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Table of Content

    25 March 2013, Volume 22 Issue 2
    The influence factors of refractive status after cataract surgery
    LIU Yi-Zhi
    2013, 22(2):  73-76. 
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    Refractive status after cataract surgery is one of the critical elements for optical visual outcomes, which may be affected by any of the following factors: measurement accuracy of intraocular lens power (e.g. corneal refractive power, axial length, anterior chamber depth and calculation formula), corneal refractive status and factors related to the intraocular lens and capsule. These factors should be thoroughly appreciated and meticulously addressed in the planning and implementation of surgery, which is of great significance for the advancement of cataract surgery towards refractive surgery in China. (Ophthalmol CHN, 2013, 22: 73-76)
    Application of femtosecond laser-assisted cataract surgery
    XING Xiao-Jie, TANG Xin, YUAN Xiao-Yong
    2013, 22(2):  77-79. 
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    Phacoemulsification is the main method for cataract surgery in the world. Femtosecond laser-assisted cataract surgery gives several surgical advantages over conventional phacoemulsification, including laser capsulotomy, lens fragmentation, clear cornea incisions and limbal relaxing incisions. The benefits such as reduced complication rates and improved postoperative refractive results are being investigated. In practical application, the surgical indication have to be detailed, and speeding up the progress of developing femtosecond laser combine phacomulsification system for cataract surgery is still important. (Ophthalmol CHN, 2013, 22: 77-79)
    The efficiency and necessity of phakic intraocular lens implantation
    DONG Zhe, WANG Ning-Li, LI Ying, LUO Yan
    2013, 22(2):  80-81. 
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    Phakic intraocular lens implantation is a new elective method for high myopia correction. The safety of this operation depends on sufficient examination pre-operation and regular observation. But the performance depends on the desire for the abandon of spectacles of the high myopia patients. Ophthalmologists must communicate with patients totally, and make sure that the high myopia patients who will take this operation comprehend the method soundly. (Ophthalmol CHN, 2013, 22: 80-81)
    Change of pulsatile ocular blood flow during phacoemulsification surgery with high pressure irrigation
    WANG Zhen-Mao, ZHANG Ming-Zhi
    2013, 22(2):  82-85. 
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    Objective To investigate in vivo the change of pulsatile ocular blood flow (POBF) and relative parameters during phacoemulsification phases with high pressure irrigation. Design Prospective non-comparative case series. Participants Twenty three patients with cataract who underwent phacoemulsification surgery. Methods A total of 23 patients with cataract who underwent phacoemulsification were included. POBF was assessed using a POBF analyzer. The parameters included POBF and average-IOP. POBF was measured 3 times: before surgery as baseline, during phacoemulsification phase and I/A phase. Blood pressure and heart rate were recorded by the ECG monitor when POBF was measured. POBF changes, IOP and the relation between age, IOP, heart rate, blood pressure and POBF were analyzed. Main Outcome Measures POBF, IOP. Results The POBF measured at baseline, during the phacoemulsification and I/A phases were 16.43±6.52, 12.36±9.60 and 8.24±6.55 μl/sec, respectively. Compared with baseline, POBF decreased during the phacoemulsification phase and continue to decrease further during I/A phase. There was a statistically significant difference between POBF at baseline and during the I/A phase (all P<0.001). The average-IOP measured at baseline, during the phacoemulsification and I/A phases were 21.10±4.10 mm Hg, 59.64±13.83 mm Hg and 39.72±10.04 mm Hg, respectively. The highest IOP measured in the 3 phases was during the phacoemulsification phase (59.64±13.83 mm Hg). Compared with baseline, IOP measured in the 2 surgery phases increased significantly (all P<0.05). POBF was found to decrease with increasing age or IOP. POBF also increased as heart rate or systolic blood pressure increased. Conclusion The present study indicated that as IOP rose during phacoemulsification surgery, POBF continued to decrease. This suggested that phacoemulsification surgery might cause ocular ischemia with high pressure irrigation. (Ophthalmol CHN, 2013, 22: 82-85)
    A C>G mutation of GJA8 associated with autosomal dominant congenital cataracts in a Chinese family
    MA Zi-Cheng, Li-Qian, Guo-Yuan-Yuan, Yang-Zhen-Fei, Zhu-Si-Quan
    2013, 22(2):  86-89. 
