The Effects of Binocular Visual Function Training after Concomitant Exotropia Surgery.

PURPOSE: This study investigated the effect and long-term efficacy of binocular visual function training after concomitant exotropia surgery. METHODS: A total of 92 patients who underwent concomitant exotropia surgery were randomly divided into group A (the training group) (n = 54), who received binocular four-dimensional (4D) visual function training after surgery, and group B (control group) (n = 38). The patients in group A received personalized 4D visual function training 2 weeks after surgery and were followed up for 12 months. The eye position, distant and near stereo acuity, respectively, and postoperative efficacy were compared with those of the patients in group B. RESULTS: The normal eye position rate in group A was higher than in group B at the end of the overall follow-up period (p < .05), and the near stereo acuity rate was higher than the distant stereo acuity rate in both groups A and B at 2 weeks after surgery and at the end of follow up. The distant and near stereo acuity rates of the patients in group A were higher than those in group B (p < .05) at the end of the follow-up period, and the distant stereo acuity of group A was significantly improved (p < .05). The functional complete and incomplete response rates of group A were significantly higher than those of group B at the end of the follow-up period (p < .05). CONCLUSIONS: Four-dimensional visual function training for patients after concomitant exotropia surgery could facilitate the recovery of postoperative binocular visual function, as well as prevent the recurrence of exotropia after surgery.

Exploring the Relationship Between Binocular Imbalance and Myopia: Refraction with a Virtual Reality Platform.

To explore the relationship between binocular imbalance (BI) and the abnormal development of binocular refraction. BI data were collected by enrolling the first 1,000 adolescents and children aged 6-18 years in Shenzhen Eye Hospital from April 2020 to January 2021. In this cross-sectional study, the imbalance value (IV) did not show a statistical correlation with the spherical equivalent (SE) (oculus dexter [OD]: r = 0.022, p = 0.586; oculus sinister [OS]: r = -0.021, p = 0.606), and had little correlation with the uncorrected visual acuity (VA) (OD: r = -0.084, p = 0.039; OS: r = -0.034, p = 0.408). The proportion of binocular contrast imbalance (BCI) (the absolute value) maintained the highest level (from 54.42 to 79.17 percent) with the increase of bilateral SE difference in the four subcategories (binocular balance, monocular suppression, binocular rivalry, and BCI). From -100 to +100 of IV, the SE of the left eye tends to increase negatively when compared with the right eye (from -95 < IV ≦ -80, SE difference = -0.83 ± 1.58, to -20 < IV ≦ -10, SE difference = -0.14 ± 0.61; from 10 ≦ IV <20, SE difference = -0.05 ± 0.80, to 80 ≦ IV <95, SE difference = 1.48 ± 2.77). BI widely exists within the general pediatric population. The BI did not show significant correlation with the unilateral eye refractive state and the VA. However, the BI may be accompanied by imbalanced development of the eye refractive system. Furthermore, the SE of the dominant eye (from the prospective of BI) tends to be more negative than that of the opposite eye as the value increases. Clinical Trial Registration number: ChiCTR2100045457.

Bioprocessing and integration of a high flux screening systematic platform based on isothermal amplification for the detection on 8 common pathogens.

During a large variety of common pathogens, E. coli, P. aeruginosa, MRSA, MRCNS, V. parahaemolyticus, L. monocytogenes and Salmonella are the leading pathogens responsible for large number of human infections and diseases. In this study, a high flux screening based on nucleic acid isothermal amplification technique has been developed. For the 8 common pathogens, species-specific targets had been selected and analyzed for their unique specificity. After optimization, separate LAMP reaction assays had been bioprocessed and integrated into one systematic detection platform, including 8 strips (PCR tubes) and 96-well plates. Eight standard strains verified for the accuracy. Application of the established high flux screening platform was used for detection for 48 samples in 4 different 96-well plates, with 2 groups of 2 operators using double-blind procedure. The accuracy of 100% was obtained, with the total time consumption as 66-75 min (for 12 samples detection on 8 different pathogens). As concluded, through the bioprocess of the systematic platform based on LAMP technique, it's been demonstrated to be capable of simultaneous detection of 8 pathogens, with high sensitivity, specificity, rapidity and convenience.

A longitudinal study of the effect of ocular biometrics measures on myopia onset.

