Table of Content

22 February 2020, Volume 44 Issue 1

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Suggestions on the protection for ophthalmologists against the infection of the novel coronavirus

Shao Lei, Wei Wenbin

2020, 44(1):  1-4.  doi:10.3760/cma.j.issn.1673-5803.2020.01.001

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There is a risk of cross infection to novel coronavirus in close contact with patients during the procedure of ophthalmologic diagnosis and treatment. This article briefly introduces the characteristics and identifications of the novel coronavirus infection, and puts forward suggestions and opinions from the aspects of personal protection of ophthalmologists, control managements of ophthalmic outpatient department and ward, cleaning and disinfection of ophthalmic equipment, which hoping to help ophthalmologists in the epidemic prevention of the novel coronavirus infection.

Stem cell transplantation therapy in glaucoma

Yu Fei, Wu Renyi

2020, 44(1):  5-10.  doi:10.3760/ cma.j.issn.1673-5803.2020.01.002

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Glaucoma is a degenerative optic neuropathy characterized by irreversible loss of vision as the result of retinal ganglion cells (RGCs) loss. Stem cells, characterized as totipotency and self\|renewal, have shown the potential in the treatment of degenerative diseases of the retina, and are supposed to be an effective method to restore the visual function in glaucoma patients. Stem cells are classified into embryonic stem cells, induced pluripotent stem cells and adult stem cells according to their sources. Delivery of stem cells for glaucoma treatment include intracameral, intravitreous, subretinal and suprachoroid injection. The main purpose of stem cell therapy for glaucoma include repairing damaged trabecular meshwork to reduce intraocular pressure and replacing/repairing damaged RGCs. At present, the main obstacles in stem cell transplantation in the treatment of glaucoma include operation safety, tumorigenicity, immune rejection. Transplantation of the extraction of mesenchymal stem cell exosomes and extracellular vesicles may be one of the safe and effective treatment approaches in stem cell therapy.

Applications of anterior\|segment optical coherence tomography on diagnosis and treatment of glaucoma

Zhao Qian1, Lin Peijie1, Lai Mingying2

2020, 44(1):  11-17.  doi:10.3760/ cma.j.issn.1673-5803.2020.01.003

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Glaucoma is the second blindness disease in the world which can lead to irreversible vision loss. Abnormal anatomy of anterior segment of the eyeball is strongly associated with the pathogenesis of glaucoma. Anterior\|segment optical coherence tomography (AS\|OCT) is an noninvasive, non\|contact scanning tool which can provide multiple quantitative measurements from anterior segment. Therefore it has unique advantages compared with other traditional examinations. The article aims to give a review on the latest applications and progress of AS\|OCT in glaucoma such as angiography\|combined AS\|OCT,  postoperative evaluation of glaucoma and AI\|assisted diagnosis etc.

Congenital optic disc depression：insights from optical coherent tomography

Li Xia1, Peng Xiaoyan2

2020, 44(1):  18-24.  doi:10.3760/ cma.j.issn.1673-5803.2020.01.004

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Congenital excavated optic disc anomalies includes optic disc pit, optic nerve coloboma, morning glory sysdrome, peripapillary staphyloma. In the past time, the diagonosis and efficacy evaluation of these diseases mainly depended on the fundus photography, fundus fluorescence angiography and ultrasonic examination. With the developmemt of ophthalmic imaging technology (OCT), especially in recent years, enhance depth imaging\|spectrum domain OCT (EDI\|SD OCT) and swept\|source OCT (SSOCT) have significantly improved the scanning depth, breadth and imaging clarity. We have a further understanding of morphological features and complications of these disease, and comparative analysis among these different diseases has also deepened our understanding of the mechanism of congenital abnormalities in optic disc.

Relationship between exfoliation syndrome and systemic diseases

Abudurehemaijiang，Ding Lin

2020, 44(1):  25-28.  doi:10.3760/ cma.j.issn.1673-5803.2020.01.005

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Exfoliation syndrome (XFS) is a complex age\|related disease in which flaky white floes deposit in the anterior chamber of the eye and other tissues in the eye, and cause glaucoma. Epidemiological studies showed that XFS increases risk of coronary artery disease, hypertension，cerebrovascular disease, abdominal aortic aneurysm， peripheral vascular disease, sensorineural hearing loss. The exact mechanism underlying the development of vascular complications in XFS remains poorly understood, although abnormal elastic fiber synthesis in vessel walls, elevated serum antiphospholipid antibody levels, increased oxidative stress, endothelial dysfunction and hyperhomocysteinemia are all hypothesized to play contributory roles.

