以色列 KTP 激光治疗仪 532nm

摘要 · 中文整理：背景：选择性激光小梁成形术（SLT）是通过降低眼压治疗开角型青光眼的一种非侵入性方法。尽管其在多种人群中作为初始治疗有效，但在撒哈拉以南非洲尤其是尼日利亚的疗效数据有限。本研究评价SLT作为尼日利亚埃努古地区开角型青光眼初始治疗的效果，以填补该地区真实世界数据的空白。方法：对2019至2021年间在尼日利亚埃努古The Eye Specialists Hospital接受SLT初始治疗的50例患者共93只眼进行回顾性病历分析。纳入开角型青光眼（原发性、青少年型或正常眼压性）且随访至少3个月的患者。采用Kaplan-Meier分析评估单纯SLT及SLT联合追加治疗随时间的生存率。成功定义为眼压下降≥3 mmHg且未追加干预，或较基线下降≥20%。数据采用SPSS 26版分析，P<0.05为差异有统计学意义。结果：基线平均眼压为17.0 ± 5.1 mmHg。SLT后，平均眼压在3个月降至12.6 ± 3.3 mmHg（下降25%），6个月12.3 ± 3.0 mmHg（25%），12个月11.9 ± 3.1 mmHg（25%），24个月12.3 ± 2.9 mmHg（22%），36个月13.9 ± 3.3 mmHg（21%）（P均<0.05）。基线眼压较高的患眼在24个月内降幅更大。抗青光眼药物数量由基线0种增至12个月0.6 ± 1.0种、36个月1.5 ± 0.9种（P<0.001）。单纯SLT的成功率为3个月86%、6个月83%、12个月67%、24个月54%、36个月43%；SLT联合追加治疗的成功率为3个月87%、6个月84%、12个月80%、36个月64%。结论：SLT是降低尼日利亚开角型青光眼患者眼压的有效初始治疗手段，尤其适用于基线眼压较高者，在36个月内仅需极少的追加药物或手术。该结果支持SLT在资源有限地区的应用价值，但仍需前瞻性研究确认长期疗效。

原文摘要：BACKGROUND: Selective Laser Trabeculoplasty (SLT) is a non-invasive procedure for managing open-angle glaucoma by reducing intraocular pressure (IOP). While effective as a primary treatment in various populations, data on its efficacy in sub-Saharan Africa, particularly Nigeria, are limited. This study evaluates SLT as a primary treatment for open-angle glaucoma in Enugu, Nigeria, addressing a regional gap in real-world outcomes. METHODS: A retrospective chart review was conducted on 93 eyes of 50 patients who underwent SLT as primary treatment at The Eye Specialists Hospital, Enugu, Nigeria, between 2019 and 2021. Patients with open-angle glaucoma (primary, juvenile, or normal-tension) and a minimum 3-month follow-up were included. Kaplan Meier analysis was used to assess survival rates of SLT alone and SLT with additional treatment therapy overtime. Success was defined as an IOP reduction of ≥ 3 mmHg without additional intervention or ≥ 20% from baseline IOP. Data were analyzed using SPSS version 26, with statistical significance set at p < 0.05. RESULTS: Mean baseline IOP was 17.0 ± 5.1 mmHg. Post-SLT, mean IOP decreased to 12.6 ± 3.3 mmHg (25% reduction) at 3 months, 12.3 ± 3.0 mmHg (25%) at 6 months, 11.9 ± 3.1 mmHg (25%) at 12 months, 12.3 ± 2.9 mmHg (22%) at 24 months, and 13.9 ± 3.3 mmHg (21%) at 36 months (all p < 0.05). Eyes with higher baseline IOP showed greater reductions up to 24 months. The number of antiglaucoma medications increased from 0 at baseline to 0.6 ± 1.0 at 12 months and 1.5 ± 0.9 at 36 months (p < 0.001). Success rates for SLT alone (without additional therapy) were 86% at 3 months, 83% at 6 months, 67% at 12 months, 54% at 24 months, and 43% at 36 months. Success rates for SLT with additional therapy were 87% at 3 months, 84% at 6 months, 80% at 12 months, and 64% at 36 months. CONCLUSION: SLT is an effective primary treatment for reducing IOP in Nigerian patients with open-angle glaucoma, particularly those with higher baseline IOP, with minimal need for additional medications or surgery over 36 months. These findings support SLT's role in resource-limited settings, though prospective studies are needed to confirm long-term outcomes.

