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The Efficacy of Anterior-Nasal Surgery in Managing Inferior Oblique Overaction either with DVD or with V Pattern 前鼻手术治疗DVD型或V型下斜肌过动的疗效观察
Pub Date : 2020-01-01 DOI: 10.35248/2155-9570.21.11.854
M. Arafa, El Sayed M Eltoukhy, M. Kamal, M. Said
Objective: This study aims at determining the efficacy of anterior and nasal transposition of Inferior Oblique to manage dissociated vertical deviation and vertically incomitant horizontal strabismus (V pattern). Method: This study was both prospective and uncontrolled; it included 60 patients who suffered from inferior oblique overaction. The participants were divided into two groups: Group A had 30 patients with vertically incomitant horizontal strabismus while group B had 30 patients with dissociated vertical deviation. Preoperative examination included: Assessment of vision, ductions and versions in the six cardinal directions of gaze and severity of IOOA graded from 0 to +4. The percentage of dissociated vertical deviation was measured using the prism under cover test in primary position. Follow-up visits occurred in the following intervals: After one week, one month, four months, and six months respectively. In each follow-up visit, the measurements of ductions, versions, and alignment in primary position were recorded. Results: Group A showed no pattern in 93.3% of cases postoperatively while 6.7% of cases developed insignificant V pattern (0.8 ± 2.9 ΔD), with statistically significant difference between the pre-and post-operative values (pvalue< 0.001). Meanwhile, group B showed a complete resolution of DVD in 100% of cases with preoperative (DVD<15 ΔD) and in 20% of cases with preoperative DVD ≥ 15 ΔD; the remaining cases had residual DVD (3.6 ± 4.1 ΔD). Conclusion: Anterior-nasal transposition of the Inferior Oblique muscle is an effective procedure for cases with severe or recurrent inferior oblique overaction when other standard procedures of Inferior Oblique muscle fail. For DVD ≥ 15 ΔD, we recommend a combined anterior-nasal transposition of inferior oblique with superior rectus recession.
目的:探讨下斜斜视前鼻转位治疗游离性垂直斜视和垂直不同时的水平斜视(V型)的疗效。方法:本研究为前瞻性和非对照研究;它包括60例患有下斜肌过度活动的患者。实验对象分为两组:A组30例垂直合并水平斜视,B组30例分离性垂直斜视。术前检查包括:视力、6个注视方向的视径和视型评估,IOOA严重程度评分0 ~ +4。在主位置采用盖下棱镜试验测量解离垂直偏差百分比。随访时间分别为一周、一个月、四个月和六个月。在每次随访中,记录导管、版本和主要位置对准的测量。结果:A组93.3%的患者术后无V型,6.7%的患者术后无V型(0.8±2.9 ΔD),两组术前、术后差异有统计学意义(p值< 0.001)。同时,B组术前DVD<15 ΔD的100%,术前DVD≥15 ΔD的20%的患者DVD完全消退;其余病例DVD残留(3.6±4.1 ΔD)。结论:下斜肌前鼻转位术是治疗严重或复发性下斜肌过度动作而其他标准下斜肌手术失败的有效方法。对于DVD≥15 ΔD,我们建议联合前鼻转位下斜肌与上直肌后退。
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引用次数: 0
Comparison of Morphological and Functional Corneal Endothelial Changes after Cataract Surgery under DBCS Program at a Tertiary Care Centre 三级保健中心DBCS项目下白内障手术后角膜内皮形态和功能变化的比较
Pub Date : 2020-01-01 DOI: 10.35248/2155-9570.20.11.823
M. Gupta, Manjunath Bh, Sachin S Shedole
Introduction: Cataract extraction constitutes the largest workload through DBCS program in ophthalmic units in India. Both SICS & Phacoemulsification surgery are performed in a limited, confined space; however, securing adequate surgical space during cataract surgery can decrease the risk of corneal endothelial cell loss.1 Thus, anatomical and surgical factors, such as adequate Anterior Chamber Depth (ACD), are important for preserving these cells from the mechanical and thermal damage that can occur during the procedure. Under normal circumstances, corneal endothelial cells do not proliferate because they are stuck in G1 phase