Identifying and Treating Ocular Manifestations in Psoriasis.

Psoriasis is a chronic immune-mediated inflammatory skin condition that commonly presents with red, thickened, and scaling plaques. Given the prominent cutaneous manifestations of psoriasis, more subtle ophthalmic findings of the disease may initially go undetected, with the potential for significant ocular morbidity. Associated ocular disease can involve nearly any structure of the eye, with the eyelids most commonly being affected, resulting in relatively common signs and symptoms of ocular surface discomfort. The presence of intraocular inflammation (i.e., uveitis) or retinal involvement carry a heightened risk of vision loss, and are often more difficult to diagnose outside of the ophthalmology clinic. Early detection and treatment of ocular disease can limit morbidity and are critical to the management of these patients, which requires coordination of care between dermatologists and ophthalmologists. The objective of this article was to review the most common ocular conditions that affect psoriatic patients, when to consider referral to an ophthalmologist, and to summarize the adverse ocular effects of current psoriasis treatments.

Effects of Deepwater Horizon crude oil on ocular development in two estuarine fish species, red drum (Sciaenops ocellatus) and sheepshead minnow (Cyprinodon variegatus).

Polycyclic aromatic hydrocarbons (PAHs) present in crude oil have been shown to cause the dysregulation of genes important in eye development and function, as well as morphological abnormalities of the eye. However, it is not currently understood how these changes in gene expression are manifested as deficits in visual function. Embryonic red drum (Sciaenops ocellatus) and sheepshead minnow (Cyprinodon variegatus) were exposed to water accommodated fractions (WAFs) of weathered crude oil and assessed for visual function using an optomotor response assay in early life-stage larvae, with subsequent samples taken for histological analysis of the eyes. Larvae of both species exposed to increasing concentrations of oil exhibited a reduced optomotor response. The mean diameters of retinal layers, which play an important role in visual function and image processing, were significantly reduced in oil-exposed sheepshead larvae, though not in red drum larvae. The present study provides evidence that weathered crude oil has a significant effect on visual function in early life-stage fishes.

Host-location behavior of the tea green leafhopper Empoasca vitis Göthe (Hemiptera: Cicadellidae): olfactory and visual effects on their orientation.

The tea green leafhopper, Empoasca vitis Göthe, is one of the most serious pests in tea growing areas. This study investigated the roles played by olfaction and vision in host orientation behavior. The compound eye of E. vitis was found to be a photopic eye; few olfactory sensilla were found on the antennae, while abundant gustatory sensilla were recorded on the mouthparts. Three opsin genes (EV_LWop, EV_UVop, EV_Bop) were isolated and found to be mainly expressed in the compound eye compared with other parts of the body. Immunolocalization indicated that the opsins mainly located in the different regions of rhabdom. The transcription levels of EV_LWop, EV_Bop and EV_UVop were reduced by 77.3, 70.0 and 40.0%, respectively, by RNA interference induced by being fed a special RNA-rich diet for 6 days. The rate of tropism to host color was effectively impaired by 67.6 and 29.5% in the dsEV_LWop and dsEV_Bop treatment groups, but there was no significant change in the dsEV_UVop group. The determination of the cause of the tropism indicated that odors from the host over long distances were unable to attract E. vitis and were only detected when the insects were close to the host. The developed compound eye of E. vitis plays a leading role in host location, and the long-wavelength opsin significantly affects the tropism to host color; the lack of olfactory sensilla results in long-distance odors not being able to be detected until the insect is near to the host-plant. The understanding of these behavioral mechanisms, especially the importance of opsin genes is expected to be useful for pest management.

[Randomized Controlled Clinical Trials of Eye-acupuncture Therapy for Patients with Post-stroke Insomnia].

