Development of medical treatment for eye injuries in the mainland of China over the past decade / 中华创伤杂志(英文版)

In the article, the development of medical treatment for eye injuries in the mainland of China was reviewed. According to the data provided in Eye Injury Vitrectomy Study (EIVS), 27% of 72 eyes with no light perception (NLP) gained recovery in term of antomy and visual function. Vitrectomy initiated at more than 4 weeks after open eye injury is an independent risk factor for developing PVR. Prognosis of anatomy and visual function of the injured eye with PVR is markedly worse than that without PVR. Serious injuries of ciliary body, choroid and retina are three key parts of the eye with NLP. The concept that the treatment of the eye injury gradually focus on the whole globe is embodied. The data from 13575 in patients with traumatic eyes in 14 hospitals revealed that the rate of immediate enucleation was remarkable reduced with comparison of 20 years ago.

Ability of Mn(2+) to Permeate the Eye and Availability of Manganese-enhanced Magnetic Resonance Imaging for Visual Pathway Imaging via Topical Administration / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Manganese-enhanced magnetic resonance imaging (MEMRI) for visual pathway imaging via topical administration requires further research. This study investigated the permeability of the corneal epithelium and corneal toxicity after topical administration of Mn2+ to understand the applicability of MEMRI.</p><p><b>METHODS</b>Forty New Zealand rabbits were divided into 0.05 mol/L, 0.10 mol/L, and 0.20 mol/L groups as well as a control group (n = 10 in each group). Each group was further subdivided into epithelium-removed and epithelium-intact subgroups (n = 5 in each subgroup). Rabbits were given 8 drops of MnCl2in 5 min intervals. The Mn2+ concentrations in the aqueous and vitreous humors were analyzed using inductively coupled plasma-mass spectrometry at different time points. MEMRI scanning was carried out to image the visual pathway after 24 h. The corneal toxicity of Mn2+ was evaluated with corneal imaging and pathology slices.</p><p><b>RESULTS</b>Between the aqueous and vitreous humors, there was a 10 h lag for the peak Mn2+ concentration times. The intraocular Mn2+ concentration increased with the concentration gradients of Mn2+ and was higher in the epithelium-removed subgroup than that in the epithelium-intact subgroup. The enhancement of the visual pathway was achieved in the 0.10 mol/L and 0.20 mol/L epithelium-removed subgroups. The corresponding peak concentrations of Mn2+ were 5087 ± 666 ng/ml, 22920 ± 1188 ng/ml in the aqueous humor and 884 ± 78 ng/ml, 2556 ± 492 ng/ml in the vitreous body, respectively. Corneal injury was evident in the epithelium-removed and 0.20 mol/L epithelium-intact subgroups.</p><p><b>CONCLUSIONS</b>The corneal epithelium is a barrier to Mn2+, and the iris and lens septum might be another intraocular barrier to the permeation of Mn2+. An elevated Mn2+ concentration contributes to the increased permeation of Mn2+, higher MEMRI signal, and corneal toxicity. The enhancement of the visual pathway requires an effective Mn2+ concentration in the vitreous body.</p>

Epidemiological survey of diabetic retinopathy in Shunyi district of Beijing / 中华实验眼科杂志

Background There are no noticeable symptoms in early stages of diabetic retinopathy(DR)and the detection of presymptomatic DR remains challenging. Therefore, data on the prevalence and progress of DR will help in prevention and treatment programs in China. Objective This study was to survey the prevalence and risk factors of diabetic retinopathy( DR ) in a population aged 40 years or older in the Shunyi district of Beijing city.Methods A cross-sectional study was designed. Cluster sampling was used to randomly select 4167 (91.6%)individuals aged ≥40 years in 24 clusters in the Shunyi district of Beijing city in China. The Questionnaire data,including general information, living habits, present history, past history, family history, education level etc., were obtained from each subjects. The height, body weight and blood pressure were examined, and slit-lamp examination, direct ophthalmoscopy,indirect ophthalmoscopy and nonmydriatic fundus photography were performed during the study duration. Diabetic mellitus (DM)was diagnosed and graded according to the criteria of Early Treatment Diabetic Retinopathy Study Research Group(ETDRS). The associated factors with DR were analyzed byx2 test,trend x2 test,and multivariate Logistic regression analysis. This protocol was approved by the Ethic Committee of Peking University. Informed consent was obtained from each individual prior to the survey. Results A total of 4167 ( 91.6% )individuals were examined from the 4549 samples with a response rate of 86. 4%. This study showed a prevalence of 29. 2% for DR, 5.4% for sight-threatening diabetic retinopathy ( STDR), and 1.3% for prolifrative retinopathy (PDR) in type 2 DM subjects. Of the type 2 DM subjects,0. 4% (4/445)had social blindness( VA＜0. 1 ) ,and 6. 3% (28/445) presented with visual impairment (VA ＜ 0. 3 )in bilateral eyes. Univariate Logistic regression analysis indicated that insulin therapy ( P = 0.011 ) and lower body mass index ( BMI, kg/m2 ) ( P = 0. 022 ) appeared to be significantly associated with DR, and the multivariate Logistic regression analysis demonstrated that longer duration of diabetes( P＜ 0. 01 ) , increased fasting glucose ( P ＜ 0.01 ) and lower education level ( P = 0. 031 ) were significant independent predictors of DR. Conclusion The prevalence of DR is lower among diabetic Chinese aged ≥ 40 years than those of matched population in Western countries. Lower BMI and insulin therapy were the significantly associated factors of DR, and a longer duration of disease and higher fasting glucose level are independent risk factors of DR. Education attainment is important for the DM patients as a protective factor of DR.

