Volume 1,Issue 4,2008 Table of Contents

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1 New ideas for medical therapy of glaucoma in the future

Y H Zou , George C Y Chiou

2008, 1(4):283-292.

[Abstract](1253) [HTML](0) [PDF 412.63 K](1285)

Abstract:
New drugs are developed rapidly with novel ideas of action mechanisms for the treatment of glaucoma. The most classic drugs under development are to lower the intraocular pressure (IOP). New agents were invented to lower the IOP through ① induction of metalloproteinases (MMPs), ② contraction of trabecular meshwork cells, ③ inhibition of aqueous humor secretion, and ④ activation of CB-1 receptor, The second class of drugs under development is intended to improve the ocular blood flow (OBF), particularly in retina and optic nerve head (ONH). Drugs that improve the OBF irrespective of the IOP changes could be quite useful for the treatment of normal tension or low-tension glaucoma. Neuroprotection is the latest developed mechanisms of glaucoma treatment. Although the history of neuroprotection research is very short, there are many agents under investigation in this class. They include ① blockade of N-methyl-D-aspartate receptor, ② neurotrophic agents, ③ inhibition of inducible nitric oxide synthases (iNOS), ④ inhibition of apoptosis, ⑤ protective autoimmunity, ⑥ stem cell therapy, and so on. Since all drugs for glaucoma treatment are used to stabilize the disease rather than to cure it, it is critical that an ideal drug with high therapeutic index and low cost price should be invented.

2 Effect of Z,E-butylidedephthalide on experimental choroidal neovascularization in rat and ocular blood flow in rabbits

Wei Jiang , Wun-Chang Ko , Shu-Huei Hsiao , George C Y Chiou

2008, 1(4):293-296.

[Abstract](1501) [HTML](0) [PDF 585.09 K](1002)

Abstract:
To investigate the effect of Z,E-butylidedephthalide (Bdph)on laser-induced experimental choroidal neovasculari- zation (CNV) in rat model and choroid blood flow in rabbits' eyes. · METHODS: Male Brown Norway rats were treated with Nd:YAG laser to break Bruch's membrane. 30mg/kg and 15mg/kg Bdph were given daily through intraperitoneal injection for 4 weeks after laser treatment. Fluorescein angiography (FA) and choroidal flat mount were used to measure the development of CNV. Female New Zealand white rabbits' eyes were instilled with 10g/L Z,E-BdPh solution, and ocular blood flow was measured with colored microsphere technique. · RESULTS: The intensity of fluorescein leakage, indicating the ocular lesion, decreased significantly in group Bdph 30mg/kg and 15mg/kg, as compared to the control at P <0.01. The area of neovascularization checked by FA in both groups of Bdph, at 30mg/kg and 15mg/kg decreased significantly compared to the control group at P <0.05. On the choroid flat mount, the areas of CNV were also smaller in both Bdph groups than that in control group. One percent drug solution instilled into rabbits' eyes could improve the choroid blood flow at 30 and 60 minutes after drug instillation (P <0.05). · CONCLUSION: Z,E-butylidedephthalide can inhibit the development of CNV in the rat eyes and increase the choroid blood flow in the rabbit eyes. These results suggest that Z,E-butylidedephthalide may be a good agent for the treatment of age-related macular degeneration (AMD).

3 Expression of transforming growth factor-β type 1 receptor and transforming growth factor-β type 2 receptor in diabetic rat retina

Dan Cao , Lin Liu , Wei Shen

2008, 1(4):297-300.

[Abstract](1187) [HTML](0) [PDF 357.73 K](957)

