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国家自然科学基金(81170849)

作品数:15 被引量:123H指数:7
相关作者:张秀兰王伟魏世辉陈士达周民稳更多>>
相关机构:中山大学中国人民解放军总医院更多>>
发文基金:国家自然科学基金广东省自然科学基金国家教育部博士点基金更多>>
相关领域:医药卫生生物学机械工程更多>>

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原发性急、慢性房角关闭行周边虹膜切除术后长期效果的比较研究被引量:3
2012年
目的比较原发性房角关闭PAC两种不同表现类型:急性PAC(APAC)与慢性PAC(CPAC)行周边虹膜切除术后的疾病转归。方法采用回顾性病例对照研究,对2005年5月至2007年9月行手术周边虹膜切除术的PAC患者按照入选标准分为APAC组和CPAC组,观察眼压变化、房角粘连范围以及视神经损害的进展情况。结果研究共纳入患者124人(APAC组48人,CPAC组76人)。两组的平均观察时间为APAC组(52.3±1.4)个月和CPAC组(54.2±1.6)个月,两组差异无统计学意义(P〉0.05)。术前两组的平均年龄、房角粘连范围的差异皆没有统计学意义,末次随访时间APAC组的平均房角粘连范围(4.2±2.4)要高于CPAC组(3.4-4-1.4)(P〈0.05),同时疾病的进展率APAC组(35.4%)显著高于CPAC组(25.0%)(P〈0.05)。结论国际地域性和流行病学眼科学组(ISGEO)分类系统下PAC急性与慢性两种不同表现形式,其周边虹膜切除术后的疾病转归存在明显差异,提示房角关闭存在不同进展机制,建议新分类系统需要考虑进一步将PAC的两种形式分开,从而提高对疾病的认识。
高新博张秀兰王忠浩蔡小于葛坚
关键词:原发性房角关闭周边虹膜切除术青光眼
Disorder of blood-aqueous barrier following Ahmed Glaucoma Valve implantation被引量:5
2013年
Background Ahmed Glaucoma Valve implantation (AGVI) is blood-aqueous barrier (BAB) has been noted after some surgica BAB disruption afterAGVl. used to treat refractory glaucoma. Breakdown of the techniques. The current study was designed to assess Methods Anterior chamber protein content was measured by the laser flare cell photometry in 22 eyes of 22 patients with refractory glaucoma before AGVI and at each postoperative visit up to 1 month. Results Before AGVI the mean aqueous flare values in all eyes were (15.17+9.84) photon counts/ms. After AGVI, the values significantly increased at day 1, day 3, and week I compared to those before AGVI (all P 〈0.05) with a peak at day 3. They returned to pre-operative levels at week 2, and were lower than preoperative level at month 1. Eyes with previous intraocular surgery history had greater aqueous flare values than those without previous intraocular surgery history, but there were no significant differences at all time points postoperatively (all P 〉0.05). Furthermore, eyes with shallow anterior chambers had greater aqueous flare values at day 3 and week 1 (all P 〈0.05). When comparing eyes with other refractory glaucoma conditions, neovascular glaucoma combined with intravitreal bevacizumab injection resulted in lower aqueous flare values after AGVI, but no significant differences were observed at all time points, postoperatively (all P 〉0.05). Conclusions The BAB was impaired and inflammation was present in the anterior chamber in refractory glaucomatous eyes following AGVI. However, such conditions were resolved within 1 month postoperatively. Intravitreal bevacizumab treatment in neovascular glaucoma eyes before AGVI may prevent BAB breakdown.
ZHOU Min-wenWANG WeiCHEN Shi-daHUANG Wen-binZHANG Xiu-lan
Neuroprotection in glaucoma: present and future被引量:6
2013年
Objective To review the updated research on neuroprotection in glaucoma, and summarize the potential agents investigated so far. Data sources The data in this review were collected from PubMed and Google Scholar databases published in English up to September 2012, with keywords including glaucoma, neuroprotection, and retinal ganglion cells, both alone and in combination. Publications from the past ten years were selected, but important older articles were not excluded. Study selection Articles about neuroprotection in glaucoma were selected and reviewed, and those that are cited in articles identified by this search strategy and judged relevant to this review were also included. Results Although lowering the intraocular pressure is the only therapy approved as being effective in the treatment of glaucoma, increasing numbers of studies have discovered various mechanisms of retinal ganglion cells death in the glaucoma and relevant neuroprotective strategies. These strategies target neurotrophic factor deprivation, excitotoxic damage, oxidative stress, mitochondrial dysfunction, inflammation, activation of intrinsic and extrinsic apoptotic signals, ischemia, and protein misfolding. Exploring the mechanism of axonal transport failure, synaptic dysfunction, the glial system in glaucoma, and stem cell used in glaucoma constitute promising research areas of the future. Conclusions Neuroprotective strategies continue to be refined, and future deep investment in researching the pathogenesis of glaucoma may provide novel and practical neuroprotection tactics. Establishing a system to assess the effects of neuroprotection treatments may further facilitate this research.
