Objective
To observe the characteristics of pupillary light reflex in the patients with retrobulbar neuritis, and to evaluate the effects of pupi llary light reflex on the diagnosis and treatment of retrobulbar neuritis.
Methods
Thirtyfive patients (thirtyfive eyes with the retrobulbar neuritis and thirtyfive fellow eyes) aged from 10 to 58 years and 50 healthy individuals (100 eyes) who didnlsquo;t differ from the patients in age and sex were examined by a automatic pupillometer. The pupillary area and response amplitude, latency and speed of papillary reflex were recorded.
Results
The latency of the pupillary light reflex delayed and the maximum amplitude decreased in patients with retrobulbar neuritis during the diseas eperiod, and the differences were highly significant compaired with the control group. After the treatment, as the symptoms were alleviated and the visual acuity improved, the latency of the pupillary light reflex and the maximum amplitude recovered. The statistic differences were both found between the results after treatment and those at the onset stage, and the results after treatment and those in the control group.Before the onset of the disease of the involued eyes and after the treatment, the papill ary light reflex and the maxium amplitude decreased, but didnamp;#146;t differe much from which in the control group.
Conclusions
The latency of the pupillary light reflex delayes and the maximum amplitude decreases in patients with retrobulbar neuritis. The examination of pupillary light reflex is helpful to diagnose retrobulbar neuritis early and inspect the condition of the disease.
(Chin J Ocul Fundus Dis,2006,22:370-372)
Objective
To observe the characteristics of indocyanine green angiography and fundus fluorescein angiography (ICGA amp; FFA) in anterior ischemic optic neuropathy ( AION ) , and to investigate the etiology of AION and the value of ICGA and FFA in the diagnosis and study of AION.
Methods
Simultaneous ICGA and FFA were performed on 32 eyes of 31 AION patients and 38 eyes of 38 non-AION patients.
Results
The eyes that all or a part of the optic disclies in the watershed zon es of the choroidal blood supply were significantly more in the AION group tha n those in the non-AION group (Plt; 0.005 ) . All the watershed zones through the optic disc were vertical in shape. The fluorescence filling of the inferior and superior choroidal blood vessels near the optic disc were all slower than that of the temporal and nasal choroidal blood vessels. The types of watershed zones in the AION group were highly correspondent to the ischemic areas of the optic disc . In early ICGA , no fluorescence appeared at the optic disc, and in later stage, the ischemic area revealed no fluorescence, and the other area showed mostly asymmetric fluorescence.
Conclusion
The onset of AION is correlative to the choroidal blood supply around the optic disc. ICGA is more valuable in the diagnosis and study of AION than FFA .
(Chin J Ocul Fundus Dis, 2001,17:111-114)
Objective To investigate the characteristics and possibility of using an image analyzer-aided method to count axotomized retinal ganglion cells (RGCs). Methods The left optic nerves of 18 rats were transected intraorbitally and a piece of gelform soaked in 5% fluorogold was applied to the ocular stump to retrogradely label the surviving RGCs. All animals were executed 2, 7 or 14 d ays after the operation (n=6 for each time point), respectively. The left retinae were removed, post-fixed and whole-mounted on the slides. The numbers of labeled RGCs were counted using both the conventional sampling method and image analysis, and compared statistically between the two methods.Results The number of surviving RGCs decreased sharply［(12 0663±9 089), (59 285±17 071) and (17 802±19 8 4) cells/mm2 for image analyzer-aided method, and (118 237±7 898), (57 648±14 533) and (18 070±1 461) cells/mm2 for conventional sampling method］when the survival time increased from 2 to 7 and 14 days. No significant difference was detected between the two groups at any corresponding time points.Conclusion The image analyzer-aided method is convenient, objective and reproducible, which can be used in the studies where counting RGCs is needed. (Chin J Ocul Fundus Dis，2003，19：333-404)
Purpose
To evaluate differences in the pattern of optic disc and retinal nerve fiber layer (RNFL) damage in normal-tension glaucoma (NTG) and high-tension glaucoma (HTG) patients.
Methods
We enrolled 49 eyes of 49 patients:30 NTG (IOP≤21 mm Hg,1 mm Hg=0.133 kPa), 19 HTG(IOP≥25 mm Hg). Mean age was 59.2±12.3 (range, 36-75) for HTG patients, and 59.6±8.6(range, 39-71) for NTG patients. All patients underwent complete ophthalmic examination, achromatic automated perimetry (AAP), scanning laser ophthalmoscopy (SLO), scanning laser polarimetry (SLP), optical coherence tomography (OCT) and Heidelberg retinal tomography (HRT). All patients had glaucomatous optic nerve damage and abnormal AAP.
