International Review of Ophthalmology

70 years development of ocular microbiology in Beijing Tongren Hospital

2019, 43(5): 289-293. doi:10.3760/ cma.j.issn.1673-5803.2019.05.001

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Since the founding of the People's Republic of China, the ocular microbiology laboratory of Beijing Institute of Ophthalmology, Beijing Tongren Hospital has been devoting itself to the study of pathogen isolation, laboratory examination, clinical diagnosis and treatment of infectious ocular diseases. It provides strong laboratory evidence for eliminating blinding trachoma and diagnosing Acanthamoeba keratitis in China. A series of laboratory diagnostic methods for infectious ocular diseases established by this laboratory have been popularized all over the country. With big data of ocular microbiology collected by this laboratory, microbiological etiological distribution and bacterial resistance analysis were published to the ophthalmologists at home and abroad. All of these could provide data basis for the improvement of diagnosis and treatment to infectious ocular disease in China. (Int Rev Ophthalmol, 2019, 43: 289-293)

Advances in metabolomics research of glaucoma

Tang Yizhen, Wu Jihong, Sun Xinghuai

2019, 43(5): 294-299. doi:10.3760/ cma.j.issn.1673-5803.2019.05.002

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Metabolomics is an emerging discipline for detecting the metabolites of all cellular processes after pathological stimulation or genetic modification. In this paper, we systematically review the application of metabolomics in the diagnosis and pathological mechanism of glaucoma patients in recent years. We summarized the similarities and differences of metabolitic changes in glaucoma diseases by various metabolomics techniques in different tissues.The result presented may enhance our understanding in the diagnosis and progression of glaucoma as well as in finding the biological indicators for early diagnosis and prognosis. The general feature of metabolites changes in glaucoma are increased expression of glutamate, sphingosine, phosphocholine, phosphatidylcholine, short\|chain unsaturated fatty acids and decreased expression of long\|chain unsaturated fatty acids and spermine etc.(Int Rev Ophthalmol, 2019, 43: 294-299)

Research advances in structure and imaging of lamina cribrosa

Wu Jian, Wang Ningli

2019, 43(5): 300-305. doi:10.3760/ cma.j.issn.1673-5803.2019.05.003

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The lamina cribrosa(LC) is a reticulated, sieve\|like structure, which unmyelinated retinal ganglion cell (RGC) axons pass through. The LC has long been identified as the main site of RGC axonal injury and hence important in the pathogenesis of glaucoma. Improvements in imaging such as optical coherence tomography（OCT） image capture and image processing have allowed detailed of LC macro\|biomechanical and micro\|architectural characteristics. In this review, we first aim to frame the biomechanical considerations of lamina cribrosa in a clinical context and to discuss the concept of the translaminar pressure gradient (TLPD). At the same time, we aim to highlight the technological advances in imaging the LC and its accompanying clinical implications, and future research directions in this field. In addition to the changes in intraocular pressure, cerebrospinal fluid pressure (CSFP) and TLPD play an important role in the pathogenesis of glaucoma. The displacement direction of the LC effects not only on the mechanical stress change caused by TLPD, but also included the biomechanical properties of the surrounding scleral structure. Scotoma in the glaucoma patient’s is associated with local damage, defects or remodeling of the LC. However, the anterior surface parameters of OCT imaging including LC depth (LCD), LC curvature (LCC) and LC global shape index (LC\|GSI) were also correlated with the occurrence and progression of glaucoma.(Int Rev Ophthalmol, 2019, 43: 300-305)

Function of intrinsically photosensitive retinal ganglion cells and eye related diseases

Wei Pinghui, Han Guoge

2019, 43(5): 306-312. doi:10.3760/ cma.j.issn.1673-5803.2019.05.004

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Intrinsically photosensitive retinal ganglion cells(ipRGCs) is another photoreceptor besides rod and cone cells in the mammalian retina. These ipRGC could convey information from the rod and cone cells, participating in imaging visual function. Furthermore, these cells are critical for non\|image forming functions, such as pupillary light reflex, circadian photoentrainment control, mood and sleep regulation. These cells could provid significant role in the occurrence and development of relevant eye diseases. Furthermore, studies have shown that ipRGC are more injury\|resistant following optic nerve injury. Therefore, this article reviews the classification and function of ipRGC, the manifestations in ophthalmology\|related diseases and the anti\|injury mechanism.Here we review the recent advances about classification, physicalfunctions and injury\|resistant character under certain conditions of these neurons.(Int Rev Ophthalmol, 2019, 43: 306-312)

