青光眼患者手术前后的护理

目的：探讨青光眼患者手术前、手术后临床特点、护理措施.方法：对2009-01~2012-01收治的经青光眼小梁切除术及在手术前、手术后采取综合护理措施的309例青光眼患者临床资料,进行回顾性分析.结果：309例青光眼患者经治疗及护理均疗效满意、治愈出院.结论：对青光眼手术患者进行有效的护患沟通、认真细致的观察、分析、适时的健康指导、及时有效的护理措施,是确保手术成功、提高治愈率的重要环节.     

小鼠视神经再生研究动物模型的建立

目的总结制作小鼠视神经完全截断性动物模型作为视神经再生研究的经验和体会。方法将雄性Bcl-2高表达转基因小鼠(Bcl-2 transgenic mice)和受GFAP启动子控制表达疱疹病毒-胸苷激酶转基因雌性小鼠(GFAP-TK)交配产生的4只8~12周成年小鼠(20~30g),Bcl-2/GFAP-TK双转基因小鼠作为实验组,同周龄4只Bcl-2转基因小鼠作为对照组。其中Bcl-2/GFAP-TK双转基因小鼠皮下植入缓释泵,连续7d释放更昔洛韦(GCV)100mg.kg-1.d-1以选择性地去除视神经损伤后激活的星形胶质细胞。更昔洛韦缓释泵植入术后2d在两组动物中制作右侧单眼标准完全性视神经钳夹损伤模型,视神经钳夹10d后获取组织标本。采用免疫荧光染色特异性检测再生轴突纤维并进行定量分析;结合罗丹明的霍乱毒素B亚单位(CTB-R)或增强表达绿色荧光蛋白的复制缺陷型腺相关病毒(AAV-EGFP)用作顺行性标记物以显示再生轴突是否到达大脑靶器官。结果在Bcl-2/GFAP-TK双转基因小鼠中存在免疫荧光阳性的再生视神经轴突,再生轴突计数为71.99±24.04,并可见生长锥(growth cone)样结构,但是再生轴突纤维未能延伸达到大脑靶器官。在对照组Bcl-2转基因小鼠中未见明显再生迹象。结论小鼠视神经完全截断性动物模型可用于视神经病变的再生研究。     

青光眼病人口服乙酰唑胺致急性肾衰6例分析

为讨论青光眼病人口服乙酰唑胺致急性肾衰的发病几率、临床表现、发病机理及其严重性，对２１３例口服乙酰唑胺的青光眼病人进行回顾性调查。结果表明，有６例病人出现急性肾衰。可认为急性肾衰为青光眼病人口服乙酰唑胺较严重且常见的并发病，为该药的不良反应所致，临床上应予以重视。     

Glaucoma classification based on visual pathway analysis using diffusion tensor imaging

Most of the existing methods for diagnosing glaucoma analyze the eye with a main focus on the retina, despite the transsynaptic nature of the fiber degeneration caused by glaucoma. Thus, they ignore a significant part of the visual system represented by the visual pathway in the brain. The advances in neuroimaging, especially diffusion tensor imaging (DTI), enable the identification and characterization of white matter fibers. In this work, we propose a system based on DTI analysis of the visual pathway fibers in the optic radiation for detecting and discriminating different glaucoma entities. The optic radiation is identified semi-automatically. DTI provides information about the fiber orientation as well as a set of derived parameters describing the degree of diffusion anisotropy and diffusivity. Features for each DTI derived measure are extracted from a specified region of interest on the optic radiation. The features are grouped into three sets: Histogram, co-occurrence matrices, and Laws features. For feature selection, the features are ranked using a support vector machine classifier. The highest ranked features are used for classification. A support vector machine classifier is used for classification in a 10-fold cross validation setup. The system is applied to three age-matched subjects’ categories containing 27 healthy, 39 primary open angle glaucoma (POAG), and 18 normal tension glaucoma (NTG) subjects. The discrimination accuracy between healthy and glaucoma (POAG and NTG) subjects is 94.1% with an area under the ROC of 0.97. Classification accuracy of 92.4% is obtained for the normal and the POAG groups while it increased to 100% in case of healthy and NTG groups. In addition, the system could differentiate between glaucoma types (POAG and NTG) with an accuracy of 98.3%. A complementary analysis was performed to estimate the selection bias in the obtained accuracy. The bias ranged from 10% to 20% depending on the group pair under consideration. The classification results indicate the high performance of the system compared to retina-based glaucoma detection systems. The proposed approach utilizes visual pathway analysis rather than the conventional eye analysis which presents a new trend in glaucoma detection. Analyzing the entire visual system could provide significant information that can improve the glaucoma examination flow and treatment.     

