Real-world outcomes and complications of different surgical approaches for significant submacular haemorrhages

Purpose: To evaluate the outcomes and complications after different surgical management of cases with significant sumacular hemorrhage (SMH) of size more than 4 disc diameter (DD). Methods: It was a retrospective interventional study. All consecutive 103 cases of significant SMHs were treated by vitrectomy and divided into three groups. In Group A (<4 weeks, confined to the macula or extending inferiorly, n = 62), vitrectomy, subretinal cocktail of tissue plasminogen activator (tPA), antivascular endothelial growth factor, and air with SF6 gas; in Group B (4–8 weeks, extending beyond macula, n = 31), subretinal tPA followed by SMH drainage either by retinotomy (Group B?1, n = 17) or by temporal 180?degree retinectomy (Group B?2, n = 14) with silicone oil (SO) tamponade; and in Group C (>8 weeks, extending beyond macula, n = 10), SMH removal with autologous retinal pigment epithelium (RPE)?Choroid patch graft transplantations with SO tamponade were performed. Parameters evaluated were best corrected visual acuity (BCVA), Optos, optical computerized tomography, and ultrasonography as required. Results: Significant visual improvement was seen from mean preoperative to mean postoperative BCVA in Group A (P < 0.001), Group B (P < 0.001), and Group C (P < 0.001). Postoperative complications were recurrent SMH (4.84% vs 12.90% vs 10%), vitreous hemorrhage (6.45%, GroupA), hyphema (4.84% vs 12.90% vs 10%), hypotony (nil vs 3.23% vs 20%), macular hole formation (6.45%, Group A), epiretinal membrane (16.13%, Group B), and retinal detachment (3.23%, Group A and 10%, Group C). Conclusion: Surgical approaches for significant submacular hemorrhage are visually awarding, though certain specific complications may arise

Percepción subjetiva del esfuerzo, la ansiedad y la autoconfianza en jugadores de fútbol semiprofesionales / Rating of perceived exertion, anxiety and self-confidence in semi-professional soccer players

Resumen Objetivo: analizar la percepción subjetiva del esfuerzo y de los estados de ansiedad (cognitiva y somática), autoconfianza en jugadores de fútbol semiprofesionales. Método: han participado 18 jugadores españoles semiprofesionales con experiencia mínima de tres años en la categoría nacional (edad: 26.4 años, peso: 75.8 kg, altura: 181 cm) clasificados en dos porteros, tres defensas centrales, tres defensas laterales, cuatro centrocampistas, tres extremos y tres delanteros. Se analizaron 10 partidos (cinco como locales y cinco como visitantes) y se usó el cuestionario Competitive State Anxiety Inventory 2 y escala Category Ratio 10 de Borg para la percepción subjetiva del esfuerzo. Se realizó el test de análisis de la varianza de un factor (posición de juego) y t-test para muestras independientes (localización y rol). Resultados: se han obtenido diferencias significativas en estas variables psicofisiológicas en relación con las posiciones de juego, localización y rol de juego. Conclusión: en este estudio de caso, los jugadores con rol defensivo y los que juegan como visitantes tienen menor percepción subjetiva del esfuerzo y los atacantes presentan mayor ansiedad somática y autoconfianza previos a la competición deportiva.

Abstract Objetive: To analyze the rate of perceived exertion and anxiety states (cognitive and somatic), self-confidence in semi-professional soccer players. Method: 18 semi-professional Spanish soccer players with at least 3 years' experience in the national category participated (age: 26.4; weight: 75.8 kg; height: 181 cm), classified as two goalkeepers, three central defenders, three internal defenders, four midfielders, three wingers, three forwards. Ten matches were analyzed (five at home and five as visitors) and the Competitive State Anxiety Inventory 2 questionnaire and Borg's Category Ratio scale 10 for the rate of perceived exertion were used. A one-way analysis of variance test (game position) and t-test for independent samples (location and role) were performed. Results: Significant differences have been obtained in these psycho-physiological variables in relation to game positions, location, and game role. Conclusion: In this case report, players with a defensive role and those who play as visitors have lower rate of perceived exertion and attackers have higher somatic anxiety and self-confidence prior to the sports competition.

