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外伤性脉络膜破裂视力预后和脉络膜新生血管膜形成的预测因素

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世界核心医学期刊文摘(眼科学分册) 2006年第12期 13-13页

作者： Ament C.S. Zacks D.N. Lane A.M. J. W. Miller 王静波 Retina Service Massachusetts Eye and Ear Infirmary 243 Charles St Boston MA 02114 United StatesDr.

Objective: To determine predictors of choroidal neovascularization (CNV) and visual outcome after traumatic choroidal rupture. Methods: A retrospective review of patients with traumatic choroidal rupture diagnosed in the Retina Service, Massachusetts Eye and Ear Infirmary, Boston, between January 1993 and August 2001 was performed. Parametric and nonparametric statistical methods were used to evaluate visual prognosis, CNV, and retinal detachment after traumatic choroidal rupture. Results: One hundred eleven cases were identified and reviewed. Visual acuity (VA) changes were recorded in all of the cases. Thirty-eight (34%) of the 111 patients recovered driving vision (VA ≥20/40). Rupture location was recorded in 107 cases. Recovery of driving vision was seen in 20 (59%) of 34 eyes with peripheral choroidal ruptures, 17 (22%) of 73 eyes with macular choroidal ruptures, 38 (38%) of 99 eyes without CNV, 1 (8%) of 12 eyes with CNV, 38 (40%) of 96 eyes without retinal detachment, and 1 (7%) of 15 eyes with retinal detachment. Older age and location of rupture within the arcades were positively associated with CNV formation (P=.04 and .03, respectively). Foveal location of rupture, multiple ruptures, and poor baseline VA were associated with failure to recover driving vision in univariate regression analyses. In multivariate analysis, rupture location and baseline VA were independently associated with visual outcome. Of 12 patients diagnosed with CNV, 5 were not treated, 4 were treated with argon laser photocoagulation, 1 was treated with surgery, 1 was treated with argon laser photocoagulation followed by surgery, and 1 was treated with verteporfin photodynamic therapy. Conclusions: Most patients with traumatic choroidal rupture do not achieve final VA of 20/40 or better. Poor visual outcome was most highly associated with a macular rupture and baseline VA of less than 20/40. The formation of CNV was most strongly associated with older age and macular choroidal rupture.

关键词：脉络膜破裂脉络膜撕裂视力预后 CNV 外伤性预测因素

老年性眼疾病研究组对老年性黄斑变性严重程度分级:AREDS第17号报道

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世界核心医学期刊文摘(眼科学分册) 2006年第3期 19-19页

作者： Davis M.D Gangnon R.E Lee L.-Y. 杨秀梅 AREDS Coordinating Center EMMES Corp 401 N Washington St Rockville MD 20850-1707 United StatesDr.

Objective: To develop a fundus photographic severity scale for age-related macular degeneration (AMD). Methods: In the Age-Related Eye Disease study, stereoscopic color fundus photographs were taken at baseline, at the 2-year follow-up visit, and annually thereafter. Photographs were graded for drusen characteristics (size, type, area), pigmentary abnormalities (increased pigment, depigmentation, geographic atrophy), and presence of abnormalities characteristic of neovascular AMD (retinal pigment epithelial detachment, serous or hemorrhagic sensory retinal detachment, subretinal or sub-retinal pigment epithelial hemorrhage, subretinal fibrous tissue). Advanced AMD was defined as presence of 1 or more neovascular AMD abnormalities, photocoagulation for AMD,or geographic atrophy involving the center of the macula. We explored associations among right eyes of 3212 participants between severity of drusen characteristics and pigmentary abnormalities at baseline and development of advanced AMD within 5 years of followup. Results: A 9-step severity scale that combines a 6-step drusen area scale with a 5-step pigmentary abnormality scale was developed, on which the 5-year risk of advanced AMD increased progressively from less than 1%in step 1 to about 50%in step 9. Among the 334 eyes that had at least a 3-step progression on the scale between the baseline and 5-year visits, almost half showed stepwise progression through intervening severity levels at intervening visits. Replicate grading s showed agreement within 1 step on the scale in 87%of eyes. Conclusions: The scale provides convenient risk categories and has acceptable reproducibility. Pro gression along it may prove to be useful as a surrogate for progression to advan ced AMD.

