ObjectiveTo observe the clinical characteristics of ophthalmic and cerebral artery occlusion after facial cosmetic injection.MethodsA retrospective case study. Twenty patients (20 eyes) with ophthalmic and cerebral artery occlusion in Department of Ophtalmology, The Fourth Hospital of Xi’an from February 2014 to December 2016 were enrolled in this study. There were 2 males (2 eyes) and 18 females (18 eyes). They aged from 21 to 41 years, with the mean age of 29.8±1.4 years. The disease courses was ranged from 3.5 hours to 21 days, with the mean of 40 hours. Facial cosmetic injections of all patients were performed at out-of-hospital beauty institutions. The visual impairment was associated with eyelid pain 1 to 10 minutes after injection.There were 12 right eyes and 8 left eyes.The injection materials, 18 patients were hyaluronic acid and 2 patients were autologous fat, respectively. At the injection site, 13 patients were sacral, 4 patients were nasal, and 3 patients were frontal. The concentration and dose of the injected filler were not known. All patients underwent vision, slit lamp microscope, fundus color photography, visual field, FFA, OCT, and brain CT, magnetic resonance angiography (MRA) examination.ResultsThe visual acuity was ranged from no light perception to 1.0. Among the 20 eyes, 3 eyes (15%) were obstructed by simple ophthalmic artery; 5 eyes (25%) were obstructed by ophthalmic artery combined with cerebral artery; 7 eyes (35%) were obstructed by simple retinal artery occlusion (RAO) alone, which including central RAO (CRAO, 4 eyes), hemi-lateral artery obstruction (1 eye) and branch RAO (2 eyes); 1 eye (5%) was CRAO with ciliary artery branch obstruction; 1 eye (5%) was branch artery occlusion with ischemic optic neuropathy; 2 eyes (10%) were CRAO with nasal dorsal artery occlusion; 1 eye (5%) was CRAO, posterior ciliary artery obstruction and right middle cerebral artery occlusion. Among 20 patients, 4 patients (20%) had eye movement disorder and eyelid skin bun; 2 patients (10%) had facial pain and nasal skin ischemic necrosis. MRA revealed 6 patients (30%) of new intracranial ischemic lesions. Among them, 5 patients of hyaluronic acid injection showed asymptomatic small blood vessel embolization; 1 patient of autologous fat injection showed ophthalmary artery occlusion, cerebral artery occlusion, ipsilateral eye blindness, eye movement disorder and contralateral limb hemiplegia.ConclusionFacial cosmetic injection can cause severe iatrogenic complications such as RAO, ciliary artery occlusion, ischemic optic neuropathy, ophthalmic artery occlusion, and cerebral artery occlusion.
Objective
To observe the morphological changes and gene expression during the transdifferentiation of adult retinal pigment epith elial(RPE) cells into neuronal
phenotype in vitro induced by retrovirus and ciliary neurotrophic factor (CNTF).
Meothds
The adult RPE cells derived from CRL 2302 were infected by retrovirus with green fluoresence protein(GFP)and then were transfected further by liposome mediated CNTF expressing plasmid.The cellular ability of producing CNTG,and the expression
of CNTF, CNTF receptor (CNTFR), and signal transduction molecule janus tyrosine kinases (JAK) were detected by enzyme linked immunosorbent assay, immunohistochemical stainin gand Western blotting method.
Results
After infected by retrovirus, the configuration of adult RPE cells didnrsquo;t change much, but expressions of neurons and some glial cells markers likeneurofilament (NF) protein and glial fibraillary acidic protein (GFAP) were detected. After further transfected by CNTF expressing plasmid, RPE cells which expressed CNTF highly
and continuously had differential neurocytes; the expression of CNTFR didnrsquo;t
change, but the distribution position changed to the cell membrane; expression
of signal transduction molecule JAK increased obviously.
Conclusion
The adult RPE cells may transdifferentiate into neurons induced by retrvirus and
CNTF. The transdifferentiation may relate to CNTF-CNTFR-JAK signal transduction pathway.
(Chin J Ocul Fundus Dis, 2006, 22: 400-403)
Objective
To probe the significance of application of ultrasound biomicroscopy (UBM) in the diagnosis and management of the iris and ciliary tumors.