Role of Swept source optical coherence tomography in management of acute Vogt-Koyanagi-Harada’s disease

Purpose: To evaluate the role of swept?source optical coherence tomography (SS?OCT) in the management of acute Vogt–Koyanagi–Harada’s (VKH) disease. Methods: Retrospective analysis of SS?OCT images of acute VKH patients between January 2015 and February 2020 in a tertiary eye care hospital. Results: We studied 34 eyes of 17 patients with acute probable VKH disease. The mean age was 31.6 ± 10.4 years. Twelve patients were women. The mean follow?up was 17.1 ± 9.3 months. The mean visual acuity was 0.86 logMAR (Snellen equivalent: 6/45) at presentation and 0.18 logMAR (Snellen equivalent: 6/9) at the last follow?up. The mean subfoveal choroidal thickness (SFCT) was 784.97 microns at presentation, 431.40 microns at the first month of therapy, 453.94 microns at six months of therapy, and 405.83 microns at the last follow?up. Qualitative features noted on SS?OCT on presentation was subretinal fluid (SRF) in 29 (85%) eyes, subretinal hyperreflective dots in 34 (100%) eyes, subretinal septa in 33 (97%) eyes, RPE undulations in 21 (61.7%) eyes, posterior vitreous cells in 34 (100%) eyes, SRF around disc in 9 (26%) eyes, and disc swelling in 34 (100%) eyes. At the end of 1 year of follow?up, RPE undulations were absent in 30 eyes (88%) and disc swelling was notably absent in all 34 eyes (100%), though SRF around disc was noted in 4 eyes (11.7%) of 2 patients who had recurrences. Conclusion: SFCT, SRF around disc, RPE undulation, and disc swelling may be important indicators on SS?OCT to guide therapy and prognosticate recurrences in acute VKH.

Simvastatin inhibits HIF-1α and VEGF expression in RPE cells under hypoxia conditions / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the effects of simvastatin(Sim)on human retinal pigment epithelial cells(RPE-19)and the possible mechanisms <i>in vitro</i> under hypoxia. <p>METHODS: RPE-19 cells were divided into three group: control group, hypoxia group(the final concentration of CoCl2 in the medium was 125 μmol/L), and Sim treatment group(3 μmol/L Sim was added in the RPE cells' medium which contain 125 μmol/L CoCl2). After 24h, the morphology of RPE-19 cells were observed, the proliferation of cells were calculated by MTT, the secretion levels and protein expression of hypoxia-inducible factor 1-Alpha(HIF-1α)and vascular endothelial growth factor(VEGF)were detected by enzyme-linked immunosorbent assay(ELISA)and Western blotting. The expression level of autophagy protein was detected by Western blot and apoptosis was detected by TUNEL.<p>RESULTS: The morphology and activity of RPE-19 cells showed an apparent change under hypoxia. The expression of HIF-1α and VEGF protein were increased obviously in the hypoxia group and then significantly decreased after Sim treatment. Beclin1, and LC3B proteins were decreased in the CoCl2+Sim group, and the expression levels were lower than the control and CoCl2 group. Under hypoxia, Sim inhibited RPE cells' proliferation and promoted the apoptosis.<p>CONCLUSION:Sim inhibits RPE cells' proliferation, decreases HIF-1α and VEGF protein, and promotes apoptosis under hypoxia. Our results suggested that the mechanism by which Sim promoted apoptosis in RPE cells may be related to its inhibition of autophagy.

Research progress on the mechanism of epithelial mesenchymal transformation in RPE cells and the treatment of PVR / 国际眼科杂志(Guoji Yanke Zazhi)

@#Proliferative vitreoretinopathy(PVR)is a serious complication arisen from ocular trauma, diabetic retinopathy, vascular retinopathy, inflammatory retinopathy and other ocular diseases. It is also the most important reason for the failure of rhegmatogenous retinal detachment surgery, which is a great threat of visual function. A large number of studies have proved that the main risk factor for PVR is the damage of blood-retinal barrier, in which retinal pigment epithelial(RPE)cells are stimulated by cytokines in the vitreous cavity. RPE cells underwent epithelial-mesenchymal transition(EMT), which transformed into fibroblasts. The cell morphology changed, the tight junctions between cells disappeared, the cell polarity lost, and the proliferation, migration, and invasion abilities were enhanced. A contractile fibrous proliferative membrane is formed on the anterior surface or under the retina. The fibrous proliferative membrane will lead to the retina folds, pull the retina and lead to retinal detachment, which will eventually lead to vision loss or even blindness. Nowadays, plenty of studies investigating the prevention and treatment of PVR have been carried out at home and abroad. In this review, we briefly illustrated the signaling pathways related to epithelial-mesenchymal transformation in RPE cells and the treatment of PVR.

