International Review of Ophthalmology

Current advance in the research of structure and biomechanical properties of the corneal stroma

SONG Wen-jing，YAN Xiao-ming

2014, 38(6): 361-365. doi:10.3760/cma. j. issn.1673-5803.2014.06.001

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Corneal stroma is the primary structure of cornea. The common technologies in studying the structure of corneal stroma are X\|Ray scattering, electron microscopy and nonlinear optical imaging(NLO). By these techniques, researchers try to find the distribution rule of collagen fibers along axial and meridian direction and to find the relation between the mechanical property and the rules. It is proved that corneal ectasia, such as keratoconus and post\|LASIK ectasia,is induced by the change of coneal mechanical property, which is caused by the change of corneal structure. Researchers are trying to find methods to treat these corneal ectasia. (Int Rev Ophthalmol, 2014, 38: 361-365)

Research progress of autophagy in glaucoma

HUANG Chang-quan1, WANG Yao1, 2, WU Ren-yi1

2014, 38(6): 366-369. doi: 10.3760/ cma. j. issn.1673-5803.2014.06.002

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Autophagy is the major patho/physiological process for lysosomal degradation and recycling of cytosolic organelles and protein, playing a key role in the cellular homeostasis. Increasing evidences had shown that autophagy is closely associated with the pathogenesis and progression of a number of ocular disorders including glaucoma. Autophagy is activated in retinal ganglion cells and trabecular meshwork cells and has an important role after intraocular pressure elevation. Mutations in the autophagy receptor OPTN/optineurin are reported to associate with the pathogenesis of glaucoma. Strategies aimed at regulating autophagy may lead to therapeutic interventions for glaucoma. (Int Rev Ophthalmol, 2014, 38: 366-369)

The prospect of optical density analysis in ophthalmology study and glaucoma diagnosis

YANG Jian-ling, ZHANG Ming-zhi

2014, 38(6): 370-374. doi:10.3760/ cma. j. issn.1673-5803.2014.06.003

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One of the most important parameter termed optical density of computer imaging has grasped attention from some scholars for it can reflect inner changes of organizational structure. Optical density has been used in a variety of studies in ophthalmology. This review will concentrate on the evaluating power of optical density on cornea refractive surgery, cataract grading, retinopathy, as well as retinal nerve fiber optical density and its prospective for glaucoma/diagnosis. (Int Rev Ophthalmol, 2014, 38: 370-374)

Development situation and appropriate application of ocular ultrasonography

WANG Zi-yang, YANG Wen-li

2014, 38(6): 375-379. doi:10.3760/ cma. j. issn.1673-5803.2014.06.004

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The ocular ultrasonography has advanced significantly in recent years. A\|mode ultrasound is extensively used for ocular biometry. With B\|mode ultrasound we can acquire two\|dimensional images. Anterior segment images can be obtained by ultrasound biomicroscopy. Color Doppler flow imaging displays blood flow information of normal and pathological tissues. Contrast\|enhanced ultrasound can even be used for quantitatively analyzing the perfusion characteristics. Ocular ultrasound has been widely utilized for diagnosis and follow\|up of eye diseases although with some limitations. Affected by penetration and resolution, ocular ultrasound is limited in diagnosis of special cases, and sometimes leading to false positive or false negative results. This review mainly introduces the indications and limitations of ultrasonic diagnosis, and also the characteristics and advantages of each method. (Int Rev Ophthalmol, 2014, 38: 375-379)

Adipose derived stem cells induced RPE like cells in vitro and its research progress on treatment of age-related macular degeneration

LU Yang, GU Ping, LUO Min

2014, 38(6): 380-385. doi:10.3760/ cma. j. issn.1673-5803.2014.06.005

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Agerelated macular degeneration (AMD), which is triggered by the destruction of retinal pigment epithelium cells (RPE cells), has become the leading cause of vision loss in developed countries. Adiposederived stem cells (ADSC) have the potential of multidirectional differentiation. Researches of these years have shown that ADSC can be differentiated into RPE cells and express the markers of RPE cells with the help of retinal cell inducing factors. Animal models have confirmed the involvement of ADSC in repairing the RPE, which may open a new era in the treatment of AMD. (Int Rev Ophthalmol, 2014, 38: 380-385)

