Table of Content

22 April 2018, Volume 42 Issue 2

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Incidence, risk factors and blindness rate of acute primary angle-closure glaucoma

LIN Si-geng1, LIN Zhou-qiao2, LIANG Yuan-bo1, QU Jia1

2018, 42(2):  73-77.  doi:10.3760/cma.j.issn.1673-5803.2018.02.001

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Prevalence of primary angle closure glaucoma (PACG) is higher in Asia. The incidence of acute primary angle-closure glaucoma (APACG) in Asia is higher than in the Euro-American countries. These studies proved that APACG has a strong association with gender, age, race and ocular anatomy. The incidence in APACG is from 2.0/100000 to 8.3/100000 in Europe and America, and from 10.4/100000 to 12.2/100000 in Asian countries. The incidence in female were more than this in male, and the incidence increased with age. The prevalence of blindness in PACG was higher than that in primary open angle glaucoma. In addition, the blindness rate of APACG was related to duration of symptoms before presentation. Therefore, there is great clinical implication to explore the way to reduce the blindness caused by APACG.  (Int Rev Ophthalmol, 2018, 42: 73-77)

Research progress on canaloplasty

ZHANG Jun1, WANG Huai-zhou2, WANG Ning-li2.

2018, 42(2):  78-82.  doi:10.3760/cma.j.issn.1673-5803.2018.02.002

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As a non-penetrating glaucoma surgery (NPGS), canaloplasty aims to restore the physiological outflow by dilating the Schlemm’s canal, thus facilitating aqueous outflow to treat glaucoma. Evolving from traditional canaloplasty, ab-interno canaloplasty (ABiC) is a new minimally invasive glaucoma surgery (MIGS) procedure that can comprehensively restore the natural outflow pathways in patients with mild-to-moderate primary open angle glaucoma. Canaloplasty represent a truly effective and excellent safety profile for reducing intraocular pressure with or without combining with other surgeries. Canaloplasty is non-bleb related with no filtering blebs which were detected a low rate of bleb-related complications such as scar formation and encapsulation. Canaloplasty has satisfactory intraocular pressure lowering effects in high efficiency and security. (Int Rev Ophthalmol, 2018, 42: 78-82)

Corneal biomechanics in glaucoma patients

WANG Rui, TANG Xin, YANG Jin, YIN Ze-lin, TIAN Xiao-feng.

2018, 42(2):  83-87.  doi:10.3760/cma.j.issn.1673-5803.2018.02.003

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In the clinical, the visual field defect of patients with ideal intraocular pressure is continued to progress, but in some patients the progress of the disease can be delayed even if the intraocular pressure cannot be significantly reduced. Therefore, the differences of individual sensitivity of the patient to the intraocular pressure determine the development of glaucoma. The collagen fibers of cornea and sclera which have similar compositions are connected to each other, and the corneal's Descemet top layer extends to form the core of the trabecular meshwork collagen. Therefore, corneal biomechanic is the first factor of the whole eyeball’s biomechanical properties. With the high pressure, the elastic tissues such as the cornea are less able to withstand deformation, leading to the compression of lamina cribrosa and the damage of visual field. The differences of the individual corneal biomechanic may explain the differences in the sensitivity of the optic nerve to intraocular pressure. This paper reviews the relationship between corneal biomechanic and glaucoma diagnosis, progression and treatment, in order to providing guidance for clinic. (Int Rev Ophthalmol, 2018, 42: 83-88)

Femtosecond laser-assisted complicated cataract surgery

XIE Dan-dan, DU Shan-shan, ZHANG Feng-yan.

2018, 42(2):  88-92.  doi:10.3760/cma.j.issn.1673-5803.2018.02.004

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Femtosecond laser-assisted cataract surgery (FLACS) is a new technology that has the potential to improve cataract surgery. Studies have shown that compared with phacoemulsification cataract extraction (PCS), FLACS greatly improves overall accuracy, predictability, and safety, minimizing intraocular manipulation time and damage to intraocular tissues. With the mastery of this technology, FLACS is gradually used in complex cataract patients such as: traumatic anterior capsular laceration, lens subluxation, small pupil, hard nucleus, etc., and has achieved very good clinical results and has received increasing attention. (Int Rev Ophthalmol, 2018, 42: 88-92)

Research of intraocular lens power calculation in cataract surgery for high myopia

QIU Wei, WU Qiang.

