Volume 6,Issue 6,2013 Table of Contents

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  • 1  A novel Norrie disease pseudoglioma gene mutation, c.-1_2delAAT, responsible for Norrie disease in a Chinese family
    Xin-Yu Zhang Wei-Ying Jiang Lu-Ming Chen Su-Qin Chen
    2013, 6(6):739-743. DOI: 10.3980/j.issn.2222-3959.2013.06.01
    [Abstract](2166) [HTML](0) [PDF 2.21 M](776)
    Abstract:
    AIM:To investigate the genetic findings and phenotypic characteristics of a Chinese family with Norrie disease (ND).METHODS:Molecular genetic analysis and clinical examinations were performed on a Chinese family with ND. Mutations in the Norrie disease pseudoglioma (NDP) gene were detected by direct sequencing. Haplotypes were constructed and compared with the phenotypes in the family. Evolutionary comparisons and mutant open reading frame (ORF) prediction were also undertaken.RESULTS:Two family members with ocular manifestations were diagnosed with ND. No signs of sensorineural hearing loss were observed in either patient, while one of them showed signs of mild mental retardation. A novel heterozygous mutation in the NDP gene, c.-1_2delAAT, was detected in both patients. The mutation and the mutation bearing haplotype co-segregated with the ND phenotype in males and was transmitted from their mothers and/or grandmothers (II:2). The male without ND did not harbor the mutation. The mutation occurred at the highly conserved nucleotides. ORF finder predicted that the mutation would lead to the production of a truncated protein that lacks the first 11 N-terminal amino acids.CONCLUSION:A novel mutation, c.-1_2delAAT in the NDP gene, was identified in a Chinese family with ND. This mutation caused ND without obvious sensorineural hearing loss. Mental disorder was found in one but not the other patients. The clinical heterogeneity in the family indicated that other genetic variants and epigenetic factors may also play a role in the disease presentation.
    2  Protective effect of basic fibroblast growth factor on laser induced retinopathy
    Unal Kartal Emel Koptagel H. Eray Bulut Haydar Erdogan
    2013, 6(6):744-751. DOI: 10.3980/j.issn.2222-3959.2013.06.02
    [Abstract](1598) [HTML](0) [PDF 6.33 M](728)
    Abstract:
    AIM:To investigate the side effects of the commonly used laser treatment along with testing the neuroprotective effect of bFGF on a potential retinal impairment.METHODS: To do this, 30 chinchilla pigmented adult male rabbits were divided into the control and experimental groups. The control and experimental groups underwent both laser application and bFGF treatment. The retinal tissue impairment and its renewal rate were tested under the light and electron microscopical levels.RESULTS:The focal laser application on rabbit eyes caused morphological alterations both in the application region and in the neighbouring areas. In the damaged areas, the outer nuclear layer of the neural retina was almost disappeared, retina pigment epithelium was interrupted, the retina pigment epithelium migrated intraretinally, and the damaged region along with neighbouring areas seemed to be not separated. bFGF application just after the laser photocoagulation, revealed better results in application areas.CONCLUSION:It could be suggested that the bFGF application following laser photocoagulation might have protective, repairing and wound healing effects on the retina.
    3  Effects of transforming growth factor β2 and connective tissue growth factor on induction of epithelial mesenchymal transition and extracellular matrix synthesis in human lens epithelial cells
    Cheng Pei Bo Ma Qian-Yan Kang Li Qin Li-JunCui
    2013, 6(6):752-757. DOI: 10.3980/j.issn.2222-3959.2013.06.03
    [Abstract](1606) [HTML](0) [PDF 1.50 M](674)
    Abstract:
    AIM:To investigate the effects of transforming growth factorβ2 (TGF-β2) and connective tissue growth factor (CTGF) on transdifferentiation of human lens epithelial cells (HLECs) cultured in vitro and synthesis of extracellular matrix (ECM).METHODS:HLECs were treated with TGF-β2 (0, 0.5, 1.0, 5, 10μg/L) and CTGF (0, 15, 30, 60, 100μg/L) for different times (0, 24, 48, 72h) in vitro and the expression of α-smooth muscle actin (α-SMA), the main component of the extracellular matrix type I collagen (Col-1) and fibronectin (Fn) were measured by using real-time polymerase chain reaction (PCR) and western-blot.RESULTS: TGF-β2 and CTGF significantly increased expression of α-SMA mRNA and protein (P<0.05, P<0.001), Fn mRNA and protein (P<0.001), Col-1 mRNA and protein (P<0.001). TGF-β2 could induce HLECs expression of CTGF mRNA and protein in dose-dependent manner (P<0.05, P<0.001). TGF-β2 and CTGF could induce HLECs to express α-SMA, Fn and Col-1 in time-dependent manner. Each time of TGF-β2 and CTGF induced HELCs expression of α-SMA, Fn, Col-1 mRNA and protein was significant increase compared with control (P<0.05, P<0.001).CONCLUSION: TGF-β2 and CTGF could induce HLECs epithelial mesenchymal transition and ECM synthesis.
