Table of Content

22 August 2016, Volume 40 Issue 4

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Research progress on scaffold materials and biocompatibility of keratoprosthesis

MA Rui-jie, LI Yan, HU Zhu-lin

2016, 40(4):  217-221.  doi:10.3760/ cma.j.issn.1673-5803.2016.04.001

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The most common and traditional treatment options of corneal diseases are penetrating keratoplasty and corneal endothelium transplantation. Moreover, transplantation of keratoprosthesis is an other important therapy method. The most common structure of keratoprosthesis is column lens-nepotism, which is constituted with a transparent optical mirror column in the centre and scaffold in the rim. The key of transplantation of keratoprosthesis lies in the biocompatibility of stent materials. With the development of polymer material science, the kinds of stent materials are increasingly diverse, also  the requirement of biocompatibility is increasingly improved. The current common artificial corneas scaffolds are made with inorganic, organic or/and biological materials. The understanding of the biocompatibility, superiority and inferiority of the different materials could improve the success rate of implantation of keratoprosthesis.

Research status in diabetic corneal neuropathy

DOU Ze-xia，ZHAO Shao-zhen

2016, 40(4):  222-226.  doi:10.3760/ cma.j.issn.1673-5803.2016.04.002

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The innervation of normal corneal nerve is critical in protective functions and maintaining the sensation of the cornea. Diabetic corneal neuropathy has the risk of corneal tissue injury, decreased sensitivity and visual impairment. The pathogenesis is not exactly clear, including glycometabolic disorder, peripheral neuropathy, oxidative stress and so on. Studys suggested that the lose of diabetic corneal nerve and the decrease of nerve fiber length and density was related with corneal sensation, diabetic retinopathy, dry eyes and other factors. The main treatment is to control blood glucose, nutrient nerve, promote the growth of nerve etc.

Advances of epigenetic related to retinal ganglion cells

HUANG Wan-jing, WU Ji-hong

2016, 40(4):  227-230.  doi:10.3760/ cma.j.issn.1673-5803.2016.04.003

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Epigenetics influences gene expression and function without modification of the base sequence of DNA and may be reversible, heritable, and influenced by the environment. Epigenetics has become an increasingly important research field in biomedical. At present, the studies of epigenetic mechanism focus on DNA methylation, histone modifications, chromosomal remodeling and non-coding RNAs. Despite the complex causes of glaucoma, the final passage are retinal ganglion cells death and loss of optic nerve fibers. Current studies found that the growth and development, apoptosis and regeneration of retinal ganglion cells were regulated by the epigenetic changes, which may proclaim the epigenetic mechanism of the glaucoma and may provide new idea for the treatment of glaucoma.

Macrophage polarization in ocular diseases

WANG Jing-yi, LONG Qin

2016, 40(4):  231-236.  doi:10.3760/ cma.j.issn.1673-5803.2016.04.004

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In the development of various ocular diseases, the immune response mediated by macrophages and inflammatory cytokine is important in the pathogenesis. Under the effect of microenvironment signals, macrophages could polarize to M1 or M2 macrophages with different cytokines, receptor expression, and functions. Macrophages are versatile and heterogeneous cells that could undergo their phenotypically/functionally dynamic. Macrophage polarization was involved in the pathogenesis of the corneal disease, age-related macular degeneration, diabetic retinopathy and autoimmune uveitis,  and the plasticity of macrophage make it possible to be an ideal target for therapy.

Age correlation of primary strabismus in adults

FU Zhu-jun, LIU Hu

2016, 40(4):  236-240.  doi:10.3760/ cma.j.issn.1673-5803.2016.04.005

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Strabismus is a kind of disease closely related with visual development, anatomy of eye, binocular vision and eye movement. Primary strabismus of adults, especially of the elderly has some distinctive features due to the age characteristic. It manifests as an idiopathic ocular misalignment without decreased vision. It usually develops after age of 60, presenting correlation with increasing age. Studies found that the occurrence and development of the disease was related to the vasculopathy, health status, presbyopia and functional degradation. The treatment of the disease included prism, fusion training and surgery.

