Table of Content

22 February 2012, Volume 36 Issue 1

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Enhanced depth imaging spectral domain optical coherence tomography

ZHOU Jin-qiong, WEI Wen-bin

2012, 36(1):  1-8.  doi:10.3760/ cma.j.issn.1673-5803.2012.01.001

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Enhanced depth imaging spectral domain optical coherence tomography (EDI SD-OCT), based on the improvement of traditional frequency domain OCT, is a new technology used to reflect the structure of the choroid. The images are obtained by positioning the SD-OCT device close enough to the eye to present an inverted representation of the fundus, and also can quantitatively measure the choroidal thickness. So far studies about this technology are focused on the changes of the choroidal thickness. By measuring the choroidal thickness, EDI SD-OCT can not only be used to explore the pathogenesis of the diseases such as high myopia, age-related macular degeneration, polypoidal choroidal vasculopathy, etc, but also be used to differentiate age-related macular degeneration, polypoidal choroidal vasculopathy, a variety number of choroidal tumors, etc. In addition, EDI SD-OCT can be used to observe the treatment effect such as choroidal neovascularization and Vogt-Koyanagi-Harada.

Femtosecond laser small incision lenticule extraction for the correction of myopia

ZHAO Jing, CHEN Zhi, ZHOU Xing-tao

2012, 36(1):  8-12.  doi:10.3760/ cma.j.issn.1673-5803.2012.01.002

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The small incision lenticule extraction (SMILE) with femtosecond laser involves creating an intrastromal lenticule by scanning at two different depth in the corneal stroma and making sidecut incisions, followed by separation and complete removal of the lenticule from the small incision. This technique revolutionizes the traditional refractive surgery to achieve "allinone", with better security, effectiveness, predictability and stability. It has a good prospect in application but its longterm efficacy needs more samples to be further investigated.

Leber’s hereditary optic neuropathy: biochemical mechanisms and gene therapy

HUANG Shu-juan, TIAN Guo-hong, ZHANG Xiao-jun

2012, 36(1):  13-17.  doi:10.3760/ cma.j.issn.1673-5803.2012.01.003

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Leber's hereditary optic neuropathy (LHON), a common blinding disease, is a maternally inherited degeneration of the optic nerve caused by point mutations of mitochondrial DNA. Complex I dysfunction, reactive oxygen species (ROS) overproduction, and cell apoptosis are the hypothesis of biochemical mechanism in LHON. Gene therapy is the ideal treatment for the disease. So far, the gene therapies used include allotropic expressing, transfecting with wild gene, and transfecting with antioxidant gene and so on. However, further investigation has to be done before clinical trials.

RetCam for retinopathy of prematurity screening

LI Rong, WANG Yu-sheng

2012, 36(1):  17-20.  doi:10.3760/ cma.j.issn.1673-5803.2012.01.004

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Retinopathy of prematurity (ROP) remains a leading cause of childhood blindness worldwide. RetCam plays an important role in ROP screening. In this article, we reviewed the current documents on applications of RetCam for ROP screening combined with our clinical experiences, and summarized its advantages and challenges for use. We particularly addressed its safety, diagnostic sensitivity and specificity, accuracy and easytouse for ROP screening. We recommended that RetCam be routinely adopted to screen ROP in China.

Introduction of multicenter clinical trials for retinopathy of retinopathy: LIGHT-ROP, STOP-ROP and BEAT-ROP

LI Rong, WANG Yu-sheng

2012, 36(1):  21-25.  doi:10-3760/ cma.j.issn.1673-5803.2012.01.005

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Evidencebased medicine is very important to clinical prevention and treatment for retinopathy of prematurity(ROP). Although retianl ablation including cryotherapy and laser has been proved to be effective in treating ROP, it can be destructive to the peripheral retina to some extent. Therefore, better and safer therapies are desired. After the two influential clinical trials—“Cryotherapy forretinopathy of prematurity(CRYO-ROP)” and “Early treatment for retinopathy of prematurity study(ET\|ROP)”, other significant multicenter clinical trials has been initiated successively in the United States in order to explore novel therapeutic ways, such as ”The effects of light reduction on retinopathy of prematurity(LIGHT-ROP)”,“Supplemental therapeutic oxygen for prethreshold retinopathy of prematurity(STOP-ROP)”and ” Bevacizumab eliminates the angiogenic threat of retinopathy of prematurity(BEAT-ROP)”. In this article, we reviewed the goals, designs, main results and conclusions of the three trials.