Abstract:
To quantitatively detect gene expression level of transforming growth factor-β type 1 receptor (TβR 1) and transforming growth factor-β type 2 receptor (TβR 2) in different stage of diabetic rats’ retina and to observe and analyze the effect of transforming growth factor-β receptors on the retina of rat diabetic animal model. · METHODS: Twenty-eight healthy adult Sprague-Dawley rats were chosen and randomly divided into two groups of normal control (CON) and diabetes mellitus (DM). Diabetes was induced by streptozotocin (STZ) intraperitoneal injection. Gene expression was detected quantitatively with real-time fluorescence quantitative reverse transcription polymerase chain reaction (QRT-PCR). · RESULTS: The mRNA level of TβR 1 and TβR 2 was 0.000493±0.000133 and 0.000166±0.000057 at 4 weeks. The mRNA level of TβR 1 and TβR 2 was 0.000608±0.000232 and 0.000113±0.000049 at 12 weeks. TβR 1 expression was gradually elevated during the progression of diabetic retinopathy. TβR 2 expression was up-regulated at 4 weeks, but down-regulated at 12 weeks. · CONCLUSION: TGF-β and its receptors (TβR 1 and TβR 2) may play important role in the pathogenesis of diabetic retinopathy.

4 The changes of protein kinase C for human retinal

Zhao-Yi Sun , Jing Hong

2008, 1(4):301-306.

[Abstract](1627) [HTML](0) [PDF 363.69 K](1052)

Abstract:
To study the effect of the subretinal fluid (SRF) on proliferation of retinal pigment epithelium (RPE) cells and retinal glial (RG) cells and associated activation and translocation of protein kinase C (PKC) as well as the application of PKC inhibitor. ·METHODS: RPE and RG cells were disintegrated to obtain PKC activity of cytoplasm and cellular membrane after being treated by the subretinal fluid (SRF) from the different stages of PVR patients (grade B and C) or being treated with PKC specific activator [phorbol-12-myris-tate-13-acetate (PMA)] or normal vitreous or DMEM culture medium. PKC activity in cytoplasm and cellular membrane was measured using radioactive isotope 32P labeling in a specific reaction of phosphorylation on PKC substrate. In addition, the PKC inhibitor, dequalinium chloride, was used to pretreat the RPE and RG cells before the cells exposed to SRF or PMA or normal vitreous. 3H-TdR (tritiated thymidine) was used to measure the levels of proliferation of RPE and RG cells with or without the activation and translocation. ·RESULTS: SRF and PMA promoted the proliferation of RPE and RG cells. SRF and PMA activated PKC in the cytoplasm of RPE and RG cells and the activated cytoplasm PKC translocated to the cellular membrane of RPE or RG cells. The cell proliferation or PKC activation or translocation was not equally active in RPE as in RG cells. However, PKC inhibitor which attenuated the cell proliferation did not show significant differenceoninhibitionof RPEandRGcell proliferation( >0.05). ·CONCLUSION: SRF can lead to the activation and translocation of PKC in RPE and RG cells, which promote the proliferation of RPE and RG cells. Dequalinium chloride can inhibit PKC activation and translocation hence slow down the cells proliferation

5 Carnosine inhibits cataract formation and inactivation of Na⁺-K⁺ATPase induced by a glucocorticoid

Yi Sun , Hong Yan

2008, 1(4):307-310.

[Abstract](1519) [HTML](0) [PDF 377.89 K](1006)

Abstract:
To investigate whether carnosine can inhibit cataract formation and protect Na⁺-K⁺ATPase against inactivation induced by a glucocorticoid. METHODS: Two hundred and twenty clear lenses cultured in vitro were randomly divided into five groups: control group (DMEM), steroid group (DMEM+Dexamethason 10μmol/L), lower concentration carnosine-treated group (DMEM+Dexamethason 10μmol/L+Carnosine 2mmol/L), higher concentration carnosine-treated group (DMEM+Dexamethason 10μmol /L+ Carnosine 5mmol/L) and carnosine group (DMEM + Carnosine 5mmol/L). Progression of cataract formation was evaluated daily using a dissecting microscope. On 1, 3, 5 and 7 days, 10 lenses of every group were homogenized and the activity of Na^{+^{-K⁺ATPase was measured by using spectrophotometer.
RESULTS: During the incubation, mistlike opacity was observed in the lenses of the control group and carnosine group, but in the steroid group appeared dense nuclear opacity, while both two carnosine-treated groups came out visible demarcation between nuclear and cortical regions on 7 days. A decrease in the activity of Na⁺-K⁺ATPase was found in the lens of the steroid group. On 3, 5, 7 days, Na⁺-K⁺ATPase activity decreased 22.34% (P =0.002), 47.98% (P <0.001), 75.37%(P <0.001) compared with that at 1 day, respectively. In the carnosine group, the activity of Na⁺-K⁺ATPase remained at the level of the control throughout the 7-day incubation, indicating that carnosine itself did not interfere with the original lens enzyme activity. In the lower concentration carnosine-treated group, on 3, 5, 7 days, the activity of Na⁺-K⁺ATPase increased 10.8% (P <0.05), 44.6% (P <0.01), 57.4% (P <0.01) of control activity, respectively. In the higher concentration carnosine-treated group, the activity of Na⁺-K⁺ ATPase increased 11.3% (P <0.05), 45.7% (P <0.01), 57.6% (P <0.01), respectively on 3, 5, 7 days. The activity of Na+-K+ATPase in both two carnosine-treated groups were only 6.7% and 6.5% lower than that of the control group after 7-day incubation. After the 7-day incubation, the Na⁺-K⁺ ATPase activity of the lenses in the steroid group decreased significantly compared with carnosine-treated groups(P ＜0.01).
CONCLUSION: Carnosine prevents the cataract formation induced by a glucocorticoid, and significantly inhibits the inactivation of Na⁺-K⁺ATPase induced by a glucocorticoid.}}

