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Table of Content

    22 August 2017, Volume 41 Issue 4
    Recent advances of TSG-6 in ophthalmic diseases
    SUN Gao-yuan, WANG Qing-ping
    2017, 41(4):  217-221.  doi:10.3760/ cma.j.issn.1673-5803.2017.04.001
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    TSG-6 protein is a protective inflammatory factor, which plays the role of anti-inflammatory by binding to hyaluronic acid, chondroitin sulfate, or proteoglycan to mediate inflammatory cell migration and adhesion, and then participate the immune regulation and extracellular matrix remodeling. Recombinant TSG-6 protein has been applied to a variety of disease models, and has shown a broad and strong inhibition of inflammation. Recent studies have found that TSG-6 not only can directly ameliorate the pathologic manifestation of various ophthalmic diseases, but also can act as the media of the stem cells to inhibit inflammatory responses. This suggests that TSG-6 may be a therapeutic target for ophthalmic diseases, with a potential clinical value for clinical application.

    Application of cross-linked or reticulated hyaluronate in glaucoma surgery
    TIAN Kun, ZHONG Hua
    2017, 41(4):  222-225.  doi:10.3760/ cma.j.issn.1673-5803.2017.04.002
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    Scar tissue deposition, which results in fibrosis of the formatted functional structures such as bleb, is the most frequent cause of glaucoma operation’s failure. Although antifibrotic agents such as mitomycin C and 5-fluorouracil have significantly improved the efficacy of the operation, concerns remain regarding the potential increases in postoperative complications. Various novel or newer pharmacological substances have been developed in recent years with different ways to modulate the wound healing after the surgery, of which cross-linked or reticulated hyaluronate appears particular attractive. It is suggested that the mechanisms of scare formation-minimizing effect of cross-linked or reticulated hyaluronate are largely attributed to its space-occupying and inherent anti-inflammatory properties directly and indirectly, and the cross-linked format confers it with a slower degrading time. The preliminary results of its clinical application in glaucoma surgery are promising in term of both controlling intraocular pressure and decreasing postoperative complications.

    Corneal interface fluid syndrome
    LIN Ke-jie, TONG Yi
    2017, 41(4):  226-231.  doi:10. 3760/ cma. j. issn.1673-5803. 2017. 04. 003
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    Corneal interface fluid syndrome is the aqueous infiltration into the interstitial space between corneal stroma, so that the stroma separation, which causes vision loss. The cause of this disease is any reason  that leads to the intraocular pressure (IOP) increasing or endothelial cell dysfunction, and then the corneal edema and corneal interface fluid after laser lamellar corneal refractive surgery. The main clinical features such as the stromal scar with interface haze is similar to diffuse lamellar keratitis, increased IOP in the central of cornea may be hidden. It was easily misdiagnosised and missed diagnosis in clinical. The AS-OCT examination can determine the diagnosis. With early diagnosis and accurate treatment, its prognosis is good.

    Research progress in video display terminal related dry eye
    GAO Yi-chen, YANG Rui-bo, ZHAO Shao-zhen
    2017, 41(4):  232-236.  doi:10.3760/ cma.j.issn.1673-5803.2017.04.004
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    Video display terminal (VDT) related dry eye, which can impair eye health significantly and has become one of the main clinical subdiseases in Ophthalmology. The pathogenesis of VDT related dry eye is complicated, involving mechanical and non-mechanical mechanisms. The mechanical mechanism is mainly related with the blink movement. It includes the reduction of complete blink, increase of incomplete blink, and increase of ocular surface exposed area.  Non-mechanical mechanisms include ocular surface inflammation, decrease of mucin concentration and lacrimal gland function. The specific examination of VDT related dry eye haven't been elucidated, and the clinical recommendation is to use the questionnaire combined with symptoms and routine dry eye examinations to diagnose this disease.

