ABSTRACT
Objective To observe multimodal imaging characteristics in eyes with focal choroidal excavation (FCE) and preliminarily analyze the risk factors in FCE with complications correlated with RPE.Methods A retrospective case series.Thirty-one patients (31 eyes) with monocular FCE,first identified by spectral-domain (SD)-OCT in the Eye Center of The Second People's Hospital of Foshan from December 2014 to December 2018,were involved in this study.There were 14 males and 17 females,with the mean age of 45.84± 13.57 years.All patients underwent BCVA,optometry,and SD-OCT examinations.FFA and ICGA were simultaneously performed in 3 FCE patients with RPE complications.The subfoveal choroidal thickness (SFCT) and excavation width were measured with enhanced depth imaging OCT (EDI-OCT).The eyes with FCE were divided into two groups (FCE alone group 17 eyes vs.FCE complication group 14 eyes),based on whether complicated by RPE dysfunction.Among 14 eyes of FCE complication group,7 (22.6％) with choroidal neovascularization,4 (12.9％) with central serous chorioretinopathy,1 (3.2％) with polypoidal choroidal vasculopathy,and 2 (6.5％) with RPE detachment.No significant difference was found in the mean age (t=0.87),gender composition (x2=0.06),ocular laterality (x2=2.58),and spherical equivalent (t=-0.81) between two groups,respectively (P＞0.05),except that the BCVA was significantly different (t=-2.11,P＜0.05).The SFCT and excavation width of eyes in both groups and the ICGA imaging characteristics of eyes in FCE complication group were analyzed.Risk factors of FCE with RPE complications were analyzed by logistic regression analysis.Results Thirty-three excavations were identified in 31 eyes with FCE.The mean SFCT was 167.00± 85.18 μm in FCE alone group vs.228.36± 67.95 μm in FCE complication group,while the excavation width was 645.00 ± 231.93 μm vs.901.00± 420.55 μm and they were both significantly different (P＜0.05).Logistic regression analysis showed the SFCT (OR=1.016,P=0.026) and excavation width (OR=1.004,P=0.034) were risk factors for RPE complications of FCE.EDI-OCT showed the RPE at the excavation was impaired or vulnerable in all eyes of the FCE alone group,especially at the boundary area of excavation.The RPE damages were located at the boundary area of excavation in 10 eyes (71.4％) of FCE complication group.Constant choroidal hypofluorescence and filling defect were observed under the excavation in 3 eyes with ICGA imaging.Conclusions SFCT and excavation width may be risk factors for RPE complications of FCE.Impairment of RPE at boundary area of excavation and focal choroidal ischemia or aberrant circulation under the excavation may correlate with the development of FCE complications.
ABSTRACT
Objective To observe the multimodal imaging characteristics of multiple evanescent white dot syndrom (MEWDS).Methods This was a retrospective series case study.Eighteen patients (18 eyes) diagnosed with MEWDS in Eye Center of The Second People's Hospital of Foshan from September 2015 to April 2017 were enrolled in this study.There were 12 females and 6 males,with the mean age of 35.9 years.The disease course ranged from 3 to 90 days,with the mean of 14 days.All the patients underwent BCVA,slit-lamp microscope with +90D preset lens,fundus photography,spectral domain OCT (SD-OCT) and FAF examinations.FFA was simultaneously performed in 6 eyes,FFA and ICGA were simultaneously performed in 12 eyes.Ten patients received the treatment of glucocorticoids and vasodilator substance,and other 8 patients without any treatment.The follow-up duration was 4.5 months.The multimodal imaging characteristics were reviewed and analyzed.Results Fundus color photography showed a variable number of small dots and large spots lesions (14 eyes),and/or fovea granularity (7 eyes) and disk swelling (5 eyes).A variable number of little dots and larger spots lesions showed respectively in FFA,FAF and ICGA were needle-like dots distributed in a wreathlike pattern and a large plaque occasionally confluent of early highly fluorescent,highly autofluorescence and hypofluoresence.Combined hypofluorescent spots with overlying dots were observed in 10 eyes of the late stages of the ICGA.Black lesions in the gray background show in ICGA were the most obvious and the most extensive,gray-white lesions in the gray-black show in FAF were the second,light gray-black lesions in the gray show in FFA were the least.Gray-white lesions in an orange background show in fundus photography were not obvious and transient.SD-OCT showed disruption of the ellipsoid zone and/or accumulations of hyperreflective material from the ellipsoid layer toward the outer plexiform layer and vitreous cells.During the period of following-up,some patients were prescribed low-dose glucocorticoid and some not,almost all the patients except one patient experienced recovery in BCVA and the lesions in fundus imaging.Conclusions The lesions in MEWDS eyes in modern multimodal imaging modalities among fundus photography (fovea granularity),FFA (needle-like dots distributed in a wreathlike pattern and a large plaque occasionally confluent of early highly fluorescent),ICGA (flake hypofluorescent) and SD-OCT (disruption of the ellipsoid zone) showed good consistency.Almost eyes were recovery.
