[Bilateral visual pathway invasion of occipital astrocytoma: a case report].

A 33-year-old female presented to the ophthalmology clinic with right periorbital redness and pain for 12 hours. CT revealed right optic nerve thickening and enlargement. Cranial MRI demonstrated abnormalities in the corpus callosum, bilateral hippocampi, thalamus, basal ganglia, temporal-parietal lobes, and the left frontal lobe. Ocular B-scan ultrasound showed elevated optic disc and high echogenic signals in the right vitreous cavity. The patient had a history of surgical resection, radiation therapy, and chemotherapy for a left occipital glioma two years prior, with pathology indicating astrocytoma (World Health Organization Grade Ⅱ). Combining the patient's history and diagnostic findings, the confirmed diagnosis is bilateral occipital astrocytoma with invasion into the right transverse sinus, bilateral optic pathways involvement related to the left occipital astrocytoma, and seeding of astrocytoma in the right vitreous cavity.

[A comparative study of three intraoperative real-time fundus examinations in cataractous eyes].

Objective: To investigate whether the wide field imaging system (WFIS), 25G optical fiber and intraoperative optical coherence tomography (iOCT) can perform real-time screening and diagnosing in patients with highly suspected fundus diseasesintraoperatively. Methods: A cross-sectional study was carried out. One hundred and eighty-three densely cataractous eyes of 183 patients with suspected fundus diseases were included in the Affiliated Hospital of Nantong University from July 2019 to June 2020. Lens phacoemulsification combined with intraocular lens implantation was performed in these eyes. Following the opaque lens was removed, the patients were divided into 4 groups according to fundus examination methods: WFIS SW-8000 group (49 eyes), 25G optical fiber group (40 eyes), iOCT group (36 eyes), and combination group of three examination methods (58 eyes). Optical coherence tomography and/or fundus fluorescence angiography were used to detect the fundus after surgery. The intraoperative and postoperative examination results were compared to verify the accuracy of intraoperative diagnosis in each group. Chi-square test was used for statistical analysis. Results: There were 79 males and 104 females in all patients, and the mean age was (69±10) years. Intraoperative examinations showed 82 eyes with fundus disease (positive rate was 44.81%), while postoperative examinations revealed 93 eyes with fundus disease (positive rate was 50.82%). In the WFIS SW-8000 group, fundus disease was found in 19 eyes intraoperatively and 26 eyes postoperatively (sensitive rate was 73.08%). In the 25G optical fiber group, fundus disease was found in 18 eyes intraoperatively and 20 eyes postoperatively (sensitive rate was 90.00%). In the iOCT group, fundus disease was observed in 20 eyes administratively and 22 eyes postoperatively (sensitive rate was 90.91%). In the combination group, fundus disease was observed in 25 eyes intraoperatively, which was consistent with the results of postoperative examinations (sensitive rate was 100.00%). There were statistically significant differences in the diagnostic sensitivity of fundus diseases among different methods (χ²=9.26; P<0.05). The diagnostic sensitivity of fundus diseases of the WFIS SW-8000 group was lower than that of the the combination group, the difference was statistically significant (χ²=7.80, P<0.01), and there was no significant difference between the other two groups (all P>0.05). Forty-nine eyes with fundus neovascular disease or severe macular edema requiring drug intervention were identified intraoperatively, and intravitreal anti-inflammatory and/or anti-vascular endothelial growth factor drugs were injected in 41 eyes. Conclusions: The WFIS, 25G optical fiber and iOCT can be used to examine the fundus and detect fundus disease intraoperatively, facilitating timely diagnosis and treatment of retinopathy in patients with dense cataract. The combined application of the three methods has the highest sensitivity. (Chin J Ophthalmol, 2021, 57: 850-856).

[Prevalence and surgery status of cataract among adults aged 60 years or above in two villages of Nantong].