    4  Using bovine pituitary extract to increase proliferation of keratocytes and maintain their phenotype in vitro
    Zhong-Zhong Xu Zhi-Jie Li Lian-Xin Du Jing Li Li-Ya Wang
    2013, 6(6):758-765. DOI: 10.3980/j.issn.2222-3959.2013.06.04
    [Abstract](1761) [HTML](0) [PDF 3.89 M](735)
    Abstract:
    AIM: To investigate the effects of bovine pituitary extract on the proliferation of keratocytes and maintaining the keratocyte phenotype in vitro.METHODS: Single keratocytes were isolated by enzyme digestion for in vitro culture. Three groups were designed according to the different culture media:a bovine pituitary extract (BPE) group, a fetal bovine serum (FBS) group and the control group. The phenotypes and proliferation of cultured cells were evaluated by morphology, immunofluorescent staining and mRNA expression of CD34, Lumican, VSX1, α-SMA and proliferating cell nuclear antigen (PCNA). In the BPE group, cells underwent serial subcultivation, and their phenotypes were identified by immunofluorescent staining. To analyze the proliferation of keratocytesin differentconcentrations of BPE, six differentconcentrations were designed to ascertain the most appropriate amount.RESULTS: In the BPE group, the cells spread out and presented dendritic morphology, and their dendrites connected to one another to form networks. On the third passage, most cells maintained their phenotype. In the FBS group, the cells exhibited a dendritic appearance in early cultured stages, but their morphology subsequently changed into a fibroblast-like shape. The number of dendritic cells in BPE group was more than FBS and control groups. Immunofluorescent staining and real-time polymerase chain reaction (PCR) confirmed that few keratocytes underwent fibroblastic transformation in the BPE and control groups, and that proliferation was higher in the BPE group than in the control group. Although the proliferation was higher in the FBS group, many keratocytes underwent fibroblastic transformation.Theanalysis of cell morphology and mRNA expressions of CD34, PCNA and VSX1 in six group showed that different concentrations of BPE affected the proliferation obviously but didn’t affect the keratocyte phenotype, and the concentration of 40μg/mL was the most appropriate one.CONCLUSION: BPE can improve the proliferation of keratocytes and maintain their phenotype in vitro. Many keratocytes can be harvested rapidly and provide seeds for the construction of corneal stroma.
    5  Local anesthetic lidocaine induces apoptosis in human corneal stromal cells in vitro
    Xin Zhou Yi-Han Li Hao-Ze Yu Rui-Xin Wang Ting-Jun Fan
    2013, 6(6):766-771. DOI: 10.3980/j.issn.2222-3959.2013.06.05
    [Abstract](2294) [HTML](0) [PDF 5.81 M](673)
    Abstract:
    AIM: To demonstrate the apoptosis-inducing effect of lidocaine on human corneal stromal (HCS) cells in vitro, and provide experimental basis for safety anesthetic usage in clinic of ophthalmology.METHODS: In vitro cultured HCS cells were treated with lidocaine at different doses and times, and their morphology was monitored successively with inverted phase contrast microscopy. The membrane permeability of them was detected by acridine orange/ethidium bromide (AO/EB) double staining. The DNA fragmentation of them was examined by agarose gel electrophoresis, and their ultrastructure was observed by transmission electron microscopy (TEM), respectively.RESULTS: Exposure to lidocaine at doses from 0.3125g/L to 20g/L induced morphological changes of HCS cells such as cytoplasmic vacuolation, cellular shrinkage, and turning round, and elevated membrane permeability of these cells in AO/EB staining. The change of morphology and membrane permeability was dose- and time-dependent, while lidocaine at dose below 0.15625g/L could not induce these changes. Furthermore, lidocaine induced DNA fragmentation and ultrastructural changes such as cytoplasmic vacuolation, structural disorganization, chromatin condensation, and apoptotic body appearance of the cells.CONCLUSION: Lidocaine has significant cytotoxicity on human corneal stromal cells in vitro in a dose- and time-dependent manner by inducing apoptosis of these cells. The established experimental model and findings based on this model here help provide new insight into the apoptosis-inducing effect of local anesthetics in eye clinic.
    6  Acetylcholinesterase function in apoptotic retina pigment epithelial cells induced by H2O2
    Li Cai Hong-Fei Liao Xue-Jun Zhang Yi Shao Man Xu Jing-Lin Yi
    2013, 6(6):772-777. DOI: 10.3980/j.issn.2222-3959.2013.06.06
    [Abstract](1643) [HTML](0) [PDF 1.37 M](746)
    Abstract:
    AIM:To investigate the acetylcholinesterase (AChE) expression involved in retina pigment epithelial (RPE) apoptosis induced by higher concentrations H2O2.METHODS:The human retinal pigment epithelium cell line ARPE-19 was from ATCC (Rockville, MD). Cultured ARPE-19 cells were treated with H2O2 at 0, 250, 500, 1 000, 2 000μmol/L and cell viability was measured with MTT assay. AChE expression and DNA fragments were analyzed by immunocytochemistry, TUNEL and PARP-1 Western blotting.RESULTS:Immunofluorescence detected AChE exist in the normal human retinal tissue. When H2O2 >500μmol/L, AChE expression showed an increase after 2h, and this concentration was selected for the present study. RPE cell was induced with 1 000μmol/L H2O2 for 2h, compared to the control group, cell activity decline detected by MTT, AChE and PARP-1 protein expression was significantly increased detected by Western blotting. AChE immunofluorescence staining was positive in RPE cell after H2O2 incubate 2h. In addition, pretreatment with 100μmol/L epigallocatechin gallate (EGCG), cell viability increased from 31.20%±3.90% to 70.23%±12.96%.CONCLUSION:AChE is weakly expressed in normal human RPE cells. Stimulation with H2O2 caused the stable increase of AChE expression in RPE cells, which may indicate that AChE may be an important role in AMD.
    7  Comparison of two methods used to culture and purify rat retinal Müller cells
    Wei-Tao Song Xue-Yong Zhang Si-Qi Xiong Dan Wen Jian Jiang Xiao-Bo Xia
    2013, 6(6):778-784. DOI: 10.3980/j.issn.2222-3959.2013.06.07
    [Abstract](1583) [HTML](0) [PDF 1.73 M](674)
    Abstract:
    AIM: To study two methods for culturing and purifying Sprague-Dawley (SD) rat retinal Müller cells and determine which one is better.METHODS: The passage culture method of Müller cells was respectively carried out by complete pancreatic enzyme digestion method and repeated incomplete pancreatic enzyme digestion method. After culturing retinal cells for one month through these two methods, fluorescence-activated cell sorter (FACS), RT-PCR, and immunohistochemistry technology were performed to examine the enrichment and purity of Müller glial cells, and carried out two-sample approximate t test using SSPS 13.0 to further compare the Müller cell positive rate in both methods.CONCLUSION:Compared with the complete pancreatic enzyme digestion method, this novel method was more efficient and a higher purity of Müller cells could be obtained using this approach.
