Volume 4,Issue 3,2011 Table of Contents

1 Surgical treatment for primary angle closure-glaucoma: a Meta analysis

Bo-Lin Deng , Cheng Jiang , Bin Ma , Wen-Fang Zhang , Peng Lü , Yuan-Yuan Du , Xu-Dong Jiu , Le-Xin Yang , Jing Tian

2011, 4(3):223-227. DOI: 10.3980/j.issn.2222-3959.2011.03.01

[Abstract](3570) [HTML](0) [PDF 412.76 K](1078)

Abstract:
AIM:To evaluate the efficacy and safety of trabeculectomy, phacotrabeculectomy plus intraocular lens implantation(phacotrab+IOL group) and phacoemulsification with IOL(phaco+IOL) in primary angle-closure glaucoma(PACG). METHODS: It was a systematic review and meta-analysis, randomized controlled trials(RCT) and clinical controlled trials(CCT) were collected through electronic searches of the Cochrane Library, PubMed, EMbase, Wanfang Database online, Chinese journal Full-text Database, Chinese Scientific Journals Full-text Database (from the date of building the database to October 2010) We also checked the bibliographies of retrieved articles. All the related data that matched our standards were abstracted. The quality of included trials was evaluated according to the Dutch Cochrane Centre. RevMan 5.0 software was used for Meta-analysis. RESULTS: A total of 5 RCT and 11 CCT involving 1495 eyes were included. The results of meta-analysis showed that phacotrab+IOL group was superior than trabeculectomy(trab group) (MD -3.93,95%CI [-7.31, -0.54]) which was also superior than phaco+IOL group(MD 0.52,95%CI [0.10, 0.95]) in decreasing Intraocular Pressure(IOP). Phacotrab group(MD -1.45,95%CI [-1.68, -1.22])and phaco group (MD-1.12,95%CI [-1.87, -0.37])are both deeper than trab group in the anterior chamber depth. In increasing the coefficient of outflow facility of aqueous humor(C values) there was no statistical difference in the three groups. And there was no statistical difference between phacotrab groups and phaco groups in visual acuity but phacotrab group was superior than phaco group (MD 1.07, 95%CI [0.73, 1.40])in the use of IOP-lowering drugs. There was no statistical difference among three groups. CONCLUSION: Current evidence suggests that phacotrab+ IOL group was superior than trab group which was also superior than phaco+IOL group in decreasing IOP. Phacotrab group and phaco group are both deeper than trab group in the anterior chamber depth. Phacotrab group was superior than phaco group in the use of IOP-lowering drugs.

2 Establishment of an untransfected human corneal epithelial cell line and its biocompatibility with denuded amniotic membrane

Ting-Jun Fan , Bin Xu , Jun Zhao , Hong-Shou Yang , Rui-Xin Wang , Xiu-Zhong Hu

2011, 4(3):228-229. DOI: 10.3980/j.issn.2222-3959.2011.03.02

[Abstract](2311) [HTML](0) [PDF 1.14 M](1047)

Abstract:
AIM: To establish an untransfected human corneal epithelial (HCEP) cell line and characterize its biocompatibility with denuded amniotic membrane (dAM). METHODS: The torn HCEP pieces were primarily cultured in DMEM/F12 media (pH 7.2) supplemented with 20% fetal bovine serum and other necessary factors, yielding an HCEP cell line which was its growth performance, chromosome morphology, tumorigenicity and expression of marker proteins analyzed. In addition, the biocompatibility of HCEP cells with dAM was evaluated through histological and immunocytochemistry analyses and with light, electron and slit-lamp microscopies. RESULTS: HCEP cells proliferated to confluence in 3 weeks, which have been subcultured to passage 160. A continuous untransfected HCEP cell line, designated as utHCEPC01, was established with a population doubling time of 45.42 hours as was determined at passage 100. The cells retained HCEP cell properties as were approved by chromosomal morphology and the expression of keratin 3. They, with no tumorigenicity, formed a multilayer epithelium-like structure on dAMs through proliferation and differentiation during air-liquid interface culture, maintained expression of marker proteins including keratin 3 and integrin β1 and attached tightly to dAMs. The reconstructed HCEP was highly transparent and morphologically and structurally similar to the original. CONCLUSION: An untransfected and non-tumorigenic HCEP cell line was established in this study. The cells maintained expression of marker proteins. The cell line was biocompatible with dAM. It holds the potential of being used for in vitro reconstruction of tissue-engineered HCEP, promising for the treatment of diseases caused by corneal epithelial disorders.

