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Corneal stromal is an important structure to maintain corneal transparency. The corneal stroma can be injured by trauma, infection and surgery. Therefore, corneal stromal wound starts repair with phenotype changes in stromal cell, extracellular matrix remodeling and immune cells migration. The corneal scar was the leading cause of blindness worldwide, which can be caused by corneal stromal fibrosis from increased myofibroblasts and deposited extracellular matrix after sever damage. At present, corneal transplantation is the main treatment for corneal scar, which has limited therapeutic effect because of corneal donor shortage, surgical requirements and the risk of postoperative immune rejection. Recently, great progress has been made in the study of control mechanism of corneal stromal wound healing with various molecules, cells and tissues. This paper reviews the repair mechanism of corneal stromal injury and the regulation mechanism of cause of corneal injury, corneal structure and molecule factors towards corneal stromal injury. It aims at providing new ideas for exploring the mechanism of corneal stromal repair and regeneration, which is supposed to help prevent corneal scar clinically.
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Contact lens(CL)is currently one of the most common methods of vision correction, with more than 140 million users worldwide and the demand is rising yearly as constantly development of materials and features. Wearing CL can lead to a variety of complications such as dry eye, corneal abrasions, giant papillary conjunctivitis, and infectious keratitis is one of the most severe complications. According to research, bacteria account for 80%～95% of the pathogens that cause CL-associated infective keratitis, it may have been related to the bacterial composition, virulence mechanism, biofilm formation and the combined effect of the lens itself and the process of use, which is prone to introducing pathogens, reducing antimicrobial capacity of the cornea and tears and causing ocular surface hypoxia and ocular surface inflammation. Overnight and prolonged lens wear, irregular lens purchase, use and care procedures can also be risk factors for bacterial infections. This article reviews the studies on the pathogenesis, risk factors, diagnosis, treatment and prevention of CL-related bacterial keratitis.
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AIM: To explore the clinical application value of analysis system for ultrasound biomicroscopy(UBM)images of anterior chamber angle(ACA)based on deep learning algorithm.METHODS: A total of 4 196 UBM images were obtained from 675 patients(1 130 eyes)at the Eye Center of Renmin Hospital of Wuhan University from January 2021 to June 2022 were collected to build an image dataset. Using Unet++network to automatically segment ACA tissue, a support vector machine(SVM)algorithm was developed to automatically classify opening and closing of chamber angle, and an algorithm to automatically locate the sclera spur and measure ACA parameters was developed. Furthermore, a total of 631 UBM images of 127 subjects(221 eyes)at Huangshi Aier Eye Hospital and 594 UBM images of 188 subjects(257 eyes)at Zhongnan Hospital of Wuhan University were selected to evaluate the performance of the system under different environments.RESULTS: The accuracy of the analysis system constructed in this study for chamber angle opening and closing was 95.71%. The intra-class correlation coefficient(ICC)values of all ACA angle parameters were greater than 0.960. ICC values of all ACA thickness parameters were greater than 0.884. The accurate measurement of ACA parameters depended in part on the accurate location of the scleral spur.CONCLUSION: The intelligent analysis system constructed in this study can accurately and effectively evaluate ACA images automatically and is a potential screening tool for the rapid identification of ACA structures.
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· Ocular surface squamous neoplasia(OSSN) is a type of ocular surface tumor,which is difficult to diagnose because of its low incidence is low and it is easy to be confused with pterygium.In recent years,the improvement of various diagnostic techniques and the extensive application of interferon (IFN) to OSSN therapy have greatly reduced the recurrence rate,and the diagnostic and therapeutic methods of OSSN tend to be diversified.Understanding the current causes of OSSN and the ways of treatment can better guide the OSSN study.
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@#Cyclosporine A is a new and potent immunosuppressant with high specificity and is widely used in controlling a variety of immunological rejection after organ transplantation. Research found that cyclosporine A suppresses the immune rejection in moderate to severe dry eye syndrome treatment. For mooren ulcers and autoimmune eye diseases, it has a significant effect. The application progress of Cyclosporine A in clinical ophthalmology is now reviewed.
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The advantages of intense pulsed light therapy in the treatment of Meibomian gland dysfunction include non-invasive, painless and good results, which has been greatly developed in the ophthalmology field.This article reviews the current situation, mechanism of action, operating procedures, treatment outcomes, safety, and other aspects of intense pulsed light therapy in the treatment of Meibomian gland dysfunction.
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AIM:To investigate the effect of intense pulsed light on the meibomian gland dysfunction ( MGD) , and to observe whether the intense pulsed light can improve the symptoms and objective indexes of the patients with meibomian gland dysfunction. · METHODS: A retrospective noncomparative interventional case series was conducted. Totally 21 MGD patients (42 eyes) were selected from November 2016 to February 2017 in Renmin Hospital of Wuhan University, the results of the following tests is recorded:OSDI score, corneal fluorescein staining, tear break-up time, ocular surface analyzer, scanning confocal microscopy, all patients respectively were received intense pulsed light treatment 3 times at 3wk intervals, and followed up after 1mo. Paired sample t test was used to analyze the difference in outcome. ·RESULTS: In the 21 cases ( 42 eyes ) , the OSDI score decreased, the mean value before treatment was 30. 18 ± 4. 07, and the mean value after treatment was 24. 87±4. 32. The first tear film break-up time ( first, BUT) increased, the mean value before treatment was 5. 37 ± 0. 82s, the mean value after treatment was 7. 12 ± 0. 74s. The mean value of meibomian gland secretion scores before the treatment was 1. 57 ± 0. 52,the mean value after treatment was 1. 22 ± 0. 52. The mean value of corneal fluorescence staining before treatment was 0. 82 ± 0. 41, and the mean value after treatment was 0. 51 ± 0. 53, the difference was statistically significant (t=11. 2, 2. 68, 3. 31, 2. 78, 2. 61;P<0. 05). · CONCLUSION: Intense pulsed light can effectively improve the subjective symptoms of patients with MGD and alleviate the obstruction of meibomian glands. It is an important method for MGD treatment.
