Alterations in Macular Microvasculature in Pterygium Patients Measured by OCT Angiography.

Previous studies have reported an association between pterygia and maculopathy, yet the underlying mechanisms and alterations to the macular microvasculature in pterygium patients have yet to be fully elucidated. Our study conducted an analysis of macular superficial vessel length density (VLD) and vessel perfusion density (VPD) to establish associations between the conjunctival and macular microvasculature in patients with unilateral and bilateral pterygia. We revealed a loss of macular microvasculature in the outer nasal (ON) region in both unilateral and bilateral pterygium patients. VLD was significantly decreased in both pterygium groups in the ON region, and VPD was notably lower in bilateral pterygium patients in the same area. Furthermore, in unilateral pterygium patients, the vessel percent pixel coverage (PPC) of the pterygium and the area of the pterygium exhibited a negative correlation with VLD in the ON region. Multiple stepwise linear regression models indicated that the PPC could best predict VLP in the ON region. Taken together, our findings suggest that patients with pterygia may be more susceptible to macular diseases, and this may be due to a compensatory increase in blood perfusion via the anterior ciliary artery. These results underscore the importance of managing maculopathy in patients with pterygia.

Macular vessel density and foveal avascular zone parameters in patients after acute primary angle closure determined by OCT angiography.

This study analyzed the optical coherence tomography angiography (OCTA) macular parameters in primary angle-closure glaucoma (PACG) patients after acute primary angle closure (APAC) episodes. Thirty-three patients with 33 APAC eyes and 33 primary angle closure suspect (PACS) eyes and 33 age-matched normal subjects (controls) were enrolled. Macular vessel density (VD) in central, inner, outer and full regions and foveal avascular zone (FAZ) parameters (area, perimeter and circularity index) were compared between APAC, PACS, and control eyes. For resolved APAC eyes, the VD in each macular region was significantly lower than that in control eyes, with less central and inner macular VD than PACS eyes. The central macular VD was significantly lower in PACS eyes than in controls. There was no difference in FAZ area and perimeter between APAC, PACS, and control eyes. FAZ circularity was highest in control eyes, followed by PACS eyes, and lowest in APAC eyes. The AUC, sensitivity and specificity of FAZ circularity were 0.944, 93.9% and 84.8%, respectively, in APAC eyes and 0.881, 84.8% and 81.8%, respectively, in PACS eyes. Therefore, FAZ circularity had the best discrimination capability for detecting both APAC and PACS eyes. Macular assessment with OCTA could provide an accurate early-stage diagnostic tool for PACG.

[Surgical treatment for persistent pupillary membranes].

OBJECTIVE: To explore surgical treatment for persistent pupillary membrane (PPM) and its effect.
 Methods: The medical records and postoperative follow-up data for 12 consecutive patients (16 eyes), who were submitted to PPM resection in Xiangya Hospital, Central South University from March 2011 to August 2016, were retrospectively reviewed.
 Results: Among 12 consecutive patients (16 eyes), 8 patients (12 eyes) with PPM and clear lens were submitted to simply PPM resection, and 4 patients (4 eyes) with PPM and cataract were submitted to PPM resection combined with cataract surgery. In the patients who received the combined operation, phacoaspiration with or without intraocular lens implantation was performed in 3 eyes or in 1 eye. In the early stage after surgery, 1 eye was complicated with a transient high intraocular pressure. In the patients who were submitted to PPM resection, the final follow-up visual acuity in 7 patients (11 eyes) were improved except 1 patient (1 eye). After the PPM resection combined with cataract surgery, the follow-up visual acuity was improved in 2 patients (2 eyes) but not in the other 2 patients (2 eyes).
 Conclusion: The surgical treatment is effect on congenital pupil residual membrane. Serious membrane pupil residual membrane should be surgically treated at early stage, and amblyopia treatment after the surgery is important.

Analysis of Clinical Characteristics of Immune-Related Dry Eye.

