Short-term Outcomes and Prognostic Factors of Cataract-combined Surgery with iStent versus iStent Inject

Purpose@#To analyze the therapeutic effects, prognostic factors, and complications that occurred after iStent® or iStent inject® implantation in South Korean glaucoma patients. @*Methods@#We retrospectively analyzed 42 eyes of South Korean glaucoma patients, who were followed-up for more than 6 months after iStent® or iStent inject® implantation alone or combined with cataract surgery. Surgical success was defined as an intraocular pressure (IOP) ≤21 mmHg and an IOP reduction ≥20% from preoperative IOP levels. @*Results@#The cumulative success rate at 6 months after surgery was 45.3 ± 8.1% for iStent inject® alone (group A), 28.6 ± 13.1% for iStent® alone (group B), 81.2 ± 6.8% for iStent inject® combined with cataract surgery (group A-1), and 27.3 ± 21.8% for iStent® combined with cataract surgery (group B-1). Group A-1 showed a higher success rate than group B-1 (p = 0.007); the difference in success rates between groups A and B was not statistically significant (p = 0.579). When the success prognostic factors were analyzed by Cox regression analysis, the results showed that a higher preoperative IOP was associated with a higher surgical success rate (hazard ratio 0.80, p = 0.02). @*Conclusions@#In our patient group, iStent inject® was more effective than iStent® in combination with cataract surgery. The higher the preoperative IOP, the higher the surgical success rate; the results were significant.

Short-term Outcomes and Prognostic Factors of Cataract-combined Surgery with iStent versus iStent Inject

Purpose@#To analyze the therapeutic effects, prognostic factors, and complications that occurred after iStent® or iStent inject® implantation in South Korean glaucoma patients. @*Methods@#We retrospectively analyzed 42 eyes of South Korean glaucoma patients, who were followed-up for more than 6 months after iStent® or iStent inject® implantation alone or combined with cataract surgery. Surgical success was defined as an intraocular pressure (IOP) ≤21 mmHg and an IOP reduction ≥20% from preoperative IOP levels. @*Results@#The cumulative success rate at 6 months after surgery was 45.3 ± 8.1% for iStent inject® alone (group A), 28.6 ± 13.1% for iStent® alone (group B), 81.2 ± 6.8% for iStent inject® combined with cataract surgery (group A-1), and 27.3 ± 21.8% for iStent® combined with cataract surgery (group B-1). Group A-1 showed a higher success rate than group B-1 (p = 0.007); the difference in success rates between groups A and B was not statistically significant (p = 0.579). When the success prognostic factors were analyzed by Cox regression analysis, the results showed that a higher preoperative IOP was associated with a higher surgical success rate (hazard ratio 0.80, p = 0.02). @*Conclusions@#In our patient group, iStent inject® was more effective than iStent® in combination with cataract surgery. The higher the preoperative IOP, the higher the surgical success rate; the results were significant.

Short-term Results of Intravitreal Dexamethasone Implant Combined with Bevacizumab versus Intravitreal Bevacizumab for Treatment-naive Diabetic Macular Edema

Purpose@#To compare the visual and anatomical outcomes of intravitreal bevacizumab combined with the dexamethasone intravitreal implant (Ozurdex®) and bevacizumab monotherapy in eyes with treatment-naive diabetic macular edema. @*Methods@#We retrospectively reviewed 41 eyes of 41 patients with diabetic macular edema who underwent either intravitreal bevacizumab (1.25 mg) (21 eyes, intravitreal bevacizumab [IVB] group) injection alone or simultaneous injection of bevacizumab (1.25 mg) and dexamethasone implant (0.7 mg) (20 eyes, intravitreal dexamethasone [IVD] group). Best-corrected visual acuity (BCVA), central macular thickness (CMT), intraocular pressure, and retreatment percentages were accessed 1, 3, and 6 months after injection. @*Results@#At 3 and 6 months, the IVD group showed a significant improvement in BCVA compared to the baseline. Only a slight improvement in BCVA was observed in the IVB group during the initial 3 months; however, significant improvement was evident at 6 months compared with the baseline. During the first 3 months, the IVD group showed significant improvement in CMT compared with the IVB group; at 1 month after the initial injection, the CMT was 264.39 ± 54.95 μm for the IVD group versus 349.00 ± 112.18 μm for the IVB group (p = 0.011). At 3 months, the CMT in the IVD group had improved significantly compared with that of the IVB group (p < 0.001). The average number of additional intravitreal injections during the 6-month follow-up was 0.45 and 1.15 for the IVD and IVB groups, respectively. In the IVD group, cortical (7%) and posterior subcapsular (15%) cataracts developed by two grades or more during follow-up in phakic eyes. @*Conclusions@#In patients with diabetic macular edema, simultaneous therapy combining a dexamethasone implant plus bevacizumab showed significant improvement in CMT during the initial 3 months and the combined treatment group had fewer additional intravitreal injections.

