摘要
ABSTRACT Purpose: This study aimed to compare the safety and effectiveness of intraocular pressure reduction between micropulse transscleral cyclophotocoagulation and "slow cook" transscleral cyclophotocoagulation in patients with refractory primary open-angle glaucoma. Methods: We included patients with primary open angle glaucoma with at least 12 months of follow-up. We collected and analyzed data on the preoperative characteristics and postoperative outcomes. The primary outcomes were a reduction of ≥20% of the baseline value (criterion A) and/or intraocular pressure between 6 and 21 mmHg (criterion B). Results: We included 128 eyes with primary open-angle glaucoma. The preoperative mean intraocular pressure was 25.53 ± 6.40 and 35.02 ± 12.57 mmHg in the micropulse- and "slow cook" transscleral cyclophotocoagulation groups, respectively (p<0.001). The mean intraocular pressure was reduced significantly to 14.33 ± 3.40 and 15.37 ± 5.85 mmHg in the micropulse- and "slow cook" transscleral cyclophotocoagulation groups at the last follow-up, respectively (p=0.110). The mean intraocular pressure reduction at 12 months was 11.20 ± 11.46 and 19.65 ± 13.22 mmHg in the micropulse- and "slow cook" transscleral cyclophotocoagulation groups, respectively (p<0.001). The median preoperative logMAR visual acuity was 0.52 ± 0.69 and 1.75 ± 1.04 in the micropulse- and "slow cook" transscleral cyclophotocoagulation groups, respectively (p<0.001). The mean visual acuity variation was −0.10 ± 0.35 and −0.074 ± 0.16 in the micropulse- and "slow cook" transscleral cyclophotocoagulation, respectively (p=0.510). Preoperatively, the mean eye drops were 3.44 ± 1.38 and 2.89 ± 0.68 drugs in the micropulse- and "slow cook" transscleral cyclophotocoagulation groups, respectively (p=0.017), but those were 2.06 ± 1.42 and 1.02 ± 1.46 at the end of the study in the "slow cook" and micropulse transscleral cyclophotocoagulation groups, respectively (p<0.001). The success of criterion A was not significant between both groups. Compared with 11 eyes (17.74%) in the "slow cook" transscleral cyclophotocoagulation group, 19 eyes (28.78%) in the micropulse transscleral cyclophotocoagulation group showed complete success (p=0.171). For criterion B, 28 (42.42%) and 2 eyes (3.22%) showed complete success after micropulse- and "slow cook" transscleral cyclophotocoagulation, respectively (p<0.001). Conclusion: Both techniques reduced intraocular pressure effectively.
摘要
Objective:To explore and validate the targets of Salvia miltiorrhiza in myopia using network pharmacology and molecular docking technology. Methods:The TCMSP database was used to extract the targets of Salvia miltiorrhiza.GeneCards, DisGeNET, Malacard and OMIM databases were used to extract the myopia-related targets.The target intersection was taken, and the intersecting targets were selected to extract the corresponding active ingredients of traditional Chinese medicine (TCM) and construct the pharmacological regulatory network of TCM using Cytoscape.The protein interaction network map for the key target genes was constructed using the String database, and the relevant proteins were selected to download the three-dimensional structures of the active ingredients from the PubChem database, and molecular docking was performed using AutoDockvina software.Twelve 3-week-old guinea pigs were induced with lens-induced myopia (LIM) in the right eye and randomly divided into normal saline group and sodium danshensu group, with 6 animals in each group.During the maintenance of LIM, periocular injection of 1 ml normal saline or sodium danshensu was performed daily.The contralateral eye was used as a negative control.On days 0, 14, and 28 of the experiment, the axial length of both eyes was measured by A-scan ultrasonography, and the refractive status was assessed with a streak retinoscope.To avoid individual differences, relative spherical equivalent (treated eye-contralateral eye) and relative axial length (treated eye-contralateral eye) were compared.On day 28, the relative expression levels of hypoxia-inducible factor-1α (HIF-1α) and transforming growth factor-β1 (TGF-β1) proteins were determined by Western blot.The feeding and use of laboratory animals followed the 3R principle, and the research program was approved by the Ethics Committee of Experimental Animal Center of