Changes in nasal septum morphology after rapid maxillary expansion: a Cone-Beam Computed Tomography study in pre-pubertal patient

ABSTRACT Introduction: Nasal septum deviation (NSD) is the most common structural cause of nasal obstruction, affecting around 65-80% of the adult population. Rapid maxillary expansion (RME) is currently used for treatment of maxillary transverse deficiency, but can also influence nasal cavity geometry. Objective: The present study aimed at evaluating the changes in NSD by using Cone-Beam Computed Tomography (CBCT) scans in pre-pubertal patients treated with RME. Methods: This retrospective exploratory study evaluated 20 pre-pubertal patients (mean age 10 ± 2 years) who were treated for transverse maxillary constriction with RME and presented mild/moderate NSD as an incidental finding. The outcome measures were NSD tortuosity and area. These measures were obtained from transverse and coronal views of records taken before and after RME treatment. Intra-rater reliability was also assessed with intraclass correlation coefficient. Results: NSD was mild in thirteen patients (65%) and moderate in seven (35%). NSD tortuosity index did not significantly change over time (mean difference 0.002 mm/year, 95% CI; p = 0.58). NSD area did not significantly change over time (mean difference 2.103 mm2/year, 95% CI; p = 0.38). Intraclass correlation coefficient was 0.73 (95% CI) for NSD tortuosity and 0.84 (95% CI) for NSD area. Conclusions: NSD tortuosity and area suggested potential changes in NSD with small clinical relevance in pre-pubertal patients who were treated with RME. Additional studies using CBCT scans in larger samples are required to clarify the role of RME in NSD treatment.

RESUMO Introdução: O desvio de septo nasal (DSN) é a causa estrutural mais frequente de obstrução nasal, afetando de 65% a 80% da população adulta. A expansão rápida da maxila (ERM), atualmente utilizada para o tratamento da deficiência transversa da maxila, também pode influenciar na geometria da cavidade nasal. Objetivos: O presente estudo teve como objetivo avaliar, usando tomografia computadorizada de feixe cônico (TCFC), as mudanças no DSN após o tratamento com ERM em pacientes pré-púberes. Métodos: Esse estudo exploratório retrospectivo avaliou 20 pacientes pré-púberes (idade média de 10 ± 2 anos) com deficiência transversa da maxila tratados com ERM, e que apresentavam DSN de leve a moderado, como um achado incidental. Foram realizadas medições da tortuosidade e área do DSN. Essas medições foram feitas em cortes transversais e coronais das TCFCs pré- e pós-tratamento com ERM. A confiabilidade intraexaminador também foi aferida por meio do coeficiente de correlação intraclasse. Resultados: O DSN era leve em 13 pacientes (65%) e moderado em 7 (35%). O índice de tortuosidade do DSN não mudou significativamente ao longo do tempo (diferença média = 0,002 mm/ano, IC 95%; p= 0,58). A área do DSN não mudou significativamente ao longo do tempo (diferença média = 2,103 mm2/ano, IC 95%; p= 0,38). O coeficiente de correlação intraclasse foi igual a 0,73 (IC 95%) para a tortuosidade do DSN e 0,84 (IC 95%) para a área do DSN. Conclusões: Os valores de tortuosidade e da área do DSN sugeriram potenciais mudanças no DSN, mas com pequena relevância clínica, nos pacientes pré-púberes tratados com ERM. Estudos adicionais utilizando TCFC em amostras maiores são necessários para esclarecer o papel da ERM no tratamento do DSN.