3 Arg124Cys mutation of the TGFBI gene in a Chinese pedigree of Reis-Bücklers corneal dystrophy

Qiao-Na Yang , Yong-Wang Zhao , Li-Heng Guo , Nai-Hong Yan , Xu-Yang Liu , Su-Ping Cai

2011, 4(3):235-238. DOI: 10.3980/j.issn.2222-3959.2011.03.03

[Abstract](2014) [HTML](0) [PDF 378.11 K](991)

Abstract:
AIM: To analyze mutations in transforming growth factor beta-induced (TGFBI) gene in a Chinese pedigree with Reis-Bücklers corneal dystrophy (RBCD, also known as GCD3). METHODS: In a five-generation Chinese family, eight members were identified with RBCD and the rest were unaffected. All members of the family underwent complete ophthalmologic examinations. Exons of TGFBI were amplified by polymerase chain reaction, sequenced, and compared with a reference database. RESULTS: A single heterozygous C>T (R124C) point mutation was found in exon 4 of TGFBI in all the affected members of the pedigree, but not in the unaffected members. CONCLUSION: R124C which was a known mutation for lattice corneal dystrophy type I, segregated with the RBCD in this pedigree. This elucidated the correlation between genotype and phenotype in a Chinese family of RBCD.

4 Inhibition of latrunculin-A on dexamethasone-induced fibronectin production in cultured human trabecular meshwork cells

Yun Wang , Juan Tan , Ye-Hong Zhuo , Cui-Lan Wang , Xu-Yang Liu , Su-Ping Cai

2011, 4(3):239-242. DOI: 10.3980/j.issn.2222-3959.2011.03.04

[Abstract](1738) [HTML](0) [PDF 405.17 K](946)

Abstract:
AIM: To determine the effects of a low dose latrunculin (LAT)-A on dexamethasone (Dex)-induced upregulation of extracellular matrix proteins fibronectin (FN) in cultured human trabecular meshwork (HTM) cells. METHODS: HTM cells were cultured to confluent and incubated with 0.4μmol/L Dex and/or 0.05μmol/L LAT-A. FN expression in HTM cells was evaluated by Western blot and immunofluorescence microscopy. RESULTS: Dex up-regulated FN production in HTM cells, failed to do so when co-incubated with LAT-A. LAT-A decreased production of FN in cultured HTM cells. CONCLUSION: This study indicated that LAT-A may modulate the expression of fibronectin in trabecular meshwork to achieve treatment for steroids and other types of glaucoma. It has an important prospect as an intraocular pressure- lowering drug.

5 Erythropoietin receptor antibody inhibits oxidative stress induced retinal neovascularization in mice

Jin-Hui Wu , Yu Gao , An-Jing Ren , Ming Zhong , Lin Liu

2011, 4(3):243-246. DOI: 10.3980/j.issn.2222-3959.2011.03.05

[Abstract](1644) [HTML](0) [PDF 321.82 K](895)

Abstract:
AIM: To observe the effect of erythropoietin receptor antibody(EpoRA) on oxygen-induced retinal neovascu- larization. METHODS: C57BL / 6J mice, newly born 7 days, were exposed in high oxygen for 5 days and then placed in normal air for another 5 days, thus the animal models of retinal neovascularization were made. Experimental animals were allocated into 3 groups: normal, experimental and therapeutic. The normal group was fed in the normal environment. Into the vitreous cavity of mice in the therapeutic group were injected 2μL of EpoRA for 5 successive days. And the experimental group was injected the same amount of normal saline. Mice were sacrificed 17 days after birth and their eyeballs were removed for detection of malonaldehyde(MDA) content in the retina and by HE staining endothelial cells were counted the breaking through internal limiting membrane. RESULTS: In the experimental group, MDA content in the retina was 25.11±3.46μmol/g , which was obviously less than those in the normal group(5.34±1.79μmol/g, P<0.01) and those in the therapeutic group (12.04±1.91μmol/g). Pathological sections showed the nuclear number of the endothelial cells breaking through internal limiting membrane was 0.7±0.2 in normal group, and 46.2±6.5 in high oxygen induced experimental group. In the therapeutic group injected with EpoRA, it was lowered to 24.0±5.0(P＜0.01). CONCLUSION: EpoRA can effectively inhibit oxygen- induced neovascularization in retina of mouse by reducing oxidative damage.

6 Effect of calcium on the proliferation and differen-tiation of murine corneal epithelial cells in vitro

Xiao-Li Ma , Han-Qiang Liu

2011, 4(3):247-249. DOI: 10.3980/j.issn.2222-3959.2011.03.06

[Abstract](2053) [HTML](0) [PDF 542.75 K](1021)

Abstract:
AIM: To investigate the effect of calcium on the proliferation and differentiation of murine corneal epithelial cells in vitro. METHODS: Mouse corneal epithelial cells were cultured in serum-free low-Ca2+ medium (KSFM) and KSFM supplemented with 0.9mmol/L Ca2+. Population doublings (PDs) were determined. The expression of corneal epithelial cell markers p63, keratin 19 (K19) and involucrin was investigated by RT-PCR analysis and semiquantitative analysis of Western blotting. RESULTS: Cells in KSFM were stably subcultured over 25 passages, however, none of the cell lines could pass P4 in KSFM with Ca2+. In KSFM, the cells was were homogeneous and small cells with typical cobblestone appearance; and expressed p63, K19 and involucrin. After medium was supplemented with calcium, cells became a heterogeneous mix of small and large cells. Furthermore, semiquantitative analysis of Western blotting showed that the expression of involucrin was increased significantly. CONCLUSION: Calcium has the effect of inhibiting pro- liferation and triggering differentiation on mouse corneal epithelial cells.

