Volume 6,Issue 4,2013 Table of Contents

  • Display Type:
  • Text List
  • Abstract List
  • 1  The correlation between rat retinal nerve fiber layer thickness around optic disc by using optical coherence tomography and histological measurements
    Ju-Fang Huang Hui-Min Yu Lei Shang Ruo-Fei Ma Ngobe Akume Cynthia Yan-Qun Cao Jia Luo Le-Ping Zeng Dan Chen Kun Xiong
    2013, 6(4):415-421. DOI: 10.3980/j.issn.2222-3959.2013.04.01
    [Abstract](2255) [HTML](0) [PDF 4.02 M](1109)
    Abstract:
    AIM:To explore the correlation between the retinal nerve fiber layer (RNFL) thickness by using optical coherence tomography (OCT) and by histological measurements in normal adult rats and optic nerve transected rats.METHODS:The RNFL thickness of 36 rats was scanned in a circle 3.46mm far from the optic disc by OCT. The two experimental groups were the normal group (n=20 rats) and the optic nerve transected group (n=16 rats). The latter group included 4 groups (n=4/group) surviving for 1 day, 3, 5 and 7 days. Then the RNFL thickness of the same retina area was also measured by NF-200 immunohistochemical staining method. Linear regression was used to analyze the correlation between the data obtained from these two methods.RESULTS: The RNFL thickness of normal right eyes around optic disc by OCT was 72.35±5.71μm and that of the left eyes was 72.65±5.88μm (P=0.074). The RNFL thickness of the corresponding histological section by immunohistochemistry was 37.54±4.05μm (right eyes) and 37.38±4.23μm (left eyes) (P=0.059). There was a good correlation between the RNFL thickness measured by OCT and that measured by histology (R2=0.8131). After optic nerve transection, the trend of the RNFL thickness was thinner with the prolonged survival time. The correlation of the thickness detected by the above two methods was approximately (R2=0.8265). Value of the RNFL thickness in rats around optic disc measured by OCT was obviously higher than that measured by common histological measurement in normal adult rats and optic nerve transected rats.CONCLUSION: The RNFL thickness measured by OCT has a strong correlation with that measured by histological method. Through OCT scanning, we found that the thickness of RNFL gradually becomes thinner in a time-dependent manner.
    2  Protective effects of curcumin on retinal Müller cell in early diabetic rats
    Zhong-Fu Zuo Qiang Zhang Xue-Zheng Liu
    2013, 6(4):422-424. DOI: 10.3980/j.issn.2222-3959.2013.04.02
    [Abstract](2330) [HTML](0) [PDF 1.25 M](973)
    Abstract:
    AIM: To explore the effects and potential mechanisms of curcumin on retinal Müller cell in early diabetic rats.METHODS: Diabetic rats were induced by a single intraperitoneal injection of streptozotocin (STZ). Male Sprague-Dawley (SD) rats were randomly assigned into 4 groups:control group (na?ve SD rats administered with a single intraperitoneal injection of citric buffer), diabetic group (STZ-diabetic rats), dimethyl sulfoxide (DMSO) group (diabetic rats intraperitoneally administered with mixture of DMSO and normal saline, once a day) and curcumin group (diabetic rats intraperitoneally administered with curcumin, 80mg/kg, once a day). Three months after diabetes onset, malondialdehyde (MDA, indication of oxidative stress level) and reduced glutathione (GSH) in retina were detected with kits, glial fibrillary acidic protein (GFAP) in retina was revealed by immunohistochemistry and Western blot, and retinal glutamine synthetase (GS) were observed by Western blot.RESULTS: Compared with control group, retinal MDA was increased, and GSH was decreased in diabetic and DMSO groups (P<0.05, respectively). While, retinal MDA and GSH in curcumin group showed no difference compared with control group (P>0.05). Furthermore, up-regulation of retinal GFAP and down-regulation of retinal GS were detected in diabetic and DMSO groups, and no alteration could be observed in curcumin group revealed with Western blot. Compared with control group, retinal Müller cells showed significant increase in GFAP immunochemistry staining in diabetic and DMSO groups. Moreover, GFAP-positive staining was decreased in curcumin group compared with diabetic group.CONCLUSION: Curcumin inhibits diabetic retinal oxidative stress, protects Müller cell, and prevents the down-regulation of GS in diabetic retina. Therefore, curcumin has a therapeutic potential in the treatment of diabetic retinopathy (DR).
    3  In vitro tissue engineering of lamellar cornea using human amniotic epithelial cells and rabbit cornea stroma
    Xiao-Yong Liu Jian Chen Qing Zhou Jing Wu Xiao-Ling Zhang Li Wang Xiao-Yan Qin
    2013, 6(4):425-429. DOI: 10.3980/j.issn.2222-3959.2013.04.03
    [Abstract](2161) [HTML](0) [PDF 3.38 M](988)
    Abstract:
    AIM:To reconstruct the lamellar cornea using human amniotic epithelial (HAE) cells and rabbit cornea stroma in vitro using tissue engineering technology.METHODS: Human amnia taken from uncomplicated caesarean sections were digested by collagenase to obtain HAE cells, and the cells were cultured to proliferate. Rabbit corneal epithelial cells were removed by n-heptanol to make lamellar matrix sheets. The second passage of HAE cells were cultured on the corneal stroma sheets for 1 or 2 days, then transferred to an air-liquid interface environment to culture for 2 weeks. Tissue engineered lamellar cornea (TELC) morphology was observed by Hematoxylin-eosin (HE) staining; its ultrastructure was observed by transmission electron microscopy (TEM) and scanning electron microscopy (SEM); corneal epithelial cell-specific keratin 3 and keratin 12 were detected with immunofluorescence microscopy.RESULTS:HAE cells grew on the rabbit corneal stroma, forming a monolayer after 1-2 days. About 4-5 layers of epithelial cells developed after 2 weeks of air-liquid interface cultivation, a result similar to normal corneal epithelium. Rabbit corneal stromal cells were significantly reduced after one week, then almost completely disappeared after 2 weeks. TEM showed desmosomes between the epithelial cells; hemidesmosomes formed between the epithelial cells and the basement membrane. SEM revealed that the HAE cells which grew on the lamellar cornea had abundant microvilli. The tissue-engineered cornea expressed keratin 3 and keratin 12, as detected by immunofluorescence assay.CONCLUSION: Functional tissue-engineered lamellar corneal grafts can be constructed in vitro using HAE cells and rabbit corneal stroma.
