2024年12月 第39卷 第12期

主管:中华人民共和国教育部
主办:中山大学
承办:中山大学中山眼科中心
主编:葛坚 刘奕志
  • 2024
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论著

喉罩在男性肥胖患者眼科日间手术中的应用:一项回顾性研究

Application of laryngeal mask airway in obese male patients undergoing ophthalmic day surgery: a retrospective study

:593-599
 

目的:分析喉罩在肥胖患者眼科日间手术中的应用特点。方法:选择 2021 年 1 月— 2024 年 3 月在中山大学中山眼科中心行日间眼科手术 且体质量指数(body mass index,BMI)≥25 kg/m2的男性患者进行分析,将患者分为2组:超重组(BMI 25~<30 kg/m2)及肥胖组(BMI≥30 kg/m2)。比较两组患者入室时(T1)、诱导后(T2)、喉罩置入后(T3)、手术开始时(T4)、手术开始10 min(T5)、手术结束时(T6)、入麻醉恢复室(post-anesthesia care unit,PACU)(T7)、喉罩拔除时(T8)的血流动力学和血氧饱和度变化情况;并分析喉罩置入后(T3)、手术开始时(T4)、手术开始10 min(T5)、手术结束时(T6)和喉罩拔除时(T8)患者的呼吸参数变化情况,记录两组患者的喉罩通气成功率及复苏室的停留时间。结果:纳入 118 例患者,其中超重组 57 例、肥胖组 61 例。两组均未出现喉罩通气失败病例,肥胖组在T3、T4、T5、T6以及T8等时点气道峰压均高于超重组(< 0.05);肥胖组的呼吸道不良事件发生率高于超重组(< 0.05)。两组患者围术期生命体征平稳(> 0.05),复苏室停留时间在组间比较差异无统计学意义> 0.05)且均顺利日间手术离院。结论:喉罩通气下全身麻醉能安全应用在肥胖患者眼科日间手术中,高BMI与高气道峰压相关。


Objective: General anesthesia using laryngeal mask airway (LMA) ventilation can facilitate ambulatory ophthalmic surgery, however, there remains debates about the use of LMA for obese patients. This study retrospectively analyzed the application of LMA in obese patients for ambulatory ophthalmic surgery. Methods: In this retrospective study, we analyzed all patients with a BMI≥25 kg/m2 who underwent ambulatory ophthalmic surgery under general anesthesia at the Zhongshan Ophthalmic Center of Sun Yat-sen University from January 2021 to March 2024.  The patients were divided into two groups: overweight group (BMI 25~<30 kg/m2) and obese group (BMI ≥30 kg/m2) . We compared the changes in hemodynamics and oxygen saturation at the several time points, baseline after entering operating room (T1), anesthesia induction (T2), LMA insertion (T3), start of surgery (T4), 10 minutes after surgery (T5), surgery completion (T6), transfer to PACU (T7), and LMA removal (T8);and analyzed the changes in respiratory parameters of the patient at T3, T4, T5, T6, and T8 time points between both groups. We also observed the differences in success rate of LMA insertion and ventilation and PACU stay time as well as time to discharge home between two groups. Results: 118 cases were found suitable for the final analysis and divided into overweight group (n=57) and obese group (n=61). All patients in the two groups uneventfully completed the ophthalmic ambulatory surgery and discharged home under the laryngeal mask airway ventilation, none of patients in both group displayed LMA ventilation failure. The hemodynamics and oxygen saturation in both groups were stable during perioperative period(> 0.05). The peak airway pressures in obese group were dramatically increased than in overweight group at T3, T4, T5, T6 and T8 time points (< 0.05), and the incidences of adverse respiratory events in obese group were significant higher than in overweight group (< 0.05). The PACU stay time was comparable in both groups (P > 0.05). Conclusion: LMA can be safely used for obese patients undergoing ophthalmic surgery, high BMI is related to high peak airway pressures.

