目的：观察健康中老年人群中心凹视觉敏感度阈值(foveal threshold，FT)及光相干断层扫描血管成像(optical coherence tomography angiography，OCTA)的双眼对称性。方法：横断面观察性研究。纳入33例66眼，测量并比较眼灌注压(ocular perfusion pressure，OPP)，FT，黄斑区3 mm × 3 mm范围内中心凹无血管区面积(non-flow area，NFA)，浅层视网膜血管密度(superior vessel density，SVD)和深层视网膜血管密度(deep vessel density，DVD)的双眼对称性；分析各指标双眼差值、均值及其比值与年龄、性别的相关性。结果：配对样本t检验结果显示除FT(t=?2.118，P=0.042)外，左右眼OPP，NFA，SVD和DVD差异均无统计学意义(P>0.05)；Pearson相关性分析和同类相关系数(intra-class correlation coefficient，ICC)检验结果显示5项指标左右眼测量值相关强度由强到弱为OPP>FT>NFA>DVD>SVD；Bland-Altman分析结果提示5项指标双眼间一致性良好。5项指标的双眼对称性不随性别、年龄改变。结论：健康中老年人群FT、黄斑区NFA，SVD及DVD的测量值具有双眼对称性。

Objective: To observe the interocular symmetry of foveal threshold (FT) and optical coherence tomography angiography (OCTA) parameters in healthy middle-aged and elderly subjects. Methods: Cross-sectional observational study. Sixty-six eyes from thirty-three subjects were enrolled to compare binocular ocular perfusion pressure (OPP), FT, non-flow area (NFA), superior vessel density (SVD) and deep vessel density (DVD) in a 3 mm × 3 mm OCTA scan of macula. The interocular symmetry of all the parameters was analyzed; the correlations of the differences (△), mean value (m) and the ratio of all the parameters with age and gender were analyzed. Results: There was no significant interocular difference revealed by paired-samples t-tests in all the parameters (P>0.05) except FT (t=?2.118, P=0.042), while the rank of Pearson’s correlation index and intraclass correlation coefffcient (ICC) from strong to weak was OPP > FT > NFA > DVD > SVD. The interocular symmetry of all the parameters was proved to be good with Bland-Altman plots, and it changed little with the variations of age and gender. Conclusion: Interocular symmetries of FT and OCTA parameters are observed in healthy middle-aged and elderly subjects.

目的：评估右美托咪定复合舒芬太尼用于老年青光眼患者经巩膜二极管激光睫状体光凝术 (transscleral diode laser cyclophotocoagulation，TDLC)术后自控静脉镇痛(patient-controlled intravenous analgesia，PCIA)的安全性和有效性。方法：选择行TDLC术老年青光眼患者80例，采用随机数字表法将患者分为SD组(n=40)和S组(n=40)。SD组术后PCIA采用舒芬太尼1.5μg/kg+右美托咪定1.5 μg/kg+托烷司琼4mg；S组采用舒芬太尼2μg/kg+托烷司琼4mg。将相应药物置入生理盐水配成100mL混合液加入电子镇痛泵，手术结束即刻行PCIA至术后24h。观察比较两组患者基本情况和手术情况，比较术前(T0)、术后即刻(T1)、术后6h(T2)、术后12h(T3)和术后24h(T4)患者的收缩压(systolic blood pressure，SBP)、舒张压(diastolic blood pressure，DBP)、心率(heart rate，HR)、NRS疼痛评分、Ramsay镇静评分及非手术眼的眼内压(intraocular pressure，IOP)，比较术后恶心呕吐、呼吸抑制、躁动等不良反应及使用其他辅助镇痛药物的情况。结果：两组患者基本情况和手术情况的差异无统计学意义。两组各时点DBP、非手术眼IOP及NRS评分差异无统计学意义。SD组T3、T4时点SBP，T2、T3、T4时点HR以及T2、T3时点Ramsay评分均低于S组，差异有统计学意义(P<0.05)。两组患者发生不良反应的总例数差异无统计学意义，但SD组恶心呕吐(1例)和烦躁(2例)发生率均低于S组(分别为6例和9例)，差异有统计学意义(P<0.05)。两组患者呼吸抑制和眩晕嗜睡发生率以及使用其他辅助镇痛药物例数差别无统计学意义，SD组舒芬太尼使用量低于S组(P<0.05)。结论：采用右美托咪定1.5μg/kg复合舒芬太尼1.5μg/kg行PCIA时不影响非手术眼IOP，可安全有效地应用于老年青光眼患者TDLC术后镇痛。

