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25G经结膜玻璃体切除术的扩大适应证

世界核心医学期刊文摘(眼科学分册) 2006年第2期 43-44页

作者： Shimada H Nakashizuka H Mori R Mizutani Y. 韩静 department of opht halmology Surugadai Hospital Nihon University 1- 8- 13 Surugadai Kanda Ch iyoda-ku Tokyo 101- 8309 Japan

Purpose: We conducted 25- gauge (25G) transconjunctival vitrectomy to treat patients with various ocular diseases, and examined the possibility of expanding the indications for this system through combined use with 20G devices when needed. Methods: The records of 167 patients (169 eyes) who underwent vitrectomy in our hospital between April and June 2004 were studied. Vitrectomy had been conducted using the 20G or 25G transconjunctival vitrectomy system. Results: In 7 of the 169 eyes (4% ), the 20G system was initially selected. Vitrectomy could be performed using the 25G system alone in 150 eyes (89% ), while 20G devices were used in combination with the 25G system in 12 (7% ). None of the 25G scleral wounds were sutured, while all the 20G scleral wounds were sutured at the completion of surgery. Low intraocular tension was noted in 15 of 162 eyes (9% ), but all these eyes recovered within 2 to 4 days. In two eyes with macular hole, retinal detachment occurred, but reattachment was achieved after reoperation. No extensive vitreoretinal hemorrhage or postoperative infection was observed. Conclusions: By combining the use of 20G devices, indications for the 25G system can be expanded. However, postoperative low ocular tension must be addressed by carefully considering surgical indications and prevention measures.

关键词：玻璃体切除术结膜眼睑适应证

锶板近距放射治疗渗出性老年性黄斑变性:3年随机研究结果

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世界核心医学期刊文摘（眼科学分册） 2005年第11期1卷 43-44页

作者： Jaakkola A. Heikkonen J. Tommila P. I. Immonen 张鹏 department of opht halmology Helsinki University Central Hospital Haartmanink. 4C FIN-00029 HUS JP220 FinlandDr.

Objective: To determine the efficacy of strontium plaque (Sr90) brachytherapy for age-related macular degeneration (AMD) with subfoveal choroidal neovascular ization (CNV). Design: Randomized clinical trial. Participants: Eighty-eight eyes of 86 patients with subfoveal CNV secondary to AMD were randomized either to plaque radiotherapy or to observation. Intervention: Radiotherapy was given as episcleral brachytherapy using Sr 90 plaques. Two different plaque types were used. Plaque I had a diameter of 8mm and delivered a dose of 15 Gy at a depth o f 1.75 mm in 54 minutes. With plaque II, the corresponding values were 4 mm, 12. 6 Gy, and 11 minutes. The control group was observed without any treatment. Main Outcome Measures: The primary outcome measure was visual acuity at 6, 12, 24, a nd 36 months. Other outcome variables were contrast sensitivity, fluorescein ang iographic, and clinically evaluated changes in the macula. Results: Eighty-two patients (84 eyes [95%]) completed the 1-year follow-up, and 80 (93%) and 74 (86%) patients completed the 2-and 3-year follow-ups, respectively. At 6 mo nths, visual loss of < 3 lines occurred in 20%of treated patients and 42%of co ntrol patients (P=0.031). At 12 months, a visual loss of < 3 lines occurred in 4 5%(treated) and 56%(controls) (P=0.325); at 24 months, in 73%and 71%(P=0.914 ); and at 36 months, in 80%and 84%of patients (P=0.591), respectively. Patient s irradiated with plaque I had better results: a visual loss of < 3 lines occurr ed in 6%at 6 months (P=0.008, relative to controls), in 18%at 12 months (P=0.0 07), in 59%at 24 months (P=0.348), and in 71%at 36 months (P=0.212). In patien ts treated with plaque II, the corresponding values were 29%(P=0.032), 65%(P=0 .459), 83%(P=0.317), and 80%(P=0.687) at 6, 12, 24, and 36 months, respectivel y. Conclusions: The short-term clinical course of exudativeAMD is affected by S r90 brachytherapy, but by 12 months, there was no treatment benefit.

