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AIM: To evaluate the efficacy of high-intensity focused ultrasound cyclo plasty(UCP)in the treatment of glaucoma and to investigate related influencing factors.METHODS: The study involved a total of 110 patients(134 eyes)who received UCP treatment between January 2019 and January 2022 at three medical centers: Tianjin Eye Aier Eye Hospital, Chongqing Aier Eye Hospital, and Chongqing Nanping Aier Eye Hospital. Patients were classified into three categories: primary angle-closure glaucoma, primary open-angle glaucoma, and secondary glaucoma. Best corrected visual acuity, intraocular pressure, and the usage of anti-glaucoma medications, etc., were recorded at 6 and 12 mo postoperatively.RESULTS: After 6 months of the UCP procedure, statistically significant differences in intraocular pressure were observed across all groups(all P<0.05). At 12 mo postoperatively, intraocular pressure of the primary angle-closure and primary open-angle glaucoma groups showed differences(all P<0.05). Notably, there were no significant changes in visual acuity at either the 6 or 12 mo compared to preoperative values across all patient groups(all P>0.05). Furthermore, the study identified a statistically significant correlation between the changes in intraocular pressure at 6 mo and factors such as age, history of previous glaucoma surgery, baseline white-to-white(corneal diameter), and the extent of UCP treatment(all P<0.05).CONCLUSION: The UCP procedure has been demonstrated to effectively lower intraocular pressure in patients with glaucoma. The efficacy appears to be influenced by variables including patient age, previous glaucoma surgery history, baseline white-to-white(corneal diameter), and the scope of UCP treatment. Importantly, UCP treatment did not adversely affect visual acuity, underscoring its favorable safety profile.
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Objective To compare the clinical efficacy and safety following the topical application of pazufloxacin mesylate eye drops with levofloxacin eye drops (LOFX) for bacterial conjunctivitis.Methods A multicenter,randomized,investigator-masked,parallel-controlled clinical trial was performed.Five hundred and twenty eyes of 520 patients with bacterial conjunctivitis were enrolled from March to October 2008 in seven ophthalmic centers in China.The patients were randomized into trial group and control group in 3 ∶ 1 ratio with the 390 eyes in the trial group and 130 eyes in the control group.Pazufloxacin mesylate eye drops was topically used 4 times per day for consecutively 7-14 days in the trial group,and levofloxacin eye drops was used in the same way in the control group.Microbiological cultures for conjunctiva sac secretions and drug sensitive test were carried out before and at the end of the administration of eye drops.The signs and symptoms were observed and scored before treatment and 0,3,7 and 14days after treatment.The adverse events following the administration of the eye drops were evaluated and compared.Results The intention to treat analysis (ITT) showed that the cure rate was 59.38％ in the trial group and 60.47％ in the control group,with the effective rate 88.80％ and 86.05％,respectively,with an insignificant difference between the two groups (x2 =0.12,P =0.72).The clinically evaluable analysis (CE) exhibited that the cure rates were 63.48％ in the trial group and 63.87％ in the control group,with the effective rate 92.46％ and 88.24％,whichwas not significantly different between them (x2 =0.54,P=0.46).The modified-ITT analysis (mITT) showed that the cure rates were 60.57％ in the trial group and 62.07％ in the control group,with the effective rate 90.32％ and 88.51％,without significant difference between the two groups (P＞0.05).Based on microbiologically evaluable analysis (ME),the clinical cure rates were 63.71％ and 63.41％ in the trial group and control group,and the effective rates were 93.44％ and 90.24％,respectively.There was no significantly difference between the both groups (P＞0.05).In the trial group and control group,the bacterial eradication rate was 89.42％ and 90.80％ based on ITT,90.11％ and 92.77％ based on CE,respectively.There was no significant difference in incidences of adverse events following the administration of the drug between the trial group and control group,including ocular tolerance,burning sensation,pricking and itching (P =0.34).Conclusions The effectiveness and adverse response were resemble between Pazufloxacin mesylate eye drops and LOFV following the topical application for bacterial conjunctivitis,which indicate that Pazufloxacin mesylate eye drops is effective and safe.
