目的：研究玻璃体腔注射曲安奈德(triamcinolone acetonide,TA)和雷珠单抗(Lucentis)治疗视网 膜中央静脉阻塞(central retinal vein occlusion,CRVO)的黄斑水肿的疗效。方法：配对病例对照研究。将2013年1月至2015年6月，在我院因CRVO并发黄斑水肿而接受玻璃体腔注射TA或Lucentis 的患者，根据患者基线水平的最佳矫正视力(best-corrected visual acuity,BCVA)(logMAR视力)和黄斑中心厚度(central macular thickness,CMT)将两组患者进行配对，选出12对患者，主要的观察 指标为随访1年时两组患者的BCVA和CMT。结果：TA组患者的BCVA由基线时的0.78±0.12提高到 0.55±0.24(P=0.005),CMT由基线时的(598.92±192.67) μm减少到(258.28±75.38) μm (P=0.002)。Lucentis组患者的BCVA由基线时的0.78±0.11提高到0.48±0.21(P=0.002), CMT由基线时的 (591.75±181.68) μm减少到(281.17±63.08) μm (P=0.002)。TA组和Lucentis组患者基线及最终的 BCVA和CMT直接均无显著差异。TA组的平均注药次数为(2.4±0.9)次，Lucentis组为(4.0±1.6)次， 两组有统计学差异(P=0.012)。结论：玻璃体腔注射TA或Lucentis均能减轻CRVO所致的黄斑水肿并提高视力，两者的疗效并无显著差异。TA的平均注射次数比Lucentis组少，但是TA更容易引起眼压升高。应该根据患者的综合情况制定个性化的治疗方案。

Objective: To compare the efficacy of intravitreal injections of triamcinolone acetonide (TA) and that of ranibizumab for macular edema secondary to central retinal vein occlusion (CRVO). Methods: In a retrospective assessment 12 TA-treated patients and 12 ranibizumab-treated ones with macular edema after CRVO were pairmatched according to initial best-corrected visual acuity (BCVA) and central macular thickness (CMT). BCVA and CMT were the main endpoints. Results: The initial BCVA of 0.78±0.12 increased significantly to 0.55±0.24 in the TA-treated patients (P=0.005). And the initial CMT of (598.92±192.67) μm decreased significantly to (258.28±75.38) μm (P=0.002). In the ranibizumab-treated patients, the initial BCVA of 0.78±0.11 increased significantly to 0.48±0.21 (P=0.002) and the initial CMT of (591.75±181.68) μm decreased significantly to (281.17±63.08) μm (P=0.002). There was no significance between the initial and final BCVA and CMT of TAtreated patients and ranibizumab-treated patients. Conclusion: Both treatments decreased the CMT and induced an improvement in BCVA from baseline.

A 45-year-old female presented with typical features of posterior scleritis in her left eye with visual acuity of 20/252. After treatment with oral steroids and immunosuppressive drugs, at 2 months follow-up, posterior scleritis resolved and visual acuity improved to 20/50. Five months later she presented with vision loss (20/160) associated with active choroidal neovascular membrane (CNVM) close to scar. Significant choroidal thinning (subfoveal choroidal thickness =137 microns), compared to fellow eye (subfoveal choroidal thickness =247 microns) was noted. Two doses of intravitreal bevacizumab (IVB) were given at 1 month interval. At 9 months follow-up, her visual acuity was maintained at 20/160 with scarred CNVM. In conclusion, IVB is safe and efficacious in treatment of inflammatory CNVM secondary to posterior scleritis. Choroidal changes after posterior scleritis could be contributory factor for formation of CNVM.

A 45-year-old female presented with typical features of posterior scleritis in her left eye with visual acuity of 20/252. After treatment with oral steroids and immunosuppressive drugs, at 2 months follow-up, posterior scleritis resolved and visual acuity improved to 20/50. Five months later she presented with vision loss (20/160) associated with active choroidal neovascular membrane (CNVM) close to scar. Significant choroidal thinning (subfoveal choroidal thickness =137 microns), compared to fellow eye (subfoveal choroidal thickness =247 microns) was noted. Two doses of intravitreal bevacizumab (IVB) were given at 1 month interval. At 9 months follow-up, her visual acuity was maintained at 20/160 with scarred CNVM. In conclusion, IVB is safe and efficacious in treatment of inflammatory CNVM secondary to posterior scleritis. Choroidal changes after posterior scleritis could be contributory factor for formation of CNVM.

