Table of Content

22 April 2015, Volume 39 Issue 2

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Clinical application of new types of multifocal intraocular lens

ZHANG Jing-shang, WAN Xiu-hua.

2015, 39(2):  73-78.  doi:DOI：10.3706/ cma. j. issn.1673/5803.2015.02.001

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In recent years new types of multifocal intraocular lens have been developed, such as aspheric multifocal intraocular lens, Toric multifocal intraocular lens and aspheric Toric multifocal intraocular lens and so on. The vision in life and work and the quality of life  in patients with cataract were significantly improved after phacoemulsification with the new types of multifocal intraocular lens. At the same time there should be a strict indications for the new types of multifocal intraocular lens, so as to make the cataract patients implanted multifocal intraocular lens getting the best visual quality.  (Int Rev Ophthalmol, 2015, 39： 73-78)

Classification and latest advances of phakic intraocular lens

LUO Dan-yan, YANG Ya-bo

2015, 39(2):  78-83.  doi:10.3706/ cma. j. issn.1673/5803.2015.02.002

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Phakic intraocular lens (pIOL) includes three types according to their intraocular position: angle\|supported anterior chamber, iris\|fixated anterior chamber, and posterior chamber. With the improvement of materials and designs, pIOL have always been upgrading, such as from unfoldable to foldable, smaller surgical incisions, better vision outcomes and less complications. Knowing the developing history,   advantages and disadvantages of each type of pIOL, surgeons could choose the better type and suitable parameters of pIOL for different patients. The aim of this paper is to review the developing history of pIOL and introduce application details of three commonly used representatives in current clinic: AcrySof, Artiflex/Veriflex and ICL.   (Int Rev Ophthalmol, 2015, 39：    78-83)

The advances of the materials and designs of the intraocular lens

ZHAO Jing, WAN Xiu-hua

2015, 39(2):  84-89.  doi:10.3706/ cma. j. issn.1673/5803.2015.02.003

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In the aging population, cataract extraction and intraocular lens (IOL) implantation  are gradually increased. IOL materials including traditional PMMA, silicone  hydrogel, acrylic  and so on. Development and use of  IOL with new design including better stability, optical quality and safety can improve the visual quality of cataract patient after surgery. New IOL including injectable IOL, nanocan materials’s IOL, hydroxyethyl methacrylate (HEMA) IOL and so on.  Postoperative complications of HEMA IOL is lower. The new acrylic IOL's unique sharp trailing edge can reduce complications and improve the stability of IOL. Injectable IOL makes smaller incision surgery as reality, as well as retains normal regulatory function of lens; nanomaterial’s IOL improves its biocompatibility. The new black iris diaphragm IOL looks better and allows to transmit near infrared light for SLO and OCT fundus examination. With further study and development of applications, these new IOLs will soon serve for cataract patients and bring better visual quality.   (Int Rev Ophthalmol, 2015, 39： 84-89)

Quality of life analysis and its influence factors after surgery of cataract

LUO Wei, SHA Xiang-yin

2015, 39(2):  89-93.  doi:10.3706/ cma. j. issn.1673/5803.2015.02.004

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With the development of the medical model, postoperative quality of life of cataract patients is  more comprehensive than postoperative vision measurement for evaluation the physical and psychological changes  caused by the operation. In recent years, more and more scholars at home and abroad compare different cataract surgical   methods, intraocular lens (IOL), preoperative and postoperative cataract patients’ quality of life. In addition,  the fundus diseases, postoperative residual refractive errors, ocular surface diseases and other factors such as age and  gender can also affect the  postoperative quality of life. Ophthalmic workers should not only care about the quality  of cataract surgery, but also understand the specific requirements and expectations of  patients with cataract surgery, in order to improve   cataract patients' quality of life.   (Int Rev Ophthalmol, 2015, 39： 89-93)

Oxidative stress and diabetic cataract

MA Jia, GUO Xiu-jin, LI Hang

2015, 39(2):  94-98.  doi:10.3706/ cma. j. issn.1673/5803.2015.02.005

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Under physiological conditions, radicals on cellular activities play an important role. When the body is subjected to noxious stimuli lead to oxidative stress, the increased production or decreased removal of radicals result in oxidative damage to cells and tissues. Diabetic cataract is one of the complications of diabetes, and an important class of blinding eye disease. Currently its pathological mechanisms were considered including polyol pathway activation, oxidative stress and non\|enzymatic glycation of lens proteins. Oxidative stress action as a central part is attractive, which is closely related to the generation of diabetic cataract. The development of nzymatic and non\|enzymatic antioxidant defense systems provides a strategy for anti\|cataract, and provides a new idea for mitigation and prevention of diabetic cataract studies.   (Int Rev Ophthalmol, 2015, 39： 94-98)