Zhengzhou University (No.ZZU-LAC 202320405[02]). Results:Sixteen intersecting key targets were screened for myopia and TCM components derived from Salvia divinorum.A TCM network pharmacology map and protein interaction map were constructed with Salvia divinorum as a drug candidate, and the corresponding proteins of target genes, such as MMP2, TGFB1, and MMP9 were screened to perform molecular docking with the active ingredients, such as lignocellulosic acid, danshensu, tanshinone ⅡA, and so on.After 14 days of induction, the relative spherical equivalent and relative axial length were (-4.67±1.03)D and (0.67±0.26)mm in sodium danshensu group, and (-6.30±1.22)D and (1.08±0.34)mm normal saline group, indicating slower myopia progression and axial elongation in sodium danshensu group, and the differences were statistically significant ( t=2.412, P=0.039; t=2.750, P=0.049). The relative expression levels of HIF-1α protein were 0.20±0.01, 1.29±0.05 and 0.63±0.02, and the relative expression levels of TGF-β1 protein were 0.93±0.05, 0.25±0.01 and 0.74±0.05 in the negative control, normal saline and sodium danshensu groups, respectively.The expression of HIF-1α protein was higher in sodium danshensu group than in negative control group but lower than in the normal saline group, and the expression of TGF-β1 protein was lower in sodium danshensu group than in negative control group but higher than in the normal saline group, showing statistically significant differences (all at P<0.05). Conclusions:Natural compounds extracted from Salvia divinorum extracts may serve as potential drug candidates to combat scleral hypoxia and improve scleral extracellular matrix remodeling.
摘要
ABSTRACT Purpose: As superotemporal implantation of the Ahmed glaucoma valve is not always feasible in cases of refractory glaucoma, this study examined the characteristics and surgical outcomes of cases in which the valve was implanted in a nonsuperotemporal quadrant using a modified long scleral tunnel technique. Methods: This retrospective case-control study included 37 eyes with nonsuperotemporal quadrant--Ahmed glaucoma valve implantation in Group 1 and 69 eyes with superotemporal Ahmed glaucoma valve implantation in Group 2. The demographic characteristics of these groups, surgical outcomes, including complications, further surgical interventions, and surgical success rates were compared. Surgical success was defined as an intraocular pressure not exceeding 21 mmHg, accompanied by a minimum reduction of 20% in intraocular pressure from the baseline without any additional intraocular pressure-lowering procedures, and the absence of light perception loss or phthisis bulbi. Results: Group 1 had significantly higher numbers of eyes with secondary glaucoma and preoperative surgical procedures than Group 2 (p<0.05). Both groups had mean preoperative intraocular pressure values, and mean intraocular pressure values at the last visit of 34.2 and 27.9 months, 35.5 ± 1.5 and 35.8 ± 1.2 mmHg, and 14.5 ± 5 and 14.9 mmHg, respectively. Although both groups had 70.2% and 75.8% as their five-year cumulative probability of success, respectively, the rates of complications, revisional surgery, and additional surgical procedures did not differ significantly (p>0.05). Conclusion: The modified long scleral tunnel technique for Ahmed glaucoma valve implantation in nonsuperotemporal quadrants achieves intraocular pressure control and complication rates comparable to superotemporal implantation.
摘要
PURPOSE: To understand effect of Scleral lens on Keratoglobus cornea. CASE STUDY: Prospective Case Study METHOD: A 19-year old male diagnosed with RE Keratoglobus and LE Keratoconus was given a trial of Scleral contact lenses (Comfort- 15), to understand vision development and rehabilitation when no other corrective option was giving fruitful results for vision rehabilitation. Upon trial final lens was chosen with respect to comfort, vision improvement for distance and near and visual rehabilitation, and was dispensed lens with follow-up of 1-week, 1- month, 3-month & 6-months. RESULT: With final lens patient was comfortable with wearing hours of 10-12 hours comfortably with vision restoration to both eyes 6/6; N6 from RE 6/60 and LE 6/24; N10 both eyes. CONCLUSION: Scleral lenses have been proven to be better corrective option for keratoglobus and keratoconus.