目的：探讨改良的外路泪囊鼻腔吻合术式联合泪道置管治疗泪囊黏液囊肿的临床疗效。
方法：对23例（23眼）泪囊黏液囊肿行改良式泪囊鼻腔吻合术，并联合泪道置管，术后行泪道冲洗，并观察泪溢情况。

结果：23例患者，1例术中改为泪囊摘除术，20例完成12个月的追踪观察治疗，1例术后6个月失访，1例12个月时失访。随访1个月，22例患者术后泪囊肿均消失，外观明显改善；随访12个月，20例患者中18例溢泪症状完全消失，所有患者泪道冲洗通畅，仅1例患者因泪溢症状对手术疗效不满意。

结论：改良式外路泪囊鼻腔吻合术联合泪道置管治疗泪囊黏液囊肿，具有良好的临床效果值得推广。

Purpose: To investigate the eficacy of modified external dacrocystorhinostomy (DCR) with intubation in the treatment of lacrimal sac cys.

Methods: Twenty-three lacrimal sac cyst cases (23 eyes) were enrolled and treated with DCR technique and tube intubation. The success was assessed based on lacrimalirrigation and symptomatic relief of epiphora.

Results: Among 23 patients, surgery was intenupted and converted to dacryocystectomy in l case, thus surgery was successfully performed in 22 cases. Among them, 1 case lost follow up at 6 month, 1 case lost follow up at 12 month. At 1 month visit, lacrimal sac cyst disappeared in 22 cases. At 12 month visit, epiphora was completed relieved in 18 out of 20 cases, irrigation indicated no obstruction in all 20 cases.

Conclusions :The modified DCR technique with intubation has satisfactory outcome for lacrimal sac cyst.

目的：分析非散瞳状态下的小学生眼屈光状态。

方法：采用横断面调查设计，对城区小学生2046人 (4092眼) 进行电脑自动验光，数据采用 SPSS10.0 软件行统计分析。

结果：在4092眼中 ,正视眼1309眼 (32.0%)，远视眼170眼 (4.2%)，近视眼2613眼 (63.8%)。 其中低度近视2102眼 (51.4%)，中度近视464眼 (11.3%)，高度近视47眼 (1.1%)。 其中，男生1348眼近视 (61.2%)，女生1265眼近视 (67%)。6个年级中正视眼比例逐渐下降 , 1年级正视眼占 45.5%、6年级正视眼占19.2%。平均屈光度 (-1.32±1.60) D，小学六个年级屈光度比较差异有统计学意义 (P < 0.01)，其中女生的平均近视程度较男生重，男女屈光度比较差异有统计学意义 (P < 0.01)。小学6年间近视的进展为 -1.0 D，平均 -0.2 D/y。

结论：我国小学生近视情况严重 ，应予以重视 ，加强早期干预 。

Purpose: To observe the eyes' refractive status without cycloplegia in 2046 pupils.

Methods: The cross-sectional study was conducted in 2046 pupils of 4092 eyes in Xi‘an city primary schools. The objective ophthalmic examinations were done on all participants, which included non-cycloplegic objective refraction, visual acuity, ocular pressure, fundus evaluation by special trained ophthalmologists and nurses. The special designed inventory scale was filled in and input special computer program, then the data were statistically analyzed with SPSS10.0.

