Volume 9,Issue 9,2016 Table of Contents

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  • 1  The role of LOX-1 on innate immunity against Aspergillus keratitis in mice
    Kun He Li-Hui Yue Gui-Qiu Zhao Cui Li Jing Lin Nan Jiang Qian Wang Qiang Xu Xu-Dong Peng Li-Ting Hu Jie Zhang
    2016, 9(9):1245-1250. DOI: 10.18240/ijo.2016.09.01
    [Abstract](1916) [HTML](254) [PDF 898.25 K](886)
    Abstract:
    AIM: To explore the effects of lectin-like ox-LDL receptor (LOX-1) on innate immunity against Aspergillus fumigatus (A. fumigatus ) in mice cornea. METHODS: The mRNA levels of LOX-1 were tested in normal and A. fumigatus infected corneas of C57BL/6 and BALB/c mice. The expression of LOX-1, pro-inflammatory cytokines TNF-α, CXCL1 and IL-6, anti-inflammatory cytokines IL-10, and matrix metalloproteinase 9 (MMP9) were tested with treatment with LOX-1 neutralizing antibody or control IgG in A. fumigatus infected corneas of C57BL/6. Macrophages and neutrophils were extracted from susceptible C57BL/6 mice, and pretreated with LOX-1 neutralizing antibody or IgG, then stimulated with A. fumigatus. The mRNA levels of LOX-1, TNF-α, CXCL1, IL-6, IL-10 and MMP9 were evaluated by polymerase chain reaction. RESULTS: The expression of LOX-1 was significantly increased in C57BL/6 mice corneas after A. fumigatus infection compared with BABL/c mice. After treatment with LOX-1 neutralizing antibody, the expression of LOX-1, TNF-α, CXCL1, IL-6, MMP9 and IL-10 in C57BL/6 corneas were significantly decreased compared with treatment with control IgG; the expression of LOX-1, CXCL1, IL-6 and IL-10 were significantly decreased in macrophages, while TNF-α and MMP9 expressions had no change; LOX-1, TNF-α, CXCL1, IL-6, MMP9 and IL-10 expressions were significantly decreased in neutrophils. CONCLUSION: The expression of LOX-1 can affect the expression of pro-inflammatory and anti-inflammatory cytokines in fungal infected corneas, macrophages and neutrophils of C57BL/6. LOX-1 inhibition rebalances the inflammatory response of fungal keratitis in mice.
    2  Inhibiting the effect of 90Sr-90Y ophthalmic applicators on rat corneal neovascularization induced by sutures
    Hong-Yan Zhou Shuang Wang Hong Zhang Ling Wang Wen-Song Zhang
    2016, 9(9):1251-1254. DOI: 10.18240/ijo.2016.09.02
    [Abstract](1292) [HTML](248) [PDF 300.08 K](727)
    Abstract:
    AIM: To investigate a practical technique used to inhibit corneal angiogenesis with a 90Sr-90Y ophthalmic applicator. METHODS: A 90Sr-90Y ophthalmic applicator was detected with a radioactive nuclide application treatment healthy protection standard. The applicator used was produced through medical dosimetry research; it had a concave applicator add measured the applicator temperature, serviceable humidity range, applicator appearance status, applicator radiation homogeneity, radioautography, and radiological safety of the original applicator surface. A vessel model was established using newborn rats, with sutures around the corneal limbus. Corneal neovascularization (CNV) were observed with a slit lamp. The new vessel length and response area were measured. RESULTS: Low-dose radiation can inhibit CNV after corneal sutures. The absorbed dose of the applicator (0.046 Gy/s) was safe for the treatment of it. The lengths of new vessels and the areas of new vessels were lower than the new born vessel rat group (P<0.01). CONCLUSION: The optimal radiation dose emitting from the applicator can be safe and potentially used in humans.