The clinical application of performance based measures of visual function in ophthalmology

NI Wei, WANG Wei

2012, 36(1):  26-30.  doi:10-3760/ cma.j.issn.1673-5803.2012.01.006

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With the transformation of the modern biomedical model, the impact of diseases on patients' living ability cannot be fully demonstrated solely by clinical visual tests and selfassessment questionnaires. As a new method of visual function evaluation, performancebased measures (PBM) of visual function have been introduced into the ophthalmology field. As an important supplement to traditional vision tests and vision related quality of life (QoL) questionnaires, performancebased measures of visual function may reflect the patients’ actual visual impact of daily life. In this article, this newly developed method was reviewed in the field of ophthalmology.

Immune mechanisms of penetrating keratoplasty rejection

JIA Zhe, ZHANG Xiao-min, ZHAO Shao-zhen

2012, 36(1):  31-35.  doi:10-3760/ cma.j.issn.1673-5803.2012.01.007

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Although the cornea enjoys a remarkable degree of immune privilege, the CD4+T cellmediated immune rejection remains the most common cause of keratoplasty failure. This review  will focus on the latest progress of effect of highrisk corneal transplantation on immune privilege, the mechanism of corneal immune response, and prevention and treatment of corneal allografts rejection. 

The application of ultrasound biomicroscope in lens surgical intervention

WANG Sheng-nan, LV Yong

2012, 36(1):  36-41.  doi:10-3760/ cma.j.issn.1673-5803.2012.01.008

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As a method  of ultrahigh frequency ultrasonic imaging inspection,  ultrasound biomicroscopy (UBM) is little influenced by nubecula, aqueous humour opacities, and microcoria, etc. UBM plays a vital role in the diagnosis and treatment of anterior segment eyes, especially of the lens diseases. This article will give a general review of the application of UBM to the judging of the lenticular nucleus hardness and the  dislocation of lens before surgery,  before intraocular lens (IOL) ciliary sulcus suture fixation surgery,  before surgery of cataract extraction combined with trabeculectomy,  after anterior chamber intraocular lens implantation, the analysis of the relationship between the location of posterior chamber intraocular lens and the surrounding tissues, safety analysis after implantation of phakic posterior chamber intraocular lens, and analysis of the causes of postoperative complication, etc. The application of UBM to lens surgery could help to identify appropriate surgical modality, to foresee and prevent potential complications.

Optical coherence tomography in Best's disease

XUE Ying, ZHANG Yong-jin

2012, 36(1):  41-46.  doi:10-3760/ cma.j.issn.1673-5803.2012.01.009

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Vitelliform macular dystrophy (BVMD, Best disease) as a kind of autosome dominant inheritance disease of the macula, can be divided into 5 stages: Stage 0: previtelliform; Stage I: vitelliform; Stage II: pseudohypopyon; Stage III: vitellruptive; Stage IV: atrophic. Optical coherence tomography (OCT) can quickly get retinal tomography images with high resolution, providing a better understanding of the characteristics and the progressions of the disease. This article reviews the OCT represents in different stages of Best's disease.

Immune mechanisms of age-related macular degeneration

CAO Li-ning, WANG Fang

2012, 36(1):  46-51.  doi:10-3760/ cma.j.issn.1673-5803.2012.01.010

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Immune mechanism plays an important role in pathology of AMD, including formation of drusen, geographic atrophy and choroidal neovascularization (CNV). Retina is an "immune privileged" site, which could maintain immune homeostasis in one's life. Disruption of this homeostatic mechanisms seems crucial in allowing excessive activation of immunologic response and the resultant chronic inflammation, which could lead to accumulation of resident immune cells, complement components and deposition of immune complex, all above may result in ocular tissue damage and degeneration. At present, deposition of immunoreactive products in ocular tissues is involved in chronic inflammation, parainflammation, dysfunction of autophagy and so on. This article  reviews recent studies on development of AMD relevant to retina aging, dysfunction of immunity and autophagy. 