20例(24眼)晶体溶解性青光眼临床观察

目的 :探讨晶体溶解性青光眼病因及治疗手段。方法 :对所诊治20例(24眼)晶体溶解性青光眼的临床表现、诊断及鉴别诊断、治疗及预后进行了分析、讨论。结果 :20例(24眼)中有21眼经过适时恰当的治疗 ,取得了满意的效果 ,3例(3眼)因延误诊治而视力无提高。结论 :完整地摘除晶状体是治疗晶体溶解性青光眼的根本措施     

A framework for voxel-based morphometric analysis of the optic radiation using diffusion tensor imaging in glaucoma

Glaucoma is an optic neuropathy affecting the entire visual system. The understanding of the glaucoma mechanism and causes remains unresolved. Diffusion tensor imaging (DTI) has been used to analyze the optic nerve and optic radiation showing global fiber abnormalities associated with glaucoma. Nevertheless, the complex structure of the optic radiation and the limitations of DTI make the localization of the glaucoma effect a difficult task. The aim of this work is to establish a framework for the determination of the local changes of the optic radiation due to glaucoma using DTI. The proposed system utilizes a semiautomated algorithm to produce an efficient identification of the optic radiation. Segmented optic radiations are transformed to a unified space using shape-based nonrigid registration. Using the deformation fields that resulted from the registration, the maps of the diffusion tensor-derived parameters are transformed to the unified space. This allows for statistical voxel-wise analysis to produce significant abnormality maps. The proposed system is applied to a group of 13 glaucoma patients and a normal control group of 10 subjects. The groups are age matched to eliminate the age effect on the analysis. Diffusion-related parameters (axial, radial and mean diffusivities) and an anisotropy index (fractional anisotropy) are studied. The anisotropy analysis indicates that the majority of the significant voxels show decreased fractional anisotropy in the glaucoma patients compared with the control group. In addition, the significant regions are mainly distributed in the middle (in reference to anterior–posterior orientation) of the optic radiation. Glaucoma subjects have increased radial diffusivity and mean diffusivity significant voxels with a main concentration in the proximal part of the right optic radiation. The proposed analysis provides a framework to capture the significant local changes of the optic radiation due to glaucoma. The preliminary analysis suggests that the glaucomatous optic radiation may suffer from localized white matter degeneration. The framework facilitates further studies and understanding of the pathophysiology of glaucoma.     

青光眼动物模型研究进展

青光眼是一种不可逆性视神经退行性病变,为全球第二位致盲眼病。在青光眼研究领域,动物模型已成为重要的研究工具。青光眼动物模型对于更好的理解青光眼性视神经病变的损伤机制及治疗措施有着重要的作用。目前研究中使用最多的动物主要有鼠、兔、猴。本综述较全面系统地概述了各种青光眼动物模型的研究进展,包括近年来发展的转基因鼠青光眼模型,如急性高眼压转基因小鼠CLR(calcitonin receptor-like receptor)、利用基因打靶技术构建的自然青光眼模型等,并分别对各种模型在视网膜神经节细胞(RGCs)、视神经、视网膜功能方面的研究做了介绍,分析各种模型的利与弊,为在青光眼研究中更好地选择合适的模型提供依据。     

虹膜嵌顿术式的再评价

目的:阐明虹膜嵌顿术在目前抗青光眼手术术式中仍有其独特的治疗优势并探讨其治疗机制.方法:整理10年来扎鲁特旗人民医院院虹嵌术治疗各类青光眼19例的资料并做了初步统计分析及介绍手术方法的一些改进.结果:全部绝对期青光眼及继发性青光眼都解除了痛苦,免去了冰冻、装阀的临床处置,个别病例有<0.05的视力,没有出现眼球萎缩,外观满意.5例急性闭角型青光眼及1例先天型青光眼视力在0.6～1.0之间及0.2.滤过功能可靠.结论:虹膜嵌顿术在青光眼手术中仍有一席之地,在复杂的临床手术治疗工作中,选择术式时应给予必要的关注.     

Proposal, verification and comparison of three computer image analysis methods for detection and evaluation of colour glaucomatous changes within the optic disc of a human eye retina

The typical symptom of the human eye glaucoma is a rise and a progression of the bright area (named pallor area) within the retina blind spot. The image analysis manner proposed by the authors detects and suitably numerically describes the relative size of the representative pallor area in the colour digital image of the retina obtained by a suitable fundus camera connected with the computer. Three new different computer image analysis statistical methods for experimental diagnostic evaluation of the obtained characteristic data are proposed in this article: the quantile curves method, the neural net method and the probability density curves method. The quantile curves method is based on the graphical comparison of a relative representative pallor area size with its determined normal value. The neural net and probability density curves methods can automatically and objectively classify the investigated eyes in exactly defined glaucoma risk classes and diagnosed glaucoma with the rated probabilities of incorrect diagnosis determination. All mentioned methods are verified and mutually compared by their application to the large statistical sets of human retina images of various healthy and glaucomatous subjects.     

不同生长期瞬目虫(Glaucoma scintillans)的同工酶的比较研究

以无菌培养的原生动物纤毛虫瞬目虫(Glaucoma scintillans)为材料,比较它们对数生长期和衰老期的酯酶同工酶,酸性磷酸酶同工酶,苹果酸脱氢酶同工酶及乳酸脱氢酶同工酶的差异.结果表明在不同生活状态下,四种酶同工酶蛋白带有明显差异;对数生长期细胞的同工酶活力和数量明显高于衰老期细胞的同工酶的活力和数量.说明同工酶不但是生物体代谢的调节者,亦能作为生物衰老的一种指标.