    8  Short term apoptotic activity of intravitreal bevacizumab on rabbit retina
    Fatih Mehmet Türkcü Mehmet Numan Alp Gül Türkcü Sezer Kulaçoğlu Gülcan Kural
    2013, 6(6):785-789. DOI: 10.3980/j.issn.2222-3959.2013.06.08
    [Abstract](1494) [HTML](0) [PDF 1.10 M](698)
    Abstract:
    AIM: To evaluate the safety and the short term apoptotic activity of intravitreal bevacizumab in rabbit eyes by histopathological analysis.METHODS:Twenty-eight eyes of 14 rabbits were divided into three groups:8 rabbits in group 1 and 3 rabbits in each of group 2 and group 3. Intravitreal bevacizumab (1.25mg/0.05mL) was applied to the right eyes of each subject in group 1 and group 2 (11 eyes) and the same volume of saline was applied to the left eyes of each subject in group 1 and group 3 (11 eyes). The left eyes in group 2 and the right eyes in group 3 were left untreated and used as control. Enucleated eyes were used for histopathologic analyses.RESULTS:After immunohistochemical staining with caspase-3 and p53, there was no histological evidence of toxicity to the retina and the optic nerve in any of the sections that were analyzed in all three groups. In addition, vascular endothelial cells located at the retina and the optic nerve tissues in all groups showed a similar staining pattern with caspase-3 and p53.CONCLUSION:Our study showed that intravitreal bevacizumab with the dose of 1.25mg/0.05mL caused no histological signs of toxicity or apoptotic activity on the rabbit retina.
    9  Safety of intravitreal triamcinolone acetonide:an electrophysiologic and histopathological study in rabbits
    Laila Hassan M. El-Shazly Amal Ahmad El-Gohary Ghada Ghanem El-Hossary
    2013, 6(6):790-795. DOI: 10.3980/j.issn.2222-3959.2013.06.09
    [Abstract](1673) [HTML](0) [PDF 2.28 M](660)
    Abstract:
    AIM: To evaluate the retinal safety of various doses of intravitreal triamcinolone acetonide (TA) in rabbits.Methods: Thirty New Zealand albino rabbits were divided into five groups (six animals each). In group 1 (control group), each animal received a single intravitreal injection of 0.1mL phosphate buffered saline. In groups 2, 3, 4 and 5, each rabbit received a single intravitreal injection of 4, 8, 16 and 32mg of TA, respectively. Each dose was contained in 0.1mL phosphate buffered saline. Clinical ocular examinations were performed before the injection and on the 1st, 3rd, 10th and 17th post-injection days. A standard dark adapted electroretinogram (ERG) was obtained before injection and on the 3rd, 10th and 17th post-injection days. After 17d, animals were sacrificed and their eyes prepared for pathological examination.RESULTS:By monitoring ERG as a functional index for the retina, intravitreal injection of 4mg TA showed no significant ERG changes. At doses of 8, 16 and 32, hyper-abnormal responses in a- and b- waves of ERG were detected on the 3rd post-injection day. These changes gradually returned back to normal limits after 17d. Histopathological examination of the retina of all animals showed no pathological changes.CONCLUSION: High doses of intravitreal TA seemed to have enhancing effects on the retinal function with gradual return to normal limits with no pathological changes detected in examined eyes.
    10  Clinical outcomes after intrastromal corneal ring segments reoperation in keratoconus patients
    Leonardo Torquetti Guilherme Ferrara Franklin Almeida Leandro Cunha Paulo Ferrara Jesús Merayo-Lloves
    2013, 6(6):796-800. DOI: 10.3980/j.issn.2222-3959.2013.06.10
    [Abstract](1670) [HTML](0) [PDF 259.38 K](606)
    Abstract:
    AIM:To evaluate the clinical outcomes after Ferrara intrastromal corneal ring segments (ICRS) reoperation in patients with keratoconus.RESULTS: The mean follow-up time after the reoperation was 30.5±9.7 months. The mean UCVA improved from 20/300 to 20/80 (P=0.005); the mean BCVA improved from 20/160 to 20/50 (P=0.0002), the mean keratometry reduced from 49.33±4.19D to 46.16±3.90D (P=0.0001), the mean pachymetry at the thinnest point increased from 450±42.9mm to 469±40.8mm (P=0.0001). The asphericity increased from -0.84±0.74 to -0.35±0.81 (P=0.15) and the spherical equivalent reduced from -4.64±4.87D to -3.04±3.45D (P=0.137). The changes in the asphericity and spherical equivalent were not statistically significant.CONCLUSION: Ferrara ICRS implantation showed to be a reversible and readjustable surgical procedure for keratoconus treatment. Good outcomes can be obtained even after removal, addition, reposition or exchange of ICRS.
    11  Comparative study measuring the dilatory effect of a mydriatic device (Mydriasert?) versus topical drops
    Manuel Saenz-de-Viteri Patricia Fernández-Robredo Elisa de Nova Elvira Bonet-Farriol Alfonso L. Sabater Javier Zarranz-Ventura Josemaria Caire Luis M. Sádaba Angel Salinas-Alamán Alfredo García-Layana
    2013, 6(6):801-804. DOI: 10.3980/j.issn.2222-3959.2013.06.11
    [Abstract](2596) [HTML](0) [PDF 257.62 K](723)
    Abstract:
    AIM: To compare the mydriatic efficacy of an ophthalmic insert (Mydriasert, MY) versus phenylephrine and tropicamide (PT) eye drops.METHODS:Two controlled, prospective, randomized, single-blind studies were performed. In the first study, a total of 80 eyes from 40 outpatient-clinic patients were analyzed. PT drops were applied to the right eye, and a MY device was inserted in the left eye for 30min. Time until maximal pupil dilation for each eye was then assessed. In the second study, 80 eyes from 80 patients undergoing cataract surgery were analyzed. Pupil dilation was achieved using either PT drops three-times for one hour prior to surgery (40 patients), or a MY device was inserted one hour prior to surgery (40 patients).RESULTS: In the first study, MY achieved superior mydriasis compared to PT eye drops at 90min (9.04±1.33mm vs 8.78±1.37mm, P=0.012). However MY took longer than PT drops to achieve maximal dilation, and mydriasis was inferior in eyes with MY compared to PT drops at 30min (7.21±1.73mm vs 8.22±1.43mm, P<0.001), the two groups only becoming similar by 60min (8.85±1.44mm vs 8.71±1.27mm, P=0.236). In the second study, both MY and PT achieved similar levels of mydriasis at the beginning of surgery (8.75±0.76mm with MY vs 8.77±0.63mm with PT), and also at the end of surgery (7.96±1.06mm with MY vs 8.32±0.72mm with PT), with no significant difference between groups (P=0.08). MY was well tolerated and cardiovascular effects were not influenced by dilation method.CONLUSION: MY could be a safe and efficacious alternative for mydriasis. The mydriatic effect of MY is as good as conventional PT eye drops after 60min, and is superior after 90min. MY also maintains good pupil dilation during cataract surgery.