OBJECTIVE: To observe the therapeutic effect of eye-acupuncture therapy for post-stroke insomnia. METHODS: Sixty patients (45-70 years in age) with post-stroke insomnia were randomized into eye-acupuncture group and routine acupuncture (body acupuncture) group (30 cases in each). Patients of the eye-acupuncture group were treated by acupuncture stimulation of bilateral Shangjiao (Upper-energizer) and Xin (Heart) regions and those of the routine acupuncture group treated by acupuncture stimulation of Baihui (GV 20), Sishencong (EX-HN 1), Anmian (EX-HN 16), etc. After Deqi, the filiform needles were retained for 20 min, and the treatment in both groups was conducted once a day, with 15 days being one therapeutic course and 2 courses altogether. The Pittsburgh Sleep Quality Index (PSQI) including the subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, daytime dysfunction, and total PSQI score was used to evaluate the overall sleep quality. The clinical efficacy was assessed according to the "Guiding Principles of Clinical Trials for New Drugs of Traditional Chinese Medicine" formulated by Chinese Ministry of Health. RESULTS: Following the treatment, of the two 30 cases in the eye-and routine acupuncture groups, 21 and 9 experienced a marked improvement in their symptoms, 8 and 17 were effective, and 1 and 4 invalid, with the effective rate being 96.7% and 86.7%, respectively. The PSQI scores of the subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, daytime dysfunction, and the total PSQI score were all significantly decreased in comparison with pre-treatment in each group (P<0.01). The therapeutic effect of the eye-acupuncture was markedly superior to those of routine acupuncture in reducing sleep latency, sleep disturbances and daytime dysfunction (P<0.05), but without significant differences between the two groups in the effective rate, sleep quality, sleep duration, sleep efficiency and total PSQI score (P>0.05). CONCLUSIONS: Both eye-acupuncture and routine acupunture are effective in the treatment of post-stroke insomnia, and the eye-acupuncture is better than routine acupuncture in reducing sleep latency, improving sleep disturbances and daytime dysfunction.

Tear Trough Deformity: Study of Filling Procedures for Its Correction.

The aim of this work is to discuss the anatomy of the tear trough region with relative danger areas, and to describe 2 different options to correct this deformity.The tear trough is a concave deformity of the orbital fat that is noticeable as a result of inherited anatomic differences and aging. However, the periorbital region is a complex area with its own septa and ligaments, fat compartments, muscles, vascularization, and lymphatic drainage and presents anatomic characteristics that must be taken into account in order to achieve good results and avoid complications.The use of hyaluronic acid gel or autologous fat for soft tissue correction is a good option.A total of 96 patients with periorbital hollowing were divided into 2 groups; each group received a different treatment, from December of 2013 to December of 2015, with hyaluronic- or lipo-filling.

Docosahexaenoic Acid and Eicosapentaenoic Acid Did not Alter trans-10,cis-12 Conjugated Linoleic Acid Incorporation into Mice Brain and Eye Lipids.

trans 10,cis 12-CLA has been reported to alter fatty acid composition in several non-neurological tissues, but its effects are less known in neurological tissues. Therefore, the purpose of this study was to determine if CLA supplementation would alter brain and eye fatty acid composition and if those changes could be prevented by concomitant supplementation with docosahexaenoic acid (DHA; 22:6n3) or eicosapentaenoic acid (EPA; 20:5n3). Eight-week-old, pathogen-free C57BL/6N female mice (n = 6/group) were fed either the control diet or diets containing 0.5% (w/w) t10,c12-CLA in the presence or absence of either 1.5% DHA or 1.5% EPA for 8 weeks. CLA concentration was significantly (P < 0.05) greater in the eye but not in the brain lipids of the CLA group when compared with the control group. The sums of saturated, monounsaturated, polyunsaturated fatty acids, and n3:n6 ratio did not differ between these two groups for both tissues. The n3:n6 ratio and concentrations of 20:5n3 and 22:5n3 were significantly greater, and those of 20:4n6, 22:4n6, and 22:5n6 were lesser in the CLA + DHA and CLA + EPA groups than in the control and CLA groups for either tissue. DHA concentration was higher in the CLA + DHA group only but not in the CLA + EPA group when compared with the CLA group for both tissues. The dietary fatty acids generally induced similar changes in brain and eye fatty acid concentration and at the concentrations used both DHA and EPA fed individually with CLA were more potent than CLA alone in altering the tissue fatty acid concentration.