6 Hydroxyapatite modified titanium promotes superior adhesion and proliferation of corneal fibroblast in comparison with pure titanium

Xiao Ma , Zhao-Hui Li , Yi-Fei Huang , Yu-Jie Lu , Le-Yun Wang , Jing-Xiang Huang

2008, 1(4):311-314.

[Abstract](1553) [HTML](0) [PDF 1.19 M](1107)

Abstract:
To determine whether hydroxyapatite modified titanium promotes superior adhesion and proliferation of rabbit corneal fibroblast in comparison with pure titanium. · METHODS: We used bioactive hydroxyapatite to modify titanium surfaces. Fourth passage fibroblasts of rabbit cornea were seeded on hydroxyapatite modified titanium surfaces, pure titanium and glass surfaces. Cell adhesion, proliferation and morphology were detected at 24, 48, and 72 hours using a acridine orange stain. Further studies of cell morphology were performed using scanning electron microscopy. · RESULTS: Cell counts were significantly greater on hydroxyapatite modified titanium surfaces at each time point (P＜0.05). At 24 hours, cell spreading was greater on hydroxyapatite-coated titanium and glass than on the pure titanium. At 72 hours, compared with pure titanium and glass surfaces, the cells on hydroxyapatite modified titanium surfaces had greater spreading area and longer stress fibers. · CONCLUSION: Hydroxyapatite modified titanium promotes superior adhesion and proliferation of rabbit corneal fibroblast in comparison with pure titanium.

7 Experimental study of TGF-β2 antisense oligodeoxynucleotide as an anti -scarring agent in glaucoma surgery

Jin-Ying Li , Pei Fu , Qi Yang

2008, 1(4):315-319.

[Abstract](1368) [HTML](0) [PDF 1.48 M](986)

Abstract:
To investigate the effect of TGF-β2 antisense oligode- oxynucleotide on differentiation, proliferation of subconjunctival fibroblast following glaucoma filtration surgery. · METHODS: Glaucoma filtration surgery was performed on both eyes of 28 rabbits. TGF-β2 antisense oligodeoxynucleotide was subconjunctivally injected in the right eyes (group A),and TGF-β2 missense oligodeoxynucleotide (group B) or PBS (group C) was used at the same method in the left eyes as controls. Rabbits were killed at 4, 7, 14 and 28 days after surgery. Intraocular pressure (IOP), bleb characteristics were recorded at different time point. Subconjunctival fibroblasts were examined by immunohistochemistry and electron microscopy. · RESULTS: The IOP of rabbits in group A was significantly lower at 14 days (6.74±1.18mmHg) and 21 days (8.15±1.97mmHg) after operation than the IOP in group B (8.53±1.04, 9.72±1.09mmHg; P <0.01) and group C (8.79±1.21, 9.43±1.27mmHg; P <0.05). The mean bleb survival time was longer (17.2 days) in group A than that of group B (14.5 days) and group C (13.5 days) (P <0.05). The population of the cells expressing α-smooth muscle actin (α-SMA) and proliferating cell nuclear antigen (PCNA) was significantly reduced in group A compared with the group B and C. The ultrastructure of fibroblast was not altered by TGF-β2 antisense oligodeoxynucleotide. · CONCLUSION: TGF-β2 antisense oligodeoxynucleotide can prevent the scar formation after glaucoma surgery by inhibiting the differentiation and proliferation of subconjunctival fibroblast. It could be a potentially useful anti-scarring alternative for the prevention of late surgical failure.