    4  Identification of a novel p.R1443W mutation in RP1 gene associated with retinitis pigmentosa sine pigmento
    Li Ma Xun-Lun Sheng Hui-Ping Li Fang-Xia Zhang Ya-Ni Liu Wei-Ning Rong Jian-Ling Zhang
    2013, 6(4):430-435. DOI: 10.3980/j.issn.2222-3959.2013.04.04
    [Abstract](1909) [HTML](0) [PDF 1.78 M](1009)
    Abstract:
    AIM: To screen mutations in the retinitis pigmentosa 1 (RP1) gene and the rhodopsin (RHO) gene in Chinese patients with retinitis pigmentosa sine pigmento (RPSP) and describe the genotype-phenotype relationship of the mutations.METHODS:Twenty affected, unrelated Chinese individuals with RPSP (4 autosomal dominant RPSP, 12 autosomal recessive RPSP and 4 unknown inheritance pattern) were recruited between 2009 and 2012. The clinical features were determined by complete ophthalmologic examinations. Polymerase chain reaction (PCR) and direct DNA sequencing were used to screen the entire coding region and splice junctions of the RP1 gene and the RHO gene. The cosegregation analysis and population frequency studies were performed for patients with identified mutations.RESULTS: Five variants in the RP1 gene and one in the RHO gene were detected in 20 probands. Four missense changes (rs444772, rs446227, rs414352, rs441800) and one non-coding variant (rs56340615) were common SNPs and none of them showed a significant relationship with RPSP. A missense mutation p.R1443W was identified in the RP1 gene in three affected individuals from a family with autosomal dominant RPSP and was found to cosegregate with the phenotype in this family, suggestive of pathogenic. In addition, population frequency analysis showed the p.R1443W mutation was absent in 300 healthy controls.CONCLUSION: The identification of p.R1443W mutation cosegregating in a family with autosomal dominant RPSP highlights an atypical phenotype of the RP1 gene mutation, while RHO gene is not associated with the pathogenesis of RPSP in this study. To our knowledge, this is the fist mutation identified to associate with RPSP.
    5  Effects of aminoguanidine on retinal apoptosis in mice with oxygen-induced retinopathy
    An-Jie Du Bing Ren Xiao-Wei Gao Lei Yang Yan Fu Xu-Dong Zhao
    2013, 6(4):436-441. DOI: 10.3980/j.issn.2222-3959.2013.04.05
    [Abstract](1910) [HTML](0) [PDF 4.86 M](1066)
    Abstract:
    AIM: To explore the protective effects of aminoguanidine (AG) on retinal apoptosis in mice with oxygen-induced retinopathy (OIR).METHODS:A total of 80 C57BL/6J mice, aged 7 days, were randomly divided into four groups:normal, high oxygen, high oxygen saline and high oxygen treated with AG. In the normal group, mice were housed in normoxic conditions from postnatal day P7 to P17. Mice in the other 3 groups were placed under hyperoxic conditions (75±2%O2) in an oxygen-regulated chamber for 5 days and subsequently placed in normoxic conditions for 5 days. Mice in the AG group were treated once daily, from P12 to P17, with AG hemisulfate (100mg/kg body weight, intraperitoneally) dissolved in physiological saline. An equivalent amount of 0.9% physiological saline was administered, as above, to mice in the high oxygen saline group. Ten mice were randomly selected from each group on P14 and on P17, euthanized and the retinas examined. Apoptotic cells in the retina were detected using the terminal-deoxynucleoitidyl transferase mediated nick end labeling (TUNEL) method. The expression of nitric oxide synthase (iNOS) in the retina was detected by immunohistochemistry and changes in rod cells were observed using electron microscopy.RESULTS:TUNEL-positive cells and iNOS immunoreactive neurons were present in the inner nuclear and ganglion cell retinal layers of mice in the high oxygen group. The number of TUNEL-positive cells was significantly greater in the high oxygen group compared with the normal group (t=-20.81, P14d <0.05; t=-15.05, P17d<0.05). However, the number of TUNEL-positive cells in the AG treatment group was significantly lower (t=-13.21, P14d<0.05; t=-6.61,P17d <0.05) compared with the high oxygen group. The expression of iNOS was significantly higher in the high oxygen group compared with the normal group (t=-21.95, P14d<0.05; t=-17.30, P17d<0.05). However, the expression of iNOS in the AG treatment group was significantly lower (t=-12.17,P14d<0.05; t=-10.30,P17d<0.05) compared with the high oxygen group. The outer segments of the rods were disorganized and short in the high oxygen group. Rod morphology appeared to be slightly improved in the AG group.CONCLUSION:AG may protect retinal neurons in OIR by inhibiting apoptosis. The mechanism may be related to iNOS.
    6  Clinicopathologic features and prognostic factors of malignant eyelid tumors
    Chang-Jun Wang Hui-Na Zhang Han Wu Xin Shi Jia-Jun Xie Jin-Jing He Koung-Hoon KooK Sang-Yeul Lee Juan Ye
    2013, 6(4):442-447. DOI: 10.3980/j.issn.2222-3959.2013.04.06
    [Abstract](1898) [HTML](0) [PDF 2.27 M](1366)
    Abstract:
    AIM:To investigate the clinical characteristics and prognosis of patients with malignant eyelid tumors.METHODS: This was a retrospective, non-randomized, clinical reviews. Between January, 2002 and December, 2011, 75 cases with histologically confirmed malignant eyelid tumors were evaluated. Patients’ charts were reviewed for clinical information, treatment procedure, and disease course. Survival analysis in terms of recurrence-free survival was performed using age, sex, location of tumor and histopathological type. The follow-up ranged from 1 to 78 months (mean=21 months).RESULTS: The 75 eyelid tumors included 35 basal cell carcinoma (BCC, 46.7%), 22 sebaceous gland carcinoma (SGC, 29.3%), 7 squamous cell carcinoma (SCC, 9.3%), 10 malignant melanoma (MM, 13.3%), and 1 Merkel cell carcinoma (MCC, 1.3%). Recurrence developed in 17 cases (22.7%). The recurrence rate of BCC (4/35, 11.4%) was significant lower than MM (6/10, 60.0%, P<0.001). The mean interval of recurrence was 21 months (range 3-62) for all eyelid tumors. Tumor located at canthus had higher recurrence rate (50%) compared with those located at eyelid (19%, P<0.05). Histological type was independent variable for recurrence by Cox regression analysis.CONCLUSION: It is important to achieve a negative tumor margin in canthus located malignant eyelid tumor. Clinicians should have a high level of suspicion for recurrence according to histological type when treating patients with eyelid tumor.