    3  Attenuation of corneal neovascularization by topical low-molecular-weight heparin-taurocholate 7 without bleeding complication
    Jae Yong Kim Soo Yeon Kim Mi Hyun Cheon Eun-Soon Kim In Seok Song Myoung Joon Kim Hungwon Tchah
    2016, 9(9):1255-1259. DOI: 10.18240/ijo.2016.09.03
    [Abstract](1399) [HTML](260) [PDF 705.30 K](676)
    Abstract:
    AIM: To investigate the antiangiogenic effects and safety of topically administered low-molecular-weight heparin-taurocholate 7 (LHT7) on corneal neovascularization (CoNV). METHODS: Twenty-four Sprague-Dawley rats were randomly distributed into four groups of six rats each. The central corneas were cauterized using a silver/potassium nitrate solution. From 2d after cauterization, 12.5 mg/mL (low LHT7 group) or 25 mg/mL (high LHT7 group) LHT7 was topically administered three times daily; 12.5 mg/mL bevacizumab was topically administered as positive control (bevacizumab) group, with normal saline (NS) administered as negative control (NS group). The corneas were digitally photographed to calculate the CoNV percentage from the neovascularized corneal area at 1 and 2wk. RESULTS: The 4 study groups did not have different CoNV percentages at 1wk after injury (P>0.05). However, the low LHT, high LHT, and bevacizumab groups had significantly lower CoNV percentages than the NS group at 2wk (all P<0.05). No significant differences in CoNV percentage were found among the low LHT, high LHT, and bevacizumab groups (all P>0.05). All groups except the NS group had lower CoNV percentages at 2wk post-injury than the levels observed at 1wk (all P<0.05). CONCLUSION: Topically-administered LHT7 inhibited CoNV without complication after chemical cauterization in the rat.
    4  Comprehensive analysis of genetic variations in strictly-defined Leber congenital amaurosis with whole-exome sequencing in Chinese
    Shi-Yuan Wang Qi Zhang Xiang Zhang Pei-Quan Zhao
    2016, 9(9):1260-1264. DOI: 10.18240/ijo.2016.09.04
    [Abstract](1799) [HTML](263) [PDF 614.60 K](722)
    Abstract:
    AIM: To make a comprehensive analysis of the potential pathogenic genes related with Leber congenital amaurosis (LCA) in Chinese. METHODS: LCA subjects and their families were retrospectively collected from 2013 to 2015. Firstly, whole-exome sequencing was performed in patients who had underwent gene mutation screening with nothing found, and then homozygous sites was selected, candidate sites were annotated, and pathogenic analysis was conducted using softwares including Sorting Tolerant from Intolerant (SIFT), Polyphen-2, Mutation assessor, Condel, and Functional Analysis through Hidden Markov Models (FATHMM). Furthermore, Gene Ontology function and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analyses of pathogenic genes were performed followed by co-segregation analysis using Fisher exact Test. Sanger sequencing was used to validate single-nucleotide variations (SNVs). Expanded verification was performed in the rest patients. RESULTS: Totally 51 LCA families with 53 patients and 24 family members were recruited. A total of 104 SNVs (66 LCA-related genes and 15 co-segregated genes) were submitted for expand verification. The frequencies of homozygous mutation of KRT12 and CYP1A1 were simultaneously observed in 3 families. Enrichment analysis showed that the potential pathogenic genes were mainly enriched in functions related to cell adhesion, biological adhesion, retinoid metabolic process, and eye development biological adhesion. Additionally, WFS1 and STAU2 had the highest homozygous frequencies. CONCLUSION: LCA is a highly heterogeneous disease. Mutations in KRT12, CYP1A1, WFS1, and STAU2 may be involved in the development of LCA.
    5  A novel model of retinopathy of prematurity in normobaric hyperoxic conditions
    Taner Ozgurtas Sercan Tekin Fatih Yesildal Umut Karaca Fevzi Nuri Aydin Muhammed Talha Ugurlu Mehmet Ozler Hakan Durukan
    2016, 9(9):1265-1270. DOI: 10.18240/ijo.2016.09.05
    [Abstract](1286) [HTML](0) [PDF 663.02 K](727)
    Abstract:
    AIM: To examine changes in retinal vasculature after treatment with different oxygen concentrations from common retinopathy of prematurity (ROP) models and to determine a novel and practical ROP model. METHODS: A sample of 14 newborn Sprague-Dawley rats was used. The study group (n=7) was exposed to 95% oxygen for 4h per day followed by normoxic laboratory conditions for 20h. This cycle was repeated for 14d. The control group (n=7) was subjected to normobaric normoxic conditions. On postnatal day 14 (P14), the two groups were placed in room air for 7d. On P21, the two groups were examined using indirect ophthalmoscopy. All eyes were enucleated for immunofluorescence (IF) staining of the vasculature of retinas and analysis of vascular endothelial growth factor (VEGF), hypoxia inducible factor-1 alpha (HIF-1α), placental growth factor (PLGF) in vitreous humor, and then the rats were sacrificed by decapitation. All procedures were repeated using another litter of 14 pups. RESULTS: In the study group and under normobaric hyperoxic conditions, retinal neovascularization and peripheral avascular retina were determined in 85% of the rats through indirect ophthalmoscopic examination. Also IF staining of retina of the study group showed retarded peripheral vascular growth. The difference between the two groups for VEGF, HIF-1α and PLGF concentrations of vitreous humor was statistically significant (P=0.003, 0.007, 0.027 respectively). CONCLUSION: Fluctuating oxygen concentrations are primarily responsible for retinal neovascularization. Our new ROP model is practical and applicable for all retinal neovascularization studies, considering the laboratory procedures.
