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AIM: To observe the changes of macular retinal structure and microcirculation in patients with pituitary adenoma(PA)by optical coherence tomography(OCT)and optical coherence tomography angiography(OCTA).METHODS: Cross-sectional study. A total of 40 PA patients treated at the department of neurosurgery, Affiliated Hospital of Guangdong Medical University from September 2021 to March 2023 were included as PA group, and 42 age- and gender-matched healthy volunteers were selected as normal control group. All patients underwent visual field, OCT and OCTA examinations, and the correlation of ocular parameters in PA patients was analyzed.RESULTS:The vessel density(VD)of each retinal layer in the macular area of the PA group was lower than that of the normal control group, and the superficial vascular complex(SVC)-VD in the macular area was positively correlated with the thickness of the macular ganglion cell complex(mGCC)(except the nasal side of the inner ring and the lower part of the outer ring; P<0.05). The thickness of mGCC in each quadrant of the macular area and the thickness of the circumpapillary retinal nerve fiber layer(CP-RNFL)in each quadrant were negatively correlated with the mean defect(MD)value of the visual field(P<0.05), and the area of the foveal avascular zone(FAZ)was positively correlated with the MD value(P<0.05).CONCLUSION:The combination of OCT and OCTA can fully understand the microscopic changes of retinal structure and microcirculation function in PA patients, which is of great value in evaluating the preoperative visual function of PA patients.
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Allogeneic hematopoietic stem cell transplantation(allo-HSCT)is a treatment for many malignant tumors of blood system and severe immunodeficiency, and chronic graft-versus-host disease(cGVHD)is one of the major complications after transplantation, which seriously affects the life quality of patients. The cGVHD can attack all the target tissues of the eye. The more common ones are lacrimal gland, eyelid, conjunctiva, cornea and limbus, meibomian gland, etc. The pathophysiological process is inflammation and fibrosis. Although many researchers at home and abroad have gradually begun to explore the disease and obtained many new findings, its pathology and pathogenesis are still not fully understood, and there is no unified and effective treatment. Clinically, the treatment of the disease is usually when symptoms have appeared. At this time, the target tissue is likely to have irreversible and permanent damage, resulting in a protracted and refractory situation. Therefore, this thesis mainly clarifies the research progress of the pathology and pathogenesis of ocular cGVHD in recent years, in order to provide new guidance for the treatment of the disease.
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Objective To compare the differences of optic nerve head (ONH) parameters and the thickness of circumpapillary retinal nerve fiber layer (CP-RNFL) between acute Vogt-Koyanagi-Harada syndrome (VKH) and acute central serous chorioretinopathy (CSC) patients.Methods Retrospective clinical case control analysis.This study included 38 eyes of 20 acute VKH patients (VKH group) and 37 eyes of 37 acute CSC patients (CSC group).Seventy five eyes of 57 normal healthy subjects,matching patients with age and gender,were collected as control group.The disc RPE angle,the thickness of average CP-RNFL,the nasal,superior,temporal and inferior quadrant CP-RNFL thickness,and ONH parameters including optic disc area,cup area,rim area,C/D area ratio,linear CD ratio (CDR),vertical CDR were measured by 3D-OCT.Analysis of variance was performed for comparison among three groups.Minimum significant difference t test was performed for comparison between two groups.Results The differences of ONH parameters between VKH group and CSC group:29 eyes of VKH group appeared retinal detachment next to disc,only 12 eyes appeared in CSC group.Twenty one eyes of VKH group appeared optic disc hyperemia while none in CSC group.The three groups' disc RPE angles were (138.62± 11.96)°,(154.09±5.85)° and (153.41 ±5.77)°.VKH group were significantly smaller than CSC group (t=-2.05,P=0.00) and control group (t=-1.68,P=0.00),while there was no significant difference between CSC group and control group (t=-1.88,P=0.72).The optic cup area and rim area were significantly bigger in VKH group than in CSC group (t=4.61,2.71;P=0.00,0.01),and the thickness of mean CP-RNFL,all quadrants of CP-RNFL were significantly thicker in VKH group than in CSC group (t=6.25,4.40,3.53,5.48,2.69;P=0.00,0.00,0.00,0.00,0.01).Conclusion Compared with the acute CSC,VKH patients are likely to appear retinal detachment next to disc,their disc RPE angles are smaller,their optic cup area and rim area are bigger,and their CP-RNFL thickness are thicker.
