摘要
Objective:To evaluate whether there are changes in cone cells in patients with pre-clinical hydroxychloroquine (HCQ) retinopathy using an adaptive optics (AO) retinal camera.Methods:A retrospective case-control study. From May 2020 to July 2020, 46 patients who were treated in Department of Rheumatism and Immunology, Hainan Hospital of PLA General Hospital with rheumatic immune diseases were included. All patients had a history of HCQ use and no obvious abnormality was found in fundus examination; 105 healthy people with similar demographic characteristics without a history of hydroxychloroquine were recruited as the control group were included. All subjects received the routine ophthalmological examination including best corrected visual auity (BCVA), spectral-domain optical coherence tomography (SD-OCT), Fundus autofluorescence (FAF), visual field, endoscopy of the cornea, and the measurement of axial length (AL). The BCVA was performed with the Snellen visual acuity chart, and the result was converted to logarithmic minimum angle of resolution (logMAR) visual acuity for statistic. Among the 46 cases, 6 cases were males and 40 cases were females. Age was (42.02±13.81) years old; logMAR BCVA was 0.063±0.015; AL was (23.95±0.726) mm. Visual field, macular SD-OCT, FAF examination showed no abnormality. The average cumulative dose of HCQ was 522.60 (6-1 728) g. rtx1 AO retinal camera was used to collect fundus images of subjects in four quadrants above the retina, nasal side, lower side and temporal side with 3°centrifugation from the fovea in both eyes. The cone density, cone spacing, cone arrangement regularity and the proportion of the nearest cones with 6 (nn=6) were measured in the four quadrants. The density of cone cells between the left and right eyes in case group and control group were compared by paired t test. The density and spacing of cone cells in each quadrant were compared by t test of two independent samples. Results:Compared with the control group, the cone cell density in the four quadrants of the left eye and the nasal, superior and inferior sides of the right eye in the case group was significantly decreased, and the difference was statistically significant ( t=4.247, 2.107, 4.884, 2.254, 2.643, 4.445, 4.116; P<0.05). The cone spacing in the nasal and temporal sides of the left eye of the patients in the case group was significantly larger than that in the control eye, with statistical significance ( t=2.750, 3.318; P<0.05). Compared with the control group, the regulatign of cone cell arrangement in the left temporal side of the right and left eye in the case group were significantly reduced, the difference was statistically significant ( P=0.002, 0.011). The proportion of nn=6 in the inferior and temporal sides of the right eye decreased significantly in the case group, and the difference was statistically significant ( P=0.006, 0.032). Conclusion:AO retinal imaging can detect the changes of cone cells in the early clinical stage of HCQ retinopathy.
摘要
Visual electrophysiological examination has strict standards and quantitative methods for stimulating light, which involves the concepts of photopic and scotopic vision of human eyes.Photopic vision is a visual perceptual activity mainly involving cones in a bright environment, while scotopic vision is a visual perceptual activity mainly involving rod cells in a dark environment.Even if the rated power of the light source is the same, the brightness (luminous flux) perceived by human eyes is different for different spectral light sources in the same or different visual environments.To enable ophthalmologists and clinical visual electrophysiological examination technicians to accurately understand the setting mechanism and recording results of stimulating light in the international standard of visual electrophysiology, this paper introduced the basic concepts such as the concept of human eye photopic and scotopic vision, the measurement and expression of brightness in different visual environments, and the luminous flux of light sources under photopic and scotopic vision in detail, and interpreted the application of the concept of photopic and scotopic vision in clinical visual electrophysiology.
摘要
Vitreoretinal interface is consisted of posterior vitreous cortex, retina internal limiting membrane, and extracellular matrix between them. Basement membrane-like complex is formed in the interface. The interface in children is of much difference with that in adult. The adhesion of it is much tight in children. The posterior edge of vitreous base is closed to ora serrata. The retina internal limiting membrane is thin. But with age, the posterior margin of vitreous base extends posteriorly, internal limiting membrane thickens and its elasticity decreases, the adhesion in vitreoretinal interface weakens, and posterior vitreous detachment develops. To recognize fully the interface in children is of much importance for understanding the pathophysiology and treatment strategy of pediatric vitreoretinal diseases.
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As a new rising edge discipline,neuro-ophthalmology is a subject of extensive radia-tion,with low awareness and poor efficiency. Specialists of General Hospital of PLA summarized a practi-cable series of teaching ideas and methods including teaching thoughts,strategies and methods. Combi-nation of traditional theory and practice with the use of modern means and platforms were introduced and satisfactory results were achieved.
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Objective To evaluate the correlation between antiphospholipid (APLA) antibodies and retinal vein occlusion (RVO).Methods A computerized search was conducted in the Pubmed,Chinese Biological Medicine Database,China National Knowledge Infrastructure,VIP database,Wanfang Database combined with manually searching of literature reference proceedings.The search time was ranged from establishment of each database to August 1st,2012.After the data extraction,quality of RCT was assessed.The meta analysis was performed by Stata 11.0.Results In total,12 case-control studies (1324subjects) that fulfilled the eligibility criteria were included in the meta-analysis involving 505 patients in RVO group and 819 subjects in control group.The odds ratio (OR) and 95％ confidence interval (CI) of APLA,anticardiolipin antibodies (ACA),lupus coagulation inhibitor and RVO were 5.01 and 3.33-7.53,4.38 and 2.38 8.05,1.72 and 0.73-4.04,respectively.The OR and 95％ CI of APLA,ACA and central RVO were 4.80 and 2.59-8.88,6.02 and 2.06-17.63,respectively.The OR and 95％ CI of APLA,ACA,lupus coagulation inhibitor and branch RVO were 4.22 and 1.67-10.63,3.69 and 1.32-10.32,2.07 and 0.79-5.41,respectively.Conclusions APLA may increase the rick of RVO,especially ACA has a prediction function to RVO.It is necessary to screening for APLA in RVO patients.
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OBJECTIVE@#To evaluate the efficacy and safety of acupuncture for optic atrophy.@*METHODS@#All the randomized controlled trials (RCTs) on optic atrophy treatment with acupuncture were included after retrieving the PubMed, Embase, Cochrane Library, CBM, CNKI, VIP, Wanfang database from their establishment to November 2012. The bibliographies of the included studies were retrieved as well. The quality of RCTs meeting the inclusion criteria was evaluated and the data were extracted. Meta-analyses were performed with Stata 11.2 software.@*RESULTS@#Thirteen RCTs involving 1180 eyes were included. Meta-analyses showed that the effect of acupuncture or combined with medicine was superior to medicine alone in terms of total effectiveness [OR=3.281, 95% CI ( 2.517, 4.278)], visual acuity [3.287, 95% CI (2.193, 4.925)], and visual field [3.215, 95% CI (1.580, 6.543)]. The visual sensitivity and P-VEP test showed the similar results.@*CONCLUSION@#Acupuncture is superior to medicine in terms of improved visual acuity, visual field and P-VEP. However, large samples, and high-quality studies are needed for stronger evidence.
Subject(s)
Adolescent , Adult , Child , Female , Humans , Male , Middle Aged , Young Adult , Acupuncture Therapy , Optic Atrophy , Therapeutics , Randomized Controlled Trials as Topic , Treatment Outcome , Visual Acuity , Visual Fields摘要
@#Objective To investigate the application of optical coherence tomography (OCT) in traumatic macular disease.MethodsOCT examination was carried out and analyzed in 56 eyes of 56 cases with traumatic macular disease.ResultsThe OCT examination showed that there were 23 cases of whole macular hole, 3 cases of lamellar macular hole, 3 cases of epi-macular membrane, 8 cases of macular hemorrhage, 5 cases of serous neuroretinal detachment, 4 cases of hemorrhagic retinal pigment epithelium detachment, 4 cases of macular edema and 6 eyes of macular neuroretinal thinning.ConclusionOCT plays an important role in diagnosis, monitoring and investigation of pathogenic mechanisms for traumatic macular disease.
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@# Objective To explore the use of Ultrasonic Biomicroscopy(UBM)for peri-operative examination of traumatic cyclodialysis.MethodsUBM was used in 33 eyes of 33 cases who were diagnosed as traumatic cyclodialysis.The morphologic characters were observed peri-operatively.ResultsCiliary detachment of 360° was verified in the 33 eyes with cyclodialysis of more than 2 clock hours.1 month after cyclopexy,the space of ciliary detachment disappeared or diminished and all reattached 3 months after operation.ConclusionUBM is safe and effective for checking traumatic cyclodialysis.
