Anthranilic diamides derivatives as potential ryanodine receptor modulators: Synthesis, biological evaluation and structure activity relationship.

A series of novel anthranilic diamides derivatives (7a-s) containing halogen, trifluoromethyl group and cyano group were designed, synthesized, and characterized by melting point, 1H NMR, 13C NMR and elemental analyses. The bioactivity revealed that most of them showed moderate to excellent activities against oriental armyworm (Mythimna separata) and diamondback moth (Plutella xylostella). Above all, the larvicidal activity of 7o against oriental armyworm was 100% and 40% at 0.25 and 0.1 mg L-1, comparable to that of the standard chlorantraniliprole (100%, 0.25 mg L-1 and 20%, 0.1 mg L-1). What is more, 7o against diamondback moth displayed 90% insecticidal activity at 0.01 mg L-1, superior to chlorantraniliprole (45%, 0.01 mg L-1). The experiments 7o on the American cockroach (Periplaneta Americana) heart beating rates (Dorsal vessel) and contractile force were compared with chlorantraniliprole. In addition, 7o could affect the calcium homeostasis in the central neurons of the third larvae of oriental armyworm, which revealed that the ryanodine receptor is the potential target of 7o. The density functional theory (DFT) calculation results revealed the amide bridge, the benzene ring of anthraniloyl moiety and pyrazole ring might play an important role in the insecticidal activity through hydrophobic interactions and π-π conjugations.

Aqueous proinflammatory cytokines in acute primary angle-closure eyes.

AIM: To evaluate changes of proinflammatory cytokines in aqueous humor of patients with acute primary angle-closure (APAC) and age-related cataracts. METHODS: Twenty eyes of 20 APAC patients and 15 eyes of 15 age-related cataract patients were included in this cross-sectional study. Aqueous humor samples were collected prospectively. The levels of 20 proinflammatory cytokines were evaluated in the aqueous humor of the APAC and cataract patients using the multiplex bead immunoassay technique. Clinical data were collected for correlation analysis. RESULTS: Seven of the 20 proinflammatory cytokines included in the magnetic bead panel were detectable in both APAC eyes and cataract eyes: interleukin (IL)-10, IL-12, IL-15, IL-21, IL-6, chemokine (C-C motif) ligand 20, and tumor necrosis factor alpha (TNF-α). IL-27 was only detectable in APAC eyes. Compared with the cataract eyes, the APAC eyes had significantly elevated concentrations of IL-12 (P=0.036), IL-15 (P=0.001), IL-6 (P=0.012), and IL-27 (only detectable in APAC eyes). Age was positively correlated with IL-12 (P=0.022) and IL-6 (P=0.037), and time elapsed between APAC onset and aqueous humor samples collection was positively correlated with IL-15 (P=0.037), IL-27 (P=0.040), and TNF-α (P=0.042). CONCLUSION: Several proinflammatory cytokines including IL-12, IL-15, IL-6 and IL-27, were elevated in the APAC eyes and may be implicated in its pathologic mechanism.

Ex-PRESS implantation versus trabeculectomy in Chinese patients with POAG: fellow eye pilot study.

AIM: To compare the outcomes of Ex-PRESS implantation in one eye versus trabeculectomy with mitomycin C in the fellow eye in Chinese patients with primary open-angle glaucoma (POAG). METHODS: This was a prospective, non-randomized comparative study. Forty-eight eyes of 24 patients with bilateral POAG necessitating surgery were included and underwent Ex-PRESS implantation under the scleral flap in one eye and trabeculectomy in the other eye according to patients' choice. Primary outcome measures included mean intraocular pressure (IOP) and success rate. Secondary outcome measures were aqueous flare, postoperative medication use, visual acuity, and incidence of complications. RESULTS: All 24 patients finished a 1-year follow-up. Both groups maintained significant reductions in IOP after surgery throughout the follow-up period. At any point in time, the IOP of the two groups did not differ significantly. The Kaplan-Meier survival curve analysis showed no significant differences in success between the two groups (P=0.289). The mean number of anti-glaucoma medicines and visual acuity in both groups were not significantly different. Eyes with Ex-PRESS implantation had lower aqueous flare values on days 1 and 3 (both P<0.05). Instances of early postoperative hypotony and choroidal effusion were significantly fewer in frequency after Ex-PRESS implantation under the scleral flap compared with those after trabeculectomy (P<0.001). CONCLUSION: Ex-PRESS is comparable to trabeculectomy in terms of IOP, success rate, number of glaucoma medications used, and visual acuity. However, Ex-PRESS resulted in fewer cases of inflammation and a lower rate of complications.

