ABSTRACT
Objective To evaluate the efficacy of 0.3％ sodium hyaluronate ophthalmic solution in mild-to-moderate dry eye patients.Metbods A prospective,multicenter,and self-controlled clinical trial was performed on 200 patients who were diagnosed as mild-to-moderate dry eye from January 2015 to June 2017 in Eye Institute of Xiamen University,Eye & ENT Hospital of Fudan University,Zhongshan Ophthalmic Center,Xiangya Hospital Central South University,Eye Hospital of Wenzhou Medical University,and Beijing Tongren Hospital,Capital Medical University.The study protocol was approved by the Ethics Committees of Eye Institute of Xiamen University,written informed consent was obtained from each patient prior to any medical examination.All patients were treated with 0.3％ sodium hyaluronate ophthalmic solution 6 times per day (one drop each time) for 28 days.Corneal fluorescein sodium staining,tear film break-up time (BUT),Schirmer Ⅰ test (S Ⅰ t),degree of conjunctival hyperemia,eyelid margin,meibomian gland secretion,secretory capacity of meibomian gland and subjective symptoms were assessed at baseline,on the 14th day and 28th day after treatment.Bulbar impression cytology was evaluated at baseline and on the 28th day after treatment.Irritation of 0.3％ sodium hyaluronate ophthalmic solution was estimated on the 14th day and 28th day after treatment.Results The total score of subjective symptoms,BUT,S Ⅰ t,degree of conjunctival hyperemia were significantly different among different treatment time points (F =108.969,27.598,16.838,36.750;all at P＜0.01).Compared with before treatment,the total score of subjective symptoms was significantly decreased,the degree of conjunctival hyperemia and the total corneal fluorescein sodium staining point number were significant decreased on the 14th day and 28th day after treatment.The total score of subjective symptoms,degree of conjunctival hyperemia and total corneal fluorescein sodium staining point number on the 28th day after treatment were significant lower than those on the 14th day after treatment.Compared with before treatment,the BUT was significantly longer and the S Ⅰ t scores were significantly increased on the 14th day and 28th day after treatment.The BUT on the 28th day after treatment was significantly longer than that on the 14th day after treatment;no significant difference in S Ⅰ t was observed between the 28th day and the 14th day after treatment.The scores of palpebral margin change,meibomian gland secretory ability and secretion characteristics were not significantly different among different treatment time points(H=0.255,2.356,0.294;all at P＞0.05).The impression cytology grade on the 28th day after treatment was 1.08±0.74,which was significantly lower than 1.53±0.76 before treatment (t =5.979,P＜0.01).The number of goblet cells on the 28th day after treatment was significantly higher than that before treatment (U =1 806.500,P＜ 0.01).On the 14th day after treatment,70％ of the patients indicated that the drug was non-irritating,and no patient had intolerable irritation affecting daily lives.All patients had good tolerance to this drug.Conclusions The use of 0.3％ sodium hyaluronate eye drops can improve the symptoms and signs of mild to moderate dry eye,which can be widely used for mild-to-moderate dry eye patients in clinic.
ABSTRACT
Objective To evaluate the efficacy of 0. 3％ sodium hyaluronate ophthalmic solution in mild.to. moderate dry eye patients. Methods A prospective,multicenter,and self.controlled clinical trial was performed on 200 patients who were diagnosed as mild.to.moderate dry eye from January 2015 to June 2017 in Eye Institute of Xiamen University,Eye &ENT Hospital of Fudan University,Zhongshan Ophthalmic Center,Xiangya Hospital Central South University, Eye Hospital of Wenzhou Medical University, and Beijing Tongren Hospital, Capital Medical University. The study protocol was approved by the Ethics Committees of Eye Institute of Xiamen University,written informed consent was obtained from each patient prior to any medical examination. All patients were treated with 0. 3％ sodium hyaluronate ophthalmic solution 6 times per day ( one drop each time) for 28 days. Corneal fluorescein sodium staining,tear film break.up time (BUT),SchirmerⅠtest (SⅠt),degree of conjunctival hyperemia,eyelid margin,meibomian gland secretion,secretory capacity of meibomian gland and subjective symptoms were assessed at baseline,on the 14th day and 28th day after treatment. Bulbar impression cytology was evaluated at baseline and on the 28th day after treatment. Irritation of 0. 3％ sodium hyaluronate ophthalmic solution was estimated on the 14th day and 28th day after treatment. Results The total score of subjective symptoms,BUT,SⅠt,degree of conjunctival hyperemia were significantly different among different treatment time points( F=108. 969,27. 598,16. 838,36. 750;all at P<0. 01). Compared with before treatment,the total score of subjective symptoms was significantly decreased, the degree of conjunctival hyperemia and the total corneal fluorescein sodium staining point number were significant decreased on the 14th day and 28th day after treatment. The total score of subjective symptoms,degree of conjunctival hyperemia and total corneal fluorescein sodium staining point number on the 28th day after treatment were significant lower than those on the 14th day after treatment. Compared with before treatment,the BUT was significantly longer and the SⅠt scores were significantly increased on the 14th day and 28th day after treatment. The BUT on the 28th day after treatment was significantly longer than that on the 14th day after treatment;no significant difference in SⅠt was observed between the 28th day and the 14th day after treatment. The scores of palpebral margin change,meibomian gland secretory ability and secretion characteristics were not significantly different among different treatment time points(H=0. 255,2. 356,0. 294;all at P>0. 05). The impression cytology grade on the 28th day after treatment was 1. 08±0. 74,which was significantly lower than 1. 53±0. 76 before treatment (t=5. 979, P<0. 01). The number of goblet cells on the 28th day after treatment was significantly higher than that before treatment(U=1806. 500,P<0. 01). On the 14th day after treatment,70％ of the patients indicated that the drug was non.irritating,and no patient had intolerable irritation affecting daily lives. All patients had good tolerance to this drug. Conclusions The use of 0. 3％ sodium hyaluronate eye drops can improve the symptoms and signs of mild to moderate dry eye,which can be widely used for mild.to.moderate dry eye patients in clinic.