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Objective To create a calibrated animal model of graded optic nerve injury (ONI) in rats, focusing on quantification of injury intensity, injury severity and the correlation between them. Methods A pair of cross-action forceps with pressure of 148.0 g was used to clip rat optic nerves for 3, 6, 30 and 60 seconds, or a pair of artery clips with constant pressure (32.4 g) used to clip rat optic nerves for 5, 10 and 15 seconds in order to create graded ONI animal models. Transcranial FluoroGold-labeled retinal ganglion cell (RGC) was used to observe the changes of RGC one month after injury, which then could be used to evaluate the injury severity. Ocular blood supply was evaluated by transcardiacly perfused Luxol Fast Blue post-injury. Results The graded ONI animal models were successfully created in rats without retinal ischemia post-trauma. The injury intensity could be well-defined by impulse or averaged impulse, while injury severity could be evaluated by the count of FluoroGold-labeled RGCs. The averaged impulse produced by artery clips clipping rat optic nerves for 15 seconds equalized with that produced by cross-action forceps for three seconds. The severer injury intensity begot less number of RGCs. The correlation between injury impulse and RGCs was fit for power function. Short time clipping of optic nerves could not lead to ischemic injury of the retina. Conclusions A calibrated graded ONI animal model is successfully created by clipping optic nerves with a pair of cross-action forceps. The model can be evaluated with RGCs count, impulse and averaged impulse, the latter two of which stand for injury intensity and injury severity, respectively.
摘要
Optic nerve injury may occur at any section from the eyeball up to the brain. There should be enough mechanical power acting on the skull to result in severe optic nerve injury. Loss of light perception immediately after injury would be followed by an unfavorable prognosis. Efficacy of decompression procedures on optic nerve canal has not been demonstrated. large doses of adrenocortical steroid may be beneficial for early recovery of visual function. Based on the observation in animal model of partial injury, the capability of regeneration of optic nerve was closely associated with the extent of the injury. The enviroment for regeneration of partially injured optic nerve fibers is different from that of complete injury. The irreversibly injured fibers may have more regenerative potency than partially injured optic nerves.
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Objective To investigate the gene expression spectrum of retina and optic nerve after partial injury of optic nerve. Methods Sixty SD rats were randomly divided into 4 groups. The optic nerves of the right eyes were clipped for 6 seconds with a pair of cross-action forceps. The retinae and optic nerves in the operation eye and contralateral sham operation eye were removed 3, 7, 14, and 21 days after the injury to detect gene expression patterns with high-density DNA microarrays. Results Changes of a mass of gene expressions were found after the optic nerve injury, and the positive rate of gene expression was 2.35%, 6.48%, 3.82% and 4.09% after 3, 7, 14, 21 days, respectively, and the total positive rate was 11.77%. The functions of positive expression of the gene involved cell survival, cytoskeleton, extracellular matrix and cell adhesion, free radicals and oxidative damage, energy and metabolism, inflammation, neurotransmission and ion transport, signal transduction, structural protein, transcription and translation. Up- or down-regulation of repaired genes was the main part of the changes of gene expression, while the altered-expression destroy genes was the minor part in the whole gene expression spectrum, in which the up- and down-regulation of expression of repaired genes accounted for 13.98% and 24.73% respectively 7 days after the injury, and the down-regulation of expression of repaired genes accounted for 17.20% 14 days after the injury. Conclusions A mass of gene expression changes occurs after the optic nerve injury, and the comprehensive view on the gene expression pattern following the optic nerve injury is crucial to discover the mechanism of post-injury reaction and regeneration.
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0 05),but obviously lower than that in NDR group (P
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Objective To determine the affected factors of intraorbital hemodynamic results in diabetic retinopathy (DR) and the risk factors related to the occurrence of DR. Methods Posterior ciliary artery (PCA), central retinal artery (CRA), central retinal vein (CRV), and vortex vein (VV) of 68 patients with DR were measured by color Doppler flow image (CDFI). Thirty-one hemodynamic parameters, including systolic velocity, diastolic velocity, mean velocity, resistive index, pulsatility index and accelerative velocity of ophthalmic artery (OA), and other variates (blood pressure, blood sugar, gender, age, duration of the disease, and so on) were collected and clustered in a principal components analysis following a forward, stepwise logistic regression on these components. Results Nine principal components were extracted from 37 original variates, reflecting the velocity of OA, velocity of PCA, resistance of OA, velocity of CRA, resistance of CRA, resistance of PCA, time-related factor, venous drainage factor and gender factor, respectively. In the result of logistic regression, resistance of OA, velocity of CRA, resistance of PCA, time-related factor, and venous drainage factor were the risk factors related to DR. Conclusion The first risk factor affecting DR is time, and intraorbital hemodynamic abnormity influencing the development of diabetic retinopathy may be the increase of resistance of OA, decrease of velocity of CRA, decrease of resistance of PCA, and increase of venous drainage.