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Objective To investigate the time relationship of the change,and diagnostic accuracy and sensitivity between retinal light threshold fluctuations (LTF) and retinal nerve fiber layer (RNFL) and ganglion cell complex(GCC) thickness on high-risk primary open-angle glaucoma (POAG).Methods Totally 319 patients (319 eyes) with high-risk in POAG from the First Affiliated Hospital of Kunming Medical Universityand during December 2009 and December 2017,50 healthy individuals (50 eyes) as control were collected in this longitudinal cohort study.Visual field and OCT were reviewed every 6 months on the high-risk group and every 12 months on the control group.High-risk groups inclusion criteria:vertical C/D≥0.6;early visual field defect (according to glaucoma visual field damage GSS2 quantitative grading standards,mean deviation and pattern standard deviation of central field exceeds the border as an early visual field defect);continuous repeatable results.The first field and OCT results in the absence of visual field defects and C/D≥0.6,which were conformed reliability indicators and removed learning effects as a baseline.When patients achieve POAG diagnosis criteria first time which was recorded as a turning point.And they were divided into early group meanwhile were ended of follow-up.After the last follow-up,the inspection data was segmented counted in yearly interval.The changes of LTF,thickness of RNFL and GCC during the follow-up period in the early POAG group and the control group were observed.The loss rate and change rate in each period were compared for the assessment of their trends with time.Followed by calculation of the area under receiver operating curves (AUC) to compare the predicted value of POAG and the sensitivity at 95％ specificity in each period.Results After last follow-up,totally 67 patients 67 eyes (early POAG group,37 males and 30 females) were entered the turning point.The mean follow-up of the early POAG group and the control group were 6.6 and 6.4 years.The average RNFL thickness was 79.05± 8.09 μm,GCC thickness was 71.58 ± 8.41 μm,LTF was -6.05 ± 7.02 dB in early POAG group.The average RNFL thickness was 93.49± 6.24 μrm,GCC thickness was 79.72± 6.32 μm,LTF was-0.31 ± 0.58 dB in the control group.The differences of LTF and the thickness of RNFL and GCC were statistically significant (t=-5.97,-10.42,-5.60;P＜0.001).The AUC of RNFL,GCC thickness and LTF increased with time in the early POAG group.The sensitivity was gradually increased at 95％ specificity:5th year before to at turning point,RNFL thickness AUC was 0.15,0.65,0.71,0.77,0.85,0.92,and sensitivity was 20％,56％,61％,65％,70％,76％,respectively;GCC thickness AUC was 0.12,0.53,0.69,0.74,0.82,0.90,and sensitivity was 14％,53％,69％,74％,82％,90％,respectively;the AUC of LTF was 0.10,0.21,0.33,0.75,0.86,0.91,and sensitivity was 7％,17％,44％,65％,78％,87％,respectively.Conclusions The earliest time of structural functional damage of POAG is at the 4th year before confirmed,simultaneous RNFL diagnosis accuracy and sensitivity are better than GCC and LTF.The earliest time of visual functional damage of POAG is at the 2th year before confirmed,simultaneous LTF diagnosis accuracy and sensitivity are better than RNFL and GCC.
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Background Diabetic retinopathy (DR) is a common ocular complication of diabetes,and its pathogenesis is associated with a variety of factors.c-Jun N terminal kinase (JNK),one of the genes involving in apoptosis,plays an important role in the pathology of diabetes,and relative research is catching increasing interests in recent years.Objective This study was to quantify the expression of JNK3 in retinas of DR murine.Methods Forty-eight SPF male C57BL/6 mice were randomly divided into the diabetes group and the normal control group.Diabetic mouse models were establishend by intraperitoneal injection of 1％ streptozocin (STZ) dissolved by sodium citrate buffer,and equvilant volume of sodium citrate buffer was used in the same way in the mice of the control mice.The left eyeballs were obtained 2,4,8 weeks after modeling and the retinas were collected.Real-time quantitaive PCR was perfored to detect the expression of JNK3 mRNA in retinas.The use and care of the experimental mice complied with the Administration of Experimental Animals in Kunming Medical College.Results Blood glucose levels were significantly higher in 2,4,8 weeks after modeling in the diabetic group compared with the normal control group (t=-5.675,-5.498,-5.347,all at P＜0.01).The relative expression levels of JNK3 mRNA (A value) in the retinas were significantly different between the groups at various time points (Fgroup =102.345,P＜0.05 ; Ftime =131.679,P＜ 0.05).The relative expression levels of JNK3 mRNA in the retinas were 3.21 ±0.14 and 5.43 ±O.37 in 4 and 8 weeks after modeling in the diabetic group,which were significantly elevated in comparison with the normal control group (2.54±0.42 versus 2.26±0.67) (t =4.073,23.399,both at P＜0.05).Compared with the second week and fourth week,the relative expression levels of JNK3 mRNA in the retinas in the eighth week were significantly raised in the diabetic group (t =10.756,16.857,both at P ＜ 0.05).Conclusions JNK3 expression in the retina upregulates in diabtic mice in a time-dependent manner.JNK3 is paopably involved in the pathogenesis and development of DR.
