Dynamic distribution of Kappa angle in myopic patients undergoing FS-LASIK and its correlation analysis / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To explore the dynamic distribution of pupil size and center, the eccentricity distribution of corneal light reflection, and its correlation analysis about suitable for femtosecond laser combined with excimer laser <i>in situ</i> keratomileusis.<p>METHODS: Randomly selected 225 patients(407 eyes)who underwent femtosecond laser combined with excimer laser <i>in situ</i> keratomileusis at Yanbian University Hospital in 2019 from January to May, preoperative use of Wavelight Allegro Topolyzer Corneal Topography to measure the pupil size and center position, the German Wavelight EX500 excimer Laser(500Hz)records the deviation between the pupil center and the coaxially sighted corneal light reflex when the patient is supine. <p>RESULTS:The average displacement distribution between the center of the cornea and the center of the pupil is 0.322±0.194mm, and 64% of the eyes are ≤0.40mm. The average displacement distribution of P-Dist(the eccentricity between the pupil center and the coaxially sighted corneal light reflex point)is 0.225±0.102mm, and 80% of the eyes are ≤0.30mm. The coaxially sighted corneal light reflex point is mainly deviated to the superior temporal side of the corneal center(34%). The X-axis of the left eye in low light conditions: -0.061±0.084mm, and the X-axis of the right eye: -0.016±0.059mm(<i>P</i>=0.002)(the left eye shifted to the temporal side in the dark light). The corneal transverse diameter(WTW)was positively correlated with changes in pupil diameter(dark pupil diameter-bright pupil diameter)(<i>r</i>=0.270, <i>P</i><0.001).<p>CONCLUSION: The left eye should be adjusted to a position of the machining center within 0.061mm. If the cornea is too large, try to maintain a dark light environment during the operation to improve the efficiency of pupil matching. This study further confirms the necessity of rationally positioning the cutting center under different angle kappa states.

Gene modification induces differentiation of bone marrow mesenchymal stem cells into neurons for treatment of optic nerve injury / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the effect of gene modification on the differentiation of bone marrow mesenchymal stem cells into neuron in treatment of optic nerve injury.<p>METHODS: Lentivirus carrying the rat ciliary neurotrophic factor(CNTF)coding sequence was transfected into bone marrow mesenchymal stem cells isolated from rat femur. Rats with optic nerve injury constructed by clamp optic nerve method were randomly divided into control group and study group. On the 4, 7, 10 and 13d after successful modeling, the transfused bone marrow were injected into the vitreous cavity of the study group. The control group was injected with the same amount of normal saline. On the 14^th day after successful modeling, the light reflexes of the two groups of rats, the number of retinal ganglion cells and the expression of glial fibrillary acidic protein(GFAP)and Caspase-3 protein were observed.<p>RESULTS: The recovery rate of the study group was significantly higher than that of the control group(83% <i>vs</i> 25%, <i>P</i><0.05). The results showed that the retinal cells in the study group were relatively neat. A small amount of vacuoles were observed; the retinal cells in the control group were not well-structured, and obvious vacuoles were observed, and the number of cells was decreased. The results of Western blot showed that the expression level of GFAP and the expression level of Caspase-3 were higher than that of the rats in the study group.<p>CONCLUSION: Genetic modification induces bone marrow mesenchymal stem cells can effectively treat optic nerve injury in rats.

Inherited retinal degeneration in a Bengal cat / 대한수의학회지

A 2-year-old intact female Bengal cat was presented with a 6-month history of visual impairment. The cat manifested bilateral negative menace responses and dazzle reflexes and sluggish pupillary light reflexes. Bilateral fundus changes included generalized tapetal hyperreflectivity, advanced retinal vascular attenuation, and increased pallor of the optic disc. A diagnosis of bilateral retinal degeneration was made. The clinical findings suggest that the investigated Bengal cat was most likely to have an inherited retinal degeneration. Further studies of the Bengal cat breed are needed to determine the prevalence of inherited retinal degeneration in this breed in Korea.

