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Objective:To observe the efficacy and safety of vitrectomy combined with submacular injection of tissue-type plasminogen activator (t-PA), gas filling and anti-VEGF drugs (multiple therapy) for thick submacular hemorrhage.Methods:A retrospective case study. From January 2014 to June 2018, 24 patients (24 eyes) with thick submacular hemorrhage who received multiple therapy at the Department of Ophthalmology of Peking University Third Hospital were included in the study. Among them, there were 15 males and 9 females with the average age of 69.05±8.86 years. The average submacular bleeding time was 17.15±10.30 days, the average bleeding area was 13.85±8.63 DD. Seventeen eyes showed hemorrhagic RPE detachment. The international standard visual acuity chart was used to BCVA examination, which was converted to logMAR visual acuity in statistics. The frequency domain OCT was used to measure the height of the foveal elevation. The average logMAR BCVA of the affected eye was 1.37±0.38. The average height of the macular fovea was 824.94±294.38 μm. All eyes underwent 23G or 25G vitrectomy. During the operation, 0.1-0.5 ml t-PA (10 μg/0.1 ml) was injected under the macula. The vitreous cavity was filled with 15% C 3F 8 after gas-liquid exchange in 13 eyes, and 11 eyes were filled with sterilized air. Eleven eyes were injected with anti-VEGF drugs at the end of the operation, and anti-VEGF drugs were given PRN treatment according to the activity of the lesion. The average follow-up time after treatment was 27.90±22.21 months. The absorption of bleeding under the macula, the improvement of vision, the occurrence of rebleeding and treatment-related complications were observed and recorded. The Wilcoxon rank sum test was performed to compare the BCVA and the height of foveal elevation before and after treatment. Results:One month after the treatment, the blood in the fovea of all affected eyes was cleared. At the last follow-up, the logMAR BCVA and macular foveal elevation were 0.82±0.28 and 253.88±71.75 μm, respectively. Compared with those before treatment, the difference was statistically significant ( Z=-3.727, -3.234; P<0.001, <0.001). The average intravitreal injection of anti-VEGF drugs was 1.08 times. During the operation, a tiny hole was formed in the center of the macula when t-PA was injected under the retina. Two eyes showed mild vitreous hemorrhage early after the operation. During the follow-up period, bleeding recurred in 2 eyes. Conclusions:Vitrectomy combined with submacular injection of t-PA, gas filling, and anti-VEGF drugs is an optimal combination for the treatment of thick submacular hemorrhage. It can effectively remove submacular hemorrhage, improve vision, reduce foveal elevation with good safety.
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The main developments and progresses of the mindset for the management of ocular trauma in China were summarized into the following 6 aspects:the emphasis on management of wound has been transferred from outside to inner site of the wound;emergence of the idea of continuous treatment;wound involving both anterior and posterior segments should be considered integratedly as an inseparable part in terms of surgical management;the zone of ciliary body receives more attention;assessment prior to the surgeries is insufficient for decision of enucleation;between vitreous body and retina,the stress of surgical management should be focoused on retina.We should pay attention to the evolutional and developing mindset in management of ocular trauma in recent ten years,it will help us to sort out the treatment ideas and summarize the treatment experience.
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Objective To evaluate the therapeutic effects of flute-needle vacuum assistant hole closure technique for large idiopathic macular hole (IMH).Methods The clinical data of 25 eyes with IMH of 408-939 μm in 23 patients who received pars plana vitrectomy with internal limiting membrane (ILM) peeling and flute-needle vacuum assistant hole closure technique from Feburary in 2017 to June in 2018 in Peking University International Hospital were retrospectively analyzed.The changes of best corrected visual acuity (BCVA) before and after operation were evaluated.The shapes of the hole closure were categorized,and the manifestations of outer retina were observed by optical coherence tomography (OCT),including external limiting membrane (ELM) and ellipsoid zone(EZ).Results The hole closure rate after surgery were 100％ (25/25),with the U type closure in 16 eyes and V type closure in 9 eyes.The BCVA was 0.76 ± 0.27 after operation,which was significantly improved in comparison with 1.05 ±0.29 before operation (t =3.61,P =0.01).The ELM of OCT image was (1 050.00±380.39)μm before operation,and that after operation reduced to (623.32 ± 328.66) μm,showing a significant difference between them (t =6.63,P=0.00).A fully reduced EZ band was seen after operation in comparison with before operation ([1 147.28±354.41] μm versus ([818.28±247.33] μm) (t=4.12,P=0.00).Conclusions A combination procedure of vitrectomy with flute-needle vacuum assistant hole closure technique is effective for large IMH,which is beneficial to the anatomical repair and functional recovery of outer retina.