Assessment methodology of optic nerve injury in glaucoma model

DONG Xing-tang, LIAO Xuan, LAN Chang-jun

2015, 39(2):  99-102.  doi:10.3706/ cma. j. issn.1673/5803.2015.02.006

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Glaucoma is characterized mainly by optic nerve injury, and the assessment of optic nerve injury contributes to research of its etiology and pathogenesis. The current assessment methodology mainly includes determination of retinal ganglion cell (RGC) number, counting of lining retinal thickness and optic nerve axons. Those methods have their own advantages and disadvantages. Apoptosis of RGC directly reflects the degree of optic nerve injury. RGC counting operates easily with retina\|stretched preparation, but the layers of cells are apt to overlap reciprocally. The retrograde fluorogold labeling of retinal ganglion cells possibly leaks out into neighboring microglia, and accordingly results in the inaccuracy of the count. The retinal thickness measurement is not directly reflected injury severity and the optic nerve axons counting is not operationally easy in some ways. The stereological method can be used for RGC counting, however relevant formulas and methods need to be mastered, and it is rarely reported in this field.  (Int Rev Ophthalmol, 2015, 39： 99-102)

Optos 200Tx scanning laser ophthalmoscope for wide-field fluorescein angiography and its clinical application

ZHOU Jin-qiong, WEI Wen-bin

2015, 39(2):  103-106.  doi:10.3706/ cma. j. issn.1673/5803.2015.02.007

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As a representative of the new technology, wide\|field fundus fluorescein angiography has opened up areas previously unknown in the vitreoretinal subspecialty, which can image the Peripheral retina, much larger than the traditional range. Optos 200Tx scanning laser ophthalmoscope used for wide\|field fluorescein angiography was another breakthrough on the history of fundus angiography. With the Optos 200Tx imaging system, it is now possible to view up to 200°of retina in a single photograph, without pupil dilation and corneal contacting. As a new technology, Optos 200Tx was wildly accepted because of its high efficiency and safety, can be used for for those vascular diseases Involved the peripheral retinal or choroid, such as diabetic retinopathy, retinal vein occlusion, retinal vasculitis, uveitis, and tumors.  (Int Rev Ophthalmol, 2015, 39：103-106)

Advances of intussusceptive angiogenesis in the diseases of intraocular neovascularization

YU Meng-xi, WU Zhi-feng

2015, 39(2):  107-111.  doi:10.3706/ cma. j. issn.1673/5803.2015.02.008

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Recent years, intraocular antiangiogenic research is still being the hot spot in the treatment of neovascularization. Intussusceptive angiogenesis, as a special type of neovascularization, is becoming the main direction of angiogenesis research. Intussusceptive angiogenesis is confirmed to have an important effect on the growth and rebuilding of intraocular neovascularization. Different from sprouting, intussusceptive angiogenesis has no vascular basement membrane damage and endothelial cell proliferation; therefore, there is no negative phenomenon such as leakage and bleeding. By reason of repeated exudation, bleeding, scarring and visual impairment which are caused by intraocular neovascular disorders, intussusceptive angiogenesis brings new thoughts for the treatment of intraocular neovascularization.   (Int Rev Ophthalmol, 2015, 39：107-111)  

The role of TGF-β on choroidal neovascularization formation

FENG Yi-fan, YUAN Fei

2015, 39(2):  111-116.  doi:10.3706/ cma. j. issn.1673/5803.2015.02.009

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Transforming growth factor \|β (TGF\|β), a polypeptide, has been shown to have biological function and may be closely related to the choroidal neovascularization (CNV) formation. Smads pathway is the classic signaling pathway when TGF\|β elicits its pleiotropic effects. TGF\|β signaling plays an important role in the development of the vascular system. It can regulate the activation of endothelial cells in different stages by binding to its specific receptors ALK5 and ALK1, and modulate the differentiation of smooth muscle cells through the Smad3 and p38/MAPK signaling pathways. TGF\|β secretion is increased during the CNV formation, which play an important role in the CNV process. TGF\|β signaling pathway intervention may become a new target for the treatment of CNV. Intervention of TGF\|β signal pathway may become a new target for CNV treatment.   (Int Rev Ophthalmol, 2015, 39： 111-116)

Posterior vitreous detachment and diabetic retinopathy

GAO Yong-feng, LEI Xiang

2015, 39(2):  116-120.  doi:10.3706/ cma. j. issn.1673/5803.2015.02.010

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Posterior vitreous detachment (PVD) in diabetic retinopathy (DR) has played an important role in the development process, and outcome of surgical treatment. Partial PVD can contribute to the worsening of DR. Neovascularization on the retinal surface cannot occur without an appropriate scaffold of collagenous material, complete PVD can eliminate the scaffold, reduce vitreous hemorrhage, increase vitreal oxygen levels, make surgery easier and safer.Intravitreal injection of plasmin and other drugs with little side effects can induce PVD, improve the surgical outcome of DR and reduce surgical complications.  (Int Rev Ophthalmol, 2015, 39： 116-120)  

