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Table of Content

    22 August 2018, Volume 42 Issue 4
    Diagnosis and treatment of advanced visual center injury
    LIU Jing-wen, WANG Jia-wei
    2018, 42(4):  217-222.  doi:10.3760/cma.j.issn.1673-5803.2018.04.001
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    Nervous system has strong plasticity, when the main visual processing area V1 damaged, projection through the corpus callosum and pulvinar to the parietal lobe and temporal lobe areas which are alternative visual pathways, will help patients recover part of the visual function. The specific areas of the ventral pathway of the visual center can be identified for the face, object or visual scene, and the dorsal pathway is selective for visual spatial positioning. Bilateral occipital lobe injury may present complete visual loss (cortical blindness), but patients are unable to recognize their defects. A person whose ventral pathway was impaired but had intact dorsal pathway perceived visual agnosia, refers to the basic aspects of vision (visual acuity, etc.) are complete but still does not recognize the visual information. Central hemiachromatopsia arises when a lesion in inferior occipital cortex diminishes or abolishes color vision in the contralateral hemifield. Impairment of angular gyrus and occipital lateral gyrus results in alexia without agraphia, as do not understand the words, not through the visual way of reading text, but can through auditory, kinesthetic, tactile and other sensory pathways to achieve the purpose of understanding the text. V1 damage can lead to "blindness". Only when the object moves, can the patient perceive it, but the color and shape can not be identified. Bilateral parietal lobe damage leads to the destruction of visual attention mechanism, patients are profoundly affected by an inability to disengage and shift their attention to various parts of a visual scene. Facial recognition core network damage causes human face recognition dysfunction, patients do not even recognize their faces, but can identify individuals through other characteristics. Visual cortex and midbrain damage can also lead to hallucinations. Further study and continuous improvement of bionic eye make it reality for blind to see light again.

    Roles of stroma cell-derived factor 1 and its receptor in ophthalmic diseases
    LIU Cang-cang 1, 2, CAI Yan2
    2018, 42(4):  223-226.  doi:10.3760/ cma.j.issn.1673-5803.2018.04.002
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    Stroma cell-derived factor (SDF-1), also known as CXC chemokine receptor 4 (CXCL12) chemokine, was first isolated from bone marrow stromal cells. CXCR4 receptor is a kind of polyhedral molecules which can be closely integrated with the SDF-1. SDF-1 and the receptor CXCR4 biological axis has an important role in mediating hematopoietic stem cell migration and homing, inflammatory reaction and the metastasis of malignant tumor. Researches confirmed that the SDF-1 / CXCR4 also expressed in normal eye tissue, and increaseed abnormally in the formation of ocular angiogenesis and the glial scar. In terms of angiogenesis of eye, SDF-1/CXCR4 provides an important target in the treatment of ocular angiogenesis disease. This article reviews the role of the SDF-1 and the receptor CXCR4  is closely related to a variety of  eye diseases, including pterygium, corneal transplant and corneal alkali burn, retinal proliferative diseases, optic nerve injury, ocular cancer and so on.

    Application of lentiviral transfection in ophthalmic diseases
    ZHANG Lu, LI Yan, HU Zhu-lin
    2018, 42(4):  227-231.  doi:10.3760/ cma.j.issn.1673-5803.2018.04.003
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    As a common vector transfection tool, lentivirus has become the first choice for gene therapy of ophthalmic diseases because of its advantages of high efficiency, large transgene, and stable integration in host cells, such as ocular neovascular diseases  applied to animal models, and retinal hereditary diseases, glaucoma, etc., have made some progress in research but have not been used clinically. The application of lentivirus focused on the ocular diseases such as Stargardt disease, diabetic retinopathy and corneal transplantation to lay the foundation for the study of the treatment of ophthalmic diseases through the regulation of gene expression.

    Effect of p38 MAPK signaling pathway on ophthalmic diseases
    WEN Hang, XIANG Min-hong, LI Qing-song
    2018, 42(4):  231-235.  doi:10.3760/ cma.j.issn.1673-5803.2018.04.004
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    p38 MAPK signaling pathway mediates the transmission of information between cells through protein phosphorylation mechanism, which plays an important role in the occurrence and evolution of various diseases in the whole body. Ophthalmological diseases are also an important "target" for the role of p38 MAPK signaling pathway. p38 MAPK signaling pathway induces inflammatory factors in conjunctival epithelial cells, participates in the metabolism of lens epithelial cells and apoptosis of retinal ganglion cells through the mechanisms of inflammatory response, immune injury, oxidative stress, cell apoptosis and other mechanisms, and mediates the retinal inflammation and participates in retinal neovascularization. p38 MAPK signaling pathway is closely related to dry eye, cataract, glaucoma and retinal diseases and so on. This provides new ideas and methods for effective diagnosis and treatment of ophthalmic diseases.

