Table of Content

22 February 2015, Volume 39 Issue 1

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Association between retinal vascular changes and hypertension

LIU Xue, WANG Shuang, XU Liang

2015, 39(1):  1-7.  doi:103706/ cma.j.issn.16735803201501001

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As severe hypertension target organ damages may threaten the life, the early diagnosis, the evaluation of severity, treatment and prognosis of hypertension is of great importance. Retinal vessels are the only microcirculation that can be observed by noninvasive methods and provide a good research model for the onset and progression of hypertension. The  retinal photograph is the main carrier of the information of the retinal vessels,  and the  automation degree of the measurement is getting higher. Moreover, some other test methods attract more and more attention, including scanning laser Doppler flowmetry, adaptive optics scanning laser and so on. The association between the retinal vascular changes and hypertension has been approved by a large number of the studies. Furthermore, the retinal vascular changes can predict the hypertension incidence and reflect the treatment of hypertension to a certain extent.

Mechanism study on endocannabinoid system to reduce introcular pressure and its neuroprotection of retina

LIU Shiliang, CHEN Yuanyuan, XING Yiqiao

2015, 39(1):  8-13.  doi:103706/ cma.j.issn.16735803201501002

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Significant strides have been made in advancing our understanding of endocannabinoids for their roles in the eye and retina. Recent evidence shows that the endocannabinoid system is widely distributed throughout the eye, with regionspecific variation and actions. The endocannabinoid system is emerging to exert neuroprotection in numerous neurodegenerative diseases of the central nervous system. This consideration is based on some properties of cannabinoids as the inhibition of the release of excitotoxic amino acids and cytokines, and the modulation of oxidative stress. Pharmacologic modulation of cannabinoid receptors or the enzymes involved in the synthesis, transport, or breakdown of endogenous cannabinoids has proved to be a valid alternative to conventional treatment of these diseases. In this review, we will discuss cannabinoid receptors and their localization in ocular tissues, endocannabinoid signal pathway and recent findings that demonstrate the involvement of the endocannabinoid system in ocular diseases. We specially focus on the pharmacological actions and mechanisms of cannabinoids in relation to retinal degeneration diseases, which based not only on the reduction of intraocular pressure but also on neuroprotection of retina. Molecules capable of interfering with the ocular endocannabinoid system could offer a broad spectrum of opportunities for basic research and to identify targets for therapeutic application in ocular diseases.

Clinical application of viscoelastics in ophthalmology

WANG Ke-hua, XIA Xiao-bo

2015, 39(1):  15-20.  doi: 103706/ cma.j.issn.1673\|5803201501003

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In recent years, viscoelastics has been widely applied to a series of ophthalmic surgeries, and meanwhile, there are deeper studies on selection and utilization of viscoelastics of the different type, and moreover numerous new surgical techniques spring up around the application of viscoelastics. In terms of cataract surgery, techniques by using the combination of different type of viscoelastics are put forward, such as soft shell technique, ultimate soft shell technique, tri\|soft shell technique, besides, appropriate selection and application of viscoelastics can improve the safety and convenience of operation in intraoperative floppy iris syndrome, capsulorhexis in pediatric cataract surgery, intraoperative posterior capsule rupture. In terms of glaucoma surgery,  viscoelastics can be used to treat flat anterior chamber after trabeculectomy, and apply it to viscocanalostomy. In terms of corneal transplantation surgery, viscoelastics can protect corneal endothelial cells effectively during donor's corneal harvesting and penetrating keratoplasty, besides, it has unique application in lamella keratoplasty and endothelial keratoplasty. In terms of vitreoretinal surgery,  viscoelastics can be used to protect retina from iatrogenic injuries during macular hole surgery or removal of posterior segment foreign bodies. 

Medication treatment of  pediatric noninfectious uveitis

WANG Min，ZHANG Mei-fen

2015, 39(1):  21-25.  doi:103706/ cma.j.issn.1673\|5803201501004

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Pediatric uveitis is accounting for  5%~10% of all the uveitis. Most individuals have an insidious onset and persistent duration, ocular complications are common. Most pediatric uveitis are noninfectious and idiopathic, the most common etiologic diagnosis is juvenile idiopathic arthritis. Treatment of pediatric uveitis is tough, the mainstays of therapy include corticosteroids, antimetabolites, and T\|cell inhibitors. In the last decade, biologic agents provide us new methods for treating pediatric uveitis. Intravitreal corticosteroid delivery devices have enhanced our ability to provide longer\|lasting local disease control, but there are very limited data showing the efficacy and safety in children.

