[Bilateral visual pathway invasion of occipital astrocytoma: a case report].

A 33-year-old female presented to the ophthalmology clinic with right periorbital redness and pain for 12 hours. CT revealed right optic nerve thickening and enlargement. Cranial MRI demonstrated abnormalities in the corpus callosum, bilateral hippocampi, thalamus, basal ganglia, temporal-parietal lobes, and the left frontal lobe. Ocular B-scan ultrasound showed elevated optic disc and high echogenic signals in the right vitreous cavity. The patient had a history of surgical resection, radiation therapy, and chemotherapy for a left occipital glioma two years prior, with pathology indicating astrocytoma (World Health Organization Grade Ⅱ). Combining the patient's history and diagnostic findings, the confirmed diagnosis is bilateral occipital astrocytoma with invasion into the right transverse sinus, bilateral optic pathways involvement related to the left occipital astrocytoma, and seeding of astrocytoma in the right vitreous cavity.

[Systematic errors and control measures during epidemiological surveys of myopia among schoolchildren and adolescents].

Systematic errors and bias are common problems that affect the validity and reliability of epidemiological surveys of myopia among schoolchildren and adolescents worldwide. To provide guidance for standardization of such surveys, the perniciousness, causes and control measures of errors in surveying respondents and bias during the examination and diagnosis are discussed in this article. It is emphasized that controlling systematic errors and bias is the key to ensuring the quality of an epidemiological survey of pediatric and adolescent myopia.

[A case of dislocation of the empty capsular bag into the anterior chamber].

A highly myopic patient complained of 2 months of visual acuity loss and 4 months of ocular pain in the right eye after 16 years after bilateral cataract extraction. The slit lamp microscopy examination showed a residual lens capsule dislocation in the right anterior chamber of the eye, which was diagnosed as a residual lens capsule dislocation in the right eye. After diagnosis and timely treatment, the patient's postoperative vision and visual field recovered well.

[Effect of phacoemulsification on the Berger space].

Objective: To investigate the effect of phacoemulsification on the Berger space (BS). Methods: A prospective cohort study. Patients with cataract who underwent phacoemulsification and intraocular lens implantation in the Department of Ophthalmology, Affiliated Hospital of Nantong University from May 2021 to October 2021 were enrolled. The BS was observed by slit-lamp microscopy and anterior segment optical coherence tomography (AS-OCT) before and 1 month after operation. Intraoperative optical coherence tomography with a 25G optical fiber was performed to observe the BS. The number of eyes with the BS and materials in the BS (MIB) detected perioperatively was counted, and the width of the BS was measured. Statistical analysis was carried out by the Chi-square test, generalized estimating equations, Mann-Whitney U test and binary logistic regression analysis. Results: A total of 119 patients (119 eyes) were included [44 males, 75 females; mean age, (65±12) years]. Preoperatively, the BS was identified in only 4 eyes (3.4%), and no MIB was found. Intraoperatively, the BS was identified in 47 eyes (39.5%), and the MIB was observed in 20 eyes (16.8%). At one month postoperatively, the BS was identified in 33 eyes (27.7%), of which 16 eyes (13.4%) still had MIB. There were significant differences in the detection rates of the BS and MIB between intraoperative and preoperative groups (both P<0.001). The difference in the detection rate of the BS postoperatively compared to intraoperatively was statistically significant (P=0.001), while the difference in the detection rate of MIB was not statistically significant (P>0.05). The intraoperative and postoperative width of the BS [M (Q1, Q3)] was 160.3 (61.6, 273.1) µm and 106.8 (0, 259.4) µm, respectively, and the difference was statistically significant (Z=-2.28, P=0.023). In addition, the detection rate of the BS and MIB in patients with a high risk of zonular fiber weakness [60.7% (17/28) and 42.9% (12/28)] was significantly higher than that in patients without this risk factor [33.0% (30/91) and 8.8% (8/91)] (χ²=6.90, P=0.009; P<0.001). In the multivariable model, weakness of zonular fibers (OR=0.214, 95%CI: 0.081 to 0.561) and higher cumulative dissipated energy (OR=1.255, 95%CI: 1.047 to 1.504) were the main risk factors for structural changes of the BS intraoperatively. Conclusion: Phacoemulsification can damage the normal anatomical structure of the BS, resulting in intraoperative entrance of fluid and particulates to the BS.