7 Toxicity of endogenous peroxynitrite and effects of puerarin on transplanted retinal pigment epithelial sheets in the subretinal space in mice

Li-Na Hao , Yan-Qing Zhang , Yu-Hua Shen , Mei-Qiao Li , Zhi-Hua Zhao , Zhi-Yun Wang , Yan-Hua Wang , Shou-Zhi He

2011, 4(3):250-254. DOI: 10.3980/j.issn.2222-3959.2011.03.07

[Abstract](1745) [HTML](0) [PDF 422.84 K](965)

Abstract:
AIM: To evaluate the toxicity of endogeneous peroxynitrite on transplanted retinal pigment epithelial (RPE) sheets and the effect of puerarin on their survival in the C57BL/6 mice after RPE sheets have been transplanted into SD rats' subretinal space . METHODS: C57BL/6 mice eyes were used to culture RPE cells. Ninety-six SD rats were involved in the experiment. They were divided into control（block control） , streptozotocin(STZ, negative control), untransplanted RPE (positive control) and transplanted RPE groups respectively. Diabetes was induced in SD rats by intra-peritoneal STZ injection in the latter three groups. Saline was injected into the subretinal space of 24 SD rats in the untransplanted RPE group and primary RPE sheets were injected into the subretinal space of 24 SD rats in the transplanted RPE group. Puerarin (45mg/kg) was administrated into both untransplanted RPE and transplanted RPE groups of diabetic rats through intra- peritoneal injection route after RPE sheets transplantation. At 20，40，60 days after surgery，Western blotting analysis, DNA ladder and RT-PCR were used for determining the differences in expression of nitrotyrosine (NT, the foot print of peroxynitrite ), apoptosis and iNOS mRNA in the control, STZ, untransplanted RPE and transplanted RPE groups respectively. HE staining was used for determining the RPE survival in the subretinal space of the transplanted RPE group. RESULTS: Apoptosis and expression of NT and iNOS mRNA were observed in STZ, untransplanted RPE and transplanted RPE groups, but were delayed in untransplanted RPE and transplanted RPE groups in a time-dependent manner compared with control and STZ groups (P＜0.01）. There were no differences between the two groups (P>0.01). NT, DNA ladder, iNOS mRNA were down-regulated, which were associated with the decrease of expression of peroxynitrite. Numerous pigmented cells emerged and increased in number in the subretinal space during the 60-day observation period after transplantation. On day 20, heavily pigmented cells were visible at the transplant site; On day 40, monolayer and multilayered transplant was visible in the subretinal space; On day 60, heavily pigmented monolayer and multilayered transplants with round apical profile were present along Bruch's membrane. CONCLUSION: Puerarin increased the 60-day survival of C57BL/6 mice RPE xenografts in the SD rats' subretinal space, which may be related to its direct inhibition of apoptosis of RPE cells and antagnism of damage of peroxynitrite to RPE cells.

8 Mechanisms of inhibition of elemene on human lens epithelial cell proliferation in vitro

Yan-Hong Hu , Xiu-Rong Huang , Ming-Xin Qi , Bu-Yuan Hou

2011, 4(3):255-258. DOI: 10.3980/j.issn.2222-3959.2011.03.08

[Abstract](1983) [HTML](0) [PDF 245.59 K](803)

Abstract:
AIM: To study the effects of elemene (Ele) on proliferation and cell cycle of human lens epithelial cells B3 (HLE-B3) and the mechanisms of its signal transduction. METHODS: Recombinant human basic fibroblast growth factor (rhbFGF) was used to induce proliferation of HLE-B3 cells, which were incubated with 80mg/L Ele for 24 hours. The inhibitory effects of Ele on the proliferation of HLE-B3 cells were evaluated by MTT method. The effect of Ele on HLE-B3 cell cycle was analyzed by flow cytometry(FCM). The expressions of protein kinase A (PKA) and protein kinase G (PKG) of HLE-B3 were also analyzed by FCM. RESULTS: Ele altered the cell cycle of HLE-B3 and effectively inhibited HLE-B3 cell proliferation induced by rhbFGF. Ele up-regulated PKA and down-regulated the expression of PKG in HLE-B3 cell. CONCLUSION: Ele inhibits HLE-B3 proliferation, making it an attractive potential agent in regimens to treat after- cataracts.

9 Effect of aminoguanidine on caspase-3 expression in rat retina after ischemia-reperfusion injury

Yang Yang , Jing-Zhu Duan , Dong-Mei Gui , Hong-Wei Yang , Dian-Wen Gao

2011, 4(3):259-261. DOI: 10.3980/j.issn.2222-3959.2011.03.09

[Abstract](1887) [HTML](0) [PDF 352.69 K](961)

