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Table of Content

    22 December 2020, Volume 44 Issue 6
    Previous Issue   
    A review of low vision rehabilitation work in China
    Hu Ailian, Zhang Xu, Zhao Weiqi
    2020, 44(6):  373-378.  doi:10.3760/cma.j.issn/1673-5803.2020.06.001
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    Low vision rehabilitation is a systematic work, involving medical treatment, rehabilitation, education, social security, family and other fields. This article reviews the history and achievements of low vision rehabilitation work in China, including the prevalence and etiology of visual disability, personnel training, research and development of visual aids, orientation and mobility training, construction of visual rehabilitation system, public health education and supporting policies. By far, low vision rehabilitation work has been carried out in China for about 40 years, with relentless exploration and advancement, now the work pattern of “led by the government, responsibilities assumed by relevant departments, and participated by whole society” has been formed. A low vision rehabilitation service system with Chinese characteristics has been established with the participation of medical institutions, China Disabled Persons' Federation,  Rehabilitation Assistive Devices and Technology Center and education system.(Int Rev Ophthalmol, 2020, 44: 373-378)
    Intraocular lens correction for age-related refractive abnormalities
    Tian Tian, Xu Yesheng, Xie Wenjia, Yao Yufeng
    2020, 44(6):  379-385.  doi:10.3760/cma.j.issn/1673-5803.2020.06.002
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    Age-related refractive abnormalities include cataract and presbyopia,  which can be managed by cataract surgery and presbyopia-correcting intraocular lens (IOL) implantation. According to different functions,  presbyopia-correcting IOL can be classified as monofocal enhanced IOL,  multifocal IOL,  extended depth of focus IOL,  and accommodative IOL. There are three methods of combination of binocular IOL implantation for presbyopia correction:  implanting the same IOLs in both eyes aiming at emmetropia,  micro-monovision,  and mix-and-match. (Int Rev Ophthalmol,  2020,  44:  379-385)

    Application of artificial intelligence in the diagnosis and treatment of cataract
    Du Yingqi, Zhou Nan, Qi Yanhua
    2020, 44(6):  386-390.  doi:10.3760/ cma.j.issn.1673-5803.2020.06.003
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    Artificial intelligence (AI) has been considerable development in AI-assisted cataract research in recent years. It can not only locate and analyzes the structure of the lens,  but also has ability in the classification of cataract diagnosis compared favorably with professional doctors. In the treatment of cataracts,  it provides an objective criterion for the selection of treatment options and the training of cataract doctors to increase the safety of surgery. At the same time,  the population screening can also be achieved by using AI,  laying the foundation for future telemedicine. (Int Rev Ophthalmol,  2020,  44:  386-390)

    The homeostasis maintenance and reconstruction of limbal niche after injury
    Gong Danni, Yan Chenxi, Fu Yao
    2020, 44(6):  391-396.  doi:10.3760/cma.j.issn.1673-5803.2020.06.004
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    The integrity of human corneal epithelium is maintained by the continuous renewal of limbal epithelial stem cells. Limbal niche-the special region of corneal limbus,  is the microenvironment that stem cells live on. The limbal niche is composed of a variety of cells,  signal molecules and extracellular matrix. The coordination of all the components in the niche maintains the homeostasis of limbal niche and promotes the proliferation,  migration and differentiation of limbal stem cells. Any disturbance to the homeostasis of limbal niche,  including congenital,  traumatic,  and immune diseases,  would lead to dysfunction of stem cells. For patients with limbal stem cell deficiency,  the reconstruction of limbal niche through the regeneration of extracellular matrix and the application of bioactive factors and mesenchymal stem cells,  is of great significance for the recovery and long-term maintenance of stem cells. (Int Rev Ophthalmol,  2020,  44:  391-396)
    Research progress of autoimmune disease-related keratitis
    2020, 44(6):  397-401.  doi:10.3760/cma.j.issn/1673-5803.2020.06.005
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    Autoimmune disease (AID) related keratitis is characterized by keratitis and corneal neovascularization, and has no active corneal infection. AID related keratitis develops rapidly and is difficult to treat. The etiology is complex and diverse. The common diseases are rheumatoid arthritis, systemic lupus erythematosus, granulomatosis with polyangiitis, Cogan syndrome, cryopirin-associated periodic syndrome, Sjgren's syndrome, etc. At present,  AID are mostly related to genetic factors, infection of some viruses and abnormal autoimmune regulation function in the literature reports, but the specific pathogenesis is still unclear. (Int Rev Ophthalmol, 2020, 44: 397-401)