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    Objective To identify the pathogenic gene in a southern Chinese family having autosomal dominant congenital cataract. Design Experimental study. Participants A Chinese family with hereditary nuclear cataract was enrolled. Method A Chinese family with inherited cataract treated at Beijing Tongren Hospital was recruited. Detailed family history was recorded. Blood was taken from the proband and available family members. Candidate genes sequencing was performed by sequencing of polymerase chain reaction (PCR) products. Bioinformatics analysis was then used to evaluate the effect of the amino acid change. Main Outcome Measures Gene sequences. Results Ophthalmologic examination showed that the congenital cataract phenotype of the family was nuclear cataract. Candidate genes sequencing revealed a C>G transition at position c.565 in the GJA8 gene. The mutation led to a Proline to Alanine substitution in position p.189 and was not found in unaffected family members and 100 unrelated controls. Bioinformatics analysis showed that the detected mutation was located within a highly conserved region and probably damaged the structure as well as function of GJA8 gene. Conclusions A novel GJA8 gene mutation was found to be associated with hereditary nuclear cataract in a Chinese ADCC family. The second extracellular domain of Cx50 may play an important role in maintaining the transparency of the lens. (Ophthalmol CHN, 2013, 22: 86-89)
    Effects of pan-retinal photocoagulation(PRP) before or after cataract surgery in patients with diabetic retinopathy
    DONG Hong-Yan, Dong-Li, Bai-Jie,
    2013, 22(2):  90-93. 
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    Objective To investigate the effects of pan-retinal photocoagulation (PRP) in patients with preproliferative (PPDR)and proliferative(PDR)diabetic retinopathy (DR) that underwent cataract surgery. Design Retrospective case series. Participants Sixty five patients (95 eyes) diagnosed with FFA as having proliferative and preproliferative DR with moderate or severe cataract. Methods In all patients we were able to see the fundus, patients with PPDR and PDR were divided into two groups according to patient′s condition after obtaining informed consent. Group A was treated with IOL implantation following peripheral laser for 2 times, then photocoagulation was carried out for 2 times during 1 month. Group B was treated with IOL implantation and then PRP treatment were given for 3 times (each time interval for one week) after 1 month. The results of FFA were used to grade DR. Obvious effects: The original neovascularization was completely atrophied and non-perfusion areas disappeared. Effectiveness: neovascularization and non-perfusion areas mostly disappeared. Ineffectiveness: no change in neovascularization, presence of vitreous hemorrhage or neovascular glaucoma. Main Outcome Measures Best corrected visual acuity, new blood vessels and areas of no perfusion evaluated with FFA, macular center thickness evaluated by OCT. Results The proportion of patients with improved visual acuity and stable visual acuity in PPDR patients before and after laser surgery was 90.5% (19/21) in group A and 86.4% (19/22) in group B, with no significant difference between the two groups (P=0.12). In PDR patients, the proportion of patients with improved visual acuity and stable visual acuity was 76.9% (20/26) in group A and 65.4% (17/26) in group B, with a statistically significant difference (P=0.02). In PPDR patients, as shown by FFA, non-perfusion areas largely disappeared in Group A (85.7% (18/21)), and in Group B (81.8% (18/22)), without significant difference between the two groups (P=0.1). In PDR patients, non-perfusion areas largely disappeared in group A (61.5% (16/26)) and in group B (42.3% (11/26)), with a  significant difference between the two groups (P=0.03). There was no significant change in the thickness of the macular center in the two treatment groups of PPDR patients (Group A: 213±11.8 μm; Group B: 189±10.4 μm, P=0.1). The macular foveal thickness of PDR treatment Group A was significantly lower in treatment Group B (group A: 286±16.7 μm; group B: 425±20.7 μm; P=0.01). Conclusion Pan-retinal photocoagulation treatment in PDR patients with  cataract is more effective for PDR when given before IOL implantation than after. (Ophthalmol CHN, 2013, 22:90-93)
    Burst mode with crushing and chopping technique phacoemulsification in patients with hard nuclear cataract
    WANG Ban-Wei, GAO Yang
    2013, 22(2):  94-97. 
