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Objective:To compare the detection rate and time cost of different imaging methods for retinal and optic disc neovascularization in proliferative diabetic retinopathy (PDR).Methods:A cross-sectional study was conducted.Thirty-eight patients (48 eyes) with PDR were enrolled in Henan Eye Hospital from October 2019 to February 2021, including 22 males (28 eyes) and 16 females (20 eyes). The average age of the patients was (51.08±13.35) years.All patients underwent ultra-widefield imaging (UWFI), fundus fluorescein angiography (FFA), optical coherence tomography angiography (OCTA), en face optical coherence tomography (OCT), near-infrared fundus imaging (IR) combined with spectral domain OCT (SD-OCT). Wide field swept-source OCTA (WF-SS-OCTA) was performed in the patients who were unsuitable for FFA.The time required for each examination in one eye and the detection rate of neovascularization at the optic disc (NVD) and retinal neovascularization elsewhere (NVE) were recorded.This study adhered to the Declaration of Helsinki.The study protocol was approved by Henan Eye Hospital (No.HNEECKY-2021[22]). All patients were informed about the method and purpose of the study and voluntarily signed the informed consent form.Results:The mean monocular examination time costs of UWFI, IR+ SD-OCT, OCTA+ en face OCT, FFA and WF-SS-OCT was (0.51±0.13), (2.08±0.57), (5.79±0.68), (17.66±1.83) and (13.38±1.23)min, respectively.There was a significant overall difference in the mean monocular examination time among the five methods ( F=2 077.960, P<0.001). The detection rates of UWFI, IR+ SD-OCT, OCTA+ en face OCT, FFA+ WF-SS-OCT for NVE and NVD were 52.1%(25/48) and 12.5%(6/48), 81.3%(39/48) and 20.8%(10/48), 83.3%(40/48) and 27.1%(13/48), 93.8%(45/48) and 29.2%(14/48), respectively.There were significant differences in the detection rates of NVE ( χ2=26.460, P<0.001) but not in the detection rates of NVD ( χ2=4.645, P=0.200) among the various methods.Five neovascular buds were detected by OCTA in 3 eyes, but not by FFA. Conclusions:UWFI and IR+ SD-OCT are faster and non-invasive methods for the screening of NVD and NVE in PDR eyes.Compared with FFA, OCTA and en face OCT can show the shape of neovascularization more clearly.FFA provides a wide-range retinal image, but it is time-consuming and invasive.WF-SS-OCTA extends the examination range of OCTA and detects neovascularization non-invasively and faster than FFA.
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Objective:The clinical phenotypes and pathogenicity of isolated cone-rod dystrophy (CORD) caused by two novel complex heterozygous variants of the CEP290 gene were analyzed using high-resolution multi-mode imaging and gene detection techniques. Methods:A retrospective study. Two patients and two family members from a CORD family who were diagnosed by genetic testing at Henan Provincial People's Hospital in December 2021 were included in the study. All subjects underwent best-corrected visual acuity (BCVA), color fundus photography, autofluorescence, swept-source optical coherence tomography (SS-OCT), adaptive optics fundus imaging, static threshold field, full field and multiple electroretinogram (ERG) examination, as well as other systemic examinations throughout the body. The peripheral venous blood of the subjects was collected, and the whole genome DNA was extracted. DNA sequencing was performed using the Inherited Retinal Disease Kit PS400, and Sanger verification and pedigree co-segregation analysis were performed on the suspected pathogenic mutation sites. Validation was performed by Sanger sequencing, pathogenicity analysis was performed in accordance with the American College of Medical Genetics and Genomics (ACMG) guidelines. Conservation of variation among different species was analyzed by GERP++, Clustal Omega and Weblogo.Results:Both patients were male, and their ages were 21 and 29 years old, respectively. The right eye and left eye about BCVAs were 0.7, 0.4 and 0.3, 0.4, respectively. The full field and multiple electroretinogram ERG showed a decreased function of cones and rods, especially cones. SS-OCT showed thinning of the outer nuclear layer of macular, and attenuation of ellipsoid zone reflectivity in B-scan. Adaptive optics fundus imaging examination showed that the arrangement of cone cells in the fovea of the fovea was disordered and the density decreased, and the retinal pigment epithelial cells were seen through the atrophy