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Objective To analyze the etiologies of severe vitreous hemorrhage in venerable age patients.Methods A retrospective series case study was adopted.Medical records of 30 cases 30 eyes severe vitreous hemorrhage venerable age patients were analyzed in Xuanwu Hospital Capital Medical University,Peking University Third Hospital and Beijing Tsinghua Chang Gung Hospital from July in 1999 to June in 2015.Visual acuity,intraocular pressure,anterior segment slit lamp microscopy,mydriasis funduscopy and ophthalmic B type ultrasound examination were used to evaluate 30 cases 30 eyes.Thirty eyes were all treated with pars plans vitrectomy (PPV).Results Mydriasis funduscopy examination showed that vitreous hemorrhage was so dense in 30 eyes that the fundus cannot be observed.The initial visual acuity examination showed that 8 eyes were count finger,5 eyes were hand move,16 eyes were light perception,and 1 eye was no light perception.There were dense light spots or clusters of high echoes in vitreous cavities,complete/incomplete posterior vitreous detachment (PVD) of all eyes;retinal detachment with different degrees in 5 eyes;proliferating cord adhesion to the wall of eyeball in 3 eyes.The etiologies included retinal vein occlusion (RVO) in 10 eyes (33.33％),retinal tear or retinal detachment in 7 eyes (23.33％),polypoidal choroidal vasculopathy (PCV) in 7 eyes (23.33％),proliferative diabetic retinopathy (PDR) in 4 eyes (13.33％).The above 4 etiologies were in 28 eyes,accounting for 93.33％.The others were ocular trauma in 2 eyes (6.67％).Conclusions The main cause to severe vitreous hemorrhage venerable age patients is RVO,followed by retinal tear or retinal detachment,PCV and PDR.Ocular trauma is rare.Vitrectomy is a diagnostic treatment,which can remove vitreous hemorrhage,improve the visual acuity of the patients,and determine the etiologies of the vitreous hemorrhage.
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Objective To observe the curative effects of anti-vascular endothelial growth factor (anti-VEGF) intracameral and intravitreal injection,trabeculectomy and pan-retinal photocoagulation by indirect ophthalmoscope for neovascular glaucoma (NVG).Methods NVG patients with uncontrolled intraocular pressure (IOP) and retinopathy was enrolled from May,2014 to May,2016.Eighteen patients were enrolled with 15 males(15 eyes) and 3 females(3 eyes) with age at (61.7 ± 13.9) years old.Anti-VEGF intracameral and intravitreal injection with anterior chamber puncture was performed in the first day of sequential treatment.Trebeculectomy was performed 3-5 days after injection and finally the pan-retinal photocoagulation was started 5-7 days after anti-glaucoma surgery.The best corrected visual acuity (BCVA),IOP,cornea,neovascularization of iris and retinal disease were observed and recorded.Results The diagnosis included 1 eye with central retinal artery occlusion (CRAO),6 eyes with central retinal vein occlusion (CRVO),5 eyes with branch retinal vein occlusion,5 eyes with proliferative diabetic retinopathy and 2 eyes with combined CRAO and CRVO.IOP before and after treatment were (43.5 ±5.1) mmHg (1 kPa =7.5 mmHg) and (15.2 ± 2.2) mmHg,there was significantly statistical difference (t =21.68,P ＜0.001).The categories of antiglaucoma medicines were 5.1 ± 0.5 and 0.5 ± 1.0 before and after treatment respectively,and the difference was statistical significant (t =12.30,P ＜ 0.001).BCVA was improved in 4 eyes,maintained in 13 eyes and decreased in only 1 eye.Conclusion The sequential treatment including anti-VEGF intracameral and intravitreal injection,trabeculectomy and pan-retinal photocoagulation by indirect ophthalmoscope is safe and effective.