Prevalence of disc cupping in non-glaucomatous eyes.

This study assessed optic disc size and cupping, using a commercially available ophthalmoscope, in order to show norms of these values for clinical practice. Subjects were office-workers referred from their respective workplaces for a routine medical examination, which included eye examination. The optic disc size was classified as small, medium or large, for having a diameter < 1.0, 1.0-1.5, or > 1.5 times (respectively) the diameter of the ophthalmoscope's selected light spot on the posterior pole. The cupping was classified as the ratio of the vertical cupping diameter and the vertical disc diameter on a relative decimal scale from 0.0 to 1.0.This study included 184 subjects with a mean age of 40.5 ± 9.5 years; 149 (81%) were males. Their mean ocular pressure was 12.4 ± 1.5 mmHg (range 10-17 mmHg). There was a high correlation between optic disc sizes and cupping in the right and left eyes (Pearson Correlation r = 0.866, p < 0.001); therefore, for simplicity only the data for right eyes are presented. According to our definition, the optic discs in these eyes comprised 27 (14.7%) small, 141 (76.6%) medium and 16 (8.7%) large. The small optic discs were rarely cupped, and the large optic discs were always cupped. Optic disc cupping greater than 0.7 was rarely found and should be suspect of glaucoma. Clinical doctors should be aware of this and refer those subjects with abnormal cupping to the specialist.

Prevalence of disc cupping in non-glaucomatous eyes

This study assessed optic disc size and cupping, using a commercially available ophthalmoscope, in order to show norms of these values for clinical practice. Subjects were office-workers referred from their respective workplaces for a routine medical examination, which included eye examination. The optic disc size was classified as small, medium or large, for having a diameter < 1.0, 1.0-1.5, or > 1.5 times (respectively) the diameter of the ophthalmoscope's selected light spot on the posterior pole. The cupping was classified as the ratio of the vertical cupping diameter and the vertical disc diameter on a relative decimal scale from 0.0 to 1.0.This study included 184 subjects with a mean age of 40.5 ± 9.5 years; 149 (81%) were males. Their mean ocular pressure was 12.4 ± 1.5 mmHg (range 10-17 mmHg). There was a high correlation between optic disc sizes and cupping in the right and left eyes (Pearson Correlation r = 0.866, p < 0.001); therefore, for simplicity only the data for right eyes are presented. According to our definition, the optic discs in these eyes comprised 27 (14.7%) small, 141 (76.6%) medium and 16 (8.7%) large. The small optic discs were rarely cupped, and the large optic discs were always cupped. Optic disc cupping greater than 0.7 was rarely found and should be suspect of glaucoma. Clinical doctors should be aware of this and refer those subjects with abnormal cupping to the specialist.

Este estudio fue concebido para desarrollar normas clínicas sobre el tamaño y la excavación de la papila usando un simple oftalmoscopio en una población emétrope sin glaucoma. Los sujetos fueron oficinistas enviados al Centro Médico San Luis para un chequeo general de salud que incluye el examen oftalmológico. El tamaño de la papila o disco óptico fue clasificado en tres diámetros (pequeño, mediano y grande) comparando con el tamaño de la proyección retinal de la luz de un oftalmoscopio de bolsillo. La excavación papilar fue clasificada como la relación entre el diámetro horizontal de la excavación y el diámetro horizontal de la papila en escala decimal de 0.0 a 1.0. El estudio incluye 184 sujetos (edad media de 40.5 ± 9.5 años) y 149 (81%) fueron varones. Su presión ocular promedio fue de 12.4 ± 1.5 mmHg (entre 10-17 mmHg). La correlación tanto de los tamaños de disco óptico como de su excavación, fue alta entre ambos ojos (Correlación de Pearson, r = 0.866, p < 0.001) de modo que se presentan solamente datos de los ojos derechos. Según nuestra definición de tamaños papilares hubo 27 (14.7%) papilas pequeñas, 141 (76.6%) medianas y 16 (8.7%) grandes. Las papilas pequeñas rara vez tuvieron excavación y las grandes estuvieron siempre excavadas. Fue raro hallar papilas ópticas con una excavación mayor a 0.7, las que deberían hacer sospechar una lesión por glaucoma. Los clínicos avezados en oftalmoscopia deberían tener esto en cuenta para referir los sujetos con excavaciones grandes al especialista para su estudio oftalmológico.