PURPOSE: To investigate the relationship between ocular biometrics (OB) and myopia onset. METHODS: OB data from students in 4 grades (aged from 6 to 14 years) in China were collected in a 1.5-year longitudinal study. Refractive error was assessed with cycloplegic autorefraction. RESULTS: At baseline, 934 (56.33%) of the subjects (right eye) had myopia. The mean spherical equivalent (SE) and axial length to corneal radius (AL/CR) were - 2.14 ± 1.49 and 3.14 ± 0.11, respectively, in the subjects with myopia and - 0.09 ± 0.21 and 2.98 ± 0.07, respectively, in the subjects without myopia. The correlation between the SE and AL/CR was r = - 0.823 (P < 0.001). The slopes of the SE changing with the AL/CR (and R-squares) were - 0.28 to - 1.80 (0.01-0.14) in the no myopia group, - 3.40 to - 6.20 (0.20-0.48) in the low myopia group, and - 3.37 to - 11.34 (0.16-0.74) in the moderate and high myopia groups. The baseline AL/CR values in grades 1, 3, and 5 were higher in those who developed myopia within 1.5 years. The odds ratio of the AL/CR to myopia onset in 1.5 years was 1.096 (95% confidence interval (CI): 1.060-1.135). CONCLUSIONS: Of the five indicators, the AL/CR showed the best correlation with the SE. The adjoint and linear relationship between the AL/CR and the SE tended to increase with SE progression. When myopia progressed beyond a certain range, the AL/CR was significantly different in those without initial myopia who developed it within 1.5 years compared with those who did not. After adjusting for age, sex, school, and grade, the interpretation capability of the current AL/CR to myopia onset in 1.5 years was limited.

Early phosphoproteomic changes in the retina following optic nerve crush.

Retinal ganglion cell (RGC) death causes irreversible blindness in adult mammals. Death of RGC occurs in diseases including glaucoma or injuries to the optic nerve (ON). To investigate mechanisms involved in RGC degeneration, we evaluated the phosphoproteomic changes in the retina induced by ON injury. Intraorbital optic nerve crush (ONC) was performed in adult C57BL/6J mice. Retinas were collected at 0, 6, and 12 h following ONC. Retinal proteins labeled with CyDye-C2 were subject to 2D-PAGE, followed by phosphoprotein staining and in-gel/cross-gel image analysis. Proteins with significant changes in phosphorylation (ratios ≥1.2) in retinas of the injured eyes compared to the control eyes were spot-picked, tryptic digested, and peptide fragments were analyzed by MALDI-TOF (MS) and TOF/TOF (tandem MS/MS). Intraorbital ONC increased phosphorylation of many retinal proteins. Among them, 29 significantly phosphorylated proteins were identified. PANTHER analysis showed that these proteins are associated with a variety of protein classes, cellular components, biological processes and signaling pathways. One of the identified proteins, phosphoprotein enriched in astrocytes 15 (PEA15), was further validated by western blotting and immunofluorescence staining. Functions of PEA15 were determined in cultured astrocytes. PEA15 knockdown reduced astrocyte phagocytic activity but promoted cell migration. Long term PEA15 knockdown also decreased astrocyte ATP level. This study provides new insights into mechanisms of RGC degeneration after ON injury, as well as central nervous system (CNS) neurodegeneration, since the retina is an extension of the CNS. These new insights will lead to novel therapeutic targets for retinal and CNS neurodegeneration.

Axial Length/Corneal Radius of Curvature Ratio Assessment of Posterior Sclera Reinforcement for Pathologic Myopia.

PURPOSE: The aim of this study was to assess the axial length/corneal radius of curvature ratio changes after posterior scleral reinforcement (PSR) for pathologic myopia. PROCEDURES: This study enrolled 32 pathologically myopic eyes treated with PSR and 35 untreated pathologically myopic eyes. Axial length, refractive error, best corrected visual acuity, corneal radius of curvature, and the axial length/corneal radius of curvature ratio were evaluated during the 1-year follow-up. RESULTS: There were no statistical differences in each parameter between the 2 groups at baseline. Significant differences were found between the 2 groups in both axial elongation and best corrected visual acuity improvement. The average axial length/horizontal corneal radius of curvature ratio significantly decreased in the PSR group. CONCLUSION: The PSR surgery can effectively delay the axial elongation in pathological myopia. Axial length/horizontal corneal radius of curvature ratio significantly decreased, which may indicate less myopic progression after surgery.

GATA-3 expression in the development of anterior chamber associated immune deviation.