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Objective To compare the clinical effect of C3F8 and air tamponade after vitrectomy for the treatment of idiopathic macular hole (IMH).Methods A total of 54 eyes of 54 patients with IMH that had undergone 23G pars plana vitrectomy with internal limiting membrane peeling were retrospectively studied.All patients received optical coherence tomography ()CT) examination and the best corrected visual acuity (BCVA).They were divided into 2 groups.26 eyes in group A were filled with air and 28 eyes in group B were filled with C3F8.In group A,6 eyes at stage Ⅱ,20 eyes at stage Ⅲ,the minimum diameter (Dmin) of macular hole in 14 eyes was less than 400 μm,and in the other eyes was larger than 400 μm.In group B,10 eyes at stage Ⅱ,18 eyes at stage Ⅲ,the Dmin of macular hole in 15 eyes was less than 400 μm,and in the other eyes was larger than 400 μm.The differences of age,course of the disease,BCVA,fundus diameter,Dmin,height,index,diameter of outer retina diameter (Dord) between the two groups were not significant (P＞0.05).The basic data before surgery and the closure rate,BCVA,Dord 1 month after surgery between two groups were compared.Results At 1 month after surgery,the IMH closure rate was 100.0％ in group A and 92.9％ in group B,the difference between these two groups was not significant (P=0.491).The closure rate of eyes with Dmin＜400 μm were both 100.0％ in two groups,and the closure rate of eyes with Dmin＞400 μm were 100.0％ in group A and 84.6％ in group B.There was no statistically significant differences between two groups (P =0.480).The mean BCVA of two groups were 0.35±0.22 and 0.33 ±0.16 respectively.The mean Dord were (782.2 ± 478.0) μm and(792.1 ± 432.7) μm respectively.All cases got better BCVA (t=-7.310,-10.506;P＜0.01) and shorter Dord (t=6.704,7.770;P＜0.01).But there was no statistically significant differences between groups 1 month after surgery in BCVA and Dord (t =0.381,0.800;P =0.705,0.937).Conclusion Air tamponade after vitrectomy has the same efficacy as C3 F8 tamponade in the treatment of IMH.
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Objective To investigate the effect of Hupo Xiaoshi granules on renal tissue pathological changes and IL-1β, TNF-α and IL-6 in blood of nephrolith model rats. Methods Sixty SD rats were divided into normal control group 10 rats with purified water by intragastric administration(IG),and model group 50 rats with ethylene glycol, calcium and vitamin D3 by IG for 4 weeks to get kidney stones animal models. The successful model rats were randomly divided into model control group, potassium citrate solution group, Hupo Xiaoshi granules low, middle and high dose group (3. 335,6. 670,13. 340 g ? kg-1 , respectively), 10 rats per group with the corresponding drugs. Four weeks later, rat's renal tissue sections were stained with hematoxylin and eosin, renal tissue changes of calcium stones and pathology were observed.Plasma concentrations of IL-1β, TNF-α and IL-6 were detected by ELISA. Results Compared with the model control group, no renal interstitial hemorrhage and a few or no visible renal tissue calcium crystal deposition in the low, middle and high dose Hupo Xiaoshi granules group. In the normal control group, model control group, potassium citrate solution group, and low, middle and high dose Hupo Xiaoshi granules group,the plasma concentrations of IL-1β were respectively(50.50±13.54),(104.00±24.13),(93.00±20.08),(77.00± 25.21),(71.30 ±26.60),(65.50±26.18) pg?mL-1 ,respectively;those of IL-6 were(570.10±119.74),(1 040.00±260.15), (861.40±130.04),(740.00± 161. 31),(680. 00 ± 239. 49),(640. 00 ± 238. 42) pg?mL-1 ,respectively;and TNF-α plasma concentrations were(470.30± 154. 63),(1 010. 00 ± 230. 94),(820. 00 ± 192. 12),(830. 50 ± 110. 01),(720. 00 ± 140. 28), (715.00±173.54) pg?mL-1 ,respectively. Compared with the model control group, the plasma concentrations of IL-1β, IL-6 , TNF-α of the low, middle and high dose Hupo Xiaoshi granules group were significantly decreased (P<0.05 or P<0.01). Conclusion Hupo Xiaoshi granules can inhibit renal tissue pathological changes of nephrolith model rats, inhibit calcium crystals stones deposition in renal tissue, and reduce blood levels of inflammatory cytokines.
