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Objective:To observe the changes of macular morphology and blood flow after minimally invasive vitrectomy (PPV) in patients with severe non-proliferative diabetic retinopathy (sNPDR).Methods:A prospective clinical study. From January 2020 to April 2021, 17 consecutive sNPDR patients with 17 eyes who were diagnosed and received PPV treatment at the Zhongshan Ophthalmic Center of Sun Yat-sen University were included in the study. There were 12 males with 12 eyes and 5 females with 5 eyes; the average age was 55 years old; the average duration of diabetes was 11 years; the average glycosylated hemoglobin was 7.9%. Before the operation and 1, 3, and 6 months after the operation, all the affected eyes underwent best corrected visual acuity (BCVA), standard 7-field fundus color photography, and optical coherence tomography angiography (OCTA). An OCTA instrument was used to scan the macular area of the affected eye with in the range of 3 mm×3 mm to measure the central subfoveal thickness (CST), the thickness of the ganglion cell complex (GCC) in the macular area, the thickness of the retinal nerve fiber layer (RNFL), and the superficial capillary plexus (SCP) vessel density and perfusion density in the macular area, macular avascular zone (FAZ) area, a-circularity index (AI). Before the operation and 6 months after the operation, the least significant difference test was used for the pairwise comparison.Results:Before the operation, 1, 3, and 6 months after the operation, the FAZ area of the macular area were 0.34±0.14, 0.35±0.10, 0.37±0.10, 0.36±0.13 mm 2, respectively; AI were 0.52±0.13, 0.54±0.11, 0.57±0.10, 0.60±0.11; CST was 282.6±66.7, 290.4±70.9, 287.2±67.5, 273.2± 49.6 μm; GCC thickness were 77.1±15.5, 74.3±13.9, 72.6±16.2, 78.5±18.3 μm; the thickness of RNFL was 97.9±13.8, 101.3±14.6, 97.7±12.0, 96.1±11.4 μm, respectively. The overall blood flow density of SCP in the macula were (16.79±1.43)%, (16.71±1.82)%, (17.30±2.25)%, (17.35±1.22)%; the overall perfusion density were 0.32±0.02, 0.32±0.03, 0.33±0.03, 0.33±0.02, respectively. After the operation, the CST increased first and then decreased; the thickness of RNFL increased 1 month after the operation, and then gradually decreased. Comparison of the parameters before and 6 months after the operation showed that the AI improved, and the difference was statistically significant ( P=0.049); the difference in FAZ area and the thickness of CST, GCC, and RNFL was not statistically significant ( P=0.600, 0.694, 0.802, 0.712); There was no statistically significant difference in the retina SCP blood flow density and perfusion density in the macular area ( P=0.347, 0.361). Conclusion:Compared with before surgery, there is no significant change in macular structure and blood flow density in sNPDR patients within 6 months after minimally invasive PPV.
ABSTRACT
Vitrectomy is the preferred surgical method for diabetic retinopathy, especially in the stage of proliferative diabetic retinopathy. Vitrectomy for diabetic retinopathy involves all aspects of vitrectomy, which is one of the signs of maturity of retinal surgeons. With the application of minimally invasive vitrectomy and perioperative anti-neovascularization drugs, indications and timing of surgery, perioperative medication, management of vitreous, and whether combined with cataract surgery have changed greatly, and new understanding is needed. Evidence-based clinical research on the timing of diabetic retinopathy surgery and perioperative drug use should be carried out to provide a new theoretical basis for the surgical treatment of diabetic retinopathy.
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Molting fluid, a liquid between the old epidermis and new epidermis, plays an important role in the process of ecdysis and metamorphosis for insect. In order to explore the function of molting fluid, we used two-dimensional electrophoresis to study the molting fluid during the prepupal stage and pre-eclosion stage. More than 200 protein spots were found in the molting fluid of the 2 stages, which distributed in the 4-9 of pI and 10-180 kDa of molecular weight. We selected 42 spots to be analyzed by the matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI TOF/TOF) from the molting fluid of pre-eclosion stage, of which 34 proteins were identified successfully, including apolipoprotein, protease and protease inhibitors, chitin-binding protein and protein involved in immunity. Some of the proteins demonstrated differential expression between the two stages of metamorphosis. In order to validate the result from proteomics analysis, we studied expression of the apolipoprotein D by Q-PCR from the developmental stages. The results showed that the gene encoding apolipoprotein D had the high expression from the 1st day to the 4th day of the pupa stage, which indicated they could be involved in eclosion due to the abundant accumulation in the late pupa. Our results offered more clues for understanding the mechanism of ecdysis and metamorphosis in insect and could give reference for further study of molting fluid.
