International Review of Ophthalmology

Application of anterior segment OCT in the diagnosis of corneal diseases

LIANG Qing-feng1, PAN Zhi-qiang1, Antoine Labbé2

2013, 37(4): 217-222. doi:10 3760/ cma. j. issn.16735803 2013 04 001

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Clinical dignosis of cornea diseases requires a precise assessment of corneal structures. However, the resolution of ophthalmic instruments such as the slitlamp is limited, and for ophthalmologists, it has always been a challenge to evaluate qualitatively but also quantitatively the microscopic structures of the cornea. Recently, a new imaging technique, anterior segment optical coherence tomography (ASOCT), has thus been developed to overcome these limitations of biomicroscopy. With it’s developed, ASOCT will increase the diagnostic and therapeutic ability to ophthalmologist. The purpose of this article is to provide a large variety of ASOCT applications in the cornea and anterior segment (eg. keratitis, cornea dystrophy, corneal / conjunctival squamous neoplasia, etc) and international review of ASOCT. It may be helpful to render this new means of imaging more familiar and make it possible to use this very promising imaging technique with optimum efficiency.

Shaken baby syndrome

HOU Hui-yuan，WANG Yu-sheng

2013, 37(4): 223-229. doi:103706/ cma.j.issn.16735803201304002

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Shaken baby syndrome (SBS) is the most common cause of childhood death resulting from abuse. Although severe injury of the nerve system occurs, patients seldom show obvious trauma signs. SBS is characterized by subdural hemorrhage and retinal hemorrhage. Ophthalmologists play critical roles in the diagnosis and treatment of SBS, as well as in the judicial expertise of child abuse. This current review focuses on the ophthalmological manifestation, pathogenesis of SBS, and the duty of ophthalmologists in diagnosis and treatment of SBS.

Bupivacaine injection corrects strabismus

WU Yi, AI Li-kun

2013, 37(4): 230-234. doi:10 3760/ cma. j. issn.16735803 2013 04 003

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Besides anesthetic effect, bupivacaine, an aminoamide anesthetic, can also cause the injected muscles experiencing a process of degeneration, necrosis and regeneration, which may increase intrinsic elastic stiffness, enlarge the size of the muscle, and finally strengthen the muscle force. It has been reported that bupivacaine can improve the eye alignment in horizontal, nonparalytic strabismus by increasing the stiffness and contractility of the injected muscle. Meanwhile, there are some researches focusing on the pathological changes of the muscle to study the underneath mechanism. This review introduces the most updated information of clinical research and related mechanism of bupivacaine to discuss the possible future research of bupivacaine in strabismus.

Progress of diagnosis and treatment on pseudophakic cystoid macular edema

CAI Lei, YANG Jin, LU Yi

2013, 37(4): 234-238. doi:103706/ cma.j.issn.16735803201304004

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Pseudophakic cystoid macular edema (PCME) is a common cause of visual impairment after cataract surgery. The pathogenesis of PCME is complex，which is related to fundus disease, aging, cataract surgical method, and many other factors. Optical coherence tomography (OCT) is now an important tool for disease diagnosis and retinopathy evaluation before cataract surgery. Use of antivascular endothelial growth factor has been becoming a new way to treat PCME in recent years. OCT, which provides fast and objective evidence for the assessment and comparison of different treatment options, has now been commonly used to evaluate the therapeutic effect for PCME.

Progress on pediatric cataract surgery

TIAN Fang, ZHANG Hong

2013, 37(4): 239-242. doi:103706/ cma.j.issn.16735803201304005

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Cataract surgery is the most commonly performed intraocular surgery in the pediatric population. Although the basic surgical techniques have not significantly changed over the last several years, there are many related issues under continual debate and research. These include use of local perioperative anesthesia, capsular management, type and power of intraocular lenses (IOLs), sutured IOLs, and risk of subsequent glaucoma. Besides, the Infant Aphakia Treatment Study has published the early report.

Research progress of TGFβ/Smad signaling pathway in posterior capsule opacification

LI Jun, GUO Ya-wen, TANG Xin

2013, 37(4): 243-246. doi:103706/ cma.j.issn.16735803201304006

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Posterior capsule opacification (PCO) is the frequent complication after cataract surgery. Transforming growth factorβ (TGFβ) is the important growth factor to modulate the transdifferentiation and formation of extracellular cell matrix (ECM) of cells. TGFβ modulates the proliferation, epithelialmesenchymal transition and the formation of ECM by Smad signaling pathway. The research progress of TGFβ/Smad signaling pathway in PCO is reviewed in this article.

Application of spectral domainOCT before and after vitreoretinal surgery

TU Ying1, PAN Cheng2, WEI Wen-bin3

2013, 37(4): 247-251. doi:103706/ cma.j.issn.16735803201304007

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Spectral domain OCT (SDOCT) has faster scanning speed and higher resolution than traditional timedomain OCT. It can distinguish the subtle lesions in the retina especially outer retina. It may provide a local configuration details before vitreoretinal surgery and help to raise the plan of the operation; after surgery, following up with SDOCT is helpful to determine the visual outcome by observation of outer retina.

Retinal repair and regeneration

JIANG Xin-tong , ZHANG Shao-chong

2013, 37(4): 252-255. doi:103706/ cma.j.issn.16735803201304008

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Retinal degeneration diseases, such as agerelated macular degeneration (ARMD) and retinitis pigmentosa (RP), are due to degeneration and apoptosis of retinal cells. Since the damaged retinal cells is difficult to repair themselves, the current researches focus on the retinal repair and regeneration through retina transplantation, tissue engineering, gene repair, protective drugs and retinal prosthesis.