[A comparative study of three intraoperative real-time fundus examinations in cataractous eyes].

Objective: To investigate whether the wide field imaging system (WFIS), 25G optical fiber and intraoperative optical coherence tomography (iOCT) can perform real-time screening and diagnosing in patients with highly suspected fundus diseasesintraoperatively. Methods: A cross-sectional study was carried out. One hundred and eighty-three densely cataractous eyes of 183 patients with suspected fundus diseases were included in the Affiliated Hospital of Nantong University from July 2019 to June 2020. Lens phacoemulsification combined with intraocular lens implantation was performed in these eyes. Following the opaque lens was removed, the patients were divided into 4 groups according to fundus examination methods: WFIS SW-8000 group (49 eyes), 25G optical fiber group (40 eyes), iOCT group (36 eyes), and combination group of three examination methods (58 eyes). Optical coherence tomography and/or fundus fluorescence angiography were used to detect the fundus after surgery. The intraoperative and postoperative examination results were compared to verify the accuracy of intraoperative diagnosis in each group. Chi-square test was used for statistical analysis. Results: There were 79 males and 104 females in all patients, and the mean age was (69±10) years. Intraoperative examinations showed 82 eyes with fundus disease (positive rate was 44.81%), while postoperative examinations revealed 93 eyes with fundus disease (positive rate was 50.82%). In the WFIS SW-8000 group, fundus disease was found in 19 eyes intraoperatively and 26 eyes postoperatively (sensitive rate was 73.08%). In the 25G optical fiber group, fundus disease was found in 18 eyes intraoperatively and 20 eyes postoperatively (sensitive rate was 90.00%). In the iOCT group, fundus disease was observed in 20 eyes administratively and 22 eyes postoperatively (sensitive rate was 90.91%). In the combination group, fundus disease was observed in 25 eyes intraoperatively, which was consistent with the results of postoperative examinations (sensitive rate was 100.00%). There were statistically significant differences in the diagnostic sensitivity of fundus diseases among different methods (χ²=9.26; P<0.05). The diagnostic sensitivity of fundus diseases of the WFIS SW-8000 group was lower than that of the the combination group, the difference was statistically significant (χ²=7.80, P<0.01), and there was no significant difference between the other two groups (all P>0.05). Forty-nine eyes with fundus neovascular disease or severe macular edema requiring drug intervention were identified intraoperatively, and intravitreal anti-inflammatory and/or anti-vascular endothelial growth factor drugs were injected in 41 eyes. Conclusions: The WFIS, 25G optical fiber and iOCT can be used to examine the fundus and detect fundus disease intraoperatively, facilitating timely diagnosis and treatment of retinopathy in patients with dense cataract. The combined application of the three methods has the highest sensitivity. (Chin J Ophthalmol, 2021, 57: 850-856).

[Epidemiological survey of visual impairment in Funing County, Jiangsu].