ABSTRACT
Objective To observe the clinical manifestation and gene mutation of a pedigree with Sorsby fundus dystrophy (SFD).Methods Ten members in 3 generations of a pedigree with SFD were included in this study.Four patients were observed in the pedigree,including 2 females and 2 males.All 10 members underwent comprehensive ophthalmic examinations,including best-corrected visual acuity,intraocular pressure,slit-lamp biomicroscopy,indirect ophthalmoscopy,fundus color photography and spectral domain optical coherence tomography.Genomic DNA was extracted from peripheral venous blood which was collected from all the members.Relevant exons of ocular diseases were detected by the next generation sequencing method from the proband.The other members underwent Sanger verification.Results Among the four patients,fading eyesight was appeared at their 44,46,47 and 40 year-old respectively.The two male patients had bilateral morbidity,and the two female patients had monocular symptoms.DNA sequencing results showed that the proband,other 3 patients and 2 members from the Ⅲ generation had heterozygous mutation of TIMP3 gene in exon 5.The amino acid encoded by TIMP3 gene No.204 codon changed from serine to cysteine (TIMP3:NM_000362:Exon5:c.A610T/p.S204C).Coclusions The invasion time of all the patients in this pedigree is after their 40 year-old.Heterozygous mutation at c.610A＞T (p.S204C) in TIMP3 gene is the causative gene of SFD in this pedigree.
ABSTRACT
Objective To compare the MdaccAutoPlan (MDAP)software with Manual planning in intensity modulated radiotherapy (IMRT) planning for nasopharyngeal carcinoma (NPC) patients.Methods A total of 20 newly diagnosed NPC patients were enrolled and their IMRT plans were designed with MDAP software and manually,respectively with identical field angle,optimization parameters and other planning requirements.Dosimetric differences and planning efficiency were compared for these two planning method.Results The PGTV Dgs％,PGTV D PTV1 Dgs％,PTV1 D PTV2 D98％,PTV2 D of plans generated from MDAP were reduced by 2.5％,0.3％,0.1％,0.5％,0.6％,1.0％,respectively,compared with those in plans generated manually.The D2％ of the PGTV,PTV1,PTV2 in MDAP plans were increased by 1.7％,1.5％,0.6％ compared with those in manual plans,respectively.There were significant differences observed in the PGTV D9s％,PGTV D2％ and PTV2 Dg8％ between these two planning method (t =5.519,6.701,0.937,P ＜ 0.05).The D50％ of right parotidand left parotid,the D and D of the spinal cord in MDAP plans were reduced significantly by 24.8％,27.7％,11.4％,14.0％,respectively,compared with those in manual plans (t =5.447,5.375,6.786,3.810,P ＜ 0.05).The dose of both lens increased significantly by 65.0％ and 19.3％,respectively,in MDAP plans compared with Manual plans (t =9.863,3.440,P ＜ 0.05).There was no significant dosimetric difference observed in opticnerve,opticchiasm and brainstem between these two planning method.The dose distribution of post neck in MDAP plans were better than those in manual plans.The dose-volume histogram curves of planning target volume,brainstem and spial cord in the manul plans were higher than those in the MDAP plans.The labor time of MDAP planning was reduced by 54.4％ compared with Manual planning,while computer working time was increased by 34.4％ with MDAP planning compared with Manual planning.Conclusions MDAP planning is clinically valualbe in its applicaion for a NPC IMRT planning with a better sparing for OARs,a decreased planning time and improvement on planning efficiency compared with manual planning.
ABSTRACT
Chemerin is a cytokine that attracts much attention in the reproductive process. This study aimed to explore the effects of chemerin and its receptor chemokine-like receptor 1 (CMKLR1) on the maintenance of early pregnancy. The expression levels of chemerin and CMKLR1 in the decidua tissues of 20 early normal pregnant women and 20 early spontaneous abortion women were examined by Western blot and real-time polymerase chain reaction analyses. CMKLR1 receptor antagonist (α-NETA) was then intrauterinely injected into normal pregnant mice model to assess its effect on the outcome of pregnancy and the phosphorylation rate of ERK1/2 in decidua tissues.We found that the expression level of chemerin in women who had experienced early spontaneous abortion was lower than in those who had experienced normal early pregnancy (P < 0.01); conversely, CMKLR1 expression was higher in the former than in the latter (P < 0.01). In a pregnant-mouse model, the embryo resorption rate of α-NETA group was higher than that in the negative control group (61.5% vs. 10.8%) (P < 0.001). Compared with the control group, ERK1/2 phosphorylation in decidua tissues decreased in the α-NETA-treated group (P < 0.01). These results suggested that the inhibition of the chemerin/CMKLR1 signaling pathway can lead to the abortion of mouse embryos, and that chemerin/CMKLR1 may play an important role in the maintenance of early pregnancy possibly by regulating ERK1/2 phosphorylation.
Subject(s)
Adult , Animals , Female , Humans , Mice , Pregnancy , Young Adult , Chemokines , Metabolism , Intercellular Signaling Peptides and Proteins , Metabolism , Metabolism , Pregnancy Rate , Pregnancy, Animal , Receptors, Chemokine , Metabolism , Receptors, G-Protein-Coupled , Metabolism , Signal TransductionABSTRACT
Objective To investigate waist-to-height ratio(WHtR) and body mass index(BMI) for the screening and prediction of metabolic syndrome and explore the best indicator for predicting metabolic syndrome(MS) in the elderly.Methods A cluster random sampling method was used.5 010 cases aged 60-70 years old of Renqiu permanent residents were selected as a screening subjects.The face to face health questionnaires,anthropometric measurements,and laboratory testing were conducted.Receiver operatiug characteristic (ROC) was used to analyze and calculate the area under the curve(AUC).Results WHtR predict the best point of tangency of MS were 0.54 (men),0.5 5 (women),BMI predict the best point of tangency of MS were 25.25kg/m2 (men),2 5.0 5 kg/m2 (women).In the same gender,the contrast of WHtR and BMI in predicts MS area under the curve,WHtR area under the curve of the larger,WHtR was higher than BMI,WHtR was a better indicator in predicted of MS.Conclusion WHtR and BMI have important roles in the screening and prediction of MS,and WHtR seems to be the best parameter in the screening and prediction of MS in the elderly.