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    22 June 2018, Volume 42 Issue 3
    Research progress on drusen in age-related macular degeneration
    WANG Shi-hui, DAI Le-shu, SONG Jian-tao
    2018, 42(3):  145-148.  doi:10.3760/cma.j.issn.1673-5803.2018.03.001
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    Drusen is early sign of age-related macular degeneration (AMD). Recent studies have suggested that formation of drusen is related to accumulation of lipoprotein in the Bruch’s membrane, which resulted in damage of retinal pigment epithelium cells by toxic intermediates, leading to apoptosis. Drusen can be classified into three categories according its diameter, i.e., hard (less than 63 μm), moderate (63~125 μm) and soft (greater than 125 μm, also known as large drusen). Large-scale drusen is an important risk factor for AMD, and the presence of a large number of rigid small drusen can be seen as an early sign of AMD.(Int Rev Ophthalmol, 2018, 42:  145-148)

    The role of periostin in the pathogenesis of vitreoretinal diseases
    LIU Shu-jing, WAN Guang-ming
    2018, 42(3):  149-153.  doi:10.3760/cma.j.issn.1673-5803.2018.03.002
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    Periostin, a secretory extracellular matrix protein that is expressed in a variety of tissues and organs, regulates cell movement by binding with integrin αvβ1, αvβ3 and αvβ5. It plays an important role in tissue development and remodeling. Periostin can induce angiogenesis and the deposition of extracelluar matrixes such as collagens and fibronectin, participating in a variety of physiological and pathological processes of fibrosis. Proliferative vitreoretinopathy, proliferative diabetic retinopathy and age-related macular degeneration are characterized by the formation of fibrous membranes in the vitreous or above and beneath the retina. There is an association between periostin and the formation of fibrous membrane and angiogenesis in vitreoretinal diseases.(Int Rev Ophthalmol, 2018, 42:  149-153)

    Neurological inflammation and diabetic retinopathy
    XUE Sheng-ding, YU Ying, CHEN Hui
    2018, 42(3):  153-158.  doi:10.3760/cma.j.issn.1673-5803.2018.03.003
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    Diabetic retinopathy (DR) is a retinal vascular disease caused by hyperglycemia. Neuroinflammation plays an important role in the pathogenesis of DR. In the hyperglycemic environment, some retina glial cells and neurons can release various inflammatory mediators, causing the up-regulation of inflammatory mediators, thus causing retina neuroinflammation in diabetic patients. Electrophysiological changes in the neuroretina happen prior to fundus microvascular lesion, suggesting neuroinflammation may become a new drug target for the prevention and treatment of DR. Drugs that inhibit neuroinflammation include minocycline, hesperetin, cannabidiol, aspirin and salicylate, aldose reductase inhibitors and so on. (Int Rev Ophthalmol, 2018, 42:  153-158)

    Factors affecting the post-operative closure rate and visual function of idiopathic macular hole
    WANG Ying,HAN Quan-hong
    2018, 42(3):  159-163.  doi:10.3760/cma.j.issn.1673-5803.2018.03.004
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    Idiopathic macular hole(IMH) is one of the common fundus diseases that cause central vision loss in patients. In recent years, with the advancement of surgical techniques,the postoperative closure rate improved gradually. The postoperative visual function was influenced by many factors, such as the height of macular hole(H), base diameter(BD), minimum linear diameter (MLD), preoperative hiatal morphology, operation method, hole-closed mophology and macular structure etc. Intraoperative factors, such as internal limiting membrane peeling, inner membrane flap and staining methods can also affect the closure rate and visual outcome.(Int Rev Ophthalmol, 2018, 42:  159-163)

    The research of visual plasticity related genes in amblyopia
    CAO Zhao-xia1.2, LIU An-guo1, YAN Xing-ke1, MA Chong-bing1, LI Xiao-juan1, WEI Yu-ting1
    2018, 42(3):  163-168.  doi:10.3760/cma.j.issn.1673-5803.2018.03.005
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    Some genes such as anti-apoptotic genes (Bcl-2, Bax), immediate early genes (c-jun, c-fos), visual plasticity neurotransmitter related genes (N- methyl-D-aspartic acid receptor, NMDAR-1 subunit gene), visual plasticity neurotrophic factors related genes (Neuritin mRNA, GDNF mRNA, BDNF mRNA, GAP-43 mRNA), PTPσ mRNA, β-catenin mRNA and so on  may be closely related to the onset of amblyopia. Bcl-2 and Bax may participate in the pathogenesis of amblyopia by regulating the survival of the related neurons in the visual system. C-jun and c-fos can alter the transcriptional activity of the target gene and regulate the functional state of the cortical neurons after entering the nucleus of neurons. NMDAR-1 subunit gene of the aspartate receptor is located in the postsynaptic membrane, which regulates the plasticity of the synapses in the visual cortex by regulating the expression level of different subunits. The neuritin mRNA encodes a kind of active molecule, which can promote the growth of dendrites and regulate the visual system. GDNF mRNA exists in the visual cortex and lateral geniculate body, which protects and repairs neurons after various injuries. It can regulate visual development by influencing the transcription of the normal development process of the visual system. BDNF mRNA regulates the plasticity of synaptic development in nervous system. The PTPσ mRNA and β-catenin mRNA are involved in the termination of the critical stage of visual cortex and the process of plasticity reactivation in the visual cortex of adult rats.(Int Rev Ophthalmol, 2018, 42:  163-168)