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Background Researches determined that the pathogenesis of retinal vein occlusion (RVO) is associated with primary open angle glaucoma (POAG) in Caucasian population.However,the relationship between RVO and POAG in Asian population is unclear.Objective This study was to survey the percentage of POAG in RVO patients in China.Methods A prospective cross-sectional observational study based on hospital was performed.Three hundred and seventy five patients with newly diagnosed RVO by fluorescein fundus angiography (FFA) were consecutively enrolled in Peking University Third Hospital from October 2011 to May 2013,and gonioscopy was carried out in all the patients.Glaucoma was diagnosed according to the criteria of the International Society of Geographical and Epidemiological Ophthalmology (ISGEO).RVO was classified into central retinal vein occlusion (CRVO),hemicentral retinal vein occlusion (HRVO) and branch retinal vein occlusion (BRVO) based on fundus photograph and FFA,or classified into arteriovenous crossing RVO (AV-RVO),optic cup RVO (OC-RVO),optic nerve RVO without optical nerve head swelling (NONHS-RVO) and RVO with optical nerve head swelling (ONHS-RVO) based on the sites of venous occlusion.The percentages of POAG in different types of RVO were calculated.This study was approved by Ethic Committee of Peking University Third Hospital,and written informed consent was obtained from each patient before entering study cohort.Results Three hundred and seventeen RVO patients finished screening of glaucoma,with the response rate 84.5％.The percentage of POAG is 8.2％ in RVO patients,including 7.1％ in the CRVO patients,23.5％ in HRVO patients and 6.2％ in BRVO patients.The percentage of POAG was significantly higher in OC-RVO patients (27.9％) and NONHS-RVO patients (13.2％) than that in AV-RVO patients (4.7％) and ONHS-RVO patients (1.3％) (all at P＜0.05).Conclusions The overall percentage of POAG in RVO patients in China is 3-4 times higher than general population.Higher percentage of POAG is found in OC-RVO patients and NONHS-RVO patients,suggesting that pathogenesis of RVO is probably associated with the glaucomatous anatomic changes of optical nerve head.
