Analysis of clinical and pathological features of ciliary body medulloepithelioma

AIM:To analyze and summarize the clinical and pathological features of ciliary body medulloepithelioma.METHODS:The clinical and pathological data of 11 patients(11 eyes) who were diagnosed with ciliary body medulloepithelioma at Beijing Tongren Hospital,Capital Medical University,from 2007 to 2021 were retrospectively analyzed.RESULTS:The initial symptoms of 11 patients included vision loss(6 eyes),atrophia bulbi(1 eye),proptosis(2 eyes),and leukocoria(2 eyes).Most patients suffered with corneal opacity,anterior chamber flare and hyphema.Iris neovascularization and synechia,complicated cataract,and secondar y glaucoma occurred in several cases.Three patients even had lens subluxation and retinal detachment.B-scan ultrasonography showed vitreous opacity and a medium-high uneven echo mass in the eyeball.Ultrasound biomicroscopy examination showed a spherical or hemispherical ciliary body mass with uneven internal echoes and irregular cystic spaces.All of the 11 patients were diagnosed with malignant ciliary body medulloepithelioma by pathological evidence.In this study,6 patients had enucleation(2 patients had systemic chemotherapy after surgery),and the other 5 patients had local tumor resection(1 patient had plaque radiotherapy after surgery).CONCLUSION:Ciliary body medulloepithelioma is a rare intraocular tumor and may be easily confused with retinoblastoma.Analyzing the clinical and pathological features of ciliary body medulloepithelioma is useful to further understand ciliary body medulloepithelioma,and can make an accurate diagnosis and better treatment.

Extracting intraocular foreign body at or near the ciliary body with scleral indentation in direct visualization

Dear Editor,I＇m Dr. Qing-Huai Liu from Department of Ophthalmology, the First Affiliated Hospital of Nanjing Medical University,Nanjing, China. I write to present four cases diagnosed with the intraocular foreign body （IOFB） at or near the ciliary body and to evaluate the effect of extracting IOFB with scleral indentation in direct visualization.

Choroidal and ciliary body tubercle: a case report

Dear Editor,I am Bing Li from the Department of Ophthalmology,Peking Union Medical College Hospital in Beijing, China,and I write to present a case report of choroidal and ciliary body tubercles.Ocular tuberculosis (TB) is an extrapulmonary tuberculous condition with variable manifestations[1].

Case Report:Adenoma of nonpigmented epithelium in ciliary body:literature review and case report

Adenomas of the nonpigmented ciliary epithelium (NPCE) are often clinically indistinguishable from amelanotic malignant melanomas of the ciliary body or metastatic carcinomas. This paper reports a case study of a distinctive variant of adenoma of the NPCE, which clinically appears as epiretinal membrane in the macular region. Histopathologic studies have revealed this is an adenoma of the NPCE. Identification of this clinic feature is important because it will miss the diagnosis of the adenoma of the NPCE. In this case study, B-scan ultrasonography as well as computerized tomography (CT) has been used to provide help in diagnosing the ciliary body tumor. Because of their anterior location in the ciliary body, partial lamellar sclerou-vectomy is an effective method of treatment.

Ultrasound biomicroscopic imaging demonstrate thinner ciliary body thickness in eyes with angle closure

·AIM:To compare the ciliary body thickness between eyes with primary angle closure(PAC)and primary angle-closure glaucoma(PACG)with the normal eyes,and to investigate the association between ciliary body thickness and ciliary processes situation.·METHODS:In this cross-sectional study,57 patients with PAC/PACG were matched to 57 normal subjects after propensity score matching(PSM)adjusting for age and gender.All subjects underwent conventional ocular examinations and ultrasound biomicroscopy(UBM)examination,among which the patients with PAC/PACG performed the examinations one month after laser peripheral iridotomy(LPI).Quantitative parameters were measured,which included ciliary body thickness at the position of 1 mm posterior to the scleral spur(CBT1),trabecular-ciliary process distance(TCPD)and trabecularciliary process angle(TCA).·RESULTS:Eyes with PAC/PACG presented significantly thinner CBT1,shorter TCPD and smaller TCA(P<0.001)than the normal eyes,both in comparison of the means of four quadrants and in comparisons of each quadrant.After removing images with peripheral anterior synechia(PAS),the same results were also found in comparisons between the two groups.Significant correlations were found between TCPD(R~2=0.537,P<0.001)and TCA(R~2=0.517,P<0.001)with CBT1.·CONCLUSION:Eyes with PAC/PACG have thinner ciliary body thickness and more anteriorly situated ciliary processes.Thinner ciliary body thickness is associated with anterior situation of the ciliary processes.

