简介:AIM:Toinvestigatethepossiblerelationshipbetweentheinfluencingfactorsoccurringbeforeandduringbirthinfull-terminfantsandtheoutcomeofretinopathy.·METHODS:Totally816full-terminfantsadmittedintheneonateintensiveunitofBoaiHospitalofZhongshanbetween1May,2008and30June,2011wereincludedinthestudy.Fundusexaminationwasperformedandevaluatedindividuallyonthemattheageof48hoursafterdelivery,2weeksand1month.Somepossibleriskfactorshappeningprenatallyorduringdeliverysuchaspregnantrelatedhypertension,placentaprevia,placentalabruptionetc,aswellassomeneonatalriskfactorssuchasneonatalasphyxia,hypoxic-ischemicencephalopathy(HIE),lowbirthweightetc,wererecordedandevacuated.Thentheeffectoftheriskfactorsoffull-terminfantsonretinopathywasstudied.·RESULTS:Theincidenceofretinalhemorrhageoffull-terminfantswithprenatalpregnantrelatedhypertension(PRH)ofthemother(43.6%)wassignificantlyhigherthanthatoffull-terminfantswithout(8.0%).(P<0.001).Theincidenceofretinalhemorrhageoffull-terminfantswithneonatalasphyxiaand/orhypoxic-ischemicencephalopathy(HIE)(29.3%)wassignificantlyhigherthanthatofthosewithout(15.7%),butcorrelationwasnotfoundbetweentheseverityofretinahemorrhageandthedegreeofhypoxicdisease.Apalecolorofopticdiscwasassociatedwithalowbirthweightoffull-terminfant.Full-terminfantswithbirthweighlessthan2500ghadasignificanthigherincidenceofretinopathythanthosewithbirthweightequalormorethan2500g(P<0.001).·CONCLUSION:Themaininfluencingfactorswhichleadtoretinopathyofhighriskfull-terminfantsareprenatalfactorssuchasPRH,andsomeneonatalriskfactorssuchasasphyxia,hypoxic-ischemicencephalopathy,andlowbirthweight.
简介:Simulationcanbedefinedasmalingering,orsometimesfunctionalvisualloss(FVL).Itmanifestsaseithersimulatinganophthalmicdisease(positivesimulation),ordenialofophthalmicdisease(negativesimulation).Consciousbehaviorandcompensationorindemnityclaimsareprominentfeaturesofsimulation.Sincesomeauthorssuggestthatthisisamanifestationofunderlyingpsychopathology,evenconversionisincludedinthiscontext.Intoday’sworld,everyophthalmologistcanfacewithsimulationofophthalmicdiseaseordisorder.Incaseofsimulationsuspect,thephysician’sresponsibilityistoprovethesimulationconsideringthedisease/disorderfirst,andsimulationasanexclusion.Insimulationexaminations,thephysicianshouldbefirmandsmarttoselectappropriatetest(s)toconvincenotonlythesubject,butalsothejudgeincaseofindemnityorcompensationtrials.Almostallophthalmicsensoryandmotorfunctionsincludingvisualacuity,visualfield,colorvisionandnightvisioncanbethesubjectofsimulation.Examinermustbeskillfulinselectingthemostappropriatetest.Apartfromthoseintheliterature,weincludedallkindsofsimulationinophthalmology.Inaddition,simulationexaminationtechniques,suchas,useofOCT(opticalcoherencetomography),frequencydoublingperimetry(FDP),andmodifiedpolarizationtestswerealsoincluded.Inthisreview,wemadeathoroughliteraturesearch,andaddedourexperiencestogivethereadersup-to-dateinformationonmalingeringorsimulationinophthalmology.
简介:AIM:ToinvestigatethesideeffectsofthecommonlyusedlasertreatmentalongwithtestingtheneuroprotectiveeffectofbFGFonapotentialretinalimpairment.METHODS:Todothis,30chinchillapigmentedadultmalerabbitsweredividedintothecontrolandexperimentalgroups.ThecontrolandexperimentalgroupsunderwentbothlaserapplicationandbFGFtreatment.Theretinaltissueimpairmentanditsrenewalrateweretestedunderthelightandelectronmicroscopicallevels.RESULTS:Thefocallaserapplicationonrabbiteyescausedmorphologicalalterationsbothintheapplicationregionandintheneighbouringareas.Inthedamagedareas,theouternuclearlayeroftheneuralretinawasalmostdisappeared,retinapigmentepitheliumwasinterrupted,theretinapigmentepitheliummigratedintraretinally,andthedamagedregionalongwithneighbouringareasseemedtobenotseparated.bFGFapplicationjustafterthelaserphotocoagulation,revealedbetterresultsinapplicationareas.CONCLUSION:ItcouldbesuggestedthatthebFGFapplicationfollowinglaserphotocoagulationmighthaveprotective,repairingandwoundhealingeffectsontheretina.
简介:AIM:ToinvestigatetheroleofRho-associatedproteinkinase(ROCK)inhibitor,Y27632,inmediatingtheproductionofextracellularmatrix(ECM)componentsincludingfibronectin,matrixmetallo-proteinase-2(MMP-2)andtypeIcollagenasinducedbyconnectivetissuegrowthfactor(CTGF)ortransforminggrowthfactor-β(TGF-β)inahumanretinalpigmentepithelialcellline,ARPE-19.METHODS:TheeffectofY27632ontheCTGForTGF-βinducedphenotypeinARPE-19cellswasmeasuredwithimmunocytochemistryasthechangeinF-actin.ARPE-19cellsweretreatedwithCTGF(1,10,100ng/mL)andTGF-β(10ng/mL)inserumfreemedia,andanalyzedforfibronectin,laminin,andMMP-2andtypeIcollagenbyRT-qPCRandimmunocytochemistry.CellswerealsopretreatedwithanROCKinhibitor,Y27632,toanalyzethesignalingcontributingtoECMproduction.·RESULTS:TreatmentofARPE-19cellsinculturewithTGF-βorCTGFinducedanECMchangefromacobblestonemorphologytoamoreelongatedswirlpatternindicatingamesenchymalphenotype.RT-qPCRanalysisanddifferentgeneexpressionanalysisdemonstratedanupregulationinexpressionofgenesassociatedwithcytoskeletalstructureandmotility.CTGForTGF-βsignificantlyincreasedexpressionoffibronectinmRNA(P=0.006,P=0.003respectively),lamininmRNA(P=0.006,P=0.005),MMP-2mRNA(P=0.006,P=0.001),COL1A1mRNA(P=0.001,P=0.001),COL1A2mRNA(P=0.001,P=0.001).PreincubationofARPE-19withY27632(10mmol/L)significantlypreventedCTGForTGF-βinducedfibronectin(P=0.005,P=0.003respectively),MMP-2(P=0.003,P=0.002),COL1A1(P=0.006,P=0.003),andCOL1A2(P=0.006,P=0.004)geneexpression,butnotlaminin(P=0.375,P=0.516).CONCLUSION:OurstudydemonstratedthatbothTGF-βandCTGFupregulatetheexpressionofECMcomponentsincludingfibronectin,laminin,MMP-2andtypeIcollagenbyactivatingtheRhoA/ROCKsignalingpathway.Duringthisprocess,ARPE-19cellswereshowntochangefromanepithelialtoamesenchymalphenotypeinvi
简介:AIM:Toevaluatetheaccuracyofsphericalequivalent(SE)estimatesofadouble-passsystemandtocompareitwithretinoscopy,subjectiverefractionandatablemountedautorefractor.METHODS:Non-cycloplegicrefractionwasperformedon125eyesof65healthyadults(age23.5±3.0years)fromOctober2010toJanuary2011usingretinoscopy,subjectiverefraction,autorefraction(AutokeratorefractometerTOPCONKR-8100,Japan)andadoublepasssystem(OpticalQualityAnalysisSystem,OQAS,VisiometricsS.L.,Spain).Nineconsecutivemeasurementswiththedouble-passsystemwereperformedonasubgroupof22eyestoassessrepeatability.ToevaluatethetruenessoftheOQASinstrument,theSElaboratorybiasbetweenthedoublepasssystemandtheothertechniqueswascalculated.RESULTS:TheSEmeancoefficientofrepeatabilityobtainedwas0.22D.SignificantcorrelationscouldbeestablishedbetweentheOQASandtheSEobtainedwithretinoscopy(r=0.956,P<0.001),subjectiverefraction(r=0.955,P<0.001)andautorefraction(r=0.957,P<0.001).ThedifferencesinSEbetweenthedouble-passsystemandtheothertechniquesweresignificant(P<0.001),butlackedclinicalrelevanceexceptforretinoscopy;Retinoscopygavemorehyperopicvaluesthanthedouble-passsystem-0.51±0.50Daswellasthesubjectiverefraction-0.23±0.50D;Moremyopicvalueswereachievedbymeansofautorefraction0.24±0.49D.CONCLUSION:Thedouble-passsystemprovidesaccurateandreliableestimatesoftheSEthatcanbeusedforclinicalstudies.Thistechniquecandeterminethecorrectfocuspositiontoassesstheocularopticalquality.However,ithasarelativelysmallmeasuringrangeincomparisonwithautorefractors(-8.00to+5.00D),andrequirespriorinformationontherefractivestateofthepatient.
简介:AIM:ToevaluatethecornealendothelialcelldensityandmorphologyinChinesepatientswithpseudoexfoliationsyndrome(PEX).·METHODS:Medicalrecordsof16patients(20eyes)withPEXwhopresentedtoourinstitutionbetweenJuly2008andJune2010wereretrospectivelyreviewed.Thirteeneyeshadcombinedglaucoma.Theinformationoffiveapparentlynormalfelloweyesinthesepatientswasalsorecorded.Lefteyesof20patientswithbilateralsenilecataractsbutnoothereyediseasewereincludedascontrols.Specularmicroscopywasperformedinalleyestoanalyzeforcornealendothelialcelldensityandmorphology.Celldensity,coefficientofvariationincellsize,andpercentageofhexagonalcellsincornealendotheliumwereevaluated.·RESULTS:ThemeancornealendothelialcelldensityinthePEXeyeswas2298±239cells/mm2,significantlylowerthanthatinthecataracteyes(2652±18cells/mm2,P=0.026),buttherewerenosignificantdifferencesincoefficientofvariationofcellsizeandfrequencyofhexagonalitybetweenthesetwogroups.NosignificantdifferencesinthethreeparameterswerefoundbetweentheapparentlynormalfelloweyesandthePEXeyesorthecataracteyes,orbetweenthePEXeyeswithandwithoutglaucoma.·CONCLUSION:CornealendothelialcelldensitymaydecreaseinChinesepatientswithPEX.ThedevelopmentofglaucomainPEXeyesdoesnotseemtoberelatedwiththechangeincornealendothelialcelldensityormorphology.
简介:沙眼是由沙眼衣原体感染所致的一种传染性角结膜炎,目前在世界57个国家流行。1998年世界卫生组织(WorldHealthOrganization,WHO)将2020年全球消灭致盲性沙眼(globalalliancetoeliminateblindingtrachomaby2020,GET&nbsp;2020)列为其防盲工作的主要目标之一。世界卫生组织制定了辨认和命名沙眼的简化分级系统及以社区干预为基础的防治沙眼的SAFE策略,此后10余年各国对此策略进行了不断推广、执行,目前世界上沙眼的流行趋势较之此前有了一定的变化,我国也启动了“计划2016年前在中国根治致盲性沙眼”的防盲工作。本文就SAFE策略推广以来沙眼诊断、治疗及流行趋势等方面的进展做一综述。
简介:Endogenousaspergillusendophthalmitis(EAE)afterkidneytransplantisararebutimportantclinicalproblemduetopotentiallydevastatingconsequences.EarlydiagnosisofEAE,timelyremovalofaffectedvitreousbyvitrectomy,properanti-fungaltreatment,allcontributedtothesuccessfulcontrolofthedisease.TherapeuticsuccessofEAEinpost-transplantpatientsdependslargelyonpromptdiagnosis.DefinitediagnosisofEAEisbasedonpositivecultureresultsofvitreousspecimen,whilefundoscopyandBscanultrasoundmayaidearlydiagnosis.Intermsofanti-fungalmedicine,amphotericinBhaslongbeenthefirstchoice,butitssystemicapplicaitonhassevereadversereactions,especiallyforpatientswithimpairedrenalfunction.Herein,wereportthetreatmentmodalityofEAEafterkidneytransplantwithvitrectomy,systemicadministrationofmicafunginplusvoriconazole,topicalapplicationoffluconazolandamphotercinB.
