International Review of Ophthalmology

Trans-lamina cribrosa pressure difference and glaucoma

ZHOU Zi-xia, LI Jin-ying

2014, 38(4): 217-221. doi:103706/ cma.j.issn.16735803201404001

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Comparing with normal subjects, the cerebrospinal fluid pressure is lower in patients with primary open angle glaucoma and normal tension glaucoma, but higher in ocular hypertension. The high translamina cribrosa pressure difference may lead to glaucomatous damage. The abnormally high cerebrospinal fluid pressure is a protective factor in glaucoma. The elevated translamina cribrosa pressure difference leads to the lamina cribrosa bending backward and thinning, optic cup deepening, C/D enlarging, may play a role in the pathogenesis and development of glaucoma. In this literature review, the conception, measurement method, influence factors of translamina cribrosa pressure difference and its relationship with glaucoma were summarized.

Progress on treatment of pediatric glaucoma

PEI Xue-ting, TANG Xin

2014, 38(4): 221-227. doi:10.3706/ cma.j.issn.1673\|5803.2014.04.002

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Pediatric glaucoma is a broad term referring to a variety of glaucomas comprising a heterogeneous group of ocular diseases and may occur among individuals from birth to 18 years of age. The paediatric glaucoma presents some of the greatest clinical challenges and can be potentially blinding. At present, medications for adult glaucoma are available to treat pediatric glaucoma, but the risk profiles in children might be more severe than in adults. Surgical results with current techniques are less than outstanding, and are associated with a significant number of complications, re\|operations, and late failure. This review summarizes current concepts regarding terminology, classification, epidemiology, medical and surgical treatment, and recent advances with an emphasis on the primary congenital glaucoma, glaucoma following congenital cataract surgery, and glaucoma associated with Sturge\|weber syndrome.

Risk factors for normal tension glaucoma

WU Yan-chan, SUN Xing-huai

2014, 38(4): 228-231. doi:103706/ cma.j.issn.16735803201404003

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Normal tension glaucoma (NTG) has been considered as a subtype of primary openangle glaucoma (POAG) since it has lots of common clinical features with the latter except the normal intraocular pressure (IOP). However, its risk factors were found to be different from those of hightension openangle glaucoma according to the gradual deepening awareness of the disease. Systemic and local factors both have an impact on the development of NTG. We discuss the risk factors including sex, age, cerebral ischemia, IOP fluctuation, axial length and refractive error respectively in this review.

The roles of aldehyde dehydrogenase in the eyes against ultraviolet radiation injury

GE Jia-jia, SU Sheng, LIU Ping

2014, 38(4): 232-235. doi:103706/ cma.j.issn.16735803201404004

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Continual exposure to solar ultraviolet radiation (UVR), the human eye will produce a large number of reactive oxygen species (ROS), which can induce oxidative stress reaction, produce large amounts of toxic aldehydes, cause serious damage to the eye tissues. The aldehyde dehydrogenase (ALDH) superfamily is a kind of multifunctional proteins, which plays an important role in the metabolism of endogenous and exogenous aldehydes. The mechanism of ALDH in the defense against UVR damage is unclear. ALDH in eye mainly distributed in the cornea and lens, among which ALDH1A1 and ALDH3A1 present abundantly, maybe have unique roles in the defense against UVR. Recent studies indicated that drugs targeted ALDH may be beneficial to some eye diseases.

Current study situation of TGFBI Gene related corneal dystrophy in China

LIANG Qing-feng, PAN Zhi-qiang

2014, 38(4): 236-241. doi:103706/ cma.j.issn.16735803201404005

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Genotypic analysis has revealed that TGFBI gene is the most important and common pathogenic gene to corneal dystrophy. Tirty\|three mutations of TGFBI gene had been reported in corneal dystrophy families. Keratoepithelin protein (KE protein) expressed by TGFBI gene was always deposited in the different layer of the cornea. In Chinese corneal dystrophy families, 17 TGFBI gene mutations (445 cases, 71 families) were detected from 1998 to 2014. Among them, 28.2% mutations were R555W which induced granular corneal dystrophy type Ⅰ(GCDⅠ), 23.9% mutations were R124H related to granular corneal dystrophy type Ⅱ (GCDⅡ), and 5% mutations were reltaed to Thiel\|Behnke corneal dystrophy.