Cross-sectional study of visual impairment in Shunyi district of Beijing, China / 中华实验眼科杂志

Background Visual impairment influent the life quality of patient and bring about the economical burden to their families and society.Epidemiology survey of the prevalence and main causes of visual impairment is the basis of the prevention of blindness.Objective The goal of this survey was to investigate the visual impairment in the subjects aged 40 years or older living in Shunyi district and assist in the design of intervention programs.Methods A cross-sectional survey was performed in this study.Cluster sampling was used to randomly select 4549 individuals aged ≥40 years in Shunyi district,and visual impairment was evaluated based on WHO criteria and analyzed based on the 10-year interval groups.The questionnaire,best corrected visual acuity (BCVA)and comprehensive eye examination were provided for eligible residents.To evaluate the independentassociation of significant sociodemographic variables with visual impairment,a regression model was constructed including age,sex and education level.This study was approved by the Ethic Committee of Peking University Medical Department.Written informed consent was signed by each subject before any medial survey.Results A total of 4167 subjects participated in this survey with the response rate of 91.6％.The age of the subjects ranged from 40-94 years(mean:56.61±11.10 years).The numbers of visual impairment was 161 with the prevalence 3.9％.Trend x2 test showed that the number and percentage of visual impairment were elevated as the increase of age,showing a significantly difference among different age groups(x2 =159.487,P＜0.01).The prevalence rate of visual impairment in 70 and older group was 15 times more than that of 60-69-year-old group(OR =0.114,95％ CI:0.056-0.234).No significant difference was found between gender and prevalence of visual impairment(OR =0.901,95％ CI:0.627 -1.295).The prevalence rate of visual impairment in illiterate group was 5.5 fold more than that of educated group (OR =2.743,95％ CI:1.830-4.111).Conclusions Ageing and low education degree are the important factors of visual impairment.Education attainment is an independent protective factor of visual impairment.

Study of Mn2+-enhanced magnetic resonance imaging for optic visual pathway in vivo / 中华实验眼科杂志

Background Functional magnetic resonance imaging technique based on a manganese (Mn2+) tracer makes labeling the optic nerve in vivo possible.However studies on the optimal concentration and dynamic change after injection of Mn2+ are rare.Objective This study was designed to explore the time- and dose-dependent response for Mn2+-enhanced MRI of visual pathway after intravitreal injection of MnCl2.Methods Different concentrations of MnCl2(0.5,1,2,5,10,15,20,40mmol/L) with a volume of 25μl were intravitreally injected into the left eyes of 48 pigmented rabbits and were randomly divided into eight groups according to the drug concentrations.No reagent reg was injected into the right eyes as controls.MRI was performed at 4,6,8,12,24,48,96 and 168 hours after the administration of MnCl2 to examine the imaging of the optic nerve,chiasma,optic tract,lateral geniculate body and epithalamus.The signal-noise ratio of MRI in visual pathway was calculated and the optimal concentration and best imaging time after injection of MnCl2 were assessed.The use of the animals followed the Regulations for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission.Results The imaging of the optical nerve in the left eyes was enhanced in comparison with the right eyes 24 hours after injection of 0.5-1 mmol/L MnCl2 with a significant difference in SNR value between these two groups (t=1.17,t=0.95,P>0.05).24 hours after the injection of 2 mmol/L MnCl2 into the left eyes,the SNR value of the optic nerve on the left side was higher than the right side t=8.43,P0.05).The strongest imaging signal in optical nerve was seen in 24 hours after the intravitreal injection of 10-40 mmol/L MnCl2 and decayed gradually from 24 to 168 hours with a transportation speed of (3.32±0.19) mm/h in rabbit visual pathway.SNR value of optic nerve showed a positive correlation with the concentrations of MnCl2 with the regression equation Y=77.786+2.467X(F=20.102,P=0.004,R2=0.770).Conclusion Manganese-enhanced MRI is a viable method for temporospatial visualization of optic never in the pigmented rabbits.The image intensity of MRI is associated with the dose of Mn2+.