摘要
Purpose: Comparison of the conjunctiva related complication rates and success rates among eyes with Ahmed glaucoma valve (AGV) implantation in which eye bank derived scleral and corneal patch grafts had been used to cover the tube. Methods: Retrospective comparative study. Patients who underwent AGV implantation between January 2000 to December 2016 were included. Demographic, clinical data, intra and post operative data was obtained from electronic medical records. Conjunctiva related complications were divided into two groups: with and without implant exposure. Conjunctiva related complication rates, success rate, risk factors among eyes with corneal and scleral patch graft were compared. Results: Three hundred and twenty three eyes of 316 patients underwent AGV implantation. Scleral patch graft was used in 214 eyes of 210 patients (65.9%) and corneal patch graft was used in 109 eyes of 107 patients (34%). Median follow up was 14 months. There was no significant difference in the conjunctiva related complication rate (7.3 % in corneal patch graft versus 7.0% in scleral patch graft;p=0.5) and conjunctival dehiscence rate (3.7% versus 4.6%, P = 0.7) among the two groups. Success rate was significantly higher in the corneal patch graft group versus the scleral patch graft group (98% versus 72%; p=0.001). Eyes with corneal patch graft had a higher survival rate (P = 0.01). Conclusion: There was no significant difference in the rate of conjunctiva related complications following corneal and scleral patch grafts used to cover the AGV tube. Eyes with corneal patch graft had a higher success rate and survival rate.
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Myopia is the most common type of refractive error. At present, the characteristics of the low age and rapid growth of myopia in our country are obvious, and the myopia of adolescents and children has become a public health problem of concern to the whole society. Visual experience guides the development of children's refractive state and emmetropization. The occurrence and development of myopia is accompanied by changes in the structure of the eyeball, and the choroid has a thinning trend. The thickness change of the choroid may be determined by blood flow perfusion. Decreased choroidal blood flow perfusion may lead to scleral ischemia and hypoxia, and hypoxia induces scleral matrix remodeling and axial length growth. This article reviews the relationship between choroidal blood flow and myopia, and suggests the significance of paying attention to choroidal changes in the prevention and control of myopia.
摘要
The occurrence and development of myopia is closely related to scleral remodeling. Therefore, in order to effectively prevent and cure myopia, it is very important to clarify the mechanism of scleral remodeling. In recent years, Chinese scholars have found that endoplasmic reticulum stress can regulate the expression of apoptotic proteins through the inositol demand protein-1/X box binding protein-1 pathway in the unfolded protein response, thus it is involved in regulating the state of scleral fibroblasts under hypoxia and regulating the occurrence and development of scleral remodeling. At the same time, some studies have found that inhibiting and knocking out protein kinase RNA-like endoplasmic reticulum kinase and activated transcription factor 6 in endoplasmic reticulum stress can effectively inhibit the growth of ocular axis. This proves that endoplasmic reticulum stress plays an important role in the occurrence and development of scleral remodeling. However, the comprehensive analysis of endoplasmic reticulum stress and scleral remodeling has not been reported at home and abroad. In-depth analysis of the relationship between endoplasmic reticulum and scleral remodeling is of great significance for the follow-up analysis and study of the mechanism of scleral remodeling.
摘要
Objective:To observe the prevention and control effect of 1% atropine on the progression of form deprivation myopia (FDM) in guinea pigs and the potential biological mechanism.Methods:Sixty-nine 3-week-old tricolor guinea pigs with normal refraction were randomly divided into a normal control group ( n=19), a FDM group ( n=19), a FDM+ atropine group ( n=19), and an atropine group ( n=12). No intervention was given to guinea pigs in normal control group.The FDM model was established by covering the right eye of guinea pigs with a semitransparent latex facemask for 4 weeks in FDM and FDM+ atropine groups.For the FDM+ atropine group, 1% atropine gel was topically administered to the form-deprived right eyes once a day for 4 weeks.For the atropine group, the right eye was treated with 1% atropine gel once a day for 4 weeks.Refraction and axial length of guinea pigs were measured by retinoscopy and ophthalmic A-scan ultrasonography respectively at baseline, experiment week 2 and week 4.In experiment week 4, eyeballs were enucleated to make sections via the paraffin wax processing procedure, and the microstructural and ultrastructural changes of the sclera were observed under the light microscope and transmission electron microscope, respectively.The isobaric tags for relative and absolute quantitation labeling combined with liquid chromatography-tandem mass spectrometry were used to identify the differentially expressed proteins.Use and care of the animals complied with the Regulation for the Administration of Affairs Concerning Experiment Animals by State Science and Technology Commission.The study protocol was approved by the Institutional