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Table of Content

    22 June 2022, Volume 46 Issue 3
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    The role of glymphatic system in optic nerve damage of glaucoma
    Cheng Ying, Wang Ningli
    2022, 46(3):  193-199.  doi:10.3760/ cma.j.issn.1673-5803.2022.03.001
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    The glymphatic system was firstly proposed in the central nervous system, and then has been proved to function as an eye scavenger of metabolic waste and neurotoxic substances. Recent studies have shown that the dysfunction of glymphatic system can aggravate the retinal deposition of amyloid β-protein (Aβ) in glaucoma. The abnormal changes of the mechanical environment in optic nerve and lamina cribrosa could interfere the function of glymphatic system, further leading to the block of axoplasmic transport and the obstacle of metabolic clearance in lamina cribrosa. The mechanical environment is firmly related to the structure of lamina cribrosa, lamina cribrosa deformation and defect can significantly affect the clearance efficiency of neurotoxic substances through glymphatic system. The advent of glymphatic system helps to rethink the mechanism of optic nerve damage in normal-tension glaucoma and advanced glaucoma from a new perspective. (Int Rev Ophthalmol, 2022, 46: 193-199)
    The pathogenesis and treatment of iridocorneal endothelial syndrome
    Ye Wenqing, Deng Yuxuan, Liang Yuanbo
    2022, 46(3):  199-206.  doi:10.3760/ cma.j.issn.1673-5803.2022.03.002
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    The pathogenesis of iridocorneal endothelial (ICE) syndrome are dominated by the theory of viral infection and membrane theory of Campbell. And the theory combining the infectious of virus with integration of viral genes into human genome may provide new thinking. The present treatments of ICE syndrome are focus on corneal decompensation and secondary glaucoma. The endothelial keratoplasty is the main surgery for corneal endothelial decompensation and the attempt of artificial keratoplasty shows pretty good preliminary outcome. Secondary glaucoma is mainly treated by filtering glaucoma surgery while the explore of minimally invasive glaucoma surgery and glaucoma implant device in sulcus are started to treat secondary glaucoma of ICE syndrome. (Int Rev Ophthalmol, 2022, 46: 199-206)
    Advances of clear lens extraction surgery for primary angle-closure glaucoma
    Chen Dongjun, Wan Xiuhua
    2022, 46(3):  207-210.  doi:10.3760/ cma.j.issn.1673-5803.2022.03.003
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    The lens plays an important role in the pathogenesis of primary angle-closure glaucoma (PACG). It has been shown that cataract surgery on PACG could deepen the anterior chamber and widen the angle, thereby reducing intraocular pressure. In recent years, clear lens extraction surgery has been considered as a treatment for this type of eye disease. We reviewed the researches on clear lens extraction for PACG. Although clear lens extraction has significant  benefits for PACG, it is challenged in terms of technical dissemination and selection of indications. (Int Rev Ophthalmol, 2022, 46: 207-210)
    Cataract surgery and IOL selection in anterior segment dysgeneses
    Wen Yinuo, Jiang Yongxiang
    2022, 46(3):  211-215.  doi:10.3760/ cma.j.issn.1673-5803.2022.03.004
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    Anterior segment dysgenesis (ASD) is a group of diseases involving a variety of anterior segment tissue abnormalities, such as cornea, iris, lens and anterior chamber angle. Due to the special clinical signs such as deep anterior chamber as well as zonular weakness, it is difficult to implement incision, capsulorhexis and phacoemulsification safely. The selection of appropriate intraocular lens (IOL) and operation modes are taken more attention. Iris-claw IOL implantation may be more suitable surgical way for ASD patients. It is worthy of further research and exploration on how to choose individualized surgery according to the different characteristics of capsular bag in cataract patients with ASD in order to obtain better surgical efficacy. (Int Rev Ophthalmol, 2022, 46: 211-215)
    Prevalence and related factors of the preschool myopia
    You Yuxia, Wei Shihui
    2022, 46(3):  216-221.  doi:10.3760/ cma.j.issn.1673-5803.2022.03.005
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    Myopia before the age of 6 is defined as preschool myopia. It has a higher risk of developing high myopia and some secondary irreversible blinding complications. Compared with school-aged children (over 6 years old), preschool myopia is relatively less. Studies have reported that the prevalence of preschool myopia is 0.42%~11%. The prevalence of myopia varies widely among races, with non-Hispanic white children lower than Hispanic children and Asian American children and often higher in Asian children. Parental myopia is often thought to increase the likelihood of myopia in preschool children. Unlike school-age myopia, the prevalence of preschool myopia decreases with age, and there is no obvious difference between genders, but whether it is related to near work is still under discussion. (Int Rev Ophthalmol, 2022, 46: 216-221)
