Table of Content

22 April 2016, Volume 40 Issue 2

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Research progress on morphology and associations of tilted optic disc

FAN Yuan-yuan, WEI Wen-bin

2016, 40(2):  73-80.  doi:10.3760/ cma.j.issn.1673-5803.2016.02.001

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Tilted optic disc is defined as one edge of the optic disc elevates in the horizontal or vertical axis. Tilted optic disc is not rare in population. The abnormal “tilted” appearance brings difficulty not only in clinical measurement analysis such as parapapillary neural retinal fiber layer (RNFL) and choroidal thickness but also confuses visual field results interpretation. Orientation and extent of optic disc tilt may correlated with glaucoma and myopia. Study on quantitative analysis of optic disc tilt angle could evaluate optic disc morphology accurately and help correcting measurement error in parapapillary structures. Quantitative measurement and prospective studies of optic disc tilt angle are helpful for research on the pathogenesis of glaucoma and myopia. It also provided basic of scientific research and clinical biomarker for monitoring related disease progression.  (Int Rev Ophthalmol,  2016,  40:  73-80)

The role of  biomechanics of endothelial cell of Schlemm’s canal in the regulation of intraocular pressure

ZHANG Jin-ling, ZHANG Yu-yan

2016, 40(2):  81-85.  doi:10.3760/ cma.j.issn.1673-5803.2016.02.002

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The elevated intraocular pressure (IOP) in primary open-angle glaucoma(POAG) is due to an increased resistance to the outflow of aqueous humor, which is the primary determinant of IOP. It remains to be explored the precise underlying mechanism how to manipulate IOP via regulating aqueous humor flow through inner wall of Schlemm's canal(SC). However it is well accepted that aqueous humor passes through the pores and vacuoles of the inner wall endothelium, and finally enters SC. The funneling model illustrates that the major outflow resistance of aqueous humor, regulated by the pores and vacuoles of endothelium, is located at the inner wall endothelium and juxtacanalicular connective tissue(JCT). Increased aqueous humor outflow resistance in POAG is due to impairment of pore formation on endothelium of SC, resulting in elevated IOP. The aim of the current review is to introduce the most updated concept in biomechanics of endothelium of SC regulating aqueous humor flow resistance.  (Int Rev Ophthalmol,  2016,  40:     81-85)

Intraocular pressure in infants and its influencing factors

SU Xiao-dan, XU Jiang-tao

2016, 40(2):  86-90.  doi:10.3760/ cma.j.issn.1673-5803.2016.02.003

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Due to the growth and development status, corneal thickness and hardness of infant's eye were different from that of adults. The range of normal intraocular pressure (IOP) of adults is not ideal for reference when assessing the IOP in infants and young children. In addition, due to the un-cooperation of infants, when measuring the IOP in infants, sedation is usually needed. Therefore, the measurement state is completely different from the adults. Studies showed that the IOP measured under sedation was significantly different from measuring in the conscious state. Multiple factors such as different ophthalmotonometer, the thickness of the central cornea, age and other factors can affect the measurement results of the IOP. Therefore, it is very important to select a suitable ophthalmotonometer for infants, and consider the related factors' influence for assessing the IOP in infants.  (Int Rev Ophthalmol,  2016,  40:     86-90)

Hypertensive retinopathy and lipids

ZHANG Wen-bo, YANG Liu

2016, 40(2):  90-93.  doi:10.3760/ cma.j.issn.1673-5803.2016.02.004

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Hypertensive retinopathy is a common complication of hypertension. Some studies showed that lipids play an important role in the development of hypertensive retinopathy. On one hand the elevated blood lipids aggravate hypertensive retinopathy by increasing the severity of hypertension,on the other hand lipids disorder can also lead to injury of vascular endothelial cell and microcirculation.In this paper, we reviewed the role of lipids in hypertensive retinopathy.   (Int Rev Ophthalmol,  2016,  40:     90-93)

The research status of pregnancy-induced hypertension retinopathy

WANG Yan-yun, ZHANG Wen-fang, YANG Yi, XIA Jin-tao, GAO Su

2016, 40(2):  94-97.  doi:10.3760/ cma.j.issn.1673-5803.2016.02.005

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Pregnancy-induced hypertension retinopathy is an ocular complication of  pregnancy-induced hypertension. The etiology and pathogenesis of the disease remains unclear. With the in-depth study of the retinopathy, researchers gradually find that choroidopathy plays an important role in the pathogenesis. In this review, we analyzed the pregnancy-induced hypertension  retinopathy, and provided characteristics of its epidemiology, etiology, pathogenesis, clinical manifestation, diagnosis，treatment and prognosis.   (Int Rev Ophthalmol,  2016,  40:     94-97)