Ocular Surface Staining Score and Salivary Gland Scintigraphy in Patients with Primary Sjögren’s Syndrome

Purpose@#To analyze the correlation between the ocular surface staining score and indices of salivary gland scintigraphy in patientswith primary Sjögren's syndrome and dry eye symptoms, and to evaluate the diagnostic value of these indices. @*Methods@#The patients were 51 adults with primary Sjögren's syndrome or non-Sjögren's syndrome plus dry eye symptoms, whowere referred to our ophthalmology clinic for evaluation of the degree of dry eye at the Department of Rheumatology, from July2017 to April 2019. The Mann-Whitney U test and student’s t-test were used for analyzing the ocular surface staining score andquantitative indices of salivary gland scintigraphy, respectively, in the primary Sjögren's syndrome and non-Sjögren's syndromepatients. Spearman correlation was used to analyze the correlations of ocular surface staining score with salivary scintigraphyindices. @*Results@#The ocular surface staining score (p= 0.021), parotid gland excretion fraction (p= 0.022), and submandibular gland excretionfraction (pp= 0.045) were significantly different between the primary Sjögren's syndrome and non-Sjögren's syndromepatients. The submandibular gland uptake ratio (r = -0.369, p= 0.008) and submandibular excretion fraction (r = -0.359, p=0.010) were significantly negatively correlated with ocular surface staining scores. @*Conclusions@#The ocular surface staining score was identified as the gold standard for evaluating the degree of dry eye in primarySjögren's syndrome patients. If salivary gland dysfunction is identified by salivary gland scintigraphy, ocular surface stainingshould be performed to confirm the presence of ocular surface lesions, regardless of the presence of dry eye symptoms.

Short-term Results of Intravitreal Dexamethasone Implant Combined with Bevacizumab versus Intravitreal Bevacizumab for Treatment-naive Diabetic Macular Edema

Purpose@#To compare the visual and anatomical outcomes of intravitreal bevacizumab combined with the dexamethasone intravitreal implant (Ozurdex®) and bevacizumab monotherapy in eyes with treatment-naive diabetic macular edema. @*Methods@#We retrospectively reviewed 41 eyes of 41 patients with diabetic macular edema who underwent either intravitreal bevacizumab (1.25 mg) (21 eyes, intravitreal bevacizumab [IVB] group) injection alone or simultaneous injection of bevacizumab (1.25 mg) and dexamethasone implant (0.7 mg) (20 eyes, intravitreal dexamethasone [IVD] group). Best-corrected visual acuity (BCVA), central macular thickness (CMT), intraocular pressure, and retreatment percentages were accessed 1, 3, and 6 months after injection. @*Results@#At 3 and 6 months, the IVD group showed a significant improvement in BCVA compared to the baseline. Only a slight improvement in BCVA was observed in the IVB group during the initial 3 months; however, significant improvement was evident at 6 months compared with the baseline. During the first 3 months, the IVD group showed significant improvement in CMT compared with the IVB group; at 1 month after the initial injection, the CMT was 264.39 ± 54.95 μm for the IVD group versus 349.00 ± 112.18 μm for the IVB group (p = 0.011). At 3 months, the CMT in the IVD group had improved significantly compared with that of the IVB group (p < 0.001). The average number of additional intravitreal injections during the 6-month follow-up was 0.45 and 1.15 for the IVD and IVB groups, respectively. In the IVD group, cortical (7%) and posterior subcapsular (15%) cataracts developed by two grades or more during follow-up in phakic eyes. @*Conclusions@#In patients with diabetic macular edema, simultaneous therapy combining a dexamethasone implant plus bevacizumab showed significant improvement in CMT during the initial 3 months and the combined treatment group had fewer additional intravitreal injections.

