Objective::To assess the clinical effectiveness of an intravitreal injection of conbercept using two different strategies, the 3+PRN and 3+Q3M strategies, for the treatment of wet age-related macular degeneration (AMD).Methods::Prospective clinical study. Patients at Qilu Hospital, Shandong University who were confirmed to have exudative AMD from August 2018 to August 2019 were included. Exudative lesions of choroidal neovascularization (CNV) in the macular area were found in all 106 eyes of these patients. The international standard decimal visual acuity chart was used to measure best corrected visual acuity (BCVA). This was converted to the logarithm of the minimum angle of resolution (LogMAR) for the analysis. Optical coherence tomography (OCT) was used to measure central retinal thickness (CRT). For all eyes, an intravitreal injection of 0.5 mg of conbercept was administered with one of two strategies: 55 eyes received once monthly injections for the first 3 months, then 3+prore nata (3+PRN), and 51 eyes received once monthly injections for the first 3 months, followed by one injection every 3 months (3+Q3M). The patients were followed up for 12 months after the treatment. Routine examinations of BCVA, intraocular pressure (IOP), and OCT were conducted at 1 and 2 weeks after the operation, then these examinations were conducted every month. FFA examination was conducted every 3 months after the operation.The changes in BCVA, CRT and exudation of CNV lesions of the eyes were measured before and after treatment. Repeated measures analysis of variance was used to compare the groups and show the time effect, while the LSD t-test was used for comparisons among different time points within the same group. Results::The mean BCVA in both groups improved significantly at 1, 3, 6, 9 and 12 months after the operation, compared to the levels before treatment (3+PRN: t=7.202, 11.178, 9.914, 9.869, 10.587, respectively, P<0.001; 3+Q3M: t=5.548, 9.780, 9.358, 11.884, 11.622, respectively, P<0.001). In addition, the BCVA of the eyes was also significantly better in the 3+Q3M group than in the 3+PRN group at 9 and 12 months after the operation ( t=2.304, P=0.023; t=2.058, P=0.042). The mean CRT of the eyes was significantly lower at 1, 3, 6, 9 and 12 months after treatment, compared to the level before treatment (3+PRN: t=12.28, 17.041, 17.615, 15.739, 16.171, P<0.001; 3+Q3M: t=10.221, 15.598, 16.297, 16.984, 17.275, P<0.001). In addition, the CRT of the eyes was significantly lower in the 3+Q3M group than in the 3+PRN group at 9 and 12 months after the operation ( t=2.032, P=0.045; t=2.092, P=0.039). The FFA and ICGA examinations at the last follow-up showed that the exudation of CNV lesions in the macular area disappeared, reduced, or increased in 31(56%), 18(33%), and 6(11%) eyes in the 3+PRN group, and in 32(63%), 15(29%), and 4(8%) eyes in the 3+Q3M group, respectively. The Chi-square test shows the difference has no significance. There were no serious treatment-related ocular complications, such as retinal detachment, retinal tear, persistent intraocular pressure increase, or endophthalmitis, as well as serious systemic adverse responses found during the follow-up. Conclusions::Both strategies, namely the 3+PRN and 3+Q3M strategies, of intravitreal injection of conbercept are effective in treating wet AMD. However, the 3+Q3M strategy needs more injections but is more effective for improving visual acuity, reducing macular CRT thickness, and decreasing the exudation area of CNV, than the 3+PRN strategy.

糖皮质激素是临床各科常用的药物之一,超生理量的糖皮质激素具有抗炎、抗过敏和免疫抑制等多种药理作用,神经眼科常用此类药治疗视神经炎.尽管糖皮质激素临床应用广泛且疗效快而显著,长期应用具有较大副作用.中医学认为糖皮质激素为纯阳辛温之品,中医中药的整体调理在缓解其不良反应方面具有一定优势,如何在糖皮质激素依赖性疾病中发挥减毒增效的作用是多年来中医领域关注的重点.本文就中药如何参与糖皮质激素治疗特发性视神经炎的理论认识进行了初步回顾,并对相关中医药治疗的实践经验做初步介绍.