Immunohistochemical Studies of Macrophages and MHC Class Ⅱ -positive Cells in the Iris and Ciliary Body of Lewis Rats

Purpose:To investigate the density, distribution and morphology of macrophages and MHC class II -positive dendritic cells in the iris and ciliary body of lewis rats. Methods:Immunohistochemistry was performed using monoclonal antibodies specific to monocytes and macrophages (ED1,ED2) and MHC class II -positive cells (OX6) on wholemounts of the iris-ciliary body complex isolated form normal lewis rats.Results:A well developed network of macrophages was present in the iris and ciliary body of normal lewis rats. These cells, morphologically displaying dendriti-form or pleiomorphic appearance, were more densely arranged in mid-iris (950 + 189 cells/mm2) than in iris base (482 ± 78 cells/mm2) and pupil margin (595 ± 92 cells/mm2). A similar network of MHC class II -positive cells with a cell density 452 ± 78 cells/mm2 was almost uniformly distributed in the iris of normal lewis rats.Conclusions : A network of macrophages and MHC class II -positive cells was established in the iris and ciliary body of

Angioleiomyoma of the Ciliary Body: A Case Report

Purpose:To report a rare case of angioleiomyoma of the ciliary body Methods:The clinical manifestation, imaging findings, histopathologic characteristics were analyzed in a 32-year-old male patient with angioleiomyoma of the ciliary body.Results:The tumor was removed intact with local resection. Histopathologic examination revealed that the tumor was full of vessels and it was composed of spindle cells with abundant cytoplasm. Immunohistochemical studies showed positive for SMA and Desmin and negative for S100 and HMB-45. Conclusions:Angioleiomyoma of the ciliary body is a rare tumor that can be successfully treated with local surgical resection in this area. It needs to be differentiated from other tumors, especially malignant melanoma. Eye Science 2004;20:19-22.

Advanced wasting in peritoneal dialysis patients

AIM To identify patients with end-stage renal disease treated by peritoneal dialysis(PD) who had zero body fat(BF) as determined by analysis of body composition using anthropometric formulas estimating body water(V) and to compare nutritional parameters between these patients and PD patients whose BF was above zero.METHODS Body weight(W) consists of fat-free mass(FFM) andBF.Anthropometric formulas for calculating V allow the calculation of FFM as V/0.73,where 0.73 is the water fraction of FFM at normal hydration.Wasting from loss of BF has adverse survival outcomes in PD.Advanced wasting was defined as zero BF when V/0.73 is equal to or exceeds W.This study,which analyzed 439 PD patients at their first clearance study,used the Watson formulas estimating V to identify patients with V_(Watson)/0.73 ≥ W and compared their nutritional indices with those of PD patients with V_(Watson)/0.73 < W.RESULTS The study identified at the first clearance study two male patients with V_(Watson)/0.73 ≥ W among 439 patients on PD.Compared to 260 other male patients on PD,the two subjects with advanced wasting had exceptionally low body mass index and serum albumin concentration.The first of the two subjects also had very low values for serum creatinine concentration and total(in urine and spent peritoneal dialysate) creatinine excretion rate while the second subject had an elevated serum creatinine concentration and high creatinine excretion rate due,most probably,to non-compliance with the PD prescription.CONCLUSION Advanced wasting(zero BF) in PD patients,identified by the anthropometric formulas that estimate V,while rare,is associated with indices of poor somatic and visceral nutrition.