Curcumin alleviates LPS-induced retinal inflammation by inhibiting PI3k/Akt signaling pathway / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate whether the curcumin reduce retinal inflammation in animal model and human retinal pigment epithelium(ARPE)-19 cells.<p>METHODS: <i>In vivo</i>, male C57/B6 mice received intraperitoneal injections of curcumin for 3d before intraperitoneal injection of lipopolysaccharide(LPS; 10mg/kg)to induce retinal inflammation. 24h after LPS application, the mRNA levels of pro-inflammatory cytokines were detected by real-time PCR(RT-PCR). Concanavalin A lectin perfusion-labeling technique evaluated leukocyte adhesion to the retinal vasculature. The protein concentration in the anterior chamber was measured with a protein quantification kit. <i>In vitro</i>, ARPE-19 cells were cultured. The optimum concentration of curcumin was detected by cell counting kit-8(CCK-8)assay. Before stimulated with 5 μg/mL LPS, ARPE-19 cells were incubated with or without curcumin for 1h. Pro-inflammatory cytokines were measured by RT-PCR and ELISA. PI3K/Akt expression was analyzed by Western Blotting.<p>RESULTS: Curcumin pre-treatment led to significant inhibition of EIU-associated leukocyte adhesion to retinal blood vessels and anterior-chamber protein leakage. The mRNA expression level of inflammatory cytokines was also significantly reduced with application of curcumin <i>in vivo</i>, such as IL-1β, IL-6 and TNF-α. Meanwhile, Curcumin significantly attenuated the expression of IL-6, IL-8 and MCP-1 at both mRNA and protein levels in ARPE-19 cells. Curcumin suppressed PI3K/Akt phosphorylation as well as NF-κB activation in LPS-activated ARPE-19 cells.<p>CONCLUSION: Curcumin plays a preventive effect on LPS-induced retinal inflammation. The beneficial effect appears associated with inhibiting of the PI3k/Akt signaling pathway.

Comparação da carga de treinamento de atletas profissionais entre modos de treinos especificos do voleibol e de força / Comparison of the training load of professional athletes between modes of volleyball specific drills and strength conditioning

RESUMO O objetivo deste estudo foi comparar a carga de treinamento em três tipos de treinamentos de uma equipe de voleibol profissional.. Participaram do estudo 28 jogadores (26,6 ± 4,7 anos; 91,5 ± 8,5 Kg; 194,1 ± 6,0 cm). Foi realizada uma análise descritiva de 29 sessões de treino técnico, 84 tecnico-tático e 75 de musculação e isoladamente das variáveis que compõem a carga de treinamento, PSE e o tempo de duração da sessão, posteriormente sendo reunidos em média e desvio padrão de acordo com tipo de treino. Para análise dos dados foi adotado o teste de Shapiro-Wilk e em seguida aplicou-se o teste Anova Two-Way com o Post Hoc de Tamhane e também foi utilizado o tamanho do efeito para análise das comparações. Os resultados demonstraram respostas significativas e grande tamanho de efeitos quando comparados técnico e técnico-tático com a musculação na carga interna de treinamento TxM (TE=1,2: grande; p= 0,002); TTxM (TE=1,3: grande; p= 0,001) e no tempo de duração da sessão TxM (TE=1,7: grande; p= 0,001); TTxM (TE=2,0: grande; p= 0,001), já a PSE da sessão apresentou apenas uma diferença sigifcativa TTxM (TE= 0,8: moderado; p= 0,001). Os estímulos de treinamentos específicos de quadra como técnico e técnico-tático promoveram maior carga interna nos atletas do que o treino de força, através principalmente pela influencia da variável tempo de duração da sessão que refletiu a carga externa.

ABSTRACT The aim of this study was to compare the training load in three types of training of a professional volleyball team. Participants were 28 players (26.6 ± 4.7 years, 91.5 ± 8.5 kg; 194.1 ± 6.0 cm). A descriptive analysis of 29 technical training sessions, 84 technical-tactical training sessions and 75 training sessions, and of the variables that compose the training load, PSE and the duration of the session were performed, and were then collected on average and standard deviation according to with type of training. To analyze the data, the Shapiro-Wilk test was adopted, and then the Anova Two-Way test was applied with Tamhane's Post Hoc and the effect size was also used for analysis of the comparisons. The results demonstrated significant responses and a large effect size when compared to technical and tactical-to- strength training (T = 1.2: large; p = 0.002); TTxM (TE = 1.3: large, p = 0.001) and the duration of the session / external load in the TxM training (TE = 1.7: large; p = 0.001); TTxM (TE = 2.0: large, p = 0.001), whereas the PSE of the session showed only a sigifcant difference TTxM (TE = 0.8: moderate; p = 0.001). The stimuli of specific training of court as technician and technician-tactician promoted greater internal load in the athletes than the strength training, mainly through the influence of the variable time of the session that reflected to external load.