Results: In the primary school of 2046 pupils of 4092 eyes,  the detective rate of emmetropia was 32.0% of 1309 eyes, hypermetropia was 4.2% of 170 eyes, myopia was 63.8% of 2613 eyes, low myopia was 51.4% of 2102 eyes, moderate myopia was 11.3% of 464 eyes, and high myopia was 1.1% of 47 eyes in total. In both eyes, the detective rate was  61.2% of 1348 eyes in 2204 boys,  67% of 1265 in 1888 girls. Among 6 grades , the constituent ratio of moderate and high myopia groups were significantly increased with the age,s growing, including emmetropia 45.5% of 343 eyes out of 754 in 1^st grade and 19.2% of 122 eyes out of 634 in 6^th grade. The average refractive error of spherical equivalent refraction was (-1.32±1.60) D. Among 6 grades, the 1^st grade, was (0.82±1.42) D , and the 6^th grade’s was (-1.82±1.68) D, there were significant differences among 6 grades (P < 0.01). There was a significant difference between girls and boys (P < 0.01).  The average myopizing rate was -0.2 D per year, -1.0 D in the total of the progression in 6 years.

Conclusion: Poor condition of myopizing was showed in Chinese pupils. It should be taking seriously and making early intervention. 

目的:研究增殖性糖尿病视网膜病变患者玻璃体基质细胞衍生因子(Strmalcell-derivedfactor-1, SDF-1)和血管内皮生长因子(Vascular endothelial growth factor, VECF)的浓度,及其相互作用关系。

方法:酶联免疫吸附法(Enzyme-linked immunosorbent assay, ELISA)检测玻璃体内 SDF-1 和 VEGF 的含量,每个标本重复3次。实验组为增性糖尿病视网膜病变(Proliferalive diabeticretinopathy, PDR)的住院患者30例,对照组为同期行玻璃体切除术的特发性黄斑裂孔患者12例。

结果: PDR 患者玻璃体 VECF 的平均浓度为(2865.87+387.85) pg/ml,明显高于特发性黄斑裂孔组[(142.42+21.03) pg/ml，P < 0.0001]。增殖性糖尿病视网膜病变患者玻璃体 SDF-1的含量平均为(298.40+24.57) pg/ml,对照组为(86.91+15.89) pg/ml,两组的差异具有统计学意义(P < 0.0001)。在30例PDR患者玻璃体内 VEGF 和 SDF-1 的含量表现为正相关(Peanson相关系数 r=0.62，P < 0.001)。

结论:增殖性糖尿病患者玻璃体 SDF-1 和 VECF 的含量均高于非糖尿病患者,提示 SDF-1 和 VEGF 共同参与了增殖性糖尿病视网膜病变患者病理性新生血管的形成过程。

Purpose: To investigate the levels of stromal cell-derived factor-1(SDF-1) andvascular endothelial growth factor (VEGF) in the vitreous of patients with proliferativediabetic retinopathy.
Methods: The levels of $DF-1 and VEGF in the vitreous of 30 eyes of 30 patients withproliferative diabetic retinopathy(PDR)and 12 eyes of 12 patients with idiopathicmacular hole (MH) were measured by enzyme-linked immunosorbent assay. Vitreousfluid samples were obtained by vitrectomy.
Resuls: The vitreous concentration of VEGF was signifcantly higher in eyes with PDR(2 865.87+387.85 pg/ml) than in eyes with idiopathic macular hole (142.42+21.03 Pgml, P< 0.000 1). The vitreous level of SDF-1 was also significantly higher in eyes withPDR (298.40+24.57 pg/ml ) than in eyes with idiopathic macular hole (86.91+15.89Pg/ml, P<0.000 1 ). The vitreous concentration of SDF-1 correlated significantly with that of VEGF in eyes with PDR( [correlation coefficient]r=0.62,P<0 .001)
Conclution: Vitreous levels of both SDF-1 and VEGF in patients with PDR aresignificantly higher than those of nondiabetic patients. SDF-1 may be correlated withVEGF in angiogenesis in PDR.

