Table of Content

22 February 2014, Volume 38 Issue 1

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Metabonomics and its application in ophthalmology

DAI Ying1, WU Zhi-feng1, SHENG Hui-ming2

2014, 38(1):  1-4.  doi:103706/ cma.j.issn.1673-5803201401001

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Metabonomics is a new discipline defined as the qualitative and quantitative measurement of low-molecular-weight metabolites in organisms subject to pathophysiological stimuli or genetic modification. This method enables us to have a new perspective on metabolic variation. It provides the possibility of exploring the biomarkers of diseases for early diagnosis and pathogenesis of diseases. The research techniques used in metabonomics include nuclear magnetic resonance (NMR) technique and mass spectrometry (MS). The unsupervised method and supervised method are useful statistical techniques for the analysis of metabonomic data. In this article, the application of metabolomics in clinical diagnosis and drug toxicology are reviewed briefly with an emphasis laid on its progress in ophthalmology. We focused on the research progress of metabolomics in early diagnosis, differential diagnosis, pathogenesis and drug efficacy of particularly relevance to eye diseases such as ocular trauma, uveitis, cataracts, ocular hypertension and optic neuropathy.

Advances of the treatment of amblyopia

YU Xin, FENG Xue-liang

2014, 38(1):  5-8.  doi:103706/ cma.j.issn.1673-5803201401002

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In recent years, some experts in ophthalmology, neuroscience and psychophysics present new insights into the  amblyopia treatment.  Neural plasticity  theory can be applied to the treatment of older amplyopia patients. Under the dichoptic viewing condition, one can obtain binocular balance and achieve the purpose of binocular therapy by reducing the suppression from the fellow eye to the lazy eye.

Effect of chromatic vision on the development of ocular refraction

KANG Jian-shu, ZHOU Hua, ZHONG Hua

2014, 38(1):  9-12.  doi:103706/ cma.j.issn.1673-5803201401003

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The ocular refraction development is dependent on the visual environment. Interference with normal visual environment can affect the refractive development. The vision system is not only responsible for the perception of object in the shape, light and shade, motion, but also charge of distinguishing the color of the object. As an important part of visual stimuli in discrimination and perceptual object properties, the chromatic vision directly affect the retinal cone cells and then change the morphology, metabolism and function of eyeball, thus affecting the eye refractive development through a variety of ways.

Application of mesenchymal stem cells in corneal wound repair and cornea transplantation

LI Fei， ZHANG Yan， ZHAO Shao-zhen

2014, 38(1):  13-17.  doi:103706/ cma.j.issn.1673-5803201401004

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The corneal healing following severe  wound and the immune rejection after keratoplasty are the key and difficult points in treatment of corneal diseases. Mesenchymal stem cells could differentiate into corneal epithelial cells, stromal cells and other cell types in cornea, as well as suppresse inflammation and angiogenesis in a paracrine manner. Hence the injury corneal tissue was protected and the healing of cornea was promoted. In addition, the mesenchymal stem cells have potent anti-inflammatory and immunomodulatory properties, which enable them to exert the therapeutic effects on corneal allograft rejection.

Application of the immunoregulatory of bone marrow mesenchymal stem cells in ophthalmology

SONG Xiao-qing， XU Guo-xing

2014, 38(1):  18-22.  doi:103706/ cma.j.issn.1673-5803201401005

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Bone marrow mesenchymal stem cells (BMSCs) have become the core of the research on seed cells. The cells can be obtained by puncturing conveniently. It brings little injury and less complications in the process of the puncture. In addition, the cells can be cultured easily and proliforate rapidly. In vivo and in vitro, it has the advantages of multi-directional differentiation potential under the specific environment. In recent years, most researches focused on the identification and cultivation,  differentiation,  biological characteristics,  and homing mechanism of BMSCs and its application of the treatment of refractory diseases (such as systemic lupus erythematosus,     myelodysplastic syndrome, femoral head necrosis, etc.). However, the research on the immune regulation mechanism of BMSCs is still on a preliminary stage, especially its application in ophthalmopathy.

