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2型糖尿病性视网膜病变的定量分析:筛选可预测继发于糖尿病黄斑病变的视力损害进展参数

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世界核心医学期刊文摘（眼科学分册） 2005年第5期1卷 12-13页

作者： Hove M.N. Kristensen J.K. Lauritzen T. Bek T. 陈立军 Department of Op hthalmology Urhus University 'Hospital N.rrebrogade 44 8000 Urhus Denmark Dr.

Purpose: To describe whether quantitative assessment of early changes in the m orphology of retinopathy lesions can predict development of vision-threatening diabetic maculopathy. Methods: We used a nested case-control study, and we stud ied 11 type 2 diabetes patients who had developed visual loss secondary to diabe tic maculopathy. For each diabetes patient, we also studied three matched contro l patients who had been followed for a comparable period of time without develop ing visual loss. Fundus photographs describing the early development of retinopa thy were digitized and subjected to a full manual quantitative grading on a comp uter monitor. Differences in the early development of retinal morphology were co mpared between the two groups. The outcome parameters were changes in the number and area of haemorrhages and exudates in different regions of the fundus, and t he weighted distance of these lesions from the fovea and the optic disc. Results : In patients who developed visual loss secondary to diabetic maculopathy there was significant early progression in the total area and number of haemorrhages a nd exudates. The haemorrhages had progressed in all retinal areas except the area around th e optic disc and the temporal vascular arcades. The exudates had progressed temp orally from the fovea and in the retinal periphery. Conclusions: The results sug gest that a quantitative description of the regional development of early diabet ic retinopathy may help in identifying patients who will later develop vision-t hreatening maculopathy.

关键词：黄斑病变视力损害中心凹眼底图像视网膜区域形态学改变量化分级病例对照研究区域性发展

VLGR1基因突变(USH2C)引起的Usher综合征表达与USH2A表型的比较研究

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世界核心医学期刊文摘（眼科学分册） 2005年第7期1卷 30-31页

作者： Schwartz S.B. Aleman T.S. Cideciyan A.V. S.G. Jacobson 刘炜 Scheie Eye Institute University of Pennsylvania51 North 39th Street Philadelphia PA 19104 United States

PURPOSE. To investigate the retinal disease expression in USH2C, the subtype of Usher syndrome type 2 recently shown to be caused by mutation in the VLGR1 gene, and compare results with those from USH2A, a more common cause of Usher syndrome. METHODS. Three siblings with USH2C and 14 patients with USH2A were studied. Visual function was measured by kinetic perimetry, static chromatic perimetry, and electroretinography (ERG). Central retinal microstructure was studied with optical coherence tomography (OCT). RESULTS. The siblings with VLGR1 mutation showed abnormal photoreceptor- mediated function in all retinal regions, and there was greater rod than cone dysfunction. USH2A had a wider spectrum of disease expression and included patients with normal function in some retinal regions. When abnormalities were detected, there was more rod than cone dysfunction. Retinal microstructure in both USH2C and USH2A shared the abnormality of loss of outer nuclear layer thickness. Central retinal structure in both genotypes was complicated by cystic macular lesions. A coincidental finding in an USH2C patient was that oral intake of antihistamines was associated with temporary resolution of the macular cystic change. CONCLUSIONS. USH2C and USH2A manifest photoreceptor disease with rod- and cone- mediated visual losses and thinning of the outer nuclear layer. An orderly progression through disease stages was estimated from cross- sectional and limited longitudinal data. Intrafamilial and interfamilial variation in retinal severity in USH2A, however, suggests that genetic or nongenetic modifiers may be involved in the disease expression.

关键词：基因突变 USH2A USH2C Usher VLGR1 视网膜疾病动态视野计视网膜区域光感受器视锥细胞

糖尿病性黄斑水肿时双眼注视研究:光凝固疗法对其产生的影响

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世界核心医学期刊文摘(眼科学分册) 2006年第1期 49-50页

作者： Mφller F. Laursen M.L. Sjφlie A.K. 王文军 Department of Ophthalmology Odense University Hospital Sdr. Boulevard 5000OdenseCDenmark

Background: During retinal photocoagulation for diabetic maculopathy there is a potential risk of foveal burns, and laser scars may later enlarge to be sight threatening when involving retinal areas previously used during fixation. Since the retinal area used during binocular steady fixation has been found to vary considerably in the normal test person and central fixation may be even further compromised in patients with diabetic maculopathy, the sight-thr-eatening side effects could possibly be reduced by taking into account the fixation area individually. However, no study has described and quantified the retinal area of fixation binocularly in patients with clinically significant macular oedema (CSME). Methods: Sixteen diabetic patients with CSME in one or both eyes were examined. Each examination included visual acuity testing (ETDRS charts), a standard eye examination, central retinal thickness assessment by omography, fluorescein angiography and binocular quantification of fixational eyemovements using an infrared recording technique. Results: Anegative correlation was found between visual acuity and mean microsaccadic amplitude (R=0.48, p=0.009). The maximal retinal extension of the fixation area ranged between 1.0 and 3.0° , and in two eyes with CSME this area was estimated to exceed 800 μ m on the retinal plane. No correlation was found between retinal thickness and visual acuity, retinal area of fixation, maximal extension of the fixation area or mean microsaccadic amplitude. Conclusion: Large interindividual differences in quantitative measures of binocular fixational eye movements were found. The mean amplitude of fixational eye movements was not correlated to central retinal thickness, and fixation area could only partly be predicted by visual acuity. Two eyes with CSME had an estimated maximal extension of the fixation area exceeding the central 800 μ m on the retinal plane the possible benefit of individualising central photocoagulation according to p