目的：观察 NIDEK EC5000 准分子激光治疗系统准分子激光原位角膜磨镶术(Laser in sitkeratomileusis, LASIK) 角膜切削深度的可预测性。
方法：采用 NIDEK EC5000 准分子激光系统对 79 例近视和(或)近视散光患者进行标准 LASIK 手术，术中使用超声角膜测厚仪分别测量制瓣后和激光切削后的剩余角膜床厚度，计算实际角膜切削深度，比较实际角膜切削深度同理论预测角膜切削深度的差异。
结果：LASIK 术中实际切削深度(92.32±29.86) μm，预测切削深度(74.16±25.95) μm，两者差值(18.16 ± 14.71) μm 有统计学意义(P < 0.001)。实际切削深度与预测切削深度具有较好的相关性，相关系数为0.87 (P < 0.001)，其直线回归方程为Y = 18.06 + 1.001X。按术前角膜 K 值、术前等效球镜绝对值及术前中央角膜厚度值分组的实际切削深度与预测切削深度的差值均有统计学意义。实际切削深度与术前等效球镜有关，与术前中央角膜厚度和 K 值无关。实际切削深度与预测切削深度差值同 K 值、等效球镜，术前中央角膜厚度均无关。
结论：NIDEK EC5000 准分子激光系统 LASIK 术中实际角膜切削深度比预测角膜切削深度高 (18.16±14.71) μm，在手术设计时要考虑实际切削与机器标示值存在偏差，应尽可能多的预留剩余角膜基质床厚度，以提高手术安全性。

Purpose: To assess the predictability of corneal ablation depth in LASIK using NIDEK EC5000 excimer laser.
Method: Standard LASlK surgery was performed in 79 myopic patients with or without astigmatism with the NDEK EC5000 excimer laser system. Ultrasonic cornealpachymetry was performed immediately after flap creation and after laser ablation during LASIK procedure, by which the actual corneal ablation depth was calculated.The values of actual and predicted ablation depth were compared.
Results: The actual ablation depth was (92.32+29.86) μm, the predicted ablationdepth was (74.16+25.95) μm. The differences between them (18.16+14.71) μm were statistically significance (P < 0.001 ). Linear regression suggested that the actual ablation depth correlated closely with the predicted ablation depth (r = 0.87 , P < 0.001 ). The regression model was Y = 18.06+1.001X. The differences remained statistically significant and were independent of the levels of preoperative corneal keratometry, absolute preoperative spherical equivalent and the preoperative central cornea thickness.
Conclusion: The actual ablation depth was about (18.16+14.71) μm thicker than thepredicted ablation depth in the NlDEK EC5000 excimer laser system. We may have totake into account this deviation in order to ensure sufficient thickness of residualstromal bed.

大部分眼科手术/操作具有创伤小、疼痛刺激轻等特点，因此，选择眼表面麻醉即可满足手术的镇痛的需要，促进了眼科日间手术的广泛开展。其中，盐酸奥布卡因滴眼液是常用的眼科表面麻醉剂，具有麻醉起效迅速、镇痛作用强、持续时间久(约13 min)等特点，已经广泛应用在眼内手术中，在使用过程中，盐酸奥布卡因滴眼液对瞳孔及血管无影响，保证了眼内手术的安全。盐酸奥布卡因滴眼液能提供良好的眼表环境，对角膜厚度及角膜上皮厚度影响轻微，从而满足屈光手术的需要。此外，盐酸奥布卡因滴眼液能提供良好的术后镇痛，减少术后镇痛药物的使用，降低斜视术后患儿的躁动发生率。不含防腐剂的表面麻醉剂不影响麻醉剂的起效时间及镇痛效果，对眼表的影响轻微，从而创造良好的手术操作环境，提高手术效果，降低并发症和手术风险，是眼科手术中较为理想的表面麻醉药物。文章就盐酸奥布卡因滴眼液的作用机制及麻醉效果、药代动力学、临床疗效、安全性等进行综述。

Most ophthalmic surgeries are characterized by small incisions and mild pain, therein, the choice of topical anesthesia can meet the needs of surgeries and accelerate ophthalmic surgeries to be conducted in day surgery model. 0.4% oxybuprocaine hydrochloride eye drops is one of commonly used topical anesthetics for ophthalmic surgery, which has the characteristics of rapid onset and sufficient analgesia with long duration (about 13 minutes). Oxybuprocaine hydrochloride eye drops has been widely and safely used in intraocular surgery without affecting the pupil and blood vessels. Meanwhile, oxybuprocaine hydrochloride eye drops has negligible effects on corneal thickness and corneal epithelial thickness to meet the needs of refractive surgery. In addition, oxybuprocaine hydrochloride eye drops can provide sufficient postoperative analgesia, reduce the use of postoperative analgesics and the incidence of emergence agitation in children after strabismus surgery. The preservative-free topical anesthetic would be one of ideal topical anesthetics as it can provide a good surgical condition and reduce complications and risks of post-operative infections without changing the onset time and analgesia effects. This article provides a review of the mechanism, analgesia, pharmacokinetics, clinical efficacy, and safety profiles of 0.4% oxybuprocaine hydrochloride eye drops.

