[A new analysis method for 24-hour intraocular pressure data].

The study aimed to introduce a new analysis method of 24-hour intraocular pressure (IOP) and to propose the concept of overall IOP. Data of 24-hour IOP of a patient with a confirmed diagnosis of normal tension glaucoma was selected. Based on the present indexes including peak IOP, trough IOP, maximum difference, and mean IOP, new indexes were proposed, which included main IOP, duration of main IOP, and rate of IOP increase. A radar chart was drawn, and overall IOP was calculated. Overall IOP value = IOP distribution (sum of IOP value multiplied by the corresponding duration) × IOP fluctuation (standard deviation) × rate of IOP increase/100. By comparing two series of IOP data, the advantages of the new IOP indexes were demonstrated. The introduction of the concept of overall IOP expands the description of IOP from a single static state to a comprehensive dynamic state, which enables us to analyze the results of 24-hour IOP monitoring more thoroughly. (Chin J Ophthalmol, 2021, 57: 228-231).

[Effect of 2% ganciclovir eye drops on cytomegalovirus positive Posner-Schlossman syndrome].

Objective: To observe the effect of 2% ganciclovir eye drops on Posner-Schlossman syndrome (PSS) patients with positive cytomegalovirus (CMV) in aqueous humor. Methods: Prospective study. The cases clinically diagnosed as PSS with positive CMV were enrolled from August 2017 to January 2018 at Department of Ophthalmology, Eye & ENT Hospital of Fudan University. All patients underwent aqueous and serum analysis for CMV by the enzyme linked immunosorbent assay and polymerase chain reaction. The history and clinical signs were noted, 2% ganciclovir eye drops were prescribed for topical use (4 times per day), and the patients were followed up. The Pearson Chi-square test was used for the comparison of factors including keratic precipitates (KPs), and the Tyndall, and paired t test or Wilcoxon rank sum test was used for factors like intraocular pressure (IOP), corticoid dosage, and IOP lowering medication dosage. Results: Fifty cases (31 males and 19 females) clinically diagnosed as PSS with positive CMV had an average age of (38±13) years. Some characteristics could help to identify CMV-positive PSS: iris depigmentation (96%, 48/50), coin-shaped KPs, loss of corneal endothelium (an average loss rate of 10.8%±5.5%), and high IOP during attack[(47.8±9.9)mmHg,1 mmHg=0.133 kPa]. After topical antivirus therapy with the mean time of (5.4±2.7) weeks, the clinical manifestations of CMV positive PSS cases improved. The granulomatous or middle-sized KPs decreased from 94%(47/50) to 52%(26/50), the coin-shaped KPs almost disappeared [from 22%(11/50) to 2%(1/50)], and the Tyndall reaction disappeared [from 12%(6/50) to 0]. The mean IOP value decreased from (26.2±10.9) mmHg to (15.5±3.6) mmHg. Furthermore, corticoid use decreased (from 3 times per day to 0 time per day, by median value), the number of cases that did not use corticoids increased from 6% (3 cases) to 60% (30 cases), and 17 (65%) out of those 26 corticoid dependent patients could withdraw corticoids. The number of IOP lowering eye drops used also decreased (from 2 to 0, by median value), and the proportion of cases without IOP lowering medication increased from 24% (12 cases) to 58% (29 cases). There were statistical differences between post-treatment and pre-treameat (all P<0.05).Thirteen cases that accepted CMV re-test of aqueous humor were all CMV DNA negative after treatment. Conclusion: Topical treatment with 2% ganciclovir eye drops has a good short-term effect on CMV-positive PSS patients by contributing to inflammation and IOP control. (Chin J Ophthalmol, 2018, 54: 833-838).

A voxel-based morphometry study of anosmic patients.

OBJECTIVE: The aim of our study was to compare volume change in grey matter (GM) and white matter (WM) in a group of subjects with anosmia and a healthy control group. We tried to find a regular pattern of atrophy within and between GM and WM and to determine whether any particular areas are more sensitive to olfactory injury. METHODS: There were 19 anosmic patients and 20 age- and sex-matched control subjects. We acquired MR images on a 3-T scanner and performed voxel-based morphometry using the VBM8 toolbox and SPM8 in a MATLAB® (MathWorks®, Natick, MA) environment. RESULTS: Patients with anosmia showed a significant decrease in GM volume, mainly in the anterior cingulate cortex, middle temporal gyrus, superior temporal gyrus, fusiform gyrus, supramarginal gyrus, superior frontal gyrus, middle frontal gyrus, middle occipital gyrus, anterior insular cortex and cerebellum. In addition, we observed volume decreases in smaller areas such as the piriform cortex, the inferior temporal gyrus, the precuneus and the subcallosal gyrus. All WM areas with atrophy were near those GM areas that experienced volume loss. There was more volume atrophy in GM areas corresponding to WM areas with more volume loss. Atrophy increased with disease duration. CONCLUSION: There is simultaneous atrophy in GM and WM, and the degree of atrophy is greater with longer disease duration. Different GM and WM areas have different sensitivities to olfactory injury. ADVANCES IN KNOWLEDGE: This study examines the atrophy pattern in and between GM and WM-a subject that has not been widely researched previously.