Reproducibility of serial creatinine excretion measurements in peritoneal dialysis

AIMTo test whether muscle mass evaluated by creatinine excretion （EXCr） is maintained in patients with end-stage kidney disease （ESKD） treated by peritoneal dialysis （PD）, we evaluated repeated measurements of EXCr in a PD population.METHODSOne hundred and sixty-six PD patients （94 male, 72 female） receiving the same PD dose for the duration of the study （up to approximately 2.5 years） had repeated determinations of total （in urine plus spent dialysate） 24-h EXCr （EXCr T） to assess the adequacy of PD by creatinine clearance. All 166 patients had two EXCr T determinations, 84 of the 166 patients had three EXCr T determinations and 44 of the 166 patients had four EXCr T measurements. EXCr T values were compared using the paired t test in the patients who had two studies and by repeated measures ANOVA in those who were studied three or four times.RESULTSIn patients who were studied twice, with the first and second EXCr T measurements performed at 9.2 ± 15.2 mo and 17.4 ± 15.8 mo after onset of PD, respectively, EXCr T did not differ between the first and second study. In patients studied three times and whose fnal assessment occurred 24.7 ± 16.3 mo after initiating PD, EXCr T did not differ between the first and second study, but was significantly lower in the third study compared to the frst study. In patients who were studied four times and whose fourth measurement was taken 31.9 ± 16.8 mo after onset of PD, EXCr T did not differ between any of the studies. The average EXCr T value did not change signifcantly, with the exception of the third study in the patients studied thrice. However, repeated determinations of EXCr T in individuals showed substantial variability, with approximately 50% of the repeated determinations being higher or lower than the first determination by 15% or more.CONCLUSIONThe average value of EXCr T remains relatively constantfor up to 2.5 years of follow-up in PD patients who adhereto the same PD schedule. However, repeated individualEXCr T values vary considerably in a large proportion ofthe patients. Further studies are needed to evaluatethe clinical signifcance of varying EXCr T values and thestability of EXCr T beyond 2.5 years of PD follow-up.

Effect of primary iris and ciliary body cyst on anterior chamber angle in patients with shallow anterior chamber

Objective:To evaluate the prevalence of primary iris and/or ciliary body cysts in eyes with shallow anterior chamber and their effect on the narrowing of the anterior chamber angle.Methods:Among the general physical check-up population,subjects with shallow anterior chambers,as judged by van Herick technique,were recruited for further investigation.Ultrasound biomicroscope(UBM) was used to detect and measure the cysts located in the iris and/or ciliary body,the anterior chamber depth(ACD),the angle opening distance at 500 μm(AOD500),and the trabecular-iris angle(TIA).A-scan ultrasonography was used to measure the ocular biometry,including lens thickness,axial length,lens/axial length factor(LAF),and relative lens position(RLP).The effect of the cyst on narrowing the corresponding anterior chamber angle and the entire angle was evaluated by the UBM images,ocular biometry,and gonioscopic grading.The eye with unilateral cyst was compared with the eye without the cyst for further analysis.Results:Among the 727 subjects with shallow anterior chamber,primary iris and ciliary body cysts were detected in 250(34.4%) patients;among them 96(38.4%) patients showed unilateral single cyst,21(8.4%) patients had unilateral double cysts,and 42(16.8%) patients manifested unilateral multiple and multi-quadrants cysts.Plateau iris configuration was found in 140 of 361(38.8%) eyes with cysts.The mean size of total cysts was(0.6547±0.2319) mm.In evaluation of the effect of the cyst size and location on narrowing the corresponding angle to their position,the proportion of the cysts causing corresponding angle narrowing or closure among the cysts larger than 0.8 mm(113/121,93.4%) was found to be significantly higher than that of the cysts smaller than 0.8 mm(373/801,46.6%),and a significant higher proportion was also found in the cysts located at iridociliary sulcus(354/437,81.0%) than in that at the pars plicata(131/484,27.1%).In evaluating the effect of the cyst on the entire anterior chamber angle,the eyes with multiple and multi-quadrants cysts manifested significant narrowing of the entire anterior chamber angle as compared with the eyes without cysts,based on the data analysis in comparison of TIA,AOD500,and gonioscopic grading evaluation.The unilateral single or double cysts in the eyes had no significant effect on narrowing of anterior chamber angle as compared with eyes without cysts.The iris and/or ciliary body cysts did not seem to affect the axial length,ACD,lens thickness,RLP,LAF.Conclusions:The prevalence of primary iris and ciliary body cyst was 34.4% in the subjects with shallow anterior chamber.The cysts larger than 0.8 mm,locating at iridociliary sulcus,or multiple and extensive cysts were inclined to cause the angle narrowing or closure.