关键词：视网膜区域黄斑水肿光凝固糖尿病性视网膜疾病双眼注视注视区域微扫视疗法

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氪激光光凝的自动化

国外医学.眼科学分册 1985年第2期 128-129页

作者：瞿佳

一般应用的氪激光具有三种波长,即氪红(647.1nm)、氪黄(568.2nm)和氪绿(514.5nm)。应用氪红的光凝治疗近来已受到临床方面的极大关注,但氪黄在临床方面仍较少受到注意。其实,氪红和氪黄在光凝治疗方面各有其自己的优点,最有效的氪激光... 详细信息

一般应用的氪激光具有三种波长,即氪红(647.1nm)、氪黄(568.2nm)和氪绿(514.5nm)。应用氪红的光凝治疗近来已受到临床方面的极大关注,但氪黄在临床方面仍较少受到注意。其实,氪红和氪黄在光凝治疗方面各有其自己的优点,最有效的氪激光临床应用应该是氪红和氪黄两种波长优点的结合。氪激光两种波长的光凝术之组织学研究已证实了这一点。作者认为:根据组织学研究的结果,为了增加光凝治疗在眼科方面的安全性和有效性,目前应用的光凝器必须具有自动化的性能。组织学研究的实验是在一种猴的眼球上进行,以激光光凝损伤不超出视网膜色素上皮层和感光细胞层、而视网暎神经纤维层和脉络膜玻璃膜(Bruch膜)完好无损为良好治疗效果。先以光斑大小均为100μm的氪红投射到猴

关键词：激光光凝内层治疗效果黑色素激光束莱塞光束葡萄膜脉络膜光凝治疗视网膜区域

无视网膜病变的糖尿病患者短期高血糖在多焦视网膜电图中的反应

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世界核心医学期刊文摘（眼科学分册） 2005年第2期1卷 37-37页

作者： Klemp K. Larsen M. Sander B. 齐翔云 Department of Ophthalmology He rlev Hospital University of Copenhagen Herlev Ringvej 75 2730 Herlev Denmark

PURPOSE. To investigate the effect of variations in blood glucose level on the multifocal electroretinogram (mfERG) in patients with type 1 diabetes without r etinopathy. METHODS. Fourteen patients were clamped sequentially and in random o rder at 5 and 15 mM blood glucose for 75 minutes on the same day. mfERG was reco rded in one eye at each level of blood glucose level. RESULTS. Compared to eugly cemia (5 mM), hyperglycemia was associated with an overall decrease in the impli cit times and an increase in the amplitudes of the multifocal ERG. The effect of hyperglycemia on implicit time reached statistical significance for the summed first positive (P1) and second negative component (N2) of the first-order kerne l (P = 0.0020 and 0.0005, respectively) and all components of the second-order kernel (P=0.014, 0.0037, and 0034, respectively). These changes in the mfERG dem onstrated no significant variation in relation to retinal location or long-term blood glucose level. CONCLUSIONS. Steady- state hyperglycemia induced shorter first-and second-order kernel implicit t imes in patients with type 1 diabetes without retinopathy. The effects of hyperg lycemia were not significant with retinal location. These results support the hy pothesis that hyperglycemia accelerates retinal metabolism.

关键词：高血糖视网膜电图视网膜病变视网膜区域绝对测量

绿色激光指示器诱发的视网膜病变:临床病理研究

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世界核心医学期刊文摘（眼科学分册） 2005年第9期1卷 28-28页

作者： Robertson D.M. McLaren J.W. Salomao D.R. Link T.P. 杨秀梅 Mayo Clinic 200 First St SW Rochester MN 55905 United States Dr.

Objective: To report retinopathy following exposure to light from a commercially available class 3A green laser pointer. Methods: A 55-year-old woman with a ring melanoma was scheduled for enucleation. The eye (visual acuity 20/ 20) had a healthy-appearing macular retina. The retina was exposed to light from a commercially available class 3A green laser: 60 seconds to the fovea, 5 minutes to a site 5°below the fovea, and 15 minutes to a site 5°superior to the fovea. Color photographs were obtained before and after exposure. The eye was enucleated 20 days after exposure. Results: Laser power measurements averaged less than 5 mW. Retinopathy was observed 24 hours after laser exposure. This was characterized by a yellowish discoloration at the level of the retinal pigment epithelium (RPE) in the subfoveal region and at the site superior to the macula where the retina received 15 minutes of laser exposure. Each site developed granular changes at the level of the RPE within 5 days of exposure. Histologic study showed RPE damage in the exposed subfoveal and parafoveal regions. Conclusion: A class 3A green laser pointer caused visible retinopathy in the human eye with exposures as short as 60 seconds.

关键词：视网膜病变临床病理研究激光指示器中心凹视网膜区域眼球摘除术黑色素瘤颗粒样表现正常绿色激光