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To improve the water solubility of daidzein, solid inclusion complexes of daidzein with two amino-modified β-cyclodextrins (ACDs), i.e., mono-6-amino-6-deoxy-β-cyclodextrin (NCD) and mono-6-ethylenediamino-6-deoxy-β-cyclodextrin (ENCD), were prepared by the saturated solution method in water under the preparation conditions as follows: the ratio of daidzein/ACD was 3∶1 and the stirring time was 72 h (83% and 67% yields, respectively).The formation of two inclusion complexes was confirmed by x-ray diffractometry (XRD) and themogravimetric (TG) analysis.The inclusion stoichiometry of the inclusion complexes was 1∶1 from the Job plot and their complexation stability constants (KS) were 899.2 and 203.8 L/mol from fluorescence titration, respectively.After formation of inclusion complexes with NCD and ENCD, the water solubility of daidzein was dramatically raised from 8.31 μg/mL to 15.2 and 13.2 mg/mL at 25℃, increasing by 1800-fold and 1500-fold.
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Objective To compare the differences of optic disc parameters and the thickness of circumpapillary retinal nerve fiber layer (CP-RNFL) in acute uveitis Vogt-Koyanagi-Harada (VKH) syndrome with different degrees of optic disc edema. Methods This is a retrospective study including 40 eyes of 23 VKH patients. The eyes were divided into 2 groups according to the results of fluorescein fundus angiography (FFA). The discs with hyperfluorescence but no leakage were in mild optic disc edema group (group A, 13 patients and 25 eyes), and the discs with hyperfluorescence and leakage were in severe optic disc edema group (group B, 10 patients and 15 eyes). The patients were significantly older in group B than in group A (t=-2.17, P<0.05). The differences of gender, diseased time (t=-1.67) and corrected visual acuity (t=-0.76) between 2 groups were not significant (P>0.05). Eighty eyes of 46 normal healthy subjects, matching group A and group B with age and gender, were divided into group C (26 subjects and 50 eyes) and group D (20 subjects and 30 eyes) respectively.All subjects underwent three dimensional optical coherence tomography examinations. The parameters included average thickness of entire circumpapillary retinal nerve fiber layer (CP-RNFL), thickness of nasal, superior, temporal and inferior quadrant of CP-RNFL, disc area, disc cup area, rim area, cup/disc (C/D) area ratio, C/D horizontal diameter ratio and C/D vertical diameter ratio. Results The disc area, disc cup area and rim area were bigger, the thickness of mean CP-RNFL and the nasal and temporal quadrants of CP-RNFL were thicker in group A than those in group C (P<0.05). The disc area and rim area were bigger, the thickness of mean CP-RNFL and the nasal, superior, temporal and inferior quadrant of CP-RNFL were thicker, C/D area ratio and C/D diameter ratio were smaller in group B than those in group D (P<0.05). The disc area was bigger, disc cup area, C/D area ratio and C/D diameter ratio were smaller, the thickness of mean CP-RNFL and the nasal , superior and inferior quadrants of CP-RNFL were thicker in group B than those in group A (P<0.05). Conclusions Acute VKH uveitis with mild optic disc edema has thicker CP-RNFL in the nasal and temporal quadrants; with severe optic disc edema has thicker CP-RNFL in all 4 quadrants. Acute VKH uveitis also has smaller C/D area ratio and C/D diameter ratio.