Local excision of ciliary body tumors： a long-term prospective cohort study in China

Background Ciliary body tumors are usually difficult to diagnose and treat in early stages. However, treatment of such tumors has trended toward ocular conservation instead of enucleation. Local excision of ciliary body tumors has become effective with the development of the modern vitrectomy, but long-term outcomes are still not clear. Therefore, we reported the outcome of locally excised ciliary body tumors after long-term follow-up. Methods Twenty-two patients （22 eyes）, who had been diagnosed with ciliary body tumors in Beijing Tongren Hospital from January 1996 to June 2001, were enrolled in this prospective cohort study. Localized lamellar sclera-ciliary excisions were performed. In some cases, vitrectomies, scleral graft transplantations, and further excisions of the anterior choroid were performed. Diagnoses were confirmed by histopathologic examination. Patients were followed from five to eleven years after surgery. Their visual acuity, intraocular pressure and local recurrence were recorded with descriptive percentages. Results After surgery, all patients maintained normal eyeball appearances. Six patients maintained circular pupils. The final best corrected visual acuities （BCVA） varied from 0.02-1.00, including 18 patients （81.82%） who had BCVA equal to or better than that before surgery. Fifteen patients （68.18%） had BCVA better than 0.3. Only two patients had intraocular pressure （lOP） of less than 10 mmHg and the other patients maintained normal lOP. Nine cases （40.91%） were given confirmed diagnosis of malignant melanoma, four （18.18%） of melanocytoma, six （27.27%） of nonpigmented ciliary epithelial adenoma, two （9.09%） of neurofibroma, and one （4.55%） of neurinoma. Twenty patients （90.91%） had no recurrence during the follow-up period. In one case melanocytoma recurred seven years after surgery and enucleation was performed. One patient, whose operation removed a malignant melanoma with a diameter of 16 mm, died of hepatic metastasis five years after the operation. Conclusion For some ciliary body tumors, especially in the early stages, local excision is an effective and safe method to save the vision and the eyeball.

Roles of paroxetine and corticosterone on adult mammalian ciliary body cell proliferation

Background The neurogenesis in retina of adult mammals is generally abolished, and this renders the retina lack of regenerative capacity. Despite this, there is a small population of nestin-positive cells in the ciliary epithelium which retains neurogenic potential. The present study aimed at investigating the effect of two drugs, corticosterone and paroxetine, on the cell proliferation of the ciliary body. Methods Adult Sprague-Dawley rats were given vehicle, corticosterone, paroxetine, or both corticosterone and paroxetine treatment for 14 days. Cell proliferation in the ciliary body was quantified using 5-bromo-2-deoxyuridine （BrdU） immunohistochemistry. Co-labelling of BrdU and stem cell marker was used to phenotype the BrdU immunoreactive cells. Results Corticosterone treatment suppressed while paroxetine treatment increased the cell proliferation of the ciliary body. Co-labelling with cell markers revealed that the BrdU positive cells also showed nestin expression but not glial fJbrillary acidic protein （GFAP）. Conclusions The results illustrate that proliferation of retinal progenitor cells situated in ciliary body are subjected to regulation by selective serotonin reuptake Jnhibitors （SSRI） and corticosteroJd, which is similar to our previous findings in neurogenic regions in central nervous system （CNS）. Paroxetine treatment could reverse the suppressive effect of corticosterone on ciliary body cell proliferation. This provides information for future investigation of retinal stem cell biology and potential treatment of retinal degenerative diseases.

