Chinese Guideline on the Management of Polypoidal Choroidal Vasculopathy (2022) / 中国医学科学杂志(英文版)

Background In mainland China, patients with neovascular age-related macular degeneration (nAMD) have approximately an 40% prevalence of polypoidal choroidal vasculopathy (PCV). This disease leads to recurrent retinal pigment epithelium detachment (PED), extensive subretinal or vitreous hemorrhages, and severe vision loss. China has introduced various treatment modalities in the past years and gained comprehensive experience in treating PCV.Methods A total of 14 retinal specialists nationwide with expertise in PCV were empaneled to prioritize six questions and address their corresponding outcomes, regarding opinions on inactive PCV, choices of anti-vascular endothelial growth factor (anti-VEGF) monotherapy, photodynamic therapy (PDT) monotherapy or combined therapy, patients with persistent subretinal fluid (SRF) or intraretinal fluid (IRF) after loading dose anti-VEGF, and patients with massive subretinal hemorrhage. An evidence synthesis team conducted systematic reviews, which informed the recommendations that address these questions. This guideline used the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach to assess the certainty of evidence and grade the strengths of recommendations. Results The panel proposed the following six conditional recommendations regarding treatment choices. (1) For patients with inactive PCV, we suggest observation over treatment. (2) For treatment-na?ve PCV patients, we suggest either anti-VEGF monotherapy or combined anti-VEGF and PDT rather than PDT monotherapy. (3) For patients with PCV who plan to initiate combined anti-VEGF and PDT treatment, we suggest later/rescue PDT over initiate PDT. (4) For PCV patients who plan to initiate anti-VEGF monotherapy, we suggest the treat and extend (T&E) regimen rather than the pro re nata (PRN) regimen following three monthly loading doses. (5) For patients with persistent SRF or IRF on optical coherence tomography (OCT) after three monthly anti-VEGF treatments, we suggest proceeding with anti-VEGF treatment rather than observation. (6) For PCV patients with massive subretinal hemorrhage (equal to or more than four optic disc areas) involving the central macula, we suggest surgery (vitrectomy in combination with tissue-plasminogen activator (tPA) intraocular injection and gas tamponade) rather than anti-VEGF monotherapy. Conclusions Six evidence-based recommendations support optimal care for PCV patients' management.

The Influence of Diabetes, Hypertension, and Hyperlipidemia on the Onset of Age-Related Macular Degeneration in North China: The Kailuan Eye Study / 生物医学与环境科学（英文）

Objective@#To analyze the prevalence of dry and wet age-related macular degeneration (AMD) in patients with diabetes, hypertension and hyperlipidemia, and to analyze the risk factors for AMD.@*Methods@#A population-based cross-sectional epidemiologic study was conducted involving 14,440 individuals. We assessed the prevalence of dry and wet AMD in diabetic and non-diabetic subjects and analyzed the risk factors for AMD.@*Results@#The prevalence of wet AMD in diabetic and non-diabetic patients was 0.3% and 0.5%, respectively, and the prevalence of dry AMD was 17% and 16.4%, respectively. The prevalence of wet AMD in healthy, hypertensive, hyperlipidemic, and hypertensive/hyperlipidemic populations was 0.5%, 0.3%, 0.2%, and 0.7%, respectively. The prevalence of dry AMD in healthy, hypertensive, hyperlipidemic, and hypertensive/hyperlipidemic populations was 16.6%, 16.2%, 15.2%, and 17.2%, respectively. Age, sex, body mass index, and use of hypoglycemic drugs or lowering blood pressure drugs were corrected in the risk factor analysis of AMD. Diabetes, diabetes/hypertension, diabetes/hyperlipidemia, and diabetes/hypertension/hyperlipidemia were analyzed. None of the factors analyzed in the current study increased the risk for the onset of AMD.@*Conclusion@#There was no significant difference in the prevalence of wet and dry AMD among diabetic and non-diabetic subjects. Similarly, there was no significant difference in the prevalence of wet and dry AMD among subjects with hypertension and hyperlipidemia. Diabetes co-existing with hypertension and hyperlipidemia were not shown to be risk factors for the onset of dry AMD.