of cell cycle. The central corneal endothelial cell density gradually decreases at an average of about 0.6% per year, reducing approximately from 3400 cells/mm2 at age 15 to 2300 cells at age 80 years. Two important factors in maintaining corneal transparency are the number and the integrity of the corneal endothelial cells.3 Corneas with cell densities as low as 500 cells/mm2 and average cell area of approximately 2000-3000 μm2 can remain clear. Protection of corneal endothelium during cataract surgery is critical for achieving good visual outcomes. Objectives: To study the endothelial cell loss in SICS and Phacoemulsification and compare the cell loss between two surgeries and to compare morphological and functional changes in corneal endothelium between the two surgeries. Materials and methods: A comparative prospective study is performed in 200 eyes of 200 patients attending DBCS Camp at Babuji Eye Hospital and Chigateri General Hospital attached to JJM Medical College Hospital, Davanagere from July 2018 to October 2019 for cataract surgery. Patients were randomly allocated to two groups. One group underwent small incision cataract surgery and the other group underwent phacoemulsification. Corneal endothelial assessment was done for patients undergoing both the surgeries using non-contact specular microscopy Tomey EM 3000 preoperatively and postoperatively at 1 week and 6 weeks. Results: In SICS group, corneal endothelial count was 2303.0 ± 329.1 preoperatively, postoperatively it was reduced to 2068.9 ± 381.1 at 1 week and 1980.3 ± 401.5 at 6 weeks. In phacoemulsification group, it was found to be 2213.9 ± 442.3 preoperatively and which reduced to 1878.7 ± 458.3 at 1 week and 1796.4 ± 467.3 at 6 weeks postoperatively. Cases in SICS group showed 10.2% loss at 1 week and 14% cell loss at 6 weeks while phacoemulsification group showed 15.1% cell loss at 1 week and 18.9% cell loss at 6 weeks. Polymegathism was increased in both the groups while hexagonality was decreased in both groups. No significant difference in functional parameters like central corneal thickness (CCT) and best corrected visual acuity (BCVA) was observed in both SICS and Phacoemulsification group at the end of 6 weeks. Conclusion: The study shows that phacoemulsification is safe procedure in experienced hands. Compared to phacoemulsificati
导读:通过DBCS项目,白内障摘除是印度眼科单位最大的工作量。超声乳化术和超声乳化术都是在有限的空间内进行的;然而,在白内障手术中确保足够的手术空间可以降低角膜内皮细胞丢失的风险因此,解剖和手术因素,如足够的前房深度(ACD),对于保护这些细胞免受手术过程中可能发生的机械和热损伤是重要的。正常情况下,角膜内皮细胞处于细胞周期G1期,不能增殖。角膜中央内皮细胞密度以平均每年0.6%的速度逐渐下降,大约从15岁时的3400个细胞/mm2减少到80岁时的2300个细胞/mm2。维持角膜透明度的两个重要因素是角膜内皮细胞的数量和完整性当细胞密度低至500个细胞/mm2,平均细胞面积约为2000-3000 μm2时,角膜仍能保持清晰。白内障手术中角膜内皮的保护是获得良好视力的关键。目的:研究超声乳化术和超声乳化术中角膜内皮细胞的损失情况,比较两种手术中角膜内皮细胞的损失情况,比较两种手术中角膜内皮细胞形态和功能的变化。材料与方法:对2018年7月至2019年10月在Davanagere JJM医学院附属Babuji眼科医院和Chigateri总医院参加DBCS营的200例白内障手术患者的200只眼进行比较前瞻性研究。患者随机分为两组。一组行小切口白内障手术,另一组行超声乳化术。术前和术后1周和6周分别使用Tomey EM 3000非接触式镜面显微镜对接受手术的患者进行角膜内皮评估。结果:SICS组角膜内皮细胞计数术前为2303.0±329.1,术后1周为2068.9±381.1,6周为1980.3±401.5。超声乳化术组术前为2213.9±442.3,术后1周为1878.7±458.3,术后6周为1796.4±467.3。超声乳化术组1周细胞损失10.2%,6周细胞损失14%,超声乳化术组1周细胞损失15.1%,6周细胞损失18.9%。多形性在两组中都有所增加,而六边形在两组中都有所减少。6周结束时,超声乳化术组和超声乳化术组角膜中央厚度(CCT)、最佳矫正视力(BCVA)等功能参数均无显著差异。结论:超声乳化术在有经验的人手中是安全的。与超声乳化术相比,小切口白内障手术术后内皮损伤较低。我们建议在白内障手术中有内皮损伤风险的患者应使用SICS。
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引用次数: 1
Macular Displacement Following Rhegmatogenous Retinal Detachment Repair Using either Silicone Oil or Gas Tamponade: A Comparative Study 硅油或气体填塞修复孔源性视网膜脱离后黄斑移位的比较研究