CHEN Shi-da WANG Lu ZHANG Xiu-lan
如何鉴别青光眼与非青光眼性视神经病变被引量:4
2012年
视乳头视杯扩大并非只见于青光眼,还可见于多种神经眼科疾病,其鉴别诊断是临床工作的重点与难点。据国外统计,非青光眼大视杯的患者有20%被误诊为青光眼视神经损害。因此,总结并准确地理解青光眼与非青光眼大视杯的鉴别要点显得非常重要。盘沿色泽以及视功能异常和视盘改变的相关性是视盘形态学上的重要鉴别点。另外,盘沿局限性丢失对于两者的鉴别具有重要的意义。现有的证据显示,其鉴别需详细地询问病史、仔细地观察视盘视杯形态和血管形态,综合视野、神经影像学检查等信息综合判断。
王伟张秀兰魏世辉
关键词:青光眼视神经
手术治疗外伤性视神经病变的研究进展被引量:3
2013年
外伤性视神经病变是头部或颅面部外伤的严重并发症之一,具有较高的致盲率,其治疗一直为研究的重点。视神经减压术是目前治疗外伤性视神经病变的主要方法,但在手术疗效、适应证、手术时机、手术方式、手术减压标准、预后影响因素等方面存在着争议与分歧。随着基础研究的进展、手术设备改良和手术技术的提高,人们对该领域有了更进一步的认识,本文就此做一综述。
王伟魏世辉张秀兰
关键词:视神经减压手术
放射性视神经病变临床分析被引量:8
2011年
目的探讨放射性视神经病变(RON)的临床特点、影响因素、诊治方法及其转归。方法回顾性系列病例研究。对1999年6月至2010年10月中山大学中山眼科中心收治的35例(60只眼)RON住院患者的临床资料进行回顾性分析。结果共收集35例(61只眼)RON患者的临床资料。所有患者均以进行性、无痛性单眼或双眼视力下降为主要表现。18例(51.4%)在完成放射治疗后3年内出现眼部症状。43只眼(70.5%)的患眼入院时中心最佳矫正视力〈0.05或视野0。。可窥见眼底的52只眼中,41只眼(78.8%)视乳头边界清晰,11只眼(21.2%)视乳头水肿和(或)出血、渗出。视乳头边界清晰的41只眼中,视乳头正常6只眼(14.6%),视乳头色较淡30只眼(73.2%),视乳头苍白5只眼(12.2%)。14只眼有视野检查记录,主要表现为神经纤维束损害性视野缺损,其中7只眼(50%)表现为上方和(或)下方弓形暗点,3只眼(21.4%)出现中心和(或)旁中心暗点,2只眼伴生理盲点扩大,1只眼伴旁中心暗点,1只眼见鼻上象限缺损。23只眼有视网膜荧光血管造影检查结果,主要的改变为视乳头低荧光和视网膜毛细血管无灌注区。图形视觉诱发电位检查发现,83.3%出现振幅降低和(或)潜伏期延长。分别用糖皮质激素治疗、高压氧、高压氧联合糖皮质激素、视网膜激光光凝等治疗,只有10只眼(16.4%)视力有不同程度的改善。结论RON潜伏期变异大,造成的视力和视野损伤重,视功能预后极差,主要眼部损伤为视网膜血管闭塞和不同程度视神经萎缩。目前针对并发症的保守治疗能短期改善视力。
杨晖王伟胡慧玲陈士达易长贤张秀兰
关键词:放射疗法视神经疾病
TRPC6:an underlying target for human glaucoma
2012年
Glaucoma is one of the leading causes of visual impairment and blindness worldwide. Of known risk factors for glaucoma, an increased in intraocular pressure is most highly correlated with glaucomatous damage. Irrespective of the cause, apoptosis of the retinal ganglion cells is the eventual outcome. It is widely accepted that glaucoma is a neurodegenerative disease that is strongly correlated with central nervous system disorders, such as Alzheimer's disease. These two disorders also share some similarities in pathogenic mechanisms. Recent studies suggest that the transient receptor potential canonical 6 channel could work together with brain-derived neurotrophic factor to promote neuron survival in brain and retina. In this study, we propose that transient receptor potential canonical 6 may contribute to the pathogenesis of human glaucoma and become a potential therapeutic target.