高效液相色谱法测定曲伏前列素滴眼液中曲伏前列素含量

Determination of content of travoprost in travoprost eye drops by HPLC

:600-607
 
目的:建立高效液相色谱法(high-performance liquid chromatography, HPLC)测定曲伏前列素滴眼液中曲伏前列素含量。方法:采用Dikma C18色谱柱(50 mm×4.6 mm, 3 μm);以磷酸溶液(取磷酸1.0 mL,用水稀释至1 000 mL,用1 mol/L氢氧化钠溶液调节pH至2.8)-乙腈(67:33)为流动相;流速为每分钟3.0 mL;柱温为25℃;检测波长为220 nm;进样体积30 μL。结果:曲伏前列素在20.28~70.98 μg /mL(= 0.999 5)范围内线性关系良好,平均回收率为100.3%,相对标准偏差(relative standard deviatio, RSD)为2.0% (= 9),该方法重现性好。对照品溶液和供试品溶液在室温放置48 h基本稳定。结论:该方法可用于曲伏前列素滴眼液中的曲伏前列素含量测定。
Objective: To establish a high-performance liquid chromatography (HPLC) method for the determination of content of Travoprost in Travoprost Eye Drops. Methods: The analytic column was Dikma C18 (50 mm×4.6 mm, 3 μm) . Using phosphoric acid solution (take 1.0 mL of phosphoric acid, dilute with water and make up to 1 000 mL, adjust the pH to 2.8 with 1 mol/L sodium hydroxide solution)-acetonitrile (67:33) as mobile phase. The flow rate is 3.0 mL/min. The column temperature is 25 ℃; The detection wavelength is 220 nm. The injection volume is 30 μL. Results: The linear range of travoprost showed were well shown within 20.28-70.98 μg/mL(r=0.998). The average recovery rate of travoprost was 100.3% with relative standard deviation (RSD) 2.0% (n=9). The method had high reproducibility. The reference solution and the test solution remain stable at room temperature for 48 hours. Conclusion: The method can be used for the determination of content of travoprost in Travoprost Eye Drops.
病例研究

先天性葡萄膜外翻继发性青光眼:病例系列报道与文献回顾

Glaucoma secondary to congenital ectropion uveae: case series report and literature review

:608-621
 

目的:分析先天性葡萄膜外翻(Congenital ectropion uveae, CEU)继发性青光眼的临床表现、影像学特点和治疗方法。方法:回顾分析就诊于中山大学中山眼科中心诊断为CEU继发性青光眼患者的电子病历资料,收集整理患者的一般情况、视力、眼压、裂隙灯检查、房角镜照相、超声生物显微镜等检查结果,以及手术治疗方式选择和术后随访眼压情况,并结合国内外文献回顾分析总结CEU继发性青光眼的临床特点和诊疗效果。结果:报告两例CEU继发性青光眼患者年龄分别为24岁和11岁,均为男性、单眼发病慢性病程,患眼都为右眼,都不伴有全身异常,最佳矫正视力为手动/40cm-0.16,就诊时平均眼压为37 mmHg,平均中央前房深度为3.45 mm。两例患者查体表现:均角膜透明,瞳孔大小约5-5.5mm,对光反应灵敏,瞳孔缘近360°葡萄膜外翻呈棕褐色,晶状体透明,眼底检查青光眼性视杯凹陷,视网膜平伏。其中24岁患者房角镜检查全周宽角开放,小梁网有色素沉着。超声生物显微镜(ultrasound biomicroscopy, UBM)检查提示右眼虹膜稍向后凹,7点位房角关闭,其余全周房角开放。而11岁患者房角镜检查以及UBM检查均为全周房角关闭。两例患者角膜内皮镜检查均正常。两例患者均诊断为右眼先天性葡萄膜外翻继发性青光眼,眼压高,最大量降眼压药物治疗下不能控制,对24岁患者行小梁切除联合术中使用抗代谢药物11岁患者行引流阀植入联合术中使用抗代谢药物,术中术后均无明显并发症,至今随访6个月,眼压控制良好。结论:CEU特征性改变为瞳孔缘葡萄膜外翻,常继发青光眼,可表现为开角型、房角发育异常(闭角型,降眼压药物治疗效果有限,通常需要手术治疗。由于CEU继发性青光眼人群以儿童和年轻患者为主,为难治性青光眼,因此抗青光眼术中联合使用抗代谢药物可获得较好的治疗效果。