Pub Date : 2020-01-01 DOI: 10.35248/2155-9570.20.11.851
Khalid Kotb AbdAllah, M. Kamal, M. Abada, Amr Abdelaziz Azaab, Ragai Magdi Hatata
Purpose: To investigate the incidence of unintentional macular displacement by using fundus auto-fluorescence (FAF) imaging in eyes undergoing PPV for repair of primary rhegmatonous retinal detachment (RRD) and tamponated with either silicon oil (SO) or gas, its association with symptoms of visual disturbance. Methods: Prospective study including 40 eyes with fresh RRD. 3 port pars planavitrectomy was done with gas or silicon oil tamponade. Three months after surgery macular displacement was evaluated by fundus autofluorescence. Results: Of the 40 cases, After silicon oil removal or complete gas absorption, macular displacement was evaluated by fundus autofluorescence fundus autofluorescence images showed retinal displacement in 11 eyes (27.5%) after surgery. In SO group, 3 eyes showed retinal displacement upwards with incidence (15%). In Gas group, 8 eyes showed retinal displacement downwards with incidence (40%). In the patients with evidence of retinal displacement on FAF, metamorphopsia and micropsia were present in 81.8% (9/11) eyes and 18.2% (2/11) respectively, on the other hand in those with no evidence of retinal displacement on FAF , metamorphopsia and micropsia were present in 58.6% (17/29) eyes and 10.3% (3/29) respectively. Conclusion: Unintentional displacement of the retina after repair of primary and uncomplicated detachments with PPV may be observed using either SO or gas, but slightly more in gas tamponade, this displacement doesn’t affecting BCVA of patients.
目的:应用眼底自身荧光(FAF)成像技术,探讨硅油或气体填塞对PPV修复原发性流变性视网膜脱离(RRD)的影响及其与视力障碍症状的关系。方法:对40只新鲜RRD眼进行前瞻性研究。采用气或硅油填塞术行3口平面玻璃体切除术。术后3个月用眼底自体荧光法评价黄斑移位。结果:40例患者中,硅油去除或气体完全吸收后,采用眼底自体荧光法评估黄斑移位,术后自体荧光图像显示视网膜移位11眼(27.5%)。SO组视网膜移位3眼,发生率上升(15%)。Gas组视网膜向下移位8眼,发生率为40%。在有FAF视网膜移位证据的患者中,变形和缩小的发生率分别为81.8%(9/11)和18.2%(2/11),而在无FAF视网膜移位证据的患者中,变形和缩小的发生率分别为58.6%(17/29)和10.3%(3/29)。结论:原发性和非复杂性PPV脱离修复后,使用SO或气体均可观察到视网膜的无意移位,但气体填塞时略多,这种移位不影响患者的BCVA。
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引用次数: 0
Epibulbar Seeding of Uveal MALT Lymphoma Following Vitrectomy 玻璃体切除术后葡萄膜MALT淋巴瘤的球外播种
Pub Date : 2020-01-01 DOI: 10.35248/2155-9570.20.11.865
P. Clark, D. McCartney, K. Mitchell, M. Shami
Purpose: One of the most feared complications of intraocular tumor biopsy with fine needle aspiration biopsy (FNAB) or vitrectomy-assisted biopsy is seeding of the tumor cells directly into the needle tract. We present a case of epibulbar seeding of uveal MALT lymphoma following vitrectomy. Observations: A 67-year-old male presented with painless loss of vision of the left eye and creamy yellow infiltrates at the level of the choroid. A diagnostic 25-gauge pars plana vitrectomy was performed using a standard 3-port approach. Choroidal biopsy of the lesion demonstrated the presence of Mucosa-Associated Lymphoid Tissue (MALT) lymphoma. Three weeks following vitrectomy, the patient developed a large fleshy subconjunctival mass centered over the prior superonasal sclerotomy site. The lesion was completely excised and histopathology of the lesion demonstrated MALT lymphoma with an identical immunohistochemical staining pattern to that of the choroidal lesion. Conclusions and Importance: Transvitreal biopsy with fine needle aspiration or vitrectomy is an increasingly common and safe procedure for clinical diagnosis of intraocular tumors. However, there is a risk of tumor seeding of the needle tract and precautions to reduce this risk are warranted.
