Purpose
To evaluate shortterm visual acuity effects of a single photodynamic therapy(PDT) treatment with Visudyne (CIBA Vision Corp, Duluth, Ga) for choroidal neovascularization (CNV) in age-related macular degeneration (AMD).
Methods
Definitely diagnostic AMD patients with classic CNV were treated with PDT (5 cases, 7 eyes). The data of visual acuity testing, ophthalmic examination, color photographs, optic coherence tomography, fluorescein angiograms and indocyanine green angiogram before photodynamic therapy and 1 week ,1 month after it were used to evaluate the effects of a single treatment of PDT with Visudyne.
Results
The visual acuity of all the treated eyes at the follow-up examination at 1 month after PDT were not reduced. Distinct reduction of fluorescein leakage from CNV was noted in all patients by 1 week after PDT. Fluorescein leakage from a portion of the CNV reappeared by 1 month after treatment in 2 eyes.
Conclusion
PDT with Visudyne achieved short-term cessation of fluorescein leakage from CNV without loss of vision or growth of classic CNV in some patwo ients with AMD.
(Chin J Ocul Fundus Dis,2000,16:213-216)
Dysregulation and activation of immune processes are important in age-related macular degeneration (AMD) pathogenesis. The single nucleotide polymorphism of complement factor H is widely recognized as a risk factor to AMD. Over-activation of nod-like receptor3 and polymorphism of Toll-Like Receptor 3 also associated with AMD. Except for innate immune processes, adaptive immunity also play a critical role in AMD, a growing body of evidence supports that auto-antibodies and T cells are related with AMD. Additionally A2E and lipid oxidation byproducts might also have a role in AMD pathogenesis.
Objective To explore the effect of polycythemia on retinopathy of prematurity (ROP). Methods The clinical data of 262 premature cases was analyzed retrospectively in Xi'an Children Hospital from January 2005 to January 2009. Polycythemia was found in 46 cases (17.56%), including 27 males and 19 females. In 216 infants without polycythemia (82.46%), 155 were male and 61 were female. The difference of the birth weight (t=0.730, P=0.466), gestational age (t=1.603,P=0.110), oxygen inhalation numbers (chi;2=0.04,P＞0.90) and times (t=1.225,P=0.223), and concentration (t=1.823,P=0.071) between polycythemia group and no polycythemia group were not significant. In order to diagnose ROP, the ocular fundus of all premature infants was examined with binocular indirect ophthalmoscope,and the stage of ROP was assessed.Results In all the premature infants,ROP was found in 120 cases (45.80%). In 46 cases of polycythemia, ROP was found in 25 cases (54.34%); in 216 infants without polycythemia, ROP was found in 95 cases (43.98%); the difference of ROP incidence between the two groups was not significant (chi;2=1.64, Pgt;0.1).In 120 ROP patients, 104 cases (86.67%) with ROP＜3 stage and 16 cases (13.33%) with ROP ge;3 stage were found. In 25 ROP patients with polycythemia, 18 cases (72.00%) with ROP ＜3 stage and 7 cases (28.00%) with ROP ge;3 stage were found. In 95 ROP patients without polycythemia, 86 cases (90.53%) with ROP ＜3 stage and 9 cases (9.47%) with ROP ge;3 stage were found. The difference of the incidence of ROP ＜and ge;3 stage between the two group was significant (chi;2=4.38, Plt;0.05). In 120 cases of ROP, prethreshold retinopathy was found in 106 cases (88.33%), while threshold and post-threshold retinopathy was in 14 cases (11.67%). In 25 ROP patients with polycythemia, prethreshold retinopathy was found in 19 cases (76.00%), and threshold and post-threshold retinopathy was in 6 cases (24.00%).In 95 ROP infants without polycythemia, pre-threshold retinopathy was found in 87 cases (91.58%),while threshold and post threshold retinopathy was in 8 cases (8.42%).The difference of the incidence of ROP with prethreshold, and threshold and post-threshold retinopathy between the two groups was not significant (chi;2=3.27,P＞0.05).Conclusion Polycythemia may not affect the incidence of ROP,but impact on the severity of ROP.
