Using choroidal thickness to detect myopic macular degeneration.

AIM: To explore the usage of choroidal thickness measured by swept-source optical coherence tomography (SS-OCT) to detect myopic macular degeneration (MMD) in high myopic participants. METHODS: Participants with bilateral high myopia (≤-6 diopters) were recruited from a subset of the Guangzhou Zhongshan Ophthalmic Center-Brien Holden Vision Institute High Myopia Cohort Study. SS-OCT was performed to determine the choroidal thickness, and myopic maculopathy was graded by the International Meta-Analysis for Pathologic Myopia (META-PM) Classification. Presence of MMD was defined as META-PM category 2 or above. RESULTS: A total of 568 right eyes were included for analysis. Eyes with MMD (n=106, 18.7%) were found to have older age, longer axial lengths (AL), higher myopic spherical equivalents (SE), and reduced choroidal thickness in each Early Treatment Diabetic Retinopathy Study (ETDRS) grid sector (P<0.001). The area under the receiver operating characteristic (ROC) curves (AUC) for subfoveal choroidal thickness (0.907) was greater than that of the model, including age, AL, and SE at 0.6249, 0.8208, and 0.8205, respectively. The choroidal thickness of the inner and outer nasal sectors was the most accurate indicator of MMD (AUC of 0.928 and 0.923, respectively). An outer nasal sector choroidal thickness of less than 74 µm demonstrated the highest odds of predicting MMD (OR=33.8). CONCLUSION: Choroidal thickness detects the presence of MMD with high agreement, particularly of the inner and outer nasal sectors of the posterior pole, which appears to be a biometric parameter more precise than age, AL, or SE.

Circular RNA hsa_circ_0007990 as a blood biomarker for unruptured intracranial aneurysm with aneurysm wall enhancement.

Background: Circular RNAs (circRNAs) may involve the formation and rupture of intracranial aneurysms (IA). Inflammation plays a vital role in the development and progression of IA, which can be reflected by aneurysm wall enhancement (AWE) on high-resolution vessel wall magnetic resonance imaging (HR-VWI). This study aims to evaluate the role of circRNAs as the blood inflammatory biomarker for unruptured IA (UIA) patients with AWE on HR-VWI. Methods: We analyzed the circRNA expression profiles in the peripheral blood samples among subjects from saccular UIA with AWE, UIA without AWE, and healthy controls by the circRNA microarray. The differential expression of hsa_circ_0007990 was assessed. We constructed the hsa_circ_0007990-microRNA-mRNA network and the regulatory axis of hub genes associated with the AWE in UIA. Results: Eighteen patients harboring saccular UIAs with HR VWI and five healthy controls were included. We found 412 differentially expressed circRNAs between UIA patients and healthy controls by circRNA microarray. Two hundred thirty-one circRNAs were significantly differentially expressed in UIA patients with AWE compared with those without AWE. Twelve upregulated circRNAs were associated with AWE of UIA, including hsa_circ_0007990, hsa_circ_0114507, hsa_circ_0020460, hsa_circ_0053944, hsa_circ_0000758, hsa_circ_0000034, hsa_circ_0009127, hsa_circ_0052793, hsa_circ_0000301 and hsa_circ_0000729. The expression of hsa_circ_0007990 was increased gradually in the healthy control, UIA without AWE, and UIA with AWE confirmed by RT-PCR (P<0.001). We predicted 4 RNA binding proteins (Ago2, DGCR8, EIF4A3, PTB) and period circadian regulator 1 as an encoding protein with hsa_circ_0007990. The hsa_circ_0007990-microRNA-mRNA network containing five microRNAs (miR-4717-5p, miR-1275, miR-150-3p, miR-18a-5p, miR-18b-5p), and 97 mRNAs was constructed. The five hub genes (hypoxia-inducible factor 1 subunit alpha, estrogen receptor 1, forkhead box O1, insulin-like growth factor 1, CREB binding protein) were involved in the inflammatory response. Conclusion: Differentially expressed blood circRNAs associated with AWE on HR-VWI may be the novel inflammatory biomarkers for assessing UIA patients. The mechanism of hsa_circRNA_0007990 for UIA progression needs to investigate further.