Progress of stem cells applications in retina repair

ZHANG Dan-dan, NI Ni, GU Ping

2014, 38(6): 386-390. doi:10.3760/ cma. j. issn.1673-5803.2014.06.006

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Due to the irreversible blinding, retinal diseases have always been an important issue affecting the life quality of human being. With the deepening of the research on stem cells, cell replacement therapy based on stem cell transplantation raises a new possibility for treatment of retinal diseases. In recent years different kinds of stem cells have made great breakthroughs in retina repair application, including the retina stem/progenitor cells from eye tissue, mesenchymal stem cells, hematopoietic stem cells, neural stem cells, embryonic stem cells and induced pluripotent stem cells. They can not only differentiate into various retinal neurons and glial cells, but also integrate into injured retina after transplantation, and even display normal function of retinal neurons. (Int Rev Ophthalmol, 2014, 38: 386-390)

Retinitis pigmentosa associated rhodopsin gene mutants

JIANG Hai-bo, XIA Xiao-bo

2014, 38(6): 391-394. doi:10.3760/ cma. j. issn.1673-5803.2014.06.007

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Rhodopsin gene mutant is the most common cause of retinitis pigmentosa(RP), accounting for about 25% to 30% of autosomal dominant retinitis pigmentosa(ADRP). More than 150 different mutations responsible for ADRP have been found. Rhodopsin mutations induce endoplasmic reticulum stress, protein aggregation, abnormal activation of membrane receptors, causing RP. P23H and T17M and other mutant mice of transgenic models were useful for investigating the role of rhodopsin in RP. It will provide a theoretical basis for interfering with the expression of the mutant gene, replacing the mutated gene and other potential therapeutic strategies. (Int Rev Ophthalmol, 2014, 38: 391-394)

The role of retinal Müller cells in diabetic retinopathy

CUI Le-le, WANG Yun-song

2014, 38(6): 395-399. doi:10.3760/ cma. j. issn.1673-5803.2014.06.008

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Retinal Müller cells are important glial cells in the retina. Müller cells provide neurons with trophic substances and remove metabolic wastes. They play a critical role in regulating the ion and water homeostasis of extracellular space and help to maintain the inner bloodretinal barrier. Most studies reported that Müller cells are closely associated with many retinal diseases, especially in the development of DR. Before the vascular lesions of diabetic retinopathy happen, Müller cells can affect retinal neural cells and retinal blood vessels by producing a variety of cytokines and taking part in the procedure of endoplasmic reticulum stress and oxidative stress. Müller cells have both protective and toxic effects on retinal neurons and were involved in the formation of diabetic macular edema. (Int Rev Ophthalmol, 2014, 38: 395-399)

The application of intravitreal bevacizumab for proliferative diabetic retinopathy

TONG Li-yang, LI Su-yan

2014, 38(6): 400-402. doi:10.3760/ cma. j. issn.1673-5803.2014.06.009

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Diabetic retinopathy is a serious complication of diabetes mellitus, especially proliferative diabetic retinopathy(PDR), which is a leading cause of visual impairment and blindness among workingage people. In recent years, the efficacy of vascular endothelial growth factor inhibitor (Bevacizumab) has been recognized for the treatment of PDR. Intravitreal bevacizumab can accelerate absorption of vitreous hemorrhage and inhibit neovascularization, alleviate macular edema and vascular leakage and decrease the incidence of retinal detachment. (Int Rev Ophthalmol, 2014, 38: 400-402)

Multi-spot scanning laser and its application in treatment of retinal vascular disease

LIU Yang, LI Lei

2014, 38(6): 403-409. doi:10.3760/ cma. j. issn.1673-5803.2014.06.010

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Multi-spot scanning laser, a semiautomated patterned scanning retinal photocoagulator, allows for shorter pulse duration, lower fluence, greater precision than single spot application. Up to 56 (the smallest number being 1) laser spots can be delivered by a single foot pedal depression. And this system has a collection of adjustable predetermined pattern shapes and sizes, including lines, squares, circular arcs, as well as userdefined patterns, and an adjustable “foveal exclusion zone”. Clinically, while treating diabetic retinopathy, panretinal photocoagulation can be accomplished in one or two sessions, and by applying the particular pattern, the macular coagulation can be finished in one foot pedal depression. Moreover, in treatment for retinal vascular diseases, such as central or branch retinal vein occlusion, neovascular glaucoma, Coats disease and so forth, compared with traditional lasers, multispot scanning laser has similar clinical efficacy but less adverse reactions, more patients’ comfort. (Int Rev Ophthalmol, 2014, 38: 403-409)