Pathogenic factors of angle\|closure glaucoma in younger patients

Zhu Xiaomin1, Zhang Yong2, Xie Lin1

2019, 43(5): 313-316. doi:10.3760/ cma.j.issn.1673-5803.2019.05.005

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Primary angle\|closure glaucoma (PACG) is the most common type of glaucoma in elderly patients, but is less common in young patients. Compared with elderly patients, PACG in young patients is a result of multiple factors and mechanisms, including abnormal anatomical structure of the eye, refractive state and various ocular or systemic diseases. The risk factors include short eye axis, hypermetropia, abnormal lens position and so on. Therefore, the etiology of PACG in young patients should be fully analyzed to avoid missed diagnosis.(Int Rev Ophthalmol, 2019, 43: 313-316)

Effect of primary glaucoma and its treatment on corneal endothelium

Liu Aihua, Dong Lijie

2019, 43(5): 317-322. doi:10.3760/ cma.j.issn.1673-5803.2019.05.006

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Normal corneal endothelial cells with a certain number and a specific monolayer hexagonal structure are the key to maintain corneal health and transparency. The high intraocular pressure of glaucoma itself, as well as the glaucoma medication, laser, and surgical treatments could affect the corneal endothelium. In angle\|closure glaucoma, especially in acute attacks, long\|term high intraocular pressure could lead to a decrease in corneal endothelial cell density. In animal experiments, high\|concentration anti\|glaucoma drugs could damage the corneal endothelium, but there was no such damage in clinical applications. Laser peripheral iridotomy could damage local corneal endothelial cells in a short period of time. The number of corneal endothelial cells near the bleb after trabeculectomy was reduced, and the damage was aggravated after the addition of mitomycin C, but the effect was not sustained. The local corneal endothelial cells were significantly reduced after the operation of Ahmed drainage valve, but EX\|PRESS drainage nails did not have this damage. The effect of minimally invasive glaucoma surgery on corneal endothelial cells was mild in the short term.(Int Rev Ophthalmol, 2019, 43: 317-322)

Progress on opacification of intraocular lens

Liu Zhenyu, He Hailong, Wang Jinda, Wan Xiuhua

2019, 43(5): 323-327. doi:10.3760/ cma.j.issn.1673-5803.2019.05.007

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Phacoemulsification with intraocular lens (IOL) implantation for cataract is the most common surgery of the ophthalmology. As a lower incidence postoperative complication,the IOL may need to be replaced if the IOL opacification is serious. There has been no certain conclusion for the causes of IOL opacification yet. The opacification of IOL may be related to itself, such as materials，manufacture and packaging. Surgical operation or intraoperative use of viscoelastic, and patient’s own factors such as systemic disease or special metabolic state maybe the causes of IOL apacification.(Int Rev Ophthalmol, 2019, 43: 323-327)

Research status of tissue engineering limbus by electrospun

Gao Qingqin1, Li Guigang2, Wang Wei2, Wang Ping1

2019, 43(5): 328-331. doi:10.3760/ cma.j.issn.1673-5803.2019.05.008

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Limbal stem cell deficiency is caused by the lack of limbal stem cells and the damage of the limbal microenvironment caused by various reasons, which can cause blindness in patients. It is one of the directions in the field of corneal disease to construct tissue engineering limbus for transplantation. Three\|dimensional scaffolds were constructed by electrospinning technology to provide growth conditions for limbal stem cells and limbal niches cells, and tissue engineered limbus was obtained, which can treat patients with binocular limbal stem cell deficiency. The advantage of electrospinning technology is that the film formation is thin, similar to the three\|dimensional structure of the limbal tissue of the human, and the fiber structure can be adjusted according to the specific situation. This article mainly summarizes the research status of tissue engineering limbus by electrospun, including the principle of electrospinning technology, the choice of polymer materials, the selection of seed cells, the advantages of electrospinning for tissue engineering scaffolds and the research progress and direction of electrospinning in the construction of tissue engineering limbus.(Int Rev Ophthalmol, 2019, 43: 328-331)

Therapeutic advances of corneal neovascularization

Zhang Haiping1, Chi Wei2, Hua Xia1

2019, 43(5): 332-336. doi:10.3760/ cma.j.issn.1673-5803.2019.05.009

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Corneal neovascularization can lead to corneal hyalinity, visual acuity decline or even loss, which occurs in various corneal diseases. At present, many methods and measures (such as the use of glucocorticoids, immunosuppressive agents, non\|steroidal anti\|inflammatory drugs, anti\|vascular endothelial gowth factor drugs, tyrosine kinase inhibitors, some natural extracts, laser therapy, fine needle diathermy, gene therapy, combination therapy, etc.) have been used to prevent and treat corneal neovascularization, and have achieved varying degrees of success. However, these treatments for corneal neovascularization are only partially effective and may lead to some side effects. This article aims to review the latest treatment of corneal neovascularization.(Int Rev Ophthalmol, 2019, 43: 332\|336)