Expression of nitric oxide synthase and guanylate cyclase in the human ciliary body and trabecular meshwork

Background The role played by the nitric oxide （NO） signaling pathway in the aqueous humor dynamics is still unclear.This study was designed to investigate the expression and distribution of NO synthase （NOS） isoforms and guanylate cyclase （GC） in human ciliary body,trabecular meshwork and the Schlemm＇s canal.Methods Twelve eyes after corneal transplantation were used.Expression of three NOS isoforms （i.e.neuronal NOS （nNOS）,inducible NOS （iNOS） and endothelial NOS （eNOS）） and GC were assessed in 10 eyes by immunohistochemical staining using monoclonal or polyclonal antibody of NOS and GC.Ciliary bodies were dissected free and the total proteins were extracted.Western blotting was performed to confirm the protein expression of 3 NOS isoforms and GC.Results Expression of 3 NOS isoforms and GC were observed in the ciliary epithelium,ciliary muscle,trabecular meshwork and the endothelium of the Schlemm＇s canal.Immunoreactivity of nNOS was detected mainly along the apical cytoplasmic junction of the non-pigmented epithelium （NPE） and pigmented epithelial （PE） cells.Protein expressions of 3 NOS isoforms and GC were confirmed in isolated human ciliary body by Western blotting.Conclusions The expression of NOS isoforms and GC in human ciliary body suggest the possible involvement of NO and cyclic guanosine monophosphate （cyclic GMP,cGMP） signaling pathway in the ciliary body,and may play a role in both processes of aqueous humor formation and drainage.

A Case of Primary Central Nervous System Lymphoma with Ciliary Body Involvement

INTRODUCTION Primary central nervous system lymphoma （PCNSL） is defined as lymphoma confined to the brain, eye, spinal cord, or leptomeninges. It constitutes approximately 3% of all brain tumors, and 2-3% of all cases of non-Hodgkin lymphoma. Ocular involvement can be detected during clinical staging in about 20% of patients with PCNSL, with primary vitreous retinal lymphoma being the most common subtype. Uveal involvement of PCNSL is uncommon, and PCNSL with ciliary body involvement （CBL）, to the best of our knowledge, has not been reported.

Ciliary body detachment after secondary intraocular lens implantation in childhood

Dear Sir,Iam Dr.Li-Na Meng,from the Qingdao Eye Hospital,Shandong Eye Institute,Shandong Academy of Medical Sciences,Qingdao,China.I want to present a rare case of secondary intraocular lens(IOL)implantation in an11-year-old boy who developed the complication of ciliary body detachment.When he was 2 years old,the boy underwent bilateral cataract extraction for congenital cataract in the other

Lymphocyte infiltration and activation in iris-ciliary body and anterior chamber of mice in corneal allograft rejection

AIM: To investigate the infiltration and activation of lymphocyte in iris-ciliary body and anterior chamber after allogenic penetrating keratoplasty (PK), for further revealing the role of iris-ciliary body in corneal allograft immune rejection. METHODS: In the mice models of PK, BALB/C mice received orthotopic isografts (n =35) or C57BL/6 donor allografts (n=25). Grafts were examined daily for 3 weeks by slit-lamp microscopy and scored for opacity. The infiltration of CD4(+) T lymphocyte in iris-ciliary body and anterior chamber was examined by immunohistology and the mRNA of CD80 and CD86 in both cornea graft and iris-ciliary body by RT-PCR was analyzed in allograft recipient at days 3, 6, 10 and the day when graft rejection occurred. Isograft recipients were examined as control at the corresponding time points. Transmission electron microscope was used to study the ultrastructure, especially cell infiltration, of iris-cilary body and corneal graft at day 3, 7 and the day when rejection occurred after allogenic PK. RESULTS: Rejection was observed in all the allograft recipients followed more than 10 days, at a median time of 15 days (range 12-18 days), but not in any of isografts. CD4(+) T cells were first detected at day 6 after transplantation in limbus and Ciliary body, and then in the stroma of recipient, iris, anterior chamber and corneal allograft with an increased number until graft rejection occurred. CD80 and CD86 mRNA were detected under RT-PCR examination in both graft and iris-ciliary body of allograft recipient, but not in any of isograft recipient. Three days after operation, lymphocytes and monocytes macrophages were visible in iris blood vessels and the anterior chamber, and vascular endothelial cell proliferation and activation were significant under transmission electron microscopy examination. At day 7, corneal endothelial cells became thinner. Lymphocytes and mononuclear macrophages were found with great number in the anterior chamber and adhered to the corneal endothelium. Blood vessels in iris increased and were filled with lymphocytes. And lymphocytes were detected to migrate through endothelial cell gap out of vessels. When allograft rejection occurred, macrophages attached to endothelial cells with large number of lymphocytes and macrophages infiltrating in iris. CONCLUSION: Lymphocyte infiltration and activation occurred in iris-ciliary body after allogenic PK, and the lymphocytes could migrate from iris blood vessel to the anterior chamber, which might play an important role in corneal allograft immune rejection.