Study progression on pathogenesis, clinical manifestations and treatment of orbital inflammatory pseudotumor

CHEN Ying，ZHOU Yun-yun, WU Li

2014, 38(6): 410-414. doi:10.3760/ cma. j. issn.1673-5803.2014.06.011

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Orbital inflammatory pseudotumor (OIP) refers to benign nonspecific inflammatory conditions of the orbit, which usually occurs in young adults. Single or multiple intraorbital structures may be involved. Extraorbital extension can also occur. Although the causes of OIP are unknown, it is thought to be associated with autoimmune condition or infection. The clinical manifestation varies according to the anatomic involvement and the degree of inflammation progress. Common clinical manifestations include ptosis, diplopia, poor vision, eyeball swelling, pain, proptosis, etc. Both computed tomography (CT) and magnetic resonance imaging (MRI) are frequently used to investigate OIP. OIP is an exclusion diagnosis based on a combination of clinical and radiographic findings. The mainstay initial therapy for OIP is oral corticosteroids and immunomodulatory agents. Lowdose radiotherapy has been successful in many cases of recurrent myositis. Limited inflammatory pseudotumor can be treated surgically. (Int Rev Ophthalmol, 2014, 38: 410-414, 419)

Corticosteroids for treatment of Graves’ ophthalmopathy

GAN Shi-bin1, MAO Yu-xiang2, CHEN Dan-yun3, CHEN Yi-tong4, YUE Shu-fan5

2014, 38(6): 415-419. doi:10.3760/ cma. j. issn.1673-5803.2014.06.012

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Graves’ ophthalmopathy (GO) is an inflammatory eye disease that develops in the orbit in association with autoimmune thyroid disorders. Symptoms include mainly proptosis and extraocular muscle dysfunction due to involvement of both extraocular muscle and orbital fat. Corticosteroid theraphy can relieve GO via both immunomodulation and antiinflammation. This review focuses on issues of the efficacy, side effects, and indications of corticosteroid therapy given by orally, subconjunctival / retrobulbar injections, versus intravenously. Corticosteroid therapy, when given orally, is more effective than given subconjunctivally, and given intravenously seemed to be the most effective, whereas more side effects in the treatment of GO. GO should be treated as early as possible, especially in patients with active inflammation to prevent the development or progression of GO. Corticosteroid therapy should be made in light of the riskbenefit ratio. (Int Rev Ophthalmol, 2014, 38: 415-419)

Role of nitric oxide in ocular diseases

CUI Hui， LI Gen-lin

2014, 38(6): 420-424. doi:10.3760/ cma. j. issn.1673-5803.2014.06.013

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In recent years it has been recognized that nitric oxide(NO) is a hot spot in research of ocular diseases. As a molecular medium synthesized by nitric oxide synthase (NOS). NO is involved in the control of ocular blood flow. Abnormalities of NO system have been observed in a variety of ocular diseases including uveitis, glaucoma, retinal ischemic diseases, diabetic retinopathy and retinitis pigmentosa. In addition, its antagonist endothelin1(ET1) also attracts much attention. All these make the nitric oxide pathway an attractive target for therapeutic interventions of ocular diseases. (Int Rev Ophthalmol, 2014, 38: 420-424)

Anti-VEGF for the treatment of neovascular glaucoma

ZUO Hua-xin, WANG Tao, WANG Hua

2014, 38(6): 425-428. doi:10.3760/ cma. j. issn.1673-5803.2014.06.014

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Neovascular glaucoma (NVG) is regarded as refractory glaucoma secondary to retinal ischemia. Previous antiglaucoma drugs and surgeries present low therapeutic effect. Recently anti\|vascular endothelial growth factor (anti-VEGF) agent has been used as an adjunction for NVG comprehensive treatment, including trabeculectomy, drainage valve implantation, cyclophotocoagulation/cyclocryotherapy and vitrectomy etc. The antiangiogenic and antifibroblastic properties of anti-VEGF agents have shown great promise in reducing retinal ischemia, rapid regression of anterior segment neovascularization, preventing intra\| and post\|operative hyphema and improving the filtering bled, which effectively increase the operative successful rate, especially for NVG in the early stage. However, injection timing, safty and other aspects of anti-VEGF therapy in NVG treatment still need further study. (Int Rev Ophthalmol, 2014, 38: 425-428)

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