BACKGROUND: Anterior chamber associated immune deviation (ACAID) is characterized by a Th2 cell response. GATA-3 has been shown to be necessary for the activation of Th2 cells. This study was designed to examine the expression of GATA-3 in the development of ACAID. METHODS: ACAID was induced by injection of 50 microg interphotoreceptor retinoid binding protein (IRBP) into the anterior chamber (AC) of Wistar rats. Delayed-type hypersensitivity (DTH) was evaluated on day 3, 7, 14, 21, 28 after IRBP inoculation. GATA-3 expression was detected using immunohistochemical staining. The expression of GATA-3 mRNA at different time points after AC injection of IRBP was assayed by reverse transcriptase polymerase chain reaction (RT-PCR). RESULTS: A significant DTH reaction was observed in Wistar rats on day 3 and 5 after IRBP inoculation. The DTH reaction was decreased 7 days after IRBP inoculation. GATA-3 expression was weak at both mRNA and protein levels in the normal spleen, but was significantly increased on day 5, 7, 14, and 21 after AC injection of IRBP. CONCLUSION: The expression of GATA-3 is increased during ACAID, suggesting that GATA-3 may be involved in the development of ACAID.

[Clinical diagnosis and treatment of uveitis associated with ankylosing spondylitis].

OBJECTIVE: To investigate the clinical features, diagnosis, treatment and prognosis of uveitis associated with ankylosing spondylitis (AS). METHODS: A history about low back pain was carefully reviewed in patients with uveitis and X-ray examination was performed if necessary. Forty-four patients were diagnosed as AS from January 1996 to June 2001 in Zhongshan Ophthalmic Center according to the modified New York criteria for AS. Data concerning these patients, especially with respect to the clinical features, diagnosis and treatment, were retrospectively analyzed. RESULTS: Of 44 patients, 41 were male. The age of the patients at onset of uveitis was (33 +/- 15) years old. All of the 34 patients who had a uveitis history over 40 days showed a recurrent inflammation. In 18 patients (52.9%), the interval between the relapse of uveitis was more than one year. Bilateral ocular involvement was found in 23 out of 34 patients with recurrent uveitis. However, none of them showed a bilateral inflammation at the onset of uveitis. All patients showed acute anterior uveitis with a duration of (27 +/- 12) days. All patients had definitely radiological evidences of bilateral sacroiliitis, although not all of them had typical history of lower back pain. Treatment with corticosteroids eyedrops and cycloplegic agent was used in all patients. Vision equal to or better than 1.0 was achieved in 82.5% of these patients. CONCLUSIONS: Uveitis associated with AS is characterized by acute nongranulamatous anterior uveitis with recurrent episodes in male. Diagnosis is made according to typical clinical features and radiological evidences of bilateral sacroiliitis. Treatment with corticosteroid eyedrops and cycloplegic is able to resolve the inflammation rapidly and leads to a good prognosis in most patients.

[Quantitative determination of aqueous flare and cells in the eyes of patients with inflammation of anterior uvea].

OBJECTIVE: To quantify aqueous flare and cells in the eyes of patients with inflammation of anterior uvea by FC-2000 laser flare cell meter (LFCM), and to compare these results with those obtained with slit lamp microscopy. METHODS: Aqueous flare and cells of 194 eyes of 110 patients with inflammation of anterior uvea and 52 eyes of 52 healthy subjects were graded into 0, 1+, 2+, 3+ and 4 + scale based on a previously described system using slit lamp microscopy. LFCM was also used for evaluation of aqueous flare and cells. RESULTS: All eyes in normal individuals were graded as "0" scale of both flare and cells by silt lamp microscopy. Flare of grade 0, 1+ and 2+ were noted in 74, 98 and 18 eyes, and cell of grade 0, 1+, 2+, 3+ and 4+ were noted in 124, 26, 19, 14 and 11 eyes in uveitis patients, respectively. LFCM examination revealed that the mean flare values in uveitis eyes with flare of grade 0, 1+ and 2+ were 7.9, 29.5 and 189.0 photon count/ms, respectively. In patients with flare of grade 3+ and 4+, LFCM readings were unreliable because of increased background noise. There was significant correlation between slit lamp examination and the laser flare measurement for flare of grade 0, 1+ and 2+ (r = 0.75, P < 0.001). The mean flare values were significantly higher in patients with flare of grade 0, 1+ and 2+ than that in normal controls (5.3 pc/ms) (t = 5.872, P < 0.05). The mean cell numbers in the eyes with cell of grade 0, 1+, 2+, 3+ and 4+ were 1.5, 12.1, 33.9, 84.9 and 193.1 count/0.5 mm(3), respectively. The results of slit lamp examination showed significant correlation with laser cell counts measurement (r = 0.72, P < 0.001). The mean cell numbers were significantly higher in uveitis patients than that in normal controls (0.9 count/0.5 mm(3)) (t = 7.351, P < 0.05). CONCLUSIONS: Our results indicate that LFCM is able to evaluate precisely the mild and moderate breakdown of blood aqueous barrier and inflammation of the anterior uvea tract, therefore it provides an important parameter for the treatment of anterior uveitis.