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<p><b>BACKGROUND</b>Traumatic optic neuropathy (TON) is one of the reasons for permanent vision loss. Currently, the clinical practices may not be sufficient for direct assessments and comprehensively determining the location and extent of the patients with optic nerve injury in traumatic optic neuropathy. Magnetic resonance imaging (MRI) provides a non-invasive option. However, rare reports have found whether the differentdegree of injury of the optic nerve can be detected by manganese-enhanced MRI (MEMRI). This study aimed to explore the efficacy of MEMRI in the visual pathway for different severity of opitic nerve injury in rats.</p><p><b>METHODS</b>The different injuries of mild, moderate, and heavy damages were created by modified reverse tweezer and were evaluated by counting retinal ganglion cells (RGCs) and VEP ananlysis. Sprague-Dawley (SD) rats were intravitreally injected with 2 l of 25 mmol/L MnCl2, which has been confirmed as a safe injection concentration. The contrast-to-noise ratio (CNR) of MEMRI for optic nerve enhancement at different injury levels was measured.</p><p><b>RESULTS</b>The location of the significantly decreased signal point on optic nerve (ON) was corresponding to the location we made. However, similar findings are not obvious, or even have not been observed in 28 days in each group and also in 14 days at F100 group, indicating that MEMRI could be directly intuitive positioned in the early stage on the optic nerve injury.</p><p><b>CONCLUSIONS</b>The possibility of using MEMRI in optic nerve injury in a safe injection concentration of 25 mmol/L is confirmed. Therefore, it is possible to detect the severity of the optic nerve by MEMRI examination.</p>
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Animals , Male , Rats , Magnetic Resonance Imaging , Methods , Manganese , Optic Nerve Injuries , Diagnosis , Pathology , Rats, Sprague-Dawley , Retinal Ganglion Cells , PathologyABSTRACT
Ovjective To observe the surgically excised specimens from eyes with hemorrhagic agerelated macular degeneration (AMD).Methods Thirty-six surgically excised specimens were captured from 36 patients with hemorrhagic AMD,26 specimens were diagnosed as occult choroidal neovascular membrane (CNVM),10 specimens were diagnosed as polypoidal choroidal vasculopathy (PCV).All specimens were routinely processed by hematoxylin and eosin,periodic acid-Schiff's stain and Masson stainings.At the maximum horizontal and vertical slice of the specimens,the category and amount of the cells in the specimen were recorded,as well as the relationship between the specimens and the surrounding tissue.Results The 36 specimens are categorized as neovascular membrane dominant (19/36),collagen fiber dominant (6/36),blood clot dominant (8/36) and degenerated thickened Bruch's membrane dominant (3/36).Eighteen occult CNVM specimens and 1 PCV specimen are categorized as neovascular membrane dominant; all 6 collagen fiber dominant specimens are occult CNVM; 1 occult CNVM and 7 PCV specimens are categorized as blood clot dominant; and 1 occult CNVM and 2 PCV specimens are categorized as degenerated thickened Bruch's membrane dominant.The occult CNVM categorized as neovascular membrane dominant present as small blood vessel with single endothelium cell attached; the PCV specimen categorized as neovascular dominant presents as big blood vessel with thick vessel wall under the Bruch's membrane,retinal pigment epithelium and choroidal melanocyte are both observed in the PCV specimens.Conclusion The components of the specimens captured from eyes with hemorrhagic AMD are diversified.
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ObjectiveTo observe the effects of vitrectomy for persistent fetal vasculature (PFV).Methods The clinical data of 11 patients (14 eyes) with PFV, including posterior PFV (one eye) and combined PFV (13 eyes), were retrospectively analyzed. Vitrectomy was performed for all patients,lensectomy was performed for seven eyes, retinotomy was performed for five eyes, retinotomy and scleral buckling was performed for one eye. Intraoperative and postoperative complications were observed. The follow-up period ranged from eight to 74 months, with the mean of 44 months. The visual acuity (VA) and intraocular pressure before and after surgery were comparatively analyzed. Results There were no intraoperative complications in all the patients. The surgery was performed successfully in 12 eyes (86.0 %)and failed in two eyes (14. 0%). The postoperative VA of five eyes (35.7%) increased, four eyes (28. 6%)didn't change and five eyes (35.7%) decreased. The postoperative intraocular pressure of two eyes (14. 3%) increased, 11 eyes (78. 6%) didn't change and one eye (7. 1%) decreased. There was one eye with persistent hypotension and one eye with recurrent retinal detachment after surgery. Conclusion Vitrectomy can prevent complications and improve visual acuity in some PFV patients.