    7  Comparison of trabeculectomy and trabeculectomy with amniotic membrane transplantation in the same patient with bilateral glaucoma
    Qing-Shan Ji Bing Qi Lian Liu Wei Lao Zhi-Hao Yang Gui-Fang Wang Guo-Cheng Yu Jing-Xiang Zhong
    2013, 6(4):448-451. DOI: 10.3980/j.issn.2222-3959.2013.04.07
    [Abstract](2218) [HTML](0) [PDF 426.67 K](962)
    Abstract:
    AIM: To observe effects of trabeculectomy with amniotic membrane transplantation (AMT) in controlling postoperative intraocular pressure (IOP) in patients with medically uncontrolled glaucoma.METHODS:This study included adult patients with requiring bilateral glaucoma surgery. Each patient underwent trabeculectomy (Non-AMT group) in one eye and with AMT (AMT group) in the other eye according to randomized principle. Success was defined as intraocular pressure (IOP)<21mmHg without any anti-glaucoma medications at 24 months follow-up. The two groups were compared in terms of IOP, complications and success rate.RESULTS: Thirty-four eyes of 17 patients were investigated in this study. There was no statistically signifcant difference in pre-operative IOP between the two groups. The mean IOP was lower in AMT group compared with Non-AMT group on follow up months 12, 18, and 24.Postoperative complications were more frequent in Non-AMT group (35.3%, 6/17) compared with AMT group (5.9%, 1/17). The success rate of surgery was 88.2% (15/17) in Non-AMT group and 100% (17/17) in AMT group.CONCLUSION: Trabeculectomy with AMT is an effective procedure to reduce IOP and complications, thereby improving surgical success rates.
    8  Comparison on conjunctival sac bacterial flora of the seniors with dry eye in Ganzi autonomous prefecture
    Yue Zhang Zhi-Rong Liu Hui Chen Ying-Chuan Fan Ji Duo Hong Zheng Guang-Jin Wang Yu-Chan Li Dan-Ba Jiachu Ge-Ma Zewang
    2013, 6(4):452-457. DOI: 10.3980/j.issn.2222-3959.2013.04.08
    [Abstract](2282) [HTML](0) [PDF 567.00 K](969)
    Abstract:
    AIM: To compare the bacterial flora in palpebral conjunctiva of xerophthalmia seniors of Tibetan, Yi and Han, and analyze the differences and similarities of the bacteria.METHODS:The test subjects were selected from 2 Tibetan, 2 Yi and 3 Han populated places, respectively. Total 222 seniors (444 eyes) with dry eye were examined. Secretion was collected from the palpebral conjunctiva of the subjects and then inoculated onto a blood agar plate. After 48h of incubation, the bacteria were examined for the differences and similarities between different ethnics.RESULTS: There was no significant difference (P>0.05) of Gram stain characterization, dominant bacteria and number of the bacterial species present in oxrophthalmia patients among Tibetan, Yi and Han nationalities. The bacteria presented in all groups include staphylococcus epidermidis, corynebacterium, micrococcus luteu, intracellular bacteria sphingomonas, pseudomonas aeruginosa. The bacteria detected from the two of three ethnic groups were staphylococcus aureus, staphylococcus haemolyticus, escherichia coli, kytococcus sedentarius, streptococcus angina, micrococcus lylae, and staphylococcus heads. The incidence rate of bacteria-associated dry eye in Tibetan population was significantly lower than that of Han and Yi population.CONCLUSION:There is no significant difference in the bacteria flora of palpebral conjunctiva observed among dry eye elder populations of Tibetan, Yi and Han people. All of staphylococcus epidermidis, corynebacterium, micrococcus luteu, intracellular bacteria sphingomonas, pseudomonas aeruginosa, staphylococcus aureus, staphylococcus haemolyticus, escherichia coli, kytococcus sedentarius, streptococcus angina, micrococcus lylae and staphylococcus heads are common bacteria flora of the three nationalities inhibiting in this area.
    9  Chinese family with atypical granular corneal dystrophy type I caused by the typical R555W mutation in TGFBI
    Su-Juan Zhao Ya-Nan Zhu Xing-Chao Shentu Qi Miao
    2013, 6(4):458-462. DOI: 10.3980/j.issn.2222-3959.2013.04.09
    [Abstract](1860) [HTML](0) [PDF 1.38 M](900)
    Abstract:
    AIM: To investigate the clinical features and genetic defects in four generations of a Chinese family affected with atypical granular corneal dystrophy type I (GCD type I).METHODS: Family history and clinical data were recorded. Genomic DNA samples were obtained from peripheral blood leukocytes of all participated. Exons of the transforming growth factor-β-induced(TGFBI) gene were directly sequenced after being amplified by polymerase chain reaction (PCR), and multi-point linkage analysis using microsatellite makers flanking the gene was applied to identify the disease-causing mutation.RESULTS: Clinical features were quite variable in patients, some patients only had opacities in the epithelium, and others revealed multiple bilateral circular, discrete, crumb-like opacities mainly in the epithelium, with several in different depths of corneal stroma, and the performance was different bilaterally, even in the same patient. Directly nucleotide sequencing revealed a heterozygous p.R555W mutation in the coding sequence of the TGFBI gene in all affected individuals of the family, but was not found in all unaffected. The maximum logarithm of odds (LOD) score obtained by multi-point analysis was detected at marker locus D5S393 (LOD=2.740; α=1.000).CONCLUSION: Our case presented with clinical futures and the pathogenic mutations in TGFBI gene, the phenotype of the pedigree was quite different from typical GCD type I, so we suggested that this phenotype was a variant of GCD type I. These findings expand the knowledge about GCD type I, and demonstrate that molecular genetic analysis is important to make an accurate diagnosis of patients with variable corneal dystrophies in clinic.
    10  Simple keratectomy and corneal tattooing for limbal dermoids:results of a 3-year study
    Dong Min Cha Kyung-Hoon Shin Keun Ho Kim Ji-Won Kwon
    2013, 6(4):463-466. DOI: 10.3980/j.issn.2222-3959.2013.04.10
    [Abstract](1809) [HTML](0) [PDF 1.08 M](943)
    Abstract:
    AIM: To evaluate and report the efficacy of combined surgical excision and corneal tattooing in patients with limbal dermoids.METHODS: In a retrospective interventional case series, 9 eyes of 8 patients were treated with combined surgery of simple keratectomy and corneal tattooing for limbal dermoids. Medical records, including best-corrected visual acuity, anterior segment photography, demographic, clinical data, and follow-up information were reviewed.RESULTS: The mean follow up period in this study was 50±15(range 36-77) months. There was no evidence of infection or recurrent limbal dermoids in any of the eyes during the follow-up period. All patients achieved good cosmetic outcomes with no complications.CONCLUSION: Simple keratectomy and corneal tattooing of limbal dermoids could be an alternative option for surgery, especially when a donor cornea is not available.