Objective: To assess the prevalence, surgical coverage rate and social burden rate of cataract blindness among adults aged ≥60 years in the suburban population of Nantong, Jiangsu, China. Methods: It was a population-based cross-section study. A census with individuals aged ≥60 years was conducted in two villages of the suburb area in Nantong from June to August, 2008. A total of 1 305 individuals received visual acuity and eye examinations. Lens and cataract operative status were evaluated by slit-lamp biomicroscopy. Multiple logistic regression analysis was employed to analyze the prevalence of cataract, cataract surgical coverage rate and cataract blindness social burden rate among different ages, genders, educational backgrounds, marital statuses and salary levels. The results in the suburb were compared to the urban and rural areas. Results: Among 1 305 individuals, 376 cases of cataract were found. The prevalence of cataract was 28.81%. The rate was higher in the aged, less educated and low salary persons (P<0.01). In 47 eyes with cataract surgery, 19.15% of eyes were treated by modern extra-capsular surgery and 38.30% received phacoemulsification. The rate of intraocular lens implantation was 57.45%. The cataract surgical coverage rate was 40.48% and the cataract blindness social burden rate was 3.22%. The cataract surgical coverage rate was higher in the primary-educational persons than illiterate persons (P<0.05). The cataract blindness social burden rate was higher in ≥80-year-old persons than ≥60-year-old persons (P<0.05) and lower in married persons than single persons (P<0.05). The cataract surgical coverage rate was lower in the suburb area than in the city area, while the cataract blindness social burden rate was opposite. The rate of postoperative presenting visual acuity and best-corrected visual acuity of over 0.7 was 14.89% and 23.40% in the operated eyes, respectively. The main causes of unfavorable postoperative visual acuity (<0.3) were retinal disorders, post-capsular opacity, corneal opacity, refractive errors and glaucoma. Conclusions: Cataract is the most common and important eye disease that may lead to blindness and severe visual impairment among adults aged 60 years or above in the suburb of Nantong City. The prevalence of cataract is related to age, education background and economy level. The cataract surgical coverage rate is low and the cataract blindness social burden rate is high. The first important task in blindness prevention is still the elimination of cataract blindness and the improvement of visual outcomes after cataract surgery. (Chin J Ophthalmol, 2017, 53: 514-521).

A study on the awareness of cataract disease and treatment options in patients who need surgery in a rural area of Eastern China.

PURPOSE: To investigate the awareness of cataract disease and treatment and to determine the major barriers for patients who need cataract treatment in a rural area of eastern China. METHODS: A total of 251 cataract patients were selected by means of eye disease screenings throughout Jiangyan County. Questionnaires were administered after the doctor determined that the patient needed cataract surgery. The patient's awareness questionnaire was developed by Fletcher and clinically validated at the Aravind Eye Hospital in India. RESULTS: A total of 89.6% of patients had been aware of their condition for more than 1 year. Only 49.8% of all patients had known for more than 1 year that their eye disease could be treated. The major barriers for those seeking eye treatment included residual functional vision (49.0%), financial problems (36.7%), no demand for the operation (8.8%), and skepticism about the operation (8.8%). Poor vision function grade and female gender were two significant factors associated with a longer awareness (>3 years) of the existence of cataracts. Patients with a history of eye disease and a longer awareness of eye disease were more likely to have known about the potential treatments for a longer period of time (>1 year). CONCLUSIONS: The patients' awareness of the presence of cataract disease and potential treatment were unbalanced. The main treatment barriers were lower demand for vision improvement and financial problems. It is imperative to educate patients on eye health care and to provide low cost, but high quality, cataract surgery to these patients.

Protective effect of bilobalide against nitric oxide-induced neurotoxicity in PC12 cells.

AIM: To examine the effects of bilobalide on nitric oxide-induced neurotoxicity in pheochromocytoma-derived PC12 cells (PC12 cells). METHODS: PC12 cell survival was monitored by LDH release and 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) assays. Superoxide dismutases (SOD) and catalase (CAT) activities were measured based on their abilities to inhibit the oxidation of epinephrine by the xanthine-xanthine oxidase system or to decompose H2O2 respectively. The content of malondialdehyde (MDA) was measured by a fluorometric assay to indicate the lipid peroxidation. RESULTS: 3-Morpholinosydnonimine (SIN-1, 50-300 mumol.L-1) induced PC12 cell damage. After the cells had been pretreated with 10 mumol.L-1 bilobalide for 24 h, the cell viability was increased to 91% +/- 30% from 52% +/- 14% in SIN-1 alone group. Moreover, the activities of SOD and CAT were increased after cells were treated with bilobalide. CONCLUSION: The NO-induced neurotoxicity can be protected by bilobalide in PC12 cells. The bilobalide-induced increase in SOD and CAT activities may serve as one of the mechanisms underlying the neuroprotective effect of bilobalide.

Specific antitumor immunologic reactivity in patients with retinoblastoma.

Retinoblastoma antigen (RbAg) and retinal tissue antigen (RAg) were made from allogeneic retinoblastoma tissues and normal retinal tissue using the 3M KCl method. We have examined leukocyte migration inhibition test (LMIT) and enzyme-linked immunosorbent assay (ELISA) to RbAg and RAg in normal controls and the patients with retinoblastoma, including two spontaneously regressed cases. In LMIT, six out of the 11 patients tested against RhAg showed positive reactivity, in which 4 cases reacted only with RbAg, but not with RAg. All nine control subjects had negative reactivity to the two antigens. In ELISA, 40% of the retinoblastoma patients and 5.56% in normal controls showed positive reaction against RbAg. It was suggested that not only retinal antigens but also retinoblastoma specific antigens present in human retinoblastoma cells. The results also suggested that patients with retinoblastoma and those with spontaneous regression of Rb had both cell-mediated immunologic reactivity and humoral immune response toward retinoblastoma antigen in vitro. These immune responses to RbAg may be responsible for spontaneous regression of retinoblastoma.