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The cultivation of clinical skills is essential for graduate education in modern ophthalmology. In order to improve the quality of graduate education and cultivate qualified ophthalmologist, postgraduates should be trained of specific purpose, coordinate the relationship between project research and clinical work, a complete clinical training system and quality control system should be established and the construction of the tutor team should also be strengthened.
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To explore the nyopic shift after cataract extrac tion(ECCE ) with intraocular lens implantation (IOL． ) during childhood．2l children (24 eyes) with ECCE+0L are retrospectively analyzed,and were divided into two groups according to the age． The initial and last postoperative refractive errors were compared． The mean myopic shift was -0.89±0.40 (3～5 years group ) and -0.97± 0.l8 (6～ l0 years N) The difference between two groups was not significantly different(t=0.2l, P>0.05 ) ．The myopic shift was less than l.5re in 91.6W of the w． 83.32 of the eyes achieved a visual acuity of 0.5 or better in their pseudosphakic eyes． Undercorrecting most children 3 to 10 years of ag e by 1.00D from the IOL power predicted to achieve emmtropia．
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Objective To evaluate changes in retinal expression of three heat shock proteins(HSPs)HSP27,HSP70 and HSP90 in normal and experimental glaucomatous rats's retina,and to explore the potential relationship between HSPs with glaucoma optic neuropathy.Design Experimental study.Participants 60 Wistar rats.Methods Rats were randomly divided into ocular hypertension group(n=30)and sham control group(n=30).The right eye was designed as the experimental eye,and the left as the control eyes.Intraocular pressure(IOP)was elevated by using underwater bipolar electro coagulation condensate 3 episcleral and limbal veins on the right eye of rats to establish of animal models of glaucoma.IOP were monitored twice weekly with a Tonopen.In treated eyes,IOP ranged from 27 to 35 mmHg throughout the study.Rats were killed with euthanasia at 10,20,or 60 days following the occurrence of ocular hypertension,with retina dissected free and protein isolated.Protein was used for Western blot analysis and probed with specific HSP antibodies,and normalized to ?-actin levels.Main Outcome Measures IOP,Western bolt.Results Western blot analysis demonstrated that HSP27 protein levels in the retinas were elevated as much as 197% at 10,20 and 60 days following the induction of ocular hypertension.No changes in protein levels were observed for HSP70 or HSP90 in retina from ocular hypertensive eyes.Conclusions The stress protein HSP27 is upregulated in retinas from ocular hypertensive rats.No changes in HSP70 or HSP90 were observed.The upregulation in HSP27 appears to be a gene specific event associated with elevated IOP,its expression may be a potential relationship associated with optic neuropathy in glaucoma.
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Objective To compare the different influences on the cornea endothelial cell of surgery methods between human cataract extraction and phacoemulsification.Methods 25 cataract patients(36 eyes) aged 55 to 84 undergoing extra capsula extraction and phacoemulsification combined with implanation ocular lens were analyzed in rate of endothelial cell and density within 2 weeks preoperatively and postoperatively.Results The rates reduced in varying degrees.Conclusions Understanding cornea endothelial cell before operation is clinically significant for evaluating cornea edema after surgery and taking essential measures.