The mechanism of blood retinal barrier impairment in diabetic retinopathy

DING Zhou,WANG Yang-ningzhi, ZHANG Zhe, JIANG Qin

2016, 40(2):  98-103.  doi:10.3760/ cma.j.issn.1673-5803.2016.02.006

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Diabetes mellitus seriously affects retinal microcirculation, which causes a series of pathological changes of tissue structure. These changes may eventually lead to abnormal proliferation of endothelial cells, the changes of vascular permeability and abnormal formation of retinal blood vessels, which cause the loss of vision. This review describes the effects of high blood glucose on retinal microvascular system, and the damage effect caused by high blood glucose from the perspectives of cell function and molecular biology. High blood glucose can impair retinal vascular cells by affecting cell junctions, inducing apoptosis, changing the interactions between cells and so on. This study will provide a new insight into understanding the molecular and cellular defects in the development of diabetic retinopathy.   (Int Rev Ophthalmol,  2016,  40:     98-103)

The effect of  complement factor H gene on treatment of wet age-related macular degeneration

MA Yan-ran, WU Ming-xing, LIU Dan-ning, ZHOU Xi-yuan

2016, 40(2):  103-106.  doi:10.3760/ cma.j.issn.1673-5803.2016.02.007

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Age-related macular degeneration(AMD) is a multifactorial disease that results from the combined contribution of age, environment and genetic predisposition.  Complement factor H(CFH) is an important inhibitor in complement system. The variant in CFH can decrease the inhibiting effect in complement pathway, which may play an important role in AMD pathogenesis. Research indicates that SNPs (single nucleotide polymorphisms) in CFH  not only have strong associations with AMD susceptibility but also affect the visual acuity improvement in anti-VEGF(vascular endothelia growth factor) therapy. This article focus on the association between CFH and the pathogenesis or treatment response of anti-VEGF therapy in wet AMD and ponit out a new way to predict response to anti-VEGF treatment of wet AMD in clinical setting.  (Int Rev Ophthalmol,  2016,  40:    103-106)

Application of internal limiting membrane peeling in the treatment of ocular fundus diseases

LI Jie1, ZHANG Xi-mei2, MA Tao2

2016, 40(2):  107-111.  doi:10.3760/ cma.j.issn.1673-5803.2016.02.008

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The internal limiting membrane (ILM) is located between the retina and vitreous, and plays an important role in the development of ocular fundus diseases. In the last 20 years, the ILM peeling has been widely used in the treatment of ocular fundus diseases, such as macular hole, epiretinal membrane, diabetic macular edema, rhegmatogenous retinal detachment and so on. Recently, the innovation of the technique, such as inverted ILM flap technique and foveola nonpeeling ILM surgery, has made the method of ILM peeling more diversified. With the development of the  optical coherent tomography technology, the changes of the retina after the ILM peeling have become more and more concerned.In this paper, the development, improvement and application of ILM peeling, and the changes of the retina after operation were reviewed.  (Int Rev Ophthalmol,  2016,  40:     107-111)

Optical coherence tomography angiography with split-spectrum amplitude decorrelation angiography

WANG Qian, WEI Wen-bin

2016, 40(2):  112-116.  doi:10.3760/ cma.j.issn.1673-5803.2016.02.009

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Optical coherence tomography angiography (OCTA) is a new method of analysis based on high-resolution imaging techniques whereby the retinal and choroidal circulation can be visualized without the need to injecting any contrast agent. OCTA operates on the principle that, all other elements remaining the same, the only difference between sequentially obtained OCT cross-sectional scans in a particular eye is attributed to motion of erythrocytes within the retinal and choroidal vasculature. Recently, a new algorithm——split-spectrum amplitude decorrelation angiography (SSADA) has been used in OCTA. It can identify movement orthogonal or transversal to the OCT beam, quantifying flow independent of the Doppler angle. An additional advantage of the amplitude-based technology, in comparison with the phase-based, is that the latter is more significantly degraded by image noise and background tissue motion. OCTA with SSADA has been widely used in various kinds of ocular diseases, such as choroidal neovascularization, diabetic retinopathy and retinal vascular occlusions and it is very important in the diagnosis and follow up in those diseases.  (Int Rev Ophthalmol,  2016,  40:     112-116)

The new development of laser surface ablation：TransPRK

LIU Hong-jie, GUO Xiu-jin

2016, 40(2):  117-120.  doi:10.3760/ cma.j.issn.1673-5803.2016.02.010

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Transepithelial photorefractive keratectomy (TransPRK) is one of surface ablation, in which the epithelial removal is carried out with laser phototherapeutic keratectomy(PTK) ablation, followed by a laser refractive ablation of the stroma. A new variation of TransPRK was introduced by Schwind eye-tech-solutions. In which, both epithelium and stroma are removed in a single step, in one ablation profile. Using these new approaches, some studies have demonstrated minimal keratocyte apoptosis and less haze, as well as better visual outcomes compared to mechanical epithelial debridement.   (Int Rev Ophthalmol,  2016,  40:    117-120)