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Objective To select the aptamer to an extracellular soluble fragment of recombinant human TGF-? receptor Ⅱ (TGF-? RⅡ) in order to antagonize TGF-? effectively by using systematic evolution of ligants by exponential enrichment (SELEX). Methods Initial random RNA library was transcripted in vitro from ssDNA 5′-TAATACGACTCACTATAGGGAGGACGATGCGG-N60-CAGACGACTCCCCGA-3′; rhTGF-? RⅡ was used as target protein. Totally,selection of 8 times was carried out in SELEX experiment. Membrane binding assay was performed to detect the evolution of enriched RNA library; Electrophoretic mobility shift assay (EMSA) was done to determine the affinity between the selected nucleic acid sequence and TGF-? RⅡ. Results Evolution of the enriched RNA library along the increased affinity to TGF-? RⅡ was observed with the development of selection. Two types of dominant sequences were isolated and named as sequence A and sequence B. In membrane binding assay,both sequences A and B showed obvious affinity to TGF-? RⅡ. However,no retarded bands were seen in EMSA. Conclusion The affinity of sequences A and B to TGF-? RⅡ is beyond satisfaction. However,possible sequences with improved affinity to TGF-? RⅡ can be selected by post-SELEX on the basis of candidate sequences A and B.
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Objective To investigate the changes of retinal ganglion cells (RGCs) exposed to hypoxia and the mechanism. Methods RGCs were isolated from the retina of neonatal Long Evans rats aged 1 day and cultured, then divided into normal control group and hypoxia group (cultured in incubator containing 1 O_2, 5 CO_2 and 94 N_2). At 1, 3, 12 and 24 h after incubation, the calcium ion level by laser scanning confocal fluorescence microimaging system, the activity of SOD and the content of MDA by biochemistry technology, TNF-? by ELISA were detected. Results No changes of calcium ion level in RGCs were observed in normal control group. The calcium ion level increased significantly in the hypoxia group (P
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Objective To explore the clinical therapeutic methods for secondary glaucoma induced by the migration of silicone oil into the anterior chamber.Methods Totally 26 cases of such secondary glaucoma,including 22 aphakic eyes and 4 phakic eyes were subjected.Silicone oil was directly taken out for the patients whose retina was reposited well after silicone oil injection for over 3 months.The aphakic patients underwent 6 o'clock position peripheral iridectomy with laser or operation on prone position,then silicon oil was reinjected,and trabeculectomy was carried out through inferior cornea.The phakic patients received silicone oil aspiration with Healon from the anterior chamber.When silicone oil remigrated into the anterior chamber,the crystal was resected,silicone oil was reinjected,and 6 o'clock position peripheral iridectomy were performed.The patients were followed up for 3 months after the intraocular pressure(IOP) reaching normal range.Results Except one patient gave up treatment,all the patients had stable and normal IOP after 3 months of follow-up.IOP was controlled through different methods in 21 aphakic eyes:5 with prone position,5 with 6'clock position peripheral iridectomy through laser or operation,4 with silicon oil reinjecting,2 with direct aspiration of silicone oil,and 3 with trabeculectomy under cornea.IOP was controled in all of phakic eyes:3 with Healon aspiration of silicone oil,1 with crystal resection and reinjection of silicone oil.Conclusion Secondary glaucoma induced by migration of silicone oil into the anterior chamber can be satisfactorily treated by many ways.
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Objective To study the safety and effectiveness of anterior chamber paracentesis,combined with antiglaucomatous medications,in the intraocular pressure control and relief of symptoms of acute primary angle-closure glaucoma(PACG).Methods Totally 327 patients with first attack of acute PACG who were admitted in our hospital during July 2000 and October 2006 were collected in this study,and were divided into 2 groups according to whether receiving anterior chamber paracentesis or not(paracentesis group and control).Their clinical data such as sex,age,intraocular pressure(IOP) and visual acuity before hospitalization,types and times of administration of IOP drugs before and after operation,preparative time for operation and postoperative complications were retrospectively analyzed.Results There were 94 out of 327 patients receiving anterior chamber paracentesis,who had faster intraocular pressure control(2.37?1.63 d vs 2.75?2.01 d),and lesser types and dosages and shorter times of IOP drugs,shorter therapeutic time after paracentesis,shorter time to prepare operation,lesser postoperative complications [shallow anterior chamber,12 cases(12.77%) vs 57 cases(24.46%)] and better visual acuity than control.Anterior chamber paracentesis more than one time didn't increase the risk of complications.Conclusion Anterior chamber paracentesis is safe and effective in controlling the intraocular pressure and eliminating symptoms in acute PACG.
