ABSTRACT
Aging is often accompanied by age-related cataract and concurrent degeneration in brain function and structure.Restoration of vision after cataract surgery not only improves visual function, but also affects brain function and structure.Cataract surgery can enhance the effective transmission of blue light by intrinsically photoreceptive ganglion cells, and increase the secretion of melatonin in vivo, thereby regulating biological rhythm and improving the cognitive level of patients.Melatonin can activate its related molecular pathways, such as Reelin, Notch signaling, etc., affecting the accumulation and deposition of β-amyloid protein, reducing neuronal apoptosis, and playing an important role in a variety of neurodegenerative diseases.Although clinical studies have confirmed that vision restoration after cataract surgery can partially reverse the decline in brain function and structure, the molecular mechanisms involved remain unclear.Based on the eye-brain relationship, this paper reviewed and discussed the effects of vision restoration after cataract surgery on brain function and structure and the potential molecular mechanism, so as to provide new ideas and methods for brain remodeling.
ABSTRACT
Objeetive To analyze the effect of treatment of rhegmatogenous retinal detachment(RRD) by scleral bucking as well as the relative risk factors affecting the anatomical reattachment and visual recovery.Methods One hundred and fortyeight patients (148 eyes) with RRD treated by sclera buckling surgery in our hospital during January 2012 to January 2016 were retrospectively analyzed.The rate of postoperative retinal anatomic reattachment,the best corrected visual acuity (BCVA) and complications were observed.Logistic regression analysis was performed to analyze the correlative factors affecting the anatomical reattachment and postoperative vision restoration.R~ults Retinal reattachment achieved in 91.9％ after initial surgery and the final success rate for anatomic reattachment was 97.3％ assessed with ophthalmoscope and fundus photography.But these two rates were assessed with the optical coherence tomography (OCT) were 60.1％ and 80.4％ respectively.Single factor Logistic regression analysis showed that retinal detachment was affected by multiple breaks and Grade C1 PVR(all P ＜0.05);Single factor Logistic regression analysis showed that preoperative BCVA,course of disease,retinal detachment range,macular involvement or not had an impact on the postoperative recovery of BCVA (all P ＜ 0.05),preoperative age,refractive status,releasing retinal fluid or not,intravitreal gas injection,combined scleral buckling,and postoperative subretinal fluid,all of these factors had no effect on BCVA recovery after surgery (all P ＞ 0.05).And through multiple factors Logistic regression analysis,preoperative BCVA was an independent risk factor for BCVA recovery after surgery (P ＜ 0.05).Conclusion Scleral bucking is an effective technique for managing RRD,but multiple breaks and Grade C1 PVR are significant risk factors for anatomic.Preoperative BCVA,course of disease,retinal detachment range,macular involvement or not have the impact on the BCVA recovery after scleral buckling,and the preoperative BCVA is the key factor.Early diagnosis and early treatment as well as protecting the preoperative visual acuity can improve prognosis.