[Effect of endotoxin-induced uveitis on GATA-3 expression and ACAID development].

OBJECTIVE: To investigate the changes of the GATA-3 expression and development of anterior chamber associated immune deviation (ACAID) after anterior chamber (AC) injection of interphotoreceptor retinoid binding protein (IRBP) under ocular inflammation. METHODS: ACAID was induced by injection of IRBP into the AC of 30 Spar-Dawley (SD) rats. Then the animals were divided into -4 days group, -24 hours group, 0 hour group, 3 days group, and 7 days group according to the lipopolysaccharide (LPS) injection 4 days and 24 hours before, or 0 hour, 3 days and 7 days after IRBP inoculation respectively. 6 rats were used as controls 8 days after IRBP injection, Serum interleukin-4 (IL-4) was evaluated to count the development of ACAID; Western blot and RT-PCR were used to determine the protein and mRNA levels of GATA-3 expression. RESULTS: In -24 hours group and 0 hour group, the ocular inflammation reached a maximum 24 hours after LPS injection; on 8 days after IRBP inoculation, serum IL-4 couldn't be detected and GATA-3 expression were not changed both on mRNA and protein levels compared with control group. In -4 days group, the ocular inflammation was subsided gradually 24 hours and disappeared 96 hours after LPS injection; serum IL-4 and GATA-3 expression were significantly elevated 8 days after IRBP injection. In 7 days group, the serum IL-4 and GATA-3 expression in spleen increased 8 days after IRBP inoculation. CONCLUSION: In ocular inflammation, the up-regulation of GATA-3 expression is inhibited and ACAID development is blocked after antigen was injected into anterior chamber. Once GATA-3 is up-regulated, LPS injection cannot affect ACAID development.

Resistance of lymphocytes to Fas-mediated apoptosis in Behçet's disease and Vogt-Koyangi-Harada syndrome.

BACKGROUND: Behçet's disease and Vogt-Koyanagi-Harada (VKH) syndrome are characterized by a severe intraocular inflammation with a long course and recurrent episodes. Activated autoreactive lymphocytes are considered to be responsible for the development of this inflammation. These lymphocytes may also be involved in the perpetuation and recurrence of this inflammation if they do not properly go into apoptosis. To investigate this hypothesis, a study was carried out to evaluate the resistance of lymphocytes to apoptosis in these two uveitis entities. METHODS: Blood samples were obtained from 17 patients with Behçet's disease, 15 patients with VKH syndrome, and 11 healthy individuals. Mononuclear cells were isolated by centrifugation with Ficoll-Paque and cultured in RPMI 1640 with or without phytohemagglutinin (PHA) for 9 h at 37 degrees C in an atmosphere with 5% CO( 2). The obtained cells were incubated with anti-Fas antibody for 8 h at 37 degrees C in an atmosphere with 5% CO(2). The cells were stained with annexin V/propidium iodide and finally subjected to flow cytometry. RESULTS: A significantly lower percentage of apoptotic lymphocytes after PHA stimulation was noted in Behçet's disease (19.7 +/- 4.1%) and VKH syndrome (20.4 +/- 6.9%) than in controls (26.1 +/- 7.3%). The percentage of apoptotic lymphocytes without PHA stimulation also tended to be lower in the patients with Behçet's disease (12.6%) and with VKH syndrome (12.8%) than in controls (14.6%), although the difference was not significant. CONCLUSION: Lymphocytes in patients with either Behçet's disease or VKH syndrome are relatively resistant to apoptosis mediated by anti-Fas antibody. These apoptosis-resistant, or long-lived, lymphocytes may be involved in the chronic and recurrent intraocular inflammation seen in these patients.