Three-dimensional gadolinium-enhanced MR venography to evaluate central venous steno-occlusive disease in hemodialysis patients.

AIM: To determine the agreement and diagnostic accuracy of three-dimensional gadolinium-enhanced magnetic resonance venography (3D-Gd-MRV) in central venous steno-occlusive disease (CVSD) in haemodialysis patients. MATERIALS AND METHODS: Fourteen consecutive haemodialysis patients underwent interventional procedures to evaluate or treat CVSD. 3D-Gd-MRV was performed before the procedures and the results were compared with digital subtraction angiography (DSA). RESULTS: DSA showed >50% stenosis in all 14 patients, 13 of whom were diagnosed correctly using 3D-Gd-MRV. Moderate stenosis was missed at 3D-Gd-MRV in one case whereby the indwelling dialysis central venous catheter may have caused an artefact on the images and hindered the accuracy of the result. The sensitivity of 3D-Gd-MRV in revealing stenosis was 93% (13/14). No complications caused by contrast agent toxicity occurred in any patient. CONCLUSION: 3D-Gd-MRV employing a non-breath-hold technique is highly sensitive in the diagnosis of CVSD and may be an alternative technique to DSA for the visualization of central veins.

Interventional treatment of hepatic artery stenosis after orthotopic liver transplantation with balloon-expandable coronary stent.

OBJECTIVE: The aim of this study was to evaluate the efficacy of hepatic artery stenting with a balloon-expandable coronary stent for the treatment of hepatic artery stenosis (HAS) after orthotopic liver transplantation (OLT). PATIENTS AND METHODS: We performed retrospective review of all 11 patients who underwent hepatic artery stenting after a diagnosis of HAS. RESULTS: A total of 13 balloon-expandable coronary stents were placed into 11 patients. The technical and immediate success rate was 100%; all stents remained patent during follow-up. One patient required 2 stents due to the length of the stenotic artery. Another underwent a second stenting after developing restenosis proximal to the original stenotic site. No procedure-related complications occurred, and no surgical revascularization or retransplantation was required during follow-up. CONCLUSIONS: A balloon-expandable coronary stent can play a role in the management of HAS. It can be used with great safety, with immediate as well as longer-term success.

Percutaneous intravascular stents for treatment of portal venous stenosis after liver transplantation: midterm results.

Portal vein stenosis after liver transplantation is a relatively uncommon vascular complication that may result in graft loss if not promptly treated. The purpose of this study was to evaluate the midterm result of the use of intravascular stents for portal vein stenosis after liver transplantation. From April 2004 to September 2005, percutaneous transhepatic balloon dilation with stent deployment was performed in nine cases. Varices were embolized with stainless steel coils in two cases. No procedure-related complication occurred. Portal venous patency was maintained in all nine patients from 6 to 19 months (mean 10 months). In conclusion, an intravascular stent is an effective treatment for the portal vein stenosis after liver transplantation with excellent midterm patency.

[Intra-arterial digital subtraction angiography (IADSA) in liver metastases].

From Dec. 1988 to Dec. 1990, fifty cases of metastatic liver tumors were examined with IADSA. The present article analysed the DSA imaging in this series and divided the DSA appearances of the tumor vessels into five types: 1. Dilatation and enlargement, 29 cases (58%); 2. Stricture and narrowing, 17 cases (34%); 3. Zigzag and tangle, 39 cases (78%); 4. Intermittence and discontinuance, 20 cases (40%); 5. Removement and encirclement, 34 cases (68%). Sometimes several types could be found in one case. There were two cases in this group without any tumor vessels. The DSA appearances of tumor stains were also divided into four types: 1. Circular, cystiform and honeycomb-like, 9 cases (18%). 2. Nodular masses, 13 cases (26%). 3. Spots and flakes, 8 cases (16%). 4. Wadding-like, 15 cases (30%). There were 5 cases without any tumor stains. In no case there was AVM or cancerous embolus in portal vein. In this series, hypervascular lesions were observed in 17 cases (34%), midvascular lesions in 25 cases (50%), and hypovascular lesions in 8 cases (16%).

[Fine needle aspiration biopsy of intrathoracic mass guided by real-time sonography--analysis of 50 cases].

From May 1987 to February 1988, fine needle aspiration biopsy of intrathoracic mass guided by real-time sonography was performed in 50 consecutive patients and succeeded in 45 (90%). In this series, there were 34 malignant neoplasms with success rate of 94.12% and 16 benign lesions with success rate of 81.25%. Statistical analysis showed no difference. The success rates were different in various sites: supraclavicular 100% (3/3), parasternal 92.86% (13/14), paravertebral 75.00% (3/4), intercostal 89.66% (26/29). But, the statistical analysis was still not significant. No other complications occurred except mild hemoptysis in 1 case. Fine needle aspiration biopsy of intrathoracic mass guided by real-time sonography, being of simplicity, less complications and no exposure of either patient or operator to radiation, should be used widely.