    6  Construction of adenovirus vectors encoding the lumican gene by gateway recombinant cloning technology
    Gui-Fang Wang Bing Qi Lei-Lei Tu Lian Liu Guo-Cheng Yu Jing-Xiang Zhong
    2016, 9(9):1271-1275. DOI: 10.18240/ijo.2016.09.06
    [Abstract](2005) [HTML](0) [PDF 818.68 K](794)
    Abstract:
    AIM: To construct adenovirus vectors of lumican gene by gateway recombinant cloning technology to further understand the role of lumican gene in myopia. METHODS: Gateway recombinant cloning technology was used to construct adenovirus vectors. The wild-type (wt) and mutant (mut) forms of the lumican gene were synthesized and amplified by polymerase chain reaction (PCR). The lumican cDNA fragments were purified and ligated into the adenovirus shuttle vector pDown-multiple cloning site (MCS)-/internal ribozyme entry site (IRES)/enhanced green fluorescent protein (EGFP). Then the desired DNA fragments were integrated into the destination vector pAV.Des1d yielding the final expression constructs pAV.Ex1d-cytomegalovirus (CMV)>wt-lumican/IRES/EGFP and pAV.Ex1d-CMV>mut-lumican/IRES /EGFP, respectively. RESULTS: The adenovirus plasmids pAV.Ex1d-CMV>wt-lumican/IRES/EGFP and pAV.Ex1d-CMV>mut-lumican/IRES/EGFP were successfully constructed by gateway recombinant cloning technology. Positive clones identified by PCR and sequencing were selected and packaged into recombinant adenovirus in HEK293 cells. CONCLUSION: We construct adenovirus vectors containing the lumican gene by gateway recombinant cloning technology, which provides a basis for investigating the role of lumican gene in the pathogenesis of high myopia.
    7  Effects of posterior corneal astigmatism on the accuracy of AcrySof toric intraocular lens astigmatism correction
    Bin Zhang Jing-Xue Ma Dan-Yan Liu Cong-Rong Guo Ying-Hua Du Xiu-Jin Guo Yue-Xian Cui
    2016, 9(9):1276-1282. DOI: 10.18240/ijo.2016.09.07
    [Abstract](1321) [HTML](0) [PDF 410.49 K](743)
    Abstract:
    AIM: To evaluate the effects of posterior corneal surface measurements on the accuracy of total estimated corneal astigmatism. METHODS: Fifty-seven patients with toric intraocular lens (IOL) implantation and posterior corneal astigmatism exceeding 0.5 diopter were enrolled in this retrospective study. The keratometric astigmatism (KA) and total corneal astigmatism (TA) were measured using a Pentacam rotating Scheimpflug camera to assess the outcomes of AcrySof IOL implantation. Toric IOLs were evaluated in 26 eyes using KA measurements and in 31 eyes using TA measurements. Preoperative corneal astigmatism and postoperative refractive astigmatism were recorded for statistical analysis. The cylindrical power of toric IOLs was estimated in all eyes. RESULTS: In all cases, the difference of toric IOL astigmatism magnitude between KA and TA measurements for the estimation of preoperative corneal astigmatism was statistically significant. Of a total of 57 cases, the 50.88% decreased from Tn to Tn-1, and 10.53% decreased from Tn to Tn-2. In all cases, 5.26% increased from Tn to Tn+1. The mean postoperative astigmatism within the TA group was significantly lower than that in the KA group. CONCLUSION: The accuracy of total corneal astigmatism calculations and the efficacy of toric IOL correction can be enhanced by measuring both the anterior and posterior corneal surfaces using a Pentacam rotating Scheimpflug camera.