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Objective To compare the differences of optic disc morphology and optic nerve head parameters between Vogt-Koyanagi-Harada (VKH) syndrome and optic neuritis (ON) with optic disc edema. Methods This is a retrospective study including 21 first-onset VKH patients (35 eyes) as VKH group and 22 first-onset ON patients with optic disc edema (27 eyes) as ON group. The differences of age (t=-1.11) and gender (χ2=0.20) between two groups were not significant (P>0.05). Sixty-two eyes of 43 age and gender-matched healthy subjects were enrolled in this study as control group. All subjects underwent three dimensional optical coherence tomography (3D-OCT) examinations. The difference of optic disc morphology between two groups was observed. The parameters included average thickness of entire circumpapillary retinal nerve fiber layer (CP-RNFL), thickness of nasal, superior, temporal and inferior quadrant of CP-RNFL, disc area, disc cup area, rim area, cup/disc (C/D) area ratio, C/D horizontal diameter ratio and C/D vertical diameter ratio. The disc retinal pigment epithelium (RPE) angle was observed too. Results Among 35 eyes in VKH group, 31 eyes (88.57%) had retinal detachment next to the disc, 3 eyes (8.57%) had serrated inner limiting membranes of the disc. Twenty eyes (64.52%) had highly reflective points, lines, or membrane-like structures in the retinal detachment areas. No such signs appeared in ON patients. Compared with ON group, the optic cup area, C/D area ratio, C/D horizontal diameter ratio and C/D vertical diameter ratio were bigger, the thickness of mean CP-RNFL and the superior, inferior quadrants of CP-RNFL were thinner, disc RPE angles was smaller in VKH group (P<0.05). Compared with control group, the disc area, optic cup area, rim area were bigger, C/D vertical diameter ratio was smaller, the mean CP-RNFL and 4 quadrants CP-RNFL were thicker, disc RPE angles was smaller in VKH group (P<0.05); the disc area, optic cup area, C/D area ratio, C/D horizontal diameter ratio and C/D vertical diameter ratio were smaller, the mean CP-RNFL and 4 quadrants CP-RNFL were thicker, disc RPE angles was bigger in VKH group (P<0.05). Conclusions VKH patients have smaller disc RPE angles and more chance to develop retinal detachment next to disc than ON patients. The C/D area ratio, C/D horizontal diameter ratio and C/D vertical diameter ratio are bigger, the mean CP-RNFL and the superior, inferior quadrants of CP-RNFL are thinner in VKH eyes.
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Objective To compare the differences of optic disc parameters and the thickness of circumpapillary retinal nerve fiber layer (CP-RNFL) in acute uveitis Vogt-Koyanagi-Harada (VKH) syndrome with different degrees of optic disc edema. Methods This is a retrospective study including 40 eyes of 23 VKH patients. The eyes were divided into 2 groups according to the results of fluorescein fundus angiography (FFA). The discs with hyperfluorescence but no leakage were in mild optic disc edema group (group A, 13 patients and 25 eyes), and the discs with hyperfluorescence and leakage were in severe optic disc edema group (group B, 10 patients and 15 eyes). The patients were significantly older in group B than in group A (t=-2.17, P<0.05). The differences of gender, diseased time (t=-1.67) and corrected visual acuity (t=-0.76) between 2 groups were not significant (P>0.05). Eighty eyes of 46 normal healthy subjects, matching group A and group B with age and gender, were divided into group C (26 subjects and 50 eyes) and group D (20 subjects and 30 eyes) respectively.All subjects underwent three dimensional optical coherence tomography examinations. The parameters included average thickness of entire circumpapillary retinal nerve fiber layer (CP-RNFL), thickness of nasal, superior, temporal and inferior quadrant of CP-RNFL, disc area, disc cup area, rim area, cup/disc (C/D) area ratio, C/D horizontal diameter ratio and C/D vertical diameter ratio. Results The disc area, disc cup area and rim area were bigger, the thickness of mean CP-RNFL and the nasal and temporal quadrants of CP-RNFL were thicker in group A than those in group C (P<0.05). The disc area and rim area were bigger, the thickness of mean CP-RNFL and the nasal, superior, temporal and inferior quadrant of CP-RNFL were thicker, C/D area ratio and C/D diameter ratio were smaller in group B than those in group D (P<0.05). The disc area was bigger, disc cup area, C/D area ratio and C/D diameter ratio were smaller, the thickness of mean CP-RNFL and the nasal , superior and inferior quadrants of CP-RNFL were thicker in group B than those in group A (P<0.05). Conclusions Acute VKH uveitis with mild optic disc edema has thicker CP-RNFL in the nasal and temporal quadrants; with severe optic disc edema has thicker CP-RNFL in all 4 quadrants. Acute VKH uveitis also has smaller C/D area ratio and C/D diameter ratio.