    12  Relationship between dietary macronutrient intake and the risk of age-related cataract in middle-aged and elderly patients in northeast China
    Zhi-Quan Lu Jia Yan Wen-Hui Sun Teng-Xuan Jiang Shu-Na Zhai Yan Li Guang-Dong Gao
    2013, 6(6):805-810. DOI: 10.3980/j.issn.2222-3959.2013.06.12
    [Abstract](1781) [HTML](0) [PDF 360.14 K](745)
    Abstract:
    AIM: To examine the association between dietary macronutrient intake and the risk of age-related cataract (ARC) in middle-aged and elderly men.METHODS:A hospital-based case-control study was conducted from December 2009 to November 2011. Cases (n=360) were patients with cataract aged 45-85 years old, and controls (n=360) were patients who had been admitted to the same hospital for diseases not related with cataract. All subjects were interviewed using a structured interviewer-administrated questionnaire that included information on socio-demographic characteristics, lifestyle habits and detailed medical history, simultaneously, the dietary intakes of nutrients were collected via a valid semi-quantitative food frequency questionnaire (FFQ). The odds ratios (OR) and corresponding 95% confidence intervals (CI) of three types of ARC were estimated using multiple logistic regression models.RESULTS: After adjusting for multiple potential confounders, total dietary intake of carbohydrate was positively associated with cortical cataract, compared to controls in the lowest quartile, and the OR for cases in the highest quartile of intake was 2.471 (95%CI:1.348-6.043, P=0.027). Higher dietary intakes of protein were protective for posterior subcapsular cataract (PSC) (OR=0.528, 95%CI:0.148-0.869, P=0.023). Dietary fat intake was not associated with any type of cataract, however, participants in the highest quartile of polyunsaturated fatty acids intake had 2.7 times the risk of nuclear cataract as did those in the lowest quartile (OR=2.742, 95%CI:1.790-4.200, P=0.033).CONCLUSION: A high intake of carbohydrate and polyunsaturated fatty acid may increase the odds of cortical and nuclear cataract, respectively, whereas high intake of protein, especially animal protein, may protect against PSC cataract. It is possible that dietary changes of target population may reduce the risk of ARC.
    13  A randomized controlled trial of omega-3 fatty acids in dry eye syndrome
    Rahul Bhargava Prachi Kumar Manjushrii Kumar Namrata Mehra Anurag Mishra
    2013, 6(6):811-816. DOI: 10.3980/j.issn.2222-3959.2013.06.13
    [Abstract](4577) [HTML](0) [PDF 569.53 K](894)
    Abstract:
    AIM: To evaluate the role of dietary supplementation of omega-3 fatty acids in dry eye syndrome.METHODS: A prospective, interventional, placebo controlled, double blind randomized trial was done at two referral eye centers. Two hundred and sixty-four eyes of patients with dry eye were randomized to receive one capsule (500mg) two times a day containing 325mg EPA and 175mg DHA for 3 months (omega-3 group). The omega-3 group was compared to a group of patients (n=254) who received a placebo (placebo group). There were 4 patient visits (at baseline, 1 month, 2 months and 3 months). On each visit, recording of corrected distance visual acuity (CDVA), slit lamp examination and questionnaire based symptom evaluation and scoring was done. A symptomatic score of 0-6 was mild, 6.1-12 moderate and 12.1-18 severe dry eye. Response to intervention was monitored by routine tear function tests like Schirmer I test, tear film break-up time (TBUT), Rose Bengal staining and most notably, conjunctival impression cytology.RESULTS: Sixty-five percent of patients in the omega-3 group and 33% of patients in placebo group had significant improvement in symptoms at 3 months (P=0.005). There was a significant change in both Schirmer’s test value and TBUT values in the omega-3 group (P<0.001), both comparisons. However, there was a larger drift in TBUT values in omega-3 than the placebo group, in comparison to Schirmer’s test values. The mean TBUT score was 2.54±2.34 in the omega-3 group and 0.13±0.16 in placebo group, respectively. The mean reduction in symptom score in omega-3 group was 2.02±0.96 as compared to 0.48±0.22 in placebo group (P<0.001). Despite a slight increase mean score, the Schirmer scores did not correlate well with symptomatic improvement.CONCLUSION: Omega-3 fatty acids have a definite role for dry eye syndrome. The benefit seems to be more marked in conditions such as blepharitis and meibomian gland disease. The role of omega fatty acids in tear production and secretion needs further evaluation.