关键词：选择性激光小梁成形术、开角型青光眼、尼日利亚、初始治疗、非洲黑人人群

研究目标：解决撒哈拉以南非洲黑人群体中缺乏SLT作为青光眼初始治疗真实世界长期疗效数据的问题，评估其在资源有限医疗环境下替代长期药物治疗的可行性。

主要结论：以色列产532nm Q开关倍频Nd:YAG激光（Selecta Duet，Lumenis）行360°SLT可作为尼日利亚黑人开角型青光眼患者的有效初始治疗，术后36个月内眼压持续下降约21%～25%，基线眼压越高降幅越大；单纯SLT成功率随时间衰减（3个月86%降至36个月43%），但联合少量追加药物后36个月成功率仍达64%，总体减少了对长期用药与手术的依赖。

创新点：首次报道SLT在尼日利亚黑人开角型青光眼人群中作为初始治疗的36个月真实世界结局，并区分“单纯SLT”与“SLT加追加治疗”两条Kaplan-Meier生存曲线，为色素较深、依从性与药物可及性受限的非洲人群提供了本土化循证依据。

后续建议：开展前瞻性随机对照试验，与局部降眼压药物初始治疗直接比较；按小梁网色素分级分层分析，明确深色素房角对激光能量选择与疗效的影响；纳入视野与RNFL结构指标，评价SLT对视功能进展的长期保护作用；评估重复SLT的时机与疗效，优化眼压回升后的再治疗策略；增加卫生经济学分析，量化SLT在资源有限地区相对长期用药的成本优势

APA 引文：Kizor-Akaraiwe, N. N., Okeke, S., Oko, C., Uche, N., & Shiweobi, O. J. (2026). Real world outcomes of selective laser trabeculoplasty as primary treatment for glaucoma in Enugu Nigeria: a retrospective study. BMC Ophthalmology, 26(1), 87. https://doi.org/10.1186/s12886-026-04665-4

仪器引用：SLT was performed using a Q-switched, frequency-doubled 532 nm Nd: YAG laser (Selecta Duet, Lumenis, Israel) with a 400 μm spot size and 3-nanosecond pulse duration. The protocol involved 100–120 applications across 360° of the trabecular meshwork of the anterior chamber angle, with 25–30 spots per quadrant at an energy level of 0.8–1.2 mJ.

摘要 · 中文整理：视网膜静脉阻塞（RVO）是一种常见的血管性疾病，可因黄斑水肿（ME）导致视力丧失。本研究探讨了溶血磷脂酶D——自分泌运动因子（ATX）在RVO发病机制中的作用。在小鼠中，通过静脉注射玫瑰红后对视网膜静脉施行激光照射诱导RVO。采用免疫组织化学评价视网膜中ATX的表达；玻璃体腔注射ATX后，采用荧光素血管造影与光学相干断层扫描（OCT）评估视网膜改变。在人视网膜微血管内皮细胞（HRMEC）中，采用跨上皮电阻（TEER）评价细胞间屏障功能。在小鼠RVO模型中玻璃体腔注射ATX抑制剂HA130，并用OCT测量比较视网膜厚度。结果显示，RVO模型中视网膜血管的ATX表达增高；玻璃体腔注射ATX可诱发视网膜水肿与浆液性视网膜脱离（SRD）；ATX显著破坏HRMEC的屏障完整性并促进血管内皮生长因子（VEGF）表达，而HA130可改善上述改变；玻璃体腔注射HA130显著减轻了RVO继发视网膜水肿引起的视网膜增厚以及视网膜中细胞间黏附分子（ICAM）-1表达的升高。上述结果提示，ATX可能通过上调视网膜内皮细胞中的VEGF并继而上调视网膜ICAM-1，破坏内皮屏障完整性，从而在RVO所致黄斑水肿中发挥关键作用。