Relation of visual field defect with pupil in patients with primary open angle glaucoma / 国际眼科杂志(Guoji Yanke Zazhi)

Abstract?AIM:To evaluate the pupil light reflex in patients with primary open angle glaucoma, and to investigate the relation between pupil and visual field defect.?METHODS:From July 2014 to October 2015, 115 eyes in 86 patients with primary open angle glaucoma and 23 eyes in 16 healthy individuals were continuously enrolled in this study.All the subjects received comprehensive eye examination, visual field examination ( Humphrey, SITA Standard 24-2 ) and dynamic pupil measurement ( MonCV3 Metrovision) .According to the visual field and the Glaucoma Staging System, the patients with glaucoma were divided into 5 subgroups: stage 1, stage 2, stage 3, stage 4 and stage 5. The parameters of pupillary light reflex were as follows: pupil diameter ( minimum, maximum ) , latency and duration of contraction, latency and duration of dilatation, contraction amplitude, contraction and dilatation speed, and percent of pupil contraction ( PPC ). SPSS 19.0 statistical software was used to analyze the measurement results.?RESULTS:The control group significantly differed from the stage 4 subgroup ( P=0.032 ) and stage 5 subgroup (P=0.014) in terms of minimum pupil diameter; there was significant difference in the pupil contraction speed between groups ( F =648.675, P <0.01 ), and the contraction speed in stage 5 subgroup was significantly lower than those in the other subgroups and control group (P<0.05); the control group significantly differed from the stage 3, stage 4, and stage 5 subgroup in terms of PPC ( P<0.05 ).Pupil contraction speed, PPC and minimum diameter showed correlation with the stages of glaucoma.?CONCLUSION:Pupil contraction ability in patients with primary open angle glaucoma was impaired, and the degree of impairment is related with the degree of visual field defect.

Clinical Utility of an Automated Pupillometer in Patients with Acute Brain Lesion

OBJECTIVE: The purpose of this study was to evaluate the clinical utility and validity of using a pupillometer to assess patients with acute brain lesions. METHODS: Pupillary examinations using an automated pupillometer (NeurOptics(R)NPi(TM)-100 Pupillometer) were performed every 4 hours and were simultaneously assessed using the Glasgow Coma Scale (GCS) and for intracranial pressure (ICP), from admission to discharge or expire in neuro-intensive care unit (NICU). Manual pupillary examinations were also recorded for comparison. By comparing these data, we evaluated the validity of using automated pupillometers to predict clinical outcomes. RESULTS: The mean values of the Neurologic Pupillary index (NPi) were different in the groups examined manually. The GCS correlated well with NPi values, especially in severe brain injury patients (GCS below 9). However, the NPi values were weakly correlated with intracranial pressure (ICP) when the ICP was lower than 30 cm H2O. The NPi value was not affected by age or intensity of illumination. In patients with a "poor" prognosis who had a Glasgow Outcome Scale (GOS) of 1 or 2, the mean initial NPi score was 0.88+/-1.68, whereas the value was 3.89+/-0.97 in patients with a "favorable" prognosis who had a GOS greater than 2 (p<0.001). For predicting clinical outcomes, the initial NPi value of 3.4 had the highest sensitivity and specificity. CONCLUSION: An automated pupillometer can serve as a simple and useful tool for the accurate measurement of pupillary reactivity in patients with acute brain lesions.

Comparison of ocular function and refractive errors both Hansen patients and old people / 나학회지