Results
There were no differences in mean deviation on AAP between NTG and HTG eyes (P=0.37), while the corrected pattern standard deviation was larger in NTG than in HTG eyes (P=0.014). Cup∶disc area ratios in global (P=0.03) and three sectors (Plt;0.05) except nasal sector were significantly larger in the NTG group, whereas rim area in global (P=0.03) and three sectors (Plt;0.05) except nasal quadrant obtained by SLO were smaller in NTG than in HTG eyes. The other numerical parameters obtained by three imaging technologies could not detect differences in the optic disc or RNFL anatomy between the two groups.
Conclusions
Cup∶disc area ratio was larger in patients with NTG than in those with HTG, whereas significant thinning of rim was associated with NTG eyes. The measurement of retinal nerve layer thickness in global and each quadrant was similar between two groups. More focal or segmental analysis of the data contained within SLO, SLP and OCT images are needed to detect localized differences in eyes with varying levels of IOP.
(Chin J Ocul Fundus Dis, 2002, 18: 109-112)
ObjectiveTo investigate the effect of heat shock protein B8 (HspB8) downregulation on retinal ganglion cell (RGC) and retinal function in the mice model of optic nerve injury (ONC).MethodsAdeno-Associated Virus (AAV) 2 AAV2-shHspB8-GFP was constructed to knockdown HspB8. 66 adult male C57/BL6 mice were randomly divided into the control group, the ONC group, the AAV2-shHspB8 group, the ONC+AAV2-shHspB8 group, and the ONC+AAV2- GFP group. There were 10, 20, 16, 10 and 10 mice respectively, and both eyes were used as experimental eyes. Western blot was used to evaluate the expression of HspB8 on day 3 and 7 after ONC. By GFP immunofluorescence staining, the efficacy of AAV2-shHspB8-GFP transfer was accessed. Moreover, it was possible to identify functional and RGC survival differences between groups by optomotor response (OMR), dark adapted full-field flash electroretinogram (ff-ERG), oscillatory potentials (OPs), photopic negative response (PhNR) and retinal flat-mount RGC counting 5 days after ONC. Comparisons between two groups were made using Mann-Whitney U test, unpaired t-test, unpaired t-test with Welch’s correction, one-way ANOVA, and Bonferroni t test.ResultsCompared with the control group, the expression of HSPB8 protein in the retina of mice in ONC3 group was significantly increased, and the difference was statistically significant (F=43.63, P＜0.01). Compared with the control group, the ONC group showed obviously lower visual acuity (P＜0.01), lower a-wave, b-wave, OPs, PhNR amplitude, longer b-wave latency (P＜0.05), and the survival rates of RGC in ONC3 group, ONC5 group and ONC7 group decreased in a time-dependent manner(F=384.90, P＜0.01). Transfection of AAV2 efficiency was highest on 4 weeks after IVT. Besides, there was no significant differences between the control group and the AAV2-shHspB8 group on visual acuity, ff-ERG, OPs, PhNR and RGC survival (P>0.05). In comparison of the control group, we found that RGC survival of the ONC5+AAV2-shHspB8 group was significantly elevated (F=10.62, P＜0.01).ConclusionsExpression of HspB8 on the retina can be induced by ONC. The investigation of RGC counting, visual acuity, and ff-ERG revealed that optic nerve injury destructed functionality of mice retina and resulted to RGC death ultimately. The Most crucial finding of this research is that HspB8 knockdown had a neuroprotective effect in RGC after ONC.
Objective To evaluate the clinical efficacy of oral calcium dobesilate(CaD) on diabetic optic neuropathy (DON).Methods The clinical data of 235 eyes of 235 patients with DON diagnosed by examination of ocular fundus were retrospectively analyzed.The patients were divided into 3 groups according to the subtypes of DON: anterior ischemic optic neuropathy(AION)group(71 eyes of 71 patients), papilloedema group (71 eyes of 71 patients),and neovascularization of disc (NVD) group (93 eyes of 93 patients).The patients in each groups were randomly subdivided into CaD treating group and control group, in which the patients underwent oral administraion of CaD at a dose of 500 mg twice per day or Vit.E at a dose of 10 mg twice per day,respectively.The course of therapy was 6 months and consecutive 2 courses were performed with the 3-4 days interval between the courses; the courses lasted for 6 months.Several parameters (VFD/V),EA/d,NA/d,LA/d) were semiquantitative analyzed 2,4,6,8 months after initial treatment. Repeated ANOVA measures and t test were used as statistical methods.Results In CaD group,VFD/V (0.25plusmn;0.10),EA/d (0.94plusmn;0.53), and LA/d(1.83plusmn;1.12) 2 months after initial treatment was obviously better than the results before the treatment (0.49plusmn;0.13,1.57plusmn;0.71,3.42plusmn;1.88)(P＜0.001), respectively.VFD/V,EA/d and LA/d in CaD group 2,4,6,and 8 months after initial treatment significantly differed from which in the control group (P＜0.01). There was significant difference of VED/V,EA/d,and LA/d between the CaD and control group during the follow-up period (P＜0.01).At each time point in the followup period, there was no significant difference of NA/d among groups and between the treating and control group (P＞0.05).Conclusion Oral administration of CaD can rapidly and remarkably decrease the extent of visual field defect,relieve optic disc edema and lessen the leakage of NVD.
