Ocular accommodation refers to the process by which the ciliary muscle creates a clear image of the object in the retina by changing the refractive power of the lens. When the accommodation ability of the eye is insufficient, the imaging focus falls on the region behind the retina and hyperopic defocus is easily formed, resulting in axial growth and leading to the development of myopia, and it is found that most myopic patients usually have some accommodation dysfunction. Myopia has become a public health problem in China, and the prevalence of adolescents has increased dramatically. How to prevent and stop the occurrence and development of myopia is a major challenge. Previous studies have found that ocular accommodation dysfunction is associated with the occurrence and development of myopia, and the measurement of parameters related to accommodation function has certain guiding significance for the prevention and control of myopia. The purpose of this paper is to review the correlation between myopia and ocular accommodation function, with a view to providing new ideas for the prevention, control and treatment of myopia.

The complex barriers to drug delivery in the eye make it difficult for traditional ophthalmic preparations to reach pathological tissues in the posterior segment of the eye via ocular surface. Therefore, intravitreal drug injection has been widely used for treating posterior segment diseases, but this invasive approach to drug delivery has disadvantages such as short drug half-lives, repeated injections, and many complications. Ophthalmic nanodrug delivery systems, which can overcome ocular drug delivery barriers, enhance drug permeability, and improve drug bioavailability, now make it possible to efficiently deliver drugs to the posterior segment of the eye. However, the carrier materials utilized for nanomedicine delivery are inherently intricate, and substantial disparities exist among research findings, posing a hindrance to the subsequent advancement of pertinent drug formulations. Consequently, this review centers on the principal physiological obstacles encountered in ocular drug delivery, emphasizing the utilization of diverse nanomedicine delivery systems in posterior segment pathologies. It aims to delve into their research progress in posterior segment diseases and establish a safer, more effective therapeutic approach for treating these ocular conditions.

目的:探究病理性近视伴脉络膜新生血管的特点并进行药物治疗观察.方法:选取2019年1月—2020年12月于本院进行病理性近视伴脉络膜新生血管治疗的患者62例,对比患者治疗前后脉络膜新生血管(CNV)病灶渗漏情况、最佳矫正视力(BCVA)、黄斑中心凹视网膜厚度(CRT)、眼部及全身不良反应等.结果:治疗后3个月随访发现34例患者渗漏停止,17例患者渗漏减少,有效率为82.26％;治疗前,患者眼压为(15.82±2.01)m m H g;治疗后1天时患者眼压为(16.11±2.12)mmHg;治疗后1周患者眼压为(16.07±1.98)mmHg,治疗后1个月患者眼压为(15.93±1.94)mmHg;治疗后各时间点患者BCVA检查结果对比治疗前均显著提高(P<0.05),治疗后各时间点患者C R T检查结果对比治疗前均显著降低(P<0.05);患者发生球结膜下出血3例,2例发生玻璃体内注药后眼压暂时性升高达25?mmHg,角膜上皮损伤1例,均恢复正常.56例患者在随访期间均未发生青光眼、眼内炎、白内障进展、视网膜脱离等眼部不良症状.结论:玻璃体内注射VEGF药物对病理性近视伴脉络膜新生血管患者的治疗安全有效.

目的 为提高免疫学课程的教学质量,加深学生对课程的理解,研究创新教学模式在免疫学教学中的应用效果.方法 2019年2-6月,选取该校2017级临床专业学生227名,分别为1班115名,2班112名开展该次创新教学模式研究.1班学生进行创新教学模式上课,包括以问题为导向的(PBL)翻转教学模式、渗透愉悦教学模式以及科研促进教学模式等,2班学生进行以授课为导向(LBL)的传统教学模式.对比不同教学模式后两组学生的期末成绩、对课程的满意度、学习动力评分、记忆学习态度评分.结果 1班学生期末成绩(83.78±5.36)分,2班学生期末成绩(78.69±5.23)分,1班学生期末成绩得分显著高于2班学生,差异有统计学意义(P<0.05);1班学生课程满意度、学习动力评分显著高于2班学生,差异有统计学意义(P<0.05);学习态度评分中,1班学生在课堂表现、作业完成度、课外自学三项评分均显著高于2班学生,差异有统计学意义(P<0.05).结论 在免疫学教学中,使用创新教学法可提高学生学习成绩,增加学生的学习动力,提高学习态度评分,使学生掌握免疫学基本理论及发展规律,创新教学模式在免疫学教学中应用效果较佳.

目的 探讨25 G玻璃体切割术联合巩膜扣带术治疗眼球内异物伴视网膜脱离的临床效果.方法 选取眼球内异物伴视网膜脱离患者44例,随机均分为对照组(25 G玻璃体切割术)和观察组(25 G玻璃体切割术联合巩膜扣带术),收集2组患者的基本信息,采用国际标准视力表和Goldmann眼压计分别于2组患者术前、术后第3及6个月时进行最佳矫正视力(BCVA)和眼压检查,观察2组患者术后第3及6个月时视网膜复位和脱离复发情况,记录2组患者术后6个月内并发症(低眼压、高眼压、化脓性眼内炎、硅油乳化和白内障等)发生情况.结果 2组患者基本资料比较,差异均无统计学意义(P>0.05);2组患者术前BCVA和眼压比较,差异无统计学意义(P>0.05),观察组患者术后第3及6个月时BCVA和眼压均低于对照组(P<0.05),2组患者术后第3及6个月时BCVA较术前有增加、但眼压较术前降低(P<0.05);所有患者眼球内异物均成功取出(成功率为100％),观察组患者术后第3、6个月时视网膜脱离复发率低于对照组(P<0.05),观察组患者术后6个月内不良反应发生率低于对照组(P<0.05).结论 25 G玻璃体切割术联合巩膜扣带术治疗可明显改善眼球内异物伴视网膜脱离患者的眼压和视力,提高复位成功率,降低复发率,具有较高安全性.