简介:AIM:Toinvestigatewhether15-Lipoxygenase-1(15-LOX-1)playsanimportantroleintheregulationofangiogenesis,inhibitinghypoxia-inducedproliferationofretinalmicrovascularendothelialcells(RMVECs)andtheunderlyingmechanism.METHODS:PrimaryRMVECswereisolatedfromtheretinasofC57/BL6JmiceandidentifiedbyanevaluationforFITC-markedCD31.ThehypoxiamodelswereestablishedwiththeBio-bagandevaluatedwithablood-gasanalyzer.ExperimentswereperformedusingRMVECstreatedwithandwithouttransferAd-15-LOX-1orAd-vectorbothunderhypoxiaandnormoxiaconditionat12,24,48,72hours.Theefficacyofthegenetransferwasassessedbyimmunofluorescencestaining.CellsproliferationwasevaluatedbytheCCK-8method.RNAandproteinexpressionsof15-LOX-1,VEGF-A,VEGFR-2,eNOsandPPAR-rwereanalyzedbyreal-timereversetranscriptionpolymerasechainreaction(RT-PCR)andWesternblot.RESULTS:RoutineevaluationforFITC-markedCD31showedthatcellswerepure.Theresultsofblood-gasanalysisshowedthatwhenthecultureswereexposedtohypoxiaformorethan2hours,thePo2was4.5to5.4Kpa.WeverifiedRMVECscouldbeinfectedwithAd-15-LOX-1orAd-vectorviaFluorescencemicroscopy.CCK-8analysisrevealedthattheproliferativecapacitiesofRMVECsinhypoxicgroupweresignificantlyhigherateachtimepointthantheywereinnormoxicgroup(P<0.05).Inahypoxiccondition,theproliferativecapacitiesofRMVECsin15-LOX-1groupweresignificantlyinhibited(P<0.05).Real-timeRT-PCRanalysisrevealedthattheexpressionsofVEGF-A,VEGF-R2andeNOsmRNAincreasedinhypoxiagroupcomparedwithnormoxiagroup(P<0.01).However,theexpressionsof15-LOX-1,PPAR-rmRNAdecreasedinhypoxiagroupcomparedwithnormoxiagroup(P<0.01).Italsoshowedthatinahypoxiccondition,theexpressionsofVEGF-A,VEGF-R2andeNOsmRNAdecreasedsignificantlyin15-LOX-1groupcomparedwithhypoxiagroup(P<0.01).However,15-LOX-1andPPAR-rmRNAincreasedsigni
简介:AIM:Todefinetheultrasonographicstructureofnormallowereyelidanatomiccompartmentsandtheirspacialrelationshipindynamicmotion.METHODS:Highresolutionultrasound(15MHz)wasperformedonthelowereyelidsof7normalsubjects.Movementsofthelowereyelidanditscompartmentswerevisualizedwithultrasound.Inaddition,themaximalexcursionareaofthelowereyelidfatcompartmentsandretractormotionswasmeasuredbeforeandaftermotion.RESULTS:Theorbicularismusclecouldbeseenasanecholucentstructurebetweenthedermisandtheechodencefatpads.Lowereyelidfatpadseemstobedividedinto2compartmentsasrangeofmotionanddirectionofmovementofeachofthemvaries.Itseemsthatthesecompartmentshavealsodifferentbehavior.Themeasuredprofileareaofthevisiblenormallowereyelidfatpadsduringmovementofglobefromup-gazetodown-gazedecreasedby50%.Orderofmovementoflowereyelidstructuresseemstobeasfollows:afterglobemovementfistweseeretractormovement,anteriororbitalfatpad,thenskinandseptum,andfinallymovementofinferiorfatpad.CONCLUSION:Ultrasoundrepresentsanoninvasivetoolforthevisualizationoflowereyelidmorphology.Expandingitsapplicationcouldhelpusunderstandthecompartmentalchangesinphysiologicaleyelidmovement,inaginganddiseasedstudypopulations,aswellasassessoperativeoutcomes.