Methods
UBM (Mode 840, Humphrey, 50 MHz 5 mm×5 mm) was done in 34 cases (35 eyes) of iris and ciliary body tumors, and some of the affected eyes underwent B-scan or Doppler ultrasound and CT scan. Histopathological examination of the resected tumor tissues was performed in 21 eyes of the operation.
Results
Among this series of 35 eyes with iris and ciliary body tumors detected by UBM, the characteristics of locality and solidity of the tumors, i,e., anterior chamber in plantation cyst, cyst behind the iris, and solid tumors of iris and ciliary body, of 21 eyes undergone surgical treatment revealed the same results both in UBM and histopathological examinations.
Conclusion
UBM can supply precise informations in diagnosis and treatment of tumors of iris and ciliary body.
(Chin J Ocul Fundus Dis, 2002, 18: 128-130)
Objective To investigate the effects of ambroxol hydrochloride on surface structure of trachea mucosa in rats injured by intratracheally instilled amikacin. Methods Thirty Wistar rats injured by intratracheally instilled amikacin ( 0. 252 mL/kg) were randomly divided into a control group ( n =15) and an ambroxol group ( n= 15) . The rats in the ambroxol group were intraperitoneally injected with ambroxol hydrochloride ( 70 mg/kg) 5 minutes after amikacin administration. They were all equally divided into five subgroups and sacrificed at 2, 4, 8, 28, 48 hours respectively. Then the samples of 1/3 lower segment of trachea were collected and observed under scanning electron microscope. Results In the control group, the mucous secretion and its stickness were increased. The cilia were found lodged, sticked together, aligned abnormally, abrupt partly, and recovered slowly, with the percentage of damaged area of 98. 2% , 98. 5% , 97. 5%, 92. 7% , 82. 1% at 2, 4, 8,24,48 h, respectively. The injuries of mucosa in the ambroxol group were much milder and recovered more rapidly than those in the control group, with the percentage of damaged area of 85. 7% , 81. 9% , 73. 0% , 61. 9% , 50. 2% at 2, 4, 8, 24, 48 h, respectively. Conclusions Intratracheal instillation of amikacin can cause cilia ultrastructure damage on tracheal mucosa. Ambroxol can promote the recovery process and alleviate airway inflammation.
ObjectiveTo analyze the ultrasonographic features of adenoma of the nonpigmented ciliary epithelium (ANPCE). MethodsA retrospective series of case studies. From January 2014 to October 2021, 31 patients (31 eyes) with ANPCE (ANPCE group) were diagnosed in the eye center of Beijing Tongren Eye Center of Beijing Tongren Hospital, Capital Medical University, and 17 patients (17 eyes) with ciliary body melanoma (control group) diagnosed at the same time were selected as the control group. There was no significant difference in age (t=－0.564) and sex composition ratio (χ2=0.182) between the two groups (P=0.576, 0.670). All patients underwent ultrasound biomicroscopy to obtain the measurement parameters: tumor height, maximum basal diameter, maximum diameter, ratio of maximum diameter to basal diameter and ratio of maximum diameter to height; tumor location, shape, internal echogenicity intensity, echogenicity uniformity, degree of sound attenuation, invasion of iris, anterior displacement of the iris, lens subluxation were observed. The measurement parameters and observation indexes of the two groups were compared by independent sample t-test and χ2 test. Receiver operating characteristic (ROC) curve was drawn, area under the ROC curve (AUC) was determined, and parameter indicators with differential diagnosis value were screened. ResultsThe maximum diameter, height, maximum basal diameter, ratio of the maximum diameter to the maximum basal diameter, and the ratio of the maximum diameter to the height of the tumors in the ANPCE group and the control group were 5.64±0.98 mm, 4.24±0.59 mm, 3.66±0.71 mm, 1.58±0.34, 1.34±0.19 and 