关键词：眼疾病严重程度黄斑变性 AREDS 老年性程度分级

妊娠相关的中心性浆液性脉络膜视网膜病变的光学相干眼底扫描结果

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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 39-39页

作者： Rezai K.A. Eliott D. 秦雪娇 Kresge Eye Institute Wayne State Univ. Schoo l of Medicine 4717 St. Antoine Detroit MI 48201 United States

Purpose: To report the presence and disappearance of subretinal fibrinous exud ate in pregnancy-induced central serous chorioretinopathy studied with optical coherence tomography (OCT). Methods: Case report. A 32-year-old woman was refe rred for ophthalmoscopic evaluation in her 32nd week of pregnancy, complaining o f reduced vision in her right eye. Results: The funduscopic examination revealed a serous detachment of the macula with subretinal exudative deposits in the rig ht eye and a peripapillary serous detachment in the left eye. OCT sections throu gh the right macula demonstrated serous elevation of the retina and the presence of highly reflective material in the subretinal space. Two weeks after delivery , OCT showed resolution of subretinal fluid and the disappearance of submacular exudate in the right eye. Conclusion: During pregnancy and immediately after del ivery, OCT may provide information reflecting the relationship between the retin a, subretinal space, and retinal pigment epithelium without any known adverse ef fects to the infant. In a patient with pregnancy-associated central serous chor ioretinopathy, a highly reflective material, presumably fibrin, was detected spa nning the subretinal space that was subsequently shown to disappear. This inform ation may help us better understand the pathological retinal changes that may oc cur during pregnancy.

关键词：视网膜下间隙视网膜病浆液性脱离视网膜色素上皮右眼视力眼底镜检查黄斑部视网膜下液乳头周围

成功治疗继发于球周注射治疗交感性眼炎穿通眼球后的孔源性视网膜脱离

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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 47-47页

作者： Sheu S.-J. Hsiao Y.-C. 肖颖 Department of Ophthalmology Kaohsi ung Veterans General Hospital 386 Ta-Chung 1st Road Kaohsiung 813 Taiwan Dr.

Rhegmatogenous retinal detachment followed peribulbar injection in a patient w ith preexisting sympathetic ophthalmia. Inadvertent globe perforation resulted i n subsequent rhegmatogenous retinal detachment. Scleral buckling and pars plana vitrectomy reattached the retina. The histopathology of the subretinal fibrotic tissue confirmed the diagnosis.

关键词：交感性眼炎穿通球周玻璃体切除术巩膜扣带术纤维组织病理学检查

血管内皮生长因子的遗传多态性与增生性早产儿视网膜病变的关系

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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 2-2页

作者： Vannay . Dunai G. Bányáasz I. 陈立军 1st Department of Paediatrics Semmelweis University B' okay J. u.53- 54 1083 Budapest HungaryDr

The intention of our retrospective study was to determine whether vascular endothelial growth factor (VEGF)- genetic polymorphisms are associated with risk for proliferative retinopathy of prematurity (ROP), a condition that is characterized by abnormal retinal neovascularization and can lead to retinal detachment and result in blindness. We enrolled 86 very low birth weight infants (birth weight ≤ 1500 g) who had been treated with cryo/laser therapy because of the risk for proliferative ROP (treated group). Their VEGF T- 460C and G+ 405C genotypes were determined from dried blood samples and were compared with VEGF genotypes of 115 VLBW infants who were not treated with cryo/laser therapy (untreated group). We found that the allele frequency of VEGF + 405C was higher in the treated group than in the untreated group (0.30 versus 0.41; psted for risk factors of ROP (95% CI): 2.00 (1.02- 3.92; p=0.04) and 3.37 (1.17- 9.65; p=0.007), respectively]. VEGF- 460TT/ + 405CC haplotype was more prevalent in the treated patients than in the untreated patients (13 of 86 versus 1 of 115; pstment for risk factors of ROP (gesta tional age, supplemental oxygen therapy, and gender). These findings suggest that the VEGF genotype may be associated with risk for proliferative ROP in VLBW infants.

关键词：遗传多态性增生性新生血管形成视网膜脱离低出生体重婴儿携带者纯合子杂合子生时了因

4期早产儿视网膜病变3通道保留晶状体式玻璃体切割术治疗后的视力预后

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世界核心医学期刊文摘（眼科学分册） 2006年第10期2卷 11-11页

作者： Lakhanpal R.R. Albini T.A. E.R.Holz 王永强 Vitreoretinal Diseases and Surgery Baylor College of MedicineNC-2056565 Fannin StHoustonTX 77030United States Dr.

