ABSTRACT
<p><b>BACKGROUND</b>Indirect traumatic optic neuropathy (TON) is an acute injury of the optic nerve associated with severe visual dysfunction, which may be a result of secondary mechanical injury and vascular disorder of the optic nerve due to trauma. We analyzed the natural course of axonal loss and blood flow disturbances in patients with indirect TON to find a possible therapeutic window.</p><p><b>METHODS</b>A cohort of 54 patients with indirect TON recruited between October 2008 and October 2010 at Beijing Tongren Hospital was retrospectively analyzed. The patients were divided into no light perception group (NLP) and better than NLP (btNLP) group. Specifically, the thickness of the retinal nerve fiber layer (RNFL) measured by spectral domain optical coherence tomography (SD-OCT), and hemodynamic parameters of the ophthalmic artery (OA), central retinal artery (CRA) and posterior ciliary artery (PCA) were determined.</p><p><b>RESULTS</b>Two weeks after injury, there was a statistically significant decrease in the thickness of RNFL in the btNLP group as compared with the fellow control eyes (P < 0.05). In contrast, in the NLP group, RNFL thickness slightly increased for 2 weeks following injury, then overtly reduced after 4 weeks (P < 0.05). Peak systolic velocity (PSV) of CRA was significantly decreased 4 weeks after injury (P < 0.05) in both the NLP group and btNLP group (P < 0.05). The thickness of RNFL in the NLP group was negatively correlated with PSV of CRA after 1 week of injury (P < 0.05, r = -0.962).</p><p><b>CONCLUSIONS</b>SD-OCT is a useful supplement in detecting the axonal loss in TON. The dynamic change of the thickness of RNFL appears to correlate with the hemodynamic disturbances in the natural course of TON. The first 2 weeks following an injury is critical and should be considered as the therapeutic window for TON patients.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Nerve Fibers , Physiology , Optic Nerve , Physiology , Optic Nerve Injuries , Retinal Neurons , Physiology , Retrospective Studies , Tomography, Optical CoherenceABSTRACT
<p><b>OBJECTIVE</b>To compare the biocompatibility and osteoinductive behavior of HA (hydroxyapatite) and HA/UHMWPE (ultra-high molecular weight polyethtlene) composite in orbital implantation.</p><p><b>METHODS</b>Osteoectomy of the upper orbital rim was perform on 24 adult New Zealand rabbits. The animals were randomly divided into 4 groups with 6 of each. The HA, HA/UHMWPE composite or UHMWPE (10 mm x 10 mm x 3 mm in size) was implanted to the upper orbital defect of the animal in respective group. Animals were sacrificed at 1, 4, 8, 12 weeks. Histopathologic sections of the implants were evaluated and compared with light and transmission electron microscopy study.</p><p><b>RESULTS</b>During the experimental period of 12 weeks, there was no implant extrusion or displacement. In the groups of HA and HA/UHMWPE composite, vascular ingrowth and fibroblasts were observed shortly and osteocytes were seen at 8 weeks. Calcium deposition of the implants showed a laminar fashion at 12 weeks. In the group of UHMWPE, fibrous membranes were seen around the implant at 1 week. Transmission electron microscopy study showed that in the HA and HA/UHMWPE groups, fibroblasts and vascular ingrowth could be seen, but osteocytes were not observed.</p><p><b>CONCLUSION</b>HA/UHMWPE composite demonstrated biocompatibility and osteoinductive property. It would be a good substitute for bone, particularly for orbital bone.</p>