8 Inhibition of human pterygium fibroblasts by vitamin E succinate

Jing Yua , Jian-Xiong Yu

2008, 1(4):320-323.

[Abstract](1353) [HTML](0) [PDF 552.86 K](1139)

Abstract:
To study the antiproliferation of vitamin E succinate (VES) on pterygium fibroblasts in vitro and to find a potential agent for prevention and treatment of primary and recurrence pterygium. · METHODS: Primary culture and subculture of pterygium fibroblasts were established in vitro, and different concentrations of VES (0, 10 and 20mg/L) were added to subcultured fibroblasts, respectively. Influence of VES on the growth curve of fibroblast was observed at day 2, 4 and 7 after treatment of VES. 3-[4,5-Dimethylthiazolzyl]-2,5-Diphenyl Tetrazolium Bromide (MTT) assay at 490nm was used to evaluate the effect of the cells proliferation. · RESULTS: The addition of VES to culture caused the marked descent of growth curve in comparison with the control group, and the inhibiting rate of 10 and 20mg/L of VES was 33.2% and 46.7%, 67.9% and 76.8%, 81.7% and 89.3% at day 2, 4 and 7, respectively. VES could obviously inhibit the fibroblast proliferation in dose-dependent manner by MTT assay. · CONCLUSION: VES can significantly inhibit the proliferation of pterygium fibroblast in vitro.

9 Construction and identification of the eukaryotic expression vector carrying specific siRNA of LEDGF p52 gene

Hai-Sheng Zhao , Yi Wang

2008, 1(4):324-327.

[Abstract](1512) [HTML](0) [PDF 558.54 K](1080)

Abstract:
To construct and identify LEDGFp52 eukaryotic expression vector for RNA interference. · METHODS: Recombinants were designed and established by targeting gene LEDGFp52 and plasmid pGensil-1 based on LEDGFp52 cDNA sequences of Genomes. Two pairs of oligonucleotides were synthesized according to the Tuschl principle and inserted into plasmid pGenSil-l to generate siRNA eukaryotic expression vector. DH5α strains were transformed, plasmids were extracted, and recombinant vectors were identified by the restriction map and the sequence analysis. The cultured cells were transfected by the recombinant plasmid (pGensil-1-RNA.LEDGFp52-1). At 48 hours after transfection, the whole cell protein was extracted, and the protein level was detected using Western blotting with mouse anti-human LEDGFp52 monoclonal antibody.　 · RESULTS: Recombinant plasmids completely concord with the designs by the restriction map and the sequence analysis, the protein level of LEDGFp52 was down-regulated at 48 hours after transfecting pGensil-1-LEDGFp52-1 expression vector into HeLa cells, the recombinant eukaryotic expression vectors were successfully constructed. · CONCLUSION: siRNA recombinant can be successfully constructed by RNAi technique to inhibit the expression of LEDGFp52.

10 Cloning and expression of immunotoxin DT389-hbFGF

Lian-Rong Yin , Jia-Qin Yuan , Lei Cui , Hai Lu

2008, 1(4):328-331.