    Application of drug-loaded contact lens in the treatment of glaucoma
    Wu Caiqing, Yu Minbin, Yang Yangfan
    2020, 44(6):  402-407.  doi:10.3760/ cma.j.issn.1673-5803.2020.06.006
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    Contact lenses (CL) could be loaded with more than one drug through various methods (such as soaking CL in drug solution,  adding vitamin E barrier,  applying polymeric colloidal nanoparticle,  etc.) to form an ocular sustained-release system,  which could reduce side effects and increase bioavailability of drugs. Different methods had their limitations and limited their clinical application and industrial production. Drug loaded by soaking method had obvious burst release,  and it was difficult to achieve an effective concentration of drugs for a long time. Methods of adding vitamin E barrier and loading drug in polymeric film within CL can prolong retention time of drugs, however,  they can change the physical properties of the CL at the same time. Polymeric colloidal nanoparticle drug delivery system could affect stability of drugs and waste a lot of drugs. Cyclodextrin and its derivatives that can be used for the sustained release of hydrophobic drugs can also affect the physical properties of the CL. The molecular imprinting method and supercritical fluid technology were relatively complicated,  and there were many factors influence their functional time of drug,  which made it was difficult to achieve industrialization. (Int Rev Ophthalmol,  2020,  44:  402-407)

    Application of CRISPR/Cas9 technology in the treatment of fundus neovascular diseases
    Liu Jinxing, Zhou Guohong, Wang Wenjuan, Wang Yongrui, Li Jing, Li Huilin
    2020, 44(6):  408-413.  doi:10.3760/ cma.j.issn.1673-5803.2020.06.007
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    Clustered regularly interspaced short palindromic repeats-associated proteins 9 (CRISPR/Cas9) technology can be used to knock-in,  replacement or knock-out of eukaryotic genes. Injecting the RNP Cas9 (VEGFA gene-specific Cas9 ribonucleoproteins) under the mouse retina can significantly reduce the area of laser-induced choroidal neovascularization (CNV). Targeting small molecule protein CjCas9 to knock out VEGFA(vascular endothelial growth factor A)or HIF-1(hypoxia-inducible factor 1)genes of RPE(retinal pigment epithelium) can also effectively reduce the area of laser-induced CNV,  and its mutation can maintain exceed 1 year. At the retinal level,  knocking out VEGFA in RPE cells or VEGFR2 in human microvascular endothelial cells (HRECs) by CRISPR/Cas9 technology can significantly inhibit the formation of retinal neovascularization. After knocking down the small ubiquit in-like modifier-specific protease 1 (SUMO-specific protease 1,  SENP1) induced by endothelial cells,  the SUMO-turned VEGFR2 in the Golgi can also effectively inhibit pathological neovascularization. After knocking out the p110δ in HRECs,  the proliferation,  migration and tube formation ability of HRECs were all weakened. The drug idelalisib,  which targets PI3Kδ,  can also inhibit pathological retinal neovascularization. Using CRISPR/Cas9 technology to knock out SCP1 (aspartic proteinase 1) can change the phosphorylation state of AKT and affect the formation of new blood vessels. The CRISPR/Cas9 synergistic activation mediator (SAM) system can screen out the positive regulator AK023948 of AKT. Knock down of AK023948 can inhibit the activity of AKT,  thereby inhibiting the formation of new blood vessels. (Int Rev Ophthalmol,  2020,  44:  408-413)
    Applications of fundus autofluorescence on diagnosis and visual prognosis assessment of idiopathic macular hole
    Yue Huifang, Zhang Yunda, Zhang Ximei
    2020, 44(6):  413-418.  doi:10.3760/ cma.j.issn.1673-5803.2020.06.008
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    Fundus autofluorescence (FAF) is a simple and non-invasive imaging modality. This technique based on the changes of lipofuscin and melanin within the retina,  gives insight into metabolic condition of retina. The FAF imaging of idiopathic macular hole (IMH) shows hyperautofluorescence corresponding to the hole area and surrounding hypoautofluorescent ring. The hyperautofluorescence can disappear or reduce due to a successful macular hole closure,  or can be persistent with an unclosed hole. FAF provides valuable information about diagnosis and follow-up of IMH,  combined with OCT has a great role both in vision prognosis,  understanding pathogenesis and anatomical and functional recovery. (Int Rev Ophthalmol,  2020,  44:  413-418)
    Human retinal pigment epithelial cell replacement therapy for retinal degenerative diseases
    Zhong Junwei, Li Yang
    2020, 44(6):  419-426.  doi:10.3760/ cma.j.issn.1673-5803.2020.06.009
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    Retinal pigment epithelium (RPE) cell replacement therapy is a potential method for the treatment of retinal degenerative disease. Unique advantages for RPE cell replacement therapy exist in treatment for the eye. Alternative RPE cells can derive from both stem cells and somatic cells. The former includes embryonic stem cell (ESC)-RPE and induced pluripotent stem cell (iPSC)-RPE. The latter is divided into adult origin (autologous or allogeneic) and fetal origin (Fetal-RPE). The clinical research of RPE cell replacement therapy is still in the early stage. At present, human ESC-RPE, human iPSC-RPE, and human Fetal-RPE cell replacement therapy for retinal degenerative diseases are all still in the preclinical and clinical research stages. In clinical trials, the visual function of some patients has improved, but neither ESC-RPE nor Fetal-RPE can avoid immune rejection. The complications of immunosuppressive agents are also worthy of attention. Whether the transplanted cells can survive for a long time needs further observation. The iPSC induction regimen, the method of ESC and iPSC differentiation into RPE cells have not formed a unified and standardized guide. Reasonable treatment time window, improvement of cell graft production and transplantation are the keys to ensure the effect of treatment. (Int Rev Ophthalmol,  2020,  44:  419-426)
    Study on histopathology and molecular biology of lacrimal adenoid cystic carcinoma
    Lu Qun, Zhang Hong
    2020, 44(6):  426-430.  doi:10.3760/cma.j.issn/1673-5803.2020.06.010
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    Adenoid cystic carcinoma(ACC) of the lacrimal gland is the most common malignant epithelial tumor of the lacrimal gland. It is classified into the crimoid type, tubular type, solid type and high-level transformation. The lacrimal ACC solid type has higher rate of metastasis and recurrence and lower surviral rate than the crimoid type and tubular type. However,  high-level transformation of lacrimal ACC has higher rate of metastasis, recurrence and mortality  than solid type. In terms of molecular biology, it has been found that MYB, miR-24-3p, bcl-2, P53 and other genes are related to the occurrence of this tumor, while positive expression of MMP-2, MP-9, VEGF, HIF-1α and other genes are related to the prognosis and recurrence of the larcrimal gland ACC. (Int Rev Ophthalmol, 2020, 44: 426-430)