Follow-up analysis on change of serum total cholesterol concentration in rural residents in Shanxi province / 中华流行病学杂志

Objective@#To analyze the longitudinal change of serum total cholesterol concentration in 733 rural residents in Shanxi province.@*Methods@#Based on the residents of five rural areas in Shanxi province who participated in China nutrition and health survey in 2002, a follow-up survey was conducted in 2015. Fasting venous blood of the participants was collected and serum TC concentration was tested by cholesterol oxidase method.@*Results@#Of 733 participants, 332 were male and 401 were female. In 2002 baseline survey, the age of the participants was (42.6±9.5) years old, 76.2% of male and 83.8% of female had junior middle school education or below. Proportion of smoking were 65.7% and 1.2%, drinking were 26.8% and 4.0%, obesity were 6.3% and 12.0%, and central obesity were 27.1% and 31.9%, respectively in male and female. The follow-up age of participants in 2015 was (55.8±9.5) years old, proportion of smoking changed to 48.2% and 1.5%, drinking were 49.7% and 3.0%, obesity increased to 11.8% and 18.2% and central obesity increased to 41.6% and 53.6%, respectively in male and female. The overall serum TC level increased from (3.82±0.89) mmol/L to (4.72±0.97) mmol/L with an average increase of 27.2%, which increased from (3.84±0.94) mmol/L to (4.54±0.93) mmol/L in male with an average increase of 22.7%, and increased from (3.81±0.84) mmol/L to (4.86±0.98) mmol/L in female with an average increase of 30.9%. The serum TC levels in 18-, 30-, 40-, and 50-59 years old group increased from (3.42±0.83), (3.72±0.77), (3.90±0.83) and (4.00±1.03) mmol/L to (4.38±1.01), (4.79±0.92), (4.73±0.99) and (4.76±0.96) mmol/L, with average increase range of 31.4%, 32.1%, 25.2% and 22.6%, respectively. The mean serum TC levels between two years all had statistically significant difference among groups of gender, age, education, marital status, family history of cardiovascular disease, smoking, drinking, BMI and waist circumference after paired t-test and ANOVA analysis (P<0.01).@*Conclusion@#The longitudinal serum TC level of rural residents in Shanxi province increased rapidly.

Outcomesi n 334 cases of Millions of Poor Cataar ct Patients'Extraction Project in Shanxi Province / 国际眼科杂志(Guoji Yanke Zazhi)

Abstract?AIM: To evaluate the visual acuity, visual function, q uality of lfi e, and cost/effectiveness of cataract surgery in patients with low soc ioeconomics tatus ( LSES ) who received government subsidies for free cataract surgery.?METHODS: Retrospectively, 334 eyes of 334 patient s were reviewed. Visual function and quality of l ife questionnaires we re available in 83 patie nts. The cost/effectiveness of cataract surgery was analyzed in 225 patients with LSES and 12 0 patients who rec eived standard cataract surgery. Mutl iple linear regression anal ysis and logistic regression analysis were used to assess the factors affecting the postoperative visual acuity.?RESULTS: At 1wk postoperatively, uncorrected visual acuity ( UCVA ) was improved significantly compared to these preoperait vely (P<0.50 ), 235 eyes (70.4%) had UCVA of 20/40 or better, and 16 eyes (4.8%) had UC VA wor se than 20/400. Multiple linear regresis on ana lysis revealed that other ocular diseases and cataract classification wer e factors contributing to po stop erative UC VA. Logistic regression analysis showed that low preoperative visual ac uti y and other ocular diseases were risk factors of postopera tive low vision, and the odds ratio (95%confidence int erval) values were 6.5 (2.8-14.8) and 1.3 (1.0-1.6), respe ctively.Visual fun ction and quality of life were significantly improved after the surgery. Th e cost/effetc iveness of c ataract su rgery in patients with LSES was lower than that in standard cataract patients.?CONCLUSION: Visual acuity and visual function were significantly better after the surgery in catara ct patients wti h LSES, and the operation cost was low.Quality of life in these patients was significantly improved.