    Pericytes-related signaling pathways in retinal microvessels
    XIANG Dan-ni, YUAN Yuan-zhi
    2018, 42(4):  236-240.  doi:10.3760/ cma.j.issn.1673-5803.2018.04.005
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    Pericytes are a type of parietal cells that surrounding the microvascular endothelial cells and regulating the formation of neovascularization, vascular remodeling, wound healing and other physiological or pathological processes. In the development and progression of many ocular diseases,such as age-related macular degeneration, diabetic retinopathy and retinopathy of prematurity, pericytes play an important role with a malfunctioning of regulating retinal microvessels. Multiple molecular mechanisms,such as platelet derived growth factor(PDGF), angiopoietin (Ang), transforming growth factor-β (TGF-β), and Notch signal channel etc., responsible for the regulation of microvascular stability and angiogenesis have been studied. Change of one or more factors in these signaling pathways modifies the biological function of pericytes.

    Optical zone and effective optical zone after corneal refractive surgery
    HOU Jie, LEI Yu-lin, ZHENG Xiu-yun, WANG Yan
    2018, 42(4):  240-244.  doi:10.3760/ cma.j.issn.1673-5803.2018.04.006
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    The optical zone and effective optical zone have been proven as a significant factor in determining the outcomes of corneal refractive surgery. It have been evidenced that the occurrence of night vision symptoms such as glare and haloes were directly related to the effective optical zone reduced compared with the programmed ablation zone. As a area of corneal surface with a high level of optical quality, the accurate measurements and evaluation of the effective optical zone are very important. This not just guide the design of the surgery but evidently avoid the occurrence of surgical complications.

    Risk factors of primary glaucoma
    LI Bo-ai, YANG Jin
    2018, 42(4):  245-249.  doi:10.3760/ cma.j.issn.1673-5803.2018.04.007
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    The primary glaucoma is one of the common diseases causing blindness. The pathogenesis of primary glaucoma has not yet been clear. Primary glaucoma can be divided into primary angle-closure glaucoma(PACG) and primary open angle glaucoma(POAG). The risk factors of PACG include heredity, gender, age, intraocular pressure, trans-lamina cribrosa pressure difference, myopia, psychological and mental factors. The risk factors of POAG include heredity, gender, age, hypertension, intraocular pressure, ocular perfusion pressure, trans-lamina cribrosa pressure difference, hypothyroidism, retinal oxygen saturation, diabetes, smoking and height. Therefore, assessment of these risk factors is of great significance for early diagnosis and treatment of primary glaucoma.

    Structure of crystallin
    ZHANG Shao-hua, ZHANG Ke-ke, ZHU Xiang-jia, LU Yi
    2018, 42(4):  250-254.  doi:10.3760/ cma.j.issn.1673-5803.2018.04.008
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    The structure of proteins is closely related to their biological functions. In addition to the X-ray diffraction and nuclear magnetic resonance imaging methods, the application of cryo-electron microscopy has greatly promoted the development of structural biology. The protein concentration within human lens is the highest of any tissue in the body. Therefore, lens have the great advantage in the study of protein related research. Recent studies have revealed certain essential structural domains and related biological functions of crystallins. The spatial configuration of the lens protein is gradually progressing under the advancement of analytical techniques in structural biology.

    Risk factor and prevention of intraoperative floppy iris syndrome
    HUA Xia1, TANG Xin2, YUAN Xiao-yong
    2018, 42(4):  256-259.  doi:10.3760/cma.j.issn.1673-5803.2018.04.009
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    Intraoperative floppy iris syndrome (IFIS) occurs in 2% of cataract surgeries. Its occurrence is mainly related to the application of alpha 1 adrenergic receptor antagonist and some antihypertensive medications, and the genenal condition such as hypertension may also participate in it. In response to these already known risk factors, IFIS cases with iris floppy, progressive pupil reduction and self prolapsing from the surgical incisions, the combined application of a variety of techniques and treatments, as alpha 1 adrenergic activator, viscoelastic agent, iris retractor, pupil dilator and so on, would greatly reduce the related complications.

    Prechop-assisted cataract surgery
    SONG Chen-jie, ZHAO Yang, ZHU Si-quan
    2018, 42(4):  260-264.  doi:10.3760/ cma.j.issn.1673-5803.2018.04.010
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    The surgical techniques for phacoemulsification are becoming more and more abundant, mainly reflected in lens fragmentation such as phaco chop technique, stop-and-chop technique, etc. Pre-chop technique includes manual pre-chop and femtosecond laser-assisted pre-chop. This technology can significantly reduce the phacoemulsification time and energy, reduce the damage to the intraocular tissue of the surgery, shorten the operator's learning curve, and increase the surgical popularity. But there are still some problems that need to be solved in the complex cataract surgery now.