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Objective To compare the differences of optic disc morphology and optic nerve head parameters between Vogt-Koyanagi-Harada (VKH) syndrome and optic neuritis (ON) with optic disc edema. Methods This is a retrospective study including 21 first-onset VKH patients (35 eyes) as VKH group and 22 first-onset ON patients with optic disc edema (27 eyes) as ON group. The differences of age (t=-1.11) and gender (χ2=0.20) between two groups were not significant (P>0.05). Sixty-two eyes of 43 age and gender-matched healthy subjects were enrolled in this study as control group. All subjects underwent three dimensional optical coherence tomography (3D-OCT) examinations. The difference of optic disc morphology between two groups was observed. The parameters included average thickness of entire circumpapillary retinal nerve fiber layer (CP-RNFL), thickness of nasal, superior, temporal and inferior quadrant of CP-RNFL, disc area, disc cup area, rim area, cup/disc (C/D) area ratio, C/D horizontal diameter ratio and C/D vertical diameter ratio. The disc retinal pigment epithelium (RPE) angle was observed too. Results Among 35 eyes in VKH group, 31 eyes (88.57%) had retinal detachment next to the disc, 3 eyes (8.57%) had serrated inner limiting membranes of the disc. Twenty eyes (64.52%) had highly reflective points, lines, or membrane-like structures in the retinal detachment areas. No such signs appeared in ON patients. Compared with ON group, the optic cup area, C/D area ratio, C/D horizontal diameter ratio and C/D vertical diameter ratio were bigger, the thickness of mean CP-RNFL and the superior, inferior quadrants of CP-RNFL were thinner, disc RPE angles was smaller in VKH group (P<0.05). Compared with control group, the disc area, optic cup area, rim area were bigger, C/D vertical diameter ratio was smaller, the mean CP-RNFL and 4 quadrants CP-RNFL were thicker, disc RPE angles was smaller in VKH group (P<0.05); the disc area, optic cup area, C/D area ratio, C/D horizontal diameter ratio and C/D vertical diameter ratio were smaller, the mean CP-RNFL and 4 quadrants CP-RNFL were thicker, disc RPE angles was bigger in VKH group (P<0.05). Conclusions VKH patients have smaller disc RPE angles and more chance to develop retinal detachment next to disc than ON patients. The C/D area ratio, C/D horizontal diameter ratio and C/D vertical diameter ratio are bigger, the mean CP-RNFL and the superior, inferior quadrants of CP-RNFL are thinner in VKH eyes.
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Objective To research the applications of resting-state functional MRI in conjunction with voxel-based morphometry on cerebral functions and structures in patients with schizophrenia. Methods Thirty-two patients with schizophrenia and 32 healthy people underwent resting state functional magnetic resonance imaging (Rs-fMRI)and sagittal scanning T1WI with 3D FFE Pulse Sequence. Rest1.8 software was applied to calculate the differences of amplitude of standardized low-frequency fluctuation(ALFF)between the two groups,then the voxel-based morphometry(VBM)data of abnormal brain regions were evaluated to compare the differences of grey matter intensity. Finally,combining with ALEF and VBM,we explored the changes of cerebral functions and structures. Results As compared to the control group ,the ALFF-elevated regions were the right putamen ,the left orbital frontal cortex extending to the left putamen and left dorsal-lateral superior frontal gyrus;the ALFF-decreased regions were the right inferior tempotalgyrus,the left posterior cingulated gyrus and the left angular gyrus(P<0.05). No elevated regions of grey matter intensity were found in the patient group. Conclusions Extensive abnormal active regions of the brain under resting state could be found in patients with schizophrenia ,the grey matter intensity of abnormal regions also decreased generally. They are in accordance with the glutamate-hypothesis of schizophrenia ,which involves extensive impairments of neurons ,disorders of neurotransmitter′s circulations and balances.
