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Objective To observe the clinical effect ofvitrectomy with internal limiting membrane peeling and air tamponade in the treatment of idiopathic macular hole (IMH).Methods A prospective,nonrandomized controlled case cohort study.Twenty eyes of 20 patients with IMH in Ophthamology Department of The Second Hospital of Jilin University from September 2016 to January 2017 were included in this study.There were 4 males (4 eyes) and 16 females (16 eyes),with the mean age of 60.60 ± 9.50 years and the mean disease course of 9.55 ± 15.5 months.The stage of macular hole ranged from Ⅱ to Ⅳ.All patients underwent BCVA,intraocular pressure,spectral-domain OCT (SD-OCT) and multifocal ERG examinations.The BCVA examination was performed using the international standard visual acuity chart,which was converted into logMAR visual acuity.The minimum diameter (MIN),bottom diameter (BD),height (H),the defective diameter of ellipsoid zone,the defective diameter of external limiting membrane (ELM) of the macular hole were measured by SD-OCT (German Heidelberg).Then the macular hole index (MHI=H/BD),hole traction index (THI=MD/BD) and hole diameter index (DHI=H/MD) were calculated.The response density in P1 wave was detected by mf-ERG.The logMAR BCVA was 1.18 ± 0.54.There were 5 eyes with less than 400 μm MIN,13 eyes with 400-700 μm MIN and 2 eyes with over than 700 μm MIN.All the patients were underwent vitrectomy with internal limiting membrane peeling and air tamponade.According to the SD-OCT image features after surgery,IMH closure was divided into type Ⅰ closed,type Ⅱ closed and unclosed.The follow-up was equal or greater than 3 months.The closure rate of IMH,BCVA and the changes of microstructure parameters of macular area were observed.Spearman correlation analysis was used to analyze the correlation between BCVA and the wave response density in P 1 before surgery and the efficacy after IMH surgery.Results Closure rate of IMH:18 eyes (90.0％) were completely closed (all type Ⅰ closed).The closure rate of macular hole with the MIN less than 400 μm was 100.0％ (5/5),400-700 μm was 92.3％ (12/13),and over than 700 μm was 50％ (1/2).BCVA:the mean logMAR BCVA at 1 week,1 month,3 months after surgery were 0.83± 0.54,0.65 ± 0.41,0.48± 0.34,and there was statistically significant difference between preoperative and postoperative BCVA (t=3.382,4.459,5.250;P=0.003,0.007,0.004).The outcomes of SD-OCT at 3 months after surgery:18 eyes (90.0％) with intact ELM.The defective diameter of ellipsoid zone was 260.34±272.08 μm,there was statistically significant difference between before and after surgery (t=13.545,P=0.002).The outcomes of mf-ERG:the P 1 wave response density of the ring 1 and ring 2 after surgery were increased compared with before surgery (t=-16.748,-6.151;P＜ 0.01,＜ 0.01).The results of Spearman correlation analysis:there was a positive correlation between postoperative BCVA and preoperative MIN,the defective diameter of ellipsoid zone and ELM,and postoperative the defective diameter of ellipsoid zone (r=0.56,0.59,0.68,0.52;P=0.010,0.006,0.001,0.019).The postoperative BCVA was negatively correlated with the P 1 wave response density of ring 1 and ring 2 of mfERG (r=-0.34,-0.16;P=0.006,0.020).The IMH closure had a significant negative correlation with MIN and the defective diameter of ELM (r=-0.449,-0.449;P=0.047,0.047).MHI and THI were positively correlated with the closure of the hole (r=0.474,0.546;P=0.035,0.013).Intraocular pressure increased in 2 eyes during the follow-up period,and returned to normal within 1 week after the administration of antihypertensive drugs.There were no complications during or after the operation.Conclusions Vitrectomy with internal limiting membrane peeling and air tamponade in the treatment of IMH is safe and effective.The MIN,MHI THI are significantly correlated with the curative effect after IMH surgery,which could be used as the index to predict and evaluate the curative effect.The response density of ring 1 and ring 2 in P1 wave of mf-ERG is signifi-cantly improved compared with before surgery,and which is negatively correlated with BCVA.