目的：观察中西医结合治疗视网膜静脉阻塞的临床疗效。方法将156例视网膜静脉阻塞分成中央静脉阻塞、分支静脉阻塞两组；又将两组病例分成非缺血型和缺血型两类。祖国医学将静脉阻塞分为肝胆火旺、肝郁气滞、脾虚气弱三个证型，参照相关资料，分别进行辨证施治。同时，根据具体患者的情况配合不同的单方治疗、外治疗法、多波长氪离子激光治疗、西药治疗。在中西医结合治疗视网膜静脉阻塞的同时，还特别注意对全身病的治疗。结果治愈34例，好转108例，无效、恶化、出现并发症11例，患者病逝3例。总有效率91％（治愈率21.8％）。结论中西医结合治疗视网膜静脉阻塞的临床疗效明显优于常规的单纯西药治疗效果。

目的 观察糖尿病患者经20G玻璃体视网膜切除手术前后泪膜变化.方法 前瞻性病例系列研究.自2012年5月至2013年2月间于我院行20G玻璃体视网膜切除手术的连续病例132例(132只眼)纳入研究.其中伴有II型糖尿病的63例(63只眼)作为A组,无糖尿病的69例(69只眼)作为B组,对侧眼为对照眼.所有患者均于术前1 d,术后1、3、7 d,1个月及3个月行泪膜破裂时间(BUT)、基础泪液分泌试验(SIT)、角膜荧光素染色(CFS)及干眼不适症状(DES)评分等检查.分析比较手术前后患者泪膜的变化,以及两组患者术后泪膜的变化.结果 与术前1 d相比,术后1、3 d患者均感到术眼明显不适,DES评分差异有统计学意义(Z=-3.771、-3.452,P<0.05);43%患者主诉患眼有轻度异物感及红肿流泪;与术前1 d相比,术眼术后1、3、7 d BUT值差异均具有统计学意义(t=-3.473、-3.218、-4.121,P<0.05),且A组(糖尿病组)泪膜稳定性恢复慢;术眼术后1,3 d CFS评分差异有统计学意义(Z=-3.375,P<0.05),且在术后3 d时评分最高,术后10 d恢复至术前水平;术后1 d及3 d术眼SIT值差异有统计学意义(t=4.312、3.814,P<0.05),术后7 d恢复至术前水平,随后变化不大.结论 糖尿病患者本身的泪膜稳定性差,20G玻璃体切除术影响泪膜的稳定性,糖尿病患者经20G玻璃体视网膜切除手术后早期可出现泪膜的异常改变,尤其表现为泪膜稳定性下降和泪液分泌量的下降,且术后泪膜恢复较无糖尿病患者恢复慢.

Objective To explore the application value of high frequency ultrasound in the diagnosis of cyclodialysis in clinic .Methods Application of ultrasound biomicroscopy was performed on 65patients with ocular trauma.To observe the relationship between the scope of cyclodialysis and the surrounding tissues . Results 24 patients with multiple time consecutive scanning from fracture ,19 cases of less than an hour from broken.The remaining 18 cases were not found from the fracture .Conclusions Application of ultrasoundbiomicroscopy of ciliary body from breaking area ,with the surrounding tissue and the postoperative effect of the diagnosis could be made more positive , but also to provide reliable diagnostic basis for clinical selection of operation scheme .

2005年1月～2007年5月,我们采用中西医结合,辅以眼底激光治疗非增生性糖尿病性视网膜病变,取得了较好的效果.现报告如下.

目的:探讨玻璃体切割联合眼内填充术治疗漏斗状视网膜脱离的效果.方法:漏斗状视网膜脱离18例、18眼,行三切口闭合式玻璃体切割术,14眼填充硅油,4眼填充C3F8.结果:18眼中视力增进13眼,占72.2%,不变4眼,占22.2%,下降1眼,占5.6%.硅油填充14眼,C3F8填充3眼视网膜均一次复位成功.C3F8填充1眼术后复发网脱,行二次手术,视网膜复位.硅油填充,术后4眼暂时性眼压升高.1眼持续高眼压,2个月取出硅油,视神经萎缩.结论:漏斗状视网膜脱离会致视功能严重损害,玻璃体切割联合眼内填充术可有效地提高视网膜复位率,挽救患者的视功能.