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Objective To observe the changes of circumpapillary retinal nerve fiber layer (CP-RNFL)thickness and optic disk parameters in retinitis pigmentosa (RP) eyes.Methods Prospective clinical case-control study.A total of 25 patients (42 eyes) with RP were in the RP group,and 42 age matched healthy subjects (84 eyes) in the control group.All subjects underwent optical coherence tomography (OCT) examination,in which 37 eyes with 3D optic disk scanning and 5 eyes with circle optic disk scanning.The parameters included average thickness of entire CP-RNFL,thickness of nasal,superior,temporal and inferior quadrant of CP-RNFL,disc area,disc cup area,rim area,cup/disc (C/D) area ratio,C/D horizontal diameter ratio,C/D vertical diameter ratio,disc cup volume and disc rim volume.Results The average thickness and the thickness of temporal and nasal quadrants of CP-RNFL in RP group were significantly thicker than the control group (t=2.27,3.73,6.44;P=0.027,0.00,0.00),while the thickness of inferior and superior areas were the same as control group(t=-1.49,-1.19;P=0.14,0.24).The disc area,disc cup area,C/D area ratio,C/D horizontal diameter ratio,C/D vertical diameter ratio,disc cup volume in RP group were significantly bigger than control group (P<0.05),while rim area and rim volume were not significant differences (t=1.75,0.40;P=0.08,0.59).Conclusion In comparison with the healthy subjects,the average thickness and temporal and nasal areas of CP-RNFL in RP eyes were thicker,and the disc area,disc cup area,C/D area ratio,C/D horizontal diameter ratio,C/D vertical diameter ratio,disc cup volume in RP eyes were bigger.
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Objective To determine the long-term changes in optic disc parameter and the thickness of circumpapillary retinal nerve fiber layer (CP-RNFL) and macular retina after acute primary angle closure.Methods Prospective clinical case-control study.A total of 26 patients (30 eyes) with acute primary angleclosure glaucoma (APACG) were in the APACG group,whose intraocular pressure were control after a single episode acute primary angle closure;30 age-and sex-matched healthy subjects (30 eyes) in the control group.All subjects underwent three dimensional optical coherence tomography (3D-OCT) examination with 3D optic disk scanning or circle optic disk scanning and 6 mm× 6 mm macular scanning.The parameters included average thickness of entire CP-RNFL,thickness of nasal,superior,temporal and inferior quadrant of CP-RNFL,disc area,disc cup area,rim area,cup/disc (C/D) area ratio,C/D horizontal diameter ratio and C/D vertical diameter ratio.The foveal retinal thickness,center retinal thickness (≤ 1 mm from the fovea),4 quadrants of macular inner-ring (> 1 mm but ≤3 mm from the fovea) retinal thickness,4 quadrants of macular outer-ring (>3 mm but ≤6 mm from the fovea) retinal thickness,average thickness of macular retinal thickness and macular volume were measured and analyzed.Results The disc area,disc cup area,C/D area ratio,C/D horizontal diameter ratio and C/D vertical diameter ratio in APACG group were significantly bigger than the control group (t=3.22,4.12,3.90,3.00,3.23;P<0.05),rim area was smaller than the control group (t=-2.63,P<0.05).The average thickness (t=-6.68) and the thickness of superior (t =-5.90),temporal (t =-11.64) and inferior (t =-5.06) quadrants of CP-RNFL,center retinal thickness (t=-2.50),4 quadrants of macular inner-ring retinal thickness (t=-4.91,-4.88,-2.83,-3.59),nasal (t=-2.13) and superior (t=-2.49) quadrants of macular outerring retinal thickness as well as average thickness of macular retinal thickness (t=-2.65) were significantly thinner than the control group (P<0.05),and the macular volume (t=-2.69) was significantly smaller than the control group (P<0.05).There was no statistically difference at nasal CP-RNFL (t=-0.11),foveal retinal thickness (t=-0.59),temporal (t=-0.67) and inferior (t=-1.02) quadrants of macular outer-ring retinal thickness between two groups (P>0.05).Conclusions In comparison with the healthy subjects,the disc area,disc cup area,C/D area ratio,C/D horizontal diameter ratio,C/D vertical diameter ratio in APACG eyes were bigger,while rim area was smaller;the CP-RNFL and macular retinal thickness were thinner except nasal CP-RNFL,fovea,temporal and inferior quadrants of macular outer-ring retinal.