Objective: To analyze the clinical manifestations, imaging characteristics, and treatment methods of secondary glaucoma associated with congenital ectropion uveae (CEU). Methods: Observational case series and literature review. A retrospective analysis was conducted on the electronic medical records of patients diagnosed with secondary glaucoma due to CEU at the Zhongshan Ophthalmic Center, Sun Yat-sen University, China. Data collected included demographics, visual acuity, intraocular pressure (IOP), slit-lamp examination, gonioscopy, ultrasound biomicroscopy (UBM), and surgical treatment methods. Postoperative IOP were also collected. A literature review was conducted to summarize the clinical characteristics and treatment outcomes of secondary glaucoma due to CEU. Results: Two male patients with secondary glaucoma due to CEU were included, aged 24 and 11 years, respectively. Both patients had a chronic course of disease affecting the right eye, with no systemic abnormalities. The best-corrected visual acuity was hand motion/40 cm to 0.16, and the average IOP at presentation was 37 mmHg, with an average central anterior chamber depth of 3.45 mm. Clinical examination revealed clear corneas, pupils measuring approximately 5-5.5 mm with brisk light reflexes, and nearly 360° of brownish ectropion of the uveae. The lenses were clear, and fundus examination showed glaucomatous optic disc cupping with a normal retina. In the 24-year-old patient, gonioscopy revealed a wide-open angle with trabecular meshwork pigmentation, while UBM indicated slight posterior bowing of the iris and angle closure at the 7 o'clock position. In the 11-year-old patient, both gonioscopy and UBM showed complete angle closure. Corneal endothelial microscopy was normal in both patients. Both were diagnosed with secondary glaucoma due to CEU in the right eye, with elevated IOP that was uncontrolled by maximal medications. The 24-year-old underwent trabeculectomy with intraoperative use of antimetabolites, while the 11-year-old received a drainage valve implantation with antimetabolites. No significant intraoperative or postoperative complications were observed, and IOP was well controlled over a six-month follow-up period. Conclusions: CEU is characterized by ectropion of the uveae and is frequently associated with secondary glaucoma, which may present as open-angle or angle-closure (goniodysgenesis) glaucoma. The effectiveness of IOP-lowering medications is limited, often necessitating surgical intervention. Given that secondary glaucoma due to CEU predominantly affects children and young adults, the use of antimetabolites during glaucoma surgery can yield favorable treatment outcomes.

视盘内出血伴视盘旁视网膜下出血:一例病例报告并文献复习

Intrapapillary hemorrhage with adjacent peripapillary subretinal hemorrhage: a case report and literature review

:622-630
 
视盘内出血伴视盘旁视网膜下出血(intrapapillary hemorrhage with adjacent peripapillary subretinal hemorrhage, IHAPSH)的病例报道较为少见。此病好发于患有轻、中度近视的中青年,且伴有视盘向倾斜或小视盘的患者,具有自限性,视力预后良好,无后遗症,而且很少复发。IHAPSH的眼底表现为视盘内出血、视盘旁视网膜下出血,严重者可出现玻璃体积血。文章报道一例IHAPSH,患者为26岁中度近视女性,主要症状为左眼无痛性视力下降伴眼前黑影飘动6 d。双眼最佳矫正视力均为1.0。眼底检查发现双眼视盘偏小,呈倾斜位,右眼视盘鼻侧见红色视网膜下出血灶;左眼视盘内及视盘鼻侧、上方、颞上方视网膜浅层出血,视盘鼻侧见边界清晰的新月形红色视网膜下出血。未进行特殊治疗,2个月后出血完全吸收。此病病因复杂多样,需与多种眼底疾病相鉴别,及时行眼科相关检查以排除其他原因导致的视盘水肿、视盘出血。文章通过文献回顾,总结其临床特征、发病机制、诊断、鉴别诊断、治疗及预后。
Intrapapillary hemorrhage with adjacent peripapillary subretinal hemorrhage (IHAPSH) is rarely reported. IHAPSH commonly affects young myopic eyes with tilted optic discs and spontaneously resolves without treatment, with an excellent prognosis for vision recovery and very rarely recur. The fundus manifestations of IHAPSH are intrapapillary hemorrhage, peripapillary subretinal hemorrhage, or even with vitreous bleeding. An 26-year-old female with mild myopia presented with symptoms of blurry vision and black filamentous floaters for 6 days. Her BCVA was 1.0 in both eyes. Fundus examination showed that both discs appear small, and elevated in the nasal regions. Intrapapillary hemorrhage, peripapillary subretinal hemorrhage and vitreous hemorrhage were observed in the left eye, while only peripapillary subretinal hemorrhage was seen in the right eye. The hemorrhage was resolved spontaneously without any complication after 2 months. The etiology of IHAPSH is complex, and it should be differentiated from other causes of papilledema and disc hemorrhage. The clinical characteristics, pathogenesis, diagnosis, differential diagnosis, treatment and prognosis were summarized through the literature review.
综述

Schlemm's canal结构和功能调控的研究进展及其在青光眼治疗中的应用

Research progress on the structure and functional regulation of Schlemm's canal and its application in glaucoma treatment