Animal Care and Use Committee of Tianjin Medical University (No.TJYY2020111028). Results:There were statistically significant differences in the diopter of guinea pigs at different time points among the four groups ( Fgroup=138.892, P<0.001; Ftime=167.270, P<0.001). Compared with normal control group, the diopter of guinea pigs in FDM group at experiment weeks 2 and 4, and FDM+ atropine group at experiment week 4 developed toward myopia, showing statistically significant differences (all at P<0.001). Compared with FDM group, the diopter of guinea pigs in FDM+ atropine group at experiment weeks 2 and 4 developed toward hyperopia, showing statistically significant differences (both at P<0.001). There were statistically significant differences in the axial length of guinea pigs at different time points among the four groups ( Fgroup=32.346, P<0.001; Ftime=353.797, P<0.001). The axial lengths of FDM group at experiment weeks 2 and 4 and FDM+ atropine group at experiment week 4 were longer than those of normal control group, and the axial lengths in FDM+ atropine group at experiment weeks 2 and 4 were shorter than those in FDM group, and the differences were statistically significant (all at P<0.001). The collagenous fibers of posterior sclera of guinea pigs were loose and disordered in FDM group, and were regular in FDM+ atropine group.The posterior scleral thickness of normal control group, FDM group, FDM+ atropine group and atropine group was (141.74±16.98), (101.46±9.15), (112.74±6.24) and (134.30±18.19) μm, respectively, with a statistically significant difference ( F=6.709, P=0.005). The posterior sclera was significantly thinner in FDM group than in normal control group and FDM+ atropine group (both at P<0.05). The diameter of posterior scleral collagen fiber gradually increased from inside to outside in normal control group, FDM+ atropine group and atropine group, and the diameters of the inner, middle and outer posterior scleral collagen fibers were smaller in FDM group than in normal control group.Proteomic analysis revealed 85 differentially expressed proteins (fold change>1.30) between FDM group and normal control group, FDM+ atropine group and FDM group, of which 38 were up-regulated and 47 were down-regulated after atropine treatment.Gene Ontology enrichment analysis showed that biological processes mainly involved were biological regulation, cell process, localization and metabolic process.Molecular function mainly involved were binding, catalytic activity, molecular function regulator, structural molecule activity and transporter activity.Cell components mainly involved were in cellular anatomical entity, intracellular and protein-containing complex. Conclusions:Atropine can increase the diameter of scleral collagen fibers in guinea pigs of FDM model, improve the arrangement of scleral collagen fiber, inhibit scleral thinning.The mechanism of atropine to control myopia progression is closely related to the tight junction between scleral cells, cytoskeleton and extracellular matrix remodeling.
摘要
In 2004, it was the first time that Wollensak and Spoerl had applied physical and chemical cross-linking methods to scleral tissue. They found that the biomechanical strength of cross-linked sclera, induced by riboflavin/ultraviolet A, glyceraldehyde and glutaraldehyde, could be improved and proposed that scleral collagen cross-linking is expected to be a new method for the treatment of pathologic myopia. In recent years, a series of explorations have been made on the effectiveness and adverse reactions of physical and chemical cross-linking in the prevention and treatment of pathologic myopia, including the establishment of various animal models and different myopia modeling methods, the improvement of cross-linking methods, the amelioration of the measurement of biomechanical strength of scleral tissue and the attention of biological parameters such as the thickness of retinal nerve fiber layer and the amplitude of electroretinogram in vivo. Genipin-crosslinking of the scleral collagen combined with posterior scleral contraction/reinforcement has been applied to clinical research. This review summarizes physical cross-linking and the genipin-crosslinking of scleral collagen to explore the effectiveness and safety of the methods in the prevention and treatment of the pathologic myopia.
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Brittle cornea syndrome (BCS) is a genetic connective tissue disorder with discernible ocular features such as blue scleral and thin cornea that predominantly presents in younger children. We herein describe cases of three siblings with BCS, two of whom presented to us with open globe injuries following trivial trauma. Clinical examination of the other eye in both showed diffusely thin corneas and blue sclera. A systemic evaluation revealed sensorineural hearing loss and hyperextensible joints. The third sibling was screened and found to have features concurrent with BCS. This report highlights the challenges faced in the management of ocular injuries and consecutive complications in these patient
摘要
@#High myopia complicated with fundus lesions is one of irreversible blinding eye diseases. Posterior seleral staphyloma(PSS)is one of the most basic pathologies in a series of complications of high myopia. This article reviews the pathogenesis, examination methods, classification and treatment of PSS in high myopia by sorting out domestic and foreign literature, providing a better understanding of the prevention and control of PSS.