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Objective To observe the response of and recurrence in patients with localized eczema after treatment with topical glucocorticoid alone or in combination with topical antibacterials.Methods Totally,217 outpatients with acute or subacute localized eczema were enrolled and randomly classified into two groups to be treated with topical corticosteroids combined with mupirocin cream (experiment group,n=191) or topical corticosteroids alone (control group,n =190) for two weeks.The patients who were cured at the end of the 2-week treatment were followed for 13 weeks for the observation of recurrence.Chi-square test and Student's t test were conducted to compare the cure and recurrence rates between different groups of patients.Results After two weeks of treatment,the cure rate in the experiment group was significantly higher than that in the control group (80.6% vs.64.8%,x2 =6.576,P =0.01).Increased cure rate was also observed in patients with acute and subacute eczema receiving glucocorticoidCaspase14antibiotic combination therapy compared with those receiving corticosteroids alone.During the 13Caspase14week follow up,a lower recurrence rate was noted in the experiment group compared with the control group (15.6% vs.33.8%,x2 =6.455,P < 0.05).Further more,the patients experiencing relapse of eczema showed a higher proportion of hand eczema cases (29.4% vs.13.0%,x2 =4.982,P < 0.05)compared with those without relapse.Adverse reaction was mild in these patients,and no statistical difference was observed between the experiment group and control group (5.71% vs.4.46%,x2 =0.176,P > 0.05).Conclusion The combination with topical antibacterials may enhance the therapeutic effect of topical glucocorticoids on and reduce the recurrence of localized eczema.
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ObjectiveTo investigate the predisposing factors and pathogenic fungal species of Malassezia folliculitis in different geographical areas and body sites.MethodsTotally,241 patients diagnosed with Malassezia folliculitis were asked to complete a questionnaire.The content of hair follicles was obtained and subjected to fungal smear and culture examination.Fungal species were identified according to morphological,physiological and biochemical features.Results Of the 241 patients with Malassezia folliculitis,204 (84.65%) were positive for smear examination.A total of 259 specimens were collected from these patients,and fungal culture grew 213(82.24%) strains,of which,209 belonged to Malassezia species,4(1.54%) to Candida species.Among the 209 Malassezia strains,186 were activated and subjected to species identification which resulted in 6 species,including M.furfur (111 strains,59.68% ),M.sloofiae (43 strains,23.12% ),M.sympodialis (17 strains,9.14%),M.globosa (9 strains,4.84%),M.pachydermatis (4 strains,2.15%),and M.obtuse(2 strains,1.08% ).Of the pathogenic fungi of Malassezia folliculitis,M.furfur predominated in the chest,back,abdomen,face and neck,M.sloofiae in the upper limbs,shoulders and vertex,M.globosa in the lower limbs.There were obvious differences in the distribution of pathogenic fungal species at different body sites in a same host,and M.furfur with M.sloofiae or M.sympodialis appeared to be the most common pathogens.ConclusionsIn this study,6 Malassezia species are identified in patients with Malassezia folliculitis in Nantong and Nanjing area,M.furfur and M.sloofiae appear to be the dominant pathogens.