[Levels and possible sources of organochlorine pesticides (OCPs) in camphor (Cinnamomum camphora) tree bark from Southern Jiangsu, China].

Thirty-three camphor tree bark samples were collected from Southern Jiangsu in August 2012. They were analyzed for organochlorine pesticides (OCPs), including hexachlorobenzene (HCB), DDTs (o,p'-DDE, p,p'-DDE, o,p'-DDD, p,p'-DDD, o,p'-DDT and p,p'-DDT), trans-chlordane and cis-chlordane. The concentrations of HCB, sigma6 DDTs and sigma Chlordanes ranged (dw) from 0.31 ng x g(-1) to 1.81 ng x g(-1), 0.40 ng x g(-1) to 17.3 ng x g(-1) and n. d. to 1.03 ng x g(-1), respectively. Due to the high volatility, the spatial distribution of HCB in Southern Jiangsu was uniform. Compared to the other results, the HCB concentration in Southern Jiangsu was lower. The historical usage of technical DDT mixture and the dicofol-type DDT were the major sources of DDTs in southern Jiangsu. The TC/CC ratio is usually used to distinguish between aged and fresh chlordane. According to the ratio of TC/CC, the chlordane in the urban area was derived from the fresh application of technical chlordane, and that in the rural area was attributed to the historical usage.

[A comparison study of glaucoma drainage implant with three different of tube coverages].

OBJECTIVE: To evaluate the efficacy and complication of glaucoma drainage implant surgery with scleral graft, scleral flap and artificial biological dural graft as the tube coverage. METHODS: Thirty-five cases (35 eyes) with refractory glaucoma who underwent FP-7 Ahmed glaucoma drainage implantation from January 2009 to June 2011 were retrospectively studied. Kaplan-Meier survival curve was applied to analyze the probability of success rate of three different tube coverage, the log-rank test used to compare the difference between tubes, and Cox proportional hazards regression analysis performed to predict the risk factors for failure. RESULTS: Conjunctival shrink back leading to exposure of tube coverage occurred in 6 eyes in artificial biological dural graft group. Intraocular pressure (IOP) elevation by encapsulated cystic blebs around the plate was seen in scleral flap group (2 eyes) and scleral graft group (1 eyes), respectively. The drainage tube exposure occurred in 1 eye in scleral graft group. Kaplan-Meier survival curve analysis showed that the success rate was 8/10, 3/9 and 14/16 in scleral graft group, artificial biological dural graft group and scleral flap group, respectively, at 12 month and 15 month. There was a significant difference among three groups (P = 0.009). The proportional hazards regression showed that artificial biological dural graft was statistically significant risk factors for failure (HR = 10.844, P = 0.015). Compared with pre-operation, the post-operative mean IOP was significantly decreased in all three groups. Postoperative IOP was not significantly different among three groups in different follow-up time point (F = 0.028 - 1.218, P > 0.05). CONCLUSIONS: Both of scleral flap group and scleral graft group are comparable in the efficacy and complication of glaucoma drainage implant surgery and have a high success rate. However, artificial biological dural graft has poor compatibility with conjunctiva resulting in severe complications, which is not recommended to be used in glaucoma drainage implant surgery.

Adjunctive with versus without intravitreal bevacizumab injection before Ahmed glaucoma valve implantation in the treatment of neovascular glaucoma.