7.82±2.03 mm, 4.47±2.44 mm, 7.02±1.96 mm, 1.13±0.16, 2.09±1.06. The maximum diameter, the maximum basal diameter, and the ratio of the maximum diameter to the height of the tumor in the ANPCE group were all smaller than those of the control group, and the ratio of the maximum diameter to the maximum basal diameter was greater than that of the control group, and the differences were statistically significant (t=－4.159, －6.808,－2.924, 6.257; P<0.05). The tumors in the ANPCE group were mainly spherical (87.1%, 27/31), with no significant acoustic attenuation (77.4%, 24/31), less invading the root iris (77.4%, 24/31), and the tumors were mostly located in the ciliary body coronal (74.2%, 23/31); tumors in the control group were mainly hemispherical (47.1%, 8/17) or spherical (47.1%, 8/17), with significant sound attenuation (76.5%, 13/17), most of the tumors invaded the iris (70.6%, 12/17), and the tumors were mostly located from the pars plana to the coronal (76.5%, 13/17). There were statistically significant differences in the position, shape, sound attenuation degree, and whether it invaded the iris between the two groups of eyes (χ2=15.132, 19.767, 13.118, 10.581; P<0.05). The results of ROC curve analysis showed that the ratio of the largest diameter to the largest base diameter, the degree of sound attenuation and the AUC of whether the iris was violated were higher, which were 0.881, 0.769, and 0.740, respectively. ConclusionsUltrasound biomicroscopy is helpful in the diagnosis and differential diagnosis of ANPCE and ciliary body melanoma. The ratio of maximum diameter to maximum basal diameter, the degree of sound attenuation and whether it invades the root iris are important parameters to distinguish the two tumors.
ObjectiveTo observe and preliminarily analyze the risk factors related to silicone oil dependence after pars plana vitrectomy (PPV) in open globe injuries (OGI) . MethodsA retrospective clinical study. This study included 211 patients with OGI who received PPV treatment from January 1, 2005 to December 31, 2016 in Eye Injury Vitrectomy Study database. Silicone oil dependence was defined as the intraocular pressure ＜10 mm Hg (1 mm Hg= 0.133 kPa) in silicone oil tamponade eye 6 months after PPV. The patient's age, intraocular pressure, type of injury, length of eyeball wound, as well as the presence of ciliary body injury, choroidal injury, and retinal resection and/or defect area were recorded in detail. Logistic multifactorial regression analyzed the correlation between age, eye wound length and ciliary body iinjury, choroidal injury and retinal resection and/or defect severity and silicone oil dependence. Results211 OGI eyes underwent vitrectomy were included, the mean age of the study population was 32.93 years (range 1-73 years), and the median follow-up period was 20.06 months (range 5.85-90.58 months). Among the 211 eyes, 121 (57.3%, 121/211), 52 (24.6%, 52/211), 23 (10.9%, 23/211) and 15 (7.1%, 15/211) were rupture, perforation, intraocular foreign bodies and penetrating injury, respectively. 98 eyes (46.4%, 98/211) of silicone oil dependence in total, among them, 64 (65.3%, 64/98), 19 (19.4%, 19/98), 9 (9.2%, 9/98) and 6 (6.1%, 6/98) eyes were rupture, perforation, intraocular foreign body and penetrating injury, respectively. Correlation analysis revealed that silicone oil dependence was significantly associated with ciliary body injury [odds ratio (OR) = 2.150, 95% confidence interval (CI) 1.052-4.393], choroidal injury (OR=3.233, 95%CI 1.454-7.191), and retinal injury (OR=2.731, 95%CI 1.393-5.353). No correlation was found with age (OR= 0.981, 95%CI 0.960-1.002) or ocular wound length (OR=1.716, 95%CI 0.987-2.984) (P＞0.05). ConclusionSilicone oil dependency following PPV in OGIs are associated with ciliary body, choroidal, and retinal injuries, but no association with age or length of the ocular wound.