Inhibitory effect of baicalin on orthodontically induced inflammatory root resorption in rats.

OBJECTIVE: This study investigated the inhibitory effect of baicalin on orthodontically induced inflammatory root resorption in rats. METHODS: Forty-five male Wistar rats were randomly divided into three groups of 15 rats each. Fifty grams of force was used to establish an orthodontic tooth movement model. Baicalin (40 mg/kg) was locally injected into rats in the baicalin group at 3-day intervals; concurrently, normal saline was injected into rats in the negative control group. On the 21st day after orthodontic treatment, the tooth movement distance and root resorption area ratio were measured. Histomorphology changes were observed by hematoxylin and eosin staining and immunohistochemistry. RESULTS: There was no significant difference in tooth movement distance between groups. The root resorption area ratio was significantly lower in the baicalin group than in the negative control group. Runx-2 expression was significantly higher in the baicalin group than in the negative control group, while tumor necrosis factor (TNF)-α expression was significantly lower in the baicalin group than in the negative control group. CONCLUSIONS: Baicalin inhibits orthodontically induced inflammatory root resorption by enhancing the expression of Runx-2 and reducing the expression of TNF-α, but does not affect tooth movement distance.

Comparisons of ganglion cell-inner plexiform layer loss patterns and its diagnostic performance between normal tension glaucoma and primary open angle glaucoma: a detailed, severity-based study.

AIM: To evaluate the patterns of macular ganglion cell-inner plexiform layer (GCIPL) loss in normal tension glaucoma (NTG) and primary open angle glaucoma (POAG) in a detailed, disease severity-matched way; and to assess the diagnostic capabilities of GCIPL thickness parameters in discriminating NTG or POAG from normal subjects. METHODS: A total of 157 eyes of 157 subjects, including 57 normal eyes, 51 eyes with POAG and 49 eyes with NTG were enrolled and strictly matched in age, refraction, and disease severity between POAG and NTG groups. The average, minimum, superotemporal, superior, superonasal, inferonasal, inferior, and inferotemporal GCIPL thickness, and the average, superior, temporal, inferior, and nasal retinal nerve fiber layer (RNFL) thickness were obtained by Cirrus optical coherence tomography (OCT). The diagnostic capabilities of OCT parameters were assessed by area under receiver operating characteristic (AUROC) curves. RESULTS: Among all the OCT thickness parameters, no statistical significant difference between NTG group and POAG group was found (all P>0.05). In discriminating NTG or POAG from normal subjects, the average and inferior RNFL thickness, and the minimum GCIPL thickness had better diagnostic capabilities. There was no significant difference in AUROC curve between the best GCIPL thickness parameter (minimum GCIPL) and the best RNFL thickness parameter in discriminating NTG (inferior RNFL; P=0.076) and indiscriminating POAG (average RNFL; P=0.913) from normal eyes. CONCLUSION: Localized GCIPL loss, especially in the inferior and inferotemporal sectors, is more common in NTG than in POAG. Among all the GCIPL thickness parameters, the minimum GCIPL thickness has the best diagnostic performance in differentiating NTG or POAG from normal subjects, which is comparable to that of the average and inferior RNFL thickness.

Prevalence of bullying among primary and middle school students in Beijing / 中国学校卫生