BACKGROUND: Neovascular glaucoma (NVG) is a refractory disease which is difficult to manage. This study aimed at evaluating the efficacy and safety of adjunctive intravitreal bevacizumab (IVB) injection in conjunction with Ahmed glaucoma valve implantation (AGVI) in the management of NVG. METHODS: This was a retrospective study of patients with NVG in whom AGVI was performed between October 2008 and May 2012. The sample was divided into two groups according to the pretreatment: with adjunctive IVB injection (the IVB group, n = 25 eyes) and without adjunctive IVB injection (the control group, n = 28 eyes). The surgical success rate, number of antiglaucoma medications used, best-corrected visual acuity (BCVA), postoperative complications, regression, and recurrence of iris neovascularization (NVI) were analyzed between the groups. RESULTS: The surgical outcomes of the two groups were compared. The complete success rates in the IVB and control groups were 84.0% and 64.3% at 12 months and 80.0% and 53.6% at 18 months, respectively. There was a significant difference between the two groups (P = 0.041). Mean postoperative intraocular pressures, mean number of postoperative antiglaucoma medications, and BCVA were not significant between the two groups. The NVI in 22 (88.0%) eyes had completely regressed within 2 - 8 days after IVB. However, NVI recurred in 10 eyes (40.0%) 2 - 9 months later after IVB. The IVB group had only 1 case (4.0%) of hyphema out of 25 eyes, while there were 8 (28.6%) cases of hyphema out of 28 eyes in the control group (P = 0.026). CONCLUSIONS: This study showed that preoperative IVB injection reduced NVI remarkably, decreased hyphema, and led to higher surgical success rates. Pre-operative IVB injection may be an effective adjunct to AGVI in the management of NVG.

Disorder of blood-aqueous barrier following Ahmed Glaucoma Valve implantation.

BACKGROUND: Ahmed Glaucoma Valve implantation (AGVI) is used to treat refractory glaucoma. Breakdown of the blood-aqueous barrier (BAB) has been noted after some surgical techniques. The current study was designed to assess BAB disruption after AGVI. METHODS: Anterior chamber protein content was measured by the laser flare cell photometry in 22 eyes of 22 patients with refractory glaucoma before AGVI and at each postoperative visit up to 1 month. RESULTS: Before AGVI the mean aqueous flare values in all eyes were (15.17 ± 9.84) photon counts/ms. After AGVI, the values significantly increased at day 1, day 3, and week 1 compared to those before AGVI (all P < 0.05) with a peak at day 3. They returned to pre-operative levels at week 2, and were lower than preoperative level at month 1. Eyes with previous intraocular surgery history had greater aqueous flare values than those without previous intraocular surgery history, but there were no significant differences at all time points postoperatively (all P > 0.05). Furthermore, eyes with shallow anterior chambers had greater aqueous flare values at day 3 and week 1 (all P < 0.05). When comparing eyes with other refractory glaucoma conditions, neovascular glaucoma combined with intravitreal bevacizumab injection resulted in lower aqueous flare values after AGVI, but no significant differences were observed at all time points, postoperatively (all P > 0.05). CONCLUSIONS: The BAB was impaired and inflammation was present in the anterior chamber in refractory glaucomatous eyes following AGVI. However, such conditions were resolved within 1 month postoperatively. Intravitreal bevacizumab treatment in neovascular glaucoma eyes before AGVI may prevent BAB breakdown.

[Comment on indications of Ex-Press miniature implant surgery].

Ex-Press miniature implant surgery (Ex-Press implantation) is a new alternative anti-glaucoma surgery. It is clinically important to clarify its indications. Ex-Press implantation has been indicated appropriate in primary open-angle glaucoma and should not be used in narrow angle-closure glaucoma and in high risk of failed scarring cases. More evidence-based studies are still needed to convince the pros and cons in other conditions including aphakia or pseudo-phakia glaucoma, secondary open-angle glaucoma and refractory glaucoma.

[Bibliometric analysis of current glaucoma research based on Pubmed database].