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Objective:To investigate the effects of riboflavin-ultraviolet A scleral collagen cross-linking on the retina under different irradiation time, and to determine the safe irradiation time.Methods:Sixty healthy New Zealand white rabbits were randomly divided into control group (0 minute group), 10 minutes group, 20 minutes group, 30 minutes group and 40 minutes irradiation group according to the irradiation time, with 12 rabbits in each group.The left eye was irradiated with riboflavin-ultraviolet A scleral collagen (370 nm, 10 mW/cm 2). The histopathological change of retina was observed by light microscope and transmission electron microscope and compared among different groups.The concentration of MDA and the activities of SOD, CAT and GSH-Px in retinal tissue were detected by corresponding kits.The expression levels of SOD and CAT proteins in retinal tissue were detected by Western blot method.The study protocol was approved by the Binzhou Medical University Laboratory Animal Ethical Committee (No.2017-80). The use and care of animals complied with the statement of ARVO and the Regulation on the Management of Laboratory Animal Quality of China. Results:Under the light microscope, the structure of the retinas in the control group was orderly arranged.Under the transmission electron microscope, the lamellar structure in the inner segment and the mitochondrial structure in the outer segment of the photoreceptor cells were intact, and the mitochondrial ridge was continuous in the control group.There was no obvious difference in retinal morphology between the 10 minutes irradiation group and the control group under both the light microscope and the transmission electron microscope, and the retinal damage became more severe with the prolongation of irradiation time.The concentration of MDA in the retina of each group was elevated gradually with the increase of irradiation time, and the difference was statistically significant ( F=65.25, P<0.05). The concentration of MDA was (11.31±1.84), (14.94±1.04)and (18.25±1.42)nmol/mgprot in the 20 minutes, 30 minutes and 40 minutes irradiation groups respectively, which were significantly higher than (1.13±0.02)nmol/mgprot in the control group (all at P<0.05). The MDA concentration in 20 minutes, 30 minutes and 40 minutes irradiation groups was increased successively, showing statistically significant differences (all at P<0.05). With the prolongation of irradiation time, the activities of SOD, CAT and GSH-Px as well as the expression levels of SOD and CAT proteins were significantly decreased gradually ( F=44.09, 34.18, 35.60, 115.75, 78.86; all at P<0.05). The differences between the control group and 20 minutes, 30 minutes, 40 minutes irradiation groups, and the differences among 20 minutes, 30 minutes, 40 minutes irradiation groups were statistically significant (all at P<0.05). Conclusions:Riboflavin-ultraviolet A 10 mW/cm 2 scleral collagen cross-linking irradiation for 10 minutes is safe.Excessive irradiation time can cause damage to the retina of rabits.
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@#AIM: To investigate subfoveal subretinal fluid thickness(SFT)and subfoveal choroidal thickness(CT)after scleral buckling surgery(SBS)for macula-off rhegmatogenous retinal detachment(RRD).<p>METHODS: Retrospective observational case series. Twenty-three patients with macula-off RRD underwent successful SBS combined with cryotherapy. Patients with recurrent retinal detachment and proliferative preretinal membranes were excluded. Optical coherence tomography(OCT)was used to measure subfoveal SFT and subfoveal CT. The OCT images were then evaluated preoperatively and postoperatively at 1wk, 1, 3, 6, and 12mo. Best-corrected visual acuity(BCVA)was measured preoperatively and postoperatively.<p>RESULTS: All of the patients had subretinal fluid 1wk after operation. Subfoveal SFT gradually reduced over time. The subfoveal CT was thicker 1wk postoperatively and gradually decreased subsequently. The BCVA(mean±SD, LogMAR)was 0.60±0.35, which was a statistically significant change from the preoperative BCVA(<i>t</i>=6.35, <i>P</i><0.01).<p>CONCLUSION: The subretinal fluid was gradually absorbed with time, and the subfoveal CT gradually decreased after the early thickening. The SBS rapidly improved the visual acuity of the patients after the early postoperative period.