2018, 42(2):  93-97.  doi:10. 3760/cma. j. issn.1673-5803. 2018. 02. 005

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High myopia is due to the gradual increase of diopter and the continuous extension of the eye axis, which leads to many pathological changes and the progressive decline of visual function. Patients with long axis eyes were more vulnerable to cataracts. With the updating of the IOL calculation formula, the A constant introduces more variables to better evaluate ocular biological datas. Cataract surgery is not only sight restoring surgery, but also refractive surgery. Suitable Intraocular lens (IOL) calculation formulas is very important to the postoperative visual quality. The Haigis formula was more accurate to predicting intraocular lens in long axis cataract than third generation formula. At present, it is still undecided whether the Holladay 2 formula was more accurate than the other third generation formulas. (Int Rev Ophthalmol, 2018, 42: 93-97)

Application of pupil expansion device in small pupil cataract surgery

WANG Jin-da, WAN Xiu-hua

2018, 42(2):  98-101.  doi: 10.3760/cma.j.issn.1673-5803.2018.02.006

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The pupil expansion device can assist small pupil cataract surgery. Currently several pupil expansion device are used in clinic, such as Morcher pupil dilator, Graether pupil ring, Perfect pupil device, Siepser pupil ring, Malyugin ring and OASIS iris expander, etc. Along with the continuous improvement of its design and use of skills, the pupil expansion device is considered a good method because of the light injury and good auxiliary function during small pupil cataract surgery.  (Int Rev Ophthalmol,  2018,  42:   98-101)

#br# Recent advances in drug delivery to the posterior segment of the eye

ZHAO Qiu-ya, DU Lei, LONG Ting, XING Yi-qiao.

2018, 42(2):  102-106.  doi:10. 3760/cma. j. issn.1673-5803. 2018. 02. 007

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Ocular posterior segment diseases always lead to serious vision loss or even blindness. The treatment of these visually devastating diseases require delivering therapeutic dose of the drug to the posterior segment. However, the effective delivery remains a significant challenge due to the special structure of the eye. The drug delivery methods used in clinical have poor efficacy, complications and other disadvantages. In order to achieve safer and more effective drug delivery to the posterior segment of the eye, advanced methods such as nanocarrier, in situ gel, intraocular implants and microneedles have been extensively studied, which are promising therapies for the treatment of posterior segment eye diseases. Some administration methods, such as intravitreal implants, have been used in clinic.(Int Rev Ophthalmol, 2018, 42: 102-107)

Treatment progress of central serous chorioretinopathy

YAO Mu-di, ZHANG Xiao-pei, YAO Jin

2018, 42(2):  107-110.  doi:10.3760/cma.j.issn.1673-5803.2018.02.008

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Central serous chorioretinopathy (CSCR) is a self-limiting disease characterized by serous retinal detachment, and choroid and retinal pigment epithelium (RPE) dysfunction. Most of acute and chronic CSCR require treatment. At present, the main treatment methods include laser, surgery, medicine and gene therapy. (Int Rev Ophthalmol, 2018, 42: 107-110)

Foldable capusular vitreous body

XUE Chao, WANG Yan.

2018, 42(2):  111-114.  doi:10.3760/cma.j.issn.1673-5803.2018.02.009

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Foldable artificial vitreous is a new vitreous substitute for simulating vitreous cortex. It consists of a capsular bag, a drainage tube and a drainage valve. The basic material of capsular bag is polysiloxane elastomer, which can be filled with normal saline, silicone oil or hydrogel. Some studies have evaluated its effectiveness and safety in vitrectomy, and it is expected to become a drug delivery system. However, the composition of its material needs further improvement, and the effect of long-term application needs further observation.(Int Rev Ophthalmol, 2018, 42: 111-114)

Research progress of pyroptosis in retinal lesions

PENG Jia-yuan, WU Ai-lin, HAN Bin, YU Xiao-ping

2018, 42(2):  115-118.  doi:10.3760/cma.j.issn.1673-5803.2018.02.010

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Pyroptosis is a form of inflammatory programmed cell death that is specifically activated by Caspase
-1 or Caspase-4/5/11. It is mediated by canonical inflammasome pathway and non-canonical inflammasome pathway.Pyroptosis involves in the pathogenesis of infectious diseases, nervous system diseases and autoimmune diseases. The canonical inflammasome pathway is activated in retinal lesions, and inhibition of inflammasome and downstream molecules may ameliorate retinal damage. Therefore, pyroptosis has become a potential therapeutic target for retinopathy.  (Int Rev Ophthalmol, 2018, 42: 115-118)