    Expression and significance of platelet derived growth factors and their receptors in proliferative vitreoretinopathy
    Li Duo, Huang Xionggao
    2022, 46(3):  222-227.  doi:10.3760/ cma.j.issn.1673-5803.2022.03.006
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    Proliferative vitreoretinopathy (PVR) is a serious complication of ocular trauma and vitreoretinal surgery, which can lead to serious visual impairment. Platelet derived growth factors (PDGFs) and their receptors (PDGFRs) are essential for a series of physiological processes, which are very important for the normal development of the body. However, the abnormally expressed PDGFs and PDGFRs can activate the downstream signal pathway and regulate the abnormal proliferation and migration of cells. PDGFs is an important cell mitogen. After ocular trauma or rhegmatogenous retinal detachment, the blood-retinal barrier is destroyed. PDGFs are released  from platelets α particles or autocrine by retinal pigment epithelial cells (RPE) to induce cell proliferation and enhance the ability of cell migration, invasion and contraction, which may further lead to tractive retinal detachment after the formation of proliferative membrane. Growth factors outside the PDGFs family in vitreous can indirectly activate PDGFRs, which is enough to cause PVR, and blocking PDGFRs can effectively inhibit PVR. PDGFs and PDGFRs play an important role in the occurrence and development of PVR. (Int Rev Ophthalmol, 2022, 46: 222-227)
    The clinical characteristics and progress in diagnosis and treatment of nystagmus
    Li Huixin, Fu Jing, Hao Jie
    2022, 46(3):  228-235.  doi:10.3760/ cma.j.issn.1673-5803.2022.03.007
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    Nystagmus can be divided into congenital nystagmus and acquired nystagmus according to the age of onset. Due to its multiplex clinical manifestations and the limited diagnosis and treatment strategies, nystagmus becomes one of the difficult and complicated diseases in ophthalmic diagnosis and treatment.  In recent years, video nystagmography (VNG) and digital eye tracker have been used to quantitatively evaluate the degree of nystagmus and the therapeutic effect of nystagmus. In terms of treatment, in addition to traditional surgical methods, optometry (correcting refractive errors, wearing prism), biofeedback therapy, drug (gabapentin and memantine) therapy, and perception training were also be used. (Int Rev Ophthalmol, 2022, 46: 228-235)
    Drug delivery system based on contact lenses and its application in the treatment of anterior segment diseases
    Wang Feng, Shao Yi
    2022, 46(3):  236-241.  doi:10.3760/ cma.j.issn.1673-5803.2022.03.008
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    Eye drop solutions are widely used by the ophthalmologist to treat the anterior segment eye diseases. However, eye drop solutions have many limitations including low bioavailability, high dose requirements, and poor patient compliance. Contact lenses are used to deliver the ocular drugs with high ocular bioavailability due to their immediate location to ocular surface. Based on the contact lenses, loading conventional drugs are used to explore the feasibility and potential to treat anterior eye disorders. Drug incorporated to the lens body is achieved with techniques, like simple soaking, inclusion of drug-loaded colloidal nanoparticles, or molecular imprinting. No matter what technique used, the key properties of the contact lens maintain unchanged, such as transparency and oxygen permeability. The drug delivery system based on contact lenses can effectively prevent and control ocular surface infection,promote corneal injury healing,treat allergic conjunctivitis,improve dry eye symptoms,and reduce intraocular pressure. It provides a new way for diagnosis and treatment of anterior segment disease. (Int Rev Ophthalmol, 2022, 46: 236-241)
    Corneal collagen crosslinking in the treatment of ultra-thin keratoconus
    Ma Ruijue, Wang Yan, Liang Shuang
    2022, 46(3):  242-246.  doi:10.3760/ cma.j.issn.1673-5803.2022.03.009