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@#AIM: To investigate the application and therapeutic effect of allogeneic sclera transplantation combined with arbitrary flap plasty in the treatment of moderate and severe deep and full-thickness eyelid defect.<p>METHODS: Medical records of 103 patients(103 eyes)who underwent allogeneic scleral transplantation combined with random flap plasty in the treatment of moderate and severe deep and full-thickness eyelid defect from June 2017 to June 2020 were retrospectively reviewed. All patients were followed up for 1-6mo after operation was performed to evaluate the postoperative effects of the resorption and compatibility of allogeneic sclera, the survival situation of skin flaps, eyelid appearance, eyelid closure, eyelid scar.<p>RESULTS: Follow up observation from 1-6mo after operation, the allogeneic sclera was gradually replaced by the receptor tissue, allogeneic sclera in the inner layer of the eyelid was covered with conjunctival cells, allogeneic sclera and skin join closely together in the outer layer of the eyelid. There was no rejection in allogeneic sclera. All patients had survived skin flaps, good eyelid shape, natural eyelid closure, and no scars.<p>CONCLUSION: The allogeneic sclera transplantation combined with random flap plasty has curative effect in the repair of moderate and severe deep and full-thickness eyelid defect. It has both function and aesthetics result, and it is suitable for clinical promotion.
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ABSTRACT This article reports a combined technique of sutureless intrascleral fixated intraocular lens implantation and Descemet membrane endothelial keratoplasty in a patient with anterior pseudophakic bullous keratopathy. Two scleral tunnels were created, corneal incisions were made, and a foldable intraocular lens was cut and removed from the anterior chamber. After performing anterior vitrectomy, a 3-piece foldable intraocular lens was implanted into the anterior chamber. One of the intraocular lens haptics was grasped with a forceps and pulled out from the scleral tunnel. Then, the end of the haptic was cauterized. Similar maneuvers were applied for the other haptic. Next, an 8-mm-diameter donor tissue was prepared, and the recipient endothelial tissue was peeled and removed from the center of the recipient cornea. The prepared donor tissue was injected into the anterior chamber. After proper opening and placement of the donor tissue, an air bubble was injected below the tissue. There were no postoperative complications during the 1-month follow-up.
RESUMO Relato de uma técnica que combina o implante de uma lente intraocular com fixação intraescleral sem sutura e uma ceratoplastia endotelial da membrana de Descemet em paciente com ceratopatia bolhosa pseudofácica anterior. Foram criados dois túneis esclerais. Foram feitas incisões na córnea e a lente intraocular dobrável foi cortada e removida da câmara anterior. Foi então efetuada uma vitrectomia anterior e uma lente intraocular dobrável de 3 peças foi implantada na câmara anterior. Um dos hápticos da lente intraocular foi pinçado com um fórceps e puxado para fora do túnel escleral. A extremidade do háptico foi cauterizada. Manobras semelhantes foram feitas no outro háptico. Foi preparado um tecido de doador com 8 mm de diâmetro e o tecido endotelial da área receptora foi removido do centro da córnea. O tecido preparado do doador foi injetado na câmara anterior. Após abertura e posicionamento adequados do tecido do doador, foi injetada uma bolha de ar abaixo do tecido. Não foi observada nenhuma complicação pós-operatória durante um mês de acompanhamento.
Subject(s)
Humans , Female , Aged , Corneal Transplantation , Lenses, Intraocular , Sclera/surgery , Surgical Instruments , Lens Implantation, Intraocular , Descemet Membrane摘要
ABSTRACT Purpose: To investigate periostin and collagen I expression during a scleral remodeling in myopic eyes and to determine their role in collagen remodeling of the myopic sclera. Methods: Fifty one-week-old guinea pigs were divided into the control and form-deprivation myopia (FDM) groups. The eyes of animals in the form-deprivation myopia group were covered for 2, 4, and 8 weeks, or were covered for 4 weeks and then uncovered for 2 weeks. The diopters and axial lengths in the eyes in each group of guinea pigs were measured. Immunohistochemistry and reverse transcription polymerase chain reaction were used to detect the relative protein and mRNA expressions of periostin and collagen I in the scleral tissues of guinea pig. Results: Before masking, guinea pigs in the control and form-deprivation myopia groups were hypermetropic and did not differ significantly (p>0.05). Hypermetropic refraction in the control group gradually decreased. In guinea pigs from the form-deprivation myopia group, the refractive power gradually changed from +2.14 ± 0.33 D to -7.22 ± 0.51 D, and the axial length gradually changed from 5.92 ± 0.37 mm to 8.05 ± 0.34 mm from before until the end of masking. Before covering, no significant difference was observed in the relative collagen I and periostin mRNA and protein expression levels in the sclera of the guinea pig control and form-deprivation myopia groups (p>0.05). The relative collagen I and periostin protein and mRNA expression levels in the sclera of guinea pigs in the form-deprivation myopia group at 2, 4, and 8 weeks, and after covering the eyes for 4 weeks followed by uncovering for 2 weeks, were significantly lower than those in the control group (p<0.05). The collagen I and periostin mRNA expression levels were positively correlated with protein expression levels in the sclera of guinea pigs (protein: r=0.936, p<0.05; mRNA: r=0.909, p<0.05). Conclusions: Periostin was expressed in the myopic sclera of guinea pigs, and changes in periostin and collagen I expression were highly consistent. Periostin and collagen I may be involved in the regulation of scleral remodeling in myopia.