OBJECTIVE: To survey the distribution pattern and subject domain knowledge of worldwide glaucoma research based on literatures in Pubmed database. METHODS: Literatures on glaucoma published in 2007 to 2011 were identified in Pubmed database. The analytic items of an article include published year, country, language author, and journal. After core mesh terms had been characterized by BICOMS, the co-occurrence matrix was built. Cluster analysis was finished by SPSS 20.0. Then visualized network was drawn using ucinet 6.0. RESULTS: Totally 6427 literatures were included, the number of annual articles changed slightly between 2007 and 2011. The United States, England, Germany, Australia, and France together accounted for 77.63% of articles. There were 52 high-frequency subjects and hot topics were clustered into the following 10 categories: (1) Pathology of optic disc and nerve fibers and OCT application, (2) METHODS: of visual field (VF) and visual function examination, (3) Glaucoma drug medications, (4) Pathology and physiology of primary open angle glaucoma (POAG) including VF and intraocular pressure (IOP), (5) Glaucoma surgery, (6) Gene research related to POAG, (7) Glaucoma disease pathology and animal models, (8) Ocular hypertension (OHT) induced complications and corneal changes, (9) Etiology of congenital glaucoma and complications, (10) Etiology and epidemiology of glaucoma. The visualized domain knowledge mapping was successfully built. The pathology of optic disc and nerve fibers, medications, and surgery were well developed. Study on IOP and visual field was in the core domain, which have an important link to etiology, diagnosis, and therapy. The researches on glaucomatous gene, disease pathology model, congenital glaucoma, etiology and epidemiology were not developed well, which are of great promotion space. CONCLUSIONS: The distribution pattern and subject domain knowledge of worldwide glaucoma research in the recent five years were shown by using bibliometric analysis.Western developed countries play a leading role in the field of glaucoma research, the international influence of related research in China needs to be strengthened.

[Current approaches in neovascular glaucoma].

Neovascular glaucoma (NVG) has long been recognized as a very difficult case to manage for its very poor prognosis of visual function. NVG is also remarked as an 'end stage' of ocular diseases. Conventional treatments with extremely uncontrolled cases are retinal cryotherapy or enucleation. Currently, management of this medical condition is directed toward a new era with great advancement in diagnosis and treatment. Glaucoma drainage implant surgery brings a time window of normal range of intraocular pressure (IOP) for physicians to process underlying disease of NVG. Regression of iris neovascularization by employing panretinal photocoagulation (PRP) or intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF) antibodies create a chance to undertaken antiglaucomatous surgery. Adjunctive anti-VEGF treatment promotes the surgical success rate for NVG. Current approaches in NVG are able to provide patients with an individualized management using a sound treatment strategy according to etiology, stage of disease, visual potential and other factors.

Ocular manifestations of intracranial germinomas: three cases report and literature review.

Intracranial germinomas are malignant neoplasms of gonadal origin, which have some features in terms of age, sex, and clinical manifestations. They mainly occur in children and adolescents. Patients with intracranial germinomas mainly manifest with hypothalamic pituitary axis dysfunction and/or compression syndromes. Visual disturbance is one of the most significant clinical presentations, which is mainly caused by tumor cell infiltration into the optic pathway. In this article, we present three cases of patient with intracranial germinoma to analyze the ocular manifestations. All the three patients presented with endocrine symptoms in the early stage and with visual disturbances (including decreased visual acuity and visual field defects) later. In general, germinoma is diagnosed by its characteristic radiological appearance, supported by tumor markers and/or stereotactic biopsy. However, decisive diagnoses were established when ocular manifestations were presented. A suspicion for germinoma should be considered, when young patients manifest visual disturbances accompanied by endocrine symptoms.

[Historical review of heart transplantation].