Ocular Manifestations of Acquired Immunodeficiency Syndrome

PURPOSE: To investigate the patterns and risk factors of the ocular manifestations of acquired immunodeficiency syndrome (AIDS) and their correlation with CD4+ count in the era of highly active antiretroviral therapy (HAART). METHODS: This retrospective study examined 127 AIDS patients who presented to Soonchunhyang University Hospital. Data were collected from patient interviews, clinical examinations, and laboratory investigations. Ophthalmologic examinations included the best-corrected visual acuity, intraocular pressure, anterior segment and adnexal examination, and dilated fundus examination. RESULTS: Of the 127 patients with AIDS, 118 were on HAART and 9 were not. The mean CD4+ count was 266.7 +/- 209.1 cells/microL. There were ocular manifestations in 61 patients (48.0%). The incidence of anterior segment manifestations was higher than posterior segment manifestations at 28.3% and 19.7%, respectively. The mean CD4+ count was significantly (p 35 years were independent risk factors for developing ocular manifestations.

Investigation on the therapeutic effects and the mechanism of mesenchymal stem cells on acute immune liver injury in mice / 中华消化杂志

Objective To explore the mechanisms of mesenchymal stem cells (MSC) in the treatment of concanavalin A (ConA)-induced acute immune liver injury in mice.Methods MSC were isolated and cultured from bone of the four limbs of three-week-old C57BL/6 mice.The specific surface markers were identified and osteogenic,adipogenic differentiation ability were tested.A total of 15 six to seven-week old C57BL/6 mice were divided into control group,MSC treatment group and phosphate buffer saline (PBS) treatment group,five mice in each group.The mice of MSC treatment group was injected through tail firstly with ConA and then MSC,PBS treatment group was injected through tail firstly with ConA and then PBS,control group was injected through tail with PBS twice.The mice were sacrificed in 14 to 16 hours after injection.The level of alanine aminotransferase (ALT),aspartate transaminase (AST) in peripheral blood were detected and the pathological change in liver tissue was scored by Knodell score system.Activation rate of splenic CD4+ T cells and the proportion changes of T hepler cell (Th)1,Th2,Th17 and regulatory T cells (Treg) were detected by flow cytometry and the ratio of Th17/Treg was calculated.The levels of tumor necrosis factor α (TNF-α),interferon (IFN)-γ and interleukin (IL)-4 in peripheral blood were detected by enzyme linked immunosorbent assay (ELISA).Independent-sample t test was used for comparison between groups of measurement data.Results ALT,AST and Knodell score of MSC treatment group was (174.2± 46.9) U/L,(185.6± 71.6) U/L and 3.4±1.3,respectively,which were better than those of PBS treatment group ((647.0± 118.0) U/L,(749.0± 104.0) U/L and 5.2 ±0.8,respectively),and the differences were statically significant (t =8.33,9.98 and 2.55,all P＜0.05).The activation rate of splenic CD4+ T cell of PBS treatment group was (26.10±2.17) ％,the proportion of Th1 and Th2 in CD4+ T cell was (5.81±0.79) ％ and (5.98± 1.22)％,the ratio of Th17/Treg was 0.29±0.03,the levels of TNF-α,IFN-γ and IL4 in peripheral blood were (1 281.95±88.61) U/L,(1 838.66±196.91) U/L and (1 192.36±163.94) U/L,which were higher than those of control group ((13.74±1.59)％,(1.35±0.17)％,(2.13±0.17)％,0.15± 0.05,(21.71±2.50) U/L,(11.84±1.28) U/L and (24.46±3.96) U/L),and the differences were statistically significant (t=10.26,12.37,7.02,5.30,31.79,15.93 and 20.75,all P＜0.01).There was no statistically significant difference in the activation rate of splenic CD4+T cell between MSC treatment group and PBS treatment group ((26.20±3.09)％ vs (26.10±2.17)％,P＞0.05).However,in MSC treatment group,the proportion of Th1 and Th2 in CD4+ T cell ((1.83±0.52) ％ and (2.75±1.06％)),the ratio of Th17/Treg (0.18±0.02) and the levels of TNF-α,IFN-γ and IL-4 in peripheral blood ((760.71± 73.19) U/L,(742.49±76.46) U/L and (825.76±101.74) U/L) significantly decreased compared with those of PBS treatment group,and the differences were statistically significant (t=9.45,4.48,6.41,10.14,5.56 and 10.22,all P＜0.01).There was no significant difference in the ratio of Th17/Treg between MSC treatment group and control group (P＞0.05).Conclusions The therapeutic effects of MSC on ConA induced acute immune liver injury were through influence splenic CD4+ T cell subsets by decreasing the proportion of Th1 and Th2 and then declining the levels of secreted cytokines such as TNF,IFN-γ and IL-4 in peripheral blood,increasing the proportion of Treg and decreasing the proportion of Th17 and keeping the balance of Th17/Treg.