BACKGROUND & OBJECTIVE: The purpose of this study is to prove the characteristics of refractive error and visual acuity about hansen patients and old people. To compare the pupil and ocular function was to investigate the characteristics of the eye of the hansen patients. METHODS: Subjects were intended for the elderly over 60 years old 85 years old or younger both hansen patients in Wonju(n=29) and old people in Yangpyeong(n=29). Auto refraction(Topcon KR-7000) to objective refraction was conducted after the subjective refraction. Pupil size at normal illumination and light reflex, response velocity and the reaction states about light reflex were measured and Color vision test were. Writing questionnaires and analyzed the subjective symptoms about two groups. Spss ver.18.0 was used for statistics analysis and significance level was based on a 0.05. Methods were used Crosstabs analysis ,Paired T test and descriptive statistics. RESULTS & CONCLUSION: VA of hansen patients and old people did not differ by 0.29 +/-0.18 and 0.35+/-0.23. (p>0.05). CC of hansen patients and old people did differ by 0.55+/-0.26 and 0.44+/-0.21(p0.05). Old people during normal illumination and light reflex is normal (p<0.05). Direct light reflex state of hansen patients was normal 17.20% and abnormal 82.8%. Pupil's response velocity during light reflex of hansen patients was normal 3.4% and abnormal 96.6%. Pupil's reaction state during light reflex of hansen patients was normal 13.8%and abnormal 86.20%. Direct light reflex state of old people was normal 96.60%and abnormal 3.4%. Subjective symptoms were ranking 1.Dim sighted(23times) 2.Eyestrain(18times) 3.Tears(15times) of Hansen, that were ranking 1.Dim sighted(25times) 2.Tears(8times) 3.Pruritus(8times)of old people. Hansen patients and old people were not differ about result of CV test.

Antagonism of obidoxime on sarin induced miosis and visual impairment in rabbits / 中国药理学与毒理学杂志

OBJECTIVE The antagonism of obidoxi me on sarin induced miosis and visual impair-ment was evaluated and its antagonistic mechanism was investigated.METHODS ① 30 min after sarin (2 μg /0.1 mL per eye)was given as an eyedrop,the ability of the 2.5%,5.0%,7.5% obidoxi me and 1 .0% atropine to reverse effects of sarin on pupil dia meter and light reflex were evaluated at different ti mes.② Another 36 rabbits received sarin and at 30 min afer sarin exposure,the drugs above were ad-ministrated and their effects on pupillary light reflex,as well as the AChE activity of cornea,iris and reti-na were recorded 4h after the treatment.RESULTS ① Miosis and impaired pupillary light reflex oc-curred soon after sarin exposure but the abnormal pupil width and pupillary light reflex had disappeared by 48 h after sarin exposure;Subcequent to 1 .0% atropine treatment,the pupil dilatedinstead while the impaired light reflex did not i mprove significantly;unlike atropine,soon after ad ministration of 2.5%, 5.0%,7.5% obidoxi me,the pupil dia meter and light reflex were significantly increased(P <0.01 )and then had beco me normal totally by 24 h post-dose,much faster than those of the control and atropine treatment group.However,there was no significant difference in the recovery ti me between the different dose groups of obidoxi me.② 4h after treatment,the AChE activity in cornea and irisof sarin-treated group were (42 ±4)%,(26 ±2)%,respectively;the AChE activity in cornea of 2.5%,5.0%,7.5%obidoxi me were (74 ±1 1 )%,(81 ±10)% and (74 ±7)%,respectively,and the AChE activity in iris were(39 ±10)%,(43 ±8)% and (43 ±8)%,respectively ,co mpared with sarin-treated group,AChE activities of cornea and iris as well as light reflex of the obidoxi me-treated group were significantly increased(P<0.01 ).But there was no difference in light reflex and AChE activity between the sarin-treated and atropine-treated groups.CONCLUSION Obidoxi me showed better antagonism of sarin-induced ocular effects than that of the commonly used drug,atropine;the antagonistic mechanism is likely closely related to its rapid reactivation of the inhibited AChE in the cornea and iris.

Application of dynamic pupillometer in the evaluation of pupillary light reflex in C57BL/6 mouse / 中华实验眼科杂志