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Objective@#To observe the clinical effect of vitrectomy with internal limiting membrane peeling and air tamponade in the treatment of idiopathic macular hole (IMH).@*Methods@#A prospective, non-randomized controlled case cohort study. Twenty eyes of 20 patients with IMH in Ophthamology Department of The Second Hospital of Jilin University from September 2016 to January 2017 were included in this study. There were 4 males (4 eyes) and 16 females (16 eyes), with the mean age of 60.60±9.50 years and the mean disease course of 9.55±15.5 months. The stage of macular hole ranged from Ⅱ to Ⅳ. All patients underwent BCVA, intraocular pressure, spectral-domain OCT (SD-OCT) and multifocal ERG examinations. The BCVA examination was performed using the international standard visual acuity chart, which was converted into logMAR visual acuity. The minimum diameter (MIN), bottom diameter (BD), height (H), the defective diameter of ellipsoid zone, the defective diameter of external limiting membrane (ELM) of the macular hole were measured by SD-OCT (German Heidelberg). Then the macular hole index (MHI=H/BD), hole traction index(THI=MD/BD) and hole diameter index (DHI=H/MD) were calculated. The response density in P1 wave was detected by mf-ERG. The logMAR BCVA was 1.18±0.54. There were 5 eyes with less than 400 μm MIN, 13 eyes with 400-700 μm MIN and 2 eyes with over than 700 μm MIN. All the patients were underwent vitrectomy with internal limiting membrane peeling and air tamponade. According to the SD-OCT image features after surgery, IMH closure was divided into type Ⅰ closed, type Ⅱ closed and unclosed. The follow-up was equal or greater than 3 months. The closure rate of IMH, BCVA and the changes of microstructure parameters of macular area were observed. Spearman correlation analysis was used to analyze the correlation between BCVA and the wave response density in P1 before surgery and the efficacy after IMH surgery.@*Results@#Closure rate of IMH: 18 eyes (90.0%) were completely closed (all type Ⅰ closed). The closure rate of macular hole with the MIN less than 400 μm was 100.0% (5/5), 400-700 μm was 92.3% (12/13), and over than 700 μm was 50% (1/2). BCVA: the mean logMAR BCVA at 1 week, 1 month, 3 months after surgery were 0.83±0.54, 0.65±0.41, 0.48±0.34, and there was statistically significant difference between preoperative and postoperative BCVA (t=3.382, 4.459, 5.250; P=0.003, 0.007, 0.004). The outcomes of SD-OCT at 3 months after surgery: 18 eyes (90.0%) with intact ELM. The defective diameter of ellipsoid zone was 260.34±272.08 μm, there was statistically significant difference between before and after surgery (t=13.545, P=0.002). The outcomes of mf-ERG: the P1 wave response density of the ring 1 and ring 2 after surgery were increased compared with before surgery (t=-16.748, - 6.151; P<0.01,<0.01). The results of Spearman correlation analysis: there was a positive correlation between postoperative BCVA and preoperative MIN, the defective diameter of ellipsoid zone and ELM, and postoperative the defective diameter of ellipsoid zone (r=0.56, 0.59, 0.68, 0.52; P=0.010, 0.006, 0.001, 0.019). The postoperative BCVA was negatively correlated with the P1 wave response density of ring 1 and ring 2 of mf- ERG (r=-0.34, -0.16; P=0.006, 0.020). The IMH closure had a significant negative correlation with MIN and the defective diameter of ELM(r=-0.449, -0.449; P=0.047, 0.047). MHI and THI were positively correlated with the closure of the hole (r=0.474, 0.546; P=0.035, 0.013). Intraocular pressure increased in 2 eyes during the follow-up period, and returned to normal within 1 week after the administration of antihypertensive drugs. There were no complications during or after the operation.@*Conclusions@#Vitrectomy with internal limiting membrane peeling and air tamponade in the treatment of IMH is safe and effective. The MIN, MHI THI are significantly correlated with the curative effect after IMH surgery, which could be used as the index to predict and evaluate the curative effect. The response density of ring 1 and ring 2 in P1 wave of mf-ERG is signifi-cantly improved compared with before surgery, and which is negatively correlated with BCVA.