    14  Pathological, immunohistochemical and microbiologicalal analysis of lacrimal sac biopsies in patients with chronic dacrocystitis
    Rowayda Mahmoud Amin Faten Aly Hussein Hisham Farouk Idriss Nesrine Fathy Hanafy Dina Mohamed Abdallah
    2013, 6(6):817-826. DOI: 10.3980/j.issn.2222-3959.2013.06.14
    [Abstract](1792) [HTML](0) [PDF 2.46 M](729)
    Abstract:
    AIM:To analyze cases of obstruction of the nasolacrimal duct which creates a fertile environment for secondary bacterial infection and can result in dacryocystitis,which is a constant threat to cornea and orbital soft tissue and a potential source of endophthalmitis following intraocular surgery. The majority of obstructions of the lacrimal excretory outflow system are acquired ones occurring in adulthood and involving the distal parts of the system. Acquired obstruction may be primary/idiopathic or secondary to a wide variety of infectious, inflammatory, traumatic, mechanical, toxic or neoplastic causes mimicking idiopathic inflammation. These cases are treated by dacryocystorhinostomy (DCR).METHODS:The present study was conducted to determine the histopathologic, immunohistochemical and current microbiologic characteristics of lacrimal sac specimens in patients undergoing external dacryocystorhinostomy.RESULTS:Non-specific lacrimal sac pathology was present in all 33 cases and 81.8% of the cases showed moderate chronic inflammation with a chronic inflammatory score (CIS) ranging between 4 and 6, whereas 12.12% showed severe inflammatory changes with a CIS of 7. Mild degree of inflammation was seen in 6.06% with a CIS of 3. The total prevalence of gram-positive, gram-negative, and culture-negative samples were 59.4%, 37.5%, and 3% respectively.CONCLUSION:Non-specific chronic inflammation with fibrosis is indeed the most commonly reported histopathological finding in lacrimal sac wall biopsy specimens.
    15  Apoptosis in the iris and trabecular meshwork of medically treated and untreated primary open angle glaucoma patients
    Zeynep Aktas Emine Esra Karaca Ipek Işik Gonul Murat Hasanreisoglu Merih Onol
    2013, 6(6):827-830. DOI: 10.3980/j.issn.2222-3959.2013.06.15
    [Abstract](1397) [HTML](0) [PDF 1.83 M](723)
    Abstract:
    AIM: To compare the trabecular meshwork (TM) and iris apoptosis of treated and untreated primary open angle glaucoma (POAG) patients.METHODS: Eight treatment-naive, newly diagnosed (group 1) and 11 medicaly treated (group 2) patients with POAG were included in the study. Each patient underwent a limbus-based trabeculectomy. The TM and peripheral iris specimens were dissected out and were snap-frozen in liquid nitrogen and stored at –80℃ until they were assayed. Apoptosis in each group was assesed by TUNEL method.RESULTS:The mean patient age was 60.6±5.8 years (53-68 years) vs 58.9±8.9 years (47-70 years) in group 1 and group 2 (P=0.859). The mean treatment time in group 2 was 22.2±7.3 months (12-34 months). Apoptotic indexes in TM and iris were significantly higher in POAG patients using medication (group 2) compared to treatment-naive POAG patients (group 1) (P=0.004, 0.015; respectively).CONCLUSION: Long term administration of topical antiglaucoma medications causes additional toxic effects on TM.
    16  Posterior chamber phakic intraocular lens implantation for high myopia
    Yan Ju Xiao-Wei Gao Bing Ren
    2013, 6(6):831-835. DOI: 10.3980/j.issn.2222-3959.2013.06.16
    [Abstract](1922) [HTML](0) [PDF 214.48 K](693)
    Abstract:
    AIM:To evaluate the efficacy, safety and stability of posterior chamber phakic intraocular lens implantation for the correction of high myopia.METHODS: Retrospective case review of 82 eyes (43 patients) undergoing implantable Collamer lens (ICL) placement by a single surgeon (Xiao-Wei Gao) to correct preoperative mean spherical equivalents between -9.00 diopter (D) and -23.00D. Main outcome measures included uncorrected visual acuity (UCVA), refraction, best spectacle-corrected visual acuity (BSCVA), endothelial cell density (ECD), intraocular pressure (IOP), lens transparency, postoperative uveitis. Visante anterior segment optical coherence tomography (AS-OCT) was used to measure anterior chamber depth (ACD) and the position of ICL.RESULTS:Mean follow-up was 6.54±3.26 months (range 3-12 months). Predictability of the manifest spherical equivalent (SE) refraction to within ±1.00D was achieved in 88% of eyes and ±0.50D in 72.5% of eyes. The mean postoperative manifest SE refraction was -1.85±0.72D, with 96.34% of eyes maintaining or gaining ≥1 line(s) of BSCVA. The mean 3-month postoperative ECD decreased but had no statistically difference compared with the preoperative ECD. Of the 7 eyes (8.54%) with a mild transient increase in intraocular pressure (up to 30mmHg), none required a second surgical procedure or prolonged topical medication. There was no loss of lens transparency. Pigmented precipitates were observed in 5 eyes (6.09%). The mean preoperative ACD measured with AS-OCT was 3.28±0.14mm, three months after surgery, the mean ACD was 2.45±0.22mm. Anterior chamber depth showed a statistically significant reduction. One eye (1.22%) had ICL spontaneous rotation, 81 eyes (98.78%) of the lens remained correctly centered.CONCLUSION: The implantation of ICL is an effective surgical option for the management of high myopia. But its long time effect and safety still need more time to prove.
    17  Importance of 3-D image reconstruction of spectral-domain OCT on outcome of grid laser photocoagulation for diffuse diabetic macular edema
    Avinoam Ophir Rana Hanna Michael R. Martinez
    2013, 6(6):836-843. DOI: 10.3980/j.issn.2222-3959.2013.06.17
    [Abstract](3902) [HTML](0) [PDF 1.88 M](687)
    Abstract:
    AIM:To present the outcome of modified grid laser photocoagulation (GLP) in diffuse diabetic macular edema (DDME) in eyes without extrafoveal and/or vitreofoveal traction. METHODS:Inclusion criteria for the retrospective study were DDME eyes of patients with type II diabetes mellitus that had ≥4 months of follow-up following GLP. Only one eye per patient was analyzed. Using 3-D spectral-domain optical coherence tomography (3-D SD-OCT), eyes that had either extrafoveal or vitreofoveal traction, or had been previously treated by an intravitreal medication(s) were excluded. Treated DDME eyes were divided into 4 groups:A) “Classic” DDME that involved the central macula; B) edema did not involve the macular center; C) eyes associated with central epiretinal membrane (ERM); D) DDME that was associated with macular capillary dropout ≥2 disc-diameter (DD). RESULTS:GLP outcome in 35 DDME eyes after 4-24 (mean, 13.1±6.9) months was as follows:Group A) 18 eyes with “classic” DDME. Following one or 2 (mean, 1.2) GLP treatments, best-corrected visual acuity (BCVA) improved by 1-2 Snellen lines in 44.4% (8/18) of eyes, and worsened by 1 line in 11.1% (2/18). Central macular thickness (CMT) improved by 7%-49% (mean, 26.6%) in 77.8% (14/18) of eyes. Causes of CMT worsening (n=4) were commonly explainable, predominantly (n=3) associated with emergence of extrafoveal traction, 5-9 months post-GLP. Group B) GLP(s) in DDME that did not involve the macular center (n=6) resulted in improved BCVA by 1-2 lines in 2 eyes. However, the central macula became involved in the edema process after the GLP in 3 (50%) eyes, associated with an emergence of extrafoveal traction in one of these eyes 4 months following the GLP. Group C) GLP failed in all 5 eyes associated with central ERM. Group D) GLP was of partial benefit in 2 of 6 treated eyes with macular capillary dropout ≥2DD. CONCLUSION:Eyes with DDME that involved the macular center were found to achieve favourable outcomes after GLP(s) during mid-term follow-up, unless complicated pre-GLP or post-GLP by vitreoretinal interface abnormalities, often extrafoveal traction or ERM, or by capillary dropout ≥2DD. Prospective studies with larger cohorts are required.