A monoclonal antibody-based icELISA for puerarin / 中国中药杂志

Puerarin was conjugated with bovine serum albumin(BSA) and ovalbumin(OVA) by periodate oxidation to serve as the immunogen and coating antigen, respectively. BALB/c mice were immunized with puerarin-BSA according to the routine immunization procedure, and the titer and specificity of serum were detected after three immunization. After booster immunization, mouse spleen lymphocytes were fused with mouse myeloma cells, and 24 hybridoma cell lines of the monoclonal antibodies against puerarin were screened by monoclonal antibody screening technique. Ascites was prepared and purified. The cross-reactivity of monoclonal antibody(mAb) M1 with 4'-methoxy puerarin, daidzin, puerarin-6″-O-xyloside, daidzein, mirificin, 3'-methoxy puerarin, and 3'-hydroxy puerarin was 239.84%, 112.18%, 67.89%, 58.28%, 22.37%, 0.40%, and 0.20%, respectively, and those with other analogs such as baicalein and baicalin were all less than 0.10%. The IC_(50) and the working range of the indirect competitive enzyme-linked immunosorbent assay(icELISA) for puerarin were 44.80 ng·mL~(-1) and 8.20-292.30 ng·mL~(-1), respectively. The average recovery was 91.95%-98.20% with an RSD in the range of 0.70%-2.60%. The content of puerarin in different Puerariae Lobatae Radix samples was determined with icELISA and validated by UPLC-MS. The correlation between data obtained from icELISA and UPLC-MS was 0.999 0, indicating that icELISA is suitable for the rapid detection of puerarin in Puerariae Lobatae Radix samples.

MicroRNA-145 suppresses uveal melanoma angiogenesis and growth by targeting neuroblastoma RAS viral oncogene homolog and vascular endothelial growth factor / 中华医学杂志(英文版)

BACKGROUND@#Uveal melanoma (UM) is the most common primary intraocular malignancy in adults. It has been demonstrated that microRNA-145 (miR-145) is correlated with the progression of various cancers by regulating the expression of multiple target genes, especially a number of genes that regulate angiogenesis and proliferation. However, the underlying mechanisms of miR-145 in tumor angiogenesis of UM are still not well illustrated. Thus, we aimed to explore the potential target genes or pathways regulated by miR-145 in UM and the effect of miR-145 on invasion and angiogenesis.@*METHODS@#Totally, 24 choroid samples were collected in our study, including 12 UM samples and 12 normal uveal tissues. The expression of neuroblastoma RAS viral oncogene homolog (N-RAS), phosphorylated protein kinase B (p-AKT), and vascular endothelial growth factor (VEGF) in UM tissues and normal uveal tissues was analyzed using Western blotting analysis. Lentivirus expression system was used to construct MUM-2B and OCM-1 cell lines with stable overexpression of miR-145. Transwell and endothelial cell tube formation assay were used to measure the effects of miR-145 on the invasion and angiogenesis of UM in vitro. The downstream target genes of miR-145 were predicted by bioinformatics and confirmed using a luciferase assay. BALB/c nude mice models were established to investigate the mechanisms of miR-145 on tumor growth and angiogenesis in vivo. Group data comparisons were performed using analysis of Student's t test. A two-tailed P < 0.05 was considered as statistically significant.@*RESULTS@#The results of Western blotting analysis indicated that the expressions of N-RAS (1.10 ± 0.35 vs. 0.41 ± 0.36, t = 3.997, P = 0.012), p-AKT (1.16 ± 0.22 vs. 0.57 ± 0.03, t = 7.05, P = 0.001), and VEGF (0.97 ± 0.32 vs. 0.45 ± 0.21, t = 3.314, P = 0.008) in UM tumor tissues were significantly higher than those in normal uveal tissue. Luciferase assay demonstrated N-RAS and VEGF as downstream targets of miR-145. Moreover, tube formation assay revealed that miR-145-transfected human microvascular endothelial cell line formed shorter tube length (36.10 ± 1.51 mm vs. 42.91 ± 0.94 mm, t = 6.603, P = 0.003) and less branch points (350.00 ± 19.97 vs. 406.67 ± 17.62, t = 3.685, P = 0.021) as compared with controls. In addition, the numbers of invaded MUM-2B and OCM-1 cells with miR-145 overexpression were significantly lower than the controls (35.7 ± 3.3 vs. 279.1 ± 4.9, t = 273.75, P < 0.001 and 69.5 ± 4.4 vs. 95.6 ± 4.7, t = 21.27, P < 0.001, respectively). In vivo, xenografts expressing miR-145 had smaller sizes (miR-145 vs. miR-scr, 717.41 ± 502.62 mmvs. 1694.80 ± 904.33 mm, t = 2.314, P = 0.045) and lower weights (miR-145 vs. miR-scr, 0.74 ± 0.46 g vs. 1.65 ± 0.85 g, t = 2.295, P = 0.045).@*CONCLUSION@#Our results indicated that miR-145 is an important tumor suppressor and the inhibitory strategies against N-RAS/VEGF signaling pathway might be potential therapeutic applications for UM in the future.