Research advances in factors affecting homeostasis of the tear film

Yan Dan, Yan Chenxi, Fu Yao

2019, 43(5): 337-340. doi: 10.3760/ cma.j.issn.1673-5803.2019.05.010

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As a component of the ocular surface microenvironment, tear film plays an important role in the development of ocular surface diseases. The stimulation of endogenous factors and exogenous factors can alter the composition of the tear film that ultimately cause the instability of the tear film, which will even act as an initial factor in ocular surface diseases, changing the morphology and function of other components of the ocular surface microenvironment. Cornea, conjunctiva and even the nerve and microbiota on the ocular surface will change. The factors that can destroy the homeostasis of the tear film can be divided into endogenous factors and exogenous factors. Endogenous factors include the destruction of tear secretion tissues, abnormal ocular surface structure, disorder of ocular surface microbiota, and abnormalities in the homeostasis of the body. The exogenous factor is the stimulation and destruction from outside that can affect the tear film. (Int Rev Ophthalmol, 2019, 43: 337\|340)

Factors affecting correction of astigmatism in SMILE

Gao Mengman, Guo Xiujin

2019, 43(5): 341-345. doi:10.3760/ cma.j.issn.1673-5803.2019.05.011

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There is a certain correlation between astigmatism correction and visual quality. In China, the proportion of low\|level astigmatism is relatively large, and the proportion of people with high astigmatism is relatively small, while may require more attention in terms of treatment accuracy. The factors affecting astigmatism correctionin in small incision lenticule extraction (SMILE) include the size of preoperative astigmatism, the rotation of intraoperative astigmatism, intraoperative lens positioning, and healing of postoperative wounds.(Int Rev Ophthalmol, 2019, 43: 341-345)

Focal choroidla excavation

Chen Zhengyu, Wei Wenbin

2019, 43(5): 346-349. doi:10.3760/ cma.j.issn.1673-5803.2019.05.012

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Focal choroidal excavation (FCE) is a newly recognized entity in recent years benefited from the wide use of optical coherence tomography (OCT). On fundus examination, the appearance of FCE was quite different, from slight pigment irregularity to yellowish white plaque. FFA revealed normal or window defect at the site of or around the FCE lesions. ICGA images in the early phase showed hypofluorescence, and medium to large choroidal blood vessels were visible. According to OCT images, FCE was divided into confirming and non\|confirming type. FCE was regarded to be a congenital choroidal abnormality based on the observations that FCE usually present without any other concomitant pathology and show little change during the follow\|up. Occasionally, complications such as choroidal neovascularization and central serious chorioretinopathy can develop.(Int Rev Ophthalmol, 2019, 43: 346-349)

Recent advance of reticular macular disease

Ye Suna, Cheng Hao

2019, 43(5): 350-354. doi:10.3760/ cma.j.issn.1673-5803.2019.05.013

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Reticular macular disease (RMD) is a morphological change different from the typical drusen, which occurs mostly in patients with age\|related macular degeneration (AMD) and has a stereotypical presentation in multiple imaging modalities. The incidence and prevalence of RMD vary greatly depending on the imaging method. Combined use of multimodal imaging can increased accuracy. RMD is associated with AMD and is a risk factor of progression to advanced AMD. This article summarizes and analyzes the latest research progress of RMD in order to provide reference for clinical research.(Int Rev Ophthalmol, 2019, 43: 350-354)

Treatment of age-related macular degeneration and polypoidal choroidal vasculopathy by Aflibercept

Qi Min, Kong Jun

2019, 43(5): 355-359. doi:10.3760/ cma.j.issn.1673-5803.2019.05.014

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Aflibercept is a fully humanized recombinant fusion protein that blocks all subtypes of vascular endothelial growth factor (VEGF)\|A and placental growth factor (PLGF) in the VEGF family. A number of large clinical trials have confirmed the efficacy and safety of aflibercept in the treatment of age\|related macular degeneration (AMD) and polypoidal choroidal vasculopathys (PCV) as well as in the treatment of AMD and PCV which are resistant to ranibizumab. Compared with other anti\|VEGF drugs, such as pegaptanib, ranibizumab and bevacizumab, aflibercept,which is a new generation of anti\|VEGF drug, has a wider target, stronger affinity and longer action time. Therefore, it can reduce the frequency of drug administration, the adverse effect caused by the repeated injection, and the economic burden of patients without reducing the curative effects. (Int Rev Ophthalmol, 2019, 43: 355-359)

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