[Deviation index of eye and mouth on peripheral facial paralysis].

Differences of some points, levels and angles of the healthy and affected sides of patients with peripheral facial paralysis were picked out according to photographs. Through analysis of the index between the healthy and affected side of the patients and the difference between healthy people and patients, it is approved that those special points, levels and angles, which are called as deviation index of eye and mouth, can evaluate peripheral facial paralysis objectively and judge the degree of deviation. Therefore, it provides references for the diagnosis of facial paralysis and its degree judgement.

[Effect on PGF2alpha in plasma in primary dysmenorrhea treated with eye acupuncture].

OBJECTIVE: To observe the clinical curative effect of primary dysmenorrhea and the content of prostaglandin F2alpha (PGF2alpha) in peripheral blood of menstrual periods treated with eye acupuncture therapy. METHODS: One hundred and ten cases of primary dysmenorrhea were randomly divided into an eye acupuncture group (60 cases) and a medication group (50 cases). In eye acupuncture group, low energizer area, liver area, kidney area, heart area and spleen area etc. were selected according to the differentiation, and the eye acupuncture therapy was applied. In medication group, Ibuprofen Sustained Release Capsules was taken with oral administration for 300 mg 1-2 days before menses coming or when the symptoms appeared, once every 12 hours, for 3-5 days totally. Three menstrual periods made one session. The content of PGF2alpha in peripheral blood, and the curative effects and recurrence 3 and 6 months after treatment were observed. RESULTS: After 3 months treatment, compared with the curative effects between both groups, the cured rate was 55.0% (33/60) and the total effective rate was 95.0% (57/60) in eye acupuncture group, which were superior to those of 34.0% (17/50) and 82.0% (41/50) in medication group (both P < 0.05). According to the following-up after 6 menstrual periods, the recurrence rate was 9.1% (3/33), inferior to that of 35.3% (6/11) in medication group. The contents of PGF2alpha in peripheral blood of menstrual periods were all reduced after treatment in two groups (both P < 0.01). CONCLUSION: The curative effect of primary dysmenorrhea treated with eye acupuncture is favorable, and the lever of PGF2alpha in peripheral blood of menstrual periods is reduced.

[Effects of eye-acupuncture therapy on the expression of AQP4 in brain tissue of rats with acute cerebral ischemia-reperfusion injury].