Role of CRISPR/Cas9 system in pathogensis of lens-related diseases

He Hailong1, Zhou Chunyuan2, Chang Di1, Wang Jinda1, Wan Xiuhua1

2020, 44(1):  29-33.  doi:10.3760/ cma.j.issn.1673-5803.2020.01.006

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The clustered regularly interspaced short palindromic repeats (CRISPR)/Cas9 system is a new type of genome editing technology, which has the advantages of high gene knockout efficiency, accurate location, easy operation, short test cycle, low cost and so on. The emergence of CRISPR/Cas9 system provides a new idea for the diagnosis and treatment of ophthalmopathy, especially lens-related diseases, and plays a certain role in the research and treatment of the pathogenesis and treatment of congenital cataract, the construction of congenital cataract model, the identification of mutated gene loci of lens-related diseases, and the prevention and treatment of posterior capsular opacification.

Advancement of epigenetics on posterior capsular opacification

Li Hua, Yuan Xiaoyong

2020, 44(1):  34-37.  doi:10.3760/ cma.j.issn.16735803.2020.01.007

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Posterior capsular opacification (PCO) is the most common complication of cataract surgery, the progression of PCO is closely related with specific gene expression. Epigenetics refers to the heritable changes and genetic modifications without a change in the DNA sequence itself, including aberrant DNA methylation, histone modification patterns and noncoding RNA regulation. In vivo and in vitro studies have found that DNA methyltransferaseinhibitor, histone deacetylaseinhibitor and noncoding RNA regulation are involved in the progression of PCO and its phenotypic changes.

Corneal thermal injury during phacoemulsification aspiration

Cao Yu, Wu Jian, Chen Wei, Gu Shanshan, Xue Ying, Guan Huaijin

2020, 44(1):  38-41.  doi:10.3760/ cma.j.issn.16735803.2020.01.008

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Phacoemulsification aspiration (PEA) has revolutionized cataract surgery. However, the production of ultrasound energy is associated with heat generation that can result in damage to corneal incision. Thermal damage to the corneal incision may result in difficulty with wound closure and consequent risk of wound leakage, as well as damage to the adjacent corneal stroma and endothelium. The heat around the tip not only causes damage to the corneal incision, but also give rise to an increase of temperature in the anterior chamber during PEA, which ultimately injures corneal endothelium. Different ultrasound durations, ultrasound modes, ultrasound energies and ultrasound instruments have certain effects on the temperature of anterior chamber. Clinicians should try to use lower ultrasound energy for PEA in pulse mode and decrease the duration of ultrasound. In addition, various ophthalmic viscosurgical devices, as well as the continuous irrigation of irrigating solution, are critical factors influencing the temperature of anterior chamber during phacoemulsification.

Signaling pathway and source of autologous replacement stem cells associated with corneal limbal epithelial stem cells

Wu Defu, Zhong Xingwu

2020, 44(1):  42-46.  doi:10.3760/ cma.j.issn.1673-5803.2020.01.009

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Corneal blindness accounts for about 40% of the total number of irreversible blindness patients in China. Stevens-Johnson syndrome and scar pemphigoid are the main causes of corneal blindness. Autologous and allogeneic corneal transplantation has achieved some success in clinical applications, but there are still many problems. At present, an important way to treat the above corneal diseases is to transplant autologous or allogeneic limbal epithelial stem cells through direct or in vitro culture. Signaling pathways, such as the Wnt signaling pathway, Notch signaling pathway, and STAT signaling pathway, have important effects on the culture of limbal epithelial stem cells in vitro, and can interact with a variety of factors to regulate the proliferation, differentiation, and resting homeostasis of limbal epithelial stem cells. Patients with limbal stem cell deficiency in both eyes are expected to induce other autologous stem cells by in vitro culture, such as mesenchymal stem cells, oral mucosal epithelial stem cells, human embryonic stem cells, dental pulp stem cells, differentiate into corneal epithelial stem cells, and reconstruct the ocular surface.