The relevance between high myopia and diabetic retinopathy

GUO Yu-nan, ZHOU Xi-yuan

2015, 39(2):  120-123.  doi:10.3706/ cma. j. issn.1673/5803.2015.02.011

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The pathogenesis of diabetic retinopathy is unclear at present. Some studies found that myopic refractive error, long axial length may be the protective factors of  diabetic retinopathy. This article reviews the possible relationship and related mechanisms between high myopia and diabetic retinopathy,and hope for a new way to the prevention and treatment of diabetic retinopathy.  (Int Rev Ophthalmol, 2015, 39：120-123)    

Role of inflammasomes in macrophages in  pathogenesis of endophthalmitis

CHEN Li, LI Bing, SHENG Min-jie

2015, 39(2):  124-129.  doi:10.3706/ cma. j. issn.1673/5803.2015.02.012

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Endophthalmitis is a serious disease causing blind, once it happens, acute loss of vision, even eyeball atrophy would occur. Macrophage is the central mechanism of the inflammation, and inflammasome is an important component of macrophages involved in the immune response. Since macrophages play a key role in the induced regulation of non\|specific immune responses, it will benefit to the diagnosis and treatment of the catastrophic diseases when the anti\|infection immune mechanisms of macrophages becomes clear in the very early stage of endophthalmitis.   (Int Rev Ophthalmol, 2015, 39： 124-129)  

Progressive research of the correlation between conjunctivochalasis and inflammatory cytokines

KE Mei-qing, ZHANG Xing-ru, LI Qing-song

2015, 39(2):  130-134.  doi:10.3706/ cma. j. issn.1673/5803.2015.02.013

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Conjunctivochalasisis (CCh) not uncommon but often was overlooked as a normal aging variation. The etiology of conjunctivochalasis has not yet to be fully elucidated. Recent studies showed that overexpression of matrix metalloproteinases by conjunctivochalasis fibroblasts, which may help explain how conjunctivochalasis manifests excessive degradation of the conjunctival matrix and Tenon’s capsule, which could cause the lack of adhesion between the conjunctiva and the sclera and conjunctivochalasis. The redundant conjunctiva located between the globe and the eyelid interferes tear meniscus, causing unstable tear film, punctal occlusion and delayed tear clearance. The accumulation of inflammatory protein, apoptosis and apoptosis related proteins and degrading enzymes or other active ingredient in tear fluid are increased due to the delay in tear clearing. Inflammatory cytokines up\|regulate the expression of matrix metalloproteinases by conjunctival fibroblasts, which will promote the further degradation of conjunctival extracellular matrix, setting up a vicious cycle to aggravate the existing conjunctivochalasisis.  (Int Rev Ophthalmol, 2015, 39： 130-134)

Effects of environmental and genetic factors on myopia

WANG Jun-liang, GONG Ying-ying, GU Zhen-sheng

2015, 39(2):  134-139.  doi:10.3706/ cma. j. issn.1673/5803.2015.02.014

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The onset and development of myopia is the result of multiple factors, including genetic and environmental interactions. This is evidenced by animal experiment. For example, form\|deprivation induced animal models of myopia showed that decreased form stimulation of retina and sclera could induce the elongation of the ocular axis. Optical defocus\|induced myopia model showed that young monkeys develop axial myopia after wearing -9.0 D contact lens for 3 months. Egr\|1 gene knockout chicken showed longer axial length than controls. Studies on young children, including form\|deprivation related observations and the development of myopia among children of different ages also demonstrated the impact of genetics and environmental factors on the occurrence and development of myopia. Epidemiological studies showed that environmental factors and social behavior, such as the degree of education, social\|economical status, reading habits, urbanization and outdoor activities are highly associated with the development of myopia. However, the biological mechanisms of how environmental factors affect the development of myopia remain controversial. Different studies showed variable contributions of environmental factors to the development of myopia. With the advancement of genome\|wide scan and linkage analysis and GWAS technologies, at least 14 genes and 40 more candidate genes were found to be closely associated with the occurrence of myopia, especially high\|myopia. However, the effect of these genes is not yet to be demonstrated in independent samples.  (Int Rev Ophthalmol, 2015, 39：134-139)  

Experimental study and its problems on the protective effects to ocular tissues of astaxanthin

YANG Ming, WANG Zhi-jun

2015, 39(2):  140-144.  doi:10.3706/ cma. j. issn.1673/5803.2015.02.015

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Astaxanthin is a naturally occurred carotenoid which has a strong antioxidant properties, anti\|inflammatory effects, resistance to apoptosis, prevention of cardio\|cerebrovascular disease and cancer. Studies had revealed that astaxanthin had a good permeability to the blood\|retina\|barrier to protect the ocular tissues from kinds of damage. This review focused on the merits and demerits of purchasable astaxanthin in experimental animal feeding, free radical peroxidative injury to cells and the antioxidant mechanism of astaxanthin. Moreover, we summarized injury mechanism of oxidative damage of common ocular diseases, and the protective effect of astaxanthin on them.  (Int Rev Ophthalmol, 2015, 39： 140-144)