OBJECTIVE: To explore the mechanism of the eye-acupuncture for treatment of acute cerebral ischemia-reperfusion injury. METHODS: Thirty-two healthy SD rats were randomly divided into a normal group, a sham operation group, a model group and an eye-acupuncture group, 8 rats in each group. The rat model of cerebral ischemia-reperfusion was established with thread occlusion method in the model group and the eye-acupuncture group. The eye-acupuncture group was treated by eye-acupuncture at "liver region", "upper energizer area", "lower energizer area" and "kidney region" for 20 min immediately after reperfusion and at 30 min before sampling. No treatment was done in the normal group and the sham operation group, and no thread occlusion was performed in the sham operation group. The Neurologic impairment was scored and the methods of immunohistochemistry staining, western-blotting and real-time fluorescent quantitation polymerase chain reaction (RQ-PCR) were taken to detect the expression of the aquaporin protein 4 (AQP4) and its mRNA in cerebral cortex after reperfusion for 3 hours. RESULTS: The neurologic impairment score of 1.50 +/- 0.54 in the eye-acupuncture group was significant lower than 2.63 +/- 0.92 in the model group (P < 0.01). The expression of the AQP4 protein by immunohistochemistry and western-blot respectively were 116.33 +/- 10.24 and 0.53 +/- 0.04 in the normal group, 118.97 +/- 12.72 and 0.55 +/- 0.07 in the sham operation group, and 129.30 +/- 18.36 and 0.67 +/- 0.08 in the eye-acupuncture group, with statistical significance compared to 150.88 +/- 15.82 and 0.94 +/- 0.04 in the model group (all P < 0.01), and there were significant differences between the eye-acupuncture group and the normal group (both P < 0.01). The tendency in the expression of AQP4 protein and its mRNA in all the group were almost the same. CONCLUSION: The eye-acupuncture therapy can relieve the cerebral ischemia-reperfusion injury and the protective mechanism is related to the downregulation of the cerebral AQP4 expression.

SAR analysis of a re-entrant resonant cavity applicator for brain tumor hyperthermia treatment with a 3-D anatomical human head model.

A re-entrant resonant cavity applicator system for non-invasive brain tumor hyperthermia treatments was presented. We have already confirmed the effectiveness of the heating properties of this heating system with cylindrical agar phantoms and with computer simulations.

Reference values for selected ophthalmic diagnostic tests and clinical characteristics of chinchilla eyes (Chinchilla lanigera).

OBJECTIVE: To establish reference values for the Schirmer tear test I (STT I), the phenol red thread tear test (PRTT), the intraocular pressure (IOP) with rebound tonometry, to determine the corneal sensitivity for healthy chinchillas, and to describe clinical aspects of normal chinchilla eyes. ANIMALS: One hundred and twenty-two eyes of 61 healthy pet chinchillas of different age and gender were investigated. PROCEDURES: A full ophthalmic exam including slit lamp biomicroscopy, ophthalmoscopy, measurement of STT I, PRTT, determination of the corneal touch threshold (CTT), and the measurement of the IOP (TonoVet) was performed. The normal appearance of the lid, the iris, the lens, the fundus, and the optic nerve disc was evaluated. Results The results of the STT I were very low and not reliable, and the measurement was discontinued. The median value of PRTT was 14.0 mm wetting/15 s (mean 14.6 ± 3.5 mm wetting/15 s). The median CTT was 32.5 mm (mean 31.2 ± 7.0 mm) respectively 1.2 g/mm(2) (mean 1.5 ± 0.9 g/mm(2)). The median IOP was 3.0 mmHg (mean 2.9 ± 1.8 mmHg). The predominating iris color was brown. The fundus pigmentation varied. Few lens alteration were seen in otherwise healthy chinchilla eyes. Most chinchillas had myelinated discs. Optic nerve cupping was present in 62% of the animals. CONCLUSION: Because of the small amount of tears, the PRT test is recommended for tear measurements in chinchillas. The IOP in chinchillas seems to be quiet is low in comparison to other rodents.

[Effects of eye-acupuncture therapy on serum and colonic SP and VIP contents in rats with irritable bowel syndrome].