角膜是基因治疗的理想靶器官。角膜碱烧伤、角膜新生血管、角膜移植术后排斥反应因其病理机制复杂，所牵涉的致病因素众多而治疗困难，疗效不佳。本文就基因治疗在上述疾病中的应用加以综述，以了解基因治疗应用于角膜病变的新进展 。

Cornea is an ideal target organ for gene therapy. Corneal alkali burn, cornealneovascularization and corneal graft rejection tend to be with poor treatment elicacydue to its complex pathogenesis. This article aims to update the recent progress of genetherapy on corneal diseases.

       髓上皮瘤是源自神经系统的一种少见的恶性肿瘤，多发生在中枢神经系统和睫状体，而源自视神经的恶性髓上皮瘤则很少见，国内尚未有病例报道。此病早期类似胶质瘤，易造成误诊。本文报道了 1 例 3 岁 10 个月的男性患儿，经部分肿物切除活检发现肿瘤具有典型恶性髓上皮瘤的病理特点， 部分瘤细胞向软骨细胞分化，并逐渐形成透明软骨岛，NSE 及 S-100 表达阳性，病理诊断为源自视神经的畸胎性恶性髓上皮瘤。

       Medulloepithelioma is a clinically uncommon tumor originated from nervous system, often occurred in central nerve system and ciliary body, and malignant medulloepithelioma of the optic nerve is far rarer. So far, there has been no case report in China. It may be clinically misdiagnosed because it resembles glioma at the early stage of the disease. We reported a boy with a tumor in his right eye at age of 3.8 years, which was shown by biopsy of the partial tumor that there were some obviously heteromorphous neoplastic cells, karyokinesis, and moreover, some neoplastic cells differentiatied into cartilage cells, gradually formed into hyaline cartilage islands and the expressions of NSE and S-100 were positive. Teratoid malignant medulloepithelioma of optic nerve was made pathologically.

目的: 报道原发性空泡蝶鞍综合征致双眼视乳头水肿病案 1 例。

方法: 回顾性研究1例原发性空泡蝶鞍综合征致双眼视乳头水肿患者的临床表现、眼底改变、CT 和 MRI 影像学检查的特征、治疗方法及疗效。

结果 : 原发性空泡蝶鞍综合征致双眼视乳头水肿除有典型视乳头水肿的临床表现外，蝶鞍 MRI 亦显示垂体窝呈液型信号、垂体上缘受压凹陷、垂体变薄等典型空泡蝶鞍影像学表现。手术治疗后患者视乳头水肿改善、视力提高。

结论: 蝶鞍 MRI 是诊断原发性空泡蝶鞍综合征的首选影像学检查方法。视力下降明显的患者及时行蝶鞍区手术，术后效果良好。

Purpose:To report a case of papilloedema caused by primary empty sella turcica syndrome.

Methods:Retrospectively review the clinical and physical features, magnetic resonance imaging records and therapies of a patient with papilloedema caused by primary empty sella turcica syndrome.

Results: Except for typical clinical manifestation of papilloedema , a characteristic magnetic resonance imaging (MRI) can be found in a case of papilloedema caused by primary empty sella turcica syndrome. These imaging features are that sella turcica expanded, the inside of sella turcica was filled with cerebrospinal fluid(CSF) signal, pituitary gland was pressed, flatted and near the basis of sella turcica. Papilloedema was relieved and acuity of vision improved after surgery.

Conclusions:MRI is the preferred imaging technique for patient with papilloedema caused by primary empty sella turcica syndrome. If acuity of vision apparentlydecreases,surgery is necessary, and therapeutic effect is excellent.