    8  Evaluation of anterior and posterior surfaces of the cornea using a dual Scheimpflug analyzer in keratoconus patients implanted with intrastromal corneal ring segments
    Leonardo Torquetti Carlos Arce Jesús Merayo-Lloves Guilherme Ferrara Paulo Ferrara Brenno Signorelli Armando Signorelli
    2016, 9(9):1283-1288. DOI: 10.18240/ijo.2016.09.08
    [Abstract](1346) [HTML](0) [PDF 860.73 K](714)
    Abstract:
    AIM: To evaluate corneal parameters measured with a dual Scheimpflug analyzer in keratoconus patients implanted with intrastromal corneal ring segments (ICRS). METHODS: Fifty eyes of 40 keratoconus patients had Ferrara ICRS implantation from November 2010 to April 2014. Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), refraction, keratometry, asphericity, elevation, pachymetry, root mean square (RMS), spherical aberration and coma were studied. All patients were evaluated using a dual Scheimpflug system. RESULTS: The mean follow-up time after the procedure was 12.7mo. The mean UCVA improved from 0.82 to 0.31 (P<0.001); the mean BCVA improved from 0.42 to 0.05 (P<0.0001), the mean spherical refraction changed from -3.06±3.80 D to -0.80±2.5 D (P<0.0001) and the mean refraction astigmatism reduced from -4.51±2.08 D to -2.26±1.18 D (P<0.0001). The changes from preoperative to postoperative, in parameters of the anterior and posterior surface of the cornea, were statistically significant except the elevation posterior at the apex of the cornea and posterior asphericity. CONCLUSION: The implantation of Ferrara ICRS induces changes in both anterior and posterior surfaces of the cornea.
    9  Toric markers-assisted implantation of the scleral-fixated intraocular lens
    Hu-Ping Song Bing-Yu Tian Jing Peng
    2016, 9(9):1289-1293. DOI: 10.18240/ijo.2016.09.09
    [Abstract](1218) [HTML](0) [PDF 283.09 K](711)
    Abstract:
    AIM: To evaluate the efficacy of toric intraocular lens markers-assisted implantation of the scleral-fixated intraocular lens (SFIOL). METHODS: From October 2010 to December 2013, all patients who had undergone secondary SFIOL implantation were assigned to group 1 and 2, in group 1 SFIOL was performed with the assist of radial keratotomy (RK)-marker, and in group 2 SFIOL was performed with the assisted of toric intraocular lens markers (T-and axis markers). Patients’ demographic data and information on baseline preoperative visual acuity, indication for surgery and latest postoperative visual acuity were collected and analyzed. The haptic and optic positions were determined by ultrasound biomicroscopy. The optic tilt angle and decentration distance were measured. RESULTS: The study evaluated 43 eyes of 43 patients ranging in age from 3 to 66y. Group 1 comprised 24 eyes (24 patients) and group 2, 19 eyes (19 patients). Uncorrected reoperative acuity was improved on all the eyes postoperatively. The improved postoperative acuity was significantly more in group 2 than that in group 1 (1.11±0.38 vs 0.82±0.45 logMAR; F=4.85, P=0.03). Ultrasonic biomicrograph examination showed that the rate of haptic asymmetry was significantly higher in group 1 (42%, 10/24) than that in group 2 (11%; 2/19) (Chi square=3.68, P=0.04). The mean tilted degree in group 1 was significantly higher than that in group 2 (P=0.04). Mean decentration distance in group 1 was greater than that in group 2 (P=0.03). CONCLUSION: During SFIOL the toric markers help the surgeon identify the placement of fixation more precisely than that with the use of RK marker.
    10  A modified approach to actively remove high viscosity silicone oil through 23-gauge cannula
    Zong-Ming Song Xu-Ting Hu Lei Wang Zhi-Xiang Hu Pei-Quan Zhao Ding Chen
    2016, 9(9):1294-1298. DOI: 10.18240/ijo.2016.09.10
    [Abstract](1520) [HTML](0) [PDF 629.57 K](716)
    Abstract:
    AIM: To report a simple approach to actively remove high viscosity silicone oil through a 23-gauge cannula via pars plana. METHODS: Forty-eight eyes of 48 patients underwent silicone oil (5700 centistokes) removal (SOR) were enrolled. A section of blood transfusion set was prepared to connect a standard 23-gauge cannula and vitrectomy machine. Silicone oil was removed with suction of 500-mm Hg vacuum through the cannula. Main outcome measures were SOR duration, number of sutured sites, intraocular pressure (IOP), best-corrected visual acuity (BCVA), and complications. RESULTS: Silicone oil was successfully removed in all cases. The mean SOR time was 5.70±0.85min. Nine eyes (18.75%) needed suture partial sclerotomies. No intraoperative complications were noted. Transient hypotony (≤8 mm Hg) was seen in 3 eyes (6.25%) on postoperative day 1, but all resolved within 1wk. Retinal reattachment was achieved in all cases and no other postoperative complications were noted during 3-month following-up. BCVA at the final visit improved or stabilized in all patients comparing to the preoperative level. CONCLUSION: Active removal of high viscosity silicone oil through a 23-gauge instrument cannula jointed with blood transfusion set is a practical and reliable technique when considering two sides of efficacy and safety.