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The ophthalmological teaching of clinical laboratory and preventive medicine specialty should base on their own characteristics,and the teaching reform must be conducted form the four aspects of material,outline,practice and test to adapt to the demands of society development.
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Objective To investigate the clinical characteristic and risk factors of corticosteriod-induced ocular hypertension after vitreoretinal surgery.Methods Retrospective analysis was made based on the clinical data of 866 patients,including 126 corticosteriod-induced ocular hypertension(89 male,37 female,age range 9-70 years old) after vitreoretinal surgery during May 2002 to May 2005.Results All cases used glucocorticoid locally or systemically.Multi-variance logistic analysis showed that male,complicated vitreoretinal surgery,longer hospital stay,therapeutic duration with glucocorticoid,cataracta were the independent predictive factors,while myopia,hypertension,diabetes were not closely related to corticosteroid-induced ocular hypertension.Conclusion The incidence of corticosteriod-induced ocular hypertension after vitreoretinal surgery was 14.55%.The important factor leading to ocular hypertension is long-term application of glucocorticoid.
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Objective To evaluate the therapeutic effect of phacoemulsification for complicated cataract secondary to uveitis. Metho ds Twenty-one eyes of 19 patients with complicated cataract secondary to uveitis were emulsified in situ frature technique after blunt separation of iris posterior synechiae, excision of organized membrane with scissors and st retching pupil. Results The visual acuities with correction on e week after operation was≥ 0.5 in 16 eyes (76.2%), and ≥0.2 in 18 eyes (85.7% ). The major complications were iris damage and corneal edema. No rupture of pos terior capsule and corneal decompensation were found. After operation, a round p upil was obtained in 19 eyes (90.5%) and an irregular pupil in 2 eyes (9.5%).Conclusion This operation is suitable for complicated cataract se condary to uveitis, and worth to popularize due to the minimization of iris dam age and postoperative inflammation in the anterior chamber, good visual acuity r ehabilitation earlier.
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Objective To observe the effect of ciliary neurotrophic factor (CNTF) with different concentrations on the growth and survival of rats' retinal ganglion cells (RGC) in vitro. Methods The retinae of 15 Wistar rats which were 2 or 3 days after birth were dissociated into cell suspension with 0 05% trypsin digestion. After 3 days, cultured RGC were identified with immunohistochemistry method using anti-rat Thy-1.1 monoclonal antibody. Cultured RGC were divided into the 10, 20, 40 ng/ml CNTF group (Ⅰ,Ⅱ, and Ⅲgroup) and the control group respectively. The duration of living RGC was recorded. After 3, 5 and 7 days, the A value of living cells was tested by methylthio-tetrazole colorimetric microassay. Results The result of immunohistochemical examination showed that 90% of living cells cultured for 3 days were RGC. No protuberance or volume increase of RGC were observed in CNTF groups and the control group. The duration of the living RGC was prolonged 3 to 4 days in CNTF groups compared with the control group. The A values of living RGC at the 5th and 7th days in the CNTF groups and the control group were: 0.075 8?0.013 9 and 0.069 3?0.011 3 in I group, 0.0902?0.011 4 and 0.082 5?0.0125 in Ⅱ group, 0.079 2?0.013 3 and 0.065 3?0.008 6 in Ⅲ group, and 0.062 0?0.007 1 and 0.051 3?0.006 8 in the control group, respectively. The differences between the simultaneous CNTF and control group were significant (between Ⅱ group and the control group: P
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Objective To observe the early ultrastructural changes of the optic nerves after the brain impact injury. Methods Eighteen 15-week-old Wistar rats were used in the air-pressure brain impact injury examination. All of the rats underwent the procedures of right-parietal-bone fenestration after abdominal cavity anesthesia with 1% sodium pentolbarbital (45 mg/kg), and then they were divided randomly into 3 groups, i.e., mild injury group (8 rats) underwent with 7 kg of air pressure in distance of 11 cm; severe injury group (8 rats) with 7 kg of airpressure in distance of 8 cm; and control group (2 rats) underwent with the parietal-bone fenestration but without impact injury.The ultrastructural changes of the optic nerves were observed 1, 6, 24, and 72 hours after the injury by electron microscopy. Results The difference of ultrastructural changes of optic nerve was not obvious in wild injury group and the control group, and the lanthanum nitrate was only found in the blood vessels in optic nerve. The lanthanum nitrate entered the nerve stroma 1 hour after severe and increased as time goes on. Simultaneously, displayed dilatation of endoplasmic reticulum, cavitation and tumefaction of mitochondrion, vacuolation of nerve stroma, and vacuolation of some axis-cylinder were seen in the glial cells. Conclusion The brain impact injury may cause ultrastructural changes of the optic nerve and increase of permeability of blood vessels.
