Retinal nerve fiber layer in primary open-angle glaucoma with high myopia determined by optical coherence tomography and scanning laser polarimetry / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Fundus changes associated with high myopia (HM) may mask those associated with primary open-angle glaucoma (POAG). This study aim to determine the characteristics of RNFL thickness changes in patients with both POAG and HM and compare these to changes in patients with only HM. The diagnostic capabilities of both OCT and GDxVCC in this subset of patients are also evaluated.</p><p><b>METHODS</b>Twenty-two eyes with POAG and HM (spherical equivalent (SE) between -6.0 and -12.0 D) were evaluated, and 22 eyes with HM were used for comparison. Characteristic retinal nerve fiber layer (RNFL) thickness profiles in patients with POAG and HM were examined using optical coherence tomography (OCT) and scanning laser polarimetry with variable corneal compensation (GDxVCC), and the diagnostic capabilities of these imaging modalities were compared. RNFL parameters evaluated included superior average (Savg-GDx), inferior average (Iavg-GDx), temporal-superior-nasal- inferior-temporal (TSNIT) average, and nerve fiber indicator (NFI) on GDxVCC and superior average (Savg-OCT), inferior average (Iavg-OCT), nasal average (Navg-OCT), temporal average (Tavg-OCT), and average thickness (AvgThick-OCT) on OCT (fast RNFL scan). Visual field testing was performed and defects were evaluated using mean defect (MD) and pattern standard deviation (PSD).</p><p><b>RESULTS</b>The RNFL parameters (P < 0.05) significantly different between groups included Savg-GDx, Iavg-GDx, TSNIT average, NFI, Savg-OCT, Iavg-OCT, Tavg-OCT, and AvgThick-OCT. Significant correlations existed between TSNIT average and AvgThick-OCT (r = 0.778), TSNIT average and MD (r = 0.749), AvgThick-OCT and MD (r = 0.647), TSNIT average and PSD (r = -0.756), and AvgThick-OCT and PSD (r = -0.784). The area under the receiver operating characteristic curve (AUROC) values of TSNIT average, Savg-GDx, Iavg-GDx, NFI, Savg-OCT, Iavg-OCT, Navg-OCT, Tavg-OCT, and AvgThick-OCT were 0.947, 0.962, 0.973, 0.994, 0.909, 0.917, 0.511, 0.906, and 0.913, respectively. The NFI AUROC was the highest value.</p><p><b>CONCLUSIONS</b>RNFL thickness was significantly lower in all but the nasal quadrant in patients with POAG and HM, compared to patients with only HM. Measurements with OCT and GDxVCC were well-correlated, and both modalities detected RNFL thickness changes. However, GDxVCC was better than OCT in detecting POAG in HM patients.</p>

Orbital Rosai-Dorfman disease in a fifty-eight years old woman

Rosai-Dorfman disease [RDD] is rare and characterized by histiocytic proliferation and massive cervical lymphadenopathy. About 40% of patients have extra-nodal involvement. Ophthalmic involvement is seen in 10% of cases. A case of orbital Rosai Dorfman disease in a 58 years old woman is presented here, who was misdiagnosed as orbital inflammatory disease initially. The patient did not respond to a course of oral prednisolone. Then complete surgical excision of the mass was performed and the histopathological examination was consistent with a diagnosis of RDD

Combined trabeculectomy and vitrectomy for intractable glaucoma with severe ocular contusion involving the posterior segment / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Intractable secondary glaucoma with severe ocular contusion involving the posterior segment is difficult to treat. In this study, we evaluated the safety and efficacy of combined trabeculectomy and vitrectomy for intractable glaucoma with severe ocular contusion involving the posterior segment.</p><p><b>METHODS</b>This retrospective interventional study enrolled 18 eyes from 18 consecutive cases with uncontrolled intraocular pressure, angle recession exceeding 180°, dense vitreous hemorrhage, and/or limited retinal detachment after severe ocular contusion. Combined trabeculectomy and vitrectomy was performed after giving the patient sufficient anti-inflammatory and intraocular pressure (IOP)-lowering medication. Follow-up averaged 26.2 (range, 6.0- 48.0) months.</p><p><b>RESULTS</b>The mean IOP decreased from (36.4 ± 10.0) mmHg on maximum IOP-lowering medications to (14.6 ± 4.4) mmHg on (0.7 ± 1.2) topical medications at the final follow-up (P < 0.0001). During the first postoperative month, four eyes (22%) had a short hypertensive phase and six eyes (33%) had early hypotony, including one case (5.6%) of bleb leakage. Seven eyes (39%) developed recurrent hypertension 3- 6 months postoperatively, five of which were controlled by topical medications. Ten (55.6%) eyes were classified as a complete success, five (27.8%) as a qualified success, and three eyes (16.7%) as failures. Kaplan-Meier survival analysis for complete and cumulative success showed 53.5% and 80.0% survival at 48 months, respectively. Visual acuity was improved in 15 eyes (83.3%). Three eyes (16.7%) had unchanged visual acuity, one (5.6%) of which developed atrophia bulbi despite a normal intraocular pressure. No recurrent retinal detachment or vitreous hemorrhage developed.</p><p><b>CONCLUSION</b>Combined trabeculectomy and vitrectomy is a viable surgical procedure for the management of intractable glaucoma with severe ocular contusion involving the posterior segment in selected cases.</p>

Changes of tear film and tear secretion after phacoemulsification in diabetic patients / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