Abstract:
AIM: To investigate the effect of aminoguanidine(AG) on the expression of caspase-3 in rat retina after ischemia- reperfusion injury. METHODS: The rats were anesthetized with 30mg/kg sodium pentobarbital introperitoneal(ip) injections. After topical application of 10g/L dicaine，the anterior chamber was punctured with a 5-gauge needle connected to a bottle containing normal saline. Intraocular pressure was raised to 100 mmHg by elevating the saline container. The infusion needle was removed from the anterior chamber 60 minutes later. Reperfusion of the retinal vasculature was confirmed by fundus examination. AG 100mg/kg was ip injected in drug group. The rats were then euthanatized at 6, 24, and 72 hours after reperfusion, and their eyes were enucleated for immunohistochemistry. RESULTS: No specific staining was detected by using the caspase-3 antibody in the retina of control group. In ischemia group, the protein of caspase-3 was over-expressed at 6 hours and relieved at 24 hours and 72 hours, while with drug treatment, the expression of protein of caspase-3 was decreased at each time point. CONCLUSION: AG provides retinal protection against ischemia-reperfusion injury in rat retina, probably through an inducible NOS-dependent mechanism.

10 Validation of PCR for the detection of Pseudomonas aeruginosa from corneal samples

Maria E. Hillenbrand , Paul P. Thompson , Robert M. Q. Shanks , Regis P. Kowalski

2011, 4(3):262-268. DOI: 10.3980/j.issn.2222-3959.2011.03.10

[Abstract](3484) [HTML](0) [PDF 723.20 K](974)

Abstract:
AIM: To determine a species-specific real-time polymerase chain reaction (PCR) assay to detect Pseudomonas aeruginosa (PA), a secondary DNA target for PA that may provide a universal target for other bacterial pathogens, and validate both assays for diagnostic testing. METHODS: PCR detection was established against the ecfX PA gene and the 16S rRNA gene using known PA keratitis isolates. The outcome parameters for both assays were “limit of detection” (LOD), amplification efficiency (AE), and PAGE amplified product analysis. Both assays were validated against 20 true-positive clinical samples positive for PA DNA and 20 true-negative samples containing no PA DNA. Descriptive statistics and PAGE analysis were used as outcome parameters. RESULTS: AE of the ecfX assay was 96.6%, and LOD was 33.6 copies of target DNA per microliter. AE of the 16S rRNA assay was 103.4%, and LOD was 8.12 copies per microliter. The sensitivity, specificity, positive predictive value, negative predictive value, and efficiency for the ecfX and 16S rRNA assays were [75%, 95%, 94%, 79%, and 85%], and [70%, 100%, 100%, 77%, and 85%], respectively. Both PCR assays were validated, followed by confirmation of DNA patterns from PAGE analysis. CONCLUSION: The PCR methodology described here may be a useful adjunct to standard methods in the diagnosis of PA keratitis.

11 Correlation of leaking microaneurysms with retinal thickening in diabetic retinopathy

Lukas Reznicek , Marcus Kernt , Christos Haritoglou , Michael Ulbig , Anselm Kampik , Aljoscha S Neubauer

2011, 4(3):269-272. DOI: 10.3980/j.issn.2222-3959.2011.03.11

[Abstract](2157) [HTML](0) [PDF 224.73 K](941)

Abstract:
AIM: To investigate the contribution of fluorescein angiographic leaking microaneurysms (leak-MA) versus non-leaking microaneurysms (non-leak-MA) to retinal thickening in diabetic retinopathy. METHODS: A consecutive series of 38 eyes from 24 patients with diabetic retinopathy was included. Leak-MA and non-leak-MA in each eye were selected in pairs at corresponding topographic location. Leaking was defined by late phase fluorescein angiograms compared to early phase. Retinal thickness was measured with Heidelberg Spectralis OCT topographically aligned on early phase angiograms at the MA site and within a 1 mm circle. RESULTS: In all eyes, significant retinal thickening at the site of leaking compared to non-leaking microaneurysms was observed (356±69μm vs 318±56μm, P <0.001), showing a mean increase in thickness in the areas of leak-MA vs non-leak-MA of 38±39μm (95% confidence interval 25-51μm, P<0.001). All 1mm area measurements also showed significant (P<0.001) thickening of the leak-MA with average thickness of leak-MA vs non-leak-MA as 351±67μm vs 319±59μm; minimum thickness 311±62μm vs 284±60μm; maximum thickness 389±78μm vs 352±66μm; and retina volume 26.4±6.0mm vs 23.6±3.7mm3, respectively. CONCLUSION: Leaking of microaneurysms on fluorescein angiography appears to cause focal thickening of retina, which can be measured with high-resolution OCT. Therefore, targeting leaking microaneursyms in diabetic retinopathy has the potential to reduce retinal thickening.