ABSTRACT
Background The study on the classification of fungi is very important for the diagnosis and treatment of fungal keratitis.Identifying the different species of filamentous fungi is a critical factor for the application of anti-fungal drug in treating keratitis.ObjectiveThis report studies the relationship between the genotype of filamentous fungi and the clinical factors.MethodsFifty-two patients with filamentous fungal keratitis determined by clinical and laboratory examination were recruited in Tongren Hospital from January 2006-December 2006.The lesions were graded on the severity of the corneal ulcer and the presence of hypopyon.The filamentous fungal keratitis was treated with topical and systemic administration of anti-fungal drugs or corneal transplantation.The isolates were cultured in potato culture and identified by morphological characteristics based on the Nelson criterion and genotyped by the rDNA ITS method.The clinical data was retrospectively analyzed.ResultsForty-eight species (eubacteria are bacteria,not fungi)of fungus were identified by morphological characteristics,and the filamentous fungi were divided into 4 types based on the phylogenetic relationships within the rDNA ITS of the 52 filamentous fungi.The morphological characteristics and genotype were confirmed in 48 strains of eubacteria and 31 strains of 52 filamentous fungi (90.3%).The 4 groups of fungi were classified by genotype as follows:group 1 represents 22 strains including 20 strains of Fusarium solani and 2 strains of Fusarium oxysporum;group 2 represents 12 strains including 8 strains of Fusarium moniliformis,3 strains of Fusarium proliferatum and 1 strain of Fusarium incarnatum;group 3 represents 5 strains including 1 strain of Fusarium moniliformis and 4 unknown strains;group 4 represents 13 strains including 10 strains of Aspergillus spp.and 3 strains of Alternaria spp.Significant differences were found in the disease duration (P=0.00),inducing cause (P=0.03),ulcer grade (P=0.01)and outcome of the anti-fungal treatment (P=0.035)when compared between group 1 and 2 with group 3 and 4.Conclusion Filamentous fungi that cause keratitis could be correctly identified by sequencing the internal tanscribed spacer of rDNA.There are significant clinical differences among the groups classified by genotype.
ABSTRACT
Objective Trachoma is a preventable infective eye disease worldwide. The incidence rate of active trachoma in children can reflect the epidemical degree of trachoma in the location. This study tried to assess the prevalence and risk factors of trachoma in students at primary school in Wuqiang County, China. Methods An epidemiological survey was carried out in Wuqiang County in 2006. The investigators were from Wuqiang County Hospital and Beijing Tongren Eye Center and received special training. Primary school children aged 6- to 16-years-old were selected by a cluster sampling with the class shift as the sampling unit. Trachoma was clinically examined under the slim lamp and assessed based on the simplified classification for trachoma proposed by the World Health Organization (WHO). The C. Trachomatis inclusion body was detected from conjunctival swab of patients with trachoma using enzyme immunoassay and polymerase chain reaction (PCR). The questionnaire was performed in the examinees and parents. The survey followed the Declaration of Helsinki and written informed consent was obtained from the examinees. Results A total 379 cases with trachoma were determined in 1622 primary school examinees with the prevalence 23. 4% (95% CI:25. 5% -21. 3%) .including follicular trachoma in 81% and intense trachoma in 19% . The overall prevalence of trachoma was higher in female students than male ones (25. 8% versus 20. 9%, P = 0. 020). No inclusion body of the conjunctiva was observed. Sixty-four cases (38. 1%) presented the positive response for C. Trachomatis antigen by enzyme immunoassay, and 109 cases (64. 9%) were positive response by PCR. The multiple factors logistic regression analysis showed the risk factors for active trachoma included living location, suburbs and female and age(0R =0.763, 1.299, 1. 147 respectively). Conclusion Trachoma showes a disseminating procedure among primary school children in Wuqiang County. The prevention strategy should be made for related risk factors.