Repeatability and Reproducibility of Quantitative Assessment of the Retinal Microvasculature Using Optical Coherence Tomography Angiography Based on Optical Microangiography / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>The aim of this study was to determine the repeatability and reproducibility of optical coherence tomography angiography (OCTA) based on optical microangiography (OMAG) measurements of macular vessels in normal eyes.</p><p><b>METHODS</b>In this prospective cohort study, 40 eyes of 40 healthy volunteers underwent repeated OCTA (Cirrus HD-OCT 5000 angiography system, Carl Zeiss Meditec, Inc.) scans on two separate visit days. On each visit day, the eyes were scanned three times. The following parameters were used to quantitatively describe the OCTA images of the superficial vascular network: vessel area density (VAD), vessel skeleton density (VSD), vessel diameter index (VDI), vessel perimeter index (VPI), vessel complexity index (VCI), flux, and foveal avascular zone (FAZ). Coefficient of variation (CV) and intraclass correlation coefficient (ICC) were calculated for evaluating intravisit and intervisit repeatability, as well as interobserver reproducibility.</p><p><b>RESULTS</b>The measurements showed high repeatability [CVs ⪕ 4.2% (intravisit) and ⪕ 4.6% (intervisit)] and interobserver reproducibility (ICCs ⪖ 0.923) for all parameters.</p><p><b>CONCLUSION</b>This study demonstrated good repeatability and reproducibility of OCTA based on OMAG for the measurement of superficial vessel parameters in normal eyes.</p>

Analysis of Macular and Retinal Nerve Fiber Layer Thickness in Children with Refractory Amblyopia after Femtosecond Laser-assisted LaserKeratomileusis: A Retrospective Study / 中华医学杂志(英文版)

<p><b>Background:</b>Localized macular edema and retinal nerve fiber layer (RNFL) thinning have been reported shortly after laser in situ keratomileusis (LASIK) in adults. However, it is still unclear how LASIK affects the retina of children. This study aimed to investigate the macular retina and RNFL thickness in children with refractive amblyopia who underwent femtosecond laser-assisted LASIK (FS-LASIK).</p><p><b>Methods:</b>In this study, we included 56 eyes of 32 patients with refractive amblyopia who underwent FS-LASIK in our hospital from January 2012 to December 2016. Foveal (foveal center retinal, parafoveal retinal, and perifoveal), macular inner retinal (superior and inferior), and peripapillary RNFL thicknesses (superior, inferior, temporal, and nasal) were measured using Fourier-domain optical coherence tomography before surgery and 1 day, 3 days, and 1 week after surgery. We divided these patients into three groups based on their refractive error: High myopic group with 22 eyes (equivalent sphere, >6.00 D), mild myopic group with 19 eyes (equivalent sphere, 0-6.00 D), and hyperopic group with 15 eyes (equivalent sphere, >+0.50 D). We compared the macular retina and RNFL thickness before and after LASIK. A paired simple t-test was used for data analysis.</p><p><b>Results:</b>One week after surgery, the visual acuity for all 56 eyes of the 32 patients reached their preoperative best-corrected vision. Visual acuity improved two lines or better for 31% of the patients. The residual refractive errors in 89% of the patients were within ±0.5 D. In the high myopic group, the foveal center retinal and parafoveal retinal thicknesses were thicker 1 day and 3 days after surgery than before surgery (t = 2.689, P = 0.012; t = 2.383, P = 0.018, respectively); no significant difference was found 1 week after surgery (P > 0.05). The foveal center retinal and parafoveal retinal thicknesses were greater 1 day after surgery than they were before surgery (P = 0.000 and P = 0.005, respectively) in the mild myopic and hyperopic groups. No significant difference was found 3 days or 1 week after surgery (P > 0.05). In all three groups, no significant difference was found in the macular inner retinal or peripapillary RNFL thickness 1 day, 3 days, or 1 week after surgery (P > 0.05).</p><p><b>Conclusions:</b>The foveal center retinal edema after FS-LASIK is mild and reversible in children, that mostly occurred in the high myopic group with no effect on the visual acuity, and is always relieved within 1 week.</p>

Research progress in applying spectral -domain OCT to explore retinal microstructure changes of diabetic macular edema / 国际眼科杂志(Guoji Yanke Zazhi)

Diabetic macular edema ( DME ) is a major cause of visual impairment in patients with diabetes mellitus, the central retinal thickness ( CRT ) is correlated with the visual impairment and the changes of visual function before and after treatment. Furthermore, CRT is related to the changes of macular microstructure. The subtle changes of retinal microstructure can be qualitative and quantitative analyzed by spectral- domain OCT ( SD -OCT) . In this study, the changes of retinal microstructure in patients with DME are reviewed, what is of great meaning to explore mechanism, observe disease progress, guide clinical treatment and prospect prognosis of DME.