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Objective To observe the content of thromboxane (TXA 2) and prostacyclin (PGI 2) in optic nerves after forehead impact injury. Methods The right forehead zones of 32 rabbits were struck by biology impact machine. Tweenty four rabbits that had afferent papillary defect after injury were chosen, and randomly divided into four groups: 1 day, 2, 4, and 7 days group. Right eyes were in the experimental group and left eyes were in the control group. Flash visual evoked potentials were examined before and after the traumatic injury. The rabbits′ eyes were removed, the optic nerves were pathologically examined, and the content of TXB 2 and 6 Keto PGF 1? which were the products of TXA 2 and PGI 2 were assayed 1, 2, 4, and 7 days after traumatic injury respectively. Results Histopathological examination revealed the findings of injuries of optic nerves of all the 24 rabbits. The latency of wave P 1 was significantly delayed after traumatic injury ( P
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The pathogenesis of the primary open angle glaucoma(POAG)has not been understood completely,but the genetic factors been generally considered as an important role in POAG's development.Maping the disease-causative gene by linkage analysis at POAG family that consistent with Mendelian feature of autosomal dominant inheritance,two POAG families located in Chongqing Zhongxian county were studied at the same time by the Da-Ping Hospital of the third Military Medical College and Human Molecular Biology and Genetics Laboratory of Sichuan Provincial People's Hospital.The disease-causative gene for POAG at two families were mapped to chromosome 2p1S-p16 that is overlapped by the Glaucoma 1,openangle,H(GLC1H)locus for adult-onset POAG by Suriyapperuma SP,etc,in 2007.The locus was first found in Chinese,but age of patients were younger and patient's conditions more serious.Haplotype analysis in these two families demonstrated that they shared the same disease haplotype,suggesting they have inherited the mutation fiom a common founder.Even more exists OPTN and CYP1B1 gene mutation at family Li.It was possiblly related to their severity phenotype.
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There are more simply and practicable using new definition and classification guide to treat angle-closure glaucoma in clinic.Closely follow up and selectively use iridotomy can deal with primary angle-closure suspects(PACS).According to mechanisms and characteristics of the angle-closure,different therapy may be given to acute primary angle closure(APAC)and chronic primary angle closure(CPAC)patients.Choosing medication or laser/surgery or both treat primary angle-closure glaucoma(PACG)on the basis of optic nerve damaged and target IOP.