Ophthalmic surgery and dry eye

WANG Shuang-mei, KANG Qian-yan, ZHENG Xuan, LI Li

2014, 38(1):  22-25.  doi:103706/ cma.j.issn.1673-5803201401006

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 The incidence of dry eye is increasing, however, mechanisms of which have not been explained clearly. The dry eye symptoms after the eye surgeries, whether anterior and posterior segment operations or outer eye surgeries, was significantly make patients less satisfied for the surgery and gradually be concerned by ophthalmologists. The choosing of operative procedure and incision, duration time of operation, and perioperative drugs may influence dry eye’s incidence after surgeries. Therefore, the improving of the operative procedure and paying attention to the preioperative medicines are the effective measures to provent the postoperative dry eye.

Surgical progress in deep anterior lamellar keratoplasty with baring of Descemet's membrane

LI Lin 1,2, SONG Peng1,2, ZHAI Hua-lei2, GAO Hua2

2014, 38(1):  26-30.  doi:103706/ cma.j.issn.1673-5803201401007

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Deep anterior lamellar keratoplasty （DALK） is a new keratoplasty technique，which transplants a partial thickness donor cornea bared of its Descemet's membrane and endothelium onto a recipient bed after full removal of recipient stromal tissue，in order to provide similar visual outcome with penetrating keratoplasty as well as to decrease intraoperative and postoperative complications. This surgical procedure is technically challenging and the critical step is to bare Descemet's membrane. The ways to bare Descemet's membrane have experienced direct open dissection，intrastromal air injection dissection，hydrodelamination dissection, viscoelastic dissection，big bubble technique，etc.. These techniques are being constantly improved to perfect. The advantage of DALK is that it relatively preserves both structural and immunological integrity of the eye，thus decreasing the risk of endothelial graft rejection, chronic corneal allograft dysfunction and traumatic wound dehiscence. This review focuses on the indications, different techniques and complications of DALK, aiming at providing ways to promote its technological improvement and widely clinical application.

Advances in pathogenesis of normal tension glaucoma

LEI Dengfeng1, FAN Ning2, HE Xiangzhen1, LIU Xuyang2

2014, 38(1):  31-36.  doi:10 3706/ cma. j. issn.16735803 2014 01 008

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Normal tension glaucoma (NTG)  is defined as the clinical situation with the characteristic glaucomtous damages in optic nerve and visual field with the persistent normal intarocular pressure. NTG is a special form of primary openangle glaucoma, but yet the mechanisms underlying the optic neuropathy remain unknown. The purpose of this review is to discuss the recent progress in the mechanisms of NTG, which includes mechanical stress, hemodynamic factors, immunomodulatory, and an improved knowledge of genetics.

Research progress of selective laser trabeculoplasty for open-angle glaucoma

QIN Jia-yin, WANG Tao

2014, 38(1):  36-40.  doi:103706/ cma.j.issn.1673-5803201401009

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Selective laser trabeculoplasty (SLT) uses Q-switched 532 nm Neodymium: YAG laser to selectively target pigment trabecular meshwork cells, thus minimizing collateral thermal damage to surrounding tissue and the possibility of subsequent scarring. Now people pay more attention to the function of cytokines and alterations of postgenomic molecular level of SLT. SLT have been used to treat patients with primary open-angle glaucoma(OAG) in the beginning of its development. Recently it has been used to treat some other types of OAG. Now low-energy SLT are explored and proved effective. Now the confirmed effect factor of the efficacy of SLT is the baseline intraocular pressure(IOP). The common complications of SLT include IOP peak, inflammation of anterior chamber and conjunctival injection. And several aspects, such as the selection of the practical energy and range for SLT treatment, if SLT could be selected as the first treatment for the OAG instead of the traditional medicine, and the best pattern to combine the SLT with medicine treatment, should be further explored in the future.

Clinical applications  of Toric intraocular lens

XIAO Xianwen, ZHANG Hong, TIAN Fang

2014, 38(1):  41-46.  doi:10 3706/ cma. j. issn.16735803 2014 01 010

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Toric intraocular lens (IOL), known as IOL with composite surface, is a new refractive IOL to correct astigmatism by cylindrical lens combined with spherical IOL. Toric IOL has become a reasonable, effective and stable refractive method to correct preoperative astigmatism of cataract patients following the continuous development of materials and technical improvements since it was  applied clinically first in 1994 The new multifocal Toric IOL provides good distance, intermediate and near functional vision and enables the complete spectacle independence for cataract patients.