12 Non-arteritic anterior ischaemic optic neuropathy in Malaysia: a 5 years review

Abdulrahman Bawazir , Reza Gharebaghi , Adil Hussein , Wan Hazabbah Wan Hitam

2011, 4(3):272-274. DOI: 10.3980/j.issn.2222-3959.2011.03.12

[Abstract](1712) [HTML](0) [PDF 286.54 K](945)

Abstract:
AIM: To evaluate the clinical presentations and visual outcomes of non-arteritic anterior ischaemic optic neuropathy (NAION). METHODS: A retrospective study was conducted involving 18 consecutive patients (20 eyes) with NAION attending Hospital Universiti Sains Malaysia from January 2005 until December 2009. RESULTS: Most patients were Malay (94.4%), and followed by Chinese (5.6 %). The female-to-male ratio was 3.5:1. The age of patients ranged from 36 to 85 years (mean, 57.1 years). The main risk factors in systemic diseases were hypertension (55.5%), diabetes mellitus (44.4%), and ischaemic heart disease (11.1%). Most patients (77.8%) presented with acute loss of vision while gradual onset was in 22.3% of cases. Majority had visual acuity worse than 1/60 (80%). The most common fundoscopic findings were peripapillary splinter haemorrhage (90%), sectorial swollen optic disc (60%) and hyperemic disc (60%). During follow up, 20% of the patients showed stabilization in visual acuity, and 80% showed worsening of vision. CONCLUSION: Majority of patients with NAION presented with acute poor vision involving middle-aged and elderly individuals. Hypertension and diabetes mellitus were among the main risk factors involved. NAION can lead to permanent visual loss despite treatment.

13 TGFBI gene mutation analysis in a Chinese pedigree of Avellino corneal dystrophy

Ai-Rui Xie , Su-Ping Cai , Yin Yang , Yin-Chuan Fan , Wen-Han Yu , Li-Heng Guo , Qiao-Na Yang , Jin Zhu , Xu-Yang Liu

2011, 4(3):275-279. DOI: 10.3980/j.issn.2222-3959.2011.03.13

[Abstract](2017) [HTML](0) [PDF 524.56 K](1095)

Abstract:
AIM: To analyze phenotype and genotype of a Chinese pedigree with Avellino corneal dystrophy (ACD). METHODS: Complete ophthalmic examinations were per- formed on all the family members. Exons of TGFBI were amplified by polymerase chain reaction, sequenced, and compared with a reference database. RESULTS: A single heterozygous G>A(R124H) point mutation was identified in exon 4 of TGFBI in three affected members and two unaffected children who were offsprings of the affected members, but not in the other family members. CONCLUSION: Mutation R124H in TGFBI was identified in this pedigree and appeared to be the disease causing mutation. Atypical phenotype and low penetrance was observed in this pedigree.

14 Novel sutureless transplantation for primary pterygium associated with cysts

Yi Shao , Xin Zhou , Yao Yu , Chong-Gang Pei , Qiong Zhou , Juan Li , Lu Yang , Wen-Jia Dong , Jing-Lin Yi

2011, 4(3):280-283. DOI: 10.3980/j.issn.2222-3959.2011.03.14

[Abstract](1818) [HTML](0) [PDF 250.31 K](883)

Abstract:
AIM: To evaluate the efficacy and safety of a novel sutureless AMT (amniotic membrane transplantation) or CAT (conjunctivolimbal autograft transplantation) using fibrin glue for reconstructing corneoconjunctival surfaces for primary pterygium associated with cysts. METHODS: A prospective descriptive study was made of the period 1 January 2006-1 May 2009. Nine patients with primary pterygium associated with cysts underwent pterygium and cyst excision followed by sutureless AMT or CAT using fibrin glue. RESULTS: During a mean follow-up of 8.00±0.67 months, all eyes maintained a smooth and stable corneal epithelial surface without recurrent erosion or persistent epithelial defect. The limbal donor site showed the presence of mild depressions without the formation of pseudopterygium. All eyes have good tear secretion function, tear film stability and ocular motility. CONCLUSION: Sutureless transplantation using fibrin glue is safe and effective for restoring a stable corneoconjunctival epithelium in primary pterygium associated with cysts.

15 Comparison of the retinal modulation transfer function between amblyopes successfully corrected and normal subjects

Xiao-Ming Huang , Xue-Gu Xu , Guo-Xing Xu

2011, 4(3):284-285. DOI: 10.3980/j.issn.2222-3959.2011.03.15

[Abstract](1625) [HTML](0) [PDF 262.36 K](937)

Abstract:
AIM：To analyze the retinal modulation transfer function between amblyopes whose visual acuity was corrected to 5.0 and normal subjects at the same age. METHODS： RM-800 used to detect contrast sensitivity was adopted to measure MTF of 96 amblyopes (96 eyes) whose visual acuity was corrected to 5.0 and 80 normal controls (80 eyes) at the same age under six interference fringes (IVA=0.06, 0.1, 0.2, 0.4, 0.6, 0.8). RESULTS： The functional values of amblyopes were significantly lower than those of normal subjects in every fringe (P<0.01), especially in medium and high frequency. CONCLUSION：For amblyopes, MTF was still abnormal after stopping the treatments.