Prejunctional 5-HT Receptors Enhance Cholinergic Neurosecretion in the Rabbit and Human Iris-ciliary Body

Purpose: To characterize prejunctional 5-HT heteroreceptors which modulate nacetylcholine (3 H-ACh release) in isolated rabbit and human iris-ciliary bodies (ICBS) . Methods: ICB tissue segments were incubated with H-choline, superfused and electrically stimulated four times (S1,S2,S3,S4) at 3 - 10 Hz for 1 min to elicit 3H-ACh. secretion. Test agents (5-HT agonists and antagonists) were added before S2,S3 and S4 and their effects determined by the stimulation ratio (Sx/S1) of evoked 3H-ACh. release. 3H-ACh in super-fusate fractions was fractionated and quantified by ion exchange chromatography. Results: In rabbit ICBs, evoked 3H-ACh. release was enhanced in a concentration-dependent manner by 5-HT (10- 9 - 10-5 M, EC50 = 5.8× 10-8 M). The maximum effect of 5-HT (10-6M) corresponded to a 45. 14 ± 7.40%) (n = 6) increase in 3H-ACh release. Higher concentrations of 5-HT ( > 10- M) induced desensitization. The response to 5-HT ( 10-6 M) in the presence of the 5-HT3/4 antagonist tropisetron (10-9 M) ,

雷珠单抗联合半量睫状体光凝术治疗新生血管性青光眼的效果观察

目的探讨雷珠单抗联合半量睫状体光凝术治疗新生血管性青光眼(NVG)的效果观察。方法选取2021年1月至2023年1月在首都医科大学宣武医院治疗的NVG患者110例(110眼)作为研究对象。在组间基线特征匹配的原则上,按照简单随机数表法将入组NVG患者分为观察组与对照组,各55例。对照组行半量睫状体光凝术,观察组在其基础上加用雷珠单抗治疗每月1次,连续3次。比较两组新生血管消退时间、治疗成功率、术后并发症及6个月复发率,治疗后1个月、3个月和6个月最佳矫正视力(BCVA)和眼压恢复情况,及治疗前、治疗3个月后血清检测指标[血清白细胞介素-1β(IL-1β)、IL-6和血管内皮生长因子水平(VEGF)]。结果观察组患者新生血管消退时间及成功率优于对照组(P<0.05)。治疗后1个月、3个月和6个月,两组患者BCVA均比治疗前明显升高,但组间比较差异无统计学意义(P>0.05);两组患者眼压均比治疗前明显降低,且观察组各时间点更低,差异有统计学意义(P<0.05)。治疗后两组患者IL-1β、IL-6和VEGF水平均低于治疗前,且观察组比对照组更低(P<0.05)。两组患者的并发症发生率及术后复发率差异均无统计学意义(P>0.05)。结论雷珠单抗联合半量睫状体光凝术治疗NVG成功率较高,可以有效改善眼压和炎症水平。