目的:探讨临床治疗病理性近视脉络膜新生血管的可靠方法,为临床实践提供参考依据.方法:选取2018年7-12月笔者所在医院临床收治的病理性近视脉络膜新生血管患者61例,给予患者玻璃体腔注射康柏西普治疗,对患者治疗前后的视网膜血流动力学指标(PSV、EDV、RI)、血清炎症因子指标(IL-1、IL-6和IL-8)、最佳矫正视力(BCVA)和黄斑中心凹视网膜的厚度(CMT)进行观察和比较.结果:治疗后患者的PSV和EDV均明显升高,RI指标明显降低,治疗前后比较差异有统计学意义(P<0.05);治疗后患者的IL-1、IL-6和IL-8均明显降低,治疗前后比较差异有统计学意义(P<0.05);治疗后患者的BCVA明显升高,CMT明显降低,治疗前后比较差异有统计学意义(P<0.05).结论:采用玻璃体腔注射康柏西普治疗病理性近视脉络膜新生血管能够有效改善患者视网膜血流动力学指标,降低局部炎症反应过程,提升患者最佳矫正视力,降低黄斑中心凹视网膜厚度,临床综合效果显著,是临床治疗病理性近视脉络膜新生血管的可靠方案之一.

黑头粉刺痣的概念由Kofmann S于1895年第1次提出,本病系先天性毛囊畸形所致,临床少见,无性别差异.本病可仅见皮肤粉刺痣样改变,也有并发系统性病变者,称为黑头粉刺样痣综合征[1].本例患者同时合并眼部、骨骼、皮肤损害,临床罕见,现报告如下.

Objective: To investigate the curative efficacy of vitreous cavity injection of monoclonal antibody( lucentis) on wet age-related macular degeneration( w AMD). Method: A total of 38 patients with w AMD were given lucentis in vitreous cavity,best corrected visual acuity( BCVA) and macular central foveal thickness( CFT) were observed before operation,two weeks,one month and three months after operation; postoperative adverse reactions and complications such as high intraocular pressure,inflammation,anterior chamber hemorrhage,retinal hemorrhage,cataracts were detected;curative effect was analyzed. Results: Two weeks,1 month and 3 months after treatment,BCVA was higher than that before treatment,and showed rising trend,while CFT was lower than that before treatment,and showed descending trend,the differences were statistically significant( P 0. 05). There was no serious adverse reaction and complication. Conclusion: Vitreous cavity injection of lucentis shows obvious curative effects and few adverse reactions.

<正>患者,男,22岁,因"用铁锤敲击金属后,左眼被金属碎片弹中10h"于2010年5月27日入院。入院检查:VOS:手动/20cm,光定位好,色觉正常,上眼睑可见一裂口,约1cm,全层穿通达巩膜;11点角膜缘可见巩膜一竖

Objective To disucss and summarize the vitrectomy treatment techniques and outcome on retinal detachment with giant retinal tear. Methods Analyze retrospectively 11 cases(11 eyes)of retinal detchment with giant retinal tear 10 of which were treated by pars plana vitrectomy combined with scleral bucking and intraocular retinal photocoagulation.One case was without scleral bucking surgery.6 cases of which were treated by perfluorocarbon liquid(heavy water)-silicone oil replacement,silicone oil tamponade;5 cases of which were adopted gas-liquid exchange,silicone oil tamponade. Results All the patients got anatomic retinal reattachment.All retinas were showed reattached well in the followed investigations.Silicone oil had been removed in two of them.However,due to a new retinal break,one of them occured retinal detachment after oil removement and silicone oil tamponade was done again.Besides,there were two cases of secondary glaucoma occurred,two cases of complicated cataract occurred in which one of them had under gone the cataract surgery.No complications such as perfluorocarbon liquid(heavy water) intraocular residue or corneal degeneration occurred. Conclusion Vitrectomy treatment combined with scleral buckling,silicone oil tamponade and retinal laser photocoagulation can effectively cure the retinal detachment with giant retinal tear.

患者,女,40岁,因左眼外伤后眼球突出7年,加重1周于2008年2月29日于贵阳医学院附属医院眼科就诊.患者于7年前左眼被桶击伤后即感疼痛、视力下降,曾在当地就诊,给予对症治疗后症状有所缓解,但眼球逐渐向前突出.1周前左眼球突出明显加重,伴眼痛、头痛,为进一步诊治门诊以左眼眶肿物收入院.既往体健.眼科检查:右眼无异常,左眼视力光感/眼前,眼压Tn-2,光定位不准,眼睑肿胀,眼球向前、向下突出,睑裂增宽,不能闭合,球结膜混合充血+ + +,水肿+,角膜中下方4 mm×4 mm混浊灶,伴脓苔附着,前房消失,隐约见虹膜脱出与混浊角膜病灶处相贴,瞳孔欠圆,光反应迟钝,晶状体透明,眼底窥不见.