Investigation and anaIysis of bacteriaI spectrum and drug sensitivity test in conjunctivaI sac of cataract patients of Kazak / 国际眼科杂志(Guoji Yanke Zazhi)

· ATM:To analyze bacterial spectrum and drug sensitivity in conjunctival sac of cataract patients of Kazak. · METHODS:A total of 538 cases of conjunctival sac secretion in cataract patients of Kazak were collected.The samples were cultured and their sensibilities to antibiotics were tested. · RESULTS: The bacterial culture was positive in 214 cases.The positive rate was 39.8%. The variety of pathogenic bacteria were mainly made up of gram positive cocci ( 88.3%), and most of them were Staphylococcus epidermidis ( 66.4%), followed by Micrococcus(9.8%).Sex had no effect on conjunctival bacteria rate in the cataract patients of Kazak, while age, place of residence had an effect on camier rate. The camier rate of conjunctival bacteria was significantly higher in people over 60 years old than that in people with age between 40 to 59 years old.And the people from city had a significant lower bacteria positive rate than those from countryside and pastoral. Most of grams were sensitive to Vancomycin, Teicoplanin, Rifampicin, Duly cloth mildew mutual and Amikacin, the tolerance was less than 20%, and they usually had higher tolerance to Penicillin, Erythromycin, Tetracycline and Chloramphenicol (>70%) . ·CONCLUSlON:Gram positivecocci is the most common bacteria in conjunctival sac in cataract patients of Kazak. Staphylococcus epidermidis was most common, followed by Micrococcus.The germ-carrying rate of conjunctival SAC in Kazakh population is associated with the patient’s age and area of residence.The clinical use of antibacterial drugs should be strictly grasp the indications, to reduce the incidence of bacterial resistance.

Non-infectious endophthalmitis after vitrectomy / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Non-infectious endophthalmitis was reported to occur after cataract surgery or intravitreal injections. This study reported a series of patients having non-infectious endophthalmitis after pars plana vitrectomy in the same two operation rooms during the same period to estimate the risk factors for non-infectious endophthalmitis after vitrectomy.</p><p><b>METHODS</b>Medical records of patients who presented with severe non-infectious endophthalmitis following vitrectomy between May 13 and June 8, 2011, were reviewed. The presenting symptoms and signs were collected, including visual acuity, intraocular pressure, cornea and anterior chamber activity. The treatments and results of microbiology examination were also recorded and analyzed.</p><p><b>RESULTS</b>Ten patients were identified with severe non-infectious endophthalmitis, presenting 1 day after pars plana vitrectomy. Three eyes (30%) had previous intraocular surgeries, four (40%) had proliferative diabetic retinopathy, and one (10%) got pars plana vitrectomy combined with phacoemulsification and intraocular lens implantation. All the patients were initially treated with topical and/or oral steroids. Only two patients had intravenous antibiotics because of the atypical presentation. One eye had paracentesis because of high intraocular pressure and the aqueous sample was sent for microbiological examination. The culture of the aqueous, air in the operation room, the swab from hand of surgeons, infusion fluid, and vitrectomy effluent were all negative for bacteria and fungi. The inflammation regressed rapidly after the initial treatment.</p><p><b>CONCLUSIONS</b>Intraocular surgery history, poor general health status, longer operation time, and more surgical procedures are the risk factors for non-infectious endophthalmitis after vitrectomy. It responds well to steroids.</p>