Lowconcentration atropine treatment for myopia

SUN Yuan， LIU Quan

2014, 38(4): 241-244. doi:10.3706/ cma.j.issn.1673\|5803.2014.04.006

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Atropine is the antagonist of muscarinic receptor. 1% atropine was found to be able to inhibit myopia progression long ago. However, its usage was restricted due to the frequently happened side effects, such as photophobia and near vision blur. Recently, the focus of researchers shifted to the lowconcentration atropine, which was demonstrated to have effects of slowing the progression of myopia. Compared to 1% atropine, the effect of lowconcentration atropine is more sustained and durable, and the incidence of side effect is much more less.

Assessment of total corneal power and its clinical application

HUA Yan-jun1, WANG Qin-mei2, HUANG Jin-hai2

2014, 38(4): 245-250. doi:103706/ cma.j.issn.16735803201404007

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Assessment of total corneal power is essential for contact lens fitting and preoperative evaluation of corneal refractive surgery. There were many kinds of devices for total corneal power measurements. According to different measuring principles, total corneal power obtained by all kinds of devices can be divided into 3 categories: simulated keratometry (SimK), total corneal power based on Gaussian optic formula (KGOF) and total corneal power obtained by ray tracing method (Kray). Accurate assessment of total corneal power plays an important role in the prediction of intraocular lens power in eyes after corneal refractive surgery. Currently, there is no uniform standard for the assessment of total corneal power in eyes after corneal refractive surgery. Many scholars proposed their own formulas according to their studies. This review focuses on the total corneal refractive power, especially total corneal power in eyes after corneal refractive surgery and its progress in research and application, providing reference for ophthalmologists in clinic.

Advanced research in the optic nerve prosthesis

CHU San-jun, XU Hai-feng

2014, 38(4): 251-254. doi:103706/ cma.j.issn.16735803201404008

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Artificial vision research refers to the implantation of different visual prostheses at diverse parts of visual pathway by artificial methods, in order to help blind patients to obtain some useful vision. Among visual prostheses, the optic nerve prosthesis has its own superiority, and it seems especially important for the patients who lost their retina. Based on the physiological basis of optic nerve’s anatomical characteristics, and the principles that the current could replace the light to produce visual perception, the optic nerve prosthesis acquires the images through the external device, and then turns the images into the electrical signals which can be detected by brain. Afterwards, the electrical signals can be transmitted to the internal device and communicate with the human nervous system. Breaking the limitation of the retinal prosthesis implanting method, optic nerve prosthesis can directly stimulate the optic nerve and it is suitable for the patients whose retina layers are all injured. However, the optic nerve prosthesis has its own limitations.

Optic neuritis: a review on nosological classification

CHEN Xiang，WEI Shi-hui，ZHANG Mao-nian

2014, 38(4): 255-259. doi: 103706/ cma.j.issn.16735803201404009

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Optic neuritis refers to all inflammatory diseases in the optic nerve. It is one of the most common optic nerve diseases in neuroophthalmology, but also most likely to suffer in the middleaged people. Currently, there are two main classifications of optic neuritis: according to anatomical site, optic neuritis was divided into retrobulbar neuritis, papillitis, optic perineuritis, and neuroretinitis; another based on the etiology, optic neuritis can be divided into the central nervous system inflammatory demyelinating disease of the optic nerve inflammation, infectious diseaserelated optic neuritis, and systemic autoimmune diseaserelated optic neuritis. At present, the etiology features of optic neuritis in China remains to be further characterized by large sample epidemiological studies.

Research progress on pathological mechanism of Terson syndrome

LI Gai-yun1, ZHANG Hong2

2014, 38(4): 259-262. doi:103706/ cma.j.issn.16735803201404010

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Vitreous haemorrhage occurring in association with subarachnoid haemorrhage is known as Terson's syndrome. It occurs most commonly due to ruptured intracranial aneurism, or after serious brain injury. The pathogenesis of vitreous haemorrhage remains controversial. The proposed theories include directly entering of intracranial hemorrhage and rupture of intraocular blood vessels caused by high intracranial pressure. The vitreous hemorrhage may be caused by a large amount of blood pushed by high intracranial pressure, entering the vitreous cavity near the optic disc. Inside the eye, the blood may spread subinternal limiting membrane and intraretinally. The understanding of pathogenesis contributes to choosing the treatment strategies and predicting clinical outcomes of Terson’s Syndrome.