In Search of a Performing Seal: Rethinking the Design of Tight-Fitting Respiratory Protective Equipment Facepieces for Users With Facial Hair

BACKGROUND: Air-purifying, tight-fitting facepieces are examples of respiratory protective equipment and are worn to protect workers from potentially harmful particulate and vapors. Research shows that the presence of facial hair on users' face significantly reduces the efficacy of these devices. This article sets out to establish if an acceptable seal could be achieved between facial hair and the facepiece. The team also created and investigated a low-cost “pressure testing” method for assessing the efficacy of a seal to be used during the early design process for a facepiece designed to overcome the facial hair issue. METHODS: Nine new designs for face mask seals were prototyped as flat samples. A researcher developed a test rig, and a test protocol was used to evaluate the efficacy of the new seal designs against facial hair. Six of the seal designs were also tested using a version of the conventional fit test. The results were compared with those of the researcher-developed test to look for a correlation between the two test methods. RESULTS: None of the seals performed any better against facial hair than a typical, commercially available facepiece. The pressure testing method devised by the researchers performed well but was not as robust as the fit factor testing. CONCLUSION: The results show that sealing against facial hair is extremely problematic unless an excessive force is applied to the facepiece's seal area pushing it against the face. The means of pressure testing devised by the researchers could be seen as a low-cost technique to be used at the early stages of a the design process, before fit testing is viable.

Study on the relationship between the expression of IL-1β and IL-6 by retinal pigment epithelium cells and cellular autophagy / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To investigate the role of cellular autophagy in the expression of IL-1β and IL-6 by retinal pigment epithelium(RPE)cells under hypoxia.<p>METHODS: A cultured human RPE cell line was randomly divided into the hypoxia group, 3-methyladenine(3-MA)+ hypoxia group, chloroquine(CQ)+ hypoxia group and the control group. Cells incubated in a hypoxic incubator were set as the hypoxia group. After culture for 24h, western blot was used to analyze the relative expression of autophagy-associated key proteins in each group, including microtubule associated protein 1 light chain 3B(LC3B), Beclin-1 and p62. Then, ELISA was applied to detect the concentration of IL-1β and IL-6 in the cell culture supernatants.<p>RESULTS: The concentration of IL-1β and IL-6 in the hypoxia group was significantly higher than that in the control group 3-MA+hypoxia group and CQ+ hypoxia group(all <i>P</i><0.01). The relative expression of LC3B-II/I and Beclin-1 in the hypoxia group was significantly higher than that in the control group and 3-MA+hypoxia group. The relative expression of LC3B-II/I in the hypoxia group was significantly lower than that in the CQ+ hypoxia group(all <i>P</i><0.01). The relative expression of p62 in the hypoxia group was significantly lower than that in the control group, 3-MA+hypoxia group and CQ+ hypoxia group(all <i>P</i><0.01).<p>CONCLUSION: Hypoxia can enhance the expression of LC3B-II/I and Beclin-1 in RPE cells, weaken the expression of p62, and promote the secretion of IL-1β and IL-6. Autophagy inhibitors 3-MA and CQ can reduce the expression of IL-1βand IL-6 in RPE cells.