体成分分析水负荷参数对不同模式透析患者预后的影响:多中心前瞻性队列研究

背景维持性血液透析(MHD)和腹膜透析(PD)是当前尿毒症患者主要的治疗方式,如何更好地制订治疗方案解决透析患者水负荷问题一直是临床研究的重要内容,应用体成分分析(BCM)对不同模式透析患者转归的影响仍有争议。目的研究BCM中的水负荷(OH)参数与MHD和PD患者预后的关系。方法纳入2017年10月—2022年3月在首都医科大学附属北京积水潭医院、北京博爱医院、航空总医院、北京市昌平区医院、北京市昌平区中西医结合医院维持性透析的334例患者为研究对象。根据患者采用肾脏替代治疗模式,将患者分为MHD组(n=188)和PD组(n=146)。通过电子病历系统收集患者一般资料,收集BCM相关参数。对纳入研究的患者进行随访,记录透析治疗参数、体质量、收缩压、舒张压,计算多次随访结果的平均值,随访期间记录终点事件,首要终点事件为全因死亡(ACM),次要终点事件包括心血管事件(CVE)、复合不良事件(CAE)、外科手术或骨折(SOF)。采用Spearman秩相关分析探究终点事件与BCM参数的相关性,多因素逐步Logistic回归分析探究患者发生次要终点事件的影响因素。采用Kaplan-Meier法绘制患者ACM生存曲线,采用Log-rank检验比较两组患者生存曲线的差异。采用多因素Cox回归分析探究患者ACM的影响因素。结果共311例患者完成了随访,中位随访时间29.9(18.0,36.0)个月,随访截至2022-09-30,其中MHD组176例,PD组135例完成了随访。MHD组透析龄、体质量、目标体质量、脂肪组织含量、脂肪含量、脂肪组织指数高于PD组,OH低于PD组(P<0.05)。MHD组体质量平均值、目标体质量平均值、收缩压平均值、脂肪组织含量平均值、脂肪组织指数平均值高于PD组,OH平均值、水负荷标准差(OHsd)、水负荷最大变化值(OHd)、水负荷最大变化值低于PD组。MHD组CVE、CAE、SOF的发生率分别为16.5%(29/176)、39.2%(69/176)、4.0%(7/176),PD组分别为45.9%(62/135)、83.0%(112/135)、8.2%(11/135)。MHD组CVE、CAE发生率低于PD组(χ^(2)=32.009,P<0.001;χ^(2)=60.132,P<0.001)。多因素Logistic回归分析结果显示MHD组细胞外水平均值/细胞内水平均值(OR=57.974,95%CI=1.393~2413.247)为CVE的影响因素(P<0.05),OHd(OR=1.255,95%CI=1.076~1.462)为CAE的影响因素(P<0.05);PD组患者年龄(OR=1.029,95%CI=1.008~1.052)为CVE的影响因素(P<0.05),OHd(OR=1.962,95%CI=1.355~2.842)为CAE的影响因素(P<0.05)。两组患者ACM的Kaplan-Meier生存曲线结果示,PD组ACM发生率高于MHD组(χ^(2)=7.145,P=0.008)。多因素Cox回归分析结果显示,年龄是MHD组ACM的影响因素(HR=1.070,95%CI=1.019~1.123),舒张压平均值(HR=0.942,95%CI=0.854~0.992)、OHsd(HR=3.612,95%CI=2.072~6.296)是PD组ACM的影响因素。结论PD患者首要终点事件、次要终点事件发生率高于MHD患者,且PD患者较MHD患者OH更明显,BCM所得OH值的波动可以预测PD患者的ACM。

超声生物显微镜在超声睫状体成形术中的应用

目的 探讨超声生物显微镜在超声睫状体成形术中的应用。方法 采用回顾性病例分析方法,纳入2020年8月—2021年7月在兰州大学第二医院眼科进行超声睫状体成形术的23例青光眼患者,对比术眼术前、术后1周、术后1个月、术后3个月的超声生物显微镜检查结果,记录分析不同时间段睫状体与睫状突形态学上的差异。结果 23例患者术前平均眼压为(44.83±6.25) mmHg,术后1周平均眼压降低了38.9%,术后1个月平均眼压降低了43.2%,术后3个月平均眼压降低了43.8%,差异均有统计学意义(P <0.001)。超声生物显微镜检查发现青光眼患者在超声睫状体成形术术前和术后不同时间中睫状突厚度,睫状突数量均有变化,与术前相比,术后不同时间段睫状突厚度减小,睫状突数量减少,差异均具有统计学意义(P <0.05)。结论 超声生物显微镜可准确观察睫状体的形态学变化,并可以定量分析,对超声睫状体成形术术前与术后睫状体形态学的观察效果明显,临床上可以用于指导超声睫状体成形术治疗参数的设定,并预判术后的治疗疗效。