16 Comparison of age-related changes between corneal and ocular aberration in young and mid-age myopic patients

Feng-Ju Zhang , Zheng Zhou , Fang-Lei Yu , Zhi-Li Lu , Ting Li , Meng-Meng Wang

2011, 4(3):286-292. DOI: 10.3980/j.issn.2222-3959.2011.03.16

[Abstract](1952) [HTML](0) [PDF 662.10 K](903)

Abstract:
AIM: To study the dynamic character of aberration between the cornea and the ocular with aging, and to evaluate the symmetry of the aberrations between right and left eye in order to supply the data for clinic to do the refractive surgery reasonably. METHODS: This is a comparative case series study. 82 normal cases (164 eyes) including 37 females (74 eyes) and 45 males (90 eyes) were recruited through the routine examinations、Topolyzer and wavefront analysis. The average age was 25.9±5.0 years old (range 18 to 49 years old), and the mean spherical equivalent (SE) is -3.82±2.21D (range -1.00 to -6.00D). The changes of aberrations regarding age, the relationship between anterior corneal and total aberrations were analyzed，as well as the symmetry between right and left eyes by using Zernike terms. RESULTS: The Z 3 1, RMS3 of corneal aberrations, Z 3 1, Z 4 0 , RMS3 and RMS4 of ocular aberrations had a positive correlation with age. The zernike terms both in corneal and whole eye were significantly correlated between right and left eyes. CONCLUSION: The corneal horizontal coma, ocular horizontal coma and ocular spherical aberrations become to increase at the age of more than 40 years old. The dynamic change of aberration with aging, balance between corneal and ocular, and the symmetric character between left eye and right eye should be designed carefully in the treatment nomogram before the refractive surgery.

17 Confocal microscopic evaluation of cornea after AquaLase liquefaction cataract extraction

Jiang-Yue Zhao , Ming-Wu Wang , Qi Sun , Jin-Song Zhang

2011, 4(3):293-297. DOI: 10.3980/j.issn.2222-3959.2011.03.17

[Abstract](1826) [HTML](0) [PDF 548.93 K](1058)

Abstract:
AIM: The most recent and innovative AquaLase liquefaction technology has offered an alternative to lens extraction. Many studies have investigated its functions and advantages. This article focuses on evaluating the in vivo microscopic cornea changes after AquaLase liquefaction by using a laser confocal microscope. METHODS: In this perspective, randomized case study, 37 eyes of 35 patients submitted to cataract surgery were chosen to undergo AquaLase liquefaction cataract extraction. Each patient was assessed before the operation, on the 1st, 7th, and 30th postoperative days, and 6 months after the cataract extraction. The morphologies and quantitative comparisons of corneal cells and corneal nerves layer by layer were evaluated in vivo with the Heidelberg Retina Tomograph III-Rostock Cornea Module (HRT-III RCM) confocal microscope. ANOVA and Post-Hoc Bonferroni test were carried out to compare the results pre- and post-operation. RESULTS: ANOVA results indicated no post-operation changes for epithelium and anterior stroma cells. Irregular segments of sub-basal nerve fiber were most pronounced seven days post-operation. In the mid and posterior stroma, keratocytes were obvious compared with the preoperative condition. Corneal endothelium cells became obviously swollen in cytoplasm and nucleus. The mid and posterior stroma cell density decreased from the 1st to 7th postoperative days (P<0.05). The corneal endothelium cell density decreased (P<0.05) and did not revert to the preoperative level after six months (P<0.05). CONCLUSION: Slight microstructural abnormalities were identified in the corneal recovery process after AquaLase liquefaction. AquaLase liquefaction cataract extraction is safe for cornea.

18 Head trauma can cause transient elevation of intraocular pressure in patients with open angle glaucoma

Hong Wei , George L. Spaeth

2011, 4(3):298-302. DOI: 10.3980/j.issn.2222-3959.2011.03.18

[Abstract](4625) [HTML](0) [PDF 220.94 K](858)

Abstract:
AIM: To describe a newly-recognized entity, illustrated by five cases of glaucoma in whom trauma to the head, but not the eye, resulted in marked, transient elevation of intraocular pressure (IOP). METHODS: Retrospective case series. Chart review. RESULTS: All five cases had a diagnosis of primary open-angle glaucoma prior to the experience of trauma to the head. All cases had an unusual elevation of IOP (around 70 percent) for days to weeks following the trauma, after which the IOP fell to pre-accident levels. No cause other than the trauma could be determined. CONCLUSION: The relationship between head trauma and elevation of IOP appears real.

19 Application of Lutein and Zeaxanthin in nonproliferative diabetic retin

Bo-Jie Hu , Ya-Nan Hu , Song Lin , Wen-Jiang Ma , Xiao-Rong Li

2011, 4(3):303-306. DOI: 10.3980/j.issn.2222-3959.2011.03.19

[Abstract](4697) [HTML](0) [PDF 317.50 K](999)