Objective@#To explore the prevalence and characteristics of traditional bullying and cyberbullying behavior among primary and middle school students and to provide evidence for the comprehensive intervention.@*Methods@#An anonymous self-administrated questionnaire survey was conducted among 12 417 students (grade 5 to 12) selected with multi-stage cluster random sampling in 16 districts in Beijing between Sept. and Oct. 2017. Descriptive statistics and chi square test were used for statistical analysis.@*Results@#In the past 6 months, 2.6% of students were reported to be involved in traditional bullying,10.6% were reported of being bullied. 1.0% of students were reported to be involved in cyberbullying, and 2.8% reported of being bullied. Boys reported significantly higher rates of traditional bullying and cyberbullying behavior. The reporting rate of traditional bullying and cyberbullying gradually increased with grade. The reporting rate of traditional bullying was highest in junior high school, while cyberbullying was common in both junior and senior high school. Students with low academic performance were more likely to involve in bully as perpetrators in both types(P<0.05). The higher maternal education background was, the higher their children involved in bullying perpetrators(P=0.03). The proportion of students who reported bullied at school was higher than cyberbullying(χ2=15.25, P<0.01). Cyberbullying were more likely to take place outside school compared with traditional bullying(χ2=3.98, 9.76, P<0.05). Compared with traditional bullying, cyberbullying has a higher proportion of various types of bullying or being bullied.@*Conclusion@#Bullying is still prevalent among primary and middle school students in Beijing, and cyberbullying is becoming more widespread. Schools, family and the community-based comprehensive prevention strategies should be developed for a safe campus and network environment to prevent traditional and cyberbullying.

Increased aquaporin-1 levels in lens epithelial cells with primary angle-closure glaucoma.

AIM: To determine the levels of aquaporin-1 (AQP-1) in the lens epithelial cells (LECs) of primary glaucoma and to clarify its correlation with lens thickness. METHODS: This study comprised 64 eyes of 64 patients with primary glaucoma, who were divided into 3 groups: 25 eyes of 25 patients with acute primary angle-closure glaucoma (APACG), 19 eyes of 19 patients with chronic primary angle-closure glaucoma (CPACG) and 20 eyes of 20 patients with primary open angle glaucoma (POAG). This study also included 12 eyes of 12 patients with senile cataract as controls. The levels of AQP-1 in LECs were examined by real-time quantitative polymerase chain reaction (RT-qPCR) and immunohistochemistry. The lens thickness was measured by A-scan ultrasonography. RESULTS: The AQP-1 mRNA levels of LECs were 0.84±0.27, 0.69±0.34, 0.44±0.19 and 0.51±0.21 in APACG, CPACG, POAG and senile cataract group, respectively. The levels of AQP-1m RNA were significantly higher in PACG groups compared with those in senile cataract and POAG group (all P<0.05). The immunohistochemistry showed the AQP-1 expression were strong-positive in PACG groups, but weak-positive in senile cataract and POAG group. A positive correlation was found between AQP-1 mRNA levels and the lens thickness (r=0.645, P<0.001). CONCLUSION: These findings show that the higher expression of AQP-1 in LECs may contribute to increased lens thickness, which might be associated with the occurrence and development of PACG.

Surgical Outcomes of Trabeculotomy in Newborns with Primary Congenital Glaucoma.

BACKGROUND: Early surgical intervention is required for the primary congenital glaucoma (PCG). There are currently few reports on the surgical outcomes in infants with PCG. This study aimed to evaluate the efficacy and safety of trabeculotomy and the postoperative visual outcomes in Chinese newborns with PCG within 4 weeks of birth. METHODS: A total of 21 eyes of 12 patients with PCG who underwent primary trabeculotomy within 4 weeks of birth were retrospectively studied. Preoperative and postoperative intraocular pressure (IOP), corneal clarity and diameter, axial length and optic disc cupping, visual acuity and postoperative refractive error, success rates, and complications were evaluated. Kaplan-Meier survival analysis was applied to evaluate the success rates. RESULTS: The mean follow-up time was 46.9 ± 34.4 months (range: 12-122 months). The postoperative IOP was significantly lower than the preoperative IOP at all of the follow-up visits (P < 0.001). The complete success rates for all eyes at 1, 2, 3, and 5 years postoperatively were 90.5%, 85.7%, 85.7%, and 85.7%, respectively. The IOPs of the three patients who needed antiglaucomatous medications postoperatively were also well controlled. At the last visit, the cornea became clear, and the cup-to-disc ratio decreased significantly (P = 0.01) although the horizontal corneal diameter did not change significantly (P = 0.11). Visual acuities were able to be recorded in eight eyes at the last visit, among which six eyes had a best-corrected visual acuity of 20/40 or better. There were no severe intraoperative or postoperative complications. CONCLUSIONS: Trabeculotomy proves to be a safe and effective treatment in reducing IOP in this group of Chinese newborns with PCG. The outcomes of vision function were satisfactory in most of the patients.