Mutation analysis of PAX6 gene in a large Chinese family with aniridia / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Mutations in PAX6 gene have been shown to be the genetic cause of aniridia, which is a severe panocular eye disease characterised by iris hypoplasia. However, there is no study to do genetic analysis of aniridia, although there are several case reports in China. Here, we describe a mutation analysis of PAX6 in a large Chinese family with aniridia.</p><p><b>METHODS</b>Genomic DNA from venous blood samples was prepared. Haplotype analysis was performed with two genetic markers (D11S904 and D11S935). Fourteen exons of the PAX6 gene were amplified from genomic DNA. Polymerase chain reaction (PCR) products of each exon were analysed by single strand conformational polymorphism (SSCP). The PCR products having an abnormal pattern were sequenced to confirm the mutation.</p><p><b>RESULTS</b>Significant evidence for allele sharing in affected patients was detected suggesting that PAX6 mutation links to aniridia in this family. An extra band corresponding to exon 9 in PAX6 was found by single strand conformational polymorphism analysis in all the aniridia patients in this family, but not detected in the unaffected members. A mutation of C to T was detected by sequencing at the nucleotide 1080 that converts the Arg codon (CGA) to the termination codon (TGA).</p><p><b>CONCLUSIONS</b>Aniridia is caused by a nonsense mutation of PAX6 gene in the large Chinese kindred. Genetic test is important to prevent the transmission of aniridia to their offsprings in the kindred by prenatal diagnosis.</p>

Level of proliferating cell nuclear antigen and interleukin-1β in rats' experimental retinal detachment / 中国康复理论与实践

@#ObjectiveTo investigate the possible effect of interleukin-1β(IL-1β)in experimental retinal detachment,and the role in proliferation.MethodsThe experimental retinal detachment and reattachment in different time were made using Sprague-Dawley rats. The expression of proliferating cell nuclear antigen (PCNA) in neuro-retina was tested with flow cytometry at different time. IL-1β in neuro-retina were analyzed by labeling with polyclonal IL-1β antibody. The level of IL-1β in neuro-retina were tested with radio-immune method. IL-1β antibody 1000 ng,IL-1Ra 20 ng were injected in the subretinal space of some rats before PCNA reached to its high point respectively,and the expression of PCNA of them were compared with that of control which were injected with 0.01 M PBS.ResultsIL-1β expressed in Muller cell,astrocyte,vascular endothelial cell in neuro-retina and reached to its peak at the 7th day after detachment,then declined and continued at a low level as long as the retina detached.The expression of PCNA began at the second day after detachment, and reached a maximum at about 10 days after,then declined and continued at a low level as long as the retina detached. IL-1βantibody and IL-1Ra could restrain the expression of PCNA.ConclusionProinflammatory cytokine IL-1β is the key factor in proliferation of experimental retinal detachment.

Expression of integrin β1 in detached and reattached retina of rabbits / 中国康复理论与实践

@#ObjectiveTo investigate the expression of integrin β1 during retinal detachment and reattachment of rabbits.Methods24 rabbits were used to make retinal detachment and reattachment model by using hyaluronidase and micropipette. The expression of integrin β1 were observed with hybridization in situ.ResultsThe expression of integrin β1 in reattached retina was lower than that in detached retina.ConclusionRetinal reattachment may inhibit the development of proliferative vireoretinopathy.

Change of IL-6 in detached and reattached retina / 中国康复理论与实践

@#ObjectiveTo determine the source of IL-6 in detached retina and the change of IL-6 level in detached and reattached retina.MethodsRetinas of SD rat were examined after subretinal injection of 1.4% Healon GV at different period of time, and the level of IL-6 in detached and reattached retina were detected by radio-immune histochemistry method. Wax-embeded sections were labeled with IL-6 antibody to determine the location of IL-6.ResultsDetached retina with normal vitreous and inner limiting membrane could only induce the subretinal fibrosis. This kind of fibrosis reached to its peak at 10th day and then remolded with time. Retinal pigment epithelial (RPE) cell, Muller cell, endothelial cell, glial cell were labled with IL-6, and the level of IL-6 in neuro-retina reached to its peak at 3rd-4th day and then downed to normal within a few days. The level of IL-6 in reattached retina was lower than in detached retina. The expression of IL-6 in RPE of detached area was stronger than in attached area.ConclusionIL-6 takes active part in wound healing process induced by the separation of RPE and neuro-retina. Reattachment can lower the expression of IL-6 in retina.