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    Keratoconus is a chronic progressive disease without inflammation. It is characterized by the gradual thinning and slow expansion of normal cornea into a cone. Corneal collagen crosslinking has become an important treatment and one of the effective methods to prevent the progress of keratoconus by improving the biomechanical properties of cornea. 400 μm corneal thickness limits many ultra-thin keratoconus from the corneal cross-linking treatment. In view of the good therapeutic effect of corneal crosslinking on corneal dilation diseases, many scholars have tried various new treatment schemes on the basis of the original standard scheme in recent years. For example, the improvement of surgical methods such as transepithelial and epithelial island preservation, the use of low permeability riboflavin, corneal contact lens and lens removed from small incision lenticule extraction to increase the total corneal thickness, and personalized adjustment of intraoperative energy use, personalized adjustment of intraoperative energy use and other improved treatment methods. These technologies are designed to break through the 400 μm limitation of corneal cross-linking surgery, so as to achieve safe and effective corneal cross-linking treatment for ultra-thin keratoconus. (Int Rev Ophthalmol, 2022, 46: 242-246)
    The treatment of herpes simplex virus necrotizing stromal keratitis
    Ni Yan, Zheng Libin, Xu Yesheng, Yao Yufeng
    2022, 46(3):  247-252.  doi:10.3760/ cma.j.issn.1673-5803.2022.03.010
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    Herpes simplex virus necrotizing stromal keratitis (HSV NSK) is a kind of rare eye disease mainly characterized by stromal necrosis, which can lead to vision loss, corneal perforation, even blindness and enucleation. At present, the management of HSV NSK can be divided into non-surgical procedure and surgical treatment. Non-surgical procedure includes antiviral drugs such as nucleoside analogues, IFN-γ-ASON, DMF, CsA, vaccine, etc. In the event of serious cases beyond the control of non-surgical therapy, surgical management is necessary. Common clinical surgeries include penetrating keratoplasty (PKP), deep anterior lamellar keratoplasty (DALK), multilayer amniotic membrane transplantation (AMT), and conjunctival flap coverage and so on. (Int Rev Ophthalmol, 2022, 46: 247-252)
    The treatment of fungal keratitis
    Gao Ning, Yang Ruibo
    2022, 46(3):  253-260.  doi:10.3760/ cma.j.issn.1673-5803.2022.03.011
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    In recent years, the development of medicine and related disciplines has provided a new prospect for the treatment of fungal keratitis (FK). In terms of drugs, it mainly focuses on the development of safe and effective antifungal drugs such as acrylamide, echinocandins, antimicrobial peptides and their derivatives. The study of FK immune mechanism provides a theoretical basis for the application of immunosuppressants. In addition, the combine of ocular drug delivery system and antifungal drugs can promote the corneal permeation of drugs, and the effectiveness has been verified by FK animal model, some complexes, such as fluconazole liposomes, have good effects. In terms of FK surgery, early surgery,  the pathogen mainly growing horizontally, slight infiltration with effective antifungal drugs are of great significance to improve the success rate of lamellar keratoplasty. At the same time, intrastromal injection of antifungal drug, corneal collagen cross-linking technology, excimer laser technology highlight their respective advantages in FK patients with early infection, slight infiltration or no response to antifungal drug. In the future, with the continuous development and application of effective antifungal drugs for ophthalmic preparations, the improvement of corneal surgery technology and the cooperation of multiple disciplines, the therapeutic effect and prognosis of FK are expected to be greatly improved.(Int Rev Ophthalmol, 2022, 46: 253-260)
    Neutrophil extracellular traps and related infection and inflammation on ocular surface#br#
    Li Yingsi, Yan Xiaoming
    2022, 46(3):  261-266.  doi:10.3760/ cma.j.issn.1673-5803.2022.03.012
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    Over the last decade, numerous studies have demonstrated that neutrophils could trap and kill pathogens by releasing a reticular structure containing DNA, which is named as neutrophil extracellular traps (NET). As a new antimicrobial mechanism, NET has been widely concerned and studied by plenty of scholars. However, increasing evidence showed that excess NET could cause some damage for tissue, which is involved in the pathological processes of various diseases. In addition, researchers have found aggregated NET in tear film, suggesting a key role of NET in defending against pathogens on ocular surface, while excessive NET promoted an inflammatory process on ocular surface. This article describes the latest research progress on the dual role of NET on ocular surface system, focusing on the anti- pathogenic effects and pro-inflammatory responses of NET to provide a new avenue for pathogenesis and therapeutic strategies of ocular surface inflammation and infection. (Int Rev Ophthalmol, 2022, 46: 261-266)
    Ocular features and treatment of Goldenhar syndrome
    A Tingxi, Fu Yao
    2022, 46(3):  267-272.  doi:10.3760/ cma.j.issn.1673-5803.2022.03.013
