大龄弱视存在该群体视觉发育的特殊性,传统的弱视治疗效果不佳。随着人们逐渐认识到可塑性的机制并尝试寻找靶点进行治疗大龄弱视,通过激活大脑神经元来达到恢复大龄弱视群体的视力和视功能的目的有了更多可能性。本篇综述概述了近年来国内外相关文献报道,阐述了大龄弱视这一特殊群体及可塑性的影响因素,介绍了在此基础上的视知觉学习方法以期使得可塑性得以重启。Older amblyopia has its special visual development, and the traditional treatment of amblyopia is not effective. As people gradually understand the mechanism of plasticity and try to find a target for treatment of amblyopia, it is more possible to restore the vision and visual function of the elderly amblyopia by activating brain neurons. In this review, the relevant literatures at home and abroad in recent years are reviewed, the special group of elderly amblyopia and the influencing factors of plasticity are expounded, and the visual perceptual learning methods based on this are introduced in order to restart plasticity.
黄斑下出血是位于视网膜光感受器细胞层和视网膜色素上皮层(retinal pigment epithelium, RPE)之间的出血,可能由年龄相关性黄斑变性(age-related macular degeneration, AMD)、视网膜大动脉瘤等疾病引起。血凝块释放的铁对感光细胞、视网膜循环等都具有毒性作用,因此血凝块的吸收快慢是预后良好与否的关键,利用41号(41G)微针行视网膜下注射人组织纤溶酶原激活剂(tissue plasminogen activator, t-PA)联合玻璃体切除术(pars plana vitrectomy, PPV)和气体填塞术能更有效、更安全地治疗视网膜下出血,从而快速吸收血凝块以保护视功能。现报道1例利用41G微针在视网膜下注射重组人组织纤溶酶原激活剂以治疗黄斑下出血。Submacular hemorrhage is bleeding between the retinal pigment epithelium (RPE) and the photoreceptor cell layer of the retina. It can be caused by age-related macular degeneration (AMD), large aneurysms of the retina and other diseases. The iron released by blood clots has toxic effects on photoreceptor cells and retinal circulation, so the absorption rate of blood clots is the key to good prognosis. Subretinal injection of human tissue plasminogen activator was performed using 41 (41G) microneedles, the combination with pars plana vitrectomy (PPV) and gas tamponage can more effectively and safely treat subretinal bleeding, thereby rapidly absorbing the blood clot to preserve visual function. We report a case of submacular hemorrhage treated by subretinal injection of recombinant human tissue plasminogen activator using 41G microneedles.
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