Objective To observe the incidence of ciliary detachment and its relationship with intraocular hypotension soon after vitrectomy. Methods A total of 46 eyes of 46 patients who underwent vitrectomy were examined by ultrasound biomicroscope (UBM). The patients were divided into three groups according to different tamponade: gas group (11 eyes), silicone oil group (8 eyes) and balanced saline solution (BSS) group (27 eyes). Basing on the postoperative intraocular pressure (IOP), the patients were divided into two groups: IOPlt; 10 mm Hg (25 eyes) and IOPge;10 mm Hg (21 eyes). UBM was applied to determine the tomographic features of the ciliary body 3 days after the surgery. IOP were monitored by noncontact tonometer daily after the surgery. The eyes with ciliary detachment were then examined once a week till the ciliary detachment reattached. The followup period was from 14 to 35 days. Results After vitrectomy, ciliary detachment was observed in 20 eyes of 46 eyes (43.5%), The incidence of ciliary detachment was 27.3％ in gas group, 25.0％ in silicone oil group, and 55.6％in BSS group. The average IOP in eyes with ciliary detachment ［(6.47plusmn;4.49) mm Hg （1 mm Hg=0.133 kPa）］ was significantly lower than that in the eyes without ciliary detachmen ［(15.61plusmn;7.72) mm Hg］ (t=8.031,Plt;0.001). The incidence of ciliary detachment was higher in eyes with postoperative IOP lt;10 mm Hg (68.0％) than that in the eyes with postoperative IOP ge;10 mm Hg (14.3%) (chi;2＝15.60, Plt;0.001). All eyes with postoperative ciliary detachment got spontaneous reattachment within 30 days after the surgery except that one eye had optic disc edema due to severe intraocular hypotension. Conclusions Early postoperative ciliary detachment is a common complication after vitrectomy. Eyes filled with BSS have the highest incidence of postoperative ciliary detachment. Most of the patients with ciliary detachment may get spontaneous reattahment within 30 days after the surgery.
Objective
To observe the effect of ciliary neurotrophic factor (CNTF) with different concentrations on the growth and survival of ratsrsquo; retinal ganglion cells (RGC) in vitro.
Methods
The retinae of 15 Wistar rats which were 2 or 3 days after birth were dissociated into cell suspension with 0.05% trypsin digestion. After 3 days, cultured RGC were identified with immunohistochemistry method using anti-rat Thy-1.1 monoclonal antibody. Cultured RGC were divided into the 10, 20, 40 ng/ml CNTF group （Ⅰ,Ⅱ, and Ⅲgroup） and the control group respectively. The duration of living RGC was recorded. After 3, 5 and 7 days, the A value of living cells was tested by methylthio-tetrazole colorimetric microassay.
Results
The result of immunohistochemical examination showed that 90% of living cells cultured for 3 days were RGC. No protuberance or volume increase of RGC were observed in CNTF groups and the control group. The duration of the living RGC was prolonged 3 to 4 days in CNTF groups compared with the control group. The A values of living RGC at the 5th and 7th days in the CNTF groups and the control group were: 0.0758plusmn;0.0139 and 0.0693plusmn;0.0113 in I group, 0.0902plusmn;0.0114 and 0.0825plusmn;0.0125 in Ⅱ group, 0.0792plusmn;0.0133 and 0.0653plusmn;0.0086 in Ⅲ group, and 0.0620plusmn;0.0071 and 0.0513plusmn;0.0068 in the control group, respectively. The differences between the simultaneous CNTF and control group were significant (between Ⅱ group and the control group: P＜0.01; between Ⅰ and Ⅲ group, and the control group: P＜0.05).
Conclusion
CNTF with some certain concentrations could facilitate survival of RGC in vitro. CNTF has no effect on the conformation of RGC.