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    Goldenhar syndrome is a rare, congenital malformation syndrome characterized by dysplasia of structures driving from the first and second branchial arches. The etiology is complex and varied with the influence of genetic and environmental factors, but the specific pathogenesis is still poorly elucidated. The main manifestations are cranial and facial dysplasia, and other organs or systems may be involved. The ocular manifestations of Goldenhar syndrome are complex and diverse, involving the anterior segment, eyelid and appendages, posterior segment, extraocular muscle and orbit, among which epibulbar choristoma and upper eyelid coloboma are the most common abnormalities. Personalized treatment should be developed according to patients' conditions. Surgical treatment is the main treatment for ocular abnormalities. Early intervention is recommended for the sake of visual development and psychosocial health of patients. (Int Rev Ophthalmol, 2022, 46: 267-272)
    Application study of NLRP3 signalling pathway-related inhibitors in the treatment of ophthalmic diseases
    Chen Zhengyu, Long Qin
    2022, 46(3):  272-277.  doi:10.3760/ cma.j.issn.1673-5803.2022.03.014
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    Inflammation plays an important role in the development of numerous diseases, of which nucleotide binding oligomerization domain like receptors protein 3(NLRP3) signaling-pathway is a key component. NLRP3 can trigger inflammation by self-assembling to form inflammasome to activate casepase-1, which then activates IL-1β and IL-18 precursors. SM934, osteopontin, fenofibrate, MCC950 and resveratrol can reduce the expression of IL-18 and IL-1β by inhibiting the expression of different sites of the NLRP3 signaling pathway (e.g. NF-κB, casepase-1, NLRP3, etc.), thereby achieving the control of oxidative stress and the aim is to control oxidative stress and chronic inflammation, and ultimately to treat ophthalmic diseases such as dry eye, diabetic retionpathy and AMD. The research on NLRP3 signalling pathway inhibitors for ophthalmic diseases is still in the early stages of animal models and in vitro experiments,and its application in ophthalmic diseases needs to be further researcheded.  (Int Rev Ophthalmol, 2022, 46: 272-277)
    Research progress of eye damage caused by first-line anti-tuberculosis drugs
    Yan Yuqing, Zuo Haihong
    2022, 46(3):  277-282.  doi:10.3760/ cma.j.issn.1673-5803.2022.03.015
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    The eye injury caused by anti-tuberculosis drugs increases year by year as the prevalence of tuberculosis. The main adverse reactions of ethambutol are ethambutol toxic optic neuropathy and occasional retinal toxicity.  The mechanism might be chelation of mitochondria with metals, the impaired function of mitochondria, and the inhibited synthesis of ATP, so as to affect the transport of mitochondria from the cell body to the distal side of nerve axons while the energy is exhausted. It could be accompanied by axon edema, and the apoptosis of nerve cells.  Daily dose and renal dysfunction have a great impact on the occurrence of ethambutol toxic optic neuropathy. Less than 1/3 patients had improved visual acuity after withdrawal. The usage of ethambutol should be lower than conventional dose for the elder and the renal dysfunction people. The main adverse reactions of isoniazid are toxic optic neuropathy, abducens nerve paralysis and retrobulbar optic neuritis in children. The loss of vitamin B6 by using isoniazid or the blocking of pyridoxal phosphate synthesis so as to consume the neurotransmitters caused by the competitive inhibition between isoniazid and vitamin B6 could be the pathogenesis of isoniazid toxic optic neuropathy. The accumulated dose of isoniazid could have great effect on toxic optic neuropathy, and conventional dose could cause abducens nerve paralysis.  The adverse reaction of rifampicin and pyrazinamide is scarce. (Int Rev Ophthalmol, 2022, 46: 277-282)
    Diagnosis and treatment of orbital schwannoma
    Wang Weiqi, Ma Jianmin
    2022, 46(3):  283-288，封三.  doi:10.3760/ cma.j.issn.1673-5803.2022.03.016
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    Orbital neurilemmoma is one of the most common orbital tumors and commonly presents as proptosis. Typical schwannoma are mainly composed of alternately distributed AntoniA and AntoniB tumor cells, most of which are AntoniA tumor cells. MRI was taken as the first choice on clinical diagnosis, and CT examination as accessory examnation, the latter mainly observing the tumor's effect on the surrounding bone mass.Histopathological examination is the gold standard for diagnosis.Attention needs to be paid to the differential diagnosis with cavernous hemangioma, malignant orbital schwannoma and so on. The most effective treatment is still surgery, and optimal treatment has not yet been found. (Int Rev Ophthalmol, 2022, 46: 283-288, cover III)
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