[Abstract](1498) [HTML](0) [PDF 362.71 K](1021)

Abstract:
To express the DT₃₈₉-hbFGF (389 amino acid residues of the N-terminus of diphtheria toxin (human basic fibroblast growth factor) fusion protein for potential targeting therapy towards posterior capsule opacification (PCO) after cataract surgery. METHODS: The DNA of inactivated diphtheria bacillus and RNA of 12-week fetal brain cortex were extracted, respectively. The fragments of truncated diphtheria toxin (containing 389 amino acids of N-terminus, DT₃₈₉) and full-length human basic fibroblast growth factor (hbFGF) sequence (encoding 18kDa protein) were amplified by PCR. The two fragments were inserted into pGEX-4T-1 prokaryotic expression vector to obtain pGEX-DT₃₈₉-hbFGF prokaryotic expression plasmid. After sequence analysis, the expressing plasmid was transformed into Escherichia Coli BL21 strain and expression was induced under IPTG. The expressed fusion protein was purified and identified. RESULTS: The gene fragments encoding DT₃₈₉ and hbFGF were amplified and their gene sequences were confirmed. Hybrid gene expression plasmid pGEX-DT₃₈₉ (hbFGF) was constructed. The fusion protein DT389-hbFGF was expressed and purified. CONCLUSION: The successful cloning and expression of DT₃₈₉-hbFGF immunotoxin provides a foundation for targeting therapy towards posterior capsule opacification.

11 Alteration of intraocular pigment epithelium-derived factor and vascular endothelial growth factor in patients with diabetic retinopathy

2008, 1(4):332-335.

[Abstract](536) [HTML](0) [PDF 539.12 K](500)

Abstract:
AIM:b To determine the aqueous, vitreous, serum levels of pigment epithelium-derived factor (PEDF) and vascular endothelial growth factor (VEGF) in patients with proliferative diabetic retinopathy (PDR), and to speculate on the source of the change in concentration and to discuss its clinical significance. METHODS:b Forty-one eyes with proliferative diabetic retinopathy were included in the study, 16 of which were complicated by neovascularization of iris (NVI). Twenty-one eyes with idiopathic macular hole (MH) were as controls. The aqueous,vitreous, serum levels of PEDF and VEGF of all the groups were determined with ELISA. PEDF, VEGF and the levels in the three groups were compared with analysis of variance(ANOVA). The PEDF, VEGF concentrations in aqueous,vitreous and serum were analyzed with Pearson correlation test, and the correlation of PEDF and VEGF levels was also analyzed with Pearson correlation test. RESULTS:b The aqueous levels of PEDF decreased significantly in sequence in groups of control, PDR without NVI,PDR with NVI. VEGF levels increased coordinately. The similar findings existed in vitreous samples. The PEDF, VEGF levels in aqueous were not correlated significantly with those in serum, but correlated positively with those in vitreous. The intraocular levels of PEDF had a negative correlation to those of VEGF. CONCLUSION:b The reduction of intraocular PEDF level and elevation of intraocular VEGF level may play an important role in the occurrence and progression of PDR. In the development of PDR, the PEDF,VEGF levels in aqueous may be mainly effected by local pathological changes, as anti-angiogenic and pro-angiogenic factors, their unbalanced intraocular distribution may promote the angiogenesis of the iris and retina.

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12  Inhibitory effect of tetrandrine eye drops on corneal allograft rejection in rats

Yue Zhang , Shi Zhang , Xiao-Ping Chen , Dai Li , Shi-Xing Hu

2008, 1(4):336-338.

[Abstract](1367) [HTML](0) [PDF 292.37 K](1018)

Abstract:
To observe the effect of tetrandrine (Tet) eye drops of different concentrations on corneal graft and on allograft rejection in rats. · METHODS: Models of allograft rejection were set up in 64 SD rats and they were then randomly divided into 3, 5, 10g/L tetrandrine eye drops-treated and control groups. At different times postoperatively, neovascularization and inflammation of corneal graft were observed using slit-lamp microscopy, HE staining, light microscopy and microphoto-analysis. · RESULTS: The graft was infiltrated mainly with lymphocytes and mononuclear-macrophages. Corneal neovascularization and inflammation were significantly inhibited in the 5g/L Tet-treated group (P <0.05), compared with control group on day 7, 14, 21, 28 postoperatively. · CONCLUSION: Corneal edema and corneal epithelial bubble appear when the graft is treated with tetrandrine of higher concentration (10g/L), but 5g/L Tet eye drops significantly inhibit corneal allograft rejection in rats without serious side-effects.