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     Objective To analyze the effect of a new phacoemulsification technique in the treatment of hard nuclear cataract. Design Retrospective case series. Participants One hundred ninety eight patients with hard nuclear cataract were enrolled in this study. Methods Phacoemulsification and intraocular lens implantation were performed. Patients were divided into two groups: A, burst mode using a crushing and chopping technique, and B, a continue mode with a divide and conquer technique. Main Outcome Measure Phaco power, phaco time, visual acuity, corneal edema and corneal endothelial cell loss were evaluated at day 1, and 1 week and 1 month postoperatively. Results Average phacoemulsification power in group A and group B were 8.1%±1.3% and 27.0%±3.4%, respectively. Average phaco time was 59.2±5.8 seconds and 256.1±14.5 seconds in group A and B, respectively. The differences were statistically significant (all P<0.001). Endothelial cells loss was 4.5±2.4% and 9.5±5.4% in group A and B, respectively. One day after surgery, 70 cases (68.0%) in group A and 12 cases (12.6%) in group B achieved corrected visual acuity of 0.5 or better. The difference was statistically significant (P<0.001). One day after surgery, 72(69.9%) and 13(13.6%) patients were found to have grade I corneal edema, and 6(5.8%) and 35(36.8%) cases had grade IV corneal edema, in group A and B respectively. Posterior capsular rupture only occurred in one case in group B. Conclusion Compared with the continue mode, phacoemulsification with the burst mode and an effective chop technique may reduce phaco power and time for the treatment of patients with hard nucleus. Burst mode seemed to be more effective with less complications. (Ophthalmol CHN, 2013, 22: 94-97)
    Clinical evaluation of penetrating keratoplasty with different race donor corneas
    ZHANG Ying-Nan, YAN Chao, WANG Li, LIU Jing, Pan-Zhi-Qiang
    2013, 22(2):  98-100. 
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     Objective To evaluate the clinical effect of penetrating keratoplasty (PKP) performed with internationally acquired corneas from donors of a different race. Design Retrospective case series. Participants 10 eyes from 10 patients with corneal leucoma, corneal endothelial dysfunction or corneal graft failure that underwent PKP in Beijing Tongren Eye Center, Beijing Tongren Hospital between October 2002 to March 2003 (10 corneas from Caucasians: 8 eyes,Hispanic:1 eye,African-American:1 eye). Method All cases underwent PKP with corneas from donors of a different race from the Tissue Bank International (TBI), and for whom a mean of 12.6±3.86 months of follow-up was available. Main Outcome Measure Visual acuity, corneal transparency, stromal edema and graft neovascularization. Results Among the 10 eyes that met inclusion criteria, there were 4 eyes graft survival at 1 year. The opacity, edema and neovascularization of the graft wore observed in the other 6 eyes. The overall rate of rejection was 60%. Conclusions This small sample study shows the internationally acquired corneas different race donor corneal tissue can be used for PKP. (Ophthalmol CHN, 2013, 22: 98-100)
    Use of corticosteroid eyedrops combined with artificial tears in the treatment of dry eyes in the convalescent phase of herpes simplex keratitis
    LIU Shu-Ying, Li-Zhi-Qing, Chen-Lu-Xia, Zhao-Shao-Zhen
    2013, 22(2):  101-104. 
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    Objective To investigate the effect of a combination of corticosteroid eyedrops and artificial tears in the treatment of dry eyes in the convalescent viral keratitis. Design Retrospective case series. Participants This study involved 52 eyes of 43 consecutive patients with dry eyes who had recovered from viral keratitis after routine treatment between June 2008 and August 2011. The average age was 35.28±11.62 (17~59) years old. Method The patients were given artificial tears without preservative 4 times per-day and corticosteroid eyedrops 3 times per-day. For all patients, the tear film break-up time (BUT), corneal fluorescein staining score (FL) and Schirmer I test (SIT) were evaluated before and 7,14,and 28 days after initiating the treatment. Main Outcome Measures BUT, FL and SIT. Results All patients completed the study until its end. The BUT, FL and SIT were improved at all time points. Symptoms completely resolved in some patients. During treatment, the SIT increased from 6.40±2.31 mm to 14.58±2.81 mm (P=0.000), the FL score decreased from 7.52±2.78 to 0.14±0.26 (P=0.000) and the BUT increased from 7.63±0.90 s to 11.53±1.78 s (P=0.000). Conclusion Corticosteroid eyedrops combined with artificial tears without preservative were helpful and effective in the treatment of dry eyes in the convalescence phase of virus keratitis. (Ophthalmol CHN, 2013, 22: 101-104)
    Cultivation and identification of fibroblasts of bulbar conjunctival in patients with conjunctivochalasis
    HAN Zhu-Mei, Zhang-Xing-Ru, Zhang-Long, Ni-Zhen-Hua, Sun-Jian, Fu-Zhi-Xuan, Li-Qing-Song, Xiang-Min-Hong
    2013, 22(2):  105-109. 
