Purpose
To observe the changes of choroidal circulati on and the retinal lesions caused by ocular contusion with indocyanine green ang iography (ICGA).
Methods
ICGA examination was performed on 30 cases (30 eyes) of various traumatic condition in conjunction with fundus fluorescein angiography (FFA).
Results
FFA of 19 cases (63.3%) showed the hypofluorence in quadrant or whole disc in accordance with the area of delayed filling of choroid. Twentysix cases (86.2%) showed d efected choroidel perfusion in ICGA,among them 16 cases showed localized delayed perfusion, in which the shortest perfusion time was 1 min 50 s and the l ongest time was 5 min.43 s,and 10 patients showed localized perfusion defect,and reversed filling time of retinochoroid vessels in 6 patients. Five cases (16.6%) had delayed filling time in both choroidal and central retinal vessels . Damage of retinal pigment epithelium was found in the areas of choroidal abnor mal perfusion.
Conclusion
ICGA combined with simultane ously FFA, is valuable in evaluating blunt injury of the ocular fundus and ben eficial to its diagnosis and treatment.
(Chin J Ocul Fundus Dis, 2001,17:122-124)
Objective
To further investigate pathologic mechanism of retinal phototrauma.
Methods
Twenty Wistar rats were divided into control and experimental groups.Their eyes were extracted in 12，24 and 36 hours after light exposure.HE stained retina samples were examined and TDT-mediated dUTP nick end labelling(TUNEL)method was employed to distinguish apoptotic cells.
Results
After 12-hour light exposure,slight vesiculation was observed in the rod outer segment of the retinas.After 24-hour light exposure,the outer nuclear layer showed predominant fractured and condensed nuclei and fragmented DNA.After 36-hour light exposure,the rod outer and inner segments were lysed and most of the nuclei in the outer nuclear layer were disappeared.
Conclusions
Apoptosis of photoreceptor cell is one of the important mechanisms which cause experimental retinal photoinjury of rats.
(Chin J Ocul Fundus Dis, 1999, 15: 167-169)
The opportunity of vitrectomy for opening eyeball injury is one of the important factors affecting the prognosis. Anterior segment wound repaired by routine suturing needs following and continuous treatment with vitrectomy. The key technique of the following treatment should be the debridement of the inside of wound and expurgation of the surrounding tissues adjacent to the wound, and the emphasis should be put on retinal reattchment and stable repairment.
Objective
To observe the effect of blue light on apoptosis of cultured human retinal pigment epithelial (RPE) cells in vitro.
Methods
Human RPE cells were exposed to blue light, and the cells were divided into 3 groups: group A, with various intensity of illumination; group B: with same intensity but different time of illumination; group C: with same intensity and time of illumination but different finish time of the culture. The apoptosis of RPE cells was observed by TdT-dUTP terminal nick-end labeling (TUNEL) and annexin V-fluoresein isothiocyanate (FITC)/propidium iodide (PI) flow cytometry, and transmission electron microscopy.
Results
The positive cells stained by TUNEL shrinked and turned round, whose nuclei concentrated and congregated like the crescent or hat. Cracked nuclei and membrane bleb were found. Swollen mitochondrial, disappeared inner limiting membrane of mitochondria, and dilation of the rough endoplasmic reticulum with metabolite were observed by transmission electronmicroscopy. In group A, mild damage of RPE cells was found when the threshold value of the intensity of illumination was less than（500±100）lx, and the apoptosis and necrosis of RPE cells aggravated as the intensity of illumination increased; in group B, as the time of illumination extended, the number of apoptotic RPE cells didn′t increase while the necrosis increased; in group C, 6 and 12 hours after illumination, apoptosis of cells was the main injury, while apoptosis with necrosis was found and necrotic cells increased as the time of illumination was prolonged.
Conclusions
Illumination with blue light may cause damages of human RPE cells in vitro, with the modalities of apoptosis, apoptotic necrosis and necrosis. The extent of injury is dependent on intensity and duration of the illumination.