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Coats disease,known as the outer exudative retinopathy,is a kind of disease characterized by retinal capillaries expansion and microvascular abnormalities,often accompanied by retinal or subretinal exudation and lipids exudative retinal detachment.Neovascular glaucoma and ocular atrophy often occur in the late time.Coats disease is significant diversity in clinical presentation and morphology.For nearly a century,with the development of understanding of the disease,vireoretinal specialists have a new view on diagnosis and treatment of it.This article reviews the recent progress in the diagnosis and treatment of Coats disease.
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The cyclodialysis cleft is a rare disease characterized by ocular hypotony and vision loss.Gonioscopy,ultrasound biomicroscopy and anterior segment optical coherence tomography are used to evaluate the cleft before treatment.The evaluation of cyclodialysis clefts provide a basis for the selection of treatment and the evaluation of effect.Current popular therapeutic approaches for cyclodialysis clefts include medical management,laser photocoagulation,transscleral diathermy,cryotherapy,cyclopexy and so on.Medical treatment is effective in small-size cyclodialysis cleft.But the indications and course of medical treatment remains controversial.Although laser photocoagulation,transscleral diathermy and cryotherapy are effective to treat cyclodialysis clefts in some cases,there are some risks,such as ocular damage,uncertainty about the effect and so on.Cyclopexy is the principal method for cyclodialysis clefts that failed to respond to conservative management,including extraocular cyclopexy,intraocular cyclopexy and cyclopexy under endoscopic.The modified cyclopexy is effective which reduces the surgical risk.For keeping the lens,intraocular cyclopexy and cyclopexy under endoscopic are not suitable.Vitrectomy combined with other method for cyclodialysis is effective for cyclodialysis clefts which combined with serious posterior segment damage.
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Objective To analyze the clinical character of uveitis in second hospital ot Jilin university.Methods Retrospectively analyze the clinical data of uveitis patients referred to from Second Hospital of Jilin University from September 2009 to September 2014.According to anatomical location,the manifestation of these uveitis patients were divided into anterior uveitis,panuveitis,intermediate uveitis and posterior uveitis.To discuss the possible causes of these patients according to the general information and relevant clinical laboratory examinations results.Results There were 1215 cases in this study,which included 587 male,accounting for 48.31％;and 628 female,accounting for 51.69％.The ratio of male-tofemale was 0.93∶1.The range of the age of these patients was from 4 to 91 years old.The mean age of these patients at the onset of these disease was (41.43±14.20) years.Of the 1215 cases,40 male and 43 female were younger than 20 years.The ratio of male-to-female was 0.93∶ 1;412 male and 396 female were between 21 and 50 years old.The ratio of male-to-female was 1.04∶ 1;135 male 189 female were older than 50 years.The ratio of male-to-female was 0.71∶1.There were 572 cases of anterior uveitis,accounting for 47.08％;527 cases of panuveitis,accounting for 43.37％;52 cases of intermediate uveitis,accounting for 4.28％;64 cases of posterior uveitis,accounting for 5.27％.703 cases had etiological diagnosis according to the clinical character and the auxiliary results,accounting for 57.68％.Vogt-koyanagi Haradal (VKH) syndrome,ankylosing spondylitis associated with uveitis and Behcet' s disease were the common entity,accounting for 30.44％,19.77％ and 14.22％ respectively.Conclusions The mean age of these patients in this study was older,compared to other reports.Female patients were more than male,especially in these patients older than 50 years.VKH syndrome,ankylosing spondylitis associated with uveitis and Behcet's disease were the common entities.
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Optical imaging technology of ocular fundus,including fundus fluorescein angiography (FFA),optical coherence tomography (OCT) and fundus autofluorescence (FAF),is growing at an unprecedented speed and scale and is integrating into the routine clinical management of ocular fundus diseases,such as diagnosis,treatment,and mechanism study.While FFA allow us to observe the retinal and choroidal blood circulation,OCT and FAF are non-invasive,fast and quantifiable measurement; such techniques show even more unique advantages and are favored tools.All these retinal imaging technologies,together with a variety of retinal function assessments,bring us into the era of big data of ocular fundus diseases.All of these developments are the challenges and opportunities for the operator and user of these fundus optics imaging technologies.In order to improve its clinical applications and allocate resources rationally,we need to understand the optical properties of these retinal imaging technologies,and standardize diagnosis behavior.This is a continuous learning process needs to continue to explore.