Applications of induced pluripotent stem cells on retinal regenerative medicine

LIU Yi-nan, WEI Wen-bin

2014, 38(4): 263-267. doi:103706/ cma.j.issn.16735803201404011

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Induced pluripotent stem cell (iPSC), a brand new cell with pluripotent differentiating ability, which was reconstructed and induced by 4 transcription factors and the genome of an adult cell. Kinds of diseases result in disfunctions of retina. The retinal regeneration will come true using the pluripotent differentiating ability of iPSCs. In the current, the hot spots of iPSC researches are as followings, the selections of donor adult cell/transcription factors/transcription carriers, mechanisms of the inducing process, ways of inducing iPSCs to differentiate to a particular layer of retina, and the transplantation of induced retinal pigmented epithelium and photoreceptor cells. However, there are still problems in the iPSC researches, such as the low differentiating efficiency, low survival rate after intraocular transplantation, and the unsecured safety in clinical utility, etc. And only by solving those problems can iPSC researches play a more important role in retinal regenerative medicine.

Research progress of combined hamartoma of retina and retinal pigment epithelium

ZHANG Peng，HUI Yan-nian，WANG Yu-sheng

2014, 38(4): 268-272. doi:103706/ cma.j.issn.16735803201404012

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Combined hamartoma of the retina and retinal pigment epithelium (CHRRPE) is a rare benign lesion in the macula, parapapillary, or peripheral retina that is commonly found in children. Clinical characteristics were elevation in retina，diferent degree of hyperpigmentation，retinal vascular tortuosity，as well as epiretinal membrane formation. Histopathologically, CHRRPE consists of disorganized glial tissue intermixed with numerous blood vessels and proliferating retinal pigment epithelium cells. Optical coherence tomography is a helpful tool in the diagnosis and management of CHRRPE. Pars plana vitrectomy with membrane peeling may result in restored retinal architecture to some extent and improved or stabled visual acuity for patients with CHRRPE.

Research status of multispot laser treatment for diabetic retinopathy

ZHANG Mo-li, TIAN Bei, WEI Wen-bin

2014, 38(4): 273-277. doi: 103706/ cma.j.issn.16735803201404013

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The traditional long pulse singlespot laser panretinal photocoagulation often is followed by some side effects in the treatment of diabetic retinopathy, including decreasing visual acuity, visual field constriction, aggravating macular edema,etc. Multispot laser, belongs to low intensity laser photocoagulation, is a focus of attention recently because of a short pulse, adjustable preset mode and other advantages, is a new treatment for diabetic retinopathy. Less research and application at home. The development status, the methods of multispot laser treatment of diabetic retinopathy, and its advantages and disadvantages are reviewed. The advantages of multispot laser are the smaller damage range, lighter pains, lower macular edema rate, less timeconsuming, and beautiful spot layout, but there are still some shortcomings.

The update mediction treatment of wet agerelated macular degeneration

QIAN Yi-wen, WANG Zhi-liang

2014, 38(4): 277-283. doi:103706/ cma.j.issn.16735803201404014

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Age-related macular degeneration (AMD) has now become the leading cause of blindness in western developed countries, and it has also become one of the major blinding diseases in elderly Chinese. The vast majority of AMD patients become blind due to the choroidal neovascularization (CNV). Targeted anti-VEGF therapy for angiogensis, like ranibizumab and aflibercept can reduce greatly the rate of blindness in AMD patients. In addition, with the further indepth study of the mechanism of angiogensis, it is expected to develop a number of drugs, including siRNA targeted for VEGF, VEGF receptor tyrosine kinase inhibitor(TKI), complement factor, chemokines, pigment epitheliumderived factor (PEDF), steroids, medications targeted for the multiple aspects of the signal pathway in neovascular, which will bring new hope for wet AMD patients.

Roles of AGEs-RAGE system in mechanism of diabetic retinopathy

CAO Jia, YAO Yong

2014, 38(4): 284-288. doi:103706/ cma.j.issn.16735803201404015

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Diabetic retinopathy (DR) is a progressive visionthreatening complication of diabetes mellitus, but its exact pathogenic mechanism is still less clear.The interactions of advanced gycation end products (AGEs) with its recptor (RAGE) induce the oxidative stress, vascular inflammation response, and predispose angiogenesis, all of which play essential roles in diabetic vascular complications.Therefore, inhibition of AGEs formation, blockade of AGEs crosslink and interaction of AGEs with RAGE may postpone the progression of DR.The article mainly sumarrizes the relationship between AGEs-RAGE system and DR, and the drug therapy of DR.

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