RESUMO Objetivo: Investigar a expressão da periostina e do colágeno I durante o remodelamento escleral em olhos míopes e determinar seu papel na remodelação do colágeno da esclera miópica. Métodos: Cinquenta cobaias com uma semana de idade foram divididas em grupo controle e miopia de privação de forma. Os olhos dos animais no grupo de miopia de privação de forma foram cobertos por 2, 4 e 8 semanas, ou foram cobertos por 4 semanas e depois descobertas por 2 semanas. As dioptrias e comprimentos axiais dos olhos em cada grupo de cobaias foram medidos. A imunohistoquímica e a reação em cadeia da polimerase com transcrição reversa foram utilizadas para detectar as expressões relativas de proteína e mRNA de periostina e colágeno I em tecidos esclerais das cobaias. Resultados: Antes do mascaramento, as cobaias nos grupos controle e miopia de privação de forma eram hipermetrópicas e não diferiam significativamente (p>0,05). A refração hipermetrópica no grupo controle diminuiu gradualmente. Nas cobaias do grupo de miopia de privação de forma, a potência de refração mudou gradualmente de +2,14 ± 0,33 D para -7,22 ± 0,51 D e o comprimento axial mudou gradualmente de 5,92 ± 0,37 mm para 8,05 ± 0,34 mm desde antes até o final do mascaramento. Antes do mascaramento, nenhuma diferença significativa foi observada nos níveis de expressão de mRNA e proteína de colágeno I e periostina na esclera dos grupos controle e miopia de privação de forma (p>0,05). Os níveis relativos de expressão de colágeno I e proteína periostina e mRNA na esclera de cobaias no grupo de miopia de privação de forma em 2, 4 e 8 semanas, e após cobertura dos olhos por 4 semanas seguido de descoberta por 2 semanas, foram significativamente menores que aqueles no grupo controle (p<0,05). Os níveis de expressão de mRNA, colágeno I e proteína periostina foram positivamente correlacionados com os níveis de expressão de proteína na esclera das cobaias (proteína: r=0,936, p<0,05; mRNA: r=0,909, p<0,05). Conclusões: A periostina foi expressa na esclerótica míope de cobaias e as alterações na expressão de periostina e colágeno I foram altamente consistentes. A periostina e o colágeno I podem estar envolvidos na regulação do remodelamento escleral na miopia.
Subject(s)
Humans , Sclera , Myopia, Degenerative , RNA, Messenger , Collagen , Disease Models, Animal , Guinea Pigs摘要
Objective To investigate the differences in mechanical properties of the sclera in different regions. Methods The sclera of sus scrofa was divided into 3 regions, namely, anterior, equatorial and posterior area. Local indentation was performed on different areas of the whole sclera. Strip specimens of different regions were circumcised along the equatorial direction, and subjected to uniaxial stretching by INSTRON 5544. Results Within the normal physiological stress range, the stiffness at anterior, equatorial, and posterior area of the sclera measured by local indentation was (0.91±0.21), (0.6±0.16), (0.39±0.13) MPa, respectively. The elastic modulus at anterior, equatorial, and posterior area of the sclera measured by uniaxial stretching was (1-28±0.37), (0.95±0.31), (0.72±0.28) MPa, respectively. Conclusions The local indentation could reflect regional mechanical properties of the sclera. The anterior sclera performed a higher stiffness than the equatorial and posterior areas. The results provide references for further study on the pathogenesis of ocular diseases including myopia.
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Osteogenesis imperfecta (OI) is a group of rare inherited disorders of connective tissue with the common feature of excessive fragility of bones caused by mutations in collagen. Diagnosis is mainly based on the clinical features of the disorder. We report a late preterm a male neonate born to a 20 years old primigravida. He had clinical features of a type II OI and severe birth asphyxia.