关键词：老年性黄斑变性随机研究渗出性放射治疗随机临床试验放射剂量对比敏感度荧光血管造影治疗作用临床病程

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第一眼和第二眼的倍频视野计检查的可靠性

世界核心医学期刊文摘(眼科学分册) 2006年第2期 45-46页

作者： Mukai S Tsukamoto H Iwase A Mishima H.K. 韩静 department of opht halmology and Visual Sciences Hiroshima University Graduate School of Biomedic al Sciences 1- 2- 3 Kasumi Minami-ku Hiroshima 734- 8551 Japan

Purpose: To compare the reliability of the perimetry results of the first eye and the second eye with frequency doubling technology (FDT). Methods: The subjects were 328 residents who underwent the C- 20- 5 mode of FDT at a city in central Japan. FDT perimetry was always performed first in the right eye and then in the left eye without any time between tests. When more than 33% fixation loss or false-positive error was detected, the result was judged unreliable. Results: Of the 328 subjects, the bilateral perimetry results were reliable in 255 subjects (77.7% ), the unilateral results were reliable in 57 (17.4% ), and there was not a reliable result in either eye in 16 (4.9% ) subjects. Of the 57 subjects whose unilateral result was unreliable, the result of the second eye was unreliable in 50 (88% ) subjects, and the result of the first eye was unreliable in 7 (12% ). This difference in the reliability between the first eye and second eye was significant (P< 0.001). There were no differences in the age, sex, visual acuity, refractive error, test duration, or number of glaucoma suspects between the two groups whose unilateral result was unreliable in the first eye or the second eye. Conclusions: The FDT perimetry result of the second eye was less reliable than that of the first eye.

关键词：视野计第一眼单眼倍频

老年性黄斑病变患者眼底自发荧光的变化及其与视功能的相关性:一项前瞻性研究

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世界核心医学期刊文摘（眼科学分册） 2005年第10期1卷 34-34页

作者： Einbock W. Moessner A. Schnurrbusch U.E.K. S. Wolf 杜兆江 department of opht halmology University of Leipzig Liebigstrasse 10-14 04103 Leipzig Germany

Background: As members of the Fundus Autofluorescence in Age-related Macular Degeneration Study Group (FAM Study Group), we report changes of fundus autofluo rescence (AF)-in patients with multiple soft drusen in correlation to visual fu nction. Methods: Inclusion criteria were age > 50 years, the presence of soft dr usen, visual acuity of 20/100 or better, and no previous laser treatment in the study eye. All patients underwent a detailed ophthalmological examination includ ing ETDRS visual acuity, binocular funduscopy, and color fundus photography. AF imaging was performed with a confocal scanning laser ophthalmoscope following a standard protocol. We used the classification of the International Fundus Auto- fluorescence Classification Group (IFAG) for the description of the AF patterns. Results: One hundred and twenty-five patients (81 women, 44 men) aged from 55 to 86 years (mean 70±7 years) were included in this prospective study. During f ollow-up (mean 18±6 months), 6 of 35 eyes with patchy AF pattern developed exu dative changes, as well as 2 eyes with focal-plaque-like AF pattern and 1 eye with reticular pattern at baseline. Geographic atrophy was seen in two eyes with focal AF pattern and one eye with focal-plaque-like pattern at baseline. A to tal of 11 eyes presented with severe visual loss (6 ETDRS lines). Ten (91%) o f these had patchy AF pattern. Conclusion: Imaging of fundus AF in patients with age-related maculopathy allows identification of different patterns of fundus AF. Our preliminary data suggest that a patchy pattern of AF indicates a relativ ely high risk of progression to age-related macular degenerationwith visual los s.

关键词：黄斑病变自发荧光视功能软性玻璃膜疣老年性黄斑变性彩色眼底照相激光扫描检眼镜眼底镜检查眼科检查斑片样

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