In 1905, Carrel and Guthrie reported the heterotopic heart transplantation on dogs for the first time. In the same year, Shone advanced the transplantation immunity theory which provided a basis for organ transplantation. In 1964, Hardy and his colleagues performed the first human chimpanzee heart transplantation. In 1967, Barnard performed the first human-to-human orthotopic heart transplantation in the world. In 1968 - 1971, 56 hospitals performed 180 heart transplantations world-wide. But because of the poor survival rate after operation, heart transplantations became less frequent. In 1972, Castaneda and Reitz summed up the experiences of heart-lung experimental transplantation, which laid a foundation for human heart-lung transplantation. In 1973, Caves invented myocardium biopsy for rejection surveillance after heart transplantation, which solved the problem of diagnosis for early rejection. In 1981, Stanford University first took cyclosporin A into clinical practice. The acute rejection after heart transplantation was effectively controlled and the long-term survival rate was significantly increased. Heart transplantation entered the second peak period. The launching of Asian heart transplantation began in 1968. Juro·Wada with his medical team performed the first heart transplantation in Japan. In 1978, Zhang Shize in Shanghai performed the first heart transplantation in China.

[Activation and significance of the PI3K/Akt pathway in endometrium with polycystic ovary syndrome patients].

OBJECTIVE: To investigate activation of the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt) pathway in the endometrium of women with polycystic ovary syndrome (PCOS) and its role in endometrium hyperplasia and carcinogenesis, and the factors affecting the activation of the PI3K/Akt pathway. METHODS: From Jan 2007 to Jun 2008, 52 patients with PCOS who underwent dilatation and curettage were selected as experimental group matched with 32 non-PCOS patients as control group. Serous hormonal parameters, fasting blood glucose and insulin, body mass index (BMI), and endometrium pathology were measured and evaluated in all patients. The PCOS patients were divided into insulin resistance and non-insulin resistance group according to homeostasis model assessment-insulin resistance index (HOMA-IR). Meanwhile, the PCOS patients were grouped as normal, endometrial hyperplasia and carcinoma depending on outcome of pathology. The expression of Akt and phosphorylated Akt (p-Akt) were determined by western blot. RESULTS: (1) The expression of p-Akt was significantly higher in PCOS group [(46 ± 18)%] than that in control [(33 ± 9)%, P < 0.01)]. (2) The expression of p-Akt was significantly higher in group of endometrial hyperplasia and carcinoma [(56 ± 19)%] when compared with those in normal endometria group [(31 ± 12)%, P < 0.05]; the expression of p-Akt was significantly higher in group of insulin resistance [(50 ± 19)%] compared with that in non-insulin resistance group [(34 ± 10)%, P < 0.01]. (3) There was a positive correlation between the expression level of p-Akt in endometrium with PCOS and HOMA-IR and BMI respectively (r = 0.400, 0.326, both P < 0.05). CONCLUSIONS: The PI3K/Akt pathway was over activated in endometrium with PCOS which may be associated with the formation of endometrial hyperplasia and carcinoma in PCOS patients. Insulin resistance and obesity may be high risk factors for over-activation of the PI3K/Akt pathway in endometrium with PCOS.

[Current research status on radiation retinopathy].

Radiation retinopathy (RR) and radiation optic neuropathy (RON) are vision-threatening complications of head and/or neck irradiation therapy. Clinical features are characterized by delayed-onset, slowly progressive, occlusive vasculopathy caused by endothelial damage. Compared with the optic nerve, retinal vessels are more sensitive and harmful to radioactive injury and cause RR, which may progress to eyeball atrophy ultimately. Thorough understanding of the incidence, pathogenesis, risk factors, clinical characteristics and treatment of RR is of practice significance. Ongoing basic laboratory and clinical research efforts have led to a better understanding of this disease. This article reviews the present research status of RR briefly.

Polychlorinated biphenyls and organochlorinated pesticides in birds from a contaminated region in South China: association with trophic level, tissue distribution and risk assessment.