    Indications for botulinum toxin and bupivacaine injection to extraocular muscle for treating strabismus
    GUO Yi-qin, AI Li-kun
    2018, 42(3):  169-174.  doi:10.3760/cma.j.issn.1673-5803.2018.03.006
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    Compared to strabismus surgery, extra ocular muscle injection is a safer, more acceptable and less invasive way of treatment, which requires less anesthesia time and results in less pain. Nowadays, botulinum toxin has the most extensive clinical use for reducing muscle strength, especially in cases of small-angle strabismus, post squint surgery care, strabismus after nasal endoscopic surgery. Bupivacaine is able to strengthen muscle,providing treatment for small-angle concomitant strabismus and early paralytic strabismus. Combination injection of bupivacaine and botulinum toxin can be used to treat medium horizontal concomitant strabismus and early-onset paralytic strabismus.(Int Rev Ophthalmol, 2018, 42:  169-174)

    EphA2 gene and congenital cataract
    YANG Pei-yao1, ZHAO Jun2
    2018, 42(3):  174-178.  doi:10.3760/cma.j.issn.1673-5803.2018.03.007
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    Congenital cataracts are mainly caused by gene mutations affecting lens development. The EphA2 gene is located in the human chromosome 1p36. It encods EphA2 tyrosine kinase receptor, which is a specific kinase receptor in mammalian cells and expressed in many human tissue cells. The EphA2 tyrosine kinase receptor is related to numerous biological processes of the lens, such as intercellular communication between lens cells and the stability of the protein structure in the lens cells. The EphA2 SAM domain is responsible for orderly recruiting proteins in lens fiber cells, which is essential for regulation of cell migration. Furthermore, the normal assembling of EphA2/ephrin signaling complexes is prerequisite for the longitudinal alignment of lens fiber cells. The lens remains transparent only if the fiber cells are stable and arranged regularly, otherwise, congenital cataract is formed.(Int Rev Ophthalmol, 2018, 42:  174-178)

    The effects of strabismus on binocular vision and postoperative rehabilitation
    ZHANG Rong-han, FU Jing
    2018, 42(3):  179-183.  doi:10.3760/cma.j.issn.1673-5803.2018.03.008
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    There are many necessary factors affecting human stereoscopic vision, and the alignment of both eyes is the most critical one. Strabismus destroying the normal alignment between both eyes, leading to the loss of the stereopsis. At the same time, loss of stereopsis and fusion means worse control of the eyes, accelerting the deviation, leading to a vicious cycle. The main treatment of strabismus is surgery. Through surgery, most patients get orthotropia, but quite a portion of them could not get normal binocular function. A few of them even encounter the recurrence of strabismus in a short term after the operation because of the deficiency of binocular visual function. Thus, the goal of strabismus treatment is not only to achieve normal orthotropia after surgery, but also the recovery of binocular vision, which is fundamental.We can use binocular function training programs to help patients get better binocular vision. Postoperative rehabilitation training methods mainly include synoptophore training, fusion ability training, computer software training, and visual perception testing and training system. Human brain possesses plasticity through our whole life. By utilizing this, we could help those patients after surgery to regain their stereopsis,and better control of the eyes to maintain orthotropia.(Int Rev Ophthalmol, 2018, 42:  179-183)

    Visual quality in posterior chamber phakic intraocular lens implantation
    CHEN Xuan-zhi1, SUN Kang2
    2018, 42(3):  184-188.  doi:10.3760/cma.j.issn.1673-5803.2018.03.009
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    Many scientific literatures about subjective(visual acuity,contrast sensitivity) and objective visual quality(wave front aberration, point spread function,Strehl ratio and modulmion transfer function) showed that the improvement of subjective visual acuity after phakic intraocular lens implantation was accompanied by the improvement of objective visual quality. However, the complications, such as anterior subcapsular cataract, glaucoma and decomposition of corneal endothelium needed long-term follow-up.(Int Rev Ophthalmol, 2018, 42:  184-188)