<p><b>OBJECTIVE</b>To evaluate tear film stability and tear secretion in patients with diabetes after phacoemulsification.</p><p><b>METHODS</b>Twenty-five diabetic cataract patients and 20 age-matched non-diabetic cataract patients as control underwent phacoemulsification. Tear film break-up time (TFBUT), Schirmer I test (SIT), corneal fluorescein staining, and dry eye symptoms were measured pre- and postoperatively.</p><p><b>RESULTS</b>Diabetics had a decreased preoperative TFBUT and SIT. TFBUT was reduced on Day 1 and recovered on Day 180 postoperatively in both groups. SIT was increased after phacoemulsification, but returned to preoperative levels by Day 180 in non-diabetics, whereas it was lower than preoperative level in diabetics. Positive corneal fluorescein staining was elevated in both groups, and returned to preoperative levels only in controls. Dry eye symptoms were similar to fluorescein staining in both groups.</p><p><b>CONCLUSION</b>Tear secretion was reduced in diabetic cataract patients after phacoemulsification, which worsened dry eye symptoms and predisposed those patients to ocular damage.</p>

Clinical investigation of surgery for intermittent exotropia / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

<p><b>OBJECTIVE</b>To investigate the time and postoperative binocular vision of strabismus surgery for children with intermittent exotropia (X(T)).</p><p><b>METHODS</b>A retrospective investigation was conducted in 80 child patients with intermittent exotropia. Pre- and postoperative angles of deviation fixating at near (33 cm) and distant targets (6 m) were measured with the prolonged alternate cover testing. The binocular function was assessed with synoptophore. Twenty-one patients took the postoperative synoptophore exercise.</p><p><b>RESULTS</b>(1) A week after surgery, 96.2% of the 80 patients had binocular normotopia, while a year after surgery, 91.3% of the 80 patients had binocular normotopia; (2) Preoperatively, 58 patients had near stereoacuity, while postoperatively, 72 patients achieved near stereoacuity (P<0.05); (3) Preoperatively, 64 patients had Grade I for the synoptophore evaluation and postoperatively, 76 patients achieved Grade I. Meanwhile, 55 patients had Grade II preoperatively and 72 achieved Grade II postoperatively. For Grade III, there were 49 patients preoperatively and 64 patients postoperatively (P<0.05); (4) Patients of 5-8 years old had a significantly better recovery rate of binocular vision than those of 9-18 years old (P<0.05); (5) Patients taking postoperative synoptophore exercise had a better binocular vision than those taking no exercise (P<0.05).</p><p><b>CONCLUSIONS</b>(1) Strabismus surgery can help to preserve or restore the binocular vision for intermittent exotropia; (2) Receiving the surgery at young ages may develop better postoperative binocular vision; (3) The postoperative synoptophore exercise can help to restore the binocular vision.</p>

MGB probe assay for rapid detection of mtDNA11778 mutation in the Chinese LHON patients by real-time PCR / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

<p><b>OBJECTIVE</b>Leber's hereditary optic neuropathy (LHON) is a maternally inherited degeneration of the optic nerve caused by point mutations of mitochondrial DNA (mtDNA). Many unsolved questions regarding the penetrance and pathophysiological mechanism of LHON demand efficient and reliable mutation testing. This study aims to develop a minor groove binder (MGB) probe assay for rapid detection of mtDNA11778 mutation and heteroplasmy in Chinese LHON patients by real-time polymerase chain reaction (PCR).</p><p><b>METHODS</b>Forty-eight patients suspected of having LHON and their maternal relatives underwent a molecular genetic evaluation, with 20 normal individuals as a control group at the same time. A real-time PCR involving two MGB probes was used to detect the mtDNA11778 mutation and heteroplasmy. A linear standard curve was obtained by pUCmLHONG and pUCmLHONA clones.</p><p><b>RESULTS</b>All 48 LHON patients and their maternal relatives were positive for mtDNA11778 mutation in our assay, 27 heteroplasmic and 21 homoplasmic. Eighteen cases did not show an occurrence of the disease, while 9 developed the disease among the 27 heteroplasmic mutation cases. Eleven did not show an occurrence of the disease, while 10 cases developed the disease among 21 homoplasmic mutation cases. There was a significant difference in the incidence between the heteroplasmic and the homoplasmic mutation types. The time needed for running a real-time PCR assay was only 80 min.</p><p><b>CONCLUSION</b>This real-time PCR assay is a rapid, reliable method for mtDNA mutation detection as well as heteroplasmy quantification. Detecting this ratio is very important for predicting phenotypic expression of unaffected carriers.</p>

A clinical study of the efficacy of topical corticosteroids on dry eye / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

<p><b>OBJECTIVE</b>To evaluate the effect of topical corticosteroid for treatment of moderate or severe dry eye.</p><p><b>METHODS</b>Sixty eyes of 30 patients with moderate or severe dry eye, who were not sensitive to artificial tears, were treated with 0.1% fluorometholone eye drops. Subjective symptom and objective tests were used to evaluate the efficacy of treatment before and after application of 0.1% fluorometholone eye drops for 1 week and 1 month. Side effects were also evaluated.</p><p><b>RESULTS</b>After 1 week of treatment, subjective symptoms were improved in all dry eye patients; objective tests were improved in all dry eye patients 1 month after treatment, and the difference was significant.</p><p><b>CONCLUSION</b>Topical corticosteroid drops can rapidly and effectively relieve the symptoms and signs of moderate or severe dry eye.</p>