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13  A study on accommodation mechanism with numeri- cal simulation

Zhuo Liu , Bo-Liang Wang , Shi-Hui Wu , Xiu-Ying Xu , Pei-Shan Dai , Ying Ju , Jie-Zhen Xie , Xiao-Yang Huang

2008, 1(4):339-343.

[Abstract](1281) [HTML](0) [PDF 637.28 K](1056)

Abstract:
To study accommodation mechanism with numerical simulation. · METHODS: A simulation model was constructed to study the mechanism of accommodation based on the experimental data derived from published resources. The displacement and pressure were applied on the model to study the deformation of lens during accommodating. · RESULTS: The simulation showed that, as the eye was accommodating, the thickness of the lens increased linearly, and the lens diameter decreased linearly. The optical power of the lens increased as the accommodation increased. This result was accord with the public facts in accommodation. Furthermore, the pressure was found to have a great influence on the shape of the lens and the optical power. The lens became thinner and flatter as the pressure increased and the pressure caused a remarkable increase of lens' optical power. · CONCLUSION: The outcome of this paper is consistent with the Helmholtz's hypothesis on accommodation to some extent. The analytical model presented in this paper can be used in the theoretical study of the accommodation mechanism of the human lens.

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14  Standard coaxial phaco microincision cataract surgery: a corneal endothelium study

Alessandro Franchini , Saverio Frosini , Vieri Boddi

2008, 1(4):344-350.

[Abstract](1804) [HTML](0) [PDF 657.59 K](1235)

Abstract:
To assess whether the new microincision cataract surgery (MICS) induces less endothelium damages than the standard coaxial phacoemulsification. · METHODS: Two hundred consecutive patients affected by age-related cataract were randomly assigned to undergo phacoemulsification using either standard coaxial phaco (SCP) or MICS. Central cornea and 12 o'clock endothelial cell count, cell size variation coefficient, percentage of hexagonality and central cornea thickness were measured before and up to one year after surgery. · RESULTS: One hundred and seventy-three patients completed the trial. At the one-year follow-up visit, the loss of endothelium cells was 6.5204% in the MICS group and 8.726% in the SCP group (P <0.00005). There were no significant differences between the two groups in terms of coefficient of variation in cell size, percentage of hexagonal cells, corneal thickness the day after surgery and variation of endothelial cell density measured both at the incision site and at the central cornea. In patients with hard cataracts, the increase in endothelial cell density loss was higher indepen- dently of the procedure. · CONCLUSION: MICS induces a significant lower endothelial cell density loss than SCP.

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15  Risk factors for anterior chamber membrane forma- tion after phacoemulsification

Ayse Gul Kocak Altintas , M Alpaslan Anayol , aban Simsek

2008, 1(4):351-355.

[Abstract](1866) [HTML](0) [PDF 242.41 K](1175)

Abstract:
To investigate the risk factors for the development of membrane formation in the anterior chamber after phacoemulsification. METHODS: A total of 1 356 patients who underwent phacoemulsification with implantation of single piece polymethyl methacrylate (PMMA) IOL were prospectively evaluated. Presence of pseudoexfoliation syndrome, nuclear hardness, pupil size, phaco time, effective phaco time, systemic diseases, postoperative complications (capsulorhexis rupture, zonular dialysis, posterior capsule rupture with vitreous loss), location of IOL placement and postoperative complications(intraocular pressurechanges, synechiaformation) were analyzed as risk factors for development of membrane formation. ·RESULTS: In 111 (8.1%) patients postoperative fibrinous anterior uveitis with membrane formation was observed. The mean time for membrane formation was postoperative second day (range postoperative 1^st and 7^th day). Mean duration of the presence of membrane was 5.2 days (range 1 to 48 days). Among the patients who had membrane formation, +4 hardness of the nucleus was present in 45%, while it was present in only 13.5% of patients who did not have membrane formation. The difference was statistically significant ( <0.05). In the membrane-forming group, mean phaco time was 2.4 minutes and mean effective phaco time was 32.8 seconds, compared to 1.8 minutes and 22.1 seconds in the membrane-free group. Both parameters were significantly longer in the membrane-forming group ( <0.05). Posterior capsule rupture with vitreous loss and sulcus implantation of IOL was seen in 33% of membrane-forming patients and in 11%of membrane-free patients ( <0.05). Other risk factors were not statistically different between membrane-forming and membrane-free patients. On postoperative first and 7^th day, the mean best corrected visual acuity in the membraneforming group was 0.2 and 0.4 respectively, versus 0.4 and 0.6 in the membrane-free group on Snellen chard ( <0.05). But three months after surgery, the best corrected visual acuity was similar between the membrane-forming and membrane- free patients (0.8 and 0.9 respectively). ·CONCLUSION: Higher nucleus hardness, longer phaco time and effective phaco time, and posterior capsule rupture during surgery are risk factors which significantly associated with postoperative fibrinous membrane formation in the anterior chamber.