of cone cells in some areas at 10°visual angle. No obvious abnormality was found in other systemic examinations of the whole body. Genetic testing showed that 2 novel compound heterozygous variants c.950T >A (p.Leu317*) (M1) and c.4144_4149del (p.Tyr1382_Glu1383del) (M2) in CEP290 were found in two patients. The first variant was predicted to be harmful in MutationTaster and CADD. GERP++ showed highly conserved among different species. The pathogenicity of the variant was suspected to be likely pathogenic according to ACMG guidelines. The pathogenicity of the second variant was uncertain significance. The parents of the proband had no similar ocular abnormalities. Verified by Sanger sequencing, it was consistent with co-separation in the family. Conclusions:Patients with pure CORD caused by CEP290 gene mutation still retain better vision when the cone structure is abnormal, the density is decreased, and the function of cone and rod cells is decreased. CEP290 M1 and M2 are newly discovered nonsense mutations and newly discovered deletion mutations, which expanded the causative gene spectrum of pure CORD.
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Objective To optimize the fermentation conditions for Enterococcus faecalis (E.faecalis) and Saccharomyces cerevisiae (S.cerevisiae) mixed culture.Methods The optimum fermentation conditions for E.faecalis and S.cerevisiae mixed culture were identified by investigating the influence of initial pH,inoculum size,and ventilation rate of the culture broth on mixed microbial growth.Results The optimal initial pH of mixed microbial culture was 7.0 and the inoculation amounts of E.faecalis and S.cerevisiae were 4％ and 10％ respectively,when fermented in 600-mL pilot fermentor (liquid volume 40％) at 30 ℃,with ventilation rate of 0.2 L/min,for 20 h.At the end of the fermentation,the E.faecalis and S.cerevisiae counts were approximately 3.8 × 108 CFU/mL and 2.4 × 108 CFU/mL,respectively.Ventilation for the amount difference of E.faecalis was no significant (P ＞ 0.05),and for the amount difference of S.cerevisiae was statistically significant (P ＜ 0.05).Conclusion The E.faecalis and S.cerevisiae counts increased by 32.2％ and 31.5％ respectively,when the optimized conditions of fermentation culture were used.In this study,high mixed microbial counts were obtained,thus providing a reference for the preparation of large-scale production of mixed microbes.
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Background It is thought in recently that photodynamic therapy (PDT) is an effective treatment method for chronic central serous chorioretinopathy (CSC), but the dosage of verteporfin and its long-term efficacy and complications is rarely elucidated ever before.Objective This study was to observe the long-term efficacy and safety of 60％ dose verteporfin PDT for chronic CSC.Methods This is a retrospective study and a self-controlled design was used.The clinical data of 25 eyes of 21 chronic CSC patients who received 60％-dose verteporfin PDT in Henan Eye Institute from January 2009 to May 2010 were reviewed, with the male 18 (85.71％) and female 3 (14.29％) as well as monocular CSC 17 patients and binocular CSC 4 patients.The average ages of the patients were (43±5) years.Fundus fluorescein angiography (FFA) , indocyanine green angiography (ICGA), optical coherence tomography(OCT) and best corrected visual acuity (BCVA) were examined in all the patients before and after treatment.PDT with the 60％-dose verteporfin (3.6 mg/m2) was carried out on the CSC eyes.The treated eyes were examined 2 weeks, 1 month and 3 months after PDT.The BCVA,subfoveal choroid thickness,FFA and ICGA findings before and after PDT were compared.The following-up duration was 5 years or more.Results The BCVA before and 3 months after PDT were 0.5 ±0.1 and 0.9±0.2, respectively, with a statistically significant difference between them (t =19.17,P =0.00).The subfoveal choroidal thickness value 3 months after PDT was (326.56±39.47) μm,which was significantly reduced in comparison with (486.24 ±47.53) μm before PDT (t =25.17, P =0.00).FFA and ICGA showed that the leakage of fluorescein (hyperfluorescence) was disappeared in all the treated eyes.No systemic or local adverse effects and recurrence were observed during the follow-up period.Conclusions On the basis of the results of this study and available information,60％-dose verteporfin PDT seems to have a better long-term efficacy and safety than full-dose verteporfin in treating chronic CSC.