Nonsteroidal anti-inflammatory drug therapy in choroidal and retinal diseases

LI Jiao, CUI Yan, WANG Xing-rong

2012, 36(1):  51-56.  doi:10-3760/ cma.j.issn.1673-5803.2012.01.011

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Nonsteroidal antiinflammatory drugs (NSAIDs) are increasingly employed in the therapy of retinal and choroidal diseases, especially in preventing cystoid macular edema and uveitis, and the potential treatment of retinal and choroidal neovascularization. In recent years, the U.S. Food and Drug Administration have approved new topical NSAIDs, such as nepafenac and bromfenac sodium eye drops. The structure of nepafenac may reduce the risk of corneal toxicity, and increase the permeability to aim tissue. While bromfenac sodium provides a fast onset of action, it has been shown to have penetrated and distributed rapidly to the cornea, iris, ciliary body, retina, and choroids, along with a longer duration of action that may last for up to 24 hours. This article also reviewed the mechanism of NSAID, the current situation of preventing and treating cystoid macular edema following cataract surgery and diabetic macular edema, the application in uveitis, the potential of preventing  the choroidal neovascularization, and the adverse effects of topical NSAIDs.

Microglia in the retina and their activation in diabetic retinopathy

CHEN Xiao-fei, ZHANG Mao-nian

2012, 36(1):  57-61.  doi:10-3760/ cma.j.issn.1673-5803.2012.01.012

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Microglia in the retina are resident immunocompetent cells and originate from myeloid lineage. Resting microglia is sensitive in immune surveillance of surrounding circumstance in normal conditions. While in pathological conditions, microglia are activated and  participate in immune and inflammatory reaction. Although activated microglia is involved in infection limitation and tissue repair through phagocytosis and cytokines release, they may also cause tissue damage when overactivated. Microglial activation has been recognized as a neuropathological hallmark in diabetic retinopathy, indicating their important role in the pathogenesis of this disease. This review summarizes biological characteristics and functions of retinal microglia and present knowledge about their activation in the diabetic retinopathy.

Genetic polymorphisms of diabetic retinopathy

HE Fang-lin, WANG Zhi-liang

2012, 36(1):  62-66.  doi:10-3760/ cma.j.issn.1673-5803.2012.01.013

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Diabetic retinopathy (DR) is a complex disease which is caused by the interaction of blood glucose levels, duration of diabetes, and genetic and environmental factors. The research of its related genes or susceptibility genes is very active in the recent years. These candidate genes include aldose reductase gene (AR), vascular endothelial growth factor gene (VEGF), angiotensinconvening enzyme gene (ACE), inducible and constitutive nitric oxide synthases gene (NOS), receptor for advanced glycation endproducts gene (RAGE) and so on. DR is a disease of the role of multiple genes, and therefore there is different polymorphisms in each gene. It is very important for us to accurately understand the mechanism of the difference expression of gene during the occurrence and development of DR for the early diagnosis and prevention of DR. The current research advance in DR relevant gene is reviewed in this article. 

Detection methods of oxygen tension in vitreous body and retina in vivo

ZHOU Hai-yan, YAN Hong

2012, 36(1):  66-70.  doi:10-3760/ cma.j.issn.1673-5803.2012.01.014

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This article reviews the recent advance of detection methods about oxygen tension in vitreous body and retina in vivo, which include electrochemical sensor, optical chemical oxygen sensor, fundus camera and liquid crystal wavelength tunable filter and frequencydomain lifetime imaging of oxygen tension, etc. The principle, current research situation and achievements of these methods were briefly introduced. The clinical application and signification of optical chemical oxygen sensor in the measurement of intraocular oxygen tension were also discussed in detail.