目的:眼内肿瘤细针穿刺活检(FNAB)或玻璃体切除术辅助活检最可怕的并发症之一是肿瘤细胞直接进入针道。我们报告一例玻璃体切除术后葡萄膜MALT淋巴瘤的球外播散。观察:67岁男性,左眼无痛性视力丧失,脉络膜水平有乳黄色浸润。采用标准的3孔入路行诊断性25号玻璃体切割。病变的脉络膜活检显示存在粘膜相关淋巴组织(MALT)淋巴瘤。玻璃体切除术后三周,患者在先前的鼻上巩膜切开术部位出现了一个大的肉质结膜下肿块。病变完全切除,组织病理学显示MALT淋巴瘤,免疫组织化学染色模式与脉络膜病变相同。结论和重要性:经玻璃体活检加细针穿刺或玻璃体切除术是临床上诊断眼内肿瘤的一种越来越普遍和安全的方法。然而,存在肿瘤植入针道的风险,采取预防措施降低这种风险是必要的。
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引用次数: 0
The Foveal Splitter 中央凹分离器
Pub Date : 2020-01-01 DOI: 10.35248/2155-9570.21.11.855
ShishirVerghese, George J. Manayath, K. Kumarswamy
A 20-year-old gentleman presented with complaints of defective vision in the right eye (OD), with best corrected visual acuity of 20/60. His anterior segment was normal. Fundus examination revealed circumpapillaryangioid streaks radiating from the optic disc with one passing subfoveally along with a presence of a Choroidal neovascular membrane (CNVM) (Figure 1A). Ocular coherence tomography (OCT) confirmed the presence of a type II CNVM under the fovea (Figure 1B). Ocular coherence tomography angiography (OCTA) reveals the subfovealneovascular network at the level of the deep capillary plexus originating from below the RPE (Figures 1C and 1D). This case highlights the uniqueness of the angioid streak splitting through the fovea and the role of OCTA as a noninvasive alternative to dye based angiography for diagnosis of CNVM secondary to angioid streaks. Up to 50% of angioid streaks are idiopathic, with the rest having an association with systemic disease [1]. The incidence of CNVM is 72%-86% in various studies [2,3]. Our patient underwent Intravitreal Injection of Ranibizumab in OD and was referred to a physician for systemic examination and haematological workup.