Background Pupillary light reflex has been widely used in the diagnosis and evaluation of visual system and nervous system diseases.However,in animal experiments,functional evaluation of the visual system and nervous system needs more advanced technology and are affected by many factors.Objective This study was to explore the use of the dynamic pupillometer in evaluating pupillary light reflex and to discuss the influence of brightness of stimulate on relevant curve parameters in C57BL/6 mouse.Methods Ten healthy SPF male C57BL/6 mice were collected in this experiment.White light of five luminance levels (2,8,32,128,256 cd/m2) was used to stimulate the mice following a 2-hour dark adaptation.The stimulation was given at the 60-second intervals,for a duration of 100 ms at every stimulation.An infrared camera and video capture card were used to capture digital images during the measuring process in a scotopic environment,at a speed of 60 frames per second.Measuring outcome was saved in the*.AVI format.A software that was developed by our group was used to determine pupil diameter and output pupillary light reflex curve offline.Pupil initial diameter (R1),constriction amplitude (CA),constriction velocity (CV),latency (T1),time for maximum velocity (T2),time for maximum constriction (T3),time for maximun con-striction to 10.1％ R1 re-dilation (RT)and re-dilation velocity (RV)were assessed,and the correlations between luminosity and measuring parameters were analyzed using the Spearman rank correlation.The use of animals followed the Regulations for thd Administration of Affairs Concerning Experimental Animals by State Science and Technology Commission.Results R1 values showed no statistically significant difference among the 5 different luminosity groups(F=1.117,P=0.361).A positive linear correlation was found between stimulating luminosity and CA(r=0.508,P＜ 0.01),but negative correlations were seen between stimulating luminosity and CV or RV (r=-0.625,-0.609,P＜0.01).T1 and T2 values in the 5 different luminosity groups were not statistically significant (F =0.202,P =0.936 ; F =1.584,P =0.195).The different levels of stimulating luminosity showed positive linear correlations with T3 and RT values (r =0.791,0.609,P＜ 0.01).Conclusions The dynamic pupillometer can quantitatively measure the pupillary light reflex of C57BL/6 mice.The pupillary light reflex dynamic curve parameters of mouse were affected by stimulus luminosity levels.These outcomes offer a basis for the application of the dynamic pupillometer system for measuring pupillary light reflex in animal models.

Changes of Ocular Version with Aging in Normal Korean Population

The purpose of this study is to estimate normative values of maximum versions in healthy Koreans and investigate age-associated changes in eye movement, using lateral and vertical version light-reflex (LVR) test. Two hundred forty normal healthy subjects whose corrected visual acuity was better than 20/50 in both eyes, from 4 to 79 yr old (30 subjects in each decade) were studied. Maximum sustained values of dextroversion, levoversion, supraversion, and infraversion in each eye were measured using LVR test. Changes of versions according to age were analyzed. Mean normal value of dextroversion, levoversion, supraversion, and infraversion in normal Koreans was 7.7 mm, 41.6degrees, 33.9degrees, and 7.7 mm respectively. Contrary to values of Caucasians, levoversion (adductive movement) was more excessive and infraversion (depression) was smaller in Koreans. All versions were decreased with aging (P<0.001 for all). Levoversion had the largest decrease with aging compared with other versions (P<0.001, respectively) and infraversion had the least decrease with age than levoversion (P<0.001), supraversion (P<0.001). All maximal sustained versions were decreased with aging but the ranges of ocular movements in Koreans were different with Caucasians as version least affected and most affected by age was infraversion and levoversion in Koreans. The study standardized normal maximal versions and aging changes of versions in Koreans.

Efficacy of the Decompressive Craniectomy for Acute Cerebral Infarction: Timing of Surgical Intervention and Clinical Prognostic Factors

OBJECTIVE: Acute cerebral infarction is often accompanied by transtentorial herniation which can be fatal. The aim of this study is to determine the timing of surgical intervention and prognostic factors in patients who present with acute cerebral infarction. METHODS: We reviewed retrospectively 23 patients with acute cerebral infarction, who received decompressive craniectomy or conservative treatment from January 2002 to December 2004. We divided patients into two groups according to the treatment modalities (Group 1: conservative treatment, Group 2: decompressive craniectomy). In all patients, the outcome was quantified with Glasgow Outcome Scale and Barthel Index. RESULTS: Of the 23 patients, 11 underwent decompressive craniectomy. With decompressive craniectomy at the time of loss of pupillary light reflex, we were able to prevent death secondary to severe brain edema in all cases. Preoperative Glasgow Coma Scale and loss of pupillary light reflex were significant to the clinical outcome statistically. With conservative treatment, 9 of the 12 patients died secondary to transtentorial herniation. The clinical outcomes of remaining 3 patients were poor. CONCLUSION: This study confirms the value of life-saving procedure of decompressive craniectomy after acute cerebral infarction. We propose that the loss of pupillary light reflex should be considered one of the most important factors to determine the timing of the decompressive craniectomy.