The role of heterogeneity of macrophages in retinal neovascularization

WANG Ya-fen, GUO Chang-mei

2018, 42(2):  119-124.  doi:10.3760/cma.j.issn.1673-5803.2018.02.011

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Retinal vascular diseases are a kind of blindness-caused diseases which etiology and pathogenesis are complex and not yet clear. Its main pathophysiological feature is retinal neovascularization. A large number of basic researches and clinical evidences confirm that macrophages (MФ) and their subtypes play an important role in retinal neovascularization. Macrophages can be divided into two classes: M1-polarized phenotype and M2-polarizedmacrophages (‘classically activated, pro-inflammatory’ and ‘alternatively activated, immunosuppressive’), and M2 macrophages can be subdivided into three types according to different stimulus signals and functions: M2a, M2b, M2c. However, the role of distinct subtypes of macrophages in the development of retinal neovascularization remains controversial. Therefore, it is crucial for the pathogenesis and clinical treatment of retinal neovascularization to clarify the specific role of different subtypes of macrophages. This review mainly summarizes different roles of macrophages and its subtypes in retinal neovascularization. (Int Rev Ophthalmol, 2018, 42: 119-124)

Tear collection methods and virology and cytokine studies in tears of HIV/AIDS

QIAN Yu-jing, WEI Wen-bin

2018, 42(2):  125-128.  doi:10.3760/cma.j.issn.1673-5803.2018.02.012

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In the study of HIV-associated ocular disease, tears are useful tools with many advantages including easy to collect and analyze, and of great research value. At present, the tear collection methods which have been successfully applied to HIV/AIDS researches including reflective tear collection, capillary glass siphon collection and Schirmer test paper collection, and other approaches learned from various areas (such as tear flushing collection). Furthermore, virological characteristics and cytokine analysis, which are two major aspects involved in the study of tears of HIV/AIDS patients. Qualitative and quantitative studies can clarify the infectiousness of HIV virus in tears and explore the HIV reservoirs. By studying the level of cytokines in tears, it is helpful to understand the pathogenesis and clinical features of HIV virus in eyes. Tears in HIV/AIDS patients contain only a very small amount of HIV virus infection dose, so the risk of HIV infection through tear contact is very small. But it is speculated that the lacrimal gland and tear related tissues may be another repository of HIV virus. (Int Rev Ophthalmol,  2018,  42:   125-128)

Adjunctive drugs on preventing recurrences of pterygium

YIN Ming-yang, PAN Zhi-qiang

2018, 42(2):  129-133.  doi:10.3760/cma.j.issn.1673-5803.2018.02.013

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Pterygium recurrence is one of the most common complications in pterygium surgery. And various medicines combined with surgery could further reduce the rates of recurrence. As traditional adjunctive therapies, anti-metabolic drugs have been applied to prevent the recurrence of pterygium for decades. However, mitomycin C has been not available  because of its shortage source, and 5-fluorouracil is less effective. Recently, some medicines such as anti-vascular endothelial growth factor agents, cyclosporine A and interferon, characterized by anti-proliferation and anti-angiogenesis, provide  new approaches to prevent the recurrence of pterygium. However, the high costs of above medicines and uncertain long-term effects are still huge problems. (Int Rev Ophthalmol,  2018,  42:   129-133)

Progress and prospect of acupuncture in the treatment of dry eye from 2007 to 2017

XU Man-shan, MA Xiao-yun

2018, 42(2):  134-138.  doi:10. 3760/cma. j. issn.1673-5803. 2018. 02. 014

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 The Acupuncture treatment for dry eye is constantly developing no matter in the therapies or the mechanism research. The mechanism of acupuncture in treating dry eye is to improve neural regulation, promote mucin expression, inhitite cell apoptosis, regulate the levels of sex hormone. The methods of acupuncture include peri-ocular acupuncture therapy, integrated acupanture therapy, special acupoint selection therapy, empirical acupuncture, etc.

 (Int Rev Ophthalmol, 2018, 42: 134-138)

Effect of cycloplegics on ocular tissue

HAO Jun-sheng1, JIA Shao-you2

2018, 42(2):  139-144.  doi:10.3760/cma.j.issn.1673-5803.2018.02.015

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Cycloplegics as M cholinergic receptor blocker, results temporarily in paralysis of accommodation and mydriasis, and also increases in central corneal thickness, corneal volume, anterior chamber depth and anterior chamber volume and higher-order aberrations. It can decrease the thickness of lens, ciliary body, choroid. It also makes diopter changes. There are some differences of those changes in different age, sex, type of refraction and different preparations. Cycloplegic agents in clinic are generally safe, although its effect on ocular tissue is temporary. To understand the changes of ocular morphology and biological parameters before and after cycloplegia will have a positive impact on the clinical diagnosis and treatment.(Int Rev Ophthalmol,  2018,  42:   139-144)