    Role of plasmacytoid dendritic cells on pathogenesis of diabetes-related dry eye
    YAO Pan-pan, LI Bing, SHENG Min-jie
    2017, 41(4):  237-244.  doi:10.3760/ cma.j.issn.1673-5803.2017.04.005
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    Dry eye has become an increasingly common ophthalmic disease, and diabetes mellitus is one of its high risk factors. In recent years, people pay much attention to diabetes-related dry eye. The two diseases are both related to the immune system disorders. A large number of studies at home and abroad have proved that plasmacytoid dendritic cells play an important role in the regulation of immune inflammatory response. It can not only connect congenital immunity and adaptived immunity, but also has the ability to innate the immune inflammatory response. While its immune dysfunction will lead to immune disorders, triggering a series of immune inflammatory cascade reaction. Therefore, plasmacytoid dendritic cells may play a prominent role in immune pathogenesis of diabetes-related dry eye.

    Impact of tear film dynamic changes on the visual quality
    ZHENG Xiao-hong, ZHAO Shao-zhen
    2017, 41(4):  245-250.  doi:10.3760/ cma.j.issn.1673-5803.2017.04.006
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    The dynamic changes of tear film in morphology include the changes in the tear film thickness, lipid layer and pattern of tear film break up. Dry eye is often accompanied with the symptom of visual disturbance. The impact of the tear film on the quality of the retinal image depends greatly on the homogeneity of the tear pellicle. We reviewed the studies assessing the effect of tear film dynamic changes on the optical quality by serial measurement of high order aberrations (HOA) and forward light scatter using Hartmann-Shack wavefront sensors and Optical Quality Analysis Systems (OQAS) in a noninvasive and quantitative fashion on healthy and dry eye patients during steady gaze after a blink as well as post the application of artificial tears. Results showed that the optical quality might deteriorate in clinically asymptomatic subjects when suppressed blinking, the variation of the temporal changes in ocular HOA and objective scatter index (OSI) shared similar features with symptomatic dry eye. The dynamics of tear film change are accelerated in dry eye, both HOA and OSI are significantly greater than those in normal eyes. After long term artificial tears instillation, the postblink optical quality is significantly improved due to the improvement in tear stability. Serial measurements of the optical quality can reflect temporal changes in  the tear film, having the potential applications for detecting preclinical phase of dry eye disease in asymptomatic subjects.

    Risk factors of meibomian gland dysfunction
    YAO Bang-tao, DONG Zhao-yang, ZHAO Xiao-gui, WANG Bei
    2017, 41(4):  251-254.  doi:10.3760/ cma.j.issn.1673-5803.2017.04.007
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    Meibomian gland dysfunction ( MGD ) is a chronic disffuse abnorm ality of the meibomian glands,commonly characterized by terminnal duct obstruction and /or qualitative /quatitative changes in the glandular secretion. The risk factors are very complicated. Anything that influence the function of the meibomian gland can lead to MGD,such as local factor, medication, physical condition, congenital disease and so on. Therefore, the risk factors should be concerned in clinic, which can help doctors to treat the MGD pointedly.

    Advances in etiology of immunorelated keratitis
    YAN Lu1, DING Lin2
    2017, 41(4):  254-258.  doi:10.3760/ cma.j.issn.1673-5803.2017.04.008
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    Because of the rapid progression, recurrent, persistent and complex etiology of immunorelated keratitis, which leads to the difficulty of clinical treatment, it is becoming a hot issue for the majority of ophthalmologists. With regard to the etiology of this disease, autoimmune factors, inflammatory reaction, surgical operation has become well-known. In recent years,there are some new factors such as abnormal morphology of meibomian gland, Dolosigranulum pigrum infection, congenital abnormal anatomy factors can also lead to the occurrence of the disease, which provides a new direction for the prevention and treatment of immunorelated keratitis.