The Amounts of Horizontal Ocular Movement in Korean People and Comparison According to Methods of Measurement

PURPOSE: To estimate and standardize horizontal ocular movement of normal Korean people and, to adapt correlations among three Methods for clinical approach. METHODS: This study investigated the amounts of horizontal ocular movement in normal Korean people whose age was ranged from 20 to 79 (50 persons in each age decades) by the lateral version light reflex Method, the limbus test of motility and the imaginary vertical line Method, and compared relationships among the amounts measured with above three Methods by Spearman correlation coefficient. The study subjects were three hundred people who visited Dept. of Ophthalmology at Gyeongsang National University Hospital, whose best corrected visual acuity was no less than 20/50 Snellen visual acuity chart, who had no history of ophthalmic operation and diseases, whose age was ranged from 20 years to 79 years (50 persons in each age decades). RESULTS: In imaginary vertical line Method, the excessive ocular movements were more frequent in younger people than in elder people. With age the proportion of the excessive ocular movement was gradually decreased and that of the normal ocular movement was increased until 6th decades. With other two Methods, the amounts of horizontal ocular movement was higher in younger ages than in elder ages and they decreased with aging. There were significantly moderate correlation (rs = - 0.54 to - 0.64) between age and ocular movement, and high correlation (rs = 0.79 to 0.86) among ocular amounts measured with imaginary vertical line Method, the lateral version light reflex test, and the limbus test of motility of Kestenbaum. CONCLUSIONS: This study suggests that any Method of three is reliable clinically.

Change on Lens Accomodation and Pupil Light Reflex in VDT works / 예방의학회지

We studied on change of lens accommodation and pupil light reflex caused by VDT work in six women and compared them with those of other office works. The results were as follows. 1. In VDT work group, the accommodation contraction velocity decreased during the first 2-hr VDT task, then recovered markedly by the end of the one-hour lunch break, and then decreased again by the end of the 2nd 2-hr VDT task. Changes of relaxation velocity showed similar pattern although it was less typical than that of contraction velocity. 2. There was no marked change in accommodation contraction velocity and amplitude of accommodation in general office work group and near-distance office work group, and in the near-distance office work accommodation relaxation velocity decreased according to work load without recovery after lunch break. 3. Initial pupil diameter, initial pupil area of light reflex decreased significantly during VDT task only in VDT work group, and didn't recover after lunch break. These results suggest possibility that changes of accommodation contraction velocity, accommodation relaxation velocity, near point distance, and pupil diameter and area are useful in evaluating characteristics of VDT work. For this, more research adjusted individual differences, circadian rhythm, emotional stress needs.

The Effect of Acupuncture on Pupillary Dynamics / 日本温泉気候物理医学会雑誌

Although the clinical usefulness of acupuncture has been widely accepted, quantitative analysis of the effects of acupuncture had received little attention. We therefore examined the pupillary dynamics before and after acupuncture treatment on 30 patients with tension type headaches and 15 healthy volunteers. We used open-loop video pupillography, which enables objective measurement of autonomic nervous functions, and obtained the results below.<br>1) In patients with tension type headaches, acupuncture reduced the pupillary area before photic stimulation (A1) (10min after: p<0.01, immediately after and 20min after: p<0.05) and increased maximum velocity (VC) and acceleration (AC) of constriction (p<0.01). However, no significant changes were observed in maximum velocity of dilatation (VD).<br>2) In healthy volunteers, acupuncture transiently increased VC alone (p<0.05), and no significant changes were observed in other parameters.<br>The above data suggested that open-loop video pupillography is a useful method to quantitatively analyze the effect of acupuncture on pupillary dynamics and that parasympathetic nervous functions play an important role in the effect of acupuncture in the patients with tension type headaches. Also, it is possible that acupuncture may affect the central nervous system at a higher level of the medulla spinalis.