Effects of lutein on transforming growth factor-β2 induced epithelial-mesenchymal transition in ARPE-19 cells / 上海交通大学学报（医学版）

Objective • To establish the transforming growth factor-β2 (TGF-β2) induced epithelial-mesenchymal transition (EMT) model of retinal pigment epithelium cells, and investigate the effect and mechanism of lutein on EMT. Methods • ARPE-19 cells were cultured and divided into 4 groups including control group, TGF-β2 group, TGF-β2+lutein group and lutein group. The mRNA levels of α-smooth muscle actin (α-SMA), fibronectin (FN) and E-cadherin were analyzed by real-time PCR. The protein expression of α-SMA, FN and occludin were assayed by Western blotting. Immunofluorescence was used to detect the change of α-SMA. Meanwhile, Western blotting was performed to detect the expression levels of pSmad3 in the TGF/Smad signaling pathway. Results • TGF-β2 induced EMT was inhibited by lutein. Lutein decreased the mRNA and protein levels of the mesenchymal markers α-SMA and FN, and increased the expression of the epithelial markers E-cadherin and occludin (all P<0.05). Immunofluorescence showed that lutein can inhibit the conversion of epithelial cells into myofibroblasts. Lutein significantly downregulated the high expression of pSmad3 in TGF-β2 treated ARPE-19 cells (P=0.001). Conclusion • Lutein inhibits TGF-β2 induced EMT by downregulating the expression of pSmad3 in TGF-β/Smad signaling pathway, indicating it may attenuate subretinal fibrosis.

Progress in research on LCA2 gene therapy / 国际眼科杂志(Guoji Yanke Zazhi)

@#Leber's congenital amaurosis(LCA)is a genetic eye disease that can cause blindness. Infants with LCA may have a severe low vision or loss of vision at the early stage. The LCA2 type of this disease is related to RPE65 mutation. According to previous studies, there is no effective treatment for genetic retinal diseases including LCA2. In recent years, with the advances in gene therapy technology, great progress in the treatment of genetic retinal diseases has been made, among which the most successful one is the gene therapy of LCA2. This paper briefly introduces the development of the gene therapy of LCA2, and reviews the correlation between age and injection type, dosage, injection method, measuring method as well as therapeutic effect and the stability of therapeutic effect in previous clinic trials, which provides reference and clinical treatment experience for the clinical application of the gene therapy of LCA2 in China.

Comparisons of recovery, external and internal load by playing position and match outcome in professional soccer

AIMS: To compare the internal and external load and the recovery by playing position and the match outcome (wins, losses or draws) in professional soccer. METHODS: 23 male professional soccer athletes from a team of the first division of the Brazilian Championship took part into the study (age 26.1 ± 3.8 years old, weight 77.5 ± 5.0 kg, height 177.6 ± 5.1 cm). During the games, athletes were monitored by GPS and the variables of external loads were taken. Additionally, the session rating of perceived exertion (session RPE) and the perceived recovery scale (PRS) were collected 30 minutes and 40h after the end of the matches, respectively. RESULTS: The external load was greater on full-backs and defense midfielders (p<0.05). The full-backs cover higher total distances compared to attackers, and, compared to all the others positions, they have more stimuli > 20 km/h, covering higher distances >20 km/h; these stimuli makes them to perceive less recovered than defenders, defense and attack midfielders (p<0.05). Moreover, the defenders are those who cover lower distances by the minute and the defense midfielders are those who present the lower Peak Velocity (p<0.05). There were no significant differences between GPS variables, internal load and recovery. In addition, it was found a correlation between the external and the internal load (r=0.66; p=0.001). CONCLUSIONS: The GPS variables and the perceived recovery are influenced by the playing position, but not by the match outcome.(AU)

Monitoring the training intensity and recovery with a psychometrics approach: a gender comparison with young athletes

AIMS: The purpose of present study was verify if the RPE-training session differs between females and males during the track and field training and if biological maturity (BM) has interference on this response. METHODS: Seventy-five athletes (13-15 years old) have participated of study, with 38 male 37 female. Five training sessions of track and field were prescribe and monitoring by RPE-training session (intensity) and Total Quality Recovery (TQR) (recovery). RESULTS: There was no statistical difference between males and females on 75-meters run, long jump and shot put. Otherwise, for training of 250 and 1000-meters females related higher RPE-values than males 3.68 ± 0.79, 3.26 ± 0.56, p < 0.01 and 4.14 ± 0.94, 3.72 ± 0.89, p < 0.05; respectively. Even when controlling the effect of biological maturity the same results were observed to 250-meters F1,73 = 2.060; p = 0.002 and 1000-meters F1,73 = 0.997; p = 0.036. There was no difference for TQR between genders. CONCLUSION: The comparison the RPE-training session of females and males indicated there were difference to 250 and 1000-m training sessions, females have more RPE-training sessions than males. Additionally, there were no differences between genders for recovery parameters, even controlling BM.(AU)