    11  Ultra-wide field imaging system and traditional retinal examinations for screening fundus changes after cataract surgery
    Jie Peng Qi Zhang Hai-Ying Jin Wu-Yi Lu Pei-Quan Zhao
    2016, 9(9):1299-1303. DOI: 10.18240/ijo.2016.09.11
    [Abstract](1887) [HTML](0) [PDF 316.91 K](759)
    Abstract:
    AIM: To compare the results of non-mydriatic ultra-wide field imaging system, mydriatic slit-lamp lens (Volk +90 D) and mydriatic Goldmann three-mirror contact lens examinations in screening fundus lesions among patients after cataract surgery. METHODS: Non-mydriatic images were obtained with an Optomap panoramic 200Tx (Optomap 200Tx) 3d after surgery and graded by a blinded ophthalmologist. A mydriatic slit-lamp lens examination was performed by another blinded retinal specialist on the same day. A third blinded retinal specialist examined patients two weeks after surgery using a Goldmann three-mirror contact lens. RESULTS: In total, 160 patients (184 eyes) were examined, and 66, 69, and 75 cases of retinal lesion(s) were identified using the Optomap 200Tx, slit-lamp lens, and Goldmann three-mirror contact lens, respectively. In 13 cases, fundus changes were sight-threatening. The results obtained by Optomap 200Tx examination and by mydriatic slit-lamp lens examination have good consistency (P=0.375, Kappa=0.942). The mydriatic Goldmann three-mirror lens examination revealed more fundus lesions but are consistent with Optomap 200Tx (P=0.004, Kappa=0.897) and mydriatic slit-lamp lens examination (P=0.031, Kappa=0.932). CONCLUSION: Early post-operative fundus screening in cataract patients is extremely important and necessary to prevent further vision loss. Wide-field imaging is a feasible and convenient tool for fundus examination that can be used as a primary screening method among patients after cataract surgery.
    12  Influence of CFH, HTRA1 and ARMS2 polymorphisms in the response to intravitreal ranibizumab treatment for wet age-related macular degeneration in a Spanish population
    Fernando Cruz-Gonzalez Lucia Cabrillo-Estevez Vanesa Rivero-Gutierrez Ana Sanchez-Jara Lourdes De Juan-Marcos Rogelio Gonzalez-Sarmiento
    2016, 9(9):1304-1309. DOI: 10.18240/ijo.2016.09.12
    [Abstract](1466) [HTML](0) [PDF 267.54 K](684)
    Abstract:
    AIM: To determine whether gene polymorphisms of the major genetic risk loci for age-related macular degeneration (AMD): ARMS2 (rs10490923), the complement factor H (CFH) (rs1410996) and HTRA1 (rs11200638) influence the response to a treatment regimen with ranibizumab for exudative AMD. METHODS: This study included 100 patients (100 eyes) with exudative AMD. Patients underwent a treatment with ranibizumab injections monthly during three months. Reinjections were made when the best corrected visual acuity (BCVA) decrease five letters (ETDRS) or central subfield retinal thickness gained 100 μm in optical coherence tomography image. Genotypes (rs10490923, rs1410996 and rs11200638) were analyzed using TaqMan probes or polymerase chain reaction-restricted fragment length polymorphisms analysis. RESULTS: There were no statistically significant differences in allelic distribution of CFH (rs1410996), ARMS2 (rs10490923) and HTRA1 (rs11200638) polymorphisms regarding to response to ranibizumab treatment. CONCLUSION: Ranibizumab treatment response is not related to CFH (rs1410996), ARMS2 (rs10490923) and HTRA1 (rs11200638) poymorphisms.