Comparison of different concentrations of elastin-like polypeptides for endoscopic submucosal dissection / 国际生物医学工程杂志

Objective To compare the effectiveness and safety of different concentrations of elastin-like polypeptides (ELP) as novel submucosal injection material for endoscopic submucosal dissection.Methods Forty healthy New Zealand white rabbits were randomly divided into two groups (n=20).The first group by submucosal injection of different drugs were randomly divide into five groups (n=4).Four concentrations of 50 ku ELP (0.05,0.025,0.012 5,0.005 g/ml) were used separately in each group,while glycerin fructose was used for control group.Each solution (2 ml) was injected into the submucosa through the resected margin,the increase of mucosal thickness and surface changes were observed and recorded at 0,5,10,and 30 min.The subgroup by submucosal injection of different drugs were randomly divide into five groups (n=4).The injection pressure of each solution (2 ml) with the 25-gauge needle was calculated by a manometer,which was connected between the needle and syringe.Results The submucosal uplift heights in groups using the 0.05 g/ml ELP and 0.025 g/ml ELP injection were significantly thicker than that of glycerin fructose (P＜0.05),the 0.012 5 g/ml ELP and glycerin fructose injection showed no significant difference (P＞0.05),whereas the uplift height in glycerin fructose group was thicker than that of the 0.005 g/ml ELP (P＜0.05).The injection pressure correlated with the ELP concentration.The injection pressures of 0.05,0.025,0.012 5,0.005 g/ml ELP solutions were (332±36) kPa,(223±24) kPa,(174±22) kPa and (142±19) kPa,respectively,and that of glycerin fructose was (269±17) kPa.The 0.025 g/ml ELP solution was easily injected into the porcine stomach to create submucosal uplift.The injection pressure of the 0.025 g/ml ELP solution showed significantly lower value compared with that of glycerin fructose (P＜0.05).Conclusions ELP might be a promising agent for submucosal injection for endoscopic submucosal dissection (ESD),and 0.025 g/ml ELP might be efficient concentration for maintaining mucosal elevation,injection pressure and safety.

Identification of a novel HLA allele HLA-B*55:35 / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To identify a novel human leukocyte antigen (HLA) B allele and explore its family heritage.</p><p><b>METHODS</b>A novel HLA allele was suspected upon routine HLA typing using a polymerase chain reaction-sequence specific oligonucleotide probe (PCR-SSOP) assay. The sequence was confirmed with DNA sequencing and compared with its closest matching allele, B*55:02. The family was also investigated.</p><p><b>RESULTS</b>An unusual reaction pattern was detected during routine HLA typing. The sequence was confirmed to be a novel HLA-B allele, which differed from the closest matching allele, B*55:02 in 7 nt positions in exon 2. Among the 7 mutations from 6 codons, there were two amino acids changes including 69Glu→Met and 70Glu→Ala.</p><p><b>CONCLUSION</b>A novel HLA-B allele has been identified and officially named as B*55:35 by the WHO Nomenclature Committee for Factors of the HLA System (GenBank accession number FJ898284).</p>

Economic Evaluation of Different Initial Treatments for Primary Open Angle Glaucoma: A Markov Model

PURPOSE: To perform an economic evaluation of the different treatment methods available for primary open-angle glaucoma in a Korean setting, including medication, selective laser trabeculoplasty, or surgery. METHODS: Three independent Markov chains were constructed for each treatment option to simulate treatment progress and to evaluate the total treatment costs for each initial strategy. The Markov chain consisted of different stages (5, 10, 20 stages), with each stage being one year. Assuming 1000 patients, a Monte Carlo simulation was iterated 1000 times to evaluate the cost of treatment over 5, 10 and 20 years. RESULTS: During the initial five years, medication as the initial treatment was the most expensive, whereas laser trabeculoplasty was the cheapest. After ten years, surgery became the cheapest treatment. In ten years, if the success rate of surgery is greater than 30.1%, it was more economic to choose surgery as the initial treatment. For laser trabeculoplasty, if the success rate was greater than 16.3%, laser treatment was more economical than was medication. Our model shows that only if the annual cost of medication decreases to 60,000 won or 55,000 won, then the cost of choosing medication as the initial treatment strategy will be more economical than that of laser therapy or surgery, respectively. CONCLUSIONS: The economic value of choosing laser therapy as the initial treatment strategy is the greatest over five simulated-years, whereas surgery had the greatest economic value over more than ten years.