Application of fundus autofluorescence in diagnosis of wet agerelated macular degeneration

XU Xiao-li1, ZHANG Xi-mei2

2015, 39(1):  25-29.  doi:103706/ cma.j.issn.16735803201501005

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Wet agerelated macular degeneration (wAMD), the advanced stage of age-related macular degeneration (AMD), can lead to severe visual loss in more than 80% patients. At present, its diagnosis mainly depends on the morphological examinations, such as optical coherence tomography (OCT)and fundus fluorescein angiography (FFA). As a noninvasive examination, fundus autofluorescence (FAF) imaging has gradually become one of the observable indicators of wAMD, which can reflect the distribution of lipofuscin and the activity of retinal pigment epithelium (RPE).

Hepranase and ocular diseases

YU Yang, YUAN Ling, LI Guo-dong

2015, 39(1):  30-33.  doi:103706/ cma.j.issn.16735803201501006

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Heparanase (HPSE) in the endo-D-heparanase; retinal neovascularization;  cancer; coagulation; eye
glucuronidase is the only mammalian heparin sulfate (HS)degrading enzymes, which cleaves heparan sulfate (HS) that links to heparin sulfate proteoglycans. HPSE is a single copy gene, which can promotes tumor invasion and metastasis,  angiogenesis, maintaining lens membrane structure, coagulation function,embryonic tissue development and other aspects of participation.Reports about the relationship between HPSE and ophthalmology diseases is less. The present studies found that HPSE was associated with the corneal inflammation and neovascularization,lens diseases, physiological structure and neovascularization of retina, proliferation and migration of retinal pigmeng epithelium cells.

Aflibercept for the treatment of fundus neovascular diseases

FENG Yan-bing1, WENG Wen-qing2

2015, 39(1):  34-38.  doi:103706/ cma.j.issn.16735803201501007

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The  prognosis of fundus neovascular diseases mainly depend on the situation of the neovascularization. vascular endothelial growth factor (VEGF) is considered to be the most important pathogenic factor, and also an important therapeutic target in fundus neovascular diseases.  Aflibercept is the latest generation of antiVEGF drugs, which binds VEGFA and VEGF\|B, as well as plateletderived growth factor (PDGF), has higher affinity with VEGF. Aflibercept is applied to the treatment of wet agerelated macular degeneration, retinal vein occlusion, diabetic retinopathy and polypoidal choroidal vasculopathy. It can improve the  best corrected visual acuity and reduce the central retinal thickness. At the same time, in some nonresponse cases the good results are also received.

Pathogenesis and treatment of Coats disease

YANG Qiong, WEI Wen-bin

2015, 39(1):  39-43.  doi:103706/ cma.j.issn.16735803201501008

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Coats disease is mostly unilateral and affects mainly males during childhood. It characterizes by retinal telangiectasis, intraretinal and subretinal exudation. The pathogenesis of Coats dieases is still unclear. The affected eye usually has poor prognosis, and enucleation may be considered in some of severe patients. In current, the pathogenesis is considered related to the vascular factors, genes, and cytokines. The treatments of Coats disease include laser, cryotherapy, and medications, and the combined therapy is the commom choice. The vitrectomy can be choose for the refractory cases, while the surgery should be carefully choosed.

Research progress in etiology and pathogenesis of pathological myopia

GAO Ting-ting, LONG Qin

2015, 39(1):  44-49.  doi:103706/ cma.j.issn.1673\|5803201501009

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Pathological myopia is an illness with diopter more than -600 D with the developing diopter  and  prolonging ocular axis progressively. Many patients complicate with macular hemorrhage, retinal detachment, and choroid neovascularization. It is a serious disease which can cause blindness. Thus the study of its etiology and pathogenesis has far\|reaching significance. However, scholars have not yet reached a consensus. Most scholars believe that the occurrence and development of pathological myopia is related to both genetic factors and environmental factors. The discovery of multiple pathological myopia related genes  （such as MYP1~MYP5, MYP11~MYP13, MYP15~MYP16) marks that its etiology research has developed to the genetic level. In addition, the study has found that signaling pathways, such as TGF-β-Smad, HGF-c-Met, Stat3, IGF relative, NO-cGMP, and Shh, play the important role in the pathogenesis of pathological myopia.