    13  Comparison of scleral buckling using wide-angle viewing systems and indirect ophthalmoscope for rhegmatogenous retinal detachment
    Xiu-Juan Li Xiao-Peng Yang Xiao-Bei Lyu
    2016, 9(9):1310-1314. DOI: 10.18240/ijo.2016.09.13
    [Abstract](1527) [HTML](0) [PDF 229.63 K](735)
    Abstract:
    AIM: To compare the effects of scleral buckling using wide-angle viewing systems (WAVS) with that using indirect ophthalmoscope for the treatment of rhegmatogenous retinal detachment. METHODS: The study was a retrospective analyses of the medical records of 94 eyes (94 patients) with rhegmatogenous retinal detachment. Among them, 47 eyes underwent scleral buckling using WAVS with endoilluminator (Group W), and 47 eyes underwent scleral buckling using indirect ophthalmoscope (Group I). Surgical durations, primary success rate, best-corrected visual acuities (BCVA), delayed subretinal fluid absorptions and surgical complications were compared between the two groups. RESULTS: At baseline, there were no statistical differences between the two groups in patient's age (P=0.997), gender (P=0.853), symptom duration (P=0.216), BCVA (P=0.389), refractive error (P=0.167), intraocular pressure (P=0.595), the number of retinal breaks (P=0.832), the extent of retinal detachment (P=0.246), subretinal demarcation line (P=0.801), and macular detachment (P=0.811). The follow-up period was 12mo. The surgical durations in Group W (with or without encircling buckling) were significant shorter than those in Group I (P?<0.001 respectively). The primary success rate was 94.27% in Group W, which was similar to that in Group I (92.38%, P?=?0.931). The BCVA in Group W was better than that in Group I (P<0.001) at 1-month follow-up visit. However, there were no significant differences between the two groups at 3-month (P=0.221), 6-month (P=0.674), and 12-month (P=0.363) follow-up visits respectively. Delayed subretinal fluid absorptions were more common in Group I than in Group W at 1-month (P=0.045) follow-up visit, but there were no significant differences between the two groups at 3-month (P=0.111), 6-month (P=1.000) and 12-month follow-up visits respectively. CONCLUSION: Scleral buckling using WAVS can be an alternative choose for rhegmatogenous retinal detachment.
    14  Analyses on the misdiagnoses of 25 patients with unilateral optic nerve sheath meningioma
    Jun-Feng Mao Xiao-Bo Xia Xiang-Bo Tang Xue-Yong Zhang Dan Wen
    2016, 9(9):1315-1319. DOI: 10.18240/ijo.2016.09.14
    [Abstract](1181) [HTML](0) [PDF 360.66 K](676)
    Abstract:
    AIM: To investigate clinical features of optic nerve sheath meningioma (ONSM) that was misdiagnosed, and to find methods to reduce the misdiagnoses. METHODS: Retrospective series study. Twenty-five misdisgnosed patients with unilateral ONSM were collected from Jan. 2008 to Jan. 2015 and the clinical records reviewed. RESULTS: Patients were misdiagnosed with acute papillitis most frequently (n=17), immediately followed by optic atrophy (n=8), ischemic optic neuropathy (n=5), acute retrobulbar optic neuritis (n=5), optic disc vasculitis (n=3). For each patient, the minimum frequency of misdiagnoses was once and the maximum was 4 times. As for the lasting time of being misdiagnosed, the shortest was 1.5mo and the longest was 45mo. Twenty-one cases (84%) were once treated with glucocorticoids, and its side effects was found in seventeen patients. Twenty patients (80%) complained with varying degree of vision loss. When a definite diagnosis was made, sixteen cases (64%) showed slight exophthalmos and eighteen cases (72%) had the tubular ONSM. CONCLUSION: ONSM without loss obvious exophthalmos is easily misdiagnosed in clinic, and for most of these ONSMs are tubular.
    15  Effects of upper lid blepharoplasty on visual quality in patients with lash ptosis and dermatochalasis
    Seoung Hyun An Sang Wook Jin Yoon Hyung Kwon Won Yeol Ryu Woo Jin Jeong Hee Bae Ahn
    2016, 9(9):1320-1324. DOI: 10.18240/ijo.2016.09.15
    [Abstract](2789) [HTML](0) [PDF 464.49 K](761)
    Abstract:
    AIM: To assess the effects of upper lid blepharoplasty on visual quality. METHODS: Seventy-three eyelids of 39 patients were subjected to upper lid blepharoplasty. Pre- and post-operative contrast sensitivity, visual acuity, vertical palpebral aperture and the degree of lash ptosis were measured. RESULTS: The mean log contrast sensitivities under photopic (P=0.017) and scotopic conditions (P=0.009) were improved after surgery, and these differences were significant. The degree of lash ptosis was also decreased after blepharoplasty (P<0.001). CONCLUSION: In our study, a significant increase in contrast sensitivity was found after surgery. These results suggest that upper lid blepharoplasty can be helpful for improving visual quality.