    11  Corneal endothelial cell density and morphology in low and moderate myopic Chinese eyes
    Samaneh Delshad Jane Mei Chun
    2013, 6(4):467-470. DOI: 10.3980/j.issn.2222-3959.2013.04.11
    [Abstract](2842) [HTML](0) [PDF 199.88 K](1099)
    Abstract:
    AIM: To describe and compare the corneal endothelial cell density and morphology in young, low and moderate myopic Chinese adults in Malaysian Chinese population.METHODS: Non-contact specular microscopy (Topcon SP3000P, Tokyo, Japan) was performed in low (n=78; 21.22±1.51 years) and moderate (n=78; 21.82±1.40 years) myopic subjects. The mean of three consecutive measurements of endothelial cell density (MCD), coefficient of variation (CV) in the cell size, and hexagonal appearance of the cell were obtained.RESULTS: In low myopic eyes the MCD was 3 063.0±176.2/mm2, the mean CV was 33.4±4.0% and the mean hexagonal appearance of the cell was 57.9±2.7%. In moderate myopic eyes the MCD was 2961.6±159.0/mm2, the mean CV was 33.9±3.6% and mean hexagonal appearance of the cell was 56.2±4.7%. There were statistically significant differences in MCD (P<0.000) and hexagonal appearance of the cell (P<0.005) between low and moderate myopic eyes.CONCLUSION:The corneal endothelial cell layer in more myopic eyes tends to have less MCD and cell hexagonality compared to lower myopic eyes. Nevertheless, there is no significant difference in CV between low and moderate myopic eyes.
    12  Effect of topical 0.05% cyclosporine A on corneal endothelium in patients with dry eye disease
    Consuelo Pérez-Rico Francisco Germain María Castro-Rebollo Agustín Moreno-Salgueiro Miguel Angel Teus
    2013, 6(4):471-474. DOI: 10.3980/j.issn.2222-3959.2013.04.12
    [Abstract](1703) [HTML](0) [PDF 366.55 K](975)
    Abstract:
    AIM:To determine the effect of topical 0.05% cyclosporine A (CsA) on corneal endothelium in patients with dry eye disease.METHODS: Observational, prospective, case series study. Fifty-five eyes of 29 consecutive patients (9 males and 20 females; median age:66.8 years, interquartile range:61-73.2 years) with moderate-severe dry eye disease were evaluated. All patients were treated with topical 0.05% CsA ophthalmic emulsion twice a day in addition to lubricant eyedrops 5 times a day. The follow-up period was 12 months. Before treatment and at 3 and 12 months post-treatment central corneal specular microscopy was performed. The endothelial cell density (ECD), coefficient of variation of cell size (CoV), and percentage of hexagonal cells (Hex %) were analyzed.RESULTS: The median ECDs pre-treatment and at 3 and 12 months post-treatment were 2 352.5/mm2 (interquartile range, 2 178-2 548.5), 2364/mm2 (interquartile range, 2 174.25-2 657.5), and 2366 cells/mm2 (interquartile range, 2 174.75-2 539.75), respectively (P=0.927, one way ANOVA). The median CoVs pre-treatment and at 3 and 12 months post-treatment were 34.5 (interquartile range, 30-37), 35 (interquartile range, 30-38), and 34 (interquartile range, 30.75-38.25), respectively (P=0.7193, one way ANOVA). The median Hex % values pre-treatment and at 3 and 12 months post-treatment were 53 (interquartile range, 47-58), 54 (interquartile range, 45.75-59), and 50.5 (interquartile range, 45.75-58), respectively (P=0.824, one way ANOVA).CONCLUSION: Treatment of patients with dry eye disease for 12 months with topical 0.05% CsA does not seem to cause substantial changes on corneal endothelium.
    13  Spontaneous regression of retinopathy of prematurity:incidence and predictive factors
    Rui-Hong Ju Jia-Qing Zhang Xiao-Yun Ke Xiao-He Lu Li-Fang Liang Wu-Jun Wang
    2013, 6(4):475-480. DOI: 10.3980/j.issn.2222-3959.2013.04.13
    [Abstract](3094) [HTML](0) [PDF 248.42 K](1008)
    Abstract:
    AIM:To evaluate the incidence of spontaneous regression of changes in the retina and vitreous in active stage of retinopathy of prematurity(ROP) and identify the possible relative factors during the regression.METHODS: This was a retrospective, hospital-based study. The study consisted of 39 premature infants with mild ROP showed spontaneous regression (Group A) and 17 with severe ROP who had been treated before naturally involuting (Group B) from August 2008 through May 2011. Data on gender, single or multiple pregnancy, gestational age, birth weight, weight gain from birth to the sixth week of life, use of oxygen in mechanical ventilation, total duration of oxygen inhalation, surfactant given or not, need for and times of blood transfusion, 1,5,10-min Apgar score, presence of bacterial or fungal or combined infection, hyaline membrane disease (HMD), patent ductus arteriosus (PDA), duration of stay in the neonatal intensive care unit (NICU) and duration of ROP were recorded.RESULTS: The incidence of spontaneous regression of ROP with stage 1 was 86.7%, and with stage 2, stage 3 was 57.1%, 5.9%, respectively. With changes in zone Ⅲ regression was detected 100%, in zoneⅡ 46.2% and in zoneⅠ 0%. The mean duration of ROP in spontaneous regression group was 5.65±3.14 weeks, lower than that of the treated ROP group (7.34±4.33 weeks), but this difference was not statistically significant (P=0.201). GA, 1min Apgar score, 5min Apgar score, duration of NICU stay, postnatal age of initial screening and oxygen therapy longer than 10 days were significant predictive factors for the spontaneous regression of ROP (P<0.05). Retinal hemorrhage was the only independent predictive factor the spontaneous regression of ROP (OR 0.030, 95%CI 0.001-0.775, P=0.035).CONCLUSION:This study showed most stage 1 and 2 ROP and changes in zone Ⅲ can spontaneously regression in the end. Retinal hemorrhage is weakly inversely associated with the spontaneous regression.