Objective To observe the safety and efficacy of posterior vitreous detachment (PVD) induced by combined intravetreal injection of lysineplasminogen and reteplase in rabbits.Methods Fifteen healthy New Zealand rabbits were divided into three groups with five rabbits in each. Take the right eyes as experimental eyes，while the left eyes as the control. The experimental eyes of three groups received combined intravetreal injection of 1250 mu;g/ml lysineplasminogen at 0.1 ml dose and 104U，3times;104U，105U reteplase at 0.05 ml dose recpectively, while the control eyes were injected intravetreally with 0.15 ml balanced salt solution. The conjunctiva, anterior chamber, lens, vitreous body, and retina were examined by slit lamp microscope and +120D preset lens. The retinal function was examined by electroretinogram (ERG).Results All the experimental eyes had PVD. The results of optical microscope showed that no change in retinal structure was found in the control group and 104 U reteplase group, clear retinal hierarchical but decreased ganglion cells and kernel layer cells were found in 3times;104 U reteplase group, only retinal pigment epithelium layer but no normal retinal structure was observed in 105U reteplase group. The results of ERG showed that compared the maximum mixed reaction of a and b wave amplitude in control group and reteplase group respectively, the difference was not statistically siginificant between 104U reteplase group and control group(a wave：t=0.881，-1.773，0.809；b-wave：t=-0.223，-0.441，1.400；P＞0.05),the differences were statistically siginificant between 3times;104 U(a wave：t=-3.20，b-wave：t=-4.182，-4.103),105 U reteplase group(a wave：t=-0.737，b wave：t=-15.150，6.597)and control group(P＜0.05). The control eyes didnprime;t had PVD.Conclusion Combined intravetreal injection of lysine-plasminogen and reteplase can induce complete PVD, and no damage to the retinal structure in rabbits.
ObjectiveTo assess the association of vascular endothelial growth factor (VEGF) gene-460C/T and-634C/G polymorphism with diabetic retinopathy (DR) among patients in Asia and European by meta-analysis.
MethodsA systematic search of electronic databases (PubMed, Cochrane Library, EMBASE, VIP, Wanfang technological, CNKI, etc.) was carried out until Jun, 2014. Case-control studies on the relationship between genetic polymorphism of VEGF-460C/T and VEGF-634C/G with diabetic retinopathy were included in this analysis. The data were quantitatively analyzed by RevMan 5.0 software after assessing the quality of included studies. The pooled odds ratios (OR) and their corresponding 95% confidence intervals (CI) were used to assess the strength of the association.
ResultsVEGF-460C/T (7 studies:899 cases and 786 controls) and VEGF-634C/G (10 studies:1615 cases and 1861 controls) were inclued in this meta-analysis. Significant association was found for-460C/T polymorphism in Aisa (C versus T:OR=1.52, 95%CI was, Z=3.72, P=0.0002; CC versus CT+TT:OR=1.61, 95%CI was[1.22, 1.90], Z=3.05, P=0.002; TT versus CT+CC:OR=0.64, 95%CI was[1.19, 2.19], Z=2.07, P=0.04), and VEGF-634CC gene type was associated with DR in European (OR=1.56, 95%CI[1.08, 2.25], Z=2.37, P=0.02). No significant publication bias was found.
ConclusionsThe meta-analysis demonstrated that DR was associated with VEGF-460C/T polymorphism in Asia, and C alleles and CC gene type was the risk polymorphism; VEGF-634C/G polymorphism was not associated with DR, but its CC genotype maybe the risk factor in European. Further case-control studies based on larger sample size are still needed, especially for-634C/G polymorphism.
Objective To explore the expression of survivin gene in retinoblastoma (RB) and its relationship with the stages and histodifferentiation degree of RB and the expression of p53、bcl-2 proteins. Methods Expression of survivin, p53 and bcl-2 proteins in 38 RB conventional paraffin samples were detected with survivin, p53 and bcl-2 monoclonal antibodies respectively by immunohistochemical assay. The expression of survivin of normal retina in 6 control samples was observed. Results In 38 cases of RB, positive expression of survivin was found in 20 (52.6%); while none of the 6 normal retinal tissue expressed survivin, which had significant difference between the two group (P＜0.05). The positive expression of survivin did not correlate with sex of patient, disease stages and histological type (P＞0.05). In 38 RB cases, positive expression of p53 was in 25 with the rate of 65.8%, and of bcl-2 in 18 with the rate of 47.4%. The positive-expressed rates were much higher in positive-expressed p53 and bcl-2 group than those in the negative-expressed p53 and bcl-2 group(P＜0.05). Conclusion The increase of the expression of survivin implies that it may take part in the occurrence and development of RB; the interaction among survivin, p53 and bcl-2 may participate in the access and the course of RB. (Chin J Ocul Fundus Dis，2004，20：215-217)
Objective To investigate the relationship between diabetic retinopathy (DR) and coronary atherosclerosis (CAS) in type 2 diabetes patients and other risk factors of DR. Methods A total of 118 patients of type 2 diabetes with DR (DR group), 120 patients of type 2 diabetes without DR matched in age and sex (non-DR group), and 86 normal controls (control group) were enrolled in this study. The body mass index (BMI), blood pressure (BP), fasting blood-glucose (FPG), glycosylated haemoglobin (HbA1C), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterin (LDL-C), creatinine, estimate glomerular filtration rate (eGFR) and urinary albumin excretion rate(UAER) in all the subjects were measured. Meanwhile, the incidence of CAS in the three groups was detected by 64slice multidetector computed tomography angiography (MDCTA). Assume concurrent DR as dependent variable, clinical indicators and laboratory parameters as independent variable, the risk factors were determined by Logistic regression analysis. In addition, CAS as dependent variable, DR as fixed factor, analysis of covariance was used to investigate the relationship between CAS and DR. Results The incidence of CAS in DR group was higher than that in nonDR group and control group, the differences were statistically significant (chi;2=26.9,35.5;P＜0.05). The results of Logistic regression analysis showed that systolic BP, BMI, CAS, myocardial infarction and UAER were key risk factors for DR ［odds ratio (OR)=1.02, 0.89, 4.50, 3.89, 1.34;P＜0.05］. There was a negative relationship between BMI and DR. The results of analysis of covariance showed that there was significant correlation between CAS and DR (OR=5.31, 95% confidence interval=2.62-10.60; P＜0.05). Conclusion CAS is independently associated with DR in type 2 diabetes patients. In addition, the other risk factors for DR include systolic BP, BMI, myocardial infarction and UAER.
