干眼治疗新思维教学课件.ppt

Before the device used at the study, we should make a calibration, A resolution test card was used to test the spatial resolution. (A) was imaged with the optical magnification 30× ,we can see element 3 of the group 5 of the resolution card. (B) With the highest magnification of 210×, the element 3 of the group 7 on the resolution card (equivalent 3.11 μm) was viewed clearly. The more magn the more resolution will be got. * The next step, With a green light filter in the illumination path, the Movie Crop Function, and the high magnification (~112×) features, the cross-sectional images of the cornea were video-recorded at 60 frames per second, This allowed us to clearly visualizethe corneal epithelium, it is noticed to thickness increase from mid-periphery to limbus, Moreover, the Bowman’s membrane was well defined (Fig. 4A), the images of corneal epithelium layers similar to those in images (E-H) obtained using ultra-high resolution OCT * With the highest magnification (~210×), tear film debris (Fig. 5A-B) were apparent on the ocular surface. In addition, corneal nerve network in the stroma were visualized with this setting. * * 眼表炎症的量化指标血管网碎片化分析和结膜血流速度测定 眼表炎症的量化指标血管网碎片化分析和结膜血流速度测定 Normal subject Dry eye patient Data unpublished—JIN YUAN and Jay Wang Va 0.4mm/S Va 0.9mm/S 干眼眼表炎症的量化指标是指： A.眼表染色评分 B眼红指数 C 结膜血流速度 D 以上都是 MGD抗炎治疗包含两个范畴：局部与全身 治疗前 治疗后 全身抗炎药物的使用 MGD伴有眼外疾病：痤疮、酒糟鼻、脂溢性皮炎 红霉素/阿齐霉素 500mg 1次/日～3次/日 强力霉素 50mg 2次/日，2周，100mg 2～3月 米诺环素 50mg 2周，100mg 3月 必须脂肪酸Ω-3的补充 1000mg/日 改善脂质分泌，抑制局部炎症反应，减轻眼表损害[A:Ⅲ] 重视诱发睑缘微环境失调的危险因素 螨虫 正常人97％携带率 以皮脂分泌物为食 引起睑缘炎症，多伴有红斑型痤疮 蠕形螨引起睑缘炎症，睫毛根部袖套样皮脂，缘间部充血 重视诱发睑缘微环境失调的危险因素 其他物理治疗？？？ 热敷 按摩 清洁睑缘（茶树油提取物） 睑缘上皮粗糙 不同程度角化 鳞状上皮化生 瞬目过程中刮擦角膜上皮 治疗性角膜接触镜 保护新生角膜上皮 维持眼表湿润 周抛型和月抛型 避免使用凝胶及眼膏剂型 泪道栓塞的种类 可降解：胶原泪点塞 永久性：smart泪小点塞， FCI硅胶型泪点塞 适应症：炎症控制，ST5mm/5min 泪小点炎症 泪小管炎 急性泪囊杨 泪道肉芽肿 Smart泪小点栓子常见并发症 Ophthal Plast Reconstr Surg 2009;25:437–439) Ophthalmology 2006：113:1859–1862 提供密闭环境，减少眼表面的空气流动及泪液的蒸发，进而达到保存泪液的目的 BUT5s、MGD,VDT适