    14  Extraocular retinoblastoma in Indian children:clinical, imaging and histopathological features
    Sumita Sethi Neelam Pushker Seema Kashyap Sanjay Sharma Mridula Mehta Sameer Bakhshi Saurbhi Khurana Supriyo Ghose
    2013, 6(4):481-486. DOI: 10.3980/j.issn.2222-3959.2013.04.14
    [Abstract](2549) [HTML](0) [PDF 14.90 M](954)
    Abstract:
    AIM: To study eyes with extraocular dissemination (EORB), with the following aims:first to establish the mean lag period and to understand various reasons for delayed presentation, second to study their imaging profiles and third to analyze histopathological features of eyes enucleated after neoadjuvant chemotherapy.METHODS: Prospective study of clinical and imaging features of EORBs (stage Ⅲ and Ⅳ International Retinoblastoma Staging System) presenting to a tertiary eye care centre. Histopathological features of eyes enucleated after receiving neoadjuvant chemotherapy were analyzed. A pictorial illustration of the varied imaging profile of EORB was also presented.RESULTS: Over a period of one year, 97 eyes were diagnosed with retinoblastoma; 32 children (36 eyes) (37.1%) had EORB. Mean age 3.6±1.9 years, 71.9% males, 71.9% unilateral, 3.1% with positive family history and 40.6% with metastasis. On imaging, there was extrascleral involvement in 22.2%, involvement of orbital part of optic nerve in 33.3%, involvement of central nervous system in 27.8% and orbital wall involvement in 2.9% eyes. On histopathological analysis of eyes enucleated after neoadjuvant chemotherapy, 25.0% had no residual viable tumour tissue and rest all tumours were poorly differentiated.CONCLUSION:There are very few human malignancies where definitive treatment is started without any confirmed histopathological diagnosis and imaging plays an important role in diagnosis and appropriate staging of the disease. Chemotherapy has a variable effect on EORB, 75.0% of eyes with EORB had residual viable tumour tissue when enucleated after receiving neoadjuvant chemotherapy.
    15  Improvement of visual acuity in children with anisometropic amblyopia treated with rotated prisms combined with near activity
    Chao-Chyun Lin Po-Liang Chen
    2013, 6(4):487-491. DOI: 10.3980/j.issn.2222-3959.2013.04.15
    [Abstract](2338) [HTML](0) [PDF 1.80 M](1089)
    Abstract:
    AIM: To evaluate the efficacy of a new modality for improving visual acuity (VA) in pediatric patients with anisometropic amblyopia.METHODS: Retrospective and interventional case series. Medical records of 360 children with anisometropic amblyopia treated with a modality that included rotated prisms, lenses, and near activities from January 2008 to January 2012 were analyzed. Characteristics such as improvement of VA and contrast sensitivity in amblyopic eyes and resolution of amblyopia (VA≤0.1logMAR or a difference of ≤2 lines in logMAR between the eyes) were assessed.RESULTS: Among the patients, the mean VA of the amblyopic eyes improved from 0.48logMAR (SD=0.16) to 0.12logMAR (SD=0.16) and the mean VA improvement was 0.36logMAR (SD=0.10, P<0.001). Resolution of amblyopia was achieved in 233 of 360 patients (64.72%). The mean time for resolution of amblyopia was 8.05 weeks (SD=4.83) or 14.14 sessions (SD=8.76). Among the study group, refraction error did not change significantly after treatment (P=0.437). We found that better baseline VA may be related to success and shorten the time to amblyopic resolution.CONCLUSION: VA and contrast sensitivity improved with rotated prisms, correcting lenses, and near activities in children with anisometropic amblyopia. The VA improvement by this modality was comparable to other methods. However, the time to resolution of amblyopia was shorter with this method than with other modalities. Rotated prisms combined with near acuity could provide an alternative treatment in children with anisometropic amblyopia who can’t tolerant traditional therapy method like patching.
    16  Effectivity of intraoperative adjustable suture technique in horizontal strabismus
    Ayse Gul Kocak Altintas Hasan Basri Arifoglu Inci Kocak Midillioglu Elif Damar Gungor Saban Simsek
    2013, 6(4):492-497. DOI: 10.3980/j.issn.2222-3959.2013.04.16
    [Abstract](1646) [HTML](0) [PDF 2.91 M](760)
    Abstract:
    AIM:To compare the long-term effectivity of intraoperative adjustable suture technique with traditional non-adjustable strabismus surgery.METHODS:Two hundred and thirty-three patients, who underwent strabismus surgery either with traditional procedures or one-stage intraoperative adjustable suture technique, were included in our long-term follow-up study. One hundred and eighteen patients were evaluated in traditional surgery group (TSG) and 115 who underwent adjustable suture were in the one-stage intraoperative adjustable surgery group (ASG). In this group 9 patients had paralytic strabismus and 16 had reoperations, 2 patients had restrictive strabismus related to thyroid eye disease. The mean follow up in the TSG was 26.2 months and it was 24.8 months in the ASG group.RESULTS:In patients with exotropia (XT) the mean correction of deviation for near fixation in ASG (32.4±13.2PD) and in TSG (26.4±8.2PD) were similar (P=0.112). The correction for distant fixation in ASG (33.2±11.4PD) and TSG (30.9±7.2PD) were not significantly different (P=0.321). In patients with esotropia (ET) even the mean correction of deviation for both near (31±12PD) and distant (30.6±12.8PD) fixations were higher in ASG than in TSG, for both near (28.27±14.2PD) and distant (28.9±12.9PD) fixations, the differences were not significant (P=0.346, 0.824 respectively). The overall success rate of XT patient was 78.9% in TSG and 78.78% in ASG, the difference was not significant (P=0.629). The success rates were 78.75% in TSG and 75.51% in ASG in ET patient, which was also not significantly different (P=0.821).CONCLUSION:Although patients in ASG had more complex deviation such as paralysis, reoperations and restrictive strabismus, success rates of this tecnique was as high as TSG which did not contain complicated deviation. One-stage intraoperative adjustable suture technique is a safe and effective method for cooperative patient who has complex deviation.