Abstract:
AIM: To compare serum Lutein and Zeaxanthin (L/Z) concentrations between patients with nonproliferative diabetic retinopathy (NDR) and normal subjects, and to explore the effect of L/Z supplementation on serum L/Z level and visual function in NDR patients METHODS: Subjects were divided into three groups: 30 NDR patients supplied with Lutein 6mg/d and Zeaxanthin 0.5mg/d for three months (DR Group), 30 NDR patients without L/Z supplementation (DR Control Group) and 30 normal subjects (Control Group). Serum L/Z concentrations were measured by liquid high-resolution chromatography (HPLC). Visual acuity was recorded at baseline, 1 month, 2 months and 3 months post initial supplementation. Serum L/Z concentration were measured at baseline, 1 month and 2 months post initial supplementation. Contrast sensitivity (CS) and fovea thickness were recorded at baseline and 3 months post initial supplementation. RESULTS: Mean serum lutein concentrations in DR group were 0.0686±0.0296μg/mL and zeaxanthin concentration was 0.0137±0.0059μg/mL. The L/Z level of DR group was significantly lower compared to the control group( lutein: 0.2302±0.1308μg/mL，zeaxanthin: 0.0456±0.0266μg/m，P = 0.000). The concentration of lutein and zeaxanthin in the DR control group at base line was 0.0714±0.0357μg/mL and 0.0119±0.0072μg/mL, respectively. There was no significant change of L/Z concentration in the DR control group during the study. Serum L/Z concentrations of DR group increased significantly after supplementation（F=109.124，P=0.000；F=219.207，P=0.000）.Visual acuity improved significantly after medication. Compared with pre-medication, the average CS values of 1.5cpd, 3cpd and 6cpd after three months increased significantly (P=0.030,0.013,0.008) and the foveal thickness decreased. (P=0.05) CONCLUSION: Serum L/Z concentrations in DR patients are significantly lower than those in normal subjects, and L/Z intake can improve the visual acuity, CS and macular edema in DR patients, suggesting that L/Z supplementation might be targeted as potential potential therapeutic agents in treating NDR.

20 Vitrectomy for vitreous amyloidosis

Jiang You

2011, 4(3):307-310. DOI: 10.3980/j.issn.2222-3959.2011.03.20

[Abstract](2042) [HTML](0) [PDF 592.45 K](921)

Abstract:
AIM: To study the clinical features of vitreous amyloidosis and the effect of vitrectomy for it. METHODS: We treated 6 eyes (4 Patients) with vitreous amyloidosis from 2008 to 2009, and followed up for 18-30 months after vitrectomy. RESULTS: The visual acuity ranged from counting fingers to 3/50 before surgery and 15/50-40/50 after vitrectomy. No severe complication was observed. CONCLUSION: Vitrectomy is an effective and safe treatment for eyes with vitreous amyloidosis. A long period of follow-up after surgery should be performed.

21 Clinicopathological survey of 23 patients with lacrimal fossa lesions in Hong Kong

Danny Siu-Chun Ng , Edwin Chan , Kin Yau , Clement Wai-Nang Chan

2011, 4(3):311-313. DOI: 10.3980/j.issn.2222-3959.2011.03.21

[Abstract](1677) [HTML](0) [PDF 256.18 K](873)

Abstract:
AIM: To survey the clinicopathological correlations of lacrimal fossa lesions in the Hong Kong population. METHODS: A total of 23 patients with lacrimal fossa lesions were identified radiologically. The mean age at the time of diagnosis was 52 year-old. The medical records of patients diagnosed with lacrimal fossa lesions and subsequently underwent radiological investigations were collected and reviewed retrospectively throughout a six years period from 2000 to 2006 from three regional hospitals (Tung Wah Eastern Hospital, Pamela Youde Nethersole Eastern Hospital and Queen Mary Hospital) belonging to the Hong Kong Mega Cluster. Patient demographics, presenting signs and symptoms, imaging modalities, pathological reports and subsequent management were recorded. RESULTS: The most common initial presenting symptom was upper lid swelling (83%) followed by proptosis (13%). 19 patients (83%) had benign lacrimal fossa lesion and 4 patients (17%) had malignancy. Three of the malignancies were lymphomas and one was adenoid cystic carcinoma. CONCLUSION: Age is an important factor in considering the differential diagnosis of lacrimal fossa lesion. Lymphoproliferative diseases have the highest incidence in patients over 60 years of age while inflammatory lesions are more common in younger patients in Hong Kong.

22 Clinic study on silicone hydrogel contact lenses used as bandage contact lenses after LASEK surgery

Xiao-Mei Qu , Jin -Hui Dai , Zhen -Ying Jiang , Yi- Feng Qian

2011, 4(3):314-318. DOI: 10.3980/j.issn.2222-3959.2011.03.22

[Abstract](2890) [HTML](0) [PDF 304.72 K](1013)

Abstract:
AIM: To compare the clinical performance of two types of silicon hydrogel contact lenses used as bandage lenses after LASEK surgery. METHODS: A prospective, double-masked study was conducted on 42 eyes of 21 patients who received binocular LASEK surgeries. The interocular difference in spherical equivalent power was less than -1.50D. Patients were randomly assigned to wear Galyfilcon A (Lens A) bandage contact lens in one eye and Balafilcon A (Lens B) in the fellow eye after the surgery. The responses to a subjective questionnaire on comfort of wearing, corneal epithelial status, conjunctival hyperemia, limbal neovascularization, lens fitting and contact lens debris were assessed 1 and 5 days postoperatively. Corneal endothelium was assessed before and 5 days after the surgery upon bandage lens removal. RESULTS: There was no difference between the two groups in terms of conjunctival hyperemia, limbal neovascularization, contact lens fitting, corneal epithelial status, corneal endothelium cell density (CD) and endothelium cell size (CS) at any postoperative visit. Complaints of discomfort, including foreign body sensation, pain and intolerance were statistically more among Lens B wearers at any postoperative visit (P<0.05). Lens B appeared to attract much more debris than Lens A at the 5-day post-operative follow-up visit (P<0.01). CONCLUSION: The two types of silicon hydrogel lenses investigated in this study demonstrated similar clinical performance in terms of corneal responses and lens fitting. However, Lens A showed a better performance in terms of comfort of wearing and deposit resistance.