Baerveldt Tube Implantation After Bleb Dysesthesia: Case Report

PURPOSE: To report a case of bleb dysesthesia successfully treated after Baerveldt tube implantation. CASE SUMMARY: A 37-year-old woman presented with a history of persistent foreign body sensation and pain in the left eye. The patient was referred to our hospital and was diagnosed as having had plateau iris syndrome. Having shown no improvement with conservative management, she eventually received trabeculectomy in the left eye six months prior to her current presentation. Under the impression of bleb dysesthesia, she received artificial tears and a bandage contact lens. These, however, failed to alleviate her symptoms. She then had a compression suture of the bleb and bleb revision. These were performed sequentially but neither was effective. Finally, a Baerveldt tube implantation was performed successfully, and, three months later, bleb revision was performed using a donor sclera, which resulted in no further complaint of ocular discomfort. CONCLUSIONS: Bleb dysesthesia, although not a common postoperative complication, can occur after trabeculectomy and can be successfully treated with Baerveldt tube implantation. Patients should receive appropriate counseling and advice on bleb dysesthesia prior to undergoing trabeculectomy.

Animal study for airway inflammation triggered by gastroesophageal reflux / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Gastroesophageal reflux disease with extra-esophageal symptoms, especially those with respiratory distress was attracting more and more attention. The related mechanisms were still in controversy. The purpose of the work was to explore airway inflammation triggered by gastroesophageal reflux.</p><p><b>METHODS</b>Sixteen Sprague-Dawley rats were used as study group and 9 as control. In the study group, a plastic extender with a trumpet-shaped distal end was inserted into the lower esophagus to dilate the cardia, the pylorus was ligated. One ml of 0.1 mol/L hydrochloric acid was injected into the stomach. While a simple laparotomy was performed for control animals. All animals from two groups were sacrificed 24 hours after operation. Then tracheotomy was carried and the bronchoalveolar lavage fluid was collected in all animals. Cells in the fluid were counted and levels of interleukin (IL)-5, -6, -8 in it were measured.</p><p><b>RESULTS</b>Compared with control group, the study group presented a neutrophil pattern of airway inflammation and an elevated concentration of IL-5, -6, -8 with no significant difference regarding eosinophil count.</p><p><b>CONCLUSION</b>The gastroesophageal reflux-triggered airway inflammation is characterized by a neutrophilic airway inflammation which differed from that caused by asthma, and enhanced levels of IL-5, -6 and -8, which are similar to that caused by asthma.</p>

Retinal Nerve Fiber Layer Thickness in Children With Glaucoma

PURPOSE: To find the optimal parameter of retinal nerve fiber layer (RNFL) analysis in optical coherence tomography (OCT) for diagnosing glaucoma in children. METHODS: The study was comprised of 127 eyes of 84 patients (aged 6 to 18 years) who visited our institute between March 2006 and February 2008. Subjects were classified into normal, glaucoma suspect and glaucoma groups, and each eye was scanned using Stratus 3.0 OCT. Routine ophthalmic examinations including fundus examination, visual field test and OCT RNFL analysis were performed. RESULTS: There were 55 normal eyes, 27 glaucoma suspect eyes and 45 glaucomatous eyes. The average RNFL thickness was the most useful parameter to differentiate between the glaucoma and non-glaucoma groups. The next most useful parameter was inferior average thickness, followed by superior RNFL thickness. The sensitivity and specificity of the new discriminant of the formula used were 78%, and 68.6%, respectively. CONCLUSIONS: In OCT analysis, the average RNFL thickness is the most useful parameter in the diagnosis of glaucoma in children. The new discriminant of the formula is useful in the diagnosis of pediatric glaucoma patients.

Herbal Medication Aggravates Cataract Formation: A Case Report

We report a case of complicated cataract aggravated after taking herbal medication for atopic dermatitis. An 11-yr-old boy was referred for the evaluation of decreased visual acuity in both eyes for 2 months. Past history showed that he had been diagnosed with atopic dermatitis when he was 1 yr old. He had been treated only with herbal medication for a period of 8 months prior to visiting our clinic. He had his visual acuity checked in a local ophthalmic clinic one year before, and the visual acuity was 20/20 in both eyes at that time. When attending our clinic the ophthalmologic examination showed that his best corrected visual acuity was 20/200 in both eyes. Lenses of both eyes had severe posterior subcapsular and posterior capsular opacity. Phacoemulsification, posterior chamber intraocular lens implantation, and posterior continuous curvilinear capsulectomy were performed in both eyes. After 3 months postoperatively, the best corrected visual acuity was recovered to 20/20 in both eyes without any complication. Our case suggests that there may be a risk of aggravation of cataract or development of cataract after treatment with some unidentified herbal medication in a patient with atopic dermatitis.