Effect of the regimen of Gaoshan Hongjingtian on the mechanism of poly (ADP-ribose) polymerase regulation of nuclear factor kappa B in the experimental diabetic retinopathy / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Poly(ADP-ribose) polymerase (PARP) plays an important role in the death of retinal capillary cells in diabetic retinopathy (DR) partly via its regulation of nuclear factor kappa B (NF-κB). The current study investigated the effect of the regimen of Gaoshan Hongjingtian (RG) on the mechanism of PARP regulation of NF-κB, and demonstrated the possible impact of the RG and Gaoshan Hongjingtian (Rhodiola sachalinensis, RS) on diabetic retinopathy.</p><p><b>METHODS</b>Wistar rats were made diabetic by administering streptozotocin. They were then assigned to three groups at random. After 2 months, the three groups of these diabetic rats were treated with RS or RG, or untreated. Analyses of expression levels of PARP, NF-κB, and intercellular adhesion molecule-1 (ICAM-1) in the retinas of rats in different groups were performed by Western blotting and immunohistochemical assays, and mRNA levels of NF-κB and ICAM-1 were determined by real-time polymerase chain reaction (PCR). In addition, the basement membranes of capillaries in the rats' retinas were observed using electron microscopy, and diabetes-induced capillary degeneration (ghost pericytes and acellular capillaries) were quantitated.</p><p><b>RESULTS</b>From the third month after the injection of streptozotocin, the diabetic rats were given daily RG, RS or tap water separately. The diabetic rats failed to gain weight compared with normal age-matched rats, whereas their glycated hemoglobin levels were significantly increased. After 5 months, the mRNA levels of NF-κB and ICAM-1 and the protein expression of PARP, NF-κB, and ICAM-1 were significantly increased in the retinas of diabetic rats in the untreated group compared with the nondiabetic controls. After 8 months, the number of degenerated retinal capillaries (ghost pericytes and acellular capillaries) was significantly increased in the diabetic rats in the untreated group compared with normal age-matched rats. RG and RS inhibited diabetes-induced over-expression of PARP, NF-κB, and ICAM-1 in the retinas of diabetic rats at the end of 5-month diabetic duration. Treatment using RG and RS significantly inhibited increases in the number of acellular capillaries and pericyte ghosts and suppressed the basement membrane thickening in the retinas of rats with diabetes for 8 months compared with the control diabetic rats.</p><p><b>CONCLUSIONS</b>These results indicate that PARP plays an important role in the pathogenesis of diabetic retinopathy. RS and RG may have acted on the mechanism of PARP regulation of NF-κB, which suppressed the expression of NF-κB and ICAM-1, and led to the inhibition of retinal capillary degeneration.</p>

Further improve the quality of epidemiological survey of eye diseases / 中华实验眼科杂志

Public Health Ophthalmology is a population-,region-or country-based as a whole object,and is committed to improving the eye health of the whole population.Epidemiological investigation of the eye was named to the region from a single disease to variation of diseases from cross-sectional survey to a longitudinal cohort study.Epidemiological investigations is the most important way which can reflect the pathogenic factors for public health policy-making,early diagnosis and prevention and treatment of eye disease,and Research to Prevent Blindness.Imaging Diagnosis,quality control,improve the reliability of the epidemiological investigation,and to strengthen the study of disease,race,and molecular levels and create a unique epidemiological study.

Analysis of post-operative endophthalmitis after pars plana vitrectomy: a 10-year experience at a single center / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Endophthalmitis can be a devastating complication after pars plana vitrectomy. The incidence of postvitrectomy endophthalmitis is significantly lower than that of endophthalmitis occurring after other intraocular operations. However, normal post-operative pain and inflammation may mask endophthalmitis and lead to delayed diagnosis and grave visual consequences. This study aimed to summarize the outcomes of cases that underwent pars plana vitrectomy over a 10-year period and to analyze the characteristics of post-vitrectomy endophthalmitis.</p><p><b>METHODS</b>A retrospective observational case study was conducted on all the cases who underwent pars plana vitrectomy in the Beijing Tongren Hospital between January 1, 2002 and March 31, 2012. All cases of endophthalmitis that occurred during a period of 10 years and 3 months were reviewed, and the possible risk factors, clinical findings, causative organism(s), and the sources of infection were analyzed.</p><p><b>RESULTS</b>Within the 10-year observational period, 14 patients developed endophthalmitis after pars plana vitrectomy. The incidence of post-vitrectomy endophthalmitis (0.05%) was lower than that reported previously from the same center (0.12%). Staphylococcus epidermidis (five patients, 35.71%) was the most common organism identified in aqueous or vitreous cultures. Eight patients (57.14%) had diabetes mellitus. There was no statistically significant difference (P > 0.05) in the incidence of endophthalmitis between period 1 (with antibiotic pretreatment) and period 2 (without antibiotic pretreatment). Surgical procedures for the treatment of endophthalmitis were performed in 10 patients (71.43%).</p><p><b>CONCLUSIONS</b>This series of cases showed that the incidence of endophthalmitis after pars plana vitrectomy is lower than what was previously reported in our hospital. A variable degree of corneal edema with relatively normal or mildly increased intraocular pressure was one of the commonly observed characteristics of post-vitrectomy endophthalmitis. Staph. epidermidis was the most common causative organism, and antibiotic pretreatment did not lower the incidence of postvitrectomy endophthalmitis.</p>