Recent advancement of collagen cross-linking in the treatment of ophthalmic diseases

MO Li-juan, LI Qing-song, ZHANG Xing-ru

2016, 40(4):  241-246.  doi:10.3760/ cma.j.issn.1673-5803.2016.04.006

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Although collagen cross-linking (CXL) technology is still in the research and experimental stage in ophthalmology, but which is likely to significantly improve the mechanical strength of the collagen fibers, so a great number of ophthalmologists are becoming concerned about it. In recent years, based on the traditional CXL, the high-energy accelerated CXL, iontophoresis CXL and combination procedures are being described. Most of the experience gained from the treatment of the keratoconus. If individuals have been diagnosed as progressive keratoconus, they can be given CXL treatment early. After the operation, patients appear to increase the corneal stability and improve the visual acuity, while as to non-progression of keratoconus, the efficacy of the CXL is still in need of further study. In addition, CXL were attempted to be applied on the treatment of the iatrogenic keratoconus, transparent marginal degeneration, corneal edema and infectious corneal diseases, but the efficacy remains to be further verified.

Research progress on disease models of corneal ectasia

QIAO Jing, YAN Xiao-ming

2016, 40(4):  246-251.  doi:10.3760/ cma.j.issn.1673-5803.2016.04.007

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Corneal ectasias including keratoconus, post-LASIK keratectasia, pellucid marginal degeneration, Terrien's marginal degeneration and keratoglobus are a group of disorders in which refractive instability occurring with progressive structural deformation of corneal shape. As valuable and indispensable tools for basic research, disease models could enable researchers to better understand the pathophysiology of corneal ectasias and to verify hypotheses of pathogenesis, as well as to evaluate potential treatments. The common disease models of corneal ectasia include post-LASIK keratectasia animal model, rodent model for hereditary keratoconus, finite element models and in vitro models of corneal ectasia, which has the merits and faults of each. However, there is still not a suitable animal model for the corneal ectasia for basic research.

Long-term efficacy of corneal cross linking

LIAO Kai, ZENG Qing-yan

2016, 40(4):  252-257.  doi:10.3760/ cma.j.issn.1673-5803.2016.04.008

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Corneal collagen cross linking has become the most effective treatment for corneal dilated diseases. The effect of tranditional epithelium-off corneal cross linking is well-known, but it take too much time on surgical time, and some patients showed side effects after surgery. In order to improve the surgical safety, some improved surgical techniques have been developed, include transepithelial corneal cross linking and  accelerated corneal cross linking, but there’s a lot of debate about the validity of these. The epithelium-off corneal cross linking is the most effective surgical method for now, the efficacy of epithelium-on and accelerated corneal cross linking in short term was well, but it still needs more long-term results to verify the effectiveness for treating keratoconus.

Dopamine and  myopia in retinopathy of prematurity

XIE Li, WANG Ping

2016, 40(4):  258-262.  doi:10.3760/ cma.j.issn.1673-5803.2016.04.009

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Retinopathy of prematurity (ROP) is a kind of abnormal neovascularization and fibrous tissue proliferation  retinopathy in premature and low birth weight infants. It is regarded as one of the important diseases causing visual impairment in children, which can lead to permanent visual loss. A large number of domestic and foreign study found that ROP affected retinal development and function, mainly affected the light-sensitive cells, and clinical study found that the retinal dysfunction even early controlled, usually following the ametropia, especially myopia. Recent studies have found that oxygen induced retinopathy (OIR) retinal dysfunction may be related to the release of dopamine (DA) and the changes in the activity of DA. Studies found that ROP early myopia and the high incidence of myopia in children with ROP were closely related to the effect of ROP on the secretion and release of dopamine in the retina. Therefore, discussing the role of DA in ROP myopia will provide a new way of thinking for the prevention and treatment of myopia in children with ROP.

Research progress on orbital fascia tissue and Pulleys

ZUO Xu-hong1, GAO Lei1, ZHUO Xu-ying1, LIU Gui-xiang2

2016, 40(4):  262-265.  doi:10.3760/ cma.j.issn.1673-5803.2016.04.010

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Extraocular muscles and orbital fascia tissue cooperate in ocular motility. Previous studies have mainly focused on the pathological changes of extraocular muscle fibers, rarely on the role of orbital fascia tissue in ocular motility. Pulleys is a resilient structure located near the orbital wall and connected to the equator of the eyeball, the rectus muscle reaches its sclera attachment through the structure. Pulleys controls the extraocular muscle (EOM) path and serves as the EOM's functional origin. Orbital fascia tissue plays more active role in ocular motility. Age-related degenerative changes of Pulleys can occur and abnormal Pulleys is related with the ocular motility disorders, which should be fully taken into account by the surgeons in the diagnosis and treatment of strabismus.