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    Objective To study pieces-stick primary culture of conjunctival tissue and identification of bulbar conjunctiva fibroblast from patient of conjunctivochalasis,for conjunctivochalasis provide a large cells in vitro study. Design Experimental study. Participants Cultures of conjunctiva fibroblasts from conjunctivochalasis. Methods The bulbar conjunctivafrom patient who accepted operation of conjunctivochalasis removal was the experimental material. Fibroblasts were cultured with tissue pieces-stick method,  trypsin-digest and transferred in vitro. Then, morphological observation was carried out, and expression of fibroblast cytoplasm-specific protein was identified by immunofluorescence and detected by Flow Cytometry. Main Outcome Measures Cellular morphology, structure and purity. Results After culture with primary culture method for 2-5 days, tissue pieces were closely attached with six well plates. After 10-15 days, lots of cluster of cell proliferation were observed under inverted microscope, cells had a mosaic shape with indistinct borders. When cells were subcultured into secondary generation, cells under microscope presented with a shuttle shape and radical arrangement. Size and morphology were uniform. There was an oval-shaped nucleus in cytoplasm, and crosslinking was formed between cells by cellular processes. Expression of Vimentin and Keratin (C11) in bulbar conjunctiva fibroblasts from patients with conjunctivochalasis were detected as positive and negative respectively by fluorescence microscope and flow cytometry. Conclusions Stable conjunctivochalasis conjunctiva fibroblast can be obtained by cell culture with tissue pieces-stick method, and can also be further identified by morphologic observation, flow cytometry and immunofluorescence. (Ophthalmol CHN, 2013, 22: 105-108)
    Corneal curvature and elevation for early diagnosis of keratoconus with Pentacam
    ZHANG Xue, Hu-Qi, Kang-Yang, Li-Xue, Zhou-Wen-Yan, Wang-Ke-Meng
    2013, 22(2):  110-116. 
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    Objective To investigate the change of anterior and posterior corneal curvature and corneal elevation parameters with Pentacam in discriminating between clinical keratoconus eyes, subclinical keratoconus eyes and normal eyes. Design Evaluation of diagnostic technology. Participants Sixteen patients (16 eyes) with clinical keratoconus, 19 patients (19 eyes) with subclinical keratoconus, and 29 patients (29 eyes) with myopic astigmatism as control group were analyzed. Method Twelve anterior and posterior corneal curvature and corneal elevation parameters provided by Pentacam were recorded for all groups. The t test and receiver operating characteristic (ROC) curves were used and partial least squares (PLS) was used to construct models with anterior and posterior corneal curvature and corneal elevation parameters for the early diagnosis of keratoconus. Main Outcome Measures The anterior and posterior corneal curvature and corneal elevation parameters. Results There were significant differences between the clinical keratoconus group, the subclinical keratoconus group and the control group. The values of area under the curve(AUC)were all closed to 1, and the diagnosis accuracy was higher. The optimum cutoff points of maximum anterior corneal elevation above the BFS at central 5.0 mm (MaxAE5) for clinical keratoconus and subclinical keratoconus were 13.5 μm and 10 μm respectively. The maximum posterior corneal elevation above the BFS at central 5.0 mm (MaxPE5) for clinical keratoconus and subclinical keratoconus were 34.5 μm and 24.5 μm. Conclusion The anterior and posterior corneal curvature and corneal elevation parameters obtained with Pentacam might be useful for the early diagnosis of clinical and subclinical keratoconus. (Ophthalmol CHN, 2013, 22: 110-115)
    Comparison between light house visual acuity chart and Freiburg electronic visual acuity chart
    YANG Yao-Hua, Zhen-Yi, WU Hai-Tao, Li-Peng- 
    2013, 22(2):  117-120. 
