目的 观察视网膜中央动脉阻塞（CRAO）的光相干断层扫描（OCT）病理形态学改变特征。方法 通过检眼镜，荧光素眼底血管造影（FFA）检查确诊的CRAO患者53例（53只眼）进行OCT检查，所有患者发病2周内。OCT检查采用水平或垂直线性扫描，扫描部位为黄斑区、后极部视网膜、视盘及出血、渗出等相应病灶部位。结果 CRAO的OCT活体病理改变的图像特征包括黄斑区及后极部全层视网膜厚度增加、反射增强，光感受器暗区增宽（水肿）；黄斑中心凹水肿或囊样水肿；后极部视网膜出血及棉絮斑可有不同的OCT表现；视盘边缘隆起，呈水肿改变；其中4例患者伴有睫状视网膜动脉，在睫状视网视膜动脉供应区视网膜结构正常。 结论 OCT可以无创伤地在活体上观察CRAO的视网膜组织病理改变，特别适用于不允许进行FFA检查的高龄或合并全身病的CRAO患者，其独特的OCT图像病理改变可以为临床即时诊断提供客观依据。

【目的】探讨羊膜在青光眼滤过手术中应用的降压效果及安全性。【方法】将各类型青光眼38例44只眼分为3组，A组为巩膜瓣下羊膜移植术（AMT）组（20只眼）；B组为巩膜瓣下联合应用丝裂霉素组（12只眼）；C组为对照组（12只眼），行单纯小梁切除术。观察手术前、术后第1、2、3、7、14、21天、第1、3、6个月各组的视力、眼压、滤过泡类型和充血程度、前房深度、眼底情况及并发症，用前房激光蛋白细胞检测仪（LFCM）测量术前和术后第1、3、7天和1个月的前房蛋白含量，进行统计学分析。【结果】3组术后平均眼压均控制在21mmHg以下，术后7～14d眼压最低：3组各观察点之间比较P值均大于0.05，差异无显著性。44只眼中40只眼为Ⅱ型滤过泡，4只眼为包裹性囊状滤过泡。羊膜组滤过泡术后2d较扁平，第3天起隆起呈弥散的Ⅱ型泡；羊膜组早期滤过泡充血较轻，与其它两组比较差异有显著性（P<0.05）。羊膜组前房蛋白含量术前、术后第1天、第30天均高于其他两组，差异有显著性（P<0.05）。【结论】羊膜运用于青光眼滤过手术中可以有效地降低眼压，减轻炎症反应，并发症较少。羊膜移植术后前房房水蛋白含量增加，可能与羊膜本身蛋白溶解有关。

Objectives To investigate image characteristics and thickness of the retinal nerve fiber la yer (RNFL) in normal and glaucomatous eyes using optical coherence tomography (OCT), and analyze the relationship between RNFL thickness and visual field index. Methods Eighty-three normal persons (150 eyes) and 83 patients with primary open angle glaucoma (POAG, 149 eyes) underwent OCT examinations with 3.4mm diameter circ le scan to calculate the RNFL thickness. Statistical analysis was used to compa re differences in RNFL thickness in quadrants and means between the normal and glaucomatous groups and the different stages of POAG. Linear correlation and reg ression analysis were used to show the correlation between RNFL thickness and vi sual field index of 115 eyes in glaucomatous patients. Reproducibility, sensiti vity and specificity of RNFL measurements using OCT were evaluated. Results RNFL thickness measured by OCT in normal subjects was thicker in superior and in ferior, less in temporal, and thinnest in nasal quadrants. The curve showed dou ble peaks. RNFL of glaucomatous patients showed local thinning or defect, diffu se thinning, or both. The mean RNFL thicknesses of the normal group in the temp oral, superior, nasal and infeior quadrants were 90.1±10.8μm, 140.4±10.5μm, 85.2±14.0μm, and 140.4±9.7μm, respectively with a mean of 114.2±6.0μm.The numbers for the glaucomatous group were respectively 56.0±31.0μm, 81.0±36.3μm, 47.1±27.5μm, and 73.4±38.4μm for th e four quadrants, with a mean of 64.6±28.8μm. There was a significant dif ference in RNFL thickness between the normal and glaucomatous groups (P<0.000), and the three stages (early, developing and late) of glaucomatous groups (P<0.000). There was a close negative relationship between RNFL thickness a nd visual field index (r=-0.796, P<0.0001). The sensitivity and speci ficity of RNFL thickness in POAG measured using OCT were 93.3% and 92.0%, res pectively. Conclusions OCT can quantitatively measure RNFL thickness differences between normal persons and glaucomatous patients. RNFL thickness gradually decreases while visual fie ld defect increases with the development of POAG.