    17  Visual performance after conventional LASIK and wavefront-guided LASIK with iris-registration:results at 1 year
    Jing Zhang Yue-Hua Zhou Rui Li Lei Tian
    2013, 6(4):498-504. DOI: 10.3980/j.issn.2222-3959.2013.04.17
    [Abstract](2339) [HTML](0) [PDF 553.83 K](899)
    Abstract:
    AIM: To compare visual performance of wavefront-guided laser in situ keratomileusis (LASIK) with iris-registration (Wg-LASIK group) and conventional LASIK (LASIK group) one year after surgery and analyze the correlation between wavefront aberrations and visual performance.METHODS: Eight hundred and fifty-two myopic eyes of 430 patients were enrolled in this prospective study and divided into two groups:Wg-LASIK group (436 eyes) and LASIK group (416 eyes). A Wavescan Wavefront aberrometer was used to analyze Zernike coefficients and the root-mean-square (RMS) of higher order aberrations, and Optec 6500 visual function instrument was used to measure contrast sensitivity (CS) before and 3, 6, 12 months after surgery.RESULTS:The mean spherical equivalent (SE) in Wg-LASIK group was significantly better than those in LASIK group one year after surgery (P=0.024). Wg-LASIK eyes showed better CS values than LASIK eyes at all spatial frequencies with and without glare after surgery (P all<0.01). Moreover, the increase of higher RMS (RMSh), coma, RMS3, RMS4, RMS5 in Wg-LASIK group were significantly lower than those in LASIK group 1 year after surgery (P all<0.05). The increase of coma, spherical aberration (SA), RMS3 and RMS4 in Wg-LASIK and coma and RMS3 in LASIK group were negatively correlated with reduction of contrast sensitivity 1 year after surgery.
    18  Change in subfoveal choroidal thickness after argon laser panretinal photocoagulation
    Ga Eun Cho Hee Yun Cho Yun Taek Kim
    2013, 6(4):505-509. DOI: 10.3980/j.issn.2222-3959.2013.04.18
    [Abstract](1803) [HTML](0) [PDF 2.07 M](927)
    Abstract:
    AIM: To evaluate changes in subfoveal choroidal thickness (SFCT) and macular thickness as measured by enhanced depth imaging spectral-domain optical coherence tomography (EDI-OCT) after argon laser panretinal photocoagulation (PRP) in patients with severe diabetic retinopathy.METHODS:This prospective, comparative case series included 21 patients (28 eyes) with severe diabetic retinopathy. All patients underwent three sessions of PRP. The SFCT and macular thickness were measured using EDI-OCT at baseline and one week after completion of 3 sessions of PRP.RESULTS:SFCT before PRP was (318.1±96.5)μm and increased to (349.9±108.3)μm (P=0.001) after PRP. Macular thickness significantly increased at one week after PRP (from 273.1±23.9μm at baseline vs 295.8±25.3μm at one week; P<0.001). No significant relationship between the changes in macular thickness and SFCT was observed (r=-0.13, P=0.52).CONCLUSION: PRP induced increases in both SFCT and macular thickness. Changes in SFCT did not correlate with changes in macular thickness.
    19  Comparison of anterior segment measurements using rotating Scheimpflug imaging and partial coherence interferometry
    Mohammad Soleimani Hassan Hashemi Shiva Mehravaran Mehdi Khabazkhoob Mohammad Hassan Emamian Mohammad Shariati Akbar Fotouhi
    2013, 6(4):510-514. DOI: 10.3980/j.issn.2222-3959.2013.04.19
    [Abstract](1766) [HTML](0) [PDF 403.73 K](1022)
    Abstract:
    METHODS:As part of the first phase of Shahroud Eye Cohort Study with 5 190 subjects of 40 to 64 years of age, CCT and ACD were measured using Scheimpflug imaging with the Pentacam (Oculus, Inc., Lynnwood, WA, USA) and partial coherence interferometry with the Allegro BioGraph (Wavelight, Erlangen, Germany).RESULTS:After applying exclusion criteria, we had data of 4 387 subjects with a mean age of 50.7±6.2 years. Mean CCT with Pentacam and BioGraph were 528.6±33.2μm and 525.6±32μm respectively; the difference was statistically significant (P<0.001), but the correlation was high (R=0.920). Mean ACD measurements using Pentacam and BioGraph were 2.68±0.35mm and 2.62±0.33mm respectively; the inter-device difference was significant (P<0.001) with high correlation (R=0.944). The 95% limits of agreements between devices were -22.65μm to 28.61μm and -0.16mm to 0.29mm for CCT and ACD measurements, respectively.CONCLUSION:For both CCT and ACD, the BioGraph gave significantly lower values than the Pentacam (P<0.05). Despite the high inter-device correlation, the 95% limits of agreements were wide, and this may limit their interchangeability in measuring the CCT and ACD.
    20  Ultrasound biomicroscopic evaluation of anterior segment cysts as a risk factor for ocular hypertension and closure angle glaucoma
    Abdurrahim Dusak Mehmet Baykara Guven Ozkaya Cuneyt Erdogan Hikmet Ozcetin Ercan Tuncel
    2013, 6(4):515-520. DOI: 10.3980/j.issn.2222-3959.2013.04.20
    [Abstract](1999) [HTML](0) [PDF 2.37 M](951)
    Abstract:
    AIM:To investigate the relationship between the ultrasound biomicroscopic (UBM) features of anterior-segment cysts (ASCs) and increased intraocular pressure (IOP) as a risk factor for closed-angle glaucoma (CAG).METHODS:Totally 24 eyes with recently diagnosed ASCs were divided into two groups . First group with ASC and ocular normotension (n=13), second group with ASC and ocular hypertension (n=11). An ophthalmologic examination, including tonometry, slit-lamp biomicroscopy (SLBM), gonioscopy, fundoscopy, pentacam, and UBM, was performed. The features of the ASCs were compared with the IOP.RESULTS:ASCs were accurately diagnosed and delineated in 24 eyes using UBM. IOP was elevated in those ASCs with a secondary aetiology (P=0.027), iridociliary location (P=0.006), deformed shape (P=0.013), increased size (P=0.001) and elongated pupillary aperture (P=0.009). However, the count (P=0.343) of ASCs, anterior chamber depth (ACD; P=0.22) and axial lenght (AL; P=0.31) were not associated with ocular hypertension. Correlations were found between the IOP and ASC size (r=-0.712; P=0.003), anterior chamber angle (ACA; r=-0.985; P<0.001), angle opening area (AOA; r=0.885; P<0.001), angulation of iris (r=-0.776, P<0.001), and affected iris quadrant (r =-0.655, P=0.002).CONCLUSION:Ocular hypertension in some eyes with ASC might be associated with various mechanisms, including secondary aetiology, iridociliary location, deformed shape, increased size and elongated pupill, which can be determined by UBM.