    16  Retinal vessels caliber changes after strabismus surgery: results of 6mo follow-up
    Ji-Peng Li Jing Fu Jin-Qiong Zhou Xiao-Zhen Wang Wen-Ying Wang Ning-Pu Liu
    2016, 9(9):1325-1328. DOI: 10.18240/ijo.2016.09.16
    [Abstract](1580) [HTML](0) [PDF 223.62 K](741)
    Abstract:
    AIM: To evaluate the effect of strabismus surgery on retinal vessels calibers with digital color fundus photographs. METHODS: Two hundred consecutive strabismus patients underwent surgery, and 118 patients (female/male, 55/63) who finished 6-month follow-up were finally included in this study. Optic disc-centered digital color fundus photographs of both eyes of all patients were taken prior to surgery and 6mo post surgery. The retinal vascular caliber of 116 operated eyes were measured using the computer program IVAN. The operated eyes were divided into 3 groups according to the surgical methods, recession of one muscle, one muscle recession and one muscle folding, one muscle resection and one muscle recession. The effect of number of altered muscles on retinal vessels was analyzed using statistic software SPSS 16.0. RESULTS: The mean age was 12.4±8.6y. Averaged central retinal artery equivalent (CRAE) of all patients was 120.31±23.02 μm preoperatively, and 122.87±15.93 μm six months after surgery. Averaged central retinal vein equivalent (CRVE) was 171.11±31.73 μm preoperatively and 175.02±21.00 μm postoperatively. There was no significant difference of averaged CRAE (P=0.22) or CRVE (P=0.19) before and after operation. Averaged arteriole to venule ratio (AVR) was 0.71±0.07 before surgery and 0.70±0.07 after surgery. Comparison of preoperative and postoperative retinal vessels calibers among different surgical groups did not show significant differences. Also, there was no advantage of rectus muscle folding to muscle resection. CONCLUSION: Up to 6mo after strabismus surgery, the retinal vascular calibers were not altered. No more than two muscles in one surgery are safe for retinal perfusion.
    17  Scientometric analysis and mapping of 20 years of glaucoma research
    Shahrokh Ramin Mohammad Pakravan Gholamreza Habibi Roghayeh Ghazavi
    2016, 9(9):1329-1335. DOI: 10.18240/ijo.2016.09.17
    [Abstract](1602) [HTML](0) [PDF 743.10 K](792)
    Abstract:
    AIM: To provide a scientometric analysis in the field of glaucoma. METHODS: A bibliometric method was used to obtain a view of the scientific production in field of glaucoma by data extracted from the Institute for Scientific Information (ISI) from 1993 to 2013. Specific parameters were retrieved from the ISI. Articles about glaucoma were analyzed regarding the topics’ structure, history, and document relationships using HistCite software. Also, the trends in the most influential publications and authors were analyzed. RESULTS: The number of articles was constantly increasing, and most highly cited articles addressed clinical and epidemiologic topics in this field. During the past three years, there has been a trend towards genomic research studies and also more molecular translational research. CONCLUSION: This was the first scientometric report on glaucoma, analyzing the characteristics of papers and the trends in scientific production. A constant increase was observed in the number of papers, while the subject of papers had a shift in the past three years towards genomic research studies.
    18  Public’s knowledge of the differences between ophthalmologists and optometrists: a critical issue in eye care service utilisation
    Boniface Ikenna Eze Obiekwe Okoye Emmanuel Nwabueze Aguwa
    2016, 9(9):1336-1342. DOI: 10.18240/ijo.2016.09.18
    [Abstract](2066) [HTML](0) [PDF 277.47 K](826)
    Abstract:
    AIM: To assess the public’s knowledge of the differences between ophthalmologists and optometrists and identify the factors associated with knowledge. METHODS: The study was a population-based random survey of adults aged 18 years or older conducted in Enugu, south eastern Nigeria, between March and June, 2011. Data on respondents’ socio-demographics, clinical profile, and knowledge of the differences between ophthalmologists and optometrists were collected using a 28-item questionnaire. Data were analysed using descriptive and analytical statistics. Values of P<0.05 were considered statistically significant. RESULTS: The respondents (n=394) comprised 198 males and 196 females (sex ratio=1.01:1), aged 18-70 (30.9±10.8) years. The majority of respondents were single (57.4%), possessed secondary education (96.9%), employed (65.2%) and had no health insurance (77.4%). Their clinical profile showed previous eye exam 54.1%, spectacle wear 41.6% and contact lens wear 5.6%. In the multivariate analysis, participants’ good knowledge of the differences between ophthalmologists and optometrists was significantly associated with educational status (OR: 0.32, 95% CI: 0.23-0.44, P<0.0001, β=-0.988), employment status (OR: 1.8, 95% CI: 1.45-2.25, P<0.0001, β=0.124) and previous eye examination (OR: 1.63, 95% CI: 1.29-2.07, P<0.0001, β=0.549). CONCLUSION: Participants’ socio-demographic and clinical characteristics are important predictors of good knowledge. The findings may have implications for all stakeholders in eye care delivery. There is need for knowledge enhancement, by the government and eye care providers, through population-based eye health literacy campaigns.