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Objective To investigate the expression of ionic channels of the rat bone marrow mesenchymal stem cells(BMSCs) and provide the basis for the change of ionic channels in the process of differentiation of stem cells.Methods The full marrow from Wistar rats was isolated by Percoll centrifugation and passaged repeatedly.The membrane currents of BMSCs were recorded with the whole-cell patch-clamp technique.The current amplitude of pathway,peal value and time course of activation and deactivation,selectivity of ions pathway,I-V curve were recorded.The currents were identified and analyzed by using various channel blockers.Results The cells began to stick in 24 h and arranged in whirlpool shape after passenger culture.They were positive for CD71,CD44,and negative for CD34,CD45 by flow cytometry,which improved that the cultured cells were BMSCs.The functional ion channels were characterized in cultured rat BMSCs with whole-cell patch clamp and reverse transcription polymerase chain reaction(RT-PCR) techniques.Three types of outward currents were found in BMSCs,including a delayed rectifier K+ current(IKDR),in addition,tetrodotoxin-sensitive sodium current(INa.TTX) and nifedipine-sensitive L-type Ca2+ current(ICa.L) were detected in 24% and 25% BMSCs.Moreover,RT-PCR result revealed the molecular evidence of mRNA for the functional ionic currents,including SCN5A,Kv4.3 and CACNA1C.Conclusion The currents are consistent with the characteristics of excitable cell membrane.
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Objective To study the emmetropization in guinea pig eyes during the normal development from birth in order to provide theoretical basis to use guinea pigs as model for research on near-sightedness.Methods Sixty-four guinea pigs were assigned to 8 groups (n=8,4 male/4 female).Each group underwent a series of ocular examinations at one of the 8 time-points (0,1,2,3,5,7,9 and 11 weeks),including refraction(R),radius of corneal curvature (RCC),depth of anterior segment(AS),thickness of crystalline lens (CL),length of vitreous chamber (VC)and axial length (AL).Pooled results from both eyes of the same animals with mixed sexes can be used for further assessment of the emmetropization with the associated biometrical changes of the eye.Correlations were made between RCC,AS,CL,VC,AL and R. Results There were no significant differences between the right eye and left eye or between male and female in results of all the examinations. The refraction at birth was (+5.25?0.22 )D in guinea pigs.This value rapidly decreased during the first 3 weeks,approaching(+1.34?0.61) D by 11 weeks.There was no significant difference in refraction between 9 and 11 weeks (P= 0.215). The RCC was (3.23?0.01) mm at birth,AS was (1.20?0.00) mm at birth,CL was (2.72?0.02) mm at birth and VC was (3.27?0.01) mm at birth,they increased within the first 3 weeks despite a transient decrease in the RCC within the first week.Such an increase continued except the AS which became constant after 3 weeks.The VC was more correlated to the emmetropization (r=-0.818,P
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Objective To investigate the effect of silicone oil on the corneal endothelium in experimental animal models,while the silicone oil in the anterior chamber of the experimental animals will be taken out so as to explore their corneal changes.Methods Forty healthy white rabbits were randomly divided into three groups : silicone oil in the anterior chamber group (SIG),silicone oil in and out of the anterior chamber group (SIOG) and control group(CG).The cornea of rabbit was investigated at different times by slit-lamp,corneal thickness instrument,endothelial cell count instrument,histology and electromicroscopy.The time of silicone oil in the anterior chamber without keratpathy and the pathological changes of cornea with taking out of the silicone oil were observed.Results The density of the corneal endothelium in SIOG and SIG decreased more obviously by endothelial cell count instrument from 8 weeks to 16 weeks compared with control group (P
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0.05). Conclusions In han-nationality people in Northern China, DRB1*04 is positively associated with Eales′ disease, suggesting that DRB1*04 may confer a major influence on Eales′ disease. Turbulence of immune function begotten by infect-agents attack may occur in the individuals with Eales′ disease due to the specific hereditary diathesis of HLA, which may cause the occurrence and development of Eales disease.