Changes in anterior chamber depth following vitrectomy / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Anterior segment morphometry is crucial for ophthalmologists to understand the visual outcomes of cataract surgery, keratorefractive surgery, as well as some other anterior segment disorders. Previous reports in literature have shown that anterior chamber depth (ACD) may shift slightly after vitrectomy. This study aimed to characterize the shortterm changes in ACD in eyes after vitrectomy by means of A-scan ultrasound.</p><p><b>METHODS</b>A prospective case series study was carried out on 29 eyes of 29 patients who underwent vitrectomy as the sole procedure. ACD was measured using A-scan ultrasound biometry shortly before vitrectomy and 1 week, 1 month, and 3 months after the surgery. Postoperative ACDs were compared with baseline.</p><p><b>RESULTS</b>Twenty-nine patients (16 males and 13 females) were enrolled in the study, with mean age of (50 ± 11) (25-65) years. Twenty-three eyes of 23 patients were vitrectomized for vitreous hemorrhage (VH) and the other six were operated for idiopathic epiretinal membrane (ERM). The mean preoperative ACD of the VH eyes was (2.98 ± 0.38) mm. No significant difference was found between the ACD of the VH eyes and their fellow eyes (P = 0.058). The average preoperative ACD in the ERM eyes was (2.94 ± 0.31) mm, which was statistically deeper than that of their fellow eyes ((2.85 ± 0.28) mm, P = 0.008). No statistical difference was found in the postoperative average ACD of the VH eyes compared with baseline. In the ERM group, the postoperative ACD in the surgical eyes was still statistically deeper than the fellow eyes 1 week after surgery (P = 0.034). However, such statistical difference disappeared at 1 or 3 months postoperative (P = 0.186 and 0.682).</p><p><b>CONCLUSIONS</b>ERM may induce deepening of the ACD, which can be recovered by uneventful vitrectomy. VH does not cause shift of ACD, neither does vitrectomy.</p>

Clinical effectiveness and safety of domestic 125I plaque irradiation for experimental choroidal melanoma / 中华实验眼科杂志

Background Choroidal melanoma (CM)is the most common primary intraocular tumor,and brachytherapy is one of the most common therapeutic modality in the treatment of the tumor.However,this irradiation approach has not been evaluated in China. Objective The present study was to analyze the effectiveness and safety of domestic 125I plaque irradiation in the treatment of CM. Methods Forty New Zealand albino rabbits were randomized into 5 groups with 8 rabbits 8 eyes (right eyes) in each group.CM models were established in 16 of 40 New Zealand albino rabbits by implanting the rat B16F10 melanoma cell fragments into the suprachoroidal space of right eyes.After 3 weeks,domestic 125I plaque was fixed at the location of CM in the irradiation group 1,and 8 rabbits with CM served as model control group.The clinical effectiveness of 125I plaque for CM was evaluated based on the fundus examination with indirect ophthalmoscopy,B scan ultrasonography,fundus photographs and color Dopplerimaging.Regarding the safety study,domestic 125I plaque was fixed on the normal right cycs of normal rabbits,while the plaques without 125I seeds were used as the sham group.No intervene was performed in the rabbits of blank group.The number of CD4+,CD8+ T cells in peripheral blood was detected by flow cytometry before plaques implanted and on 3,7,15 and 30 days after the plaque was removed.The animals were sacrificed and the eyes were obtained for histology examination.The use of the experimental animals complied with Statement of ARVO. Results After implantation of B16F10 melanoma cell fragments,CM grew steadily and rapidly with the similar size between irradiation group 1 and model control group ( P =0.550).One week after administration of the treatment,tumor size was(0.31±0.07 )cm in irradiation group 1 and (0.85±0.18 )em in the model control group,with the significant difference between them( P=0.001 ).Two week after application of 125I plaque,the size of tumor was smaller than that before irradiation (P=0.007 ).Histologically,the tumors were mostly limited beneath the pigment epithelial layer with less neovascularization,fibrosis in the tumor was found in some area in the irradiation group when compared with model control group.No significant differences were found in the proportions of CD4+,CD8+ T cells and CD4+/CD8+ at different time points in the irradiation groups of normal eyes and sham group (Fgroup =0.770,8.110,2.230; P=0.380,0.060,0.140; Ftime =0.770,3.220,4.230; P =0.550,0.170,0.004 ).Chronic inflammatory cells infiltration cornea,subconjunctival epithelial and selera surface,but sclera had no necrosis and organization.Conclusions These results suggest that domestic 125I plaque irradiation is effective for the treatment of CM,and has limited side effects on normal rabbits.