Objective: To evaluate the safety and efficacy of dexmedetomidine combined with sufentanil for postoperative patient-controlled intravenous analgesia (PCIA) after transscleral diode laser cyclophotocoagulation (TDLC) in elderly patients with glaucoma. Methods: Eighty elderly glaucoma patients undergoing TDLC were selected and randomly divided into a SD group (n=40) and a S group (n=40) by random number table method. In SD group (n=40), sufentanil 1.5 μg/kg, dexmedetomidine 1.5 μg/kg and tropisetron 4 mg were used for postoperative PCIA, and sufentanil 2 μg/kg and tropisetron 4 mg were used in S Group (n=40). The corresponding drugs in saline solution was added into 100 mL solution with electronic analgesia pump. PCIA was performed immediately after the operation until 24 h after the operation. The basic condition and operation situation of the two groups were observed and compared, and systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), NRS pain score, Ramsay sedation score and non-operation eye intraocular pressure (IOP) at preoperative (T0), after operation (T1), postoperative 6 h (T2), 12 h after operation (T3) and 24 h after operation (T4) were compared, and postoperative adverse reactions such as nausea and vomiting, respiratory depression, restlessness and use of other auxiliary analgesic drug were also compared. Results: There was no significant difference between two groups of patients’ basic and surgical conditions. There was no significant difference between two groups at each time point DBP, non-operation eye IOP and NRS score. SBP at T3 and T4, HR at T2, T3 and T4, and Ramsay score at T2 and T3 in SD group were lower than the S group, the difference was statistically significant. There was no significant difference in the total number of adverse reactions between two groups, but the incidence of nausea and vomiting and restlessness in group SD were lower than those in group respectively, the difference was statistically significant (P<0.05). There was no significant difference between the two groups in the incidence of respiratory depression, dizziness, lethargy and the use of other auxiliary analgesics. The sufentanil usage in group SD was lower than that in group S (P<0.05). Conclusion: PCIA with dexmedetomidine 1.5 g/kg combined with sufentanil 1.5 g/kg does not affect the non-operation eye IOP. It can be safely and effectively applied to postoperative analgesia for elderly patients with glaucoma after TDLC

目的：观察健康中老年人群中心凹视觉敏感度阈值(foveal threshold，FT)及光相干断层扫描血管成像(optical coherence tomography angiography，OCTA)的双眼对称性。方法：横断面观察性研究。纳入33例66眼，测量并比较眼灌注压(ocular perfusion pressure，OPP)，FT，黄斑区3 mm × 3 mm范围内中心凹无血管区面积(non-flow area，NFA)，浅层视网膜血管密度(superior vessel density，SVD)和深层视网膜血管密度(deep vessel density，DVD)的双眼对称性；分析各指标双眼差值、均值及其比值与年龄、性别的相关性。结果：配对样本t检验结果显示除FT(t=?2.118，P=0.042)外，左右眼OPP，NFA，SVD和DVD差异均无统计学意义(P>0.05)；Pearson相关性分析和同类相关系数(intra-class correlation coefficient，ICC)检验结果显示5项指标左右眼测量值相关强度由强到弱为OPP>FT>NFA>DVD>SVD；Bland-Altman分析结果提示5项指标双眼间一致性良好。5项指标的双眼对称性不随性别、年龄改变。结论：健康中老年人群FT、黄斑区NFA，SVD及DVD的测量值具有双眼对称性。

Objective: To observe the interocular symmetry of foveal threshold (FT) and optical coherence tomography angiography (OCTA) parameters in healthy middle-aged and elderly subjects. Methods: Cross-sectional observational study. Sixty-six eyes from thirty-three subjects were enrolled to compare binocular ocular perfusion pressure (OPP), FT, non-flow area (NFA), superior vessel density (SVD) and deep vessel density (DVD) in a 3 mm × 3 mm OCTA scan of macula. The interocular symmetry of all the parameters was analyzed; the correlations of the differences (△), mean value (m) and the ratio of all the parameters with age and gender were analyzed. Results: There was no significant interocular difference revealed by paired-samples t-tests in all the parameters (P>0.05) except FT (t=?2.118, P=0.042), while the rank of Pearson’s correlation index and intraclass correlation coefficient (ICC) from strong to weak was OPP > FT > NFA > DVD > SVD. The interocular symmetry of all the parameters was proved to be good with Bland-Altman plots, and it changed little with the variations of age and gender. Conclusion: Interocular symmetries of FT and OCTA parameters are observed in healthy middle-aged and elderly subjects.