Study on the Yersinia pestis plasmid along the Qinghai-Tibet Railway / 中国地方病学杂志

Objective To detect the Yersinia pestis plasmid and molecular weight along the Qinghai-Tibet Railway.Methods Yersinia pestis plasmids molecular weight detected and analyzed using alkaline lysis,phenol-chloroform extraction of Yersinia pestis plasmid by agarose gel electrophoresis.Results The 18 Yersinia pestis strains of Qinghai-Tibet Railway contained 6×106,45×106,52×106,65×106,92×106plasmid,varing in the range of the 52×106-92×106.Conclusions The Yersinia pestis of Qinghai-Tibet Railway has a standardplasmid graphics,with the biggest Yersinia pestis plasmid changing in a certain regular degree,which providessignificance in the study of plague natural foci of the spatial structure and the genetic.characteristics of Yersiniapestis.

Comparison of Diagnostic Precision between Preprogramed Indicator and Newly Calculated Indicator in Optical Coherence Tomography

PURPOSE: To find the optimal parameter of retinal nerve fiber layer (RNFL) analysis using optical coherence tomography (OCT) and to compare the diagnostic precision between the new discriminant formula and the preprogrammed indicator (95%, 99% cut off value of normal RNFL thickness) in the diagnosis of glaucoma. METHODS: The study comprised 499 eyes of 284 patients. Routine ophthalmic examinations, fundus examination, visual field test, OCT optic nerve head analysis and OCT RNFL analysis were performed. Results were analyzed and classified into normal, suspected glaucoma, and glaucoma groups. RESULTS: There were 237 glaucomatous eyes and all parameters of the OCT RNFL analysis showed statistically significant differences between the glaucoma and non-glaucoma groups. The average RNFL thickness was most significantly correlated with the visual field indexes and was the most useful parameter in the detection of glaucoma. Using age, horizontal integrated rim area (HIRA) and average thickness, the accuracy, sensitivity and specificity of the new discriminant formula were 76.2%, 73.1% and 73.1% respectively. CONCLUSIONS: Average thickness was the most useful parameter in the detection of glaucoma. The next most useful parameter was inferior average thickness, and both were more precise than the preprogrammed indicator. The new discriminant formula is useful in the diagnosis and follow-up of the glaucoma patients.

Comparison of Delayed-Onset Glaucoma and Early-Onset Glaucoma after Infantile Cataract Surgery

PURPOSE: To investigate the causes and characteristics of glaucoma in children following cataract surgery. METHODS: Twenty-four patients (37 eyes) with uncomplicated congenital cataracts who developed glaucoma after cataract surgery were studied retrospectively. Variables included cataract morphology, surgical techniques, post-operative complications, time to the onset of glaucoma, gonioscopic findings, presence of microcornea and the histopathologic characteristics of the filtration angle (in one case). RESULTS: There was a bimodal onset of glaucoma after cataract surgery. Early-onset glaucoma occurred at a mean age of 6 months in 15 eyes and delayed-onset glaucoma at a mean age of 12 years in 22 eyes. Early-onset glaucoma was significantly (p=0.018) more likely to be due to angle closure than delayed-onset glaucoma. With delayed-onset glaucoma, the filtration angle was open in 86% of eyes and significantly (p=0.006) more eyes in the delayed-onset group had microcornea. Medical treatment was sufficient to control intraocular pressure in the delayed-onset group while the early-onset group required surgical treatment (P<0.001). CONCLUSIONS: The onset of glaucoma after cataract surgery during infancy follows a bimodal pattern that is correlated with the configuration of the filtration angle. The early-onset glaucoma group had high incidence of angle closure requiring surgical treatment, while in the delayed-onset group non-surgical treatment was sufficient to control intraocular pressure. Prophylactic iridectomy in eyes at risk for pupillary block is recommended. Eyes with delayed-onset glaucoma have open filtration angles yet also have findings of incomplete development of filtration structures. Microcornea is a risk factor for delayed-onset glaucoma.