Role of epithelial-mesenchymal transition in pathogenesis of  proliferative vitreoretinopathy

LIU Shuai, JIN Hai-ying

2016, 40(4):  266-271.  doi:10.3760/ cma.j.issn.1673-5803.2016.04.011

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Proliferative vitreoretinopathy (PVR) is a common complication after rhegmatogenous retinal detachment and vitreoretinal surgery, which is characterized by the formation of avascular fibrocellular membranes on the surface of the retina.  Studies on ultrastructural manifestation and immunopathology have demonstrated that epiretinal membranes associated with PVR comprised of multiple cells, such as retinal pigment epithelial cell, glia cell, macrophage, hyalocyte, fibroblast and myofibroblast. Among those cells, myofibroblast,  which is responsible for the contractility of epiretinal membranes and then leads to the failure of retinal reattachment, is mainly derived from epithelial-mesenchymal transition of the retinal pigment epithelial cells, playing a critical role in the development of the PVR. Thus, it is possible a effective treatment for PVR that prevents the transdifferentiation of retinal pigment epithelial cells to myofibroblast.

Progress in medication for diabetic retinopathy

LIU Zhao-hui1, GAO Xiao-hong2, LI Gai-yun2, MA Tao2, LI Kang2

2016, 40(4):  272-276.  doi:10.3760/ cma.j.issn.1673-5803.2016.04.012

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With the update of the pathologic mechanisms of diabetic retinopathy (DR), currently medication therapy has also made some progress, including corticosteroids, anti-vascular endothelial growth factor, anti-platelet derived growth factor, non-steroidal anti-inflammatory drugs, as well as drugs to improve the function of the optic nerve. Currently, in the treatment of diabetic macular edema, intravitreal pharmacotherapies, especially anti-vascular endothelial growth factor (anti-VEGF) agents, have gained popularity.

Relationship between pericytes and  early  diabetic retinopathy

ZHOU Ya-lan, ZENG Jun, CHEN Bai-hua

2016, 40(4):  277-282.  doi:10.3760/ cma.j.issn.1673-5803.2016.04.013

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The onset of diabetic retinopathy is characterized by morphologic alterations of the microvessels, with thickening of the basement membrane, loss of inter-endothelial tight junctions and selective loss of pericytes in the early stage, together with increased vascular permeability, capillary occlusions, microaneurysms, and later loss of endothelial cells (EC). Pericytes, can regulate vascular tone and perfusion pressure. When the tight link between pericytes and EC was disrupted by the dropout of pericytes,  which would give rise to new vessels, and cause the first abnormalities of the diabetic eye which can be observed clinically. Hyperglycaemia and local hypertension are known to be a direct cause of pericyte apoptosis and dropout, and intracellular biochemical pathways of the glucose metabolites have been explored. However, the exact mechanisms are not yet fully understood and need further clarification in order to develop new effective drugs for the prevention of retinopathy.

Progress on the pathogenesis of endotoxin-induced uveitis

LIU Xin-li, LU Hong

2016, 40(4):  283-288.  doi:10.3760/ cma.j.issn.1673-5803.2016.04.014

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Uveitis is not only a common inflammation disease of eyes but also a leading cause of blindness. Its complex  pathogenesis is not fully understood. An endotoxin-induced uveitis (EIU) animal model has been established for the study of uveitis to avoid the limits of taking specimens from human. These animal models of uveitis have made great contribution to understanding the mechanism and have set up the experimental foundation for clinical treatments of uveitis. Endotoxin mediates the activation of inflammatory cell and the damage of tissue. Toll like receptor 4 is the primary signal receptor of endotoxin lipopolysaccharide recognition and cell activation. The activation of Toll like receptor 4 signal pathway which results in the activation of related inflammatory cytokines and the inflammatory reaction in the anterior segment of the eye plays a key role in the pathogenesis of EIU. The discovery, methodology, pathological characters and inflammatory pathways as well as the blocking mechanism of these models were introduced in this paper. Furthermore, the research and application prospects of the model were discussed.