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Objective To observe and compare the accurate dynamic changes of types Ⅰ, Ⅲ, Ⅴ, and Ⅵ collagens in the wound healing processes of the rabbit cornea undergoing laser epithelial keratomileusis (LASEK) or photorefractive keratectomy (PRK) and to investigate the possible mechanisms of corneal haze and myopic regression. Methods New Zealand White rabbits were divided into 8 groups: normal control group (n=6), 1, 7 d, and 1, 3, 4, 5, and 6 month groups (n=14). Every rabbit underwent LASEK in one eye while the other one with PRK. We used Western blot analysis to compare the wound healing process of dynamic changes of types Ⅰ, Ⅲ, Ⅴ, and Ⅵ collagens in the rabbit cornea at every time point. The results were analyzed with data analysis software. Results Western blot analysis showed that after LASEK, the cornea wound healing with types Ⅰand Ⅲ collagens were much faster than that of PRK, and the wound response was also much weaker. Whereas for types Ⅴ and Ⅵ collagens, their dynamic changes were similar between LASEK and PRK, and they both reached the peak value at 3 month after the surgery, but LASEK group returned to normal earlier than PRK group. The value of these two types of collagens after PRK was higher than that by LASEK. The changes of these four types of collagens may offer us at least partial explanation to the difference of formation of corneal haze and refractive regression. Conclusion There are significant differences between LASEK and PRK in types Ⅰ, Ⅲ, Ⅴ, and Ⅵ collagens or the time of reacting, reaching apex, and returning to normal. LASEK has slighter intensity of reaction. The results indicate that there is excessive aggradation of collagens after PRK, which may be the histological foundation of obvious haze and myopia regression.
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Objective To compare the changes of retinal sensitivity of central 30? visual field after correction with spectacles with those before correction in juveniles and to provide data for the necessity of correction with spectacles in the measurement of juvenile central visual field. Methods The changes of the retinal sensitivity of central 30? visual field after correction with spectacles in 122 eyes of juveniles were measured using Humphrev 750 Ⅱ perimeter, and were compared with those before correction. Results All the myopic eyes of 122 juveniles passed the reliability of parameters. Among the detected eyes, 110 eyes showed degree dependent changes of the retinal sensitivity of central visual field. Conclusion Correction with spectacles should be used for the measurement of central visual field in juveniles. Otherwise, the results might be unreliable, especially in the cases with moderate and high myopia.
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N". Except the average (Avg)-RNFLT had positive correlation with diopter in severe myopia group (r=0.372, P=0.047), no significant correlation was observed in other parameters among three groups. Conclusion RNFLT in myopia measured by OCT may have its own rule. Avg-RNFLT may have positive correlation with diopter in severe myopia group.
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Objective To investigate the changes of systolic pressure,diastolic pressure,oculocardiac reflex(OCR) and vision of patients suffering from cardiovascular disease when they applied phacoemulsification.Methods Totally 168 cases(182 eyes) who had underwent phacoemulsification were analyzed in random selection.Of all the cases,97(106 eyes) were combined with cardiovascular disease,the others were without any general disease.The changes of blood pressure,OCR,ECG and vision were observed in two groups.Results Compared with preoperative period,the mean systolic blood pressure increased significantly during operation,but the differences of diastolic pressure,OCR,ECG and vision were not significant between the two groups.Conclusion The safety and reliability of the surgery depend on reasonable medication,careful surgical procedure and monitoring for the patients with cardiovascular disease in the peri-operation period.
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Objective To study immunoresponse of SD rats to different dosages of Nogo66 vaccine,and then select the best vaccination concentration.Methods Nogo-66 peptide vaccine plus complete and imcomplete Freund's adjuvant were prepared in concentrations of 50?g/300?l,100?g/300?l,200?g/300?l,400?g/300?l and 800?g/300?l.The vaccines of different concentrations were used to immunize SD rats weekly for 8 weeks,and either complete or imcomplete Freund's adjuvant alone was used as control.Blood was drawn from caudal vein of rats weekly after the first immunization,and the titer of serum special IgG antibody was measured by ELISA.Two animals of every group were sacrificed every four weeks,and the spleens were harvested,and erythrocytes were removed with hypotonic saline.The proliferation rate of the cultured spleen T cells was determined with MTT.Meanwhile the experimental autoimmune encephalomyelitis(EAE) was evaluated for all experimental animals.Results The antibody titer of serum specific IgG of all experimental groups elevated quickly since the 4th week after vaccination,and reached the top value at the 8th week,and it then kept stable for 10 weeks.The IgG antibody titer in 200?g/300?l group was significant higher than that in other experimental groups(P