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16  Vitrectomy results in proliferative diabetic retinopathy

Jie Luan , Fumitaka Ando , Hirosi Hirose , Osumu Yasui

2008, 1(4):356-358.

[Abstract](1360) [HTML](0) [PDF 209.42 K](1162)

Abstract:
To evaluate the effectiveness of vitrectomy on eyes with proliferative diabetic retinopathy (PDR). · METHODS: A total of 139 eyes of 93 cases with PDR underwent vitrectomy and were followed up for 3-24 months (16.72±8.53 months; mean±SD). The visual acuity and the factors causing recurrence of operation were analyzed. · RESULTS: The visual acuity was improved in 98 eyes (70.50%) after vitrectomy. The mean postoperative visual acuity was significantly better than the mean preoperative visual acuity. The main reasons for the failure of operation were retinal detachment and maculopathy. · CONCLUSION: These results demonstrate that vitrectomy is generally an effective procedure in treating PDR

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17  Low vision aid in exudative macular degeneration treated by photodynamic therapy and thermal laser photocoagulation

Montero JA , Ruiz-Moreno JM , Sanchez -de Castro MJ , Fabiani C

2008, 1(4):359-361.

[Abstract](1374) [HTML](0) [PDF 251.99 K](1001)

Abstract:
To determine the efficacy of low vision rehabilitation (LVR) in patients with age-related macular degeneration (AMD) treated by photodynamic therapy (PDT) compared to those treated by thermal laser photocoagulation (TLP). · METHODS: A retrospective study was performed examining the files of 42 patients (42 eyes) with AMD who had been treated either by TLP (Group 1) and PDT (Group 2). Once AMD was considered to be inactive they underwent visual rehabilitation in the LVR Unit in order to increase their ability for distant and near vision. · RESULTS: Eighteen eyes had received PDT and 24 had received TLP. Average corrected visual acuity after laser therapy was 0.14 in Group 1, and 0.16 in Group 2. No statistically significant differences were found between both groups before and after laser therapy. Both groups showed improvement after LVR; however, statistically significant differences between both groups were found only for near vision. · CONCLUSION: Our findings suggest that even though both PDT and TLP are associated to a decreased visual acuity after treatment, LVR may be more successful for near vision among patients treated by PDT

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18  Pterygium surgery: amniotic membrane or conjunc- tival autograft transplantation

Mohammad Reza Besharati , Seyed Ali Mohammad Miratashi , Amir Bahrami Ahmadi

2008, 1(4):362-366.

[Abstract](2220) [HTML](0) [PDF 364.26 K](1176)

Abstract:
To compare the outcomes of amniotic membrane transplantation (AMT) with conjunctival autograft transplantation (CAT) in primary and recurrent pterygium. · METHODS: This study was designed as a prospective study on consecutive cases of pterygium from April 2004 to February 2006. The cases were randomly divided into two groups of AMT (26 cases) and CAT (24 cases). All subjects were operated with an extensive excision of the fibro vascular tissues with AMT or CAT approach. Patients were followed for recurrence and complications for 24 months. The surgical procedures were performed by a single surgeon. The associations between demographic variables, surgical techniques (AMT, CAT), recurrences and postoperative complications were analyzed. · RESULTS: The patients' male to female ratio was 4:1. Involvement of right to left eye ratio was 3:2. Pterygium in 70% of cases was primary and in 30% was recurrent. The most common clinical signs were red eye and reduced visual acuity while the most common complications were recurrence and corneal scar. In the first month of follow up, the recurrence rates in AMT and CAT approaches were 3.8% vs 8.3% respectively and these rates increased to 46.2% vs 25% respectively after 24 months of follow up. · CONCLUSION: The success rate of 2 years follow up was better in CAT technique. The AMT technique for pterygium surgery has an unacceptably high recurrence rate.