(Chin J Ocul Fundus Dis, 2005, 21: 384-387)
Objective To explore the therapeutic value and effects of relaxing retinotomy for perforating traction retinal detachment(PTRD). Method A retrospective survey was done in 21 patinets (21 eyes) with PTRD who underwent vitrectomy combined with relaxing retinotomy in our hospital from 1998 to 2001.Results The retinae were completely reattached in all 21 cases. The visual acuity of 12 patients (57%) was counting finger, and the best visual acuity was 0.05. Among the 18 patients who were followed up for 6 to 25 months, 14(77.8%) remained retinal reattachment. Conclusions Relaxing retinotomy is effective for anatomic reattachment of PTRD, especially to the patients with retinal incarceration and severe proliferative vitreoretinopathy. (Chin J Ocul Fundus Dis，2003，19：5-7)
Objective To investigate the etiological factors of endophthalmitis and evaluate the outcomes of vitrectomy for endophthalmitis.Methods From January 1999 to December 2001, 53 consecutive patients (54 eyes ), 38 men and 15 women, diagnosed as endophthalmitis were retrospectively evaluated. The patients′ ages ranged from 1 year to 74 years (mean 32 years). Two patients (2 eyes) with mild inflammation received antibiotic medication therapy, 5 patients (5 eyes) with no light perception and severe inflammation underwent evisceration, and the other 46 patients (47 eyes) underwent pars plana vitrectomy. Postoperative follow-up ranged from 2 to 32 months (mean 10.5 months). Results Endophthalmitis was diagnosed as resulting from penetrating injury in 32 eyes (59.26%), endogenous endophthalmitis in 8 eyes (14.81%), cataract surgery in 7 eyes (12.96%), gl au coma surgery in 2 eyes (3.70%), vitrectomy in 3 eyes (5.56%), radial keratotomy in 1 eye (1.85%), and unknown reason in 1 eye (1.85%). The postoperative visual a cuities (VA) of these patients increased significantly (P=0.003). The VA of the patients underwent vitrectomy in 3 days was obviously better than those after 3 days (P=0.014), and the VA of the patients underwent vitrectomy in 7 days was obviously beter than those after 7 days (P=0.021). Thirty-seven eyes (68.52 %) had functional success (VA≥0.02), 47 eyes (87.04%) had anatomical success (VAlt;0.02) , and 27 eyes (50.00%) were out of blindness (VA≥0.05). Conclusions Penetrating ocular injury, especially with retained intraocular foreign bodies, is the most common cause of suppurative endophthalmitis. Vitrectomy is a good method for the treatment of endophthalmitis. (Chin J Ocul Fundus Dis，2003，19：93-95)
Purpose
To evaluate the efficacy of vitreous surgery for treatment of fundus damages caused by ocular blunt trauma.
Methods
Clinical records were reviewed retrospectively for a series of consecutive 101 patients (105 eyes) with fundus damages caused by ocular blunt trauma underwent vitreous surgery from October 1992 to March 1998．
Results
Based on clinical examination and findings during surgery,all cases were divided into 4 subgroups:vitreous hemorrhage(VH)in 23 yes,VH with retinochoroidal rupture or optic damage in 25 eyes,traumatic retinal detachment in 46 eyes,and retinal giant tear in 11 eyes.Vision acuity improvement achieved in 77 eyes(73.3%)and of them 69 eyes(65．7%)had 0.02～0．6with 38 eyes(55．0%)better than 0．1.Two eye s with no light perception obtained better than 0.1． Visual acuity remained unchanged in 26 eyes(24.8%)and 2 eyes(1.9%)became worse after operation．The retina reattached in 54 eyes(94.7%).
Conclusion
Severe ocular blunt trauma may cause visual impairment and various fundus damages.Appropriate vitreous surgery can salvage most eyes with those injuries.
(Chin J Ocul Fundus Dis,1999,15:100-102)
Objective
To investigate the therapeutic effects of subconjunctival verapamil on outcome in an experimental model of traumatic proliferative vitreoretinopathy.
Methods
An experimental model of traumatic proliferative vitreoretinopathy was induced in pigme nt rabbits,which then were selected randomly to receive either subconjunctival verapamil injection treatment or a placebo injection(control)daily for 3 weeks.Animals were examined by indirect ophthalmoscopy at weekly intervals for 5 weeks. Eyes were enucleated for light microscopy 5 weeks later.