Advanced research on the retinal prosthesis

CHU San-jun1， XU Hai-feng2

2013, 37(4): 256-260. doi:103706/ cma.j.issn.16735803201304009

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At present, retinal prosthesis implant has become the most successful prosthesis technology among all kinds of visual prosthesis. The goal of the related research is providing useful vision for those patients who are left with no alternatives, especially for those who have retinitis pigmentosa or agerelated macular degeneration diseases. In accordance with the electrical stimulation position, retinal prosthesis can be divided into epiretinal and subretinal prosthesis. The former implants the microelectrode in the retina through the vitreous surgery. The latter implants the microelectrode between the retinal nerve epithelium and retinal pigment epithelium by sclera or vitreous pathway. In recent years, electrode array and stimulated current of the epiretinal prosthesis was improved. Scientists also developed the chips and the energy supply form of the subretinal prosthesis and expected their efforts could help blind people.

Alzheimer’s disease and retinal degeneration

LI Xiao1,2, ZHANG Mao-nian2

2013, 37(4): 260-264. doi:103706/ cma.j.issn.16735803201304010

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Alzheimer’s disease (AD), a devastating neurodegenerative disease, is the primary cause of dementia with no cure available. Amyloid plaques and neurofibrillary tangles underlie the two pathological hallmarks in AD brain. In addition to cognitive and behavioral deficits, vision abnormalities are prevalent in AD patients. While most AD related pathology occurs in the brain, the disease has also been reported to affect the retina, which is more accessible for imaging than the brain. Therefore, studying ADrelated retinal degeneration is a promising way for the investigation on AD pathologies and therapies that would eventually benefit the brain and cellular mechanisms in other retinal degenerations such as glaucoma and agerelated macular degeneration.

Congenital choroideremia and CHM gene

LIN Ying, LIU Xia-lin, LIU Yu-hua, LIU Yi-zhi

2013, 37(4): 265-268. doi:103706/ cma.j.issn.16735803201304011

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Choroideremia (CHM) is known as a genetic heterogeneous Xlinked recessive disease associated with different types of mutations in the CHM gene. Affected males develop night blindness in their teenage years, followed by loss of peripheral vision because of the progressive visual field constriction, and blindness. CHM has been recognized as clinically distinct from other retinal degenerations for more than half a century. So far, no effective treatment exists for either disease. General advice is offered to patients regarding minimizing their exposure to ultraviolet light and optimizing their general wellbeing through a healthy lifestyle. Some groups are now testing cellbased therapies. Transplantation of autologous transduced iris pigment epithelial (IPE) cells into the subretinal space might help CHM patients in the future.

The role of müller cell in proliferative retinopathy

YANG Xiao, YUAN Yuan-sheng, ZHONG Hua

2013, 37(4): 269-273. doi:10.3706/ cma.j.issn.16735803.2013.04.012

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The retinal Müller cell is the principal glial cell of the vertebrate retina that responsible for the maintenance of the homeostasis of the retina. Müller cells play an important role in proliferative vitreoretinopathy (PVR) and proliferative diabetic retinopathy (PDR) through proliferation, migration, constriction, and changing of the cell phenotype. The potential roles of Müller cells in the pathogenesy and progression of PVR and PDR were reviewed as follow.

Retinal microRNAs and their roles in retinal diseases

JIN Xiao-liang, LV-Li-xia, XU Guo-tong

2013, 37(4): 274-279. doi:103706/ cma.j.issn.16735803201304013

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MicroRNAs (miRNAs) are small noncoding RNAs involved in gene expression regulation. The miRNA expression is tissuespecific, and involved in many biological processes, such as development, differentiation, proliferation and apoptosis. In recent years, numerous studies have shown that some miRNAs preferably express in different cell layers of retinas. Although there are no direct evidence, those differentially expressed miRNAs in retina may tightly participate pathogenesis and progression of some retinal diseases, such as retinitis pigmentosa (RP) and diabetic retinopathy (DR). This review focuses on the substantial research progress in retinalspecific miRNA and their relationship with retinal diseases, and further discusses the therapeutic potentials of miRNAs in retinal diseases.

The roles of aldose reductase in diabetic retinopathy

HAN Xue, SU Sheng, LIU Ping

2013, 37(4): 279-283. doi:103706/ cma.j.issn.16735803201304014

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Aldose reductase (AR) is the key enzyme of the polyol (sorbitol) pathway. The changes of its activity play an important role in the pathogenesis of DR. Increased AR activity is closely linked to the destruction of retinal capillary cells in the ealy stage of DR, and the retinal neovascularization in advanced DR. The mechanisms underlying involvement of increased AR activity in DR are not completely understood. Increased activity of AR promotes the development of DR through a series of biochemical reaction mechanisms, such as the formation of AGE, PKC and MAPK activation, oxidativenitrosative stress, PARP activation and proinflammatory response. New potent AR inhibitor (fidarestat) has been applied, and studies have shown its beneficial effect on diabetic macular edema.

Oxidative stress in uveitis

YANG Ting-ting, DENG Juan

2013, 37(4): 284-288. doi:103706/ cma.j.issn.16735803201304015

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Active free radicals produced following the oxidative stress have been found recently to be a requisite medium of cytokines and chemokines associated with uveitis. Oxidative stress plays a key role in infectious and non infective uveitis. Regulating or controlling oxidative stress could alleviate the symptoms of uveitis. Various antioxidants treat uveitis through different mechanisms, such as inhibiting oxidative stress, reducing oxidative stress damage or enhancing antioxidant capability of the organism. Antioxidant will be a new strategy for the treatment of uveitis.

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