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To research the association between primary progressive pterygium and tear film. ●METHODS: Totally 60 cases of primary progressive pterygium from September 2012 to June 2013 in our hospital were enrolled. The pterygium eye was for observation group and the contralateral eye as the control group. The differences of eye symptoms, tear film break-up time ( BUT ), Schirmer Ⅰ test ( S Ⅰ t ), corneal fluorescein staining (FL), tear ferning test (TFT) and the conjunctival impression cytology ( ClC) were compared between two groups. ●RESULTS: The eyes in observation group had higher symptoms score, FL score, grades of conjunctival squamous metaplasia, percentage of abnormal tear ferning, but had lower BUT and density of goblet cell, the differences had statistically significance (P0. 05). ● CONCLUSlON: Primary progressive pterygium can cause a decrease in tear film stability, which in turn lead to some dry eye symptoms such as dry feeling and burning sensation, and its mechanism may be caused by multi-factors, such as density change of goblet cell and the tear fluid dynamics.
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Background Previous studies showed that after herpes simplex virus-1 (HSV-1) infection of the cornea,matrix metallo proteinase-2 (MMP-2) (produced by corneal cells and corneal epithelial cells) plays an important role in the development of HSK.Focal adhesion kinase (FAK)plays an important role on the expression,release and activation of MMPs.This study explored the expressions of MMP-2 and FAK,which induced by HSV-1 infected human corneal epithelial cells.Objective To investigate MMP-2 and FAK expression in HSV-1 infected human corneal epithelial cells.Methods Human corneal epithelial cells were infected with HSV-1 in vitro to establish cell model of viral infection.The expression of MMP-2 and FAK were detected by reverse transcription PCR (RT-PCR),Western blot,immunohistochemical method and immunofluorescence method at 2 hours,20 hours and 40 hours after infection.Results At 2 hours,20 hours and 40 hours after infection,the expressionis of MMP-2 mRNA and FAK mRNA were significantly increased in comparison with uninfected cells (MMP-2 mRNA:Ftime =0.968,P=0.436 ; Fgroup =47.649,P =0.000 ; Fi ion =0.757,P =0.536.FAK mRNA:Ftime =0.658,P =0.631 ; Fgroup =35.182,P=0.000;Finteraction =1.386,P=0.137).Western blot assays showed that there were no significant differences in p-FAK,FAK or MMP-2 expressions between infected cells and control cells after 2 hours (P＞0.05),but the expression levels of infected cells were significantly increased at 20 hours and 40 hours (both at P ＜ 0.05).Immunohistochemistry results showed that longer infection time was associated with an increased number of cells staining for MMP-2,FAK and p-FAK.Conclusions At the initial stage of HSV-1 infected,p-FAK plays an important role in the process of virus invading and MMP-2 activation.
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Background Salivary transplantation or duct transposition can provide continuous physiological secretion of tear substitutes.This may be an ideal method in treatment of dry eye.But the relative anatomical literatures is few,and some of the conclusions in the literatures are still controversial,which limit its clinical application.Objective This study was to discuss the possibility and the advantage and disadvantage of applying three major salivary glands to treat xerophthalmia.Methods The relationship between the branches of the facial nerve out of the parotid gland and the salivary glands,the salivary glands size,origin of blood supply,out diameter of vessels and adjacent relation were observed in 34 sides pate specimens perfused with red latex under the operating microscope.To find the vessels in recipient site to anastomose,the vessels around fossa orbitalis and forehead were anatomized and observed.The parotid gland duct transfer operation,the submandibular gland free transplantation surgery and sublingual gland free transplantation surgery in the human anatomy specimens were simulated.Results The position of parotid duct was constant.The duct length was(4.20± 1.10) cm,duct diameter was (O.60±0.30) cm.The stensen's duct was likely to be prolonged by the cheek mucous membrane or venous andthe damage of buccal branch,zygomatic branch and temporal branches of facial nerve should be avoided during the operation of transplanting stensen' s duct.When submandibular gland was transplanted,facial vessel was taken as its pedicle,whose outside diameter was (2.70 ± 0.28) mm,and the length of the transplant vascular pedicle was (1.90 ± O.30) cm.Thc anastomosed vessel was superficial temporal vessel in recipient site.When sublingual gland was transplanted,sublingual(88.2％,30 sides) or submental vessel(11.8％,4 sides) was taken as its pedicle,whose outside diameter was(1.92±0.36) mm and (1.96±0.54) mm,and the length of the transplant vascular pedicle was(2.60± 1.10) cm and(3.50±0.40) cm,and the anastomosed vessel was the frontal branch of superficial temporal vessel in recipient site.Three sides of specimens lacked sublingual glands.Conclusions It is feasible that treating severe xerophthalmia by the operation of grafting the major salivary glands or transplanting stensen' s duct on the point of anatomical view.Parotid duct inversion and the submandibular gland transplantation have been applied to clinic.However,sublingual transplantation remains to be further confirmed by the animal experiments.