(Chin J Ocul Fundus Dis, 2002, 18: 283-285)
ObjectiveTo observe the morphological and functional changes of retinal degeneration in mice with CLN7 neuronal ceroid-lipofuscinosis, and the therapeutic effects of glial cell derived neurotrophic factor (GDNF) and/or ciliary neurotrophic factor (CNTF) based on neural stem cells (NSC) on mouse photoreceptor cells. MethodsA total of 100 CLN7 mice aged 14 days were randomly divided into the experimental group and the control group, with 80 and 20 mice respectively. Twenty C57BL/6J mice aged 14 days were assigned as wild-type group (WT group). Mice in control group and WT group did not receive any interventions. At 2, 4, and 6 months of age, immunohistochemical staining was conducted to examine alterations in the distribution and quantity of cones, rod-bipolar cells, and cone-bipolar cells within the retinal of mice while electroretinography (ERG) examination was utilized to record scotopic a and b-waves and photopic b-wave amplitudes. At 14 days of age, the mice in the experimental group were intravitreally injected with 2 μl of CNTF-NSC, GDNF-NSC, and a 1:1 cell mixture of CNTF-NSC and GDNF-NSC (GDNF/CNTF-NSC). Those mice were then subdivided into the CNTF-NSC group, the GDNF-NSC group, and the GDNF/CNTF-NSC group accordingly. The contralateral eyes of the mice were injected with 2 μl of control NSC without neurotrophic factor (NTF) as their own control group. At 2 and 4 months of age, the rows of photoreceptor cells in mice was observed by immunohistochemical staining while ERG was performed to record amplitudes. At 4 months of age, the differentiation of grafted NSC and the expression of NTF were observed. Statistical comparisons between the groups were performed using a two-way ANOVA. ResultsCompared with WT group, the density of cones in the peripheral region of the control group at 2, 4 and 6 months of age (F=285.10), rod-bipolar cell density in central and peripheral retina (F=823.20, 346.20), cone-bipolar cell density (F=356.30, 210.60) and the scotopic amplitude of a and b waves (F=1 911.00, 387.10) in central and peripheral retina were significantly decreased, with statistical significance (P＜0.05). At the age of 4 and 6 months, the density of retinal cone cells (F=127.30) and b-wave photopic amplitude (F=51.13) in the control group were significantly decreased, and the difference was statistically significant (P＜0.05). Immunofluorescence microscopy showed that the NSC transplanted in the experimental group preferentially differentiated into astrocytes, and stably expressed CNTF and GDNF at high levels. Comparison of retinal photoreceptor nucleus lines in different treatment subgroups of the experimental group at different ages: CNTF-NSC group, at 2 months of age: the whole, central and peripheral regions were significantly different (F=31.73, 75.06, 75.06; P＜0.05); 4 months of age: The difference between the whole area and the peripheral region was statistically significant (F=12.27, 12.27; P＜0.05). GDNF/CNTF-NSC group, 2 and 4 months of age: the whole (F=27.26, 27.26) and the peripheral area (F=16.01, 13.55) were significantly different (P＜0.05). In GDNF-NSC group, there was no statistical significance at all in the whole, central and peripheral areas at different months of age (F=0.00, 0.01, 0.02; P＞0.05). ConclusionsCLN7 neuronal ceroid-lipofuscinosis mice exhibit progressively increasing degenerative alterations in photoreceptor cells and bipolar cells with age growing, aligning with both morphological and functional observations. Intravitreal administration of stem cell-based CNTF as well as GDNF/CNTF show therapeutic potential in rescuing photoreceptor cells. Nevertheless, the combined application of GDNF/CNTF-NSC do not demonstrate the anticipated synergistic protective effect. GDNF has no therapeutic effect on the retinal morphology and function in CLN7 neuronal ceroid-lipofuscinosis mice.
Objective
To observe the classification,clinical and pathological features of ciliary body tumors.
Methods
The clinical and pathological data of 11 cases of primary ciliary body tumors were analysed retrospectively.
Results
By pathological examination,the tumors of these cases were devided into malignant melanoma (2 cases), benign melanocytoma (3 cases),leiomyoma (2 cases), and angio-leiomyoma, neurilemoma, non-special granuloma and medulloepithelioma (1 case respectively). Both of the benign and malignant tumors of ciliary body tended to grow and enlarge progressively. The cardinal clinical manifestations of this series of 11 cases were as follows: elevation of intraocular pressure in 7, local scleral vascular dilatation in 5, secondary exudative retinal detachment in 5,and the signs of anterior uveitis in the early stage of tumor growth in 4.
Conclusion
The histopathological types of cilliary tumors are manifold,and the tumors are prone to enlarge progressively in developement either in benign or malignant ones, so that the rates of clinical misdiagnosis are relatively high.
(Chin J Ocul Fundus Dis, 2002, 18: 273-275)