    Treatment for keratoconus
    HOU Si-meng, ZHOU Yue-hua
    2017, 41(4):  259-265.  doi:10.3760/ cma.j.issn.1673-5803.2017.04.009
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    Keratoconus is a bilateral disease of cornea characterized by progressive thinning, bulging, and distortion of the cornea. However, there were not systematic review of all kinds of treatments.  The clinical managements of the keratoconus in current include rigid contact lens, penetrating keratoplasty, deep anterior lamellar keratoplasty, intrastromal corneal ring implantation and corneal crosslinking and several combined surgerys.

    Drug therapy for strabismus
    WANG Jia-nan, AI Li-kun
    2017, 41(4):  265-269.  doi:10.3760/ cma.j.issn.1673-5803.2017.04.010
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    Drug therapy is one of the main techniques of strabismus treatment. Drugs improve eye alignment primarily through changing the strength of extraocular muscles. Currently, drug in research for the treatment of strabismus, includes botulinum toxin, bupivacaine, ricin-mAb35, insulin-like growth factors and so on. Mechanisms of these drugs, side effects and clinical applications are different. This article mainly focuses on the mechanisms, side effects and clinical practice of different drugs used for strabismus, in order to find out future research directions.

    Advance in changes of pathogens and treatment of acute endophthalmitis after cataract surgery
    Taraprasad Das1, Savitri Sharma2, LIU Fang3
    2017, 41(4):  270-274.  doi:10.3760/ cma.j.issn.1673-5803.2017.04.011
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    Endophthalmitis after cataract surgery is a serious complication that leads to blindness. In recent years, there have been new changes in pathogenic bacteria. In India and China, there are many infections caused by Gram-negative bacteria and fungi. At the same time, the resistance of bacteria to antibiotics is also increasing. A continuous research and periodic evaluation of the current practice against the new evidences is necessary for a safe cataract surgery.

    Endophthalmitis after cataract surgery
    CHU Hui-ming, QI Yan-hua
    2017, 41(4):  275-279.  doi:10.3760/ cma.j.issn.1673-5803.2017.04.012
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    Endophthalmitis, as an exogenous endophthalmitis, is one of the most serious postoperative complications of cataract surgery. It is caused mainly by bacterial and fungal infections. Understanding and mastering the risk factors of endophthalmitis after cataract surgery is of important clinical significance for the prevention and treatment of the disease. A timely diagnosis is crucial for the recovery of vision. Currently, intravitreal injections have become a major treatment option, and there is no consensus on whether systemic use of antibiotics is beneficial.

    Surgery managment of traumatic lens subluxation
    LIU Jing-jing, ZHANG Feng-yan
    2017, 41(4):  280-284.  doi:10.3760/ cma.j.issn.1673-5803.2017.04.013
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    Eye trauma is one of dominant factors of lens dislocation. In clinic, traumatic lens subluxation which result in serious complication and low vision should be treated by surgery. The skills of capsulorhexis, the usage of devices which could support capsular, the surgical skills of phacoemulsification and posterior capsule rupture, the usage of intraocular lens and so on should be concerned during the operation. It is a challenge for ophthalmologist to deal with the traumatic lens subluxation, and it provides many choices as well. Choosing the best surgery method, continuing refinement of surgical skills and appropriate adjunctive prosthetic devices will improve the operational success.

    Research progress on psychological status and quality of life in patients with age-related macular degeneration
    XIONG Xiao-jing, WU Ming-xing, ZHOU Xi-yuan
    2017, 41(4):  285-288.  doi:10.3760/ cma.j.issn.1673-5803.2017.04.014
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    Age-related macular degeneration (AMD) is the primary cause of the blindness of the elderly, among the population aged more than 50 years old. AMD remains prevalent among older adults despite the advances in its prevention and medical treatment options. Resulting in functional losses that negatively affect the mental health of older adults,leading to serious mental health problems. In particular, the prevalence of both anxiety and depression in patients with AMD is high. Along with medical treatment options, low vision rehabilitation and AMD-specific behavioral and self-management programs have been developed and have demonstrated effectiveness in improving the mental health of AMD patients.