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Background Antigen retrieval method is the key of improving the successful rate of immunohistochemical assay in paraffin sections.To study an available method of antigen retrieval is a goal to achieve both good immunochemistry result and preserving retinal proteins.ObjectiveThe aim of present study is to investigate tyrosin digestion,high-temperature heat pressure,water bath heating and microwave repair in antigen retrieval for retinal tissues.MethodsRetinal tissue was isolated and obtained from clean Chinchilla rabbits.Four hundreds retinal paraffin sections were prepared.Four kinds of antigen retrieval methods for retinal tissue including tyrosin digestion,high-temperature heat pressure,water bath heating and microwave repair were used respectively.The depigmentated retinal paraffin section without antigen retrieval was used as control.The positive rates of expression of CRALBP,Rhodopsin and opsin proteins were evaluated and compared among four kinds of antigen retrieval methods by immunochemistry.ResultsCRALBP,Rhodopsin and opsin protein was positively expressed in cytoplasm of retinal pigment epithelial cells and the outer segment of photoreceptor respectively.No significant difference was found in the positive expression rates of these three proteins among four kinds of antigen retrieval methods (P＞0.05),but the differences in tissue integrity and background staining were statistically significant (P＜0.01).The structural damage of retina included loss and pucker of scalera,crack of nucleus and abnormal background stain in high-temperature heat pressure method,water bath heating method and microwave retrieval method.However,stable CRALBP,Rhodopsin and opsin protein expression and strain effectiveness,clear background without unspecific staining and integrated tissue were seen in tyrosin digestion method.ConclusionDuring the clinical pathology analysis of retinal tissue,the application of tyrosin digestion in antigen retrieval could obtain a better effectiveness.
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The opportunity of vitrectomy for opening eyeball injury is one of the important factors affecting the prognosis.Anterior segment wound repaired by routine suturing needs following and continuous treatment with vitrectomy.The key technique of the following treatment should be the debridement of the inside of wound and expurgation of the surrounding tissues adjacent to the wound,and the emphasis should be put on retinal reattchment and stable repairment.
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BACKGROUND: Endoscopic transnasal lacrimal duct reconstruction by grafting of autogenous tissue is a novel method for treatment of severe lacrimal duct obstruction and it needs detailed anatomical data for surgery.OBJECTIVE: To study the applied microsurgical anatomy of lacrimal duct and to provide anatomical evidence for endoscopic transnasal lacrimal duct reconstruction by grafting of autoganous tissue.DESIGN, TIME AND SETTING: This study was performed at the laboratory of the Department of Ophthalmology, Armed Police General Hospital from July 2006 to June 2007.MATERIALS: Twenty 10% formaldehyde-treated adult cadaveric heads, 14 males and 6 females, comprising 40 lacrimal ducts were included in this study.METHODS: The cadaveric heads were split on the level of the line between the superior border of the superciliary arch and the site 10 mm higher than occipital tuberosity. After removal of brain tissue,the heads were decalcified for approximate 1 week with 10%nitric acid. This promised non-alteration of morphological structure and facilitation for surgical cutting. Following dissection of facial cranium in the median sagittal plane, the nasal septum was excised to expose the lateral wall of the nasal cavity.MAIN OUTCOME MEASURES: The anteroposterior diameter and depth of lacrimal fossa; at middle third level, the thickness of lacrimal fossa at the anterior lacrimal crest, vertical middle line, and posterior lacrimal crest; the cross section area of nasolacrimal canal upper opening, middle part, and lower opening; horizontal distance, 30° oblique distance, and 45°oblique distance from lacrimal caruncie to nasal cavity; distance from lacrimal caruncle to nasolacrimal canal upper opening; and