PURPOSE: Birds have been used successfully for biomonitoring of the levels and effects of persistent organic pollutants (POPs) in the environments; however, there is exceedingly little data on organochlorinated pesticide (OCPs) and polychlorinated biphenyls (PCBs) residues in bird inhabiting in China. In the present study, we detected the concentrations of PCBs, dichlorodiphenyltrichloroethane and its metabolites (DDTs) and hexachlorocyclohexanes (HCHs) in muscle, liver and kidney of birds that inhabit in an e-waste recycling site. Associated with the stable isotope ratio (δ (15)N), we investigated the effect of trophic level on the body burdens of persistent contaminants in birds. The tissue distributions of contaminants in these birds were examined, and a preliminary risk assessment was also conducted. MATERIALS AND METHODS: Specimens from eight bird species were collected from Qingyuan County, Guangdong Province, South China. Pectoral muscle, liver and kidney tissues were Soxhlet-extracted and finally dissolved in isooctane. Both PCBs and OCPs were analyzed by gas chromatography-mass spectrometry. The subsamples for nitrogen stable isotope analysis were lyophilized, ground and analyzed by a flash EA 112 series elemental analyzer interfaced with an isotope ration mass spectrometer. RESULTS AND DISCUSSION: PCBs exhibited the highest concentrations among all target compounds, and a preliminary risk assessment suggested that adverse effects might occur in some birds for its high level. Generally, the concentrations of pollutants in liver and kidney were higher than those in muscle, which was mainly driven by passive diffusion to the 'lipid-compartment'. Significant differences in level of contaminants were obtained among species due to the varieties in dietary composition and habitat. An increasing trend was obtained between concentrations of PCBs and DDTs with trophic levels; however, HCHs exhibited the same level among species. RECOMMENDATIONS AND PERSPECTIVES: Because of the e-waste recycling activities, the study area has been heavily polluted by PCBs. Studies on the species-specific hazard assessment associated with exposure to PCBs are urgently needed in the study of birds in the area.

Cod liver oil: a potential protective supplement for human glaucoma.

Glaucoma is one of the leading causes of visual impairment and blindness. Improved knowledge of the pathogenesis of this disease has allowed the exploration of new therapeutic methods. In general, elevated intraocular pressure (IOP), oxidative stress, and vascular insufficiency are accepted as the major risk factors for the progression of glaucoma. Many natural compounds have been found beneficial for glaucoma. Nutritional therapies are now emerging as potentially effective in glaucomatous therapy. One nutritional supplement with potential therapeutic value is cod liver oil, a dietary supplement that contains vitamin A and omega-3 polyunsaturated fatty acids (PUFAs). Vitamin A is important for preserving normal vision and it is a well-known antioxidant that prevents the oxidative damage that contributes to the etiology and progression of glaucoma. Vitamin A is also a crucial factor for maintaining the integrity of conjunctival and corneal ocular surfaces, and preventing the impairment of ocular epithelium caused by topical antiglaucomatous drugs. Omega-3 fatty acids are beneficial for glaucoma patients as they decrease IOP, increase ocular blood flow, and improve optic neuroprotective function. In this article, we propose that cod liver oil, as a combination of vitamin A and omega-3 fatty acids, should be beneficial for the treatment of glaucoma. However, further studies are needed to explore the relationship between cod liver oil and glaucoma.

[The blood-aqueous barrier changes after laser peripheral iridotomy or surgery peripheral iridectomy].