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    Objective To investigate the clinical application value of Freiburg electronic visual acuity chart by comparing the consistency and repeatability between light house visual acuity chart (LHVAC) and Freiburg electronic visual acuity chart(Freiburg). Design Evaluation of diagnostic technology. Participants Eighty-six staff members(45 men and 41 women)from the Air Force of Hangzhou Aviation Medicine Training Center were involved, with an average age of 26.3±2.1 years. Method All subjects were examined randomly and successively using LHVAC and Freiburg. All examinations were done in the same room. The brightness of the room was less than 3 lux and the work distance was 3 m. For each subject, the difference in visual acuity measurements obtained with the two visual acuity charts were evaluated by paired t-test and R value of the correlation coefficient were calculated. Main Outcome Measures LogMAR visual acuity obtained using the two charts. Results When used first, the logMAR visual acuity of LHVAC was 0.19±0.23. Accordingly, the result of Freiburg was 0.20±0.15. The difference between the two results was -0.011±0.141, the results showed that these two charts had no statistically significant difference between them(t=-0.741, P=0.461)and had significant correlation (r=0.808, P=0.000). When used in second, the logMAR visual acuity of LHVAC chart was 0.32±0.25. Accordingly, the result of Freiburg  was 0.20±0.15. The difference between the two results was -0.118±0.151, the results showed that these two charts had a statistically significant difference between them(t=7.191, P=0.000, however the results were significantly correlated (r=0.810, P=0.000). Using LHVAC, the difference between the two examinations was significant (F=11.872,P=0.001) and the correlation coefficient was 0.938 (P=0.000). Using Freiburg examination, the difference between the two examinations was not significant (F=0.019,P=0.890) and the correlation coefficient was 0.986 (P=0.000). Conclusion The influence of examination order on Freiburg was less than with LHVAC and the repeatability of Freiburg was better than LHVAC. (Ophthalmol CHN, 2013, 22: 117-120)
    Treatment of children partially accommodative esotropia and the use of adjustable suture in surgery
    QI Ya, YU Gang, WU Qian, CAO Wen-Hong, FAN Yun-Wei, ZHANG Cheng-Yue, CUI Jie, LIN Qi, HU Man
    2013, 22(2):  121-123. 
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    Objective To evaluate the use of adjustable suture for the surgical treatment of children with partially accommodative esotropia and treatment before surgery.  Design Retrospective cases series. Participants Thirty patients with of partially accommodative esotropia that underwent surgical treatment at Beijing Children’s Hospital. Methods The clinical data of patients with partially accommodative esotropia that underwent surgery were reviewed retrospectively. When residue esotropia was stable and amblyopia had been managed, patients should have surgery in time. Surgery was performed according to the average deviation with and without refractive correction. Adjustable suture were used. Patients were followed-up for 6 to 15 months. Strabismus and binocular vision were observed. Main Outcome Measures Deviation after surgery, binocular vision function, the use of adjustable suture after surgery. Results Three patients were adjusted for overcorrection after surgery. At the last follow-up, 26 cases (87%) were within orthotropia-+8△, 4 cases (13%) were within +10△~+15△ at the last follow-up. Two cases among 19 cases (11%) had binocular vision before surgery. Fifteen cases among of 21 cases (71%) had binocular vision at the last follow-up. Conclusion Partially accommodative esotropia should be prescriptde full hyperopic correction. Patients should be treated by surgery in time when residue esotropia was stable and management of amblyopia. Strabismus surgery depend on the average of the size of deviation of with and without glasses. Adjustable suture use in strabismus surgery was conducive for eye alignment.  (Ophthalmol CHN, 2013, 22: 121-123)
    Evaluation of Pittsburgh Sleep Quality Index in patients with central serous chorioretinopathy
    WEI Jian-Li, ZHANG Lu-Rong, ZHOU He-Ding
    2013, 22(2):  124-125. 