:631-639
 
Schlemm管(Schlemm's canal,SC)作为房水流出的主要通道,通过调节房水外排来维持眼内压的平衡,其结构和功能的异常与高眼压及青光眼的发生发展密切相关。对SC的研究有助于阐明房水外排阻滞的发生机制、探索新的途径以增加房水排出,从而为降低眼压和青光眼治疗的新药物开发提供基础。目前,对SC发育和功能的调节机制的认识仍然有限,缺乏针对SC的特异性治疗策略。近年来,关于SC细胞命运决定及其结构发育的细胞学机制逐渐被揭示,功能调控的关键分子靶标也相继被发现,这促进了对SC结构和功能调控的深入理解。此外,作为降眼压药物靶点和针对性手术的创新应用也在不断拓展。文章系统回顾SC的结构与功能研究,总结关键的分子和细胞学调控机制,归纳SC靶向药物和手术疗法的最新进展,为青光眼的临床诊治提供了新的思路。
Schlemm's canal (SC), as the primary pathway for aqueous humor drainage, maintains intraocular pressure balance by regulating aqueous outflow. Abnormalities in its structure and function are closely associated with elevated intraocular pressure and the development of glaucoma. Research on SC aids in elucidating the mechanisms behind outflow resistance and exploring new avenues to enhance aqueous drainage, thereby providing a foundation for the development of new drugs aimed at lowering intraocular pressure and treating glaucoma. Currently, our understanding of the mechanisms regulating SC development and functionality remains limited, with a lack of specific therapeutic strategies targeting SC. In recent years, advancements in measurement and imaging technologies have revealed the molecular and cellular mechanisms underlying SC development, leading to the identification of key regulatory targets. This has enhanced our understanding of SC structural and functional regulation. Furthermore, innovative applications of SC as a target for intraocular pressure-lowering medications and surgical interventions are continually expanding. This article systematically reviews the research on the structure and function of SC, summarizes the key molecular and cellular regulatory mechanisms, and discusses the latest advancements in SC-targeted pharmacological and surgical therapies, providing new insights for the clinical diagnosis and management of glaucoma.

慢性肝病患者眼底表现及眼底检查的临床应用进展

Ocular fundus manifestations and the clinical application of fundal examinations in patients with chronic liver disease: a systematic review

:640-647
 
慢性肝病(chronic liver disease, CLD)是一种或多种损伤因素长期作用于肝脏导致的疾病总称,其影响范围广、患者人群基数大。病毒性肝炎、非酒精性脂肪性肝病和终末期肝病等慢性肝病会累及眼底,造成视网膜渗出、出血等病变;同时眼底结构改变,如脉络膜和视网膜不同层次厚度,也与慢性肝病严重程度相关。对慢性肝病患者进行眼底检查不仅用于防治相关的眼底并发症,也对肝病临床评估及监测具有潜在应用价值。文章综述不同病因、严重程度和药物治疗下的慢性肝病患者可能出现的眼底病变,以及眼底结构功能检查在慢性肝病患者中的临床应用进展,以比较不同眼底检查方法在慢性肝病患者临床实施过程中的特点及适用场景,并提示未来在慢性肝病患者中应用眼底检查的潜在新方向。
Chronic Liver Disease (CLD) is a collective term for diseases resulting from the long-term effects of one or more damaging factors on the liver. It has a broad impact and affects a large patient population. Viral hepatitis, non-alcoholic fatty liver disease, and end-stage liver disease can involve the ocular fundus, leading to retinal exudates and hemorrhages. Additionally, structural changes in the fundus, such as the thickness of the choroid and different retinal layers, are associated with the severity of chronic liver disease. Through fundus examinations in patients with chronic liver disease, not only can ocular complications related to liver disease be prevented and treated, but these examinations may also offer potential value in the clinical assessment and monitoring of liver disease. This article reviews the potential ocular fundus abnormalities in patients with chronic liver disease under different etiologies, severities, and drug treatments. It discusses the progress in the clinical application of fundus structure and function examinations in patients with chronic liver disease. It compares the characteristics and appropriate clinical scenarios of various fundus examination methods in these patients and suggests potential new directions for the future use of fundus examinations in chronic liver disease management.