OBJECTIVE: To investigate the ocular blood-aqueous barrier (BAB) alteration after laser peripheral iridotomy (LPI) or surgery peripheral iridectomy (SPI) in patients with primary chronic angle-closure glaucoma (PCACG). METHODS: This was a clinical randomized controlled trial. Sixty eyes of 60 subjects with early stage of PCACG were randomly received either LPI or SPI and followed up postoperatively at day 3, week 1, 2, 3, and 4. Aqueous flare in anterior chamber was measured by FC-2000 flare-cell photometry, intraocular pressure (IOP) measured by tonometer, central corneal endothelium cell counted by endothelioscopy, peripheral anterior synechiae (PAS) detected by gonioscopy. Data were analyzed by using two-way ANOVA for repeated measures, independent samples t-test, paired t-test, nonparametric test, and Spearman rank correlation test. RESULTS: On follow-ups of pre-operative and post-operative 3 days, 1 week (w), 2w, 3w and 4w respectively, the mean aqueous flare values for LPI group were (5.47 ± 1.09), (11.96 ± 3.07), (8.08 ± 2.18), (5.68 ± 0.83), (5.80 ± 1.00), (5.69 ± 1.12) PC/ms, and for SPI group were (5.43 ± 1.13), (8.44 ± 3.22), (6.42 ± 1.77), (5.35 ± 0.71), (5.53 ± 1.26), (5.45 ± 1.23) PC/ms. During post-operative 1w the flare values in both LPI and SPI groups were significantly higher than that on pre-operation (t = -12.753, -8.101, P < 0.05; t = -5.971, -3.870;P < 0.05) and LPI group had a significantly higher mean flare value than SPI group (t = 4.329, 3.231;P < 0.05). The IOP spike in LPI group was significantly (χ(2) = 5.079, 4.022, P < 0.05) higher than that in SPI group at week 1 of post-operation. Increased IOP was positively correlated with BAB damage (r = 0.899, 0.833; P < 0.05). The numbers of medications required to maintain IOP ≤ 21 mm Hg (1 mm Hg = 0.133 kPa) at week 4 of post-operation in LPI was significantly (Z = -1.984, P < 0.05) more than that in SPI group. There were no significant differences in central corneal endothelium cell count at week 1 (t = -0.696, 0.008) and in extension of PAS at week 4 (Z = -1.270, -1.490) of post-operation when compared to pre-operation (P > 0.05). No obvious complications occurred in both groups. CONCLUSIONS: Our results demonstrated that IOP spike in both of LPI and SPI is due, at least in part, to BAB damage, which appears to be more severe in LPI group and can recover within two weeks. PAS progression and central corneal endothelium cell loss are not aggravated in 1 month after operation.

[Clinical analysis of radiation optic neuropathy].

OBJECTIVE: To investigate the clinical features, risk factors, diagnostic methods, treatment regimens and outcomes of Chinese adult patients with radiation optic neuropathy (RON). METHODS: Retrospective case series. Clinical data with RON admitted to Zhongshan Ophthalmic Center from June 1999 to October 2010 were investigated retrospectively. RESULTS: Thirty-five cases (61 eyes) with RON were analyzed. All cases manifested as sudden binocular or monocular painless vision decrease. In 18 cases (51.4%), symptoms occurred within 36 months after the completion of radiation. In 43 eyes (70.5%), the visual acuity was less than 0.05 and/or with a visual field less than 10 degrees. In 52 eyes which the fundus could be examined, 41 eyes (78.8%) showed a clear boundary of optic papilla, including 6 eyes (14.6%) with normal appearance of optic papilla, 30 eyes (73.2%) with lighter color, 5 eyes (12.2%) with pale optic papilla, and 11 eyes (21.2%) with edematous or hemorrhagic and/or exudative optic papilla. Only 14 eyes showed abnormal visual field examination, mainly manifested as nerve bundle defect scotoma. Seven eyes (50%) manifested as arcuate scotoma, 3 eyes (21.4%) manifested as central scotoma and/or paracentral scotoma, 2 eyes accompanied by blind spot enlargement, 1 eye showed paracentral scotoma and 1 eye with quadrantanopia. Twenty-three eyes received fluorescein angiography (FFA), the major manifestations were low fluorescence at the optic nerve and areas of capillary nonperfusion. Pattern visual evoked potential revealed reduced amplitude and/or extended incubation period in 83.3% eyes. Treatment regimens including systemic corticosteroids, hyperbaric oxygen therapy, hyperbaric oxygen in combination with corticosteroid and laser photocoagulation, the visual acuity of 10 eyes (16.4%) had merely been improved. CONCLUSIONS: The prognosis of visual function in RON is poor resulting from devastating visual loss and/or visual field defect. The main damage of the fundus is retinal vascular occlusion and optic atrophy at different degrees. No adequately effective therapies are proved currently. The treatment aimed on the complication could only provide a short-term improvement of the vision.