摘要
Purpose: To study the changes in corneal astigmatism before and after pterygium excision as well as with differences between various surgical techniques (bare sclera, conjunctival autograft, amniotic membrane graft). Methods: The study population included 71 patients with primary pterygium who underwent surgery. The surgical techniques used differed among the study population. All the patients were preoperatively assessed for visual acuity, anterior and posterior segments, autorefraction, and autokeratometry. After surgery, the patients were assessed for visual acuity, autorefraction, and autokeratometry on day 5, 1 month, and 3 months and the results were analyzed. Paired and unpaired t-tests were used to compare the variables. The probability level of 0.05 was considered as statistically significant. Results: The reduction in the mean preoperative astigmatism of 3.47 ± 1.74 Diopters (D) to 1.10 ± 0.78 D 3 months after surgery was statistically significant (P < 0.0001). Bare sclera, conjunctival autograft, and amniotic membrane graft techniques exhibited changes in astigmatism amounting to 1.85 ± 0.88 D, 2.55 ± 1.26 D, and 2.67 ± 1.44 D, respectively. Pterygium excision surgeries using amniotic membrane graft and conjunctival autograft techniques were more effective than pterygium excision surgery using bare sclera technique in reducing astigmatism. Conclusion: Pterygium excision results in significant reduction in astigmatism which leads to improvement in visual acuity. Amniotic membrane graft and conjunctival autograft are better surgical techniques than bare sclera as far as reducing astigmatism is concerned.
摘要
ABSTRACT Purpose: We aimed to compare the thickness of anterior sclera, corneal layers, and pre-ocular tear film between patients with primary Sjögren's syndrome and healthy individuals. Methods: Fifty-one patients with primary Sjögren's syndrome and 41 healthy control participants were recruited in this cross-sectional and comparative study. The thickness of the pre-ocular tear film, corneal epithelium, Bowman's layer, stroma, Descemet's membrane, and endothelium were measured on the corneal apex. Anterior scleral thickness was measured at distances of 1 mm and 3 mm from the limbus. The anterior segment module of spectral-domain optical coherence tomography was used to measure thicknesses of pre-ocular tear film, corneal layers, and anterior sclera. Results: Tear film thickness, Schirmer's test, and tear break up time values were significantly lower in the Sjögren's disease group than in the healthy controls (p<0.05). The thickness measurements of corneal layers and sclera were similar between the groups. Tear film thickness was moderately correlated with the Schirmer's test results (r=0.34, p=0.001), but there was no correlation between the Schirmer's test results and tear break up time (r=0.18, p=0.09). Conclusions: Pre-ocular tear film, as measured by anterior segment optical coherence tomography, was thinner in patients with primary Sjögren's syndrome than in the healthy controls. The thicknesses of corneal layers and anterior sclera were similar between the groups.
RESUMO Propósito: Nosso objetivo foi comparar a espessura da esclera anterior, camadas da córnea e do filme lacrimal pré-ocular entre pacientes com síndrome de Sjögren primária e indivíduos saudáveis. Métodos: Cinquenta e um pacientes com síndrome de Sjögren primária e 41 controles saudáveis foram recrutados neste estudo comparativo e transversal. A espessura do filme lacrimal pré-ocular, epitélio corneal, camada de Bowman, estroma, membrana de Descemet e endotélio foram medidos no ápice corneal. A espessura da esclera anterior foi medida às distâncias de 1 mm e 3 mm do limbo. O módulo do segmento anterior da tomografia de coerência óptica de domínio espectral foi utilizado para mensurar as espessuras do filme lacrimal pré-ocular, camadas da córnea e esclera anterior. Resultados: A espessura do filme lacrimal, o teste de Schirmer e os valores do tempo de ruptura do filme lacrimal foram significativamente menores no grupo com síndrome de Sjögren do que nos controles saudáveis (p<0,05). As medidas de espessura das camadas corneais e da esclera foram similares entre os grupos. A espessura do filme lacrimal foi moderadamente correlacionada com os resultados do teste de Schirmer (r=0,34, p=0,001), mas não houve correlação entre os resultados do teste de Schirmer e tempo de ruptura (r=0,18, p=0,09). Conclusões: O filme lacrimal pré-ocular, medido pela tomografia de coerência óptica de segmento anterior, foi mais fino em pacientes com síndrome de Sjögren primária do que nos controles saudáveis. As espessuras das camadas da córnea e da esclera anterior foram semelhantes entre os grupos.