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    Objective To analyze sleep quality in patients with central serous chorioretinopathy (CSC). Design Questionnaire survey. Participants Twenty one patients with CSC and 21 normal control subjects.  Methods Twenty one patients with CSC and 21 normal control groups were evaluated using the Pittsburgh Sleep Quality Index (PSQI). All subjects were requested to fill out the PSQI questionnaire by themselves. Main Outcome Measures PSQI Global score and component score. Results The PSQI Global score in patients with CSC (8.76±5.07) was higher as compared to normal control subjects (3.57±1.72) (P=0.000). Sleep quality component score in patients with CSC (1.67±0.86) was higher than in normal control subjects (0.71±0.64) (P=0.000). Sleep efficiency component score in patients with CSC (0.86±1.15) was higher than in the normal control group (0.19±0.40) (P=0.019). Conclusions Patients with CSC had sleep disorders. A relationship between CSC and sleep disorders might exist. (Ophthalmol CHN, 2013, 22: 124-126)
    Compound anisodine hydrobromide improves the retinal blood supply of patients with proliferative diabetic retinopathy after vitrectomy
    ZHENG Jiao, Cao-Fei
    2013, 22(2):  126-129. 
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    Objective To investigate the effect of anisodine hydrobromide injection on proliferative diabetic retinopathy (PDR) after vitrectomy surgery. Design Perspestive comparative case series. Participants Forty four selected PDR cases (44 eyes) without improvement of visual acuity 7 days after vitrectomy surgery or  fresh bleeding within the retina. Methods Patients were randomly assigned to the compound anisodine hydrobromide injection treatment group(group A, 22 eyes of 22 patients) or to the blank control group that received vitamin B tablets(group B: 22 eyes of 22 patients and 6 lost of follow-up). All groups received the treatment during 28 days. Color-Doppler Ultrasound parameters of retinal vessels and the best corrected visual acuity were evaluated before and after treatment. Main Outcome Measures Best corrected visual acuity, the ophthalmic artery peak systolic velocity(PSV), end diastolic velocity(EDV), averaged maximum velocity (TAMV), the resistance index(RI) and pulsatility index(PI). Results Fourteen eyes in group A (63.6%) and 3 eyes in group B (18.8%) had visual acuity improvement. The visual acuity of group A was significantly improved after treatment(χ2=5.84,P=0.016) while in group B there was no significant change. In group A, the ophthalmic artery PSV(t=8.44,P=0.000), the EDV(t=4.52,P=0.000)and the TAMV(t=3.77,P=0.001) increased significantly whereas the RI(t=2.92,P=0.006) and PI (t=3.69,P=0.001)decreased. After treatment, hemodynamic parameters were significantly improved. Conclusions The treatment of PDR patients after vitrectomy with compound anisodine hydrobromide could improve the retinal blood supply and visual acuity. (Ophthalmol CHN, 2013, 22: 126-129)
    Quantitative study of retinal nerve fiber layer thickness and macular thickness after idiopathic demyelinating optic neuritis by optical coherence tomography
    ZHANG Yi-Xin, Dai-Yan-Li, Huang-Hou-Bin, Wei-Shi-Hui
    2013, 22(2):  130-134. 
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    Objective To analyze retinal nerve fiber layer thickness (RNFLT) and macular thickness (MT) using optical coherence tomography (OCT) in eyes with optic atrophy following idiopathic demyelinating optic neuritis (IDON) and to evaluate the relationship between RNFLT, MT, disease duration and best corrected visual acuity (BCVA). Design Retrospective case series. Participants Sixteen eyes with optic atrophy from 16 IDON patients and 23 normal eyes from 23 age and sex-matched healthy controls. Methods All participants underwent optical coherence tomography (OCT) and BCVA examinations. The difference between the two groups, and the linear relationship between average (360°) RNFLT, cube average MT, disease duration and BCVA were evaluated. Main Outcome Measures Average RNFLT, RNFLT in the four quadrants, cube average MT, MT of 9 ETDRS sub-areas, disease duration and BCVA. Results Except for the central sub-area MT, all MT and RNFLT of optic atrophy eyes in IDON patients showed significant reduction (P=0.00). Cube average MT had a linear relationship with average RNFLT (r=0.662, P=0.01). Both average RNFLT and cube average MT had no linear relationship with disease duration (P=0.70,P=0.13). Both average RNFLT and cube average MT had no linear relationship with BCVA (P=0.80,P=0.28). Conclusions Except for the central sub-area MT, all MT and RNFLT measurements of optic atrophy eyes in IDON patients showed a significant reduction. Cube average MT had a linear relationship with average RNFLT and was dependent on RNFLT. Both average RNFLT and cube average MT had no linear relationship with disease duration or BCVA. (Ophthalmol CHN, 2013, 22: 130-134)
    Experimental study of the effects of Rhubarb polysaccharides on TLR4/ NF-κB signal transaction in LPS-induced acute anterior uveitis
    ZHANG Xiao-Long, Wang-Jing, Xu-Zhuo-Zai, Li-Zhong-Qiu, Lu-Hong-
    2013, 22(2):  134-140. 