Objective:To assess the visual acuity of eyes successfully treated with 3-port lens-sparing vitrectomy for stage 4 retinopathy of ***:Of 102 consecutive eyes achieving at least posterior pole reattachment,30 eyes of 26 patients were tested by Teller or Allen acuity measurements and were subsequently converted to logarithm of the minimum angle of resolution(logMAR).Visual outcomes were also examined as either favorable or unfavorable(Snellen equivalent >20/200).Results:Seventy-two eyes were not tested because of either inability to performtesting(age or neurologic sequelae related to prematurity)or loss of *** those tested,mean± SD logMAR visual acuity for the stage 4A and stage 4B groups was 0.51± 0.09(Snellen approximate 20/62)and 1.03± 0.19(Snellen approximate 20/200),respectively(odds ratio,0.39;95% confidence interval,0.24-0.64;P=.001).Of those eyes assessed by Teller measurements,10 of 10 stage 4A eyes and 3(37.5%)of 8 stage 4B eyes had favorable outcomes;among eyes assessed with Allen measurements,4 of 4 stage 4A eyes and 0 of 8 stage 4B eyes had favorable ***:The majority of eyes were not *** eyes tested after successful 3-port lens-sparing vitrectomy,some eyes treated prior to macular detachment may be associated with a more favorable outcome and improved maintenance of functional visual acuity.

关键词：玻璃体切割术黄斑脱离视网膜复位视功能后极部失访能力问题测量方法 Teller

后部葡萄膜黑色素瘤^(125)I板放射治疗后的脂质渗出

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世界核心医学期刊文摘（眼科学分册） 2006年第6期2卷 18-18页

作者： Mills M. D. Harbour J. W. 王大江(译) 不详 Department of Ophthalmology and Visual Sciences Washington University School of Medicine Campus Box 8096 660 South Euclid Avenue St Louis MO 63110 United States

PURPOSE: To investigate factors associated with lipid exudation after plaque radiotherapy for uveal melanoma. DESIGN: Retrospective interventional case series. METHODS: Records of 139 consecutive uveal melanoma patients treated with I-125 plaque radiotherapy were reviewed. Lipid exudation was the major outcome measured. RESULTS: Lipid exudation was detected in 19 patients (13.7% ). Mean time from plaque therapy to lipid exudation was 10 months (range,3-23 months). Lipid exudation was associated with younger patient age (P=.0002),increased low-density lipoprotein (P=.004),decreased highdensity lipoprotein (P=.026),increased tumor thickness (P=.024),and exudative retinal detachment (P=.016). Patients with lipid exudation had worse visual outcome (P stinct from those associated with radiation retinopathy,and they may suggest interventions to combat this complication.

关键词：渗出性视网膜脱离葡萄膜黑色素瘤放射治疗后 ^125I 脂质新生血管性青光眼患者年龄低密度脂蛋白高密度脂蛋白视网膜病变

Pegaptanib治疗新生血管性老年性黄斑变性

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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 8-8页

作者： Gragoudas E.S. Adamis A.P. Cunningham Jr. E.T. 陈立军 Ret ina Service Massachusetts Eye and Ear Infirmary Harvard Medical School 243 Ch arles St. Boston MA 02114 United States Dr.

BACKGROUND: Pegaptanib, an anti-vascular endothelial growth factor therapy, w as evaluated in the treatment of neovascular age-related macular degeneration. METHODS: We conducted two concurrent, prospective, randomized, double-blind, mu lticenter, dose-ranging, controlled clinical trials using broad entry criteria. Intravitreous injection into one eye per patient of pegaptanib (at a dose of 0. 3 mg, 1.0 mg, or 3.0 mg) or sham injections were administered every 6 weeks over a period of 48 weeks. The primary end point was the proportion of patients who had lost fewer than 15 letters of visual acuity at 54 weeks. RESULTS: In the com bined analysis of the primary end point (for a total of 1186 patients), efficacy was demonstrated, without a dose-response relationship, for all three doses of pegaptanib (Pst fewer than 15 letters of visual acuity, as compared with 5 5 percent among the controls (P study drug, and at a ll subsequent points, the mean visual acuity among patients receiving 0.3 mg of pegaptanib was better than in those receiving sham injections (P detachment (in 0.6 p ercent) were the most serious and required vigilance. These events were assoc

关键词：老年性黄斑变性 Pegaptanib 玻璃体腔注射组视网膜脱离晶体损伤临床试验周给眼内炎并行性