    18  A new specialized visual acuity chart for amblyopic children aged 3-5 years old:development and its clinical applications
    Yang-Qing Huang He Huang Rong-Zhi Huang
    2013, 6(6):844-850. DOI: 10.3980/j.issn.2222-3959.2013.06.18
    [Abstract](1751) [HTML](0) [PDF 769.56 K](874)
    Abstract:
    AIM: To introduce a new specialized visual acuity chart for amblyopic children aged 3-5 years old and its clinical applications.METHODS:The new visual acuity chart and notations were designed based on Weber-Fechner law. The optotypes were red against a white background and were specially shaped four basic geometric symbols:circle, square, triangle,and cross. A regular geometric progression of the optotype sizes and distribution was employed to arrange in 14 lines. The progression rate of the optotype size between two lines was 1.2589 and the testing distance was 3m. Visual acuity score could be recorded as logMAR notation or decimal notation. Age-stratified diagnostic criteria for amblyopia established by consensus statement on diagnosis of amblyopia (2011) among members of the Strabismus and Pediatric Ophthalmology Group, Ophthalmology Society, Chinese Medical Association (SPOGOSCMA) were illustrated in the new visual acuity chart.RESULTS: When assessing visual acuity in children aged 3-5 years old, this new visual acuity chart that consists of four symmetrical shapes (triangle, square, cross, and circle) overcame an inability to recognize the letters of the alphabet and difficulties in designating the direction of black abstract symbols such as the tumbling ‘E’ or Landolt ‘C’, which the subjects were prone to lose interest in. The visual acuity score may be recorded in different notations:decimal acuity and logMAR. These two notations can be easily converted each other in the new eye chart. The measurements of this new chart not only showed a significant correlation and a good consistency with the international standard logarithmic visual acuity chart (r=0.932, P<0.01), but also indicated a high test-retest reliability (89% of retest scores were within 0.1logMAR units of the initial test score).CONCLUSION: The results of this study support the validity and reliability of distance visual acuity measurements using the new eye chart in children aged 3 to 5 years over a wide range of visual acuities, and the new eye chart is great for early detection of amblyopia. It can be applied in various clinical settings.
    19  Effect of 1% brinzolamide and 0.5% timolol fixed combination on intraocular pressure after cataract surgery with phacoemulsification
    Kemal Örnek Nesrin Büyüktortop Nurgül Örnek Reyhan Oğurel İnci Elif Erbahçeci Zafer Onaran
    2013, 6(6):851-854. DOI: 10.3980/j.issn.2222-3959.2013.06.19
    [Abstract](1936) [HTML](0) [PDF 256.14 K](654)
    Abstract:
    AIM: To evaluate the effect of brinzolamide-timolol fixed combination on intraocular pressure (IOP) after cataract surgery.METHODS:The study included 92 eyes of 87 patients who underwent cataract surgery and intraocular lens implantation. Patients scheduled for phacoemulsification were assigned to 1 of 2 groups. The treatment group received 1 drop of brinzolamide-timolol fixed combination immediately after surgery, and the control group received no treatment. The IOP was measured preoperatively and at 2h and 24h postoperatively.RESULTS: The mean IOP change was lower in the treatment group than in the control group at 2h postoperatively. The difference between the mean IOP values of the two groups at 2h postoperatively was found to be statistically significant. Twenty-four hours after the surgery, the mean IOP change was still higher in the control group when compared to the treatment group.CONCLUSION: The fixed combination brinzolamide-timolol can effectively reduce IOP after cataract surgery.
    20  Epidemiological and clinical features of paediatric open globe injuries in southwestern Turkey
    Hatice Deniz Ilhan Ahmet Burak Bilgin Aslı Çetinkaya Mustafa Unal Iclal Yucel
    2013, 6(6):855-860. DOI: 10.3980/j.issn.2222-3959.2013.06.20
    [Abstract](1610) [HTML](0) [PDF 508.21 K](700)
    Abstract:
    AIM:To evaluate the epidemiologic, anatomic, and clinical features of open globe injuries in children.METHODS: The medical files of patients under the age of 16 who had been operated for an open globe injury at Akdeniz University Hospital’s Department of Ophthalmology were retrospectively evaluated.RESULTS: A total of 90 patients were evaluated in this study. Among these patients, 26 (28.9%) were female and 64 (71.1%) were male. The mean age of the patients was 7.7±4.2 years. The male/female ratio was observed to increase with increasing age (P=0.006, r=7.48). Injuries were most likely to occur in spring and autumn (P=0.028). The time interval between the injury and the surgical repair was 9.36±27.4h. Forty (44.4%) of the injuries occurred in the home, 27 (30%) occurred in the yard, and 21 (23.3%) happened while playing in the street. The most common causes of injury were sharp metal objects (P<0.001). Injury to the cornea occurred in 47 (52.2%) of the patients (P<0.001). The most common complication to occur was cataract formation. Additional operations were necessary for 37 (41.1%) of the patients. The final visual acuity was correlated with both the initial visual acuity of the wounded eye prior to surgery and the length of the wound (P<0.001, r=0.502 and P<0.001, r=-0.442, respectively).CONCLUSION:Open globe injuries that are suffered in childhood generally occur either at home, in the yard, or on the street, with sharp metal objects being the most common cause of injury. The initial visual acuity and the length of the wound are the most important determinants of the final visual acuity.