    Orbital decompression surgery for treatment of dysthyroid optic neuropathy
    Tian Rui, Xue Shangcai
    2020, 44(6):  431-437.  doi:10.3760/cma.j.issn/1673-5803.2020.06.011
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    Dysthyroid optic neuropathy (DON) is one of the serious complications of thyroid associated ophthalmopathy. Due to multiple etiologies,  the increase of orbital contents and intraorbital pressure will result in irreversible vision loss if treatment is delayed. Timely orbital decompression to reduce intraorbital pressure and reduce disease activity is the key to treat DON to rescue vision and improve ocular protrusion. Orbital decompression includes orbital wall decompression,  orbital fat removal of decompression  etc. In recent years,  surgical technique improvement,  including deep lateral wall decompression,  internal and external wall balanced decompression,  three-wall to maximize orbital decompression,  minimally invasive epidural orbital decompression,  orbital wall decompression with different approaches under nasal endoscope,  computer-assisted decompression, multiple surgical methods combined decompression  etc,  has been developed for getting better treatment effects.(Int Rev Ophthalmol,  2020,  44:  431-437)
    The basic and clinical studies of retinal changes in Parkinson's disease
    Huang Leyi, Lin Ling
    2020, 44(6):  438-442.  doi:10.3760/cma.j.issn/1673-5803.2020.06.012
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    Parkinson's disease (PD) is a neurodegenerative disease, which is pathologically characterized by progressive neurodegeneration of the nigrostriatal dopamine system. In addition to showing motor symptoms such as rest tremor, PD patients also have non-motor symptoms such as visual impairment. It has been shown that changes of retinal and visual dysfunction in PD patients are biological signals, which appear earlier than the motor symptoms. At present, several studies have found that the imbalance between dopamine and melatonin and the accumulation of α-synuclein are related to retinal changes of PD. At the same time, the thickness of the retinal nerve fiber layer (RNFL) and the macular area in PD patients will become thinner, and a certain degree of visual impairments will appear.(Int Rev Ophthalmol, 2020, 44: 438-442)
    Role of oxidative stress-responsive miRNA targeting regulation of Nrf2-ARE signaling pathway in the development of fundus diseases#br#
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    Xu Xiangzhong, Jiang Qin, Li Keran
    2020, 44(6):  443-447.  doi:10.3760/cma.j.issn/1673-5803.2020.06.013
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    Nrf2-ARE is an important anti-oxidative stress pathway,  which can regulate the expression of many antioxidants in cells,  and has a variety of biological activities such as maintaining cell oxidation-antioxidant balance,  inhibiting apoptosis,  and anti-inflammatory. MicroRNAs (miRNAs) are a type of non-coding and extremely short RNA molecules that are widely present in eukaryotes which can regulate gene expression. It has been found that a variety of miRNAs can directly or indirectly act on the Nrf2-ARE signaling pathway and regulate the expression of related genes,  promoting or inhibiting the occurrence and development of retinal oxidative damage and fundus degeneration. (Int Rev Ophthalmol,  2020,  44:  443-447)
    The role of abnormal expression of key signal molecules in target tissues in the occurrence and development of myopia
    Chi Qingqing, Jiang Feng
    2020, 44(6):  448-452.  doi:10.3760/ cma.j.issn.1673-5803.2020.06.014
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    During the development of myopia, there are special pathological changes in each layer of the eyeball, which are mainly manifested as thinning of the retinal pigment epithelium, choroidal atrophy, thinning of sclera. The expression and changes of many signaling molecules, such as dopamine, acetylcholine, glucagon, and cell growth factors, which eventually act on the retina, choroid and sclera tissue, causing myopic pathological changes. However, the information transmission pathways and specific targets of some important signal molecules are still unclear, further research is needed.(Int Rev Ophthalmol, 2020, 44: 448-452)
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