Results
Fifty-six percent(18 of 32)of the rabbits receiving subconjunctival verapamil injection had developed tractional retinal detachment,whereas eighty-one percent(26 of 32)of control animals had developed tractional retinal detachment(chi;2=4.655,P=0.031).The results of clinical examination and light microscopy didn't show evidence of toxicity between the verapamil treated animals and control animals.
Conclusion
Subconjunctival verapamil decreased the incidence of tractional retinal detachment due to traumatic proliferative vetreoretinopathy in this rabbit model.Verapamil at the dose used in this model has no evident toxicity on rabbit eyes.Further studies are needed to determine the doseresponse and efficacy of the drug.
(Chin J Ocul Fundus Dis,1999,15:69-71)
Objective To investigate the effect of retinectomy 360° for severe ocular rupture and evaluate the related factors associated w ith prognosis. Methods We retrospectively analyzed 28 consecutive patients (28 eyes), 18 men and 10 women, with severe ocular rupture admitted to the Chinese PLA General Hospital between January 1999 and October 2002. The patient′s ages ragned from 16 to 58 years, mean 29 years. According to the internation standardized classification of ocular trauma, the injuries located in zone I in 5 eyes, zone I-II in 8 eyes，zone II in 3 eyes, zone II-IIIⅢ in 5 eyes, zone III in 7 eyes, zone II in 3 eyes, zone II-III in 5 eyes and zone III in 7 eyes. The presenting visual acuity was in grade 4 (0.02 to light perception) in 19 eyes, and grade 5 in 9 eyes. In 28 patients, 13 had the total absence of iris and lens, 10 had iris deletion more than 1/2, and 15 had lens opacity or rupture. Ultrasound biomicroscopy and B-scan revealed ciliochoroidal detachment in 17 eyes. The B-scan revealed vitreous hemorrhage and retinal detachment in all paitents. The intraocular pressure was from 5 to 11 mm Hg in all patients. The therappeutic operative procedures which were performed by one surgeon in all of the affected eyes included standard 3-port pars plana vitrectomy with scleral encircling buckle, endophotocoagulation and tamponading with silicone oil in all patients; lensectomy in 15 eyes; 360° retinotomy and retinectomy at anterior equator in 16 patients, and posterior equator in 12 eyes.Results During the operation, all patients were confirmed with vitreous hemorrhage and retinal detachment, including hemorrhagic ciliary body detachment in 9 eyes, suprachoroidal hemorrha ge in 12 eyes, retinal twisting like morning glory in 11 eyes, and retinal incarceration in 17 eyes. Postoperative follow-up In 26 eyes who were followed up postoperatively from 6 months to 46 months, retinal reattachment was found in 20 patients (76.9%) in whom the retina of 3 was reattached after revitrectomy and the silicone oil of 8 was removed at the fourth month after operation. In 20 eyes with reattached retina, 14 (70.0%) had corrected visual acuity of 0.02 or more, including 7 (35.0%) had 0.05 or more, 3 had 0.1 or mor e, and 1 had the best visual acuity of 0.3.Conclusion Retine ctomy may improve the prognosis of severe ocular rupture and save the visual fun ction of some patients.(Chin J Ocul Fundus Dis，2003，19：333-404)
Objective To observe the changes of the multifocal electr oretinograph (mf-ERG) in commotio retinae. Methods The affected eyes (traumatic group) and the fellow eyes (control group) of 31 patients with unilateral commotio retinae were examined by RETI scan 3.15 system. The responses of 61 retinal regions were recorded, and the average amplitude densities of the N1 (the first negative) wave and P1 (the first positive) wave in different regions of retinal were analyzed. Results The average amplitude densities of 1-4 rings in N1wave and 1-5 rings in P1wave were much lower in traumatic group than those in the control. Conclusions The average amplitude densities of N1wave and P1wave of mf-ERG in retin al affected regions decreases markedly in eyes with commotio retina; mf-ERG may provide the quantificational and orientational detection for the visual ability of the eyes with commotio retinae.(Chin J Ocul Fundus Dis，2004，20：226-228)