    21  Measurements of anterior segment parameters using three different non-contact optical devices in keratoconus patients
    Ahmet Taylan Yazıcı Gökhan Pekel Ercüment Bozkurt Yusuf Yıldırım Evre Pekel Ahmet Demirok Ömer Faruk Yılmaz
    2013, 6(4):521-525. DOI: 10.3980/j.issn.2222-3959.2013.04.21
    [Abstract](1921) [HTML](0) [PDF 430.10 K](972)
    Abstract:
    AIM: To evaluate the measurements of anterior segment parameters using three different non-contact optical devices in keratoconus patients.METHODS:A hundred and one eyes of 55 keratoconus patients were enrolled in this study. The mean age was 26.2±8.9 years. The inclusion criteria were keratoconus stage I to III according to the Amsler-Krumeich keratoconus classification. All the measurements were done by the same operator, under the mesopic light condition and repeated with three different optical methods; Visante , Orbscan and Pentacam. The evaluated anterior segment parameters were anterior chamber depth (ACD), central and thinnest corneal thickness (CCT and TCT) and pupil diameter (PD).RESULTS: The mean CCT measured by Visante, Orbscan and Pentacam were as follows:462.0±48.1μm, 463.9±60.9μm, 476.5±45.3μm, respectively (P=0.873). The mean ACD values were 3.34±0.33mm, 3.26±0.33mm, 3.49±0.40mm, respectively (P=0.118). The mean PD measurements were 5.11±1.14mm, 4.80±0.85mm, 3.80±1.38mm, respectively (P<0.001). The mean TCT measurements of Visante, Orbscan and Pentacam were 437.9±48.2μm, 447.6±60.6μm and 459.9±44.0μm, respectively (P=0.214). The Visante and Orbscan measured CCT similarly, while Pentacam measured CCT thicker than the other two. The Visante measured TCT thinner than the other two devices. In ACD measurements, Orbscan was the one giving the lowest values. PD was measured differently by the devices.CONCLUSION: Although TCT, CCT and ACD measurements acquired by Visante, Orbscan and Pentacam in keratoconus patients are similar, PD measurements show large differences among the devices.
    22  Vitreo-retinal interface changes on optical coherence tomography in the fellow eyes of patients with macular hole
    Ajit Babu Majji Jay Kumar Chhablani Bupesh Bagga
    2013, 6(4):526-530. DOI: 10.3980/j.issn.2222-3959.2013.04.22
    [Abstract](1720) [HTML](0) [PDF 3.28 M](949)
    Abstract:
    AIM: To study the vitreo-retinal interface and macular changes on optical coherence tomography (OCT) in the fellow eyes of patients with macular hole.METHODS: Patients with idiopathic macular hole in one or both eyes presented to our institute between January 2003 and December 2009 were evaluated retrospectively. Demographic details, best-corrected visual acuity and vitreo-retinal interface, and macular changes of the fellow eye on OCT were studied.RESULTS: Seventy patients underwent OCT of both eyes during the study period. The average age group was 61.96 years and 35 (50%) were females. Among the fellow eyes, normal foveal contour was noted in 36 (51.4%) eyes and 34 (48.6%) eyes were observed to have vitreo-retinal interface changes. Of them, 13 (18.6%) eyes had some stage of full thickness macular hole and 21 (30.0%) eyes had interface changes. There was no statistical correlation between involved eye lesions (P=0.64) or visual acuity (P=0.55) as predictors of development of either fellow eye lesions or poor visual acuity.CONCLUSION:There is a significant chance of having vitreo-retinal interface findings in the fellow eyes of patients presenting with macular hole. OCT should be considered in both eyes of patients with macular hole to detect early changes in the fellow eyes, which may require an early intervention.
    23  Changes of total antioxidant capacity and total oxidant status of aqueous humor in diabetes patients and correlations with diabetic retinopathy
    Emrullah Beyazyıldız Ali Bülent Çankaya Esra Ergan Mustafa Alparslan Anayol Yasemin Özdamar Sevilay Sezer Mehmet Hakan Tırhış Pelin Yılmazbaş Faruk Öztürk
    2013, 6(4):531-536. DOI: 10.3980/j.issn.2222-3959.2013.04.23
    [Abstract](2545) [HTML](0) [PDF 323.46 K](897)
    Abstract:
    AIM:To measure changes of total oxidant status (TOS) and total antioxidant capacity (TAC) of aqueous humor (AH) in diabetic retinopathy (DR) patients, and to determine if there were any differences in TOS and TAC of AH in diabetic patients without retinopathy compared with non-diabetic patients. METHODS:One hundred and three eyes of 103 patients who were enrolled for cataract surgery were included in this study. Patients were grouped according to presence of diabetes and stage of DR. Prior to cataract surgery, 0.1mL to 0.2mL of AH was aspirated and analyzed for TAC and TOS level using a colorimetric method. RESULTS:TOS levels were highest among proliferative diabetic retinopathy (PDR) patients and lowest in patients with only cataracts. Results were statistically significant between all groups (P<0.05). Whereas result between diabetic without retinopathy patients and non-proliferative diabetic retinopathy (NPDR) patients was not statistically significant (P=0.757). TAC levels were highest in patients with only cataract and lowest among PDR patients and results were statistically significant between all groups (P<0.05). CONCLUSION:Aqueous humor TAC levels are low in diabetic patients and reduced further in DR patients, TOS levels are increased in diabetic patients and this is exacerbated in DR patients.
    24  Effects of phacoemulsification surgery on ocular hemodynamics
    Adem Turk Suleyman Mollamehmetoglu Halil Ibrahim Imamoglu Mehmet Kola Hidayet Erdol Nurettin Akyol
    2013, 6(4):537-541. DOI: 10.3980/j.issn.2222-3959.2013.04.24
    [Abstract](1918) [HTML](0) [PDF 557.78 K](884)
    Abstract:
    AIM: To evaluate the possible effects of phacoemulsification cataract surgery on ocular hemodynamics.METHODS:In this prospective study, intraocular pressure (IOP), pulsatile ocular blood flow (POBF), and ocular pulse amplitude (OPA) were measured pre-operatively (baseline) and at 1 week and 3 weeks postoperation in 52 eyes of 26 patients (mean age 63.15±10.25 years) scheduled for unilateral phacoemulsification cataract surgery with intraocular lens implantation. In all of the eyes, a blood flow analyzer (Paradigm DICON; Paradigm Medical Industries Inc.; USA) was used to obtain measurements of IOP, POBF, and OPA. The data obtained from operated eyes were compared statistically to untreated fellow phakic eyes of the patients.RESULTS: For operated eyes, the mean baseline IOP, POBF, and OPA values were 15.9±4.64mmHg, 17.41±4.84μL/s, and 2.91±1.12mmHg, respectively. The IOP, POBF, and OPA values were 17.19±4.34mmHg, 17.56±6.46μL/s, and 3.12±1.1mmHg, respectively, in the nonoperated control eyes. Statistically significant differences from baseline measurements were not observed 1 week and 3 weeks postoperation for the operated or nonoperated eyes. There were also no statistically significant differences in any measurements between the operated and nonoperated eyes in all the examination periods (P>0.05 for all).CONCLUSION: Uncomplicated phacoemulsification surgery does not affect ocular hemodynamics in normotensive eyes with cataracts.