    Surgical management of complicated cataract in uveitis
    LU Wan,LU Hui,ZHU Si-quan
    2018, 42(4):  265-269.  doi:10.3760/ cma.j.issn.1673-5803.2018.04.011
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    Cataract is one of the common complications of uveitis, which may be associated with recurrent episodes of inflammation and long-term use of glucocorticoids. Cataract extraction with intraocular lens implantation has become the main treatment. Patients with activity inflammation have a serious postoperative inflammatory reaction and complications. It is generally believed that the operation time should be three months after the inflammation resolution at least. Local or systemic treatment with glucocorticoids is more effective over perioperative. For avoiding systemic side effects of glucocorticoids and increasing the concentration in eyes, some experts choose to inject drugs or implant the sustained release agent in anterior chamber. The extensive iris adhesion and pupillary atresia caused by the recurrent inflammation makes the operation much more difficult, which is a challenge for surgeon. In addition, the appropriate intraocular lens can reduce postoperative inflammatory reactions and the incidence of subsequent cataracts.

    Molecular biology of lacrimal gland epithelial tumor
    WANG Jing, ZHU Yu
    2018, 42(4):  269-273.  doi:10.3760/ cma.j.issn.1673-5803.2018.04.012
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    Epithelial tumor of lacrimal gland is a common orbital tumor, and the common benign and malignant tumors are respectively lacrimal pleomorphic adenoma and adenoid cystic carcinoma. Lacrimal pleomorphic adenoma is prone to relapse, malignant change, adenoid cystic carcinoma is not satisfactory to operate simply, easy to relapse, and poor prognosis. In recent years, molecular biology studies have found that oncogene PLAG1 and HMGA2 have high sensitivity and specificity in the diagnosis of pleomorphic adenoma. MYB gene expression can be used as the molecular diagnostic index of adenoid cystic carcinoma. Tumor-suppressor genes INK4a - ARF, signaling pathways, such as IL-6 / JAK/STAT3 and Notch, matrix metalloproteinases (MMP) and cyclooxygenase 2 (COX-2) and so on, have some effect on the development, recurrence, metastasis and transformation of the epithelial tumor of lacrimal gland.

    MicroRNAs and diabetic retinopathy
    CHEN Xiu-ping, YUAN Fei
    2018, 42(4):  274-278.  doi:10.3760/ cma.j.issn.1673-5803.2018.04.013
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    Diabetic retinopathy is the main cause of blindness among adults in the world. Its pathogenesis is complex, and the molecular mechanism is not yet fully understood. MicroRNA (miRNA) is a kind of endogenous and highly conservative RNA with tissue specificity. The expression of target genes is negatively regulated by complementary pairing with mRNA to degrade mRNA or inhibit mRNA translation at post transcriptional levels. In recent years, more and more evidences show that miRNA can play an important role in the pathogenesis of DR through various mechanisms, such as angiogenesis, apoptosis and inflammation. The functions and mechanisms of miRNAs, known as abnormal expression in DR, and its targets genes, providing new strategies and directions for the prevention and research of DR.

    Research advances on retinal microaneurysm
    LI Dong-hui, WANG Qi-chang
    2018, 42(4):  279-282.  doi:10.3760/ cma.j.issn.1673-5803.2018.04.014
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    Retinal microaneurysm can appear in multiple fundus diseases.  It occurs mostly in the early stage of the disease, and its number often indicates the severity of the disease. Its mechanisms include changes in retinal hemodynamics, inflammatory mechanisms, oxidative stress and oxidative damage.  Optic coherence tomography angiography (OCTA) and adaptive optics scanning light ophthalmoscope-fluorescein angiography (AOSLO-FA) as a newly developed vascular imaging method may become a major development in the detection of retinal microaneurysm.

    Vitreomacular traction syndrome
    CHEN Zheng-yu, WEI Wen-bin
    2018, 42(4):  283-288.  doi:10.3760/ cma.j.issn.1673-5803.2018.04.015
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    In recent years, with the advancement in the examination of fundus diseases, a more in-depth understanding of the pathological changes, treatment methods, prognosis and influencing factors of vitreomacular traction syndrome has been made. In particular, in addition to conventional vitrectomy, Ocriplasmin intravitreal injection and pneumatic vitreolysis have gradually been introduced into the clinic; in accordance with the progress in treatment, factors that may affects the prognosis of vitreomacular traction syndrome, such as the existence and grading of premacular membrane, age, gender, the range of the vitreomacular traction and the diameter of the macular hole, was determined and clarified.