Some aspect of diagnosis and type of clinical management and risk factors of age-related macular degeneration / Шинэ санаа Шинэ нээлт

Age-related macular degeneration (AMD) is the leading cause of severe visual loss in people aged 50 years or older. It estimates that 25-35 million people lost vision due to AMD in the world. Rapid increase of aging population, 33.2 million people was affected by AMD in 1994and there is estimation the number will reach 80 million by 2050. Prevalence of disease is different in countries it relates due to aging population and the ratio is higher in developed countries. The risk factors of AMD; race, nationality, life style, cigarette smoking, alcoholconsumption, UV exposure, diet, vitamin or food supplements consumption, drugs and high blood pressure. This study was to evaluate risk factors in age related macular degeneration because cigarette smoking, alcohol consumption and high blood pressure are high among elder Mongolians. Introduction of Optical Coherent Tomography /OCT/ in ophthalmology enables us to early diagnose and prevention. It will be basic data for developing AMD prevention policy and improving methods of diagnosis and management.

Decreased VEGF-A and sustained PEDF expression in a human retinal pigment epithelium cell line cultured under hypothermia

BACKGROUND: Previous reports have described a decrease in retinal temperature and clinical improvement of wet age-related macular degeneration (AMD) after vitrectomy. We hypothesized that the retinal temperature decrease after vitrectomy plays a part in the suppression of wet AMD development. To test this hypothesis, we evaluated the temperature dependence of the expression of vascular endothelial growth factor-A (VEGF-A) and in vitro angiogen-esis in retinal pigment epithelium (RPE). RESULTS: We cultured ARPE-19 cells at 37, 35, 33 and 31°C and measured the expression of VEGF-A, VEGF-A splicing variants, and pigment epithelium-derived factor (PEDF). We performed an in vitro tube formation assay. The dehydrogenase activity was also evaluated at each temperature. Expression of VEGF-A significantly decreased with decreased temperature while PEDF expression did not. VEGF165 expression and in vitro angiogenesis also were temperature dependent. The dehydrogenase activity significantly decreased as the culture temperature decreased. CONCLUSIONS: RPE cultured under hypothermia that decreased cellular metabolism also had decreased VEGF-A and sustained PEDF expression, creating an anti-angiogenic environment. This mechanism may be associated with a beneficial effect after vitrectomy in patients with wet AMD.

Surgically assisted rapid palatal expansion with tent screws and a custom-made palatal expander: a case report / 대한악안면성형재건외과학회지

Rapid palatal expansion(RPE) with the tooth-born appliance is not sufficient to apply to the patients with periodontal problem or insufficient tooth anchorage, and it leads to tipping of the anchorage teeth and increasing teeth mobility and root resorption. To avoid these disadvantages, we present the case using palatal screws and custommade palatal expander. A 23-year-old patient underwent surgically assisted rapid maxillary expansion with the Hyrax expansion using 4 tent screws. The study models were used to measure the pre-/-post surgical width of the anterior and posterior dental arches with a digital sliding caliper. In the result, the custom-made palatal expander with 4 tent screws is suitable for delivering a force to the mid-palatal suture expansion. And it is low cost, small sized and simply applied. The results indicated that maxillary expansion with the custom-made palatal anchorage device is predictable and stable technique without significant complications in patients.

The research status of preclinical animal experiments of gene therapy for Leber congenital amaurosis / 中华实验眼科杂志

Leber congenital amaurosis (LCA) is extremely severe hereditary retinal dystrophy,because it leads to congenital bilateral blindness in early childhood.With the development of molecular genetics and the therapeutic gene replacement technology,gene therapy clinical trials have obtained exciting results on the basis of relatively satisfied with preliminary clinical experimental results by adeno-associated virus (AAV) vector-mediated gene therapy in the past decade.These researching methods include intravitreal injection and subretinal space injection of gene vector,and the investigating indexes include evaluations of visual function and safety,such as immune reaction of the animals,ocular histopathological change,complications and bio-distribution of gene sequence.The preliminary success of the LCAⅡ Ⅱ gene therapy will give some clues to the other inherited retinal diseases.This review focuses on the present status of pre-clinical animal experiments of its gene therapy.