Objective: To investigate the prevalence of visual impairment and factors associated with visual impairment among people aged 50 years and above in Funing County, Jiangsu Province. Methods: Cross-sectional study. Random cluster sampling was used in selecting individuals aged ≥50 years in 30 clusters, and 5 947 individuals received visual acuity testing and eye examination. Stata 13.0 software was used to analyze the data. Multivariate logistic regression was used to detect possible factors of visual impairment such as age, gender and education. Statistical significance was defined as P< 0.05. Results: A total of 6 145 persons aged 50 years and above were enumerated, and 5 947 (96.8%) participants were examined. Based on the criteria of World Health Organization (WHO) visual impairment classification and presenting visual acuity, 138 persons were diagnosed as blindness, and 1 405 persons were diagnosed as low vision. The prevalence of blindness and low vision was 2.32% and 23.63%, respectively. And the prevalence of visual impairment was 25.95%. Based on the criteria of WHO visual impairment classification and best-corrected visual acuity, 92 persons were diagnosed as blindness, and 383 persons were diagnosed as low vision. The prevalence of blindness and low vision was 1.55% and 6.44%, respectively. And the prevalence of visual impairment was 7.99%. Concerning presenting visual acuity and best-corrected visual acuity, the prevalence of blindness and low vision was higher in old people, females and less educated persons. Cataract (46.63%) was the leading cause of blindness. Uncorrected refractive error (36.51%) was also a main cause of visual impairment. Conclusion: The prevalence of visual impairment is higher in old people, females and less educated persons in Funing County, Jiangsu Province. Cataract is still the leading cause of visual impairment. (Chin J Ophthalmol, 2017, 53: 502-508).

[Prevalence and surgery status of cataract among adults aged 60 years or above in two villages of Nantong].

Objective: To assess the prevalence, surgical coverage rate and social burden rate of cataract blindness among adults aged ≥60 years in the suburban population of Nantong, Jiangsu, China. Methods: It was a population-based cross-section study. A census with individuals aged ≥60 years was conducted in two villages of the suburb area in Nantong from June to August, 2008. A total of 1 305 individuals received visual acuity and eye examinations. Lens and cataract operative status were evaluated by slit-lamp biomicroscopy. Multiple logistic regression analysis was employed to analyze the prevalence of cataract, cataract surgical coverage rate and cataract blindness social burden rate among different ages, genders, educational backgrounds, marital statuses and salary levels. The results in the suburb were compared to the urban and rural areas. Results: Among 1 305 individuals, 376 cases of cataract were found. The prevalence of cataract was 28.81%. The rate was higher in the aged, less educated and low salary persons (P<0.01). In 47 eyes with cataract surgery, 19.15% of eyes were treated by modern extra-capsular surgery and 38.30% received phacoemulsification. The rate of intraocular lens implantation was 57.45%. The cataract surgical coverage rate was 40.48% and the cataract blindness social burden rate was 3.22%. The cataract surgical coverage rate was higher in the primary-educational persons than illiterate persons (P<0.05). The cataract blindness social burden rate was higher in ≥80-year-old persons than ≥60-year-old persons (P<0.05) and lower in married persons than single persons (P<0.05). The cataract surgical coverage rate was lower in the suburb area than in the city area, while the cataract blindness social burden rate was opposite. The rate of postoperative presenting visual acuity and best-corrected visual acuity of over 0.7 was 14.89% and 23.40% in the operated eyes, respectively. The main causes of unfavorable postoperative visual acuity (<0.3) were retinal disorders, post-capsular opacity, corneal opacity, refractive errors and glaucoma. Conclusions: Cataract is the most common and important eye disease that may lead to blindness and severe visual impairment among adults aged 60 years or above in the suburb of Nantong City. The prevalence of cataract is related to age, education background and economy level. The cataract surgical coverage rate is low and the cataract blindness social burden rate is high. The first important task in blindness prevention is still the elimination of cataract blindness and the improvement of visual outcomes after cataract surgery. (Chin J Ophthalmol, 2017, 53: 514-521).

Genome-wide analysis of single nucleotide polymorphisms in patients with atrophic age-related macular degeneration in oldest old Han Chinese.