Damage to the Blood-Aqueous Barrier in Ocular Blunt Trauma and Its Association with Intraocular Pressure Elevation.

BACKGROUND: The aim of this study is to provide a quantitative evaluation of the blood-aqueous barrier (BAB) in patients with ocular blunt trauma and evaluate its association with intraocular pressure (IOP) elevation. METHODS: This is a prospective case-control study, and the following 3 groups were included: elevated IOP (45 patients with an elevated IOP secondary to ocular blunt trauma), normal IOP (27 patients with a normal IOP after ocular blunt trauma), and healthy controls. The main outcome measures were IOP and BAB function evaluated using a laser flare-cell meter (LFCM). RESULTS: Patients had significantly higher flare intensities and cell counts than the normal controls (both p < 0.001), and the elevated-IOP group displayed even higher LFCM readings than the normal-IOP group. Aqueous flare and cell readings were positively correlated with IOP (r = 0.529 and 0.590, respectively, p < 0.001). LFCM readings in the elevated-IOP group were still significantly high even on postraumatic day 120 following anti-inflammatory treatment. CONCLUSION: BAB dysfunction occurred following ocular blunt trauma. Eyes with an elevated IOP displayed a more seriously disturbed BAB and a longer recovery course. Examination with a LFCM provides insight into the pathophysiology of IOP elevation and assists in making decisions concerning anti-inflammatory treatment during follow-up.

Therapeutic Effects of Sodium Hyaluronate on Ocular Surface Damage Induced by Benzalkonium Chloride Preserved Anti-glaucoma Medications.

BACKGROUND: Long-term use of benzalkonium chloride (BAC)-preserved drugs is often associated with ocular surface toxicity. Ocular surface symptoms had a substantial impact on the glaucoma patients' quality of life and compliance. This study aimed to investigate the effects of sodium hyaluronate (SH) on ocular surface toxicity induced by BAC-preserved anti-glaucoma medications treatment. METHODS: Fifty-eight patients (101 eyes), who received topical BAC-preserved anti-glaucoma medications treatment and met the severe dry eye criteria, were included in the analysis. All patients were maintained the original topical anti-glaucoma treatment. In the SH-treated group (56 eyes), unpreserved 0.3% SH eye drops were administered with 3 times daily for 90 days. In the control group (55 eyes), phosphate-buffered saline were administered with 3 times daily for 90 days. Ocular Surface Disease Index (OSDI) questionnaire, break-up time (BUT) test, corneal fluorescein staining, corneal and conjunctival rose Bengal staining, Schirmer test, and conjunctiva impression cytology were performed sequentially on days 0 and 91. RESULTS: Compared with the control group, SH-treated group showed decrease in OSDI scores (Kruskal-Wallis test: H = 38.668, P < 0.001), fluorescein and rose Bengal scores (Wilcoxon signed-ranks test: z = -3.843, P < 0.001, and z = -3.508, P < 0.001, respectively), increase in tear film BUT (t-test: t = -10.994, P < 0.001) and aqueous tear production (t-test: t = -10.328, P < 0.001) on day 91. The goblet cell density was increased (t-test: t = -9.981, P < 0.001), and the morphology of the conjunctival epithelium were also improved after SH treatment. CONCLUSIONS: SH significantly improved both symptoms and signs of ocular surface damage in patients with BAC-preserved anti-glaucoma medications treatment. SH could be proposed as a new attempt to reduce ocular surface toxicity, and alleviate symptoms of ocular surface damage in BAC-preserved anti-glaucoma medications treatment.

[Detection of the anterior segment configuration of primary angle-closure glaucoma by anterior segment optical coherence tomography].