AIM: To discuss the clinical characteristics of immune-related dry eye. METHODS: Simple dry eye (SDE) group: we selected 224 patients of simple dry eye with no systemic lesions. Immune-related dry eye (IRDE) group: we selected 207 patients of dry eye complicated with immune system diseases, including 70 cases of Sjögren's syndrome (SS), 72 cases of systemic lupus erythematosus (SLE), and 65 cases of rheumatoid arthritis (RA). The classification of all patients was performed. The difference between the two groups was compared, including age, gender, ocular surface fluorescein staining and inflammatory reaction, tear breakup time (TBUT), Shirmer I test, confocal microscopy scan, and dry eye grading. RESULTS: Compared with the SDE group, the patients of IRDE group were younger (P < 0.05). The female patients were significantly more than the male ones (P < 0.05). Corneal staining counts and ocular surface inflammation were significantly increased (P < 0.05). TBUT and Shirmer I test shortened significantly (P < 0.05). Corneal nerve fibers were less, and the number of local lymphocyte was significant increased. The number of dry eye patients in the moderate or above IRDE group was significantly increased (P < 0.05). CONCLUSIONS: The dry eye symptom and sign and ocular surface inflammation of IRDE were significantly more severe than those of the SDE.

Comparison of the Ahmed glaucoma valve with the Baerveldt glaucoma implant: a meta-analysis.

BACKGROUND: This study aims to compare the efficacy and safety of the Ahmed glaucoma valve (AGV) with the Baerveldt glaucoma implant (BGI) in glaucoma patients. METHODS: Databases were searched to identify studies that met pre-stated inclusion criteria, involving randomized controlled clinical trials (RCTs) and non-randomized controlled clinical trials. Treatment effect was analyzed using a random-effect model. RESULTS: Ten controlled clinical trials (1048 eyes) were analyzed, involving two RCTs and eight retrospective comparative studies. Short-term results (6-18 months) and long-term results (>18 months) were analyzed separately. There was no significant difference in the success rate for short-term follow-up between the AGV and BGI groups (5 studies, 714 eyes, odds ratio [OR]: 0.97; 95 % confidence interval [CI]: 0.56, 1.66; P = 0.90). For long-term pooled results (7 studies, 835 eyes), the success rate of AGVs was lower than that of BGIs (OR: 0.73; 95 % CI: 0.54, 0.99, P = 0.04), However, subgroup and sensitivity analyses did not show a significant difference in the success rate between the two groups (P ≥0.05). The AGV group had a higher mean intraocular pressure than the BGI group in short-term (6 studies, 685 eyes, weighted mean difference [WMD]: 2.12 mmHg; 95 % CI: 0.72-3.52; P <0.05) and long-term pooled results (7 studies, 659 eyes, WMD: 1.85 mmHg; 95 % CI: 0.43, 3.28; P = 0.01). The BGI group required fewer glaucoma medications after implantation than the AGV group in two follow-up periods (all P <0.05). The AGV was found to be associated with a significantly lower frequency of total complications (8 studies, 971 eyes, OR: 0.67; 95 % CI: 0.50-0.90; P = 0.007) and severe complications (8 studies, 971 eyes, OR: 0.57; 95 % CI: 0.36-0.91; P = 0.02) than the BGI. CONCLUSIONS: The study showed no significant difference in success rate between the two groups. The BGI was more effective for control of intraocular pressure and required fewer medications than the AGV, but the AGV had lower incidence of total and severe complications than the BGI.

[Clinical analysis of malignant glaucoma after glaucoma surgery].

OBJECTIVE: To explore the risk factors, the ciliary body anatomy structures, the therapeutic methods and the prognosis for malignant glaucoma through retrospectively collecting the clinical data from primary angle-closure glaucoma (PACG) patients. METHODS: Clinical data in 1183 patients (1456 eyes) with PACG were collected between July, 2010 and May, 2014 from Xiangya Hospital, Central South University. Thirty patients (38 eyes) were diagnosed as malignant glaucoma. According to symptom, these patients were divided into a PACG group (1418 eyes) and a malignant glaucoma group (38 eyes); according to age, they were divided into a 3-40 years old group (171 eyes), a 41-70 years old group (1016 eyes) and a ≥71 years old group (269 eyes); according to therapeutic methods, they were divided into a drug therapy group (5 eyes), a lens extraction group (6 eyes) and a vitrectomy surgery group (27 eyes); according to the different method of surgery, they were divided into a vitrectomy group (27 eyes), a nonvitrectomy group (11 eyes). The age, sex, anterior chamber depth (ACD), axial length (AL), lens thickness (LT), visual acuity, intraocular pressure, therapeutic methods and surgery history were recorded. Meanwhile, the ciliary body thickness (CBT), trabecular ciliary process angle (TCA) and lens diameter were measured by ultrsound biomicroscopy (UBM). RESULTS: Male and female ratio was 1:2 in the malignant glaucoma group. The average age [(51.87±12.92) years] in the malignant glaucoma group was less than that in the PACG group [(57.87±8.78) years](P<0.05). Malignant glaucoma was more likely to occur in the first 3 months after PACG trabeculectomy with a rate of 85.7%. The LT [(4.33±0.67) mm], AL[(21.44±1.18) mm] and ACD [(2.12±0.41) mm] in the malignant glaucoma group were less than those in the PACG group [(4.81±0.50), (22.17±0.97) and (2.49±0.48) mm, respectively](all P<0.05). The CBT0, CBT1, CBTmax, TCA and lens diameter in the malignant glaucoma group were less than those in the PACG group (all P<0.05). CONCLUSION: Female PACG patients, with short axial length, shallow anterior chamber, thin lens, thin ciliary body, small trabecular ciliary process angle and short lens diameter, are more likely to suffer from malignant glaucoma. Vitrectomy can significantly reduce intraocular pressure.

Crystal structure of 9-(4-bromo-but-yl)-9H-fluorene-9-carb-oxy-lic acid.

The title compound, C18H17BrO2, is a key inter-mediate in the synthesis of lomitapide mesylate, a microsomal triglyceride transfer protein inhibitor. Its asymmetric unit contains two independent mol-ecules with slightly different conformations; the mean planes of the 4-bromo-butyl and carboxyl-ate groups in the two mol-ecules form dihedral angles of 24.54 (12) and 17.10 (18)°. In the crystal, carboxyl-ate groups are involved in O-H⋯O hydrogen bonding, which leads to the formation of two crystallographically independent centrosymmetric dimers. Weak inter-molecular C-H⋯O inter-actions further link these dimers into layers parallel to the bc plane.

1,3-Dimethyl-1H-indazol-6-amine.

The mol-ecular skeleton of the title compound, C(9)H(11)N(3), is almost planar, with a maximum deviation of 0.0325 (19) Šfor the amino N atom. In the crystal, N-H⋯N hydrogen bonds establish the packing.

2-[4-(4-Methylphenylsulfonyl)piperazin-1-yl]-1-(4,5,6,7-tetrahydrothieno[3,2-c]pyridin-5-yl)ethanone.

In the title thienopyridine derivative, C(20)H(25)N(3)O(3)S(2), the piperazine ring exhibits a chair conformation and the tetra-hydro-pyridine ring exhibits a half-chair conformation. The folded conformation of the mol-ecule is defined by the N-C-C-N torsion angle of -70.20 (2) °. Inter-molecular C-H⋯S and C-H⋯O hydrogen bonds help to establish the packing.

1-(2-Nitro-benz-yl)-1H-pyrrole-2-carbaldehyde.

In the title compound, C(12)H(10)N(2)O(3), the five- and six-membered rings form a dihedral angle of 83.96 (6)°. The nitro group is twisted by 5.92 (8)° from the plane of the attached benzene ring. In the crystal, weak inter-molecular C-H⋯O hydrogen bonds link the mol-ecules into columns in the [100] direction, with a short distance of 3.725 (3) Šbetween the centroids of benzene rings inside these columns.

[Synthesis of thienopyridine derivatives and its anti-platelet activity in vivo].

To explore novel ADP receptor inhibitors with anti-thrombotic activity, eighteen compounds were synthesized and their structures were confirmed by 1H NMR and MS. The results showed that the activity of compound C1 was superior to ticlopidine in platelet aggregation inhibition tests in vivo and worthy for further investigation. Compounds A4, B2, C4 and C7 possessed moderate platelet aggregation inhibitory activities.

2-Chloro-1-(4,5,6,7-tetrahydro-thieno[3,2-c]pyridin-5-yl)ethanone.

In the title compound, C(9)H(10)ClNOS, the dihedral angle between the planar thio-phene ring and 2-chloro-ethane moiety (r.m.s deviations of 0.003 and 0.015 Å, respectively) is 45.79 (6)°. The tetra-hydro-pyridine ring adopts a half-chair conformation. The crystal packing reveals inter-molecular C-H⋯O inter-actions.

[Color pattern reversal visual evoked potentials in primary open angle and angle closure glaucoma].

OBJECTIVE: To investigate the difference in color pattern reversal visual evoked potential (CPR-VEP)between primary open angle glaucoma (POAG) and primary angle closure glaucoma (PACG) patients. METHODS: Vision Monitor visual electrophysiograph made by Metro Vision Inc. in France was used to record CPR-VEP in 17 eyes of 12 POAG patients, 56 eyes of 41 PACG patients, and 26 eyes of 13 age-equivalent normal persons at an ascending series of temporal frequency (1, 2, 4, 8, 16, and 32 Hz) and color stimulation (black/white, red/green, and blue/yellow). P(100) wave amplitudes and latencies of these patients were compared respectively with those of the normal group. RESULTS: With black/white stimulation, the P(100) wave amplitudes were reduced with the increase of temporal frequency in the 3 groups. The P(100) wave latencies were extended with the increase of temporal frequency with different color stimulations. The P(100) amplitudes were PACG group > NC group > POAG group and black/white > blue/yellow > red/green. The P(100) wave latencies in the POAG group and the PACG group were extended compared with the NC group, but there was no significant difference between PACG group and POAG group. CONCLUSION: CPR-VEP P(100) amplitudes in the PACG group and POAG group have their own characteristics. The P(100) amplitude of PACG is higher, and POAG is lower than normal. The P(100) wave latencies of PACG and POAG are extended.

[Mid-term and long-term clinical effect of micro-perforating trabecular surgery with amniotic membrane implants on open angle glaucoma].

OBJECTIVE: To evaluate the mid-term and long-term clinical effect and complication of micro-perforating trabecular surgery (MPTS) with amniotic membrane implants on open angle glaucoma (OAG). METHODS: Thirty OAG patients (49 eyes) were treated with MPTS with amniotic membrane implants. Visual acuity, intraocular pressure, visual field, type of blebs, and complications were recorded pre-and post-operatively. RESULTS: Patients were followed up for 6~24(15.93+/-2.35) months. The mean IOPs before the operation and 24 months after the operation were (36.84+/-11.02) mmHg and (18.24+/-1.34) mmHg, respectively (P=0.000). The mean numbers of anti-glaucoma drugs used before and after the operation were (2.76+/-0.69) and (0.59+/-0.89), respectively (P<0.05). The global index of the early to moderate glaucomatous visual field loss was significantly improved postoperatively (P<0.05), and no significant difference was found in aggressive glaucoma pre- and postoperatively. Functional filter bleb was formed in 70.8% patients 24 months after the operation. The complete success rate and quality success rate were 75.5% (37/49) and 93.9% (46/49), respectively. There was no significant change in visual acuity pre- and postoperatively and no severe complication was found. CONCLUSION: Micro-perforating trabecular surgery with amniotic membrane implants is effective and safe for OAG, with reliable effect on lowering IOP in the mid-term and long-term.

[Effect of vasoactive intestinal peptide receptor antagonist VIPhybrid on the development of form deprivation myopia in chicks].

OBJECTIVE: To investigate the effect of regulation of VIPhybrid, an unselective antagonist of vasoactive intestinal peptide receptors (VIPR), on the formation and development of form deprivation myopia (FDM) in chick and the expression of protein and mRNA of VIP on the retina and choroids of in chicks. METHODS: Seventy-two 1-day-old yellow healthy leghorn chicks were assigned into 6 groups (12 in each group). Eyes in Group I were covered on the right as a blank control group. Eyes in GroupII were those eyes having been injected with 20 microL saline into vitreous cavity and then covered as a negative control group. Eyes in GroupIII,IV and V were injected with 20 microL VIPhybrid with low (3*10(-12) mol/L), middle (3*10(-10) mol/L) and high (3*10(-8) mol/L) dosage into vitreous cavity and then covered as experimental groups. The above groups had been continuously covered for 1 week. Eyes in Group VI were uncovered and uninjected as a normal control group. Diopter was detected using retinoscopic refraction. The eyeball axis was determined using ophthalmological ultra-A. The expression of protein and mRNA of VIP on retina-choroids-sclera were investigated by SP immunohistochemistry staining and RT-PCR. RESULTS: Form deprivation for 1 week induced high myopia eyes and elongated eyeball axis in GroupI and GroupII, and there was no difference between the 2 groups (P>0.05). The diopter and eyeball axis were significantly reduced in Group III, IV, and V as compared with Group I and II (P<0.01), but the diopter was higher and the eyeball axis was longer than those of Group VI. The diopter and eyeball axis had negative correlation with the concentration gradient of VIPhybrid. The expressions of protein and mRNA of VIP in Group III, IV, and V were down-regulated as compared with those of Group I and I I(P<0.01)and also down-regulated with the increase of concentration of VIPhybrid. CONCLUSION: VIPhybrid can decrease the development of FDM in chicks, which may provide a new pathway for drug therapy of myopia in human beings.

[Changes of color pattern reversal visual evoked potential of primary glaucoma].

OBJECTIVE: To investigate the changes of color pattern reversal visual evoked potential (CPR-VEP)of primary glaucoma using different temporal frequencies, and to search for the best temporal frequency parameters and color parameters. METHODS: Vision Monitor visual electrophysiograph (Métrovision, France) was used to record CPR-VEP at different temporal frequencies (1, 2, 4, 8, 16, and 32 Hz) and different color stimulations (black/white, red/green, blue/yellow) in 41 cases (70 eyes) with primary glaucoma (glaucoma group) and 13 normal subjects (26 eyes) (normal control group). P100 wave amplitudes were compared. RESULTS: (1) In the normal control group, P100 amplitudes declined while the temporal frequency of black/white stimulation was increasing, but they had peaks at 2 Hz and 8 Hz red/green stimulation and blue/yellow stimulation. (2) In the glaucoma group, CPR-VEP P100 declined while temporal frequency was increasing under 3 color stimulations, but had a peak at 8 Hz. At 2 Hz-16 Hz, P100 amplitudes were related with the mean defect of Humphrey visual field, especially with all 3 color stimulations at 8 Hz and with blue/yellow stimulation at 2 Hz and 16 Hz. (3) P100 amplitude was most different under the 3 color stimulations between the 2 groups at 8 Hz. CONCLUSION: The changes of CPR-VEP P(100) amplitude can objectively reflect the glaucoma visual function damage. CPR-VEP P100 amplitude has certain value in studying glaucoma under different color stimulations (black/white, red/green, blue/yellow) at 8 Hz, and blue/yellow stimulation at 2 Hz and 16 Hz.

[Dynamic expression of VIPR2 in form deprivation myopia].

OBJECTIVE: To investigate the dynamic expression and significance of vasoactive intestinal peptide receptor 2 (VIPR2) on retina-choroid-clera in high myopia. METHODS: Twenty-one yellow chicks of 1 day old were used in the research. The right eyes were the experimental group, covered continuously for 1 week, 2 weeks and 4 weeks respectively. The left eyes were not covered as the normal control group. Both groups were detected diopter degrees using retinoscopic refraction, determinated eyeball axis using ophthalmology ultra-A, and investigated VIPR2 expression on retina-choroid-sclera in both groups at three stages by SP immunohistochemical staining. RESULTS: The experimental eyes changed from hypermetropia at pre-experiment to high myopia during the experiment stages, and the diopter degrees were deeper and eyeball axis was longer along with the period of being covered. Both groups had strong expression of VIPR2 on photoreceptor-outer segment of the retina and choroids. The expression was down-regulated with the time in both groups. Compared with the control group, VIPR2 expression of the experimental group was significantly up-regulated (P < 0.05). CONCLUSION: Form deprivation could induce high myopia. The expression of VIPR2 existed on photoreceptor-outer segment of the retina and choroids. VIPR2 may play an important role on the formation and development of myopia.

[Analysis of intraocular pressure after myopic photorefractive keratectomy].

OBJECTIVE: To explore the factors related to intraocular pressure (IOP) after excimer laser photorefractive keratectomy (PRK). METHODS: Two hundred and nine cases (364 eyes) of myopia were studied with Goldmann applanation tonometer. All the patients were followed up for 12 months. RESULTS: After PRK, a decrease was observed in the IOP. The IOP reading in the 12(th) month was lower than that in the 6(th) month (P < 0.001). A positive correlation was found between IOP and corneal thickness or corneal curvature (r = 0.172, P < 0.001, r = 0.182, P < 0.001). Regression equation for IOP drop (mmHg) = 1.156 + 0.22X(1) + 0.052X(2), [X(1) = decrease in corneal thickness ( micro m), X(2) = decrease in corneal curvature (D)]. CONCLUSION: The IOP measured after PRK for myopia is influenced by the corneal thickness, corneal curvature and steroid.