一位20岁的男士以右眼视力缺陷(OD)自诉,最佳矫正视力为20/60。他的前段正常。眼底检查显示视盘放射出乳突周围类羊条纹,其中一条穿过中央凹下,并伴有脉络膜新生血管膜(CNVM)(图1A)。眼相干断层扫描(OCT)证实在中央凹下存在II型CNVM(图1B)。眼相干断层扫描血管造影(OCTA)显示起源于RPE下方的深毛细血管丛水平的凹下新生血管网络(图1C和1D)。本病例强调了血管样条纹穿过中央凹的独特性,以及OCTA作为一种无创替代染色血管造影诊断继发于血管样条纹的CNVM的作用。高达50%的血管样条纹是特发性的,其余的与全身性疾病有关[1]。在各种研究中,CNVM的发生率为72%-86%[2,3]。我们的患者在OD中接受了雷尼单抗玻璃体内注射,并被转介给医生进行全身检查和血液学检查。
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引用次数: 0
Clinical Outcomes of Iris vs. Scleral Intraocular Lens Fixation 虹膜与巩膜人工晶状体固定的临床效果
Pub Date : 2020-01-01 DOI: 10.35248/2155-9570.20.11.840
Shani Levy-Neuman, A. Marcovich, A. Bukelman, O. Reitblat, G. Kleinmann
Background: We aimed to compare the safety and efficacy of two techniques for the correction of subluxated posterior intraocular lens (IOL): scleral fixation (SFIOL) and iris fixation of IOL (IFIOL). Methods: 112 eyes of 105 patients that underwent SFIOL or IFIOL at the Kaplan Medical Center between 2008 and 2018 were retrospectively included, 73 eyes had SFIOL and 39 eyes had IFIOL. The main outcome measures were: operation time, postoperative visual acuity and intra and post-operative complications. Results: There was no significant difference in the mean operation time between SFIOL and IFIOL. The mean follow-up time was significantly longer for the IFIOL compared with the SFIOL (34 ± 31 vs. 14 ± 20 months, respectively [p>0.001]).Postoperative distance corrected visual acuity (DCVA) at the last follow-up was significantly better than the preoperative DCVA in both groups (SFIOL: 0.52 ± 0.49 vs. 1.20 ± 0.84, [p<0.001], and IFIOL: 0.75 ± 0.88 vs. 1.31 ± 0.81 [p<0.001], respectively [LogMar]). No difference in DCVA was found between the groups. Irregular pupil was found in 59% IFIOL vs. 20.5% of the SFIOL [p<0.001] and corneal edema was found in 10.3% of the IFIOL vs. 1.4% of the SFIOL [p=0.05]. No other differences in intra and post-operative complications were found between the two groups. Conclusion: Both IFIOL and SFIOL are effective and safe for the secure of IOL in the absence of adequate capsular support. Both techniques resulted in a significant improvement in DCVA. Pupil ovalization and corneal edema were more common in the IFIOL group. Longer follow-up was noticed at the IFIOL group.
背景:我们旨在比较两种矫正半脱位人工晶状体(IOL)的技术:巩膜固定(SFIOL)和虹膜固定(IFIOL)的安全性和有效性。方法:回顾性分析2008年至2018年在Kaplan医疗中心接受SFIOL或IFIOL治疗的105例患者中的112只眼,其中73只眼为SFIOL, 39只眼为IFIOL。主要观察指标为:手术时间、术后视力、术中术后并发症。结果:SFIOL与IFIOL的平均手术时间差异无统计学意义。IFIOL的平均随访时间明显长于SFIOL(分别为34±31个月和14±20个月,p>0.001)。两组患者术后末次随访时距离矫正视力(DCVA)均显著优于术前(SFIOL: 0.52±0.49∶1.20±0.84,[p<0.001]; IFIOL: 0.75±0.88∶1.31±0.81 [p<0.001], [LogMar])。两组间DCVA无差异。59%的IFIOL组和20.5%的SFIOL组出现不规则瞳孔[p<0.001], 10.3%的IFIOL组和1.4%的SFIOL组出现角膜水肿[p=0.05]。两组间术中及术后并发症无差异。结论:IFIOL和SFIOL都是有效和安全的安全的晶体在缺乏足够的荚膜的支持。两种技术均可显著改善DCVA。瞳孔卵化和角膜水肿在IFIOL组更为常见。IFIOL组随访时间较长。
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引用次数: 0
Optical Coherence Tomography Angiography Evaluation of Morphological andVascular Changes in Choroidal Neovascularization in Response to Anti-Angiogenic Treatment 光学相干断层扫描血管造影评价抗血管生成治疗后脉络膜新生血管的形态和血管变化
Pub Date : 2020-01-01 DOI: 10.35248/2155-9570.20.11.847
S. E. Sayed, M. Kamal, S. Sadek, R. Hatata
Objective: To detect qualitative and quantitative analysis of the choroidal neovascular membrane based on opticalcoherence tomography angiography OCTA in response to treatment with anti-angiogenesis. Patients and methods: This is a prospective observational study recruited 20 eyes of 20 patients with treatment-naiveCNVM. Patients were examined using the OCTA before and after treatment with Ranibizumab. Patients werefollowed-up monthly over 3 successive months and 1 month after the last injection. The collected data werestatistically analyzed using SPSS software version 22. Repeated measures ANOVA was performed and a paired t-testwas also used for comparison. Main outcome measures: membrane types, patterns, corrected visual acuity, retinalfluids, membrane size, and flow area; all were measured pre and post-intervention. Results: Five patients were males and 15 were females (50.6 ± 17.7 years). Different configuration were detected; adensenet configuration in 6 eyes, a loosenet configuration in 6 eyes, mixed net in 3 eyes, and an unidentifiablepattern in 5 eyes. Visual acuity improved post-injection in all membrane patterns (p value 0.002 in loose-net andunidentifiable types). Signs of membrane activity, size, and flow area; all decreased in all patterns following treatment(p value 0.001). Conclusions: OCTA in conjunction with OCT is both needed for more precise evaluation of differentmorphological and functional membrane criteria at which treatment strategy is based. Detection of blood flowchanges within the membrane itself can be considered as reliable biomarkers in monitoring the membrane activity.
目的:探讨基于光学酒精断层血管造影(OCTA)的脉络膜新生血管膜在抗血管生成治疗中的定性和定量分析。患者和方法:这是一项前瞻性观察性研究,招募了20名未接受治疗的nvm患者的20只眼睛。患者在使用雷尼单抗治疗前后使用OCTA进行检查。随访时间为连续3个月及末次注射后1个月。采用SPSS软件22对收集的数据进行统计分析。采用重复测量方差分析,配对t检验进行比较。主要观察指标:膜类型、类型、矫正视力、视黄液、膜大小和流动面积;均在干预前后进行测量。结果:男性5例,女性15例(50.6±17.7岁)。检测到不同的配置;腺样结构6眼,松散结构6眼,混合网状结构3眼,无法识别的图案5眼。所有膜型注射后视力均有改善(松网型和未识别型p值为0.002)。膜活性,大小和流动面积的迹象;所有模式治疗后均下降(p值0.001)。结论:OCTA与OCT的结合对于更精确地评估不同的形态学和功能膜标准是必要的,这是治疗策略的基础。检测膜内血流变化本身可以被认为是监测膜活性的可靠生物标志物。
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引用次数: 0
Effects of Bee Bread Extract from Meliponula Ferriguinea on Chemical Induced and Bacterial Infected Corneal Ulcers of Rabbit Eyes 蜜蜂面包提取物对兔眼角膜化学溃疡和细菌感染的影响
Pub Date : 2020-01-01 DOI: 10.35248/2155-9570.20.11.834
Andrew Wekesa, A. Ragot, Walter Yego
Aim: Corneal ulcerations are immediate risks to avoidable blindness. In many developing countries, their treatment present huge challenges, often due to increased resistance to anti-bacterial drugs, costs and accessibility issues. Bee bread is a valuable apitherapeutic product greatly appreciated by the natural medicine because of its potential medical and nutritional applications. In this study, we investigated the pharmacological effect of extract from M. ferriguinea on chemical-induced and bacterial-infected corneal ulceration of rabbit’s eyes. Method: A randomized-controlled experiment, was conducted on 15 New Zealand rabbits weighing 1.4 ± 0.42 kgrandomly assigned to 3 groups; A (Experimental group), B (Positive Control group) and C (Negative control group) of five animals each. All rabbits were adapted for 2 weeks. The right eye corneas were then injured using a drop of 1 Molar sodium hydroxide (NaOH). After 12 hours, animals in all groups in their injured corneas were infected with 1 drop of a laboratory prepared solution of P Aeruginosa. Treatment with extracts of M. ferriguinea-groups A group B treated with ciprofloxacin then group C treated with atropine alone commenced after 24 hours and continued every 4 hours for 7 days. Results: Although the mean healing effect of extracts of M. ferriguinea was not significantly (p>0.05) better after the 168th hour of treatment compared to its effect after the 24th hour, the effect size however, was clinical significant (57%). Furthermore, we found no significant difference (p>0.05) between the mean healing effects of the standard treatment protocol and the extracts of M. ferriguinea, but the standard treatment protocol showed a better clinical effect (33%) over the experimental extract. Also, the healing effects of atropine alone showed a better clinical effect (22%) than that of the experimental extract, but again, these were not statistically significant (p>0.05). Conclusion: Extracts of M. ferriguinea shows anti-inflammatory and anti-infective effects on chemical-induced and bacterial-infected corneal ulcers in rabbit ’s eyes. We found these effects to be comparable to that of standard treatment protocol for bacterial corneal ulcers. We thus conclude that in resource-constrained areas where M. ferriguinea is richly available, their extracts may provide alternative and/or complementary treatment option for chemical-induced and bacterial-infected corneal ulcers.
目的:角膜溃疡是可避免失明的直接风险。在许多发展中国家,它们的治疗面临巨大挑战,这往往是由于对抗菌药物的耐药性增加、费用和可及性问题。蜜蜂面包因其潜在的医疗和营养用途而受到天然医学的高度重视。本实验研究了铁铁氧体提取物对化学诱导和细菌感染兔眼角膜溃疡的药理作用。方法:采用随机对照试验,选取体重1.4±0.42 kg的新西兰兔15只,随机分为3组;A(实验组)、B(阳性对照组)、C(阴性对照组)各5只。所有家兔均适应2周。然后用一滴1摩尔氢氧化钠(NaOH)损伤右眼角膜。12小时后,用1滴实验室配制的铜绿假单胞菌溶液感染各组损伤角膜。铁蒺藜提取物治疗:A组,B组用环丙沙星治疗,C组单独用阿托品治疗,24 h后开始治疗,每4 h持续一次,连用7 d。结果:虽然铁铁蒺藜提取物在治疗第168 h后的平均愈合效果优于治疗第24 h后的平均愈合效果(p>0.05),但其效应大小具有临床意义(57%)。此外,我们发现标准治疗方案与铁铁蒺藜提取物的平均愈合效果无显著差异(p>0.05),但标准治疗方案的临床效果优于实验提取物(33%)。阿托品单独治疗的临床疗效(22%)优于实验提取物,但差异无统计学意义(p>0.05)。结论:铁血支原体提取物对化学诱导和细菌感染的家兔角膜溃疡具有抗炎、抗感染作用。我们发现这些效果与细菌性角膜溃疡的标准治疗方案相当。因此,我们得出结论,在资源有限的地区,铁螺旋藻丰富,它们的提取物可能为化学诱导和细菌感染的角膜溃疡提供替代和/或补充治疗选择。
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引用次数: 0
Need and Time to Redo Selective Laser Trabeculoplasty in Glaucoma Patients 青光眼患者重做选择性激光小梁成形术的需要和时间
Pub Date : 2020-01-01 DOI: 10.35248/2155-9570.20.11.844
M. D. Keyser, Jonas De Belder, Brice Ballet, E. Mertens
Purpose: Examine the need and the timeframe to redo selective laser trabeculoplasty (SLT) that was applied in open angle glaucoma or ocular hypertensive patients. Methods: Patients received SLT as primary, adjunctive or replacement therapy. Data were recorded up to 5.5 years after SLT treatment. Target pressure was defined as intraocular pressure at least 20% lowered. On exceeding the target pressure, patients received a second SLT. Primary outcome were the need and the time to redo the SLT. We examined differences between the groups (primary, replacement or adjunct SLT) and correlations between time and need to redo and pre-SLT parameters. Results: 108 patients (194 eyes) could be followed for at least 0.5 year and up to 4.5 years, with a mean follow up of 22.35 ± 18.94 months. Our population at start was a varied one; 34% of patients received primary SLT, 50% had replacement SLT, 16% had SLT as adjunctive treatment. These three groups showed no difference in evolution of IOP or medication in time. Time to redo varied, with a mean of 31.13 ± 11.24 months. Conclusion: We set out to have a general idea of how many patients could be expected to need a retreatment with SLT after a first successful SLT in a private clinic setting. In our population, the percentage of redo needed was 5.6% after 2 years, 35.4% after 3 years and 45.4% after 4 years. No differences could be measured with regard to the type of SLT performed nor could any significant correlation be found between need to redo and pre-SLT characteristics.
目的:探讨选择性激光小梁成形术治疗开角型青光眼和高眼压患者的必要性和手术时间。方法:患者接受SLT作为主要、辅助或替代治疗。数据记录到SLT治疗后5.5年。目标压定义为眼压至少降低20%。超过目标压力时,患者接受第二次SLT。主要结果是重做SLT的需要和时间。我们检查了各组(原发性、替代性或辅助性SLT)之间的差异,以及时间和重做需求与SLT前参数之间的相关性。结果:108例患者(194只眼)可随访0.5年以上,最长可达4.5年,平均随访22.35±18.94个月。一开始,我们的人口是多种多样的;34%的患者接受了原发性SLT, 50%的患者接受了替代SLT, 16%的患者接受了SLT作为辅助治疗。三组患者眼压变化及用药时间无明显差异。复诊时间各不相同,平均为31.13±11.24个月。结论:我们开始有一个大致的想法,有多少患者可能需要SLT再治疗后,在私人诊所设置成功的SLT。在我们的人群中,2年后需要重做的百分比为5.6%,3年后为35.4%,4年后为45.4%。在进行SLT的类型方面没有测量到差异,在需要重做和SLT前的特征之间也没有发现任何显著的相关性。
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引用次数: 0
The Involvement of the Retina in the Development of Myopia in a Model Eye of Chicks 视网膜在雏鸡模型眼近视发育中的作用
Pub Date : 2020-01-01 DOI: 10.35248/2155-9570.20.11.853
Koslowe Kc, L. Rozentzvaig, U. Yinon, M. Rosner
Background: The current concept of eye growth and emmetropization is thought to be dependent on visual stimulation of the mid-peripheral retinal cells. The aim of the current study was to examine whether damage to this part of the retinal tissue can affect the growth and function of the eye during development. Methods: We had two groups of domestic fowl chicks. One group was normal (N) and the other had a laser burn on 10% of the nasal retinal area of one eye. The optical components of the eye were examined by retinoscopy while physical measurements were made using ultrasonography and micrometry. The function of the retina was examined by standard flash ERG test. There were no differences in the refractive and the ultrasonographic results between the two groups. Results: The experimental group (right eye) showed a significant decrease in the amplitude and the latency results of both a and b wave compared to the other eye (left) and to the control group. However, there were no differences in the refractive and the ultrasonographic results between the two groups. Conclusion: This study found that the ERG in damaged eye was significantly affected by the laser as compared to that of control eye, while there was no difference in the refractive status and growth between the experimental and control groups. Therefore we concluded that burning only a 10% of the retina has no influence on the eye's growth or refractive development, notwithstanding the ensuing decrease in retinal function.
背景:目前的观点认为,眼睛的生长和正视化依赖于视网膜中周细胞的视觉刺激。目前研究的目的是检查视网膜组织的这部分损伤是否会影响眼睛发育过程中的生长和功能。方法:选取两组家禽雏鸡。一组正常(N),另一组在一只眼睛鼻视网膜区域的10%处进行激光烧伤。通过视网膜镜检查眼睛的光学成分,同时使用超声和显微测量法进行物理测量。采用标准闪光ERG法检测视网膜功能。两组患者的屈光和超声检查结果无明显差异。结果:实验组(右眼)与另一只眼(左眼)和对照组相比,a波和b波的振幅和潜伏期结果均明显降低。两组患者的屈光和超声检查结果无明显差异。结论:本研究发现,激光对损伤眼的ERG有明显影响,而实验组和对照组的屈光状态和生长无差异。因此,我们得出的结论是,尽管视网膜功能随之下降,但仅燃烧10%的视网膜对眼睛的生长或屈光发育没有影响。
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引用次数: 0
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Journal of Clinical & Experimental Ophthalmology
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