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19  An overview of management of pterygium in Nigeria

Ernest N Onwasigwe , Ifeoma R Ezegwui

2008, 1(4):367-369.

[Abstract](1700) [HTML](0) [PDF 203.96 K](1099)

Abstract:
To review the management of pterygiumin Nigeria. ·METHODS: The medical records of patients who had pterygium excisions over a four year period (January 1999-December 2002) were reviewed. These patients were seen at University of Nigeria Teaching Hospital and Ebrans Clinic both in Enugu, Nigeria. The analysis of patients' bio-data, clinical presentation, surgical management and post-operative complications were carried out using EPI-INFO version 6.1. Three surgical techniques were employed: bare sclera procedure only (60 eyes); bare sclera with adjuvant 5-fluorouracil (42 eyes) and bare sclera with mitomycin-C, MMC, (22 eyes). · RESULTS: One hundred and twenty-four eyes of 72 patients had pterygium excisions and were followed up for a least one year post-operatively. There were 41 males (56.9%) and 31 females (43.1%) giving a male to female ratio of 1:0.8. The mean age was 42.8 years while the range was 20-69 years. Recurrence was highest in stage III (55.6%) and lowest in stage I (22.2%). Concerning the 3 surgical techniques, the recurrence rates were 65.0%, 52% and 13.6%respectively. ·CONCLUSION: In the management of pterygiumin a developing country, early excision with use of intraoperative MMC is advocated. It is safe, affordable, technically easier and less invasive.

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20  Optical coherence tomography for assessment of diabetic macular edema

Wei Zhang , Kaori Yamamoto , Sadao Hori

2008, 1(4):370-373.

[Abstract](1946) [HTML](0) [PDF 450.94 K](1154)

Abstract:
Optical coherence tomography (OCT) is a noninvasive objective diagnostic technique that has become a powerful method for the clinical assessment of diabetic macular edema. It is a very useful imaging technique to diagnose and follow-up diabetic macular edema (DME). The present paper aims to present an overview of the principles, progress, and uses of OCT in the diagnosis and management of DME.

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21  Delayed posterior dislocation of silicone plate-haptic lenses following anterior and posterior Nd:YAG laser capsulotomy

K I Papageorgiou , A Ioannidis , A J Sinha , P S Andreou

2008, 1(4):374-376.

[Abstract](1369) [HTML](0) [PDF 379.16 K](1179)

Abstract:
To observe the stability of silicone plate-haptic intraocular lenses implanted following cataract surgery and analyze the reasons related to decentration and dislocation into the posterior segment. · METHODS: We report 3 cases of posterior dislocation of silicone plate-haptic lenses (Bausch and Lomb C11UB and Chiron C11UB) in patients who underwent uneventful phacoemulsification. · RESULTS: One occurred 4 years following sectoral anterior capsulotomy for advanced anterior capsular contraction, the other in the early post-operative period following posterior capsulotomy and the third is a delayed (3 months), dislocation following uneventful posterior capsulotomy. None of the cases were associated with a history of trauma or other precipitating event. · CONCLUSION: Silicone plate haptic IOLs seem to be prone to dislocation due to poor capsular adherence as they are only held in place by the fibrotic fusion of the haptics. If either the posterior or anterior capsules are disrupted, the forces created by capsular contraction may cause extension of radial tears, with subsequent posterior dislocation of the implant. Though the use of silicone plate-haptic lenses has been surpassed by other models, there are patients who had implantation of such lenses that may undergo YAG laser capsulotomy. It is important to inform them about the potential risk of posterior dislocation as an early or late complication following this procedure.

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Journal introduce

Editors-in-Chief: Yan-Nian Hui and Peter Wiedemann

Established in April, 2008

ISSN 2222-3959 print

ISSN 2227-4898 online

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Volume 1,Issue 4,2008 Table of Contents