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Background The aqueous flare is obvious in uveitic glaucomatous eye due to the damage of blood-aqueous barrier,especially following intraocular surgery.How to quantitatively determine the aqueous flare is important for us to understand the severity of inflammatory response.Objective This study was to assess inflammatory response following Ahmed glaucoma valve implantation in uveitic glaucomatous eye.Methods A nonrandomized controlled study was carried out under the approval of Ethic Committee of Zhongshan Ophthalmic Center of Sun Yat-sen University.Twenty-nine eyes of 29 subjects with refractory glaucoma were enrolled this hospital from October 2011 through July 2012.The patients were divided into the uveitic glaucoma group (10 eyes) and the other refractory glaucoma group (19 eyes) with the matched demography,and Ahmed glaucoma valve implantation was performed on all the eyes under the informed consent of each patient.The aqueous flare value was determined with FC-2000 flare-cell photometry and intraocular pressure (IOP) was measured with Goldmann tonometer before surgery and 1 day,3 days,1 week,2 weeks,1 month and 3 months after surgery.The outcomes were compared between the two groups,and the correlation of aqueous flare value with IOP was analyzed.Results In the uveitic glaucoma group,the aqueous flare values were 21.10 (10.50,38.58) photoparticles/ms,88.00 (23.55,168.63) photoparticles/ms and 29.90 (8.90,65.18)photoparticles/ms 1 day,3 days and 1 week after surgery,which were significantly higher than 13.53 (7.60,24.00) photoparticles/ms before surgery (all at P＜0.01).The same trend was found in the other refractory glaucoma group.In addition,the aqueous flare value was higher in the uveitic glaucoma group than that in the other refractory glaucoma group in 3 months after surgery (q=-3.445,P＜0.01).No significant differences were seen in IOP between the two groups at various time points (all at P＞0.05).Also,no significant correlations were seen between IOP and aqueous flare value in all patients at various time points (preoperation:rs =0.136,P =0.481; postoperative 1 day:rs =0.019,P =0.922 ; postoperative 3 days:rs =-0.035,P =0.858 ; postoperative 1 week:rs =0.317,P=0.094; postoperative 2 weeks:rs =0.034,P =0.861 ; postoperative 1 month:rs =-0.094,P =0.628 ; postoperative 3 months:rs =0.065,P =0.738).Conclusions FC-2000 flare-cell photometry can reflect the inflammatory reaction of the anterior chamber following Ahmed glaucoma valve implantation in various types of refractory glaucomatous eyes.The postoperative inflammatory response is more serious and lasting in uveitic glaucomatous eye.
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Silkworm is a holometabolous insect of Lepidoptera. During metamorphosis, significant morphological changes happen including the dissociation of old tissues and remodeling of new tissues. It has been reported that cathepsins are involved in these processes. Cathepsin is a kind of intracellular proteinase that exists in many species. It includes some subfamilies like cathepsin B, H and L. The studies on cathepsin are useful for clarifying the details of silkworm metamorphosis process. In total, 13 cathepsins were identified by screening the silkworm genome database. The basic information and the expression patterns about these genes were analyzed. Interestingly, an ovary-specific cathepsin L gene (Gene ID: BGIBMGAOO4622) was investigated by the data of silkworm microarray and real-time quantitative PCR (qPCR). The full-length cDNA is 1,209 bp, encoding a protein with 402 amino acids. Sequences alignment revealed that it has a high sequence similarity with cathepsin L of other species, and it is highly conserved in the active-site of the enzyme. The phylogenetic analysis showed that ovary-specific cathepsin L is clustered with other lepidopterous insects. Furthermore, this gene was cloned and prokaryotic expressed. Recombinant protein was present in inclusion body. Importantly, the qPCR result showed that the expression level of this gene is increasing during the early stage of pupal development and reaches the highest value at the 3rd day of pupal stage, which suggests that this gene may be involved in the process of development of the ovary and oocyte.
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Animals , Bombyx , Genetics , Cathepsins , Genetics , Insect Proteins , Genetics , PhylogenyABSTRACT
<p><b>BACKGROUND</b>Neovascular glaucoma is a refractory disease, and difficult to manage. The aim of this study was to evaluate the clinical outcomes of Ahmed glaucoma valve implantation (AGVI) in neovascular glaucoma (NVG) and non-NVG patients.</p><p><b>METHODS</b>This prospective, non-randomized study included 55 eyes of 55 patients with refractory glaucoma; 27 had NVG (NVG group) and 28 had non-NVG (non-NVG group). All of the patients underwent AGVI. The NVG group was adjunctively injected with intravitreal ranibizumab/bevacizumab (IVR/IVB) before AGVI. Intraocular pressure (IOP) was the primary outcome measure in this study. Surgical success rate, number of antiglaucoma medications used, best corrected visual acuity (BCVA), and postoperative complications were analyzed between the groups.</p><p><b>RESULTS</b>All of the patients completed the study (follow-up of 12 months). Kaplan-Meier survival curve analysis indicated that the qualified success rates in the NVG and non-NVG groups at 12 months were 70.5% and 92.9%, respectively; this difference was significant (P = 0.036). The complete success rates in the NVG and non-NVG groups at 12 months were 66.7% and 89.3%, respectively (P = 0.049). Compared with preoperative examinations, the postoperative mean IOP and use of medications were significantly lower at all follow-up time points in both groups (all P < 0.05). There were significant differences in BCVA between the two groups at the 12-month follow-up (χ(2) = 9.86, P = 0.020). Cox proportional hazards regression showed NVG as a risk factor for surgical failure (RR = 15.08, P = 0.033). Postoperative complications were similar between the two groups.</p><p><b>CONCLUSIONS</b>AGVI is a safe and effective procedure in refractory glaucoma, but the success rate of surgery was related to the type of refractory glaucoma. The complete and qualified success rates of NVG patient adjunctive anti-vascular endothelial growth factor treatment are still lower than those of non-NVG patients.</p>