[Therapeutic regimen in Vogt-Koyanagi-Harada syndrome].

OBJECTIVE: To compare the effectiveness of therapeutic regimen in Vogt-Koyanagi-Harada (VKH) syndrome and determine the reasonable regimen for different patients. METHODS: Data of 82 patients with VKH syndrome, coming from all over China and referred to Zhongshan Ophthalmic Center from January 1996 to December 2000 were retrospectively analyzed. Twenty-eight patients (56 eyes) with first attack of the intraocular inflammation were treated with oral prednisone for more than one year, whereas 54 patients (108 eyes) with recurrent episodes were treated with chlorambucil for more than one year. All patients were treated with a combination of these immunosuppressives with traditional Chinese medicine herbs, and followed up more than one year after systemic treatment. The previous treatment for these 54 patients was also analyzed in an attempt to compare these results with those presented here. RESULTS: Uveitis was completely controlled in 96.4% of the patients treated with oral prednisone, and all of these patients showed improved vision after treatment. A complete control of uveitis was achieved in 94.4% and improved vision was seen in 88.0% of the patients treated with chlorambucil. All of these 54 patients, although treated with longer but intermittent systemic corticosteroids before installation of chlorambucil, showed a chronic or recurrent uveitis and most cases had markedly decreased vision as compared with those treated by us with regular systemic corticosteroids. CONCLUSIONS: Intensive and prolonged systemic treatment with corticosteroids is recommended for the patients with first attack of VKH syndrome, where as regular treatment with chlorambucil is useful for control of chronic and recurrent uveitis seen in VKH syndrome. Traditional Chinese medicine herbs may be helpful in amelioration of uveitis and reduction of side effects of immunosuppressives.

[GATA-3 in the development of anterior chamber associated immune deviation].

OBJECTIVE: To determine the role of GATA-3 (a transcript factor that has influences on Th2 cell differentiation) in the development of anterior chamber associated immune deviation (ACAID). METHOD: Immunohistochemistry and Western blot were used to determine the localization and relative protein levels of GATA-3 respectively at different time points after anterior chamber injection of 50 microgram interphotoreceptor retinoid binding protein (IRBP). RESULT: GATA-3 was detected weakly in normal spleen and increased significantly at 5, 7, 14 and 21 days after anterior chamber inoculation. It was detected mainly in CD(4)(+) T cells in spleen. CONCLUSION: The expression of GATA-3 increases earlier than development of ACAID. It suggests that GATA-3 play an important role in Th2 commitment during ACAID development.

[Clinical manifestations and diagnosis of Vogt-Koyanagi-Harada syndrome].

OBJECTIVE: To investigate the clinical features, causes of blindness and diagnosis of Vogt-Koyanagi-Harada (VKH) syndrome. METHODS: The data of 157 patients with VKH syndrome were reviewed and analyzed. Patients were carefully examined with slit lamp, ophthalmoscope, three-mirror lens, fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA) and HLA typing. RESULTS: Headache was noted in 73.5% of these patients. Simultaneous involvement of both eyes occurred in 80.8% of these patients. Choroiditis, papilledema and edema of the retina adjacent to the optic nerve were noted in 100% of these patients in the posterior uveitis stage, whereas recurrent granulomatous anterior uveitis (98.4%), "sunset glow" fundus (95.8%) and Dalen-Fuchs nodules (71.2%) were the common ocular findings in the recurrent anterior uveitis stage. The common causes of blindness were papillitis, exudative retinal detachment and complicated cataract in the posterior uveitis stage, anterior uveal involvement stage and its recurrent stage. Poliosis (36.3%) and alopecia (35.0%) were the most common extraocular findings. Early irregular patches of fluorescence, followed by localized hyperfluorescent spots were the typical findings of FFA. Dilation of choroidal vessels and leakage of ICG from the choroidal vessels were the common ICGA findings. The prevalence of HLA-DR4 and HLA-DRw53 in patients (54.9% and 71.8% respectively) was significantly higher than that in controls (14.7% and 38.2% respectively). CONCLUSIONS: VKH syndrome is characterized by choroiditis, papillitis or neuroretinitis in the posterior uveitis stage, followed by a generalized uveitis with a typical recurrent granulomatous anterior uveitis. Extraocular findings and relevant examinations including FFA, ICGA and HLA typing are helpful to the diagnosis of VKH syndrome.