手术安全性,提高患者满意度,相较于巩膜扣带术更具有优越性.

Objective:To investigate the changes of FAZ, BCVA and F-ERG after RRD.Methods:A retrospective analysis was performed on 40 cases of 40 eyes with RRD as the first diagnosis in our hospital. The data of BCVA, FAZ and F-ERG were recorded at different time points after operation.Results:the blood flow density of the SCP and DCP in the total 3 mm×3 mm area was higher in both groups 6 months after the operation( P=0.001).Partial correlation analysis showed that the change of FAZ area was negatively correlated with the BCVA( r =-0.215, P =0.014).Six months after surgery, the amplitude of F-ERG in group B was lower than that in group A, and the peak time was longer than that in group A, ( P < 0.05). Conclusion:PPV is superior to SB in the recovery of RRD patients with macular retinal blood flow density and visual function.

探讨黄斑部视网膜血流密度变化以及(The best corrected visual acuity) BCVA(最佳矫正视力)在孔源性视网膜脱离(Rhegmatogenous retinal detachment,RRD)两种术式后的对比研究.回顾性分析我院以孔源性视网膜脱离为第一诊断的病例资料40例40眼,依据术式分为2组,A巩膜扣带术组,B玻璃体切除术组.记录术后2w、1、3、6个月BCVA、黄斑部视网膜血流密度等检查资料.结果 显示两组患者总3 mm×3 mm区域浅层及深层毛细血管丛血流密度在术后6个月均较高(均P=O.001).偏相关分析显示,患者的FAZ面积的变化与最佳矫正视力呈负相关性(r=-0.215,P=0.014).玻璃体切除术对RRD患者黄斑部视网膜血流密度的恢复优于巩膜扣带术.应用OCTA检查随访RRD患者术后黄斑区血流密度变化,对于评估黄斑部视网膜结构和功能的变化有重要意义.但选择哪种手术方式,仍需要大样本研究及长期随访进行评估.

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：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。

我科从2000年5月开始对103例翼状胬肉患者行带蒂结膜瓣转位移植取得了较好的临床效果,现报告如下.

翼状胬肉是我国常见的眼表疾病,其患病率较高,达到2%～5%,估计我国患此病的总人数约为2 000万～5 000万[1-3].虽然眼科医师对翼状胬肉的发病机制进行了大量研究,但至今仍不明.流行病学调查显示环境因素,如紫外线照射是翼状胬肉的重要诱发原因[3].

0引言 翼状胬肉是我国常见的眼表疾病.虽然治疗翼状胬肉的方法很多,但手术仍是此病的主要治疗措施,因此提高手术质量对此病的预后十分关键.我院从2000-05开始对103例翼状胬肉患者施行带蒂结膜瓣转位移植治疗取得了非常满意的效果,报告如下.

1 病历介绍 患者,男,67岁.主因双眼突然视物不清3d于2003年3月10日来我科就诊,患者无眼红、眼痛.既往无眼病史及糖尿病史.

1病例报告 例1:女,40岁.主因盆栽花叶万年青汁液溅入左眼3h于2002-08-10就诊.患者于就诊3h前修剪万年青时,叶柄部折断,汁液溅入左眼.当即左眼刺疼难忍,立即用自来水冲洗,0.5h后左眼肿胀睁眼因难、疼痛流泪、视物不清.

1病例報告 男,47歲,2001年11月4日因雙眼視力减退3個月來診.既往在1998年4月因鼻出血發现鼻咽癌并于4月20日開始60Co外部放射治疗.耳前6cm×8cm放射野,左右雨侧交替進行.眼部戴防護單.治疗分12次,離時60天,放射總量7468cGY.

慢性进行性眼外肌麻痹又称von Graefe眼肌病,为慢性、进行性、双侧性,以上睑下垂开始,逐渐出现眼球运动障碍,最后眼球固定不动[1].现报告1例如下.

急性視網膜壞死(ARN)是一種嚴重損害視功能且難以治愈的視網膜病變,通常在幾天或幾周内導致失明.于1971年首先由日本浦山晃等報道,近幾年,國内外對此病報道增多,并對其病因、臨床經過、診斷和治療方面作了詳細叙述.近來我院遇到1例單眼急性視網膜壞死誤診爲虹膜睫狀體炎的患者,現報告如下:

患儿,女,9岁.自出生后父母发现其颞部有一瘘口,经常排豆腐渣样物.1年前因右上睑红肿、疼痛,在当地医院切开引流,愈合后反复破溃,于1999年12月4日收入院.检查:右颞部皮肤距外眦角35mm处可见一直径1 mm大小瘘口,挤压有豆渣样物排出.

患儿,女,9岁.自出生后父母发现其颞部有一瘘口,经常排豆腐渣样物.1年前因右上睑红肿、疼痛,在当地医院切开引流,愈合后反复破溃.于1999年12月4日收入我院.检查:右颞部皮肤距外眦角35mm处可见一直径1mm大小瘘口,挤压有豆渣样物排出.右上睑亦见一瘘口,外溢黄白色脓液,瘘口周围组织与眶骨粘连.

1 临床资料 患者，女， 34岁。右眼视物不清 1年，于 1998年 11月 1日就诊。 23岁时出现双眼上睑下垂。 27岁外院行上睑下垂矫正术。同年出现面部表情呆滞，说话声音变粗，语音低沉，双眼球活动受限且逐渐加重。 32岁在外院行左眼外斜视矫正术。 33岁因左眼白内障行手术治疗。家族史：父母无眼疾史，其兄双眼球运动受限，其子 10岁内斜视。体检：面部表情呆滞，苦笑状表情。皱额、露齿、鼓气与吹哨均有困难。说话口齿不清、语音低沉、声嘶、吞咽轻度困难。视物时，下颏上抬。四肢活动无受限。眼科检查：视力右眼 0.12～ 3.00DS=0.25,左眼 0.5。眼位：右眼－ 35°。遮盖试验：右注，左眼－ 40°，左注，右眼－ 35°。双眼向内上、下转动受限，左眼外转距外眦角 2mm。平视时：双眼上睑遮盖角膜上 1/3，双眼睑闭合不全 (图 1.2)。 Bell现象存在。右眼晶体混浊，左眼人工晶状体在位。新斯的明试验，双眼睑及眼球运动无改变。实验室检查：肝、肾功能及血糖正常，头颅 C T正常。诊断：①慢性进行性眼外肌麻痹；②并发性白内障（右）。入院后局麻下行右眼白内障超声乳化＋人工晶体植入术，术后第 10天视力 0.5。