OBJECTIVE: To observe the effect of the eye-acupuncture therapy on serum and colonic substance P (SP) and vasoactive intestinal peptide (VIP) contents in rats with irritable bowel syndrome (IBS) so as to explore its underlying mechanism. METHODS: Forty male Wistar rats were equally randomized into control group, IBS model group, eye-acupuncture group and medication (Pinaverium bromide, 7.5 mg/kg, twice daily, intragastric administration) group. IBS model was established by giving the rat with chronic stress stimulation (cold-water swimming, tail clamping, electrical shock, etc.) for 18 days. Eye-acupuncture of Xiajiao (Low Energizer) Area, Pi (Spleen) Area, Gan (Liver) Area and Dachang (Large Intestine) Area was given to the rat 20 min, twice daily for 7 d. Histopathological changes of the colon tissue were displayed by HE staining; and serum and colonic SP and VIP contents were detected by enzyme linked immunosorbent assay (ELISA). RESULTS: No significant difference was found among 4 groups in the histopathological changes of the colon. In comparison with normal control group, both serum and colonic SP and VIP contents in model group increased significantly (P < 0.01), while compared with model group, those in eye-acupuncture and medication groups lowered considerably (P < 0.01). CONCLUSION: Eye-acupuncture can reduce serum and coIonic SP and VIP contents in IBS rats, which may play a role in relieving IBS in eye-acupuncture clinic.

[Observation on therapeutic effect of eye acupuncture on cognition disorders in patients of chronic cerebral circulation insufficiency].

OBJECTIVE: To observe the therapeutic effect of eye acupuncture on cognition disorders in patients of chronic cerebral circulation insufficiency (CCCI). METHODS: Sixty cases were randomly divided into an observation group and a control group, 30 cases in each group. All patients were treated with oral administration of compound Danshen tablets, and the observation group was treated with eye acupuncture based on the pharmacotherapy and upper energizer area, kidney area, spleen area were selected. Their therapeutic effects were observed after 8 weeks. RESULTS: The total effective rate of 80.0% in the observation group was better than that of 53.3% in the control group (P<0.05). The score of mini-mental state (MMSE) in the observation group was also higher than that in the control group (P<0.05). CONCLUSION: Eye acupuncture has a good effect on cognition disorders in patients of CCCI and can enhance life quality of the patients.

Holistic approach to pre-operative assessment for cataract patients.

When patients agree to have cataract surgery it is important that they are fully assessed to determine their fitness for surgery. This article discusses the benefits of a nurse-led holistic approach to patient assessment, which, in practice, should be more than simply a 'tick-box exercise'. Essential components of the assessment include obtaining valid informed consent and performing biometry - the process by which the required dioptric power of an intraocular lens (IOL) implant is calculated prior to cataract surgery. It is a highly skilled procedure, which involves the measurement of corneal curvature and the axial length of the eye using either ultrasound or optical methods of biometry. This article examines the vital nursing roles aimed at improving the quality and efficiency of the patient's 'journey'.

Oxidative stress and glaucoma: injury in the anterior segment of the eye.

The perturbation of the pro-oxidant/antioxidant balance can lead to increased oxidative damage, especially when the first line of antioxidant defense weakens with age. Chronic changes in the composition of factors present in aqueous or vitreous humor may induce alterations both in trabecular cells and in cells of the optic nerve head. Free radicals and reactive oxygen species are able to affect the cellularity of the human trabecular meshwork (HTM). These findings suggest that intraocular pressure increase, which characterizes most glaucomas, is related to oxidative and degenerative processes affecting the HTM and, more specifically, its endothelial cells. This supports the theory that glaucomatous damage is the pathophysiological consequence of oxidative stress. Glaucomatous subjects might have a genetic predisposition, rendering them more susceptible to reactive oxygen species-induced damage. It is likely that specific genetic factors contribute to both the elevation of IOP and susceptibility of the optic nerve/retinal ganglion cells (RGCs) to degeneration. Thus, oxidative stress plays a fundamental role during the arising of glaucoma-associated lesions, first in the HTM and then, when the balance between nitric oxide and endothelins is broken, in neuronal cell. Vascular damage and hypoxia, often associated with glaucoma, lead to apoptosis of RGCs and may also contribute to the induction of oxidative damage to the HTM. On the whole, these findings support the hypothesis that oxidative damage is an important step in the pathogenesis of primary open-angle glaucoma and might be a relevant target for both prevention and therapy.