The surgical treatment for the cataract eyes after corneal refractive surgery

ZHANG Jing-shang, WAN Xiu-hua

2016, 40(2):  121-125.  doi:10.3760/ cma.j.issn.1673-5803.2016.02.011

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In recent years, the age-related cataract and complicated cataract increased in post-corneal-refractive-surgery eyes. The treatments for cataracts in these eyes are rather different from treatments for normal cataract patients. IOLMaster is preferred for accurately measuring the refractive data preoperatively in these eyes. During operation, the wavefront aberrometer can be used for calculating intraocular lens power at the aphakic status, and guiding for selection of the appropriate aspheric and multifocal intraocular lens to improve visual quality. The accommodative intraocular lens enable accommodation postoperatively to obtain the most accurate refraction. These stratigies ensure the satisfaction of the post-corneal-refractive-surgery cataract patients about visual status after cataract surgery.  (Int Rev Ophthalmol,  2016,  40:     121-125)

The advances in treatments of meibomian gland dysfunction

WANG Xiao-hong1，DING Lin2

2016, 40(2):  126-131.  doi:10.3760/ cma.j.issn.1673-5803.2016.02.012

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Meibomian gland dysfunction (MGD) has great impact on ocular surface, affecting the eye surgical outcome and reducing the quality of life, thus drawing increasing attention in clinical ophthalmologist. The methods of treatment for MGD include eyelids clean, hot pack, meibomian gland massage, nutritional therapy, hormones and antibiotics and so on. In recent years, more and more safe, effective, convenient and easy using devices are used in clinics, such as eyelid heating device, intense pulsed light and intraductal meibomian gland probing, etc. These treatment have improved the patient's symptoms and signs,  achieving good therapeutic effect.  (Int Rev Ophthalmol,  2016,  40:     126-131)

Mechanism of immune privilege and immune responses in bacterial endophthalmitis

DUAN Yi-qin, LIN Ding

2016, 40(2):  132-135.  doi:10.3760/ cma.j.issn.1673-5803.2016.02.013

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Bacterial endophthalmitis is an emergency in ophthalmology, which can cause serious vision loss. Though taken prompt and aggressive therapeutic and surgical intervention，devastating imparity in vision acuity may happen. Researches on bacterial endophthalmitis focus on analyzing the mechanisms of the inflammatory responses to infection and the molecular and cellular interactions between the pathogen and host. The latest advances in enucleating the mechanisms of bacterial endophthalmitis include immune privilege, innate immunity, complement system, fas ligand, cellular infiltration, cytokines and adhesion molecules.  (Int Rev Ophthalmol,  2016,  40:     132-135)

The effect of bone morphogenetic proteins in fibrotic diseases in ophthalmology

YAO Hai-pei, WANG Fang

2016, 40(2):  136-139.  doi:10.3760/ cma.j.issn.1673-5803.2016.02.014

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Bone morphogenetic proteins (BMP) are multi-potential growth factors, which belong to transforming growth factor beta (TGF-β) superfamily. BMP are involved in a lot of physical and pathophysiological process, including embryogenesis, skeletal formation and fibrosis. Fibrosis is the crucial pathologic change of many ophthalmological diseases, such as keratohelcosis, glaucoma, myopia and retinal detachment. These fibrotic diseases are characterized by trans-differetiation from the various cells to fibroblasts. It highlights the functions of BMP in fibrotic diseases in ophthalmology. Recent studies suggest important roles of BMP subtypes BMP2, BMP4 and BMP7 in the suppression of fibrosis. These evidences imply that BMP4 and BMP7 might become new drugs to the fibrosis to be deeply researched.   (Int Rev Ophthalmol,  2016,  40:     136-139)

Research progress of neuroglobin in ophthalmology

LI Kang, LI Jing, GAO Xiao-hong

2016, 40(2):  140-144.  doi:10.3760/ cma.j.issn.1673-5803.2016.02.015

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Neuroglobin (NGB), a kind of specific oxygen carrying globin of nervous system, was found following the hemoglobin and myoglobin. It has a high affinity for oxygen and neuroprotective effect. The previous studies of NGB were mainly about the nervous system diseases. Recently, it was found that its content in the retina is 100 times as much as that in the brain, which has great importance against the ischemia and hypoxia injury of the eye, playing a significant role in the research of ophthalmologic diseases. The distribution of neuroglobin in the eye, its neuroprotective mechanism in the retinal photochemical damage，diabetic retinopathy and glaucoma were reviewed.  (Int Rev Ophthalmol,  2016,  40:     140-144)