    21  Complement factor B polymorphism (rs641153) and susceptibility to age-related macular degeneration:evidence from published studies
    Xin Wang Ying Zhang Mao-Nian Zhang
    2013, 6(6):861-867. DOI: 10.3980/j.issn.2222-3959.2013.06.21
    [Abstract](1667) [HTML](0) [PDF 2.27 M](644)
    Abstract:
    AIM:To determine whether single nucleotide polymorphism (SNP) rs641153 is associated with the risk of age-related macular degeneration (AMD), we performed a systematic meta-analysis of 15 eligible studies. SNP in the complement factor B (CFB) gene is considered to have significant association with AMD susceptibility, but there is great discrepancy in these results.METHODS: The eligible studies were identified by searching the databases of PubMed, EMBASE, and Web of Science. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the association. All data were analyzed using Stata software.RESULTS:The association between rs641153 and AMD risk was statistically significant under the homozygous model (AA vs GG:OR=0.26, 95%CI=0.15-0.45, Ph=0.973, I2=0.0%, fixed effects), dominant model (AA+GA vs GG:OR=0.49, 95%CI=0.40-0.59, Ph=0.004, I2=56.4%, random effects) and recessive model (AA vs GA+GG:OR=0.30, 95%CI=0.17-0.51, Ph=0.983, I2=0.0%, fixed effects). The same results were also observed in the stratified analyses by ethnicity, source of control and sample size.CONCLUSION:Our meta-analysis suggests that rs641153 in the CFB gene may play a protective role in AMD susceptibility, the late AMD in particular, both in Caucasians and in Asians.
    22  Magnetic resonance diffusion tensor imaging of optic nerve and optic radiation in healthy adults at 3T
    Hong-Hong Sun Dong Wang Qiu-Juan Zhang Zhi-Lan Bai Ping He
    2013, 6(6):868-872. DOI: 10.3980/j.issn.2222-3959.2013.06.22
    [Abstract](2052) [HTML](0) [PDF 2.30 M](660)
    Abstract:
    AIM: To investigate the diffusion characteristics of water of optic nerve and optic radiation in healthy adults and its related factors by diffusion tensor imaging (DTI) at 3T.METHODS: A total of 107 healthy volunteers performed head conventional MRI and bilateral optic nerve and optic radiation DTI. The primary data of DTI was processed by post-processing software of DTI studio 2.3, obtaining fractional anisotropy value, mean diffusivity value, principal engine value, orthogonal engine value by measuring, and analyzed by the SPSS13.0 statistical software.RESULTS:The bilateral optic nerve and optic radiation fibers presented green color in directional encoded color (DEC) maps and presented high signal in fractional anisotropy (FA) maps. The FA value of the left optic nerve was 0.598±0.069 and the right was 0.593±0.065; the mean diffusivity (MD) value of the left optic nerve was (1.324±0.349)×10-3mm2/s and the right was (1.312±0.350)×10-3mm2/s; the principal engine value (λ‖) of the left optic nerve was (2.297±0.522)×10-3mm2/s and the right was (2.277±0.526)×10-3mm2/s; the orthogonal engine value (λ⊥) of the left optic nerve was (0.838±0.285)×10-3mm2/s and the right was (0.830±0.280)×10-3mm2/s; the FA value of the left optic radiation was 0.636±0.057 and the right was 0.628±0.056; the mean diffusivity (MD) value of the left optic radiation was (0.907±0.103)×10-3mm2/s and the right was (0.889±0.125)×10-3mm2/s; the principal eigenvalue (λ‖) of the left optic radiation was (1.655±0.210)×10-3mm2/s and the right was (1.614±0.171)×10-3mm2/s; the orthogonal enginvalue (λ⊥) of the left optic radiation was (0.531±0.103)×10﹣3mm2/s and the right was (0.524±0.152)×10-3mm2/s. There was no obvious difference between the FA, MD, λ‖, λ⊥ of the bilateral optic radiation and the bilateral optic nerve (P>0.05) and no obvious difference between male and female group. The FA, MD, λ‖, λ⊥ of the bilateral optic radiation and the bilateral optic nerve had no obvious correlations to the age.CONCLUSION: DTI is sensitive to the optic nerve and radiation and the relevant DTI parameters of the optic nerve and radiation are established preliminarily in this study.
    23  Evaluation of corneal cell growth on tissue engineering materials as artificial cornea scaffolds
    Hai-Yan Wang Rui-Hua Wei Shao-Zhen Zhao
    2013, 6(6):873-878. DOI: 10.3980/j.issn.2222-3959.2013.06.23
    [Abstract](2159) [HTML](0) [PDF 290.62 K](679)
    Abstract:
    The keratoprosthesis (KPro; artificial cornea) is a special refractive device to replace human cornea by using heterogeneous forming materials for the implantation into the damaged eyes in order to obtain a certain vision. The main problems of artificial cornea are the biocompatibility and stability of the tissue particularly in penetrating keratoplasty. The current studies of tissue-engineered scaffold materials through comprising composites of natural and synthetic biopolymers together have developed a new way to artificial cornea. Although a wide agreement that the long-term stability of these devices would be greatly improved by the presence of cornea cells, modification of keratoprosthesis to support cornea cells remains elusive. Most of the studies on corneal substrate materials and surface modification of composites have tried to improve the growth and biocompatibility of cornea cells which can not only reduce the stimulus of heterogeneous materials, but also more importantly continuous and stable cornea cells can prevent the destruction of collagenase. The necrosis of stroma and spontaneous extrusion of the device, allow for maintenance of a precorneal tear layer, and play the role of ensuring a good optical surface and resisting bacterial infection. As a result, improvement in corneal cells has been the main aim of several recent investigations; some effort has focused on biomaterial for its well biological properties such as promoting the growth of cornea cells. The purpose of this review is to summary the growth status of the corneal cells after the implantation of several artificial corneas.