Clinical application of femtosecond laser-assisted cataract surgery

ZHANG Lei, ZHANG Hong, TIAN Fang

2014, 38(1):  47-51.  doi:103706/ cma.j.issn.1673-5803201401011

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Femtosecond laser-assisted cataract surgery system has been put into clinical application for four years. It has been mainly performed in three key steps: capsulotomy, lens fragmentation, and corneal incisions. Recently, the researchers' attention has been  focused on its safety and new applications, such as  the postoperative corneal endothelial cell loss and the change of corneal thickness, postoperative anterior flare, retinal thickness changes when using the femtosecond laser compared with conventional phacoemulsification. The femtosecond laser system has been used in implanting adult BIL (bag - in - the - lens) intraocular lens by some scholars, and it also has been combined with nanosecond laser surgery system, making the whole process of cataract surgery in completely "bladeless". This article compares the four systems and reviews the safety, effectivity, shortness, learning curve and latest applications of femtosecond laser-assisted cataract surgery system.

Research progress of small RNA interfere with TGF-β-singaling pathways in process of lens epithelial-to-mesenehymal transition to prevent posterior capsular opacification

WAN Xiu-hua1, LI Xiao-xia2

2014, 38(1):  51-55.  doi:103706/ cma.j.issn.1673-5803201401012

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Posterior capsular opacification (PCO) is the most common complication after cataract operation. It has been established that the major reason of PCO is epithelial-mesenchymal transition (EMT) of residual lens epithelial cells (LECs) which forming fabric PCO. TGF-β had been proved as the strongest inducer to EMT. Recently, the small non-coding RNA-dependent posttranscriptional regulation of genes was proposed to play an important role in cataract-associated EMT. This review  describes the research progress of small RNA interference regulating different TGF-β-singaling pathways，such as TGF-β antibody II, Smad2/3, Smad4, Snail, methy1 CpG binding protein 2, matrix metalloproteinases, and Skp2 gene, in preventing the process of lens EMT  and PCO.

Application of fundus autofluorescence imaging in diagnosis of retinal diseases

LI Hui, JIA Ya-ding

2014, 38(1):  56-61.  doi:103706/ cma.j.issn.1673-5803201401013

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Fundus autofluorescence is a non-invasive imaging technology, which reflects the distribution of lipofuscin and melanin in the retinal pigment epithelium and choroid. This review focuses on the short wavelength autofluorescence and near-infrared autofluorescence imaging methods, and their applications in the retina diseases, including age-related macular degeneration, choroidal nevus and choroidal melanoma, retinitis pigmentosa, chloroquine retinopathy, congenital choroidal neovascularization, central serous chorioretinopathy.

Clinic application of ultrahigh-resolution OCT in outer retinal micromorphology

HUO Yan-jiao, WEI Wen-bin

2014, 38(1):  62-67.  doi:103706/ cma.j.issn.1673-5803201401014

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Optical coherence tomography (OCT) is a medical imaging technology that can perform high resolution, cross-sectional imaging of tissue morphology in situ and in real time, which is widely used in diagnosis of retinal diseases. Recently, the advances of OCT technology have enabled OCT imaging with increasingly speed and more axial resolution, which is called ultrahigh-resolution OCT. The outer retina was resolved several separate bands by the newer OCT and many studies focus on the changes of these bands in retinal diseases in recent years, which can help us understand outer retinal micromorphology more deeply. In addition,  enhanced depth imaging (EDI) technique can lead to increased visualization of the choriocapillaris anatomy in OCT image. This article reviews the research progress and clinic application of ultrahigh-resolution OCT in outer retinal micromorphology and choroidal imaging.

Research progress in diagnosis and treatment of traumatic retinopathy

ZHOU Dan, WEI Wen-bin

2014, 38(1):  67-72.  doi:103706/ cma.j.issn.1673-5803201401015

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Traumatic retinopathy is the common complication of ocular trauma mainly in blunt ocular trauma and one of the main cause of vision loss. In the recent years, ophthalmic examinations such as optic coherence tomography （OCT) and adaptive optics scanning ophthalmoscope (AOSO) have revealed more valuable information for the diagnosis and prognosis of traumatic retinopathy. Meanwhile medication and surgical techniques, including small-gauge vitrectomy and anti-VEGF drugs, have become more refined and effective. So it is now unusual that an eye cannot be saved, even following severe ocular injury.