    Risk factors of dry eye
    DU Juan, LIANG Qing-feng
    2018, 42(3):  189-193.  doi:10.3760/cma.j.issn.1673-5803.2018.03.010
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    Dry eye is one of the most common diseases in ophthalmology. Its pathogenesis is complicated. The risk factors of dry eye include the eye disease related factors, such as refractive surgery, pterygium, diabetes, and graft-versus-host disease, etc; environment related factors, such as low humidity environment, ultraviolet irradiation, dry climate, plateau hypoxia, etc; nutrient related factors, such as essential fatty acid and vitamin A deficiency; sex hormone related factors; lifestyle related factors, such as video terminal use and contact lenses wearing, etc.(Int Rev Ophthalmol, 2018, 42:  189-193)

    Phenotypic transformation of corneal stromal cells and prevention of scar formation
    ZHANG Lu, LI Yan, HU Zhu-lin
    2018, 42(3):  194-198.  doi:10.3760/cma.j.issn.1673-5803.2018.03.011
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    Corneal stromal cells(CSCs), normally in a static state, are prone to change in phenotype and physiological functions when damaged. They can transform into fibroblasts or myofibroblasts. Different injury factors affect the response of corneal cells and determine whether corneal tissue is repaired completely or to form scar tissue. CSCs can synthesize and secrete a variety of extracellular matrix. Activated CSCs are beneficial to repair corneal injury. Corneal myofibroblast may cause turbidity of corneal surface. Injury, infection of bacteria or virus and other factors lead to scarring. Platelet rich plasma, TGF-β and other physicochemical factors play an important role in phenotypic transformation of CSCs, clinical treatment and prevention of corneal scar tissue.(Int Rev Ophthalmol, 2018, 42:  194-198)

    Research in imaging of conjunctival microcirculation
    WEI Rong, GAO Gui-ping, SHAO Yi
    2018, 42(3):  199-203.  doi:10.3760/cma.j.issn.1673-5803.2018.03.012
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    Microcirculation refers to arterioles, veins and capillaries circulation and lymph circulation, is a central part of the circulatory system. The microvascular morphology assessment and quantitative analysis of the dynamic circulation plays an important role in understanding disease pathophysiology and monitoring microvascular treatment. Bulbar conjunctiva microcirculation is closely related with a variety of eye diseases. Now the conjunctival microvasculature may be measured and analyzed using light microscope, electron microscope, laser scanning confocal microscope, optical coherence tomography angiography, retinal function imager, orthogonal polarization spectral, functional slit lamp biomicroscope, etc.(Int Rev Ophthalmol, 2018, 42:  199-203)

    Measurements and clinical applications of peripheral vision
    CHEN Zhi-peng, YU Min-bin, LV Zhong-lin, LI Jin-rong
    2018, 42(3):  204-208.  doi:10.3760/cma.j.issn.1673-5803.2018.03.013
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    Peripheral vision, representing perceptual function of the peripheral retinal region, plays a significant role in our daily life and in clinic. Recently, the rapid progression in psychophysics, EEG and fMRI has made peripheral vision psychophysical tests more rapid and accurate, such as the peripheral contrast sensitivity function test. Peripheral vision is closely associated with diseases,such as glaucoma, myopia and amblyopia. The clinical applications of peripheral vision are mainly reflected in following, the early diagnosis and detection of diseases like glaucoma, the low vision recovery of patients with central vision defect, perceptual learning of patients with paracentral fixation, and the control of myopia progression etc.(Int Rev Ophthalmol, 2018, 42:  204-208)

    Three-dimension (3D) technology applied in ophthalmic microsurgeries
    HOU Si-meng, ZHANG Jing-shang, WAN Xiu-hua
    2018, 42(3):  209-212.  doi:10.3760/cma.j.issn.1673-5803.2018.03.014
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    In recent years, three-dimension (3D) technology is gradually applied to ophthalmic microsurgeries, such as corneal transplantation surgery, anti-glaucoma surgery, cataract extraction surgery and vitreoretinal surgery. The 3D display has many advantages, such as improving surgeon ergonomics, reducing risk of retinal phototoxicity, real-time digital signal processing and offering more information for surgeries and so on. The disadvantages, including low resolution, frequent focusing or so, will be resolved by advancement of mathematics and digital signal module in the future. (Int Rev Ophthalmol, 2018, 42:  209-212)

    Ophthalmology robot technology
    ZHU Gu-yu, ZHANG Jing-shang, WAN Xiu-hua, MA Yao, MA Ke
    2018, 42(3):  213-216.  doi:10.3760/cma.j.issn.1673-5803.2018.03.015
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    In ophthalmology, medical robot surgery systems are mainly used in corneal transplantation, vitrectomy, retinal surgery, etc. For corneal transplantation, it can complete the two major steps of corneal drilling and suturing. In vitreoretinal surgery, it may involve in laser photocoagulation, vitrectomy and vitreous posterior detachment surgery, retinal surface foreign body removal and retinal vessel intubation and so on. In recent years, robotic systems have made breakthroughs in assisting cataract surgery.  (Int Rev Ophthalmol, 2018, 42:  213-216)