Application of  choroidal thickness measurement in diagnosis and monitor of ocular diseases

JI Su-juan, LI Su-yan, ZHANG Zheng-pei, WANG Wei, WANG Xin-ting

2015, 39(1):  50-54.  doi:103706/ cma.j.issn.16735803201501010

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Enhanced depth imaging optical coherence tomography technique (EDIOCT) is based on the traditional frequencydomain optical coherence tomography (OCT) and improved to reflect the choroidal organizational structure, can quantitatively measure the choroidal thickness, initially detect the choroidal blood flow situation, is a simple, fast, economical, and practical new method provided for clinical research. At present, this technology has been used to study a variety of retinal diseases, especially macular disease，such as central serous chorioretinopathy, agerelated macular degeneration, polypoidal choroidal vasculopathy，high myopia, diabetic macular edema, and macular hole etc.

Diagnosis and treatment of active thyroid associated ophthalmopathy

WANG Hua-li, LI Xian-feng

2015, 39(1):  55-60.  doi:103706/ cma.j.issn.1673\|5803201501011

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Thyroid\|associated ophthalmopathy (TAO) is also called Graves’ ophthalmopathy (GO). It is an organ specific autoimmune disease, most patients experience two stages：  activity and stable. Assessment of the activity of TAO is of great important for its diagnosis in clinic. In current, we still lack of an accurate and specific method to determine the activity of TAO. Combining the three methods, the clinical activity score, single photon emission computed tomography (SPECT)/CT images, and the tear cytokines, help us to measure the activity degree of eye inflammation accurately, and benefit to giving the right choice of the treatment and then controlling the disease development timely. Three dimensional conformal orbital radiotherapy is the first\|line treatment for moderate\|to\|severe TAO. And it is recommended to combined with glucocorticoids because of the increasing efficacy and reducing side effects.

Progress in prevention and treatment of traumatic proliferative vitreoretinopathy

ZHANG Qiong，CHEN Song

2015, 39(1):  60-64.  doi:103706/ cma.j.issn.1673\|5803201501012

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Traumatic proliferative vitreoretinopathy (PVR) is the main reason for the failure of retinal detachment surgery, which is very difficult to be cure. Internal limiting membrane peeling, retinal release incision, vitreous cavity filling using perfluorocarbon liquid or using combined weight and light silicone oil are the new surgery treatment direction of PVR. Medications, such as antimetabolites, corticosteroids, drugs inhibiting cellulose, as well as the new therapy, such as gene therapy, immunosuppressants, phosphorylated glycoprotein etc. And the sustained\|release fine particles therapy can reduce the morbidity and the severity of the PVR.

Pathogenic mechanisms and intervention  of  myopia progression in school-aged children

WANG dong-jie, LI Ning-dong

2015, 39(1):  65-69.  doi:103706/ cma.j.issn.1673\|5803201501013

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Nowadays,  investigators have done a lot of clinical and animal experiments to explore the pathogenic mechanisms and the new clinical treatments for retarding the progression of myopia, which including bifocals, progressive addition lenses (PAL), rigid gas permeable contact lenses (RGP) and orthokeratology (OK). Besides, some meaningful trials  have been done  to explore the effect of atropine in treatment of progression myopia.

Differentiation of bone marrow mesenchymal stem cells into retinal cells

LIU Jing-wen1,2, QIN Bo1

2015, 39(1):  70-72.  doi:103706/ cma.j.issn.1673\|5803201501014

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As one type of adult stem cells, bone marrow mesenchymal stem cells (BMSCs) have the ability of self\|renewal and multiple differentiation potential which allow them to differentiate to bone, muscle, fat, neuron cells etc. In this review, a general background of BMSCs was summarized, and we also give a brief introduction of how BMSCs could differentiate to retinal neurons, retinal pigment epithelium and photoreceptor cells in different environment.