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Culturing sientific research ability and innovative ability of medical college students is important for the development of themselves and the medical colleges as well,which also meets the needs of the local economy and social development.This paper studies the undergraduate research projects in recent five years,to underst and tmedical students' research ability.Countermeasures are proposed to improve the situation.
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Objective To investigate the characteristics of imaging appearances and diagnostic value of ciliochoroidal detachment.Methods Ultrasound,MRI and CT appearances of 19 cases of ciliochoroidal detachment were reviewed,which included 9 cases of serous ciliochoroidal detachment,7 cases of choroid hematoma,and 3 cases of ciliary body detachment.All cases were examined by both B ultrasound and MRI at the same time,11 of them were examined by CT.Results UItrasound showed membrane bulge of the eyeball wall with different extent in 9 cases of serous ciliochoroidal detachment.Its postzone connected the equator or close to optic disc and its prozone could not been detected by ultrasound.There was echofree fluid darkspace under detached membrane.MRI showed membrane detachment at both nasal side and temporal side of ocular annulation in 9 cases of ciliochoroidal detachment.The detached membrane was approximately symmetry,its anterior margin did not exceed ciliary body adhesion of ocular annnlation and its posterior margin stopped at posterior part of ocular annulafion.There was long T1 and long T2 signal under detached membrane.CT showed slight thickening of ocular annulafion and slightly increased density of eyeball in 5 cases of serous cilioehoroidal detachment.Ultrasound showed hemispheroid or curve bulge of eyeball wall,projected toward the vitreous cavity in 7 cases of choroid hematoma,and there was an amount of low echo light spot under the detached membrane.Both MRI (7 cases)and CT (5 cases) showed hemispheroid,fusfform or curve bulge on the nasal side,temporal side and posterior part of ocular annulation.They appeared as isodensity or slight high density on CT,iso- or high signal on T1 WI and T2WI.Stratification was seen on T2WI in I case of choroid hematoma.Ciliary body detachment could not been detected by either MBI (3 cases) or CT (1 case) except ultrasound.Conclusion Imaging examination may provide reliable diagnostic evidence for ciliochoroidal detachment.
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Objective To study the ultrasonographic manifestation character of age related macular degeneration (AMD). Methods The ultrasonographic manifestation of thirty five cases (38 eyes) of AMD diagnosed by fundus fluorescein angiography (FFA) with positive findings of ultrasonic B scan were analysed. Results The ultrasonic appearance of interlamellar transaudient cleft were found in 26 eyes, in which FFA appearance were serous detachment of pigment epithelium and subretinal neovascularization, 5 of them associated with small excavation of choroid, 4 of them associated with strong echo belt at the posterior edge of the interlamellar transaudient cleft in which the FFA appearance was extensive subretinal neovascularization.In another 4 eyes with choroidal hematoma under FFA revealed thin echo light spots in the interlamellar transaudient cleft. There was scar staining in the other 8 eyes in which the ultrasonic appearance showed an unequal thickening of the ocular wall in the posterior pole,unequal echo of interior edge and irregular inner echo. Conclusion The main ultrasonographic manifestation of AMD is the presence of interlamellar transaudient cleft in the thickened ocular wall.