简介:目的分析原发性眼眶肿瘤的组织来源、手术进路及手术效果。方法回顾性分析5年开眶手术治疗的眼眶肿瘤101例。结果前十位的眼眶肿瘤分别是:海绵状血管瘤22例(21.78%),静脉性血管瘤10例(9.9%),(表)皮样囊肿泪腺10例(9.9%),泪腺混合瘤8例(7.92%),炎性假瘤7例(6.93%),脑膜瘤6例(5.94%),腺样囊性癌5例(4.95%),淋巴瘤4例(3.96%),肉瘤3例(2.97%),神经鞘瘤2例(1.98%)。手术方法包括前路入眶68例,外侧开眶27例,眶内容6例,术后复发4例。结论开眶手术的术式选择与肿瘤的性质、位置、粘连情况、病变范围密切相关。术前对肿瘤的性质、位置、粘连程度的正确判断和手术操作技巧可减少术后复发等并发症。术后复发病例主要为脑膜瘤及泪腺肿瘤。
简介:AIM:TocomprehensivelyevaluatethepotentialassociationofCOL1A1polymorphismswithhighmyopiabyasystematicreviewandMeta-analysis.METHODS:AllassociationstudiesonCOL1A1andhighmyopiareporteduptoJune10,2014inPubMed,Embase,WebofScience,andtheChineseBiomedicalDatabasewereretrieved.Oddsratios(ORs)and95%confidenceintervals(95%CIs)wereanalyzedforsinglenucleotidepolymorphisms(SNPs)usingfixed-andrandom-effectsmodelsaccordingtobetween-studyheterogeneity.PublicationbiasanalyseswereconductedbyEgger’stest.RESULTS:Atotaloffourstudiesfromreportedpaperswereincludedinthisanalysis.TheMeta-analysesforCOL1A1rs2075555,composedof2304highmyopiapatientsand2272controls,failedtodetectanysignificantassociationwithhighmyopia.Atotalof971casesand649controlsweretestedforCOL1A1rs2269336.TheassociationofCOL1A1rs2269336withhighmyopiawasobservedinrecessivemodel(CCvsCG+GG,P=0.03)andinheterozygousmodel(CGvsGG,P=0.04),butnotinothermodels.CONCLUSION:ThisMeta-analysisshowsthatCOL1A1rs2269336(CCvsCG+GG)affectsindividualsusceptibilitytohighmyopia,whereasthereisnoassociationdetectedbetweenSNPsrs2075555andhighmyopia.Giventhelimitedsamplesize,furtherinvestigationsincludingmoreethnicgroupsarerequiredtovalidatetheassociation.
简介:AIM:Topresenttheoutcomeofmodifiedgridlaserphotocoagulation(GLP)indiffusediabeticmacularedema(DDME)ineyeswithoutextrafovealand/orvitreofovealtraction.METHODS:InclusioncriteriafortheretrospectivestudywereDDMEeyesofpatientswithtypeⅡdiabetesmellitusthathad≥4monthsoffollow-upfollowingGLP.Onlyoneeyeperpatientwasanalyzed.Using3-Dspectral-domainopticalcoherencetomography(3-DSDOCT),eyesthathadeitherextrafovealorvitreofovealtraction,orhadbeenpreviouslytreatedbyanintravitrealmedication(s)wereexcluded.TreatedDDMEeyesweredividedinto4groups:A)'Classic'DDMEthatinvolvedthecentralmacula;B)edemadidnotinvolvethemacularcenter;C)eyesassociatedwithcentralepiretinalmembrane(ERM);D)DDMEthatwasassociatedwithmacularcapillarydropout≥2disc-diameter(DD).RESULTS:GLPoutcomein35DDMEeyesafter4-24(mean,13.1±6.9)monthswasasfollows:GroupA)18eyeswith'classic'DDME.Followingoneor2(mean,1.2)GLPtreatments,best-correctedvisualacuity(BCVA)improvedby1-2Snellenlinesin44.4%(8/18)ofeyes,andworsenedby1linein11.1%(2/18).Centralmacularthickness(CMT)improvedby7%-49%(mean,26.6%)in77.8%(14/18)ofeyes.CausesofCMTworsening(n=4)werecommonlyexplainable,predominantly(n=3)associatedwithemergenceofextrafovealtraction,5-9monthspost-GLP.GroupB)GLP(s)inDDMEthatdidnotinvolvethemacularcenter(n=6)resultedinimprovedBCVAby1-2linesin2eyes.However,thecentralmaculabecameinvolvedintheedemaprocessaftertheGLPin3(50%)eyes,associatedwithanemergenceofextrafovealtractioninoneoftheseeyes4monthsfollowingtheGLP.GroupC)GLPfailedinall5eyesassociatedwithcentralERM.GroupD)GLPwasofpartialbenefitin2of6treatedeyeswithmacularcapillarydropout≥2DD.CONCLUSION:EyeswithDDMEthatinvolvedthemacularcenterwerefoundtoachievefavourableoutcomesafterGLP(s)duringmid-termfollow-up,unlesscomplicatedpre-GLPorpost-GLPbyvltreoretinalinterfaceabnormalities,oftenextrafovealtra
简介:患者,男,51岁,2004年8月因“左眼颈椎手术后视物不见2个月”至本院就诊。左眼:视力无光感,眼球各方向运动中度受限,屈光介质透明,瞳孔散大,直接对光(-),间接对光反应迟钝,视网膜灰黄色,血管变细,视乳头苍白,脉络膜背景污秽色,眼底无出血渗出。右眼:无阳性体征。现病史:患者2004年6月因“无骨折脱位性颈脊髓损伤并不全瘫”在当地医院行颈椎手术。麻醉方式:静脉复合麻醉,俯卧,颈部过伸位。手术持续时间:4小时40分。术前患者双眼视力均正常,苏醒后即左眼视物完全不见,右眼正常,当地医院眼科检查治疗情况不详。我院诊断:左眼部缺血综合征。