ObjectiveTo explore the histopathological changes of the pigs′ eyes in vivo after radial optic neurotomy (RON), and provide the experimental foundation for the safety of RON.MethodsA total of 12 healthy miniature pigs were used in the experiment, in whom 8 were executed at the 1st, 3rd , 7th , and 48th day respectively after underwent RON in both eyes, and 4 were executed at the 120th day after underwent RON unilaterally (the other eye was as the control in 2 and underwent single vitrectomy in 2). All the enucleated eyes were cut in sections routinely and embeded in paraffin. The sections were stained by HE, Masson trichrome staining or Luxol fast blue staining and the different sections of optic nerve were observed by light microscope.ResultsNo damages of the major vessel wall were found and the cerebral pia mater of orbital optic nerves kept integrated. At the 1st day after the operation, the incisions came into being and local hemorrhages infiltrated into the circumambience and backside. The vacuole-like change induced by the demyelination of optic nerve fiber located at the incisions. At the 3rdday, the vacuolelike changes widened. At the 7thday, the fibroblasts aggregated at the incision, with hyperplastic neuroglia cells and dispersed pigmented granules. Lymphocytes and monocytes were the major infiltrated inflammatory cells. At the 48th day, collagen filled in the incisions and aggregated neuroglia cells of the rear optic nerves behind the incision were found, which showed weak staining with obvious boundary which was somewhat beyond the midline of optic nerves. At the 120th day, localized atrophy of optic nerve occurred under the incision. No abnormal pathological findings were found in the normal eyes and the eyes underogo vitrectomy.ConclusionsLocalized atrophy of optic nerves comes into being after the normal pig eyes in vivo underwent RON. The surgery is safe to some extent.(Chin J Ocul Fundus Dis, 2005,21:13-15)
Objective To evaluate the expressive varieties of Nogo-A mRNA in injured optic nerves of rats. Methods Reverse transcription polymerase chain reaction (RT-PCR) method was used to hemi-quantitatively analyze the levels of Nogo-A mRNA in the optic nerves 3, 7, 9, 15, 21, and 25 days respectively after injury.Results The level of the expression of Nogo-A mRNA was low in the normal optic nerves, while it was significantly high in the optic nerves 3 days after in jury, and kept the high level still after 25 days.Conclusion The expression of Nogo-A mRNA in injured optic nerves is increased. (Chin J Ocul Fundus Dis，2003，19：201-268)
Optic nerve glioma (ONG) is a rare central nervous system tumor that occurs in children and adolescents. It’s main pathological type is low-grade pilocytic astrocytoma. It is divided into sporadic ONG and neurofibromatosis type 1 (NF-1) related ONG. Due to the close relationship between ONG and the optic nerve, there is its particularity in diagnosis and treatment. The diagnosis of ONG mainly relies on medical history, symptoms and signs, as well as imaging examinations such as MRI and CT. ONG should be differentiated from optic nerve sheath meningioma, optic neuritis, optic nerve metastasis and other diseases. In recent years, newly discovered molecular targeted therapy and anti-vascular endothelial growth factor drugs are a powerful supplement to ONG. When chemotherapy is not sensitive or resistant, radiotherapy can be considered, but it is only recommended for patients over 7 years of age. Surgery can be considered when the patient’s visual impairment is severe and the appearance of the eye is significantly affected. In addition, due to the susceptibility of NF-1 patients to tumors, the chemotherapy regimen should take into account the risk of secondary leukemia caused by the drug, and the timing of radiotherapy should be after the age of 10. We look forward to further ONG clinical research, which will bring more references for future clinical work.
PURPOSE:To investigate the effect of the retinal ganglion cell on the origin of the scotopic threshold response(STR)of the cat and human electroretinogram. METHODS:An optic atrophy model was established in cats with retinal photocoagulation around the optic disc. The STR and flash visual evoked potentials(FVEP)were recorded from 18 cases(24 eyes)of normal human,6 cases of the optic atrophy patients,6 cases of normal cats and 4 cases of retinal photocoagulating cats in 4, 8 and 16 weeks after retinal photocoagulation. In addition,ganglion cells were observated in 8 and 16 weeks after retinal photocoagulation using light and electron microscopes. RESULTS :The pathologic changes after retinal photocoagulation verify secondary atrophy of ganglion cells. STR was normal and FVEP was not recorded in cats of retinal photocoagulation and patients with optic atrophy. CONCLUSION :Retinal ganglion cell loss does not abolish the cat and human STR.There is no effect of ganglion cell on the origin of STR.
（Chin J Ocul Fundus Dis,1997,13: 215-218 ）