Paying attention to the research on dry age-related macular degeneration / 中华实验眼科杂志

Dry age-related macular degeneration(AMD)is a prevalent form of irreversible blindness worldwide in the elderly population with an increasing incidence in China.It is found that some dry AMD will develop to wet AMD and therefore damage visual function.Pathogenesis of AMD is below understand now,but it is thought to be related to the light-induced ocular damage,oxidative stress response,extracellular disposition and immunology.Up to now,effective and safe prevention and treatment methods of AMD are still studying,especially wet AMD,but the concern on dry AMD is not enough.Some basic and clinical pharmaceutics researches on AMD include antioxidants,anti-extracellular disposition drugs and anti-inflammatory agents.With the rise of aging population,we should pay special attention to the research on pathogenesis,diagnosis and treatment of dry AMD.

Clinical characteristics and treatment of neurofibroma of the choroid / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Neurofibroma is a kind of benign neoplasm that derives from nervous tissues. Though this tumor is the most common types in the peripheral nervous system, it is rarely seen in the choroid and easy to be misdiagnosed of choroidal melanoma. The aim of this study was to review the clinical features of neurofibroma of the choroid in the Chinese race.</p><p><b>METHODS</b>A retrospective case series design was used. Two male and one female patients diagnosed with choroidal neurofibroma in Beijing Tongren Eye Center were included in this study. The clinical histories were abstracted from the patients' medical records. Routine eye examinations including visual acuity, intraocular pressure, slit lamp and ophthalmoscope were performed. Auxiliary examinations included fluorescein fundus angiography (FFA), AB-ultrasound scan, color doppler imaging (CDI), and magnetic resonance imaging (MRI). Local resection of the tumors was performed and the specimens underwent pathological examinations.</p><p><b>RESULTS</b>The tumors were of yellow-pink color with pigmentation on the surface. CDI showed arterial blood signals in the tumor and MRI showed high-intensity in the T1-weighted image and a slightly increased intensity in the T2-weighted image. FFA and indocyaninegreen angiography demonstrated the tumors were of hypofluorescence at early stage and hyperfluorescence with prominent leakage at late stage. The pathological examination confirmed the tumors were choroidal neurofibroma. After 5 - 10-year follow-up, there were no recurrences of the tumors and the retinas were well attached.</p><p><b>CONCLUSIONS</b>Choroidal neurofibroma is difficult to be diagnosed clinically and pathological confirmation is important. These tumors can be managed conservatively by local resection.</p>

Quantitative parameter character of choroidal melanoma in contrast-enhanced ultrasound / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Choroidal melanoma is the most common intraocular malignant tumor in adults. It threatens not only the visual function but also the patient's life. Therefore, it is important to find a non-traumatic, quantitative and repetitive diagnostic method. This study investigated the value of quantitative analysis of contrast-enhanced ultrasound (CEUS) in the diagnosis of choroidal melanoma.</p><p><b>METHODS</b>CEUS were performed in 51 cases of choroidal melanoma, which were diagnosed either pathologically or clinically and in 14 cases of choroidal hemangioma. The characteristics of the time-intensity curve of the contrast agent were analyzed. For the quantitative analysis, the following parameters of the contrast agent in the lesion were included: rising time (RT), time to peak (TTP), maximum intensity (MI) and the mean transit time (MTT).</p><p><b>RESULTS</b>Choroidal melanoma had the following characteristics on CEUS: Choroidal lesions were completely filled with contrast agent. The typical filling pattern was centripetal, with the peripheral of the choroidal lesion filled with the contrast agent first and then the center of the lesion. In some cases, areas with contrast agent filling defect were observed in the lesions. The contrast agent filled the lesion slower than the normal eye and orbital tissue but faded faster in the lesion. Quantitative analysis showed that in choroidal melanoma, MI of contrast agent (191.31% ± 146.90%) was significantly more than that of the normal tissue (100.00% ± 0.00%) (P < 0.05) and MTT ((63.56 ± 26.04) seconds) was significantly less than that of the normal tissue ((149.87 ± 182.68) seconds) (P < 0.05). TTP (22.80 ± 9.85) was less than that of the normal tissue ((29.57 ± 24.76) seconds) and RT ((18.52 ± 7.09) seconds) was less than that of the normal tissue ((26.45 ± 21.83) seconds). Both the differences of TTP and RT were not statistically significant though. Logistic regression showed that to predict choroidal melanoma and choroidal hemangioma with MI and MTT, the sensitivity was 90.5% and the specific degrees was 85.7%.</p><p><b>CONCLUSIONS</b>CEUS is a new method to diagnose tumors in the eye. Choroidal melanoma may be diagnosed objectively and accurately by combining the graphic characteristics on CEUS and the time-intensity curve quantitative analysis.</p>