ObjectiveTo observe and analyze the pathogenic gene types and clinical phenotypes of Leber congenital amaurosis (LCA).MethodsA retrospective clinical study. Six patients with LCA confirmed by genetic testing and 18 family members were included in the study. The patients came from six unrelated families. The family was investigated with a specific hereditary eye disease enrichment panel which contained 463 known pathogenic genes and based on targeted exome capture technology first to indentify the potential pathogenic genes and mutations. Then the TULP1, RPGRIP1, GUCY2D pathogenic mutations were conformed by Sanger sequencing. The pathogenicity of the gene variation was searched through relevant databases and PubMed literature, and its function was explained by protein prediction software.ResultsOf the 6 patients, 3 were males and 3 were females; the age was from 3 to 33 years. Nystagmus, finger pressing eyes, photophobia, and night blindness were seen in 5 cases; electroretinogram showed 3 cases of extinction or near extinction; and 4 cases of retinopathy. The results showed patients with compound heterozygous mutation of c.1318C＞T and c.1142T＞G, homozygous mutation ofc.1318C＞T and compound heterozygous mutation of c.1153G＞A and c.1561C＞T of TULP1 in Family 1, Family 2 and Family 5, respectively. There were compound heterozygous mutations of RPGRIP1 c.391delG and c.1468-2A＞G in Family 3 and c.715delA and c.1765C＞T in Family 6, respectively. Homozygous mutation of c.3177_3178delAC of GUCY2D was found in Family 4.The parents of all six patients were carriers of corresponding heterozygous mutations.TULP1 gene c.1142T＞G, RPGRIP1 gene c.391delG, c.715delA and c.1765C＞T and GUCY2D gene c.3177_3178delAC mutations were novel mutations and unreported. The 381th amino acid locus of product protein of TULP1 gene was highly conserved among species. The protein prediction software predicted that the mutation pathogenic. The c.391delG, c.715delA and c.1765C＞T mutations of RPGRIP1 gene and c.3177_3178delAC mutation of GUCY2D gene can lead to early translation termination of their product proteins, which are pathogenic variants.ConclusionThe pathogenic mutations of TULP1, RPGRIP1 and GUCY2D genes led to LCA 15, LCA 6 and LCA 1 in six families.
Objective
To explore underlying causes of presumptive optic neuritis (ON) in children.
Methods
Retrospective study of continuous cases with presumed diagnosis of optic neuritis in childhood.
Results
104 cases(65.8%) met ON criteria in this cohort of children, among wh ich 80 cases (76.9%) were considered as idiopathic demyelinating optic neuritis (IDON). Infectious optic neuritis and inflammatory optic neuropathy were found on 3 cases respectively. The cause of 18 cases remains unknown. Leber hereditary optic neuropathy and non-organic visual acuity loss account most of the 54 case s misdiagnosed as optic neuritis.
Conclusions
As in adult patients, idiopathic demyelinating optic neuritis is the most common pathogeny of optic neuritis in children, while infectious events were more common in children. Leber hereditary optic neuropathy and nonorganic visual acuity loss were the most common disease confused with optic neuritis in childhood. Some rare disease in childhood which can cause optic nerve lesion should also be considered.
(Chin J Ocul Fundus Dis, 2008,24：95-98)
Serpiginous choroiditis (SC) is infrequent, chronic and posterior uveitis displaying a geographic pattern of choroiditis easy to recur. Studies reveal that the active lesions of inflammatory processes are mainly localized to the choriocapillaris and retinal pigment epithelium cells. SC may manifest with variable features, although a creeping pattern of choroiditis, extending from the juxtapapillary area, with grayish yellow discoloration. Fundus fluorescein angiography, indocyanine green angiography, fundus auto-fluorescence and optical coherence tomography are helpful to diagnose atypical SC. In addition, these image examinations can evaluate the activity and progression of lesion, and detect any complication that might occur. SC is mainly distinguished from multifocal SC related with tuberculosis or virus and etc. Pathogenesis is unclear, an organ-specific autoimmune inflammation or infection seems likely to be the underlying process. It is mainly using glucocorticoid with immunosuppressant therapy at present. Timely and effectively control inflammation can effectively prevent vision loss, choroidal neovascularization and choroidal scar in SC patients.