The aim of this study was to identify disease-associated loci in oldest old Han Chinese with atrophic age-related macular degeneration (AMD). This genome-wide association study (GWAS) only included oldest old (≥95 years old) subjects in Rugao County, China. Thirty atrophic AMD patients and 47 age-matched non-AMD controls were enrolled. The study subjects underwent a complete ophthalmic examination. Genomic DNA was extracted from peripheral blood samples. Single nucleotide polymorphisms (SNPs) were scanned by Genome-Wide Human Mapping SNP 6.0 Arrays and GeneChip Scanner 3000 7G. The results were read and analyzed by the Affymetrix Genotyping Console software. We filtered out the SNPs with a no-call rate ≥10%, MAF P < 0.05, and HWE P < 0.001. The remaining 561,277 SNPs were included in the association analysis. We found that the following 2 SNPs had the highest association with atrophic AMD: rs7624556 (located on 3q24) and rs13119914 (located on 4q34.3). In conclusion, we identified two atrophic AMD-associated SNPs (rs7624556 and rs13119914) in an oldest old Han Chinese population. This finding may lead to new strategies for screening of atrophic AMD for Han Chinese.

A study on the awareness of cataract disease and treatment options in patients who need surgery in a rural area of Eastern China.

PURPOSE: To investigate the awareness of cataract disease and treatment and to determine the major barriers for patients who need cataract treatment in a rural area of eastern China. METHODS: A total of 251 cataract patients were selected by means of eye disease screenings throughout Jiangyan County. Questionnaires were administered after the doctor determined that the patient needed cataract surgery. The patient's awareness questionnaire was developed by Fletcher and clinically validated at the Aravind Eye Hospital in India. RESULTS: A total of 89.6% of patients had been aware of their condition for more than 1 year. Only 49.8% of all patients had known for more than 1 year that their eye disease could be treated. The major barriers for those seeking eye treatment included residual functional vision (49.0%), financial problems (36.7%), no demand for the operation (8.8%), and skepticism about the operation (8.8%). Poor vision function grade and female gender were two significant factors associated with a longer awareness (>3 years) of the existence of cataracts. Patients with a history of eye disease and a longer awareness of eye disease were more likely to have known about the potential treatments for a longer period of time (>1 year). CONCLUSIONS: The patients' awareness of the presence of cataract disease and potential treatment were unbalanced. The main treatment barriers were lower demand for vision improvement and financial problems. It is imperative to educate patients on eye health care and to provide low cost, but high quality, cataract surgery to these patients.

Atypical antipsychotic effects of quetiapine fumarate in animal models.

AIM: To evaluate the effect of quetiapine fumarate in animal models of schizophrenia and its possibility to induce extrapyramidal side effects (EPSE). METHODS: The enhancement of immobility in a forced swimming test of mice induced by repeated treatment with phencyclidine and amphetamine swimming "normalization" test of mice were used as animal models of negative and positive symptoms of schizophrenia, respectively. The paw test of rats was used to evaluate the possibility by quetiapine fumarate to induce EPSE. RESULTS: After treatment with phencyclidine (10 mg.kg-1.d-1, s.c., 14 d), the immobility time in the forced swimming test of mice was increased (P < 0.01). Quetiapine fumarate (20, 40, and 80 mg.kg-1, ig) and clozapine (10 and 30 mg.kg-1, ig) attenuated the enhanced immobility in the forced swimming test induced by repeated treatment with phencyclidine (P < 0.01), whereas haloperidol (0.3 and 1 mg.kg-1, ig) had no effect. In amphetamine swimming "normalization" test, quetiapine fumarate ameliorated the disorder induced by amphetamine in a dose-dependent manner. In paw test, quetiapine fumarate was much less effective in increasing the forelimb retraction time (FRT) than the hindlimb retraction time (HRT). The minimal effective dose (MED) of HRT (MEDHRT) and FRT (MEDFRT) of quetiapine fumarate was 20 mg.kg-1 and 100 mg.kg-1, respectively, and the ratio of MEDFRT to MEDHRT was 5. CONCLUSION: The effects of quetiapine fumarate in these models indicated its clinical effect on schizophrenia with a reduced liability to produce EPSE.

Protective effect of bilobalide against nitric oxide-induced neurotoxicity in PC12 cells.