    24  Interoperative fundus image and report sharing in compliance with integrating the healthcare enterprise conformance and web access todigital imaging and communication in medicinepersistent object protocol
    Hui-Qun Wu Zheng-Min Lv Xing-Yun Geng Kui Jiang Le-Min Tang Guo-Min Zhou Jian-Cheng Dong
    2013, 6(6):879-883. DOI: 10.3980/j.issn.2222-3959.2013.06.24
    [Abstract](1775) [HTML](0) [PDF 379.90 K](643)
    Abstract:
    AIM:To address issues in interoperability between different fundus image systems, we proposed a web eye-picture archiving and communication system (PACS) framework in conformance with digital imaging and communication in medicine (DICOM) and health level 7 (HL7) protocol to realize fundus images and reports sharing and communication through internet.METHODS: Firstly, a telemedicine-based eye care work flow was established based on integrating the healthcare enterprise (IHE) Eye Care technical framework. Then, a browser/server architecture eye-PACS system was established in conformance with the web access to DICOM persistent object (WADO) protocol, which contains three tiers.RESULTS:In any client system installed with web browser, clinicians could log in the eye-PACS to observe fundus images and reports. Multipurpose internet mail extensions (MIME) type of a structured report is saved as pdf/html with reference link to relevant fundus image using the WADO syntax could provide enough information for clinicians. Some functions provided by open-source Oviyam could be used to query, zoom, move, measure, view DICOM fundus images.CONCLUSION:Such web eye-PACS in compliance to WADO protocol could be used to store and communicate fundus images and reports, therefore is of great significance for teleophthalmology.
    25  Co-existent choroidal neovascular membrane and macular hole in pathologic myopia:a long follow-up clinical outcome and literature review
    Zhi-Qing Chen Ji-Jian Lin Pan-Pan Ye Li Zhang Xiao-Yun Fang
    2013, 6(6):884-887. DOI: 10.3980/j.issn.2222-3959.2013.06.25
    [Abstract](1939) [HTML](0) [PDF 1.78 M](701)
    Abstract:
    Choroidal neovascularization (CNV) is an uncommon complication associated with a macular hole. In this case report of a rare condition, we present a pathologic myopia patient with a co-existent macular hole and choroidal neovascular membrane. The patient was treated with photodynamic therapy for CNV, and then vitreous surgery for the retinal detachment and macular hole. At the end of 4 years follow-up, her visual acuity was improved to 0.1 while the macular hole remained open. Optical coherence tomography is a useful inspection method of the diagnosis of CNV and macular hole.
    26  Primary Sj?gren’s syndrome related optic neuritis
    Wei-Qiang Tang Shi-Hui Wei
    2013, 6(6):888-891. DOI: 10.3980/j.issn.2222-3959.2013.06.26
    [Abstract](1795) [HTML](0) [PDF 800.17 K](803)
    Abstract:
    AIM:To determine the clinical features, diagnosis and treatment of the primary Sj?gren syndrome (SS) related optic neuritis.METHODS:The clinical data of 8 patients (12 eyes) with primary SS related optic neuritis were analyzed retrospectively.RESULTS: Eight of 128 consecutive patients with optic neuritis resulted from varied causes fulfilled the diagnostic criteria for the primary SS. They presented initially with the signs and symptoms of non-specific optic neuritis, and 5 patients presenting without dryness showed a chronic inflammation of submandibular gland or parotid gland, and lymphocyte infiltration was demonstrated by labial gland biopsy in 2 patients. There were serum positive titers for anti-Sj?gren syndrome A (SSA) in 7 patients and anti-Sj?gren syndrome B (SSB) in 8 patients. Anti-aquaporin-4 (AQP4) antibody was negative in all the 8 patients. Both glucocorticoids and immunosuppressive agent were administered, and visual acuity elevated in 8 eyes (66.7%), 3 patients (37.5%) recurred in the follow-up.CONCLUSION:Primary SS related optic neuritis is less common and easily misdiagnosed. The conventional therapies for optic neuritis could not control the recurrence.
    27  Cauterization technique for suture erosion in transscleralfixation of intraocular lenses
    Xu-Ting Hu Zong-Duan Zhang Rong Zhou Qin-Tuo Pan
    2013, 6(6):892-894. DOI: 10.3980/j.issn.2222-3959.2013.06.27
    [Abstract](1885) [HTML](0) [PDF 717.21 K](679)
    Abstract:
    Transscleral suturing is a commonly applied technique to fix intraocular implants in the sulcus. A major problem after transscleral implantation is suture erosion that normally happens in the late post-surgery period and may result in an increased incidence of endophthalmitis. Here we describe an original cauterization method by using a glass rod to melt the exposed suture end without damaging the suture knot in the sclera to avoid suture exposure in sclera-fixed IOL implantation. This is a simple, quick and effective technique that can be performed without conjunctiva incisions and will help to reduce suture erosion related complications.
    28  Ciliary body detachment after secondary intraocular lens implantation in childhood
    Li-Na Meng Xiao-Guang Dong
    2013, 6(6):895-896. DOI: 10.3980/j.issn.2222-3959.2013.06.28
    [Abstract](1186) [HTML](0) [PDF 502.25 K](626)
    Abstract:
    29  How long is the interval of onsets of bilateral retinoblastoma?
    Ye Zhang Jian-Min Ma Ning-Li Wang
    2013, 6(6):897-899. DOI: 10.3980/j.issn.2222-3959.2013.06.29
    [Abstract](1306) [HTML](0) [PDF 1.59 M](675)
    Abstract:
    30  New onset atrial fibrillation following sub-Tenon’s anaesthesia
    Elliott Y. Ah-kee James F. Li Yim
    2013, 6(6):900-901. DOI: 10.3980/j.issn.2222-3959.2013.06.30
    [Abstract](1323) [HTML](0) [PDF 1.70 M](681)
    Abstract:

    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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