23 Prevalence of refraction errors and color blindness in heavy vehicle drivers

Haydar Erdogan , Levent Özdemir , Seher Arslan , Ilhan Çetin , Ayse Vural ?ze? , Selma ?etinkaya , Haldun Sümer

2011, 4(3):319-322. DOI: 10.3980/j.issn.2222-3959.2011.03.23

[Abstract](2887) [HTML](0) [PDF 297.23 K](997)

Abstract:
AIM: To investigate the frequency of eye disorders in heavy vehicle drivers. METHODS: A cross-sectional type study was conducted between November 2004 and September 2006 in 200 driver and 200 non-driver persons. A complete ophthalmologic examination was performed, including visual acuity, and dilated examination of the posterior segment. We used the auto refractometer for determining refractive errors. RESULTS: According to eye examination results, the prevalence of the refractive error was 21.5% and 31.3% in study and control groups respectively (P<0.05). The most common type of refraction error in the study group was myopic astigmatism (8.3%) while in the control group simple myopia (12.8%). Prevalence of dyschromatopsia in the rivers, control group and total group was 2.2%, 2.8% and 2.6% respectively. CONCLUSION: A considerably high number of drivers are in lack of optimal visual acuity. Refraction errors in drivers may impair the traffic security.

24 Incidence of cilioretinal arteries in Chinese Han population

Lei Liu , Li-Min Liu , Lei Chen

2011, 4(3):323-325. DOI: 10.3980/j.issn.2222-3959.2011.03.24

[Abstract](1846) [HTML](0) [PDF 286.83 K](989)

Abstract:
AIM: To estimate the incidence of cilioretinal arteries among Han population of north China. METHODS: A cross-sectional sample of subjects aged from 20 years old to 80 years old were selected using a cluster sampling technique from Shenyang of Liaoning Province for Diabetic Eye Disease Study. Eligible subjects were recruited in the Community Health Center which took the stereo fundus photography using 45°Non-Mydriatic Fundus Camera. Data were analyzed by SPSS 14.0. RESULTS: The incidence of cilioretinal arteries in 5000 eyes of 2500 subjects was determined. One, two or more cilioretinal arteries were present in 876 of all subjects and in 923 of all the eyes. Difference of presence, number and distribution of cilioretinal arteries was observed. During the subjects, the arteries occurred bilaterally in 6.9% and contributed to some portion of the temporal circulation in 78.3%, nasal circulation 14.8%, respectively. Statistical analysis indicated that there was no significant difference in incidence between men and women, left and right eyes (P>0.05). CONCLUSION: 35.0% persons have the cilioretinal arteries in Han population of north China. Men and women have an equal distribution of cilioretinal arteries.

25 Intralenticular metallic foreign body: a case report

S C Reddy

2011, 4(3):326-328. DOI: 10.3980/j.issn.2222-3959.2011.03.25

[Abstract](2370) [HTML](0) [PDF 212.83 K](923)

Abstract:
A case of retained intralenticular iron piece with signs of mild anterior uveitis at the time of presentation is reported in a 45 year-old man. His vision improved with topical cycloplegics and corticosteroids. After six months, his vision deteriorated grossly due to cataract formation. He regained good vision following removal of foreign body, extracapsular extraction with posterior chamber intraocular lens implantation. This case highlights the conservative management of the condition till the patient develops cataract resulting in visual disability; and good visual recovery following cataract surgery with intraocular lens implantation.

26 Transthyretin Arg-83 mutation in vitreous amyloidosis

Ling-Yan Chen , Lin Lu , Yong-Hao Li , Hui Zhong , Wang Fang , Li Zhang , Weng-Lin Li

2011, 4(3):329-331. DOI: 10.3980/j.issn.2222-3959.2011.03.26

[Abstract](1824) [HTML](0) [PDF 486.62 K](927)

Abstract:
Both of the patients in the report had floaters and progressive vision loss for years. Two cases of familial vitreous amyloidosis occurred in three generations with typical white fibrilar opacities in the vitreous body. Pars plana vitrectomy was performed in the two patients. The vitreous specimens were subjected to histopathological examination. The specimens showed typical microscopic features of amyloidosis with Congo red stain and non-branching fibrils were seen randomly distributed with 5-10nm in diameter on a transmission electron microscope. All of the exons of the transthyretin gene were amplified with DNA isolated from the peripheral blood cells. Bi-directional sequencing of the transthyretin gene revealed a single base-pair substitution, which results in an amino acid substitution at position83, glycine to arginine (transthyretin Arg-83).

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Volume 4,Issue 3,2011 Table of Contents