Pigment epithelium-derived factor and its role in the pathogenesis of ocular surface diseases

Liu Xuemei, Lu Xiaoxiao, Liu Hui, Zhao Shaozhen

2020, 44(1):  47-51.  doi:10.3760/ cma.j.issn.1673-5803.2020.01.010

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Pigment epithelium-derived factor (PEDF) is an endogenous glycoprotein and a member of the noninhibitory serine protease inhibitor superfamily. It has biological functions such as neuronutrition, anti-neovascularization, anti-inflammatory and antioxidant. Numerous studies have shown that PEDF plays a protective role in the pathogenesis of various ocular surface diseases (such as keratitis, corneal neovascular disorders, dry eye, etc.) by promoting corneal nerve regeneration, inhibiting corneal neovascularization, reduce inflammatory response.

Application of RB1 gene detection on diagnosis and treatment of retinoblastoma

Xie Ying1，2, Xu Xiaolin1, Wei Wenbin1

2020, 44(1):  52-56.  doi:10.3760/ cma.j.issn.16735803.2020.01.011

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Retinoblastoma (RB) is the most common  primary intraocular malignant tumor in infants. Its occurrence and development are closely related to the inactivation of tumor suppressor geneRB1 gene. Deeply study on RB1 gene detection is helpful to select the optimal strategies for genetic testing and genetic counseling  in clinical work. RB seriously endangers the life and visual function of children, so it is urgent to improve the coverage of genetic testing and genetic counseling for RB patients in China. RB1 gene  detection is helpful to achieve the individualized comprehensive treatment  and genetic guidance for RB patients. It is neccessary to promote its application in clinical diagnosis and treatment for RB.

Systemic related factors of diabetic macular edema

Yang Su, Sun Dawei

2020, 44(1):  57-62.  doi:10.3760/ cma.j.issn.1673-5803.2020.01.012

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In the past, the basic and clinical studies on the control of diabetic macular edema (DME) are mostly on the eyes, but the study of the correlation with the systemic factors is less. In recent years, there is ample evidence that control of systemic-related factors, such as hyperglycemia, hypertension, hyperlipemia, etc. tends to largely reduce the treatment costs of the DME. And, if it can be found early, the prognosis of the DME is still optimistic.

Research progress on zebrafish model of diabetic retinopathy

Li Lele1, Zhu Manhui2, Tu Yuanyuan2, Yang Kaiwen3, Liu Dong4, Shi Yunwei4, Sang Aimin1

2020, 44(1):  63-67.  doi:10.3760/ cma.j.issn.16735803.2020.01.013

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Diabetic retinopathy (DR) is the most important manifestation of diabetic microangiopathy. It is a kind of fundus lesion with specific changes, one of the serious complications of diabetes. The specific pathogenesis of DR remains unclear, and there are no effective treatments. As a model animal, zebrafish can well simulate the pathogenesis of diabetes and DR through certain treatments. Some scholars have found that zebrafish can simulate early fundus aneurismlike changes in DR. At the same time, zebrafish can also provide a reliable reference for the therapeutic effects of newly developed drugs.

Roles of exosomes in pathogenesis of diabetic retinopathy

Wang Shiyi, Yu Ying, Zhu Rongrong

2020, 44(1):  67-72.  doi:10.3760/ cma.j.issn.16735803.2020.01.014

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Exosomes are nanoscale microvesicles secreted into the extracellular matrix after the fusion of intracellular polycystic bodies with the plasma membranes. They are widely distributed in biological tissues and body fluids, and play an important role in the secretion defects of islet β cells and insulin resistance, which are two critical pathogenic factors of diabetes. They are also involved in the occurrence and development of diabetes and its extraocular complications, such as cardiovascular disease, diabetic nephropathy and diabetic skin damage. Exosomes existing in the eye (vitreous cavity, retinal cells, etc.) and in plasma, can be transmitted in the ocular and systemic circulation in patients with diabetic retinopathy (DR). Exosomes carry some biomolecules related to the pathogenesis of DR, such as fibroblast growth factor, vascular endothelial growth factor, various inflammatory factors, etc. Under the stimulation of high glucose and hypoxia, these molecules are transported and released by exosomes and then activate or inhibit some signal transduction pathways, stimulate the proliferation of vascular endothelial cells and neovascularization of retina in patients with DR, thereby promote the occurrence and progress of DR. Due to the small size and doublemembrane structure, exosomes can target the transport of coated components, which is an efficient drug delivery tool for the treatment of DR in the future.