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手术治疗前段巨眼合并白内障:病例报道和文献综述
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作者 陈晓云(综述) 黄圣松(审校) 《眼科学报》 CAS 2024年第9期454-461,F0002,共9页
前段巨眼(anterior megalophthalmos,AM)是一种罕见的双侧非进展性先天性眼前段增大疾病,表现为大角膜(直径≥12.5 mm)、前房极深、角膜厚度正常或轻中度变薄和睫状环扩大等。并发性白内障以及晶状体脱位是导致AM视力下降的主要原因。然... 前段巨眼(anterior megalophthalmos,AM)是一种罕见的双侧非进展性先天性眼前段增大疾病,表现为大角膜(直径≥12.5 mm)、前房极深、角膜厚度正常或轻中度变薄和睫状环扩大等。并发性白内障以及晶状体脱位是导致AM视力下降的主要原因。然而,解剖结构的异常使AM白内障手术具有很大的挑战性。文章报道了一例AM合并白内障的48岁男性患者,成功为其行手法小切口白内障摘除联合人工晶状体(intraocular lens,IOL)一期植入术,患者术后视力恢复良好,IOL位置居中,未出现较大的屈光误差。对该典型AM病例的临床特点以及手术难点的回顾总结,有助于加深广大眼科临床工作者对该疾病的认识。 展开更多
关键词 前段巨眼 大角膜 白内障手术 人工晶状体计算 人工晶状体脱位
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Diagnostics and Prediction of Glaucoma in Patients with Familial Congenital Iris Hypoplasia 被引量:2
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作者 Tatiana Iureva Andrey Shchuko Yulia Pyatova 《Open Journal of Ophthalmology》 2015年第3期115-123,共9页
Purpose: To identify the clinical features of the syndrome Frank-Kamenetsky and determine the criteria of early formation of glaucoma. Materials and Methods: We observed 52 patients. Follow up period was from 5 to 22 ... Purpose: To identify the clinical features of the syndrome Frank-Kamenetsky and determine the criteria of early formation of glaucoma. Materials and Methods: We observed 52 patients. Follow up period was from 5 to 22 years. The first group (juvenile) consisted of males who had the first signs of glaucoma diagnosed before the age of 12 (n = 22). The average age of the group was 10.1 ± 2.4 years. The control group included healthy males (n = 30) in the same age range (average age 7.2 ± 1.6 years). The second group (adults) consisted of patients who had the first signs of glaucoma diagnosed after the age of 18 and elder. The average age of the group was 32.44 ± 6.28 years. The control group had males (n = 30) in the same age range (average age 26.59 ± 4.12 years). The inclusion criterion was: the presence of congenital bilateral mesodermal iris leaf hypoplasia, tra-becular dysgenesis signs, the presence of blood relatives on the maternal line (grandfather, uncle) male with similar changes iridociliary zone and glaucoma. Criteria of glaucoma formation were: increased IOP more than 21 mmHg with accompanying it expansion of the cup/disc ratio, reducing the thickness of the nerve fiber layer (RNFL) according to OCT. Results: It was found that Frank-Kamenetsky Syndrome had an X-linked with sex, recessive inheritance and was characterized by bilateral congenital irisdysgenesis and goniodysgenesis with the accession glaucoma. Predictors of glaucoma formation in early childhood are a combination of: 1) congenital subtotal atrophy of iris mesodermal layer (from 0 to 30 mkm) with signs of progressive dystrophy;2) nonprogressive congenital megalocornea (cornea diameter 12 - 14 mm);3) iridotrabecular dysgenesis of II-III degree;4) hyperopic refraction in axial myopia. 展开更多
关键词 GLAUCOMA megalocornea CONGENITAL Mesodermal IRIS ATROPHY Goniodysgenesis
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CHRDL1基因无义变异引起大角膜免疫反应
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作者 史平玲 但汉东 +6 位作者 王艳歌 王娇娇 张贝贝 魏圆梦 唐贺 李苗 宋宗明 《中华眼视光学与视觉科学杂志》 CAS CSCD 北大核心 2024年第6期450-459,共10页
目的:确定先天性大角膜一家系致病基因变异,并探讨该基因致病机制。方法:实验研究。于2022年7月采集一X连锁大角膜(MGC1)家系先证者1例和其他家系成员2例的外周静脉血标本。并详细采集患者病史后,对患者行最佳矫正视力(BCVA)、眼压、裂... 目的:确定先天性大角膜一家系致病基因变异,并探讨该基因致病机制。方法:实验研究。于2022年7月采集一X连锁大角膜(MGC1)家系先证者1例和其他家系成员2例的外周静脉血标本。并详细采集患者病史后,对患者行最佳矫正视力(BCVA)、眼压、裂隙灯显微镜联合前置镜、眼前节分析(OrbscanⅡ)、角膜地形图和眼底彩色照相检查。应用包含439个基因的眼前节疾病检测Panel和包含22个基因的青光眼检测Panel进行靶向捕获富集及高通量测序,筛选与疾病表型相关的致病基因变异,并使用Sanger测序进行验证。利用RT-PCR和免疫蛋白印迹法检测CHRDL1基因mRNA和蛋白的表达;荧光显微镜观察绿色荧光蛋白的表达。通过转录组测序和生物信息学分析,检测CHRDL1无义变异对分子功能和信号通路的影响。数据均采用独立样本t检验进行分析。结果:先证者被诊断为MGC1,眼压最高达27 mmHg(1 mmHg=0.133 kPa);角膜中央厚度右眼为469μm,左眼为470μm,均减少;角膜直径右眼为13.95 mm,左眼为13.65 mm。基因检测结果显示,先证者CHRDL1基因存在c.36delC(p.Tyr12^(*))半合子无义变异。与pHBLV-CHRDL1 wt组比较,pHBLV-CHRDL1 Tyr12^(*)组CHRDL1蛋白表达显著下降(t=24.16,P<0.001),CHRDL1Tyr12^(*)变异能够激活免疫系统信号通路并促进炎症因子和趋化因子表达。结论:CHRDL1基因c.36delC(p.Tyr12^(*))无义变异为MGC1家系的变异位点,该变异激活的免疫信号通路可能在MGC1的发病机制中发挥重要作用。 展开更多
关键词 大角膜 青光眼 CHRDL1基因 免疫反应
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