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    find Author "徐延山" 3 results
    • 糖尿病性黃斑水腫的藥物治療進展

      糖尿病性黃斑水腫(DME)是導致糖尿病視網膜病變(DR)患者視力下降的主要原因之一。目前,激光光凝和玻璃體手術治療已經明顯降低了DR的致盲率,但二者對于改善視力的療效、特別是對于糖尿病性黃斑水腫的療效尚不能令人滿意。隨著對DR發病機制的深入研究,目前已開發出多種藥物用于防治DR,特別是在治療DME方面取得了一定的療效,包括糖皮質激素、抗血管內皮生長因子藥物、非甾體類藥物、降血脂藥物、血管緊張素抑制劑和選擇性蛋白激酶Cbeta;抑制劑。本文就近幾年來藥物治療糖尿病性黃斑水腫的進展作一綜述。

      Release date:2016-09-02 05:40 Export PDF Favorites Scan
    • The differences of horizontal optic disc diameter and cup/disc ratio in eyes with different kinds of retinal vein occlusion

      ObjectiveTo observe the differences of horizontal optic disc diameter and cup/disc (C/D) ratio in eyes with different kinds of retinal vein occlusion (RVO). MethodsA total of 392 eyes from 385 RVO patients diagnosed by fundus fluorescein angiography (FFA) were included in this study. The patients included 192 males and 193 females. The average age was (58.30±11.51) years. The disease duration was from 7 days to 1 month. The eyes were divided into RVO group (356 eyes), RVO combining diabetes mellitus (DM) group (20 eyes) and RVO combining high blood pressure (HP) group (16 eyes). One hundred normal eyes examined by FFA in the same testing period were selected as the control group. Among the 356 eyes in the RVO group, there were 201 eyes with branch RVO (BRVO), 100 eyes with central RVO (CRVO), 17 eyes with hemi CRVO (H-CRVO), and 38 eyes with macular BRVO (M-BRVO). Among the 101 non-ischemic RVO eyes, there were 17 eyes with BRVO, 53 eyes with CRVO, 6 eyes with H-CRVO, and 25 eyes with M-BRVO. Among the 255 ischemic RVO eyes, there were 184 eyes with BRVO, 47 eyes with CRVO, 11 eyes with H-CRVO and 13 eyes with M-BRVO. The diameter of optic cup and disk, and the C/D ratio was measured on fundus infrared radiation (IR) IR30°image by Heidelberg confocal laser fundus imaging system. ResultsThere was no significant difference of horizontal optic disc diameter among 4 groups (F=1.17, P>0.05). The difference of C/D ratio was significant among 4 groups (F=82.24, P<0.05). The differences of horizontal optic disc diameter and C/D ratio in different kinds of RVO in normal group and RVO group were significant (F=4.49, 61.396; P<0.05). The horizontal optic disc diameter of eyes with CRVO was a little smaller than normal eyes (P<0.05). There was no difference of horizontal optic disc diameter between the eyes with BRVO, M-BRVO, H-CRVO and normal eyes (P>0.05). The difference of C/D ratio was significant between the eyes with BRVO, CRVO, M-BRVO, H-CRVO and normal eyes (P<0.05). The differences of horizontal optic disc diameter and C/D ratio were significant between RVO group (in different kinds of RVO eyes) and control group (F=3.94, 33.16; P<0.05). Compared the horizontal optic disc diameters of RVO eyes with the same subtype, the difference was significant between non-ischemic H-CRVO and ischemic H-CRVO (P<0.05), while the differences were not significant between other non-ischemic RVO and ischemic CRVO (BRVO:P=0.35,CRVO:P=0.86,M-BRVO:P=0.22). The difference of C/D ratio between non-ischemic RVO and ischemic CRVO was not significant (BRVO:P=0.35,CRVO:P=0.48,H-CRVO:P=1.00,M-BRVO:P=1.00). ConclusionsThe C/D ratio increased with varying degrees in RVO eyes. There is no obvious change in horizontal optic disc diameters except for CRVO eyes.

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    • Comparision of multifocal electroretinogram and optical coherence tomography in diabetic retinopathy before and after photocoagulation

      Objective Toinvestigate the influence of photocoagulation on macular function and morphous in patients with diabetic retinopathy (DR).Methods Forty eyes of thirty patients with severe nonproliferative diabetic retinopathy (NPDR) were examined by multifocal electroretinogram (mfERG) and optical coherence tomography (OCT) before and 2,7, and 14 days after photocoagulation. The results were statistically analyzed by using analysis of variance and t test; the changes of macular function and macular fovea thickness were detected and observed.Results P1 response densities of ring 1,3,and 5 were 131.79plusmn;50.92,37.50plusmn;17.27,24.07plusmn;11.49,respectively,2 days after photocoagulation; and were 212.96plusmn;53.75,46.70plusmn;15.89,and 30.91plusmn;10.78, respectively, before photocoagulation. The densities before and after photocoagulation differed much(t=7.910, 2.174, 2.205; Plt;0.05). N1 response density of ring 4 was(60.39plusmn;20.69) and the prephotocoagulation corresponding response density was (107.11plusmn;44.63); the difference was significant(t=5.375,Plt;0.01). The latency of P1 of ring 4 was(41.83plusmn;3.41),which had significant statistically difference(t=-2.770,Plt;0.05) with that before photocoagulation(39.52plusmn;2.64); there was no significant changes in the latency of N1 (Pgt;0.05). The most significant changes of P1 and N1 response densities occurred in the central macular 5deg; area. Seven days after photocoagulation, the response density of P1 and N1 in the central macular 5deg; area seemed to be recoverd to some extend and increased to (179.70plusmn;47.10)and (81.11plusmn;34.18) respectively until 14 days after photocoagulation, which was still much lower than that before the photocoagulation(t=3.840, 2.746; P<0.05); the response densities of other areas had no significant differences (P>0.05). Seven days after photocoagulation,the latency of P1 in ring 4 was delayed to(41.78plusmn;3.57), which had significant difference(t=-3.144,P<0.01)with that before the photocoagulation(39.52plusmn;2.64) ; but there was no significant difference between 14 days after photocoagulation and prephotocoagulation (t=-1.809,P>0.05). The latency of N1 in ring 1 was(20.67plusmn;3.85)at seven days after photocoagulation, It had no significant difference (t=-1.171,P>0.05) with that before the phtocoaguation(18.78plusmn;3.29). Before and 2 days after photocoagulation, the macular fovea thickness were(224.42plusmn;122.88)and(274.85plusmn;108.20)respectively, and the difference was statistically significant(t=-2.420,P<0.05). Forteen days after photocoagulation,the macular fovea thickness was(236.29plusmn;70.45),It had no significant difference with that before the photocoagulation(t=-0.578,P>0.05). Before and seven days after photocoagulation, P1 response density had obvious negative correlation with corresponding macular fovea thickness(r=-0.755,Plt;0.01; r=-0.594,Plt;0.05). Conclusions  After photocoagulation in patients with DR,the macular function decreased in a certain degree,and the relationship of macular retinal function and macular morphology changes was close; combination of mfERG and OCT can evaluate macular function and macular morphology structure comprehensively and objectively.

      Release date:2016-09-02 05:43 Export PDF Favorites Scan
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  • 松坂南