Long-Term Observation of Retinal Pigment Epithelial Tear after Anti-VEGF Treatment for Age-Related Macular Degeneration

PURPOSE: To evaluate the long-term clinical outcomes of retinal pigment epithelium (RPE) tears after intravitreal injection of anti-vascular endothelial growth factor (VEGF) agent for the treatment of neovascular age-related macular degeneration (AMD). METHODS: The authors performed a retrospective chart review of 13 eyes of 13 patients who developed RPE tears after intravitreal anti-VEGF injection between February 2009 and June 2013. We investigated continuation of the treatment after tear, visual acuity, presence of cystoid macular edema, and central macular thickness (CMT) using optical coherence tomography (OCT) before and after treatment and visual outcomes depending on foveal sparing. RESULTS: After RPE tear, 12 of 13 patients continued injection of an anti-VEGF agent. The average number of injections was 6.08 +/- 5.18. Mean visual acuity immediately after tear was 1.65 +/- 0.8 log MAR, and that at the last visit was 1.82 +/- 0.88 log MAR. Nine eyes with macular edema in OCT continued receiving injection, and improvement of macular edema was observed in four eyes at the final visit. The final visual acuity of patients with foveal involvement was 2.17 +/- 0.49 log MAR, which was worse than the 1.51 +/- 1.06 log MAR in patients without foveal involvement, although the difference was not significant (p = 0.295). CONCLUSIONS: When anti-VEGF injections were continued after RPE tear, no improvement in visual acuity was observed, although better anatomical outcomes did result. Patients with foveal involvement had worse visual acuity than patients without foveal involvement, but the difference was not significant.

Comparação de diferentes métodos de controle da carga interna em jogadores de voleibol / Comparisson of different methods of internal load control in volleyball players

INTRODUÇÃO: A capacidade de monitorar precisamente a carga de treinamento é um importante aspecto para a efetividade da periodização e para a prevenção de efeitos negativos, como a queda no rendimento. OBJETIVOS: Comparar e correlacionar diferentes métodos de controle de carga interna de treinamento em jogadores de voleibol. MÉTODOS: Quinze atletas profissionais de voleibol do sexo masculino, com idade entre 18 e 30 anos, que competiam em níveis estaduais e nacionais, participaram deste estudo. A carga de treino para cada sessão foi calculada utilizando três diferentes métodos: PSE da Sessão, Zonas de FC (TRIMP) de Edwards e de Stagno. RESULTADOS: Verificou-se que há correlação positiva e significativa entre o método proposto por Foster, Edwards e Stagno. No entanto, os valores das correlações individuais entre PSE e Edwards (0,451 a 0,670), em geral, foram ligeiramente maiores que os da correlação entre PSE e Stagno (0,206 a 0,597). CONCLUSÃO: O método proposto por Edwards, bem como o método proposto por Foster, melhor refletem as cargas de treino no voleibol, fazendo com que o monitoramento das cargas seja realizado de maneira mais fidedigna e confiável quando realizado por esses dois métodos.

INTRODUCTION: The ability to accurately monitor training loads is an important aspect of athlete effectiveness and the prevention of negative effects, such as performance decrease. OBJECTIVES: Compare and correlate different methods for controlling internal training loads in volleyball players. METHODS: Fifteen male volleyball athletes between 18 and 30 years old who compete at state and national levels, participated in this study. Training load for each session was calculated using three different methods: RPE/Foster, HR zones (TRIMP) Edwards and Stagno. RESULTS: It was observed that there is positive and significant correlation between the method proposed by Foster and Edwards and Stagno. However, the values of individual correlations RPE x Edwards (0.451 to 0.670), in general, were larger than RPE x Stagno (0.206 to 0.597). CONCLUSION: The method proposed by Edwards, as well as the method proposed by Foster, better reflect the training loads in volleyball, making it more reliable to control them that the method proposed by Stagno.