简介:AIM:Toevaluatetheefficacyandsafetyoftrabeculectomy,phacotrabeculectomyplusintraocularlensimplantation(phacotrab+IOLgroup)andphacoemulsificationwithIOL(phaco+IOL)inprimaryangle-closureglaucoma(PACG).METHODS:Itwasasystematicreviewandmeta-analysis,randomizedcontrolledtrials(RCT)andclinicalcontrolledtrials(CCT)werecollectedthroughelectronicsearchesoftheCochraneLibrary,PubMed,EMbase,WanfangDatabaseonline,ChinesejournalFull-textDatabase,ChineseScientificJournalsFull-textDatabase(fromthedateofbuildingthedatabasetoOctober2010)Wealsocheckedthebibliographiesofretrievedarticles.Alltherelateddatathatmatchedourstandardswereabstracted.ThequalityofincludedtrialswasevaluatedaccordingtotheDutchCochraneCentre.RevMan5.0softwarewasusedforMeta-analysis.RESULTS:Atotalof5RCTand11CCTinvolving1495eyeswereincluded.Theresultsofmeta-analysisshowedthatphacotrab+IOLgroupwassuperiorthantrabeculectomy(trabgroup)(MD-3.93,95%CI[-7.31,-0.54])whichwasalsosuperiorthanphaco+IOLgroup(MD0.52,95%CI[0.10,0.95])indecreasingIntraocularPressure(IOP).Phacotrabgroup(MD-1.45,95%CI[-1.68,-1.22])andphacogroup(MD-1.12,95%CI[-1.87,-0.37])arebothdeeperthantrabgroupintheanteriorchamberdepth.Inincreasingthecoefficientofoutflowfacilityofaqueoushumor(Cvalues)therewasnostatisticaldifferenceinthethreegroups.Andtherewasnostatisticaldifferencebetweenphacotrabgroupsandphacogroupsinvisualacuitybutphacotrabgroupwassuperiorthanphacogroup(MD1.07,95%CI[0.73,1.40])intheuseofIOP-loweringdrugs.Therewasnostatisticaldifferenceamongthreegroups.CONCLUSION:Currentevidencesuggeststhatphacotrab+IOLgroupwassuperiorthantrabgroupwhichwasalsosuperiorthanphaco+IOLgroupindecreasingIOP.Phacotrabgroupandphacogrouparebothdeeperthantrabgroupintheanteriorchamberdepth.PhacotrabgroupwassuperiorthanphacogroupintheuseofIOP-loweringdrugs.
简介:泪道阻塞是眼科的常见病,有先天性和后天性两大类,易发展为急,慢性泪囊炎,以手术治疗为主,目的是重建或恢复泪液的引流通路,传统手术方面报道较多的是泪囊鼻腔吻合术(EXT-DCR)虽然成功率可达85%,但在颜面部残留永久性疤痕,影响美容,非手术方法主要有:探通,置线,置管等,但只是简单的解决问题,而且易致周围组织刺激,更容易形成粘连和疤痕使管腔再度阻塞。目前,虽然报道使用激光泪道成形术收到较好的效果,泪道能够冲洗通畅,但部分仍有溢泪症状。近年来,随着内窥镜技术不断成熟,既微创又美观的手术要求越来越高,因此,诸如鼻内窥镜下泪囊鼻腔吻合术(IECR)得以开展和创新。另外高分子材料及其它医疗器械的不断更新和完善,其治疗手段有了长足的进步。