AIM: To examine the effects of bilobalide on nitric oxide-induced neurotoxicity in pheochromocytoma-derived PC12 cells (PC12 cells). METHODS: PC12 cell survival was monitored by LDH release and 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) assays. Superoxide dismutases (SOD) and catalase (CAT) activities were measured based on their abilities to inhibit the oxidation of epinephrine by the xanthine-xanthine oxidase system or to decompose H2O2 respectively. The content of malondialdehyde (MDA) was measured by a fluorometric assay to indicate the lipid peroxidation. RESULTS: 3-Morpholinosydnonimine (SIN-1, 50-300 mumol.L-1) induced PC12 cell damage. After the cells had been pretreated with 10 mumol.L-1 bilobalide for 24 h, the cell viability was increased to 91% +/- 30% from 52% +/- 14% in SIN-1 alone group. Moreover, the activities of SOD and CAT were increased after cells were treated with bilobalide. CONCLUSION: The NO-induced neurotoxicity can be protected by bilobalide in PC12 cells. The bilobalide-induced increase in SOD and CAT activities may serve as one of the mechanisms underlying the neuroprotective effect of bilobalide.

Neuroprotective rather than neurorescue or neurorestorative effect of selegiline against MPTP-induced dopaminergic toxicity.

AIM: To study the neuroprotective, neurorescue, neurorestorative effects of selegiline (Sel) on nigrostriatal dopaminergic neuronal system and its inhibition of brain monoamine oxidase B (MAO-B). METHODS: The striatal levels of dopamine and its metabolites were measured using HPLC with electrochemical detection (HPLC-EC). The inhibition of MAO-B was tested by an improved fluorimetric assay. RESULTS: 1-Methyl-4-phenyl-1,2,3,6-tetrahydro-pyridine (MPTP) (30 mg.kg-1 i.p.) reduced the striatal dopamine level by 73% in mice. Selegiline (Sel, 10 mg.kg-1 i.p.) before, but not after, MPTP treatment protected against MPTP-induced nigrostriatal dopaminergic neurotoxicity. There were no differential effects between Sel and saline treatments on the recovery of striatal dopamine levels, which were partially restored during 2 wk. 1-Methyl-4-phenylpyridinium (MPP+) (5 mg.kg-1 i.p.) produced no dopaminergic neurotoxicity. Furthermore, Sel selectively and irreversibly inhibited mouse brain MAO-B in vitro (IC50 = 17 nmol.L-1, 95% confidence limits = 14-20 nmol.L-1). CONCLUSION: Selegiline has neuroprotective rather than neurorescue or neurorestorative effects on MPTP-induced nigrostriatal dopaminergic neuronal degeneration, which is directly pertinent to its selective and irreversible inhibition of brain MAO-B activity.

Specific antitumor immunologic reactivity in patients with retinoblastoma.

Retinoblastoma antigen (RbAg) and retinal tissue antigen (RAg) were made from allogeneic retinoblastoma tissues and normal retinal tissue using the 3M KCl method. We have examined leukocyte migration inhibition test (LMIT) and enzyme-linked immunosorbent assay (ELISA) to RbAg and RAg in normal controls and the patients with retinoblastoma, including two spontaneously regressed cases. In LMIT, six out of the 11 patients tested against RhAg showed positive reactivity, in which 4 cases reacted only with RbAg, but not with RAg. All nine control subjects had negative reactivity to the two antigens. In ELISA, 40% of the retinoblastoma patients and 5.56% in normal controls showed positive reaction against RbAg. It was suggested that not only retinal antigens but also retinoblastoma specific antigens present in human retinoblastoma cells. The results also suggested that patients with retinoblastoma and those with spontaneous regression of Rb had both cell-mediated immunologic reactivity and humoral immune response toward retinoblastoma antigen in vitro. These immune responses to RbAg may be responsible for spontaneous regression of retinoblastoma.