城市颗粒物与眼表疾病及其潜在致病机制

Urban particulate matter related ocular surface diseases and their potential pathogenic mechanism

:648-656
 
越来越多的证据表明,空气污染可严重损害人体健康,成为全球疾病负担的主要原因。并且污染空气中的主要成分空气颗粒物可渗透到肺部和心血管系统,引起缺血性心脏病、肺炎、慢性阻塞性肺疾病甚至肺癌,导致空气污染相关的发病率和死亡率升高。城市颗粒物作为城市居住人群面临的主要空气污染问题,被证实与多种炎症性眼表疾病密切相关,如过敏性结膜炎、角膜炎、干眼等。高浓度城市颗粒物暴露还会引起睑板腺病理性结构改变和功能异常,诱发炎性睑板腺功能障碍。文章综述了城市颗粒物相关的眼表疾病类型及其致病机制的最新研究,旨在阐明空气污染对于眼表组织的损害和相应的潜在治疗靶点,指导临床上环境相关眼病的诊断与治疗。
More and more evidence indicate that air pollution can seriously damage human health and become a major cause of the global disease burden. The main component of air pollution, particulate matter, can penetrate the lungs and cardiovascular system, causing ischemic heart disease, pneumonia, chronic obstructive pulmonary disease, and even lung cancer, leading to an increase in the incidence and mortality rates related to air pollution. Urban particulate matter, as the main air pollution problem faced by urban residents, has been shown to be closely related to various inflammatory eye diseases, such as allergic conjunctivitis, keratitis, and dry eye. Our research further confirms that exposure to high concentration of urban particulate matter can also cause pathological structural changes and functional abnormalities in the meibomian gland, leading to inflammatory meibomian gland dysfunction. This review comprehensively summarizes the latest research on the eye surface diseases related to urban particulate matter and their pathogenic mechanisms, aims to elucidate the damage of air pollution to eye surface tissues, identify potential therapeutic targets, and guide the diagnosis and treatment of environmentally related eye diseases in clinical practice.

脉络膜在近视发展中的调控作用及其机制

The regulatory role and mechanism of choroid in the development of myopia

:657-665
 
近年来,随着现代社会生活节奏的加快以及电子产品的普及,近视逐渐呈现低龄化、高发病率的趋势,成为不容忽视的公共卫生问题。动物和人类研究均发现,在近视的发展过程中,脉络膜表现出变薄的现象,并伴有血流量减少,这些变化与近视度数增加和眼轴增长呈正相关。研究表明,脉络膜厚度的变化不仅发生在近视初期,而是在近视进展阶段持续发生。此外,脉络膜血流量的调节也与近视的发生和发展密切相关,可能通过神经机制及生长因子的作用影响眼球的生长。光学相干断层扫描血管成像(optical coherence tomography angiography, OCTA)技术在探索近视进程中的脉络膜变化和血管功能方面展现了巨大的潜力。它能够提供无创性的脉络膜结构和血流信息,对于理解脉络膜在近视调控中的作用至关重要。未来的研究应当结合先进的OCTA技术,进一步探讨脉络膜在不同阶段近视中的具体变化及其背后的机制,特别是脉络膜血流调节与眼球生长之间的关系。深化对脉络膜在近视调控中作用的理解,将有助于开发有效的预防和控制措施,为近视防控策略提供理论依据。
In recent years, with the acceleration of the pace of life in modern society and the popularization of electronic products, myopia has gradually affected younger individuals and has a higher incidence rate, becoming a public health problem that cannot be ignored. Both animal and human studies have found that during the development of myopia, the choroid exhibits thinning and is accompanied by reduced blood perfusion. These changes are positively correlated with increased myopia and axial growth. Studies have shown that changes in choroidal thickness not only occur in the early stages of myopia, but also continue to occur in the progression stage of myopia. In addition, the regulation of choroidal blood flow is also closely related to the occurrence and development of myopia, which may affect the growth of the eyeball through the action of neural mechanisms and growth factors. Optical coherence tomography angiography (OCTA) technology has shown great potential in exploring choroidal changes and vascular function in the progression of myopia. It can provide non-invasive information on choroidal structure and blood flow, which is crucial for understanding the role of the choroid in the regulation of myopia. Future research should combine advanced OCTA technology to further explore the specific changes in the choroid in different stages of myopia and the underlying mechanisms, especially the relationship between choroidal blood flow regulation and eyeball growth. A better understanding of the role of choroid in myopia regulation will aid in developing effective prevention and control measures, providing a solid theoretical foundation for myopia prevention strategies.