原文摘要：Retinal vein occlusion (RVO) is a common vascular disease that leads to vision loss due to macular edema (ME). This study investigated the role of autotaxin (ATX), a lysophospholipase D, in the pathogenesis of RVO. In mice, RVO was induced by intravenous administration of rose bengal followed by laser irradiation of retinal veins. ATX expression in the retina was evaluated using immunohistochemistry. Intravitreal ATX was administered, and retinal changes were assessed using fluorescence angiography and optical coherence tomography (OCT). In human retinal microvascular endothelial cells (HRMECs), intercellular barrier function was evaluated using transepithelial electrical resistance (TEER). In the murine RVO model, the ATX inhibitor HA130 was administered intravitreally, and retinal thickness was measured and compared using OCT. ATX expression was increased in retinal vessels in the RVO model. Intravitreal administration of ATX induced retinal edema and serous retinal detachment (SRD). ATX significantly disrupted the barrier integrity of HRMECs and promoted the expression of vascular endothelial growth factor (VEGF), which was ameliorated by HA130. Intravitreal administration of HA130 significantly reduced retinal thickening caused by retinal edema secondary to RVO and the elevated expression of intercellular adhesion molecule (ICAM)-1 in the retina. These findings suggest that ATX plays a critical role in RVO-induced ME by disrupting endothelial barrier integrity, potentially through the upregulation of VEGF in retinal endothelial cells and subsequent ICAM-1 upregulation in the retina.

关键词：视网膜静脉阻塞、黄斑水肿、自分泌运动因子

研究目标：解决视网膜静脉阻塞继发黄斑水肿中抗VEGF治疗应答不佳、机制尚不完全清楚的问题，探索自分泌运动因子（ATX）作为内皮屏障破坏上游调控分子的新治疗靶点。

主要结论：借助玫瑰红光敏剂联合532nm激光照射视网膜静脉所建立的小鼠RVO模型证实，ATX在视网膜血管中表达升高；ATX可直接破坏视网膜微血管内皮屏障并上调VEGF，进而升高视网膜ICAM-1；ATX抑制剂HA130能显著减轻模型的视网膜增厚与炎症分子表达，提示抑制ATX可能成为RVO继发黄斑水肿的新型治疗策略。

创新点：首次将ATX定位于RVO继发黄斑水肿的VEGF信号上游，采用“激光诱导RVO在体模型＋玻璃体腔注射ATX/抑制剂＋HRMEC跨上皮电阻体外体系”三位一体的验证路径，提出了不同于单纯抗VEGF的新靶点与治疗思路。

后续建议：延长观察周期并增加视功能（如视网膜电图、视觉行为学）终点，评价ATX抑制的长期获益；开展HA130与抗VEGF药物的联合或头对头比较研究，明确其附加价值；检测RVO患者房水或玻璃体中ATX与溶血磷脂酸水平，验证临床相关性；优化激光造模参数并统一阻塞静脉数量，降低模型严重程度的个体差异；探索局部缓释或非侵入性给药途径，减少反复玻璃体腔注射带来的风险

APA 引文：Terao, R., Fujino, R., Hayashi, K., Suzuki, T., Shimizu, S., Yamagishi, R., Ueta, T., Shiraya, T., Honjo, M., & Aihara, M. (2026). Role of autotaxin in the pathogenesis of retina ischemia and its therapeutic implications. International Journal of Molecular Sciences, 27(6), 2776. https://doi.org/10.3390/ijms27062776

仪器引用：A 532 nm diode laser (Novus Spectra; Lumenis Japan Co., Ltd., Tokyo, Japan) was used at 100–120 mW, with a duration of 300 ms and a spot size of 50 μm.