    25  Ethambutol induced toxic optic neuropathy in HIV positive patients
    Hamzah Mustak Graeme Rogers Colin Cook
    2013, 6(4):542-545. DOI: 10.3980/j.issn.2222-3959.2013.04.25
    [Abstract](1998) [HTML](0) [PDF 199.04 K](918)
    Abstract:
    AIM:To determine whether HIV and the use of antiretroviral therapy is a risk factor for the development of ethambutol toxic optic neuropathy. To describe the clinical course of ethambutol toxic optic neuropathy in patients with HIV and to identify prognostic factors.METHODS: The case notes of 14 consecutive patients referred to the neuro-ophthalmology clinic were reviewed. Data regarding HIV status, antiretroviral therapy, visual function, ethambutol therapy dosage, and ethambutol therapy duration were collected and analysed.RESULTS: Eleven of the 14 patients were HIV positive. Ten of the HIV positive patients were receiving antiretroviral therapy. The mean dose of ethambutol was 17.25mg/kg/day. No statistically significant difference in mean dose, duration of therapy, age or CD4 count was found between those who showed visual improvement and those who did not. Delay in presentation of more than one month post symptom onset was correlated with poor visual outcome (P=0.001).CONCLUSION:HIV and, perhaps more importantly, the potential mitochondrial toxic effects of Nucleoside analogue reverse transcriptase inhibitors (NRTIs) may be a risk factor for the development of toxic optic neuropathy from ethambutol therapy via a multiple hit effect. Delay in presentation results in poor visual outcome. Regular monitoring is recommended for HIV positive patients receiving antiretrovirals and requiring ethambutol therapy in order to avoid permanent visual loss.
    26  Intravitreal triamcinolone versus intravitreal bevacizumab for diabetic macular edema:a meta-analysis
    Xiao-Ling Zhang Jian Chen Ri-Jia Zhang Wen-Jie Wang Qing Zhou Xiao-Yan Qin
    2013, 6(4):546-552. DOI: 10.3980/j.issn.2222-3959.2013.04.26
    [Abstract](2400) [HTML](0) [PDF 3.58 M](931)
    Abstract:
    AIM: To compare the efficacy of the sole intravitreal triamcinolone (IVT) versus intravitreal bevacizumab (IVB) alone or IVB combined with IVT in the treatment of diabetic macular edema (DME).METHODS: Pertinent publications were identified through systematic searches of database and manually searching. Methodological quality of the literatures was valuated according to the Jadad Score. RevMan 5.1.0 was used to do the meta-analysis. Heterogeneity was determined and sensitivity was conducted.RESULTS: Six studies were ultimately included in the meta-analysis. The results of our analysis showed IVT had a statistically significant improvement in vision over the IVB at 1 month and 3 months (P<0.01=. However, the reduction was not significant regarding central macular thickness (CMT) during the earlier (1 month and 3 months) follow-up period (P=0.12, P=0.41, respectively). At later visit (6 months), IVT had a significant decrease in CMT when compared to IVB (P<0.01) while no significant improvement in visual acuity (VA) was observed (P=0.14). The incidence of intraocular hypertension was 13/102 in IVT group during follow-up period while 0/103 in IVB group. The difference was significant (P<0.01). With regards to IVT versus IVB combined with IVT, there were no significant differences in CMT at 1 month (P=0.86) and 3 months (P=0.06). The incidence of intraocular hypertension was 6/67 in IVT group during follow-up period while 4/66 in IVB+IVT group. But the difference was not significant (P=0.53).CONCLUSION:Current evidence shows IVT is superior in improving VA at earlier follow-up (1 month and 3 months) and in reducing CMT at later follow-up (6 months) for DME. At other time, it is in favor of IVT treatment but there are no statistically significances. However, IVT has the side-effect of ocular hypertension. There is no adequate evidence of the benefit adding IVB to IVT in contrast to IVT alone.
    27  Electron microscopic investigation of anterior lens capsule in an individual with true exfoliation
    Xing-Chao Shentu Ya-Nan Zhu Ying-Hui Gao Su-Juan Zhao Ye-Lei Tang
    2013, 6(4):553-556. DOI: 10.3980/j.issn.2222-3959.2013.04.27
    [Abstract](1727) [HTML](0) [PDF 2.34 M](852)
    Abstract:
    AIM: To determine the changes which occur in the anterior capsule in true exfoliation which is a very rare condition.METHODS: The anterior capsule from a 93 year-old patient and 6 other patients with age-related cataract during capsulorhexis was examined via transmission electron microscopy (TEM).RESULTS: TEM revealed apoptosis of lens epithelial cells in both two groups. Moreover, we observed lamellar delamination, granular belts in the anterior capsular zone and loss of the subcapsular epithelium cells in the posterior capsular zone, as well as abnormal fibrils located in the central capsular layer only in the sample from the patient with true exfoliation.CONCLUSION:We suggest that loss of lens epithelial cells and appearance of abnormal fibrils is important in disease developing, and our study supported age-related degeneration is one of causative factors in true exfoliation.
    28  Ocular leech infestation initially misdiagnosed as conjunctival pigmented nevus
    Wen-Wei Li Ting Shen Jin Jiang
    2013, 6(4):557-558. DOI: 10.3980/j.issn.2222-3959.2013.04.28
    [Abstract](2046) [HTML](0) [PDF 1.78 M](944)
    Abstract:

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

    Established in April, 2008

    ISSN 2222-3959 print

    ISSN 2227-4898 online

    Press search
    Search term
    From To
    • Most Read
    • Most Cited
    • Article Ranking