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    Objective TLR4-mediated acute anterior uveitis is a serious ocular inflammatory disease. New targeted therapies are its most advanced treatments. Our objective was to study experimentally the molecular intervention mechanism of Rhubarb polysaccharides (RP) on endotoxin Lipopolysaccharides (LPS)-induced acute anterior uveitis TLR4 pathway and evaluate their interest as a new treatment. Design  Experimental Study. Participants Wild-type Wistar rats and RAW264.7 macrophage cell line. Method (1) 15 wild-type Wistar rats were randomly divided into three groups:one normal control group, and two model groups: LPS group and RP treatment group (n=5). RP group was treated with 400 mg/kg rhubarb polysaccharides by intraperitoneal injection, the control group and the model group were injected with equivalent PBS. Two hours later both LPS group and RP group was injected with 0.1 ml LPS, the control group was injected with a isovolumetric of PBS. After 24 hr we observed the rat anterior segment inflammation using a slit-lamp and giving an inflammation grading score. The TLR4 expression in the rats iris was analyzed by Real time (RT)-PCR. (2) RAW264.7 macrophage cells were cultured in vitro. RP and LPS were used to stimulate cells. Then macrophages and their related molecules were evaluated by Western blot analysis, RT-PCR, ELISA and immuno-fluorescence techniques. Main Outcome Measures The degree of inflammation of the rat anterior segment, and TLR4 expression changes on macrophages. Results (1) Under slit-lamp observation of rats we found in the LPS group, severe iris hyperemia, anterior chamber flare, pupil fibrin exudate, while in the RP intervention group showed only mild iris hyperemia, no obvious pupil exudative membrane and no pupil to shrink. Using RT-PCR, the TLR4 mRNA expression in RP intervention group was significantly lower as compared with the LPS group. (2) Western blot and RT-PCR results showed that RP in vitro could induce an increase expression of TLR4, myeloid differentiation protein-88 (MyD88), nuclear factor-κB(NF-κB) p65 protein and mRNA by macrophages. ELISA showed that RP can increase supernatant inflammatory cytokines IL-17, IL-10, TNF- α, IFN-γ, IL-1β expression by Raw264.7 cells. Immunofluorescence showed that RP could cause activation of cultured cells of TLR4 complex and increased NF-κB p65 expression. Conclusion RP significantly inhibited the activation of TLR4 pathway in endotoxin-induced acute anterior uveitis rats model. In vitro study, we found that RP have the same role as LPS on the activation of TLR4 and its downstream MyD88 and NF-κB and can also regulate the expression of cytokine.(Ophthalmol CHN, 2013, 22: 134-140)
    How internet can modify teaching processes in ophthalmology
    LIANG Qing-Feng, Antoine Labbé, LI Jian-Jun- 
    2013, 22(2):  141-143. 
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    With increasing number of subspecialties, development of new imaging techniques, use of constantly developing surgical procedures, ophthalmology may benefit from new teaching methods. The purpose of this article is to provide the reader a comprehensive analysis of internet resources in the field of ophthalmology. The characteristics of this new teaching material with abundant resources, interactivity and the possibility of self-education but also its own limitations will be presented. The major resources (international teaching programs, major ophthalmology journals and image database) and the procedures to access rapidly to the better information will be also described. (Ophthalmol CHN, 2013, 22: 141-143)