目的 研究分析真实世界中玻璃体腔注射抗血管内皮生长因子(vascular endothelial growth factor,VEGF)药物在新生血管性眼病中的应用疗效.方法 回顾性分析2016年10月至2018年6月在我科接受抗VEGF治疗的新生血管性眼病病例.所有病例均详细记录治疗前和治疗后1 d、治疗后1周的最佳矫正视力(LogMAR)、眼压、眼底情况.并对纳入病例的资料特征、所用药物、治疗方案、注药次数、疗效等指标进行分析比较.结果 纳入符合条件的临床病例227例313眼,其中93例163眼为糖尿病视网膜病变(diabetic retinopathy,DR),45例58眼为湿性年龄相关性黄斑变性(wet age-related macular degenera-tion,wAMD),26例29眼为息肉样脉络膜血管病变(polyloidal choroidal vasculopathy,PCV),39例39眼为视网膜静脉阻塞(retinal vein occlusion,RVO),13例13眼为病理性近视伴发脉络膜新生血管(myopic choroi-dal neovascularization,PM-CNV),4例4眼为特发性脉络膜新生血管(idiopathic choroidal neovascularization,ICNV),4例4眼为新生血管性青光眼(neovascular glaucoma,NVG),余3例3眼为其他眼病.单眼注药141例,双眼注药86例.22.0％的患眼实施了3+PRN方案,78.0％的患眼实施了1+PRN方案.雷珠单抗治疗的有152眼,康柏西普治疗的有140眼,有21眼在治疗过程中更换了药物.所有患者共计接受抗VEGF治疗544次,平均(1.8±1.0)次/眼.总体治疗后平均LogMAR视力(0.92±0.76)与基线(1.12±0.84)差异有统计学意义(P<0.001).结论 抗VEGF治疗确可有效促进患者视功能的恢复、减少视力损害,是临床上治疗新生血管性眼病的一线治疗用药.但在真实世界中,抗VEGF药物的应用仍然受多方面因素影响.
Objective To investigate the pathological type distribution and variation of eyelid tumor through study of clinical pathology data. Methods A total of 408 eyelid tumors were collected from January 2012 to December 2017.Histopathologic classification and variation of eyelid neoplasms were studied retrospectively. Results There were 385 cases of benign neoplasm in 408 case of eyelid tumors, accounted for 94. 39％, the top three pathological types were intradermal nevi (20. 6％), seborrheic keratosis (18. 7％) and epidermoid cyst (15. 6％) . The top three pathological types of malignant eyelid tumors were basal cell carcinoma (52. 17％), sebaceous gland carcinoma (26. 09％) and malignant lymphoma (13. 04％) . The number of seborrheic keratosis and xanthoma increased year by year (P < 0. 05), while the number of malignant eyelid tumors decreased annually (P < 0. 05) . Conclusions Benign eyelid tumors are predominant. The number of eyelid tumor increased year by year.
玻璃体积血的治疗因积血量的不同而不尽相同,少量或中等量的玻璃体积血可在3～6个月内自行吸收,而大量的玻璃体积血则需行玻璃体切除术治疗[1].不同病因导致的玻璃体大量积血,其手术方式的选择及预后有所区别,故术前明确玻璃体大量积血的病因尤为重要.但由于玻璃体严重混浊、术前无法详细检查眼底,很难判断玻璃体大量积血的病因,因此,对玻璃体大量积血的病因进行总结与分析,将有助于术前对病因的初步判断并为个性化治疗方案的制定提供依据.引起玻璃体大量积血的病因很多,可简单分为外伤性和非外伤性两大类.