Dilemma in management of ocular medulloepithelioma in a child / 中华医学杂志(英文版)

Medulloepithelioma, a rare tumor, arises from the epithelium of the medullary tube. In this article, we present a 3-year-old boy who suffered from secondary glaucoma, initially presumed the primary disease was endophthalmitis. Subconjunctival mass was later found, pathologically proved to be medulloepithelioma. We discuss the patient management with emphasis on the early signs of examination and the role of ultrabiomicroscopy (UBM) in evaluating pediatric secondary glaucoma and in influencing the management of patients with medulloepithelioma.

Progression of diabetic retinopathy: the Beijing Eye Study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Diabetic retinopathy (DR) has emerged as a leading cause of visual impairment and blindness in the working-aged population worldwide. This study aimed to assess frequency and associated factors of progression of DR in subjects with known diabetes in a population-based setting.</p><p><b>METHODS</b>The Beijing Eye Study is a population based study performed in Greater Beijing in 2001 and 2006. The present investigation included all subjects with known diabetes mellitus in 2001, who participated in the follow-up examination in 2006. Fundus photographs were assessed.</p><p><b>RESULTS</b>The study included 170 subjects; 51 (30%) subjects showed signs of DR in 2001 and were re-examined in 2006, 36 (21.2%) subjects (18 subjects with DR present at baseline, 18 subjects with newly diagnosed DR in 2006) showed a progression of DR during follow-up. Progression of DR was associated with rural region (odds ratio (OR): 5.43, P = 0.001) and self-reported arterial hypertension (OR: 3.85, P = 0.023). In the non-progressive subgroup, presence of DR was associated with different levels of education (< middle school, middle school, college or higher, OR: 0.30, P = 0.023), treatment modes of diabetes mellitus (OR: 10.24, P = 0.003) and cataract surgery (OR: 9.14, P = 0.007).</p><p><b>CONCLUSIONS</b>In a population-based setting in Greater Beijing, progression of DR occurred in 35% of subjects with pre-existing DR and overall in 21% of subjects with known diabetes within a 5-year period. Progression of DR was significantly associated with rural region and self-reported arterial hypertension. In the stable subjects, presence of DR was significantly associated with poor educational level, insulin treatment of diabetes and cataract surgery.</p>

A new rat model of glaucoma induced by intracameral injection of silicone oil and electrocoagulation of limbal vessels / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>A satisfied glaucoma model is absent now. The aim of this study was to evaluate the effect of a combination of intracameral injection of silicone oil and electrocoagulation of corneal limbal vessels and episcleral veins in the rats to establish glaucoma model.</p><p><b>METHODS</b>Operation was performed in each of the left eyes of 90 adult male rats. Right eyes were used as controls. Measurement of intraocular pressure (IOP) was performed with an applanation tonometer (Tono-Pen). Retinal ganglion cells (RGCs) were retrogradely labeled by applying FluoroGold onto the bilateral superior colliculus.</p><p><b>RESULTS</b>During the follow-up (24 weeks), the IOP of the study eyes was significantly higher (P < 0.05) than the control eyes (at final examination, IOP of control eyes was (13.4 ± 1.0) mmHg and IOP of study eyes was (16.1 ± 1.8) mmHg). Correspondingly, at 24 weeks after operation, the RGCs density of the study eyes (2286.11 ± 290.45/mm(2)) was significantly lower than the control eyes (2626.46 ± 164.85/mm(2), P < 0.01). In the operated eyes, histological examination showed excavation of optic disc and increased neuroglial cells in the optic nerve, reduced thickness of retina and diminution of retinal ganglion cells, and atrophy of ciliary body and iris. Notably, the anterior chamber angle of the operated eye remained open.</p><p><b>CONCLUSIONS</b>A combination of intracameral injection of silicone oil and electrocoagulation of corneal limbal vessels and episcleral veins may establish a reliable glaucoma model for further research.</p>