    19  The role of Toll-like receptors in retinal ischemic diseases
    Wen-Qin Xu Yu-Sheng Wang
    2016, 9(9):1343-1351. DOI: 10.18240/ijo.2016.09.19
    [Abstract](1575) [HTML](0) [PDF 376.00 K](840)
    Abstract:
    Toll-like receptors (TLRs) are commonly referred to a series of evolutionary conserved receptors which recognize and respond to various microbes and endogenous ligands. Growing evidence has demonstrated that the expression of TLRs in the retina is regulated during retinal ischemic diseases, including ischemia-reperfusion injury, glaucoma, diabetic retinopathy (DR) and retinopathy of prematurity (ROP). TLRs can be expressed in multiple cells in the retina, such as glial cells, retinal pigment epithelium (RPE), as well as photoreceptor cells and endothelium cells.? Activation of TLRs in retina could initiate a complex signal transduction cascade, induce the production of inflammatory cytokines and regulate the level of co-stimulatory molecules, which play prominent roles in the pathogenesis of retinal ischemic diseases. In this review, we summarized current studies about the relationship between TLRs and ischemic retinopathy. A greater understanding of the effect of TLRs on ischemic injuries may contribute to the development of specific TLR targeted therapeutic strategies in these conditions.
    20  Analysis of optic disc damage by optical coherence tomography in terms of therapy in non-arteritic anterior ischemic optic neuropathy
    Zsuzsa Balogh Márta Kasza Julianna Várdai Izabella Reznek Judit Damjanovich Adrienne Csutak András Berta Valéria Nagy
    2016, 9(9):1352-1354. DOI: 10.18240/ijo.2016.09.20
    [Abstract](1460) [HTML](0) [PDF 241.06 K](682)
    Abstract:
    This study aimed to assess the relationship between the rate of nerve fiber loss in non-arteritic anterior ischemic optic neuropathy (NAION) and time delay before therapy. Total 24 patients received the same treatment within or after 2wk (early and late groups). There were significantly lower level of destruction of nerve fibers (P=0.0014) and significantly better visual field sensitivity (P=0.039) in early group. The results indicate that therapy should be started within 2wk. The degree of ischemic damage due to NAION correlates well with retinal nerve fiber layer thickness and the ischemia-induced decrease in visual field sensitivity.
    21  A statistical approach to classification of keratoconus
    Murat Ucar Hasan Basri Cakmak Baha Sen
    2016, 9(9):1355-1357. DOI: 10.18240/ijo.2016.09.21
    [Abstract](1416) [HTML](0) [PDF 185.82 K](716)
    Abstract:
    Opinion
    22  Urrets-Zavalia syndrome in different methods of keratoplasty
    Alireza Foroutan Seyed Ali Tabatabaei Mohammad Soleimani Shahbaz Nekoozadeh
    2016, 9(9):1358-1360. DOI: 10.18240/ijo.2016.09.22
    [Abstract](1063) [HTML](0) [PDF 266.91 K](613)
    Abstract:
    Opinion
    23  A delayed diagnosis of unsuspected retinoblastoma in an in vitro fertilisation infant with retinopathy of prematurity
    Tian Tian Xun-Da Ji Qi Zhang Jie Peng Pei-Quan Zhao
    2016, 9(9):1361-1363. DOI: 10.18240/ijo.2016.09.23
    [Abstract](1178) [HTML](0) [PDF 621.10 K](728)
    Abstract:
    Letter to the Editor
    24  Macular hole closure following anti-vascular endothelial growth factor injection in an eye with myopic choroidal neovascularization
    Cheolmin Yun Seong-Woo Kim Kuhl Huh Jaeryung Oh
    2016, 9(9):1364-1366. DOI: 10.18240/ijo.2016.09.24
    [Abstract](1171) [HTML](0) [PDF 744.47 K](737)
    Abstract:
    Letter to the Editor
    25  A novel nonsense mutation of GPR143 gene in a Korean kindred with X-linked congenital nystagmus
    Ungsoo Samuel Kim Eunhae Cho Hyon J. Kim
    2016, 9(9):1367-1370. DOI: 10.18240/ijo.2016.09.25
    [Abstract](1644) [HTML](0) [PDF 960.91 K](691)
    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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