the included angle between lacrimal caruncle-nasolacrimal canal upper opening line and Aeby's plane.RESULTS: The length, anteroposterior diameter, and depth of lacrimal fossa were (17.85±1.72) mm, (6.74+1.28) mm, and (3.09+0.78) mm, respectively. At middle third level, the thickness of lacrimal fossa at the anterior lacrimal crest,perpendicular bisector, and posterior lacrimal crest was (4.03±0.89) mm, (0.61±0.36) mm, and (0.63±0.24) mm, respectively.Anterior lacrimal crest was significantly thicker than vertical middle line and posterior lacrimal crest (P ＞ 0.05). Horizontal distance, 30°oblique distance, and 45° oblique distance from lacrimal caruncle to nasal cavity was (17.23±0.70) mm,(14.51±1.72) mm, and (17.34±2.38) mm, accordingly, with a difference which was not significant (P ＞ 0.05). The distance from lacrimal caruncle to lateral wall middle point of nasolacrimal duct superior opening was (11.86±1.84) mm, and the included angle between lacrimal caruncle-lateral wall middle point of nasolacrimal duct superior opening line and Aeby's plane averaged (49.9±1.8)°.CONCLUSION: The distances from lacrimal caruncle to nasal cavity and lacrimal sac and the included angles between lacrimal caruncle-nasolacrimal canal upper opening line and Aeby's plane provide guidance significance for selection of bony opening position on the lateral wall of nasal cavity and determinations of tunnel oblique angle and autogenous tissue length. Creation of bony tunnel should start from the middle or posterior middle part of lacrimal fossa and then extend towards anterior inferior region with an optimal downward oblique angle of 45°. The length of autogenous tissue used for lacrimal duct reconstruction should exceed 21.22 mm.
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Objective:To summarize the clinical results of the artificial iris diaphragm (AID)implantation for eyes with silicone oil longstanding tamponade.Methods: In this study,the operation indications,results and complications of 11 consecutive cases of artificial iris diaphragm implantation for eyes with silicone oil longstanding tamponade were studied. Results: In all of the 11 primary ocular disorder cases , 7 cases (7/11) were serious ocular trauma, 2(2/11)cases were diabetic retinopathy with traction retinal detachment , 1 case (1/11) was recurrent retinal detachment with complicated PVR, and 1 case (1/11) was Coats disease; The silicone oil was retained completely behind the surface of artificial iris diaphragm in 7(7/11) of all the 11 cases,in which no visual acuity was affected The complications were low intraocular pressure (IOP)and heavy fibrosis on the surface of artificial iris diaphragm. Conclusion: Open type artificial iris diaphragm implantation in eyes with longstanding silicone oil tamponade can effectively prevent the silicone oil from cotacting the cornea causing complication by spontaneously blocking and rescuing anterior chamber fluid circulation.
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Objective: To observe the pathological changes of the lens and anterior lens capsule of the patients with familial congenital aniridia, and discuss the histopathological etiology of the fragility of the anterior capsule and the significance of surgical project. Methods: Anterior lens capsules and lens specimens were obtained from aniridic patients during cataract surgery. The intraoperative behavior of each capsule was noted, after which the specimens were submitted for histopathologic evaluation and electron microscope examination. Results: The anterior lens capsule was extremely fragile and remarkably thin. Degenerative changes(degeneration, necrosis, loss) of the lens epithelium and discontinuity of the lens epithelium were found in some specimens. Proliferation and double layer of the epithelial cells in some area of the specimens can be seen also. Ply structure of the anterior capsule became thin or disappeared. Conclusion: Degenerative or proliferative changes of the lens epithelial cells were associated with the thinness and extreme intraperative fragility of the anterior lens capsules in familial aniridia with cataract. Greater awareness of anterior capsule fragility in some aniridic patients with cataract may reduce the risk of capsule complications and lead to safer surgical outcomes.