中医热疗在古代中国眼科的发展简史

Historical overview of thermotherapy in traditional Chinese ophthalmology

:666-670
 
近年来,热疗因其操作简便和显著疗效,在干眼及相关眼病治疗中受到关注。热疗通过加热睑板腺区域,软化睑脂,改善睑板腺导管通畅,广泛应用于睑板腺囊肿、睑腺炎、睑缘炎及睑板腺功能障碍等眼病。此外,热疗还有效缓解视疲劳和干眼不适,促进眼部创口愈合,减少感染风险。在中国古代,《黄帝内经》及《韩非子》早期记载了热疗技术的应用。西汉《淮南子》提到烧灼法用于眼病,东晋葛洪的《肘后备急方》描述了热敷治疗眼部不适的方法。隋唐时期的《备急千金要方》和《外台秘要》详细介绍了热疗的应用,宋代《圣济总录》和《龙树菩萨眼论》进一步精细化了热疗技术。明清时期的《普济方》和《目经大成》中记载了热疗的新进展。由此,古代热疗在眼科应用中积累了丰富的经验,尽管现代医学技术不断进步,但这些传统方法仍具有重要参考价值。
In recent years, heat therapy has gained attention for its simplicity and significant efficacy in treating dry eye and related ocular conditions. By heating the meibomian gland area, heat therapy softens meibomian secretions and improves gland duct patency, making it widely used for chalazion, hordeolum, blepharitis, and meibomian gland dysfunction. Additionally, it effectively alleviates visual fatigue and dry eye discomfort, promotes ocular healing, and reduces the risk of infection.In ancient China, the application of heat therapy was recorded early in texts such as the Huangdi Neijing and Han Feizi. The Huainanzi from the Western Han Dynasty mentions the use of cautery for eye diseases, while Zhouhou Beiji Fang by Ge Hong in the Eastern Jin Dynasty describes methods for treating eye discomfort with hot compresses. During the Sui and Tang dynasties, Beiji Qianjin Yaofang and Wai Tai Mi Yao provided detailed accounts of heat therapy applications. The Song Dynasty works *Shengji Zonglu* and Longshu Bodhisattva's Eye Treatise further refined the techniques. The Ming and Qing dynasties’ texts Pujifang and Mujing Dacheng documented new advancements in heat therapy.In summary, ancient heat therapy for ophthalmology accumulated substantial experience. Despite advances in modern medical technology, these traditional methods still hold significant reference value.
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Schlemm's canal 结构和功能调控的研究进展及其在青光眼治疗中的应用

Research progress on the structure and functional regulation of Schlemm's canal and its application in glaucoma treatment

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Schlemm管(Schlemm’ s canal, SC)作为房水流出的主要通道,通过调节房水外排来维持眼内压的平衡,其结构和功能的异常与高眼压及青光眼的发生发展密切相关。对SC的研究有助于阐明房水外排阻滞的发生机制、探索促进房水外排新的途径,从而为降低眼压和青光眼治疗的新药物开发提供理论基础。目前,对SC发育和功能的调节机制的认识仍然有限,缺乏针对SC的特异性治疗策略。近年来,关于SC细胞命运决定及其结构发育的细胞学机制逐渐被揭示,功能调控的关键分子靶标也相继被发现,这促进了对SC结构和功能调控的深入理解。此外,作为降眼压药物靶点和针对性手术的创新应用也在不断拓展。文章系统回顾SC的结构与功能研究,总结关键的分子和细胞学调控机制,归纳SC相关药物和手术疗法的最新进展,为青光眼的临床诊治提供了新的思路。
Schlemm管(Schlemm’ s canal, SC)作为房水流出的主要通道,通过调节房水外排来维持眼内压的平衡,其结构和功能的异常与高眼压及青光眼的发生发展密切相关。对SC的研究有助于阐明房水外排阻滞的发生机制、探索促进房水外排新的途径,从而为降低眼压和青光眼治疗的新药物开发提供理论基础。目前,对SC发育和功能的调节机制的认识仍然有限,缺乏针对SC的特异性治疗策略。近年来,关于SC细胞命运决定及其结构发育的细胞学机制逐渐被揭示,功能调控的关键分子靶标也相继被发现,这促进了对SC结构和功能调控的深入理解。此外,作为降眼压药物靶点和针对性手术的创新应用也在不断拓展。文章系统回顾SC的结构与功能研究,总结关键的分子和细胞学调控机制,归纳SC相关药物和手术疗法的最新进展,为青光眼的临床诊治提供了新的思路。
其他期刊
  • 眼科学报

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
    浏览
  • Eye Science

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
    浏览
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