OBJECTIVE: To quantitatively measure and evaluate the ocular anterior segment parameters in different subtypes of primary angle-closure glaucoma (PACG) using anterior segment optical coherence tomography (AS-OCT). METHODS: This retrospective study collected Fifty-five subjects (55 eyes) with APACG, 63 (63 eyes) with chronic primary angle-closure glaucoma (CPACG) and 90 (90 eyes) normal controls from December 2009 to December 2010 in Zhongshan Ophthalmic Center. AS-OCT examination was performed on all patients and the anterior segment parameters were recorded including: central anterior chamber depth (ACD), anterior chamber width (ACW), anterior chamber volume (ACV), angle opening distance (AOD), trabecular iris area (TISA), angle recess area (ARA), lens thickness (LT) and crystalline lens rise (CLR). The differences of parameters between APACG, CPACG and normal controls were compared. RESULTS: The anterior segment parameters of APACG and CPACG were significantly (P ≤ 0.001) smaller, respectively, than those of normal controls (PACG: ACD 1.81 ± 0.25 mm, ACW 11.30 ± 0.43 mm, AOD 0.039 mm, ARA 0.038 mm(2), ACV 72.8 ± 16.04 mm(3), TISA 0.017 mm(2), Mean ± SD, and CPACG: ACD 2.02 ± 0.25, ACW 11.49 ± 0.45, AOD 0.042, ARA 0.053, ACV 83.60 ± 19.49, TISA 0.022 vs. normal: ACD 2.70 ± 0.35, ACW 11.81 ± 0.47, AOD 0.260, ARA 0.197, ACV 148.52 ± 31.89, TISA 0.100). The LT and CLR of PACG were significantly (P < 0.001) larger, respectively, than that of normal controls (LT: APACG 5.22 ± 0.38, CPACG 5.06 ± 0.36 mm, CLR: APACG 1.07 ± 0.26, CPACG 0.94 ± 0.21 mm vs. normal: LT 4.57 ± 0.42, CLR 0.39 ± 0.33 mm). Compared with CPACG, the anterior segment parameters of APACG were significantly (P < 0.001 - 0.015) decreased, but the LT (P = 0.003) and CLR were significantly (P < 0.001) increased. Compared with APACG-fellow eyes, the anterior segment parameters of APACG-attacked eyes were significantly (P < 0.001 - 0.041) decreased (Fellow-eye: ACD 1.90 ± 0.23 mm, AOD 0.045 mm, TISA 0.037 mm(2), ARA 0.047 mm(2) vs. attached-eye: ACD 1.81 ± 0.25, AOD 0.039, TISA 0.017 and ARA 0.038), while CLR was significantly (t = 1.349, P = 0.043) increased (fellow-eye: 1.01 ± 0.23 mm vs. Attached-eye: 1.07 ± 0.26). There was no significant difference in the other AS-OCT parameters between APACG-attacked eyes and fellow eyes (t = 0.574 - 1.147, P = 0.257 - 0.567). CONCLUSIONS: Our results indicated a more crowding anterior segment configuration in PACG than that in normal controls and a more anterior located and thicker lensing APACG than that in CPACG, which constitute a morphological basis of acute attack.

[Fundus features of nanophthalmos analyzed by optical coherence tomography].

OBJECTIVE: To observe the fundus features of nanophthalmos with or without secondary glaucoma using spectral domain optical coherence tomography (SD-OCT). METHODS: It was a retrospective case-series study. Twenty-three eyes of 12 patients (6 female, 6 male) who were clinically identified to be nanophthalmos (axial length ≤ 20.0 mm) in Zhongshan Ophthalmic Center from June 2008 to December 2010 and twenty-three eyes of 23 age and sex matched normal controls were included in this study. All patients underwent ophthalmological examinations including best-corrected visual acuity, refraction, slit-lamp biomicroscopy and fundus examination, Goldmann applanation tonometry, A-scan and B-scan ultrasound examinations, ultrasound biomicroscopy, fundus photography and spectral domain optical coherence tomography (SD-OCT). