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Infectious keratitis is one of the leading causes of irreversible vision loss.With the emergence of multidrug-resistant pathogen,despite appropriate diagnosis and antimicrobial treatment,infectious keratitis can still result in corneal opacity and even melting and perforation.Therefore,it is imperative to develop novel treatment for infectious keratitis.More recently,several articles have demonstrated the effectiveness of collagen cross-linking (CXL) in treating infectious keratitis via direct antimicrobial activity and inhibition of corneal enzymatic degradation.In order to highlight the use of CXL tor infectious keratitis treatment,a new term was proposed at the 9th CXL congress to rename its use in infections as photoactivated chromophore for infectious keratitis-CXL (PACK-CXL).Based on the current literature,PACK-CXL appears to be effective for bacterial keratitis,especially on inhibiting corneal perforation.The effect was limited for fungal and amoebic keratitis,and maybe aggravative on viral keratitis.In this article,we will review the basic profile,technical operation,prevention of complication of CXL,the principle mechanism of PACK-CXL and its clinical application for bacterial,fungal keratitis,amoebic and viral keratitis.
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Objective:To evaluate the efficacy of intravitreal lucentis or conbercept injection combined with ahmed glaucoma valve (AGV)implantation on the treatment of neovascular glaucoma (NVG).Methods:A total of 68 NVG patients (68 eyes)were divided into three groups according to the pretreatment (the intravitreal injection of lucentis or conbercept or no intravitreal injection 3 - 7 d before AGV implantation):lucentis group (n = 26, given intravitreal injection of 10 g · L-1 lucentis),conbercept group (n = 21, given intravitreal injection of 10 g·L-1 conbercept)and control group (n=21,given medicine or puncture of anterior chamber to smoothen the IOP and received AGV implantation).The panretina photocoagnlation (PRP)was performed in the patients with clear ocular media before intravitreal injection or AGV implantation.For the patients with cloudy ocular media,the intravitreal injection of anti-VEGF drugs was performed first and the PRP was performed when fundus could be seen.Results:Compared with before operation,the mean IOP and the number of antiglaucoma medications of the patients used in three groups after operation were significantly decreased (P < 0.01).There were no significant differences in the successful rates of operation of the patients in three groups at different time points after operation (P >0.05).1 month and 3 months after operation,the BCVA of the patients in lucentis and conbercept groups was significantly better than that in control group (P <0.05).There were no significant differences in the incidence of complications of the pateints between lucentis and conbercept groups at different time points after operation (P >0.05).Conclusion:Intravitreal injection of anti-VEGF drugs combined with AGV implantation is effective and safe in the treatment of NVG.In short term,it can improve the vision,relieve the pain and reduce the complications.
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Objective: To discuss the clinical efficacy of bandage contact lens (BCL)in pterygium excision combined with conjunctival transplantation for the older adults,and to explain its advantages.Methods:The clinical materials of 70 older patients (70 eyes ) who underwent the pterygium excision combined with conjunctival transplantation were retrospectively analyzed.They were divided into two groups according to the postoperative treatment.In the observation group,35 cases (35 eyes)wore BCL after operation.In control group,35 cases (35 eyes)were covered with normal eye pad.The scores of blurred vision,photophobia,foreign body sensation, lacrimation,eye-soreness,corneal fluorescence stain (FSC)and epithelial defect areas were observed at 1,3,7 and 10 d afer operation.Results:The scores of blurred vision,photophobia,foreign body sensation,lacrimation,eye-soreness of the patients in observation group were significantly lower than those in control group at 1,3,and 7 d afer operation (P 0.05).No complications of infection and implant healing badness were observed in all patients.Conclusion:BCL can significantly reduce the irritations after pterygium excision combined with conjunctival transplantation for the older adults and promote the healing of the corneal epithelium.
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Background Poly(adenosine diphosphate-ribose) polymerase 1 (PARP-1) plays an important role in the pathogenesis of diabetic retinopathy (DR),and Notch1 signal pathway is one of the important signal transduction pathways in the organism which may antagonize retinal vascular diseases.However,if Notch1 signaling pathway is involved in pathogenesis of DR has not been confirmed yet.Objective This study was to investigate the expressions of Notch1,Dll4,PARP-1,Akt,nuclear factor-κB (NF-κB) and caspase-3 in the retina of diabetic mouse model and retinal vascular endothelial cells (RVECs) under the high glucose.Methods The expressions of Notch1,Dll4,PARP-1,Akt,NF-κB and caspase-3 in the retina of diabetic mouse models were investigated using immunochemistry and Western blot method after the diabetic mouse models were established.And these proteins were detected in retinal RVECs under the high glucose by Western blot.Results The expressions of Notch1,Dll4 and phosphorylated Akt (p-Akt) in retinas reduced significantly and simultaneously companied with increases of PARP-1 and caspase-3 in diabetic mice compared with normal mice (all at P＜0.05).However,no obvious change was found in the expression of NF-κB (P＞0.05).Expressions of Notch1 and p-Akt in RVECs increased with the increase of glucose concentration,but expressions of cleaved PARP-1 and caspase-3 decreased,especially in the 30 mmol/L group,showing significant differences in comparison with the normal control group (all at P＜0.05).But no altering of NF-κB expression was seen in the mice with diabetes mellitus.Conclusions The expressions of cleaved-PARP-1 and caspase-3 in the retinas is up-regulated,but the expressions of Notch1 and p-Akt are down-regulated in diabetic mice.
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Background It has been determined that dipeptidyl peptidase Ⅲ (DPPⅢ) plays an important role in the metabolism and modification of proteins and DPPⅢ of human has highly homologous to rat.Researches have shown that DPPⅢ is associated with the formation of cataract.However,few relevant studies have been reported.ObjectiveThe present study is to find out the relationship between the expression of DPPⅢ in rat lenses and age-related cataract.Methods Lenses were obtained from general Wistar rats of ages 3,6,9,or 12 weeks old (10 lenses each ) and homogenized with different concentrations of standard bovine serum.The proteins were resolved using SDS-PAGE gel electrophoresis.Peak concentration and total concentration of DPPⅢ protein in lenses from rats of different ages were detected by Western blot.Enzyme activity of DPPⅢ was determined by monitoring the amount of dipeptides removed from a special substrate (Arg-Arg-4mb NA) by measuring the absorbance with UV-2500PC at 525 nm.The relationship between the enzyme activity of DPPⅢ in lenses and age of rats was evaluated using regression analysis.Results DPPⅢ was detected at a molecular weight of 82000 Da.The peak concentration and total concentration of DPPⅢ in normal rat lenses increased with the growth of age.The total protease activity of DPPⅢ in the lenses of rats was correlated with the ages of the rats (r=0.99,P＜0.05).Conclusion DPPⅢ may be involved in the alteration of crystallin during the development of lenses,and it may play an important role in the formation and aggravation of age-related cataract.
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Objective To explore the relationship between dipeptidyl peptidaseⅡ(DPPⅡ) and the pathogenesis of congenital cataract.Methods Eighty SCR rats with congenital cataract were randomly divided into four groups:8,10,12 and 14 weeks groups(n=20).Normal Wistar rats at each age were used as control groups.Immunohistochemical experiments using the streptavidin-biotin immunoper-oxidase method were used to observe the immunoreactivity changes of DPPⅡ in lens in SCR rats at different time(8,10,12,14 weeks).Results The immunoreactivities of DPPⅡ in the lens epithelial cells and fibres of cataractous lenses of all ages were higher than those in control groups.At the 12th and 14th week,immunoreactive staining of DPPⅡwas found to extend into the perinuclear region.Conclusion The immunoreactivity of DPPⅡ is enhanced in cataractous rat lenses.DPPⅡ may be participated in the proteolytic modification of lens proteins during cataractogenesis.