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Objective To create a calibrated animal model of graded optic nerve injury (ONI) in rats, focusing on quantification of injury intensity, injury severity and the correlation between them. Methods A pair of cross-action forceps with pressure of 148.0 g was used to clip rat optic nerves for 3, 6, 30 and 60 seconds, or a pair of artery clips with constant pressure (32.4 g) used to clip rat optic nerves for 5, 10 and 15 seconds in order to create graded ONI animal models. Transcranial FluoroGold-labeled retinal ganglion cell (RGC) was used to observe the changes of RGC one month after injury, which then could be used to evaluate the injury severity. Ocular blood supply was evaluated by transcardiacly perfused Luxol Fast Blue post-injury. Results The graded ONI animal models were successfully created in rats without retinal ischemia post-trauma. The injury intensity could be well-defined by impulse or averaged impulse, while injury severity could be evaluated by the count of FluoroGold-labeled RGCs. The averaged impulse produced by artery clips clipping rat optic nerves for 15 seconds equalized with that produced by cross-action forceps for three seconds. The severer injury intensity begot less number of RGCs. The correlation between injury impulse and RGCs was fit for power function. Short time clipping of optic nerves could not lead to ischemic injury of the retina. Conclusions A calibrated graded ONI animal model is successfully created by clipping optic nerves with a pair of cross-action forceps. The model can be evaluated with RGCs count, impulse and averaged impulse, the latter two of which stand for injury intensity and injury severity, respectively.
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Objective To investigate the expression of matrix metalloproteinase (MMP)-2 and MMP-9 in rats′ optical nerves after extrusion wound. Methods We set up the model of rats with extrusion wound of the optical nerves, detected activity changes of MMP-2 and MMP-9 in the optical nerves by gelatin zymography, identified the attribute by Western blotting, and verified the expression of mRNA of MMP-2 and MMP-9 by reverse transcriptase-polymerase chain reaction (RT-PCR). Results MMP-2 existed in normal optial nerves and optical nerves with extrusion wound, while MMP-9 was only detected in the latter. The expression of MMP-9 was the highest 1 day after the extrusion wound, while that of MMP-2 was the highest 7 days after the extrusion wound. Conclusions MMP-2 and MMP-9 may participate in the pathological recovery process of optical nerves after extrusion wound. The glial cells in the optical nerves may be one of the sources of MMP-2 and MMP-9.
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To study proliferation of the retinal pigment epithelium (RPE) after experimental retinal detachment, an antibody that recognizes the specific proliferating cell nuclear antigen (PCNA) in proliferating cells was used. Retinal detachment was produced in cats by subretinal injection of 0 25% solution of Healon through a micropipette. At different intervals the animals were sacrificed and eye globes were fixed in 10% at malin and embeded in paraffin. Histologic sections were processed for immunohistochemisty using an antibody to detect the PCNA protein. Labeled RPE cells were identified, and the proliferative response was quantified. In the retina detached at 0 5, 1, 2, 3, 4, 5, 6, 7, 10, 14, 20, 30, and 60 days, the number of PCNA labled cells was 0 055, 0 444, 0 861, 1 972, 3 139, 5 833, 6 028, 4 917, 3 333, 2 195, 1 083, 0 195, and 0 056 cells per millimeter of retina, respectively. In non detached retina of the same eye, approximately from 0 to 0 639 cells per millimeter of retina were labeled. The difference of PCNA labeled cells between detached and non detached retina of the same eye was significant. These results indicate that RPE cells are induced to proliferate when they lose contact with neural retina.
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Objective To examine and evaluate the ability of spontaneous regeneration following various extent of incomplete injury in adult rats. Methods The quantities and reduplicated various extent incomplete injured model of adult rats optic nerve was established using different wounding time with constant wounding force produced by across action forceps at 2mm behind eyeball. GAP-43 (growth associated protein-43) and its mRNA expressions were detected with immunohistochemistry (IHC) and reverse transcription polymerase chain reaction (RT-PCR). All data were analyzed by ANOVA. Results GAP-43 and its mRNA expression levels revealed that there was negative response at the distal area contrast to the strong positive response at the proximal in earlier period after injury until half mouth. One mouth later, the increased GAP-43 and its mRNA expression levels became more and more high and reached the climax at second month post injury. Then it decreased gradually. The result of RT-PCR showed there are significant difference among the various extent incomplete injured models and different time after injury. Conclusion Spontaneous regeneration of adult rat’s optic nerve can be detected and identified following incomplete injury, and the extent of regenerating ability is correlated with the extent of injury.