Qian FanWen-Bin Huangand Xiu-Lan Zhang
关键词:GLAUCOMANEUROPROTECTION
非动脉炎性前部缺血性视神经病变的临床治疗现状被引量:18
2013年
非动脉炎性前部缺血性视神经病变(NAION)是50岁以上人群常见的急性视神经病变,以突发、单眼、无痛性视力下降为特征。多种治疗方法被尝试用于治疗NAION,包括药物治疗和手术治疗,但是迄今为止尚无一种治疗方案被证实明确有效。近年的一项非随机前瞻性研究显示,患者急性期口服糖皮质激素可改善视力和视野,减轻视盘水肿,然而其确切疗效仍待证实。对于NAION患者进行的玻璃体腔内注射曲安奈德、抗血管内皮生长因子抗体、促红细胞生成素治疗的试验结果令人鼓舞,然而其所带来的风险不容忽视。目前,NAION的治疗尚缺乏有力的证据,有待更深入的研究,尤其要加强临床前的基础研究。
王伟综述张秀兰魏世辉审校
关键词:视神经非动脉炎性前部缺血性视神经病变糖皮质激素
房水引流阀植入手术的喜和忧被引量:7
2012年
随着青光眼房水引流装置的不断改进和植入技术的逐渐娴熟,开展房水引流阀植人手术日渐增多,手术的适应证也有扩大的趋势。临床应用结果表明房水引流阀植入术应用于难治性青光眼的治疗,有较好的临床疗效和安全性。然而,房水引流阀植人手术的并发症不容忽视!尽管新一代引流装置和材质的发展,使过去术后早期严重的并发症如浅前房、低眼压、脉络膜脱离、眼内出血等发生率大大降低,但其他的并发症如结膜退缩,引流管暴露、移位、堵塞,眼内感染,角膜失代偿,后期引流盘周纤维包裹、眼压不降等都严重影响着术后的长期疗效。比起常规的小梁切除手术作者认为房水引流阀植人手术导致的眼内严重并发症明显减少,手术相对更安全,但术后调控眼压的可操作性较低,引流管相关的并发症的处理较棘手。建议把握好适应证,规范手术,并积极处理并发症。
张秀兰
关键词:青光眼并发症
Cod liver oil: a potential protective supplement for human glaucoma被引量:1
2011年
Glaucoma is one of the leading causes of visual impairment and blindness. Improved knowledge of the pathogenesis of this disease has allowed the exploration of new therapeutic methods. In general, elevated intraocular pressure (IOP), oxidative stress, and vascular insufficiency are accepted as the major risk factors for the progression of glaucoma. Many natural compounds have been found beneficial for glaucoma. Nutritional therapies are now emerging as potentially effective in glaucomatous therapy. One nutritional supplement with potential therapeutic value is cod liver oil, a dietary supplement that contains vitamin A and omega-3 polyunsaturated fatty acids (PUFAs). Vitamin A is important for preserving normal vision and it is a well-known antioxidant that prevents the oxidative damage that contributes to the etiology and progression of glaucoma. Vitamin A is also a crucial factor for maintaining the integrity of conjunctival and corneal ocular surfaces, and preventing the impairment of ocular epithelium caused by topical antiglaucomatous drugs. Omega-3 fatty acids are beneficial for glaucoma patients as they decrease IOP, increase ocular blood flow, and improve optic neuroprotective function. In this article, we propose that cod liver oil, as a combination of vitamin A and omega-3 fatty acids, should be beneficial for the treatment of glaucoma. However, further studies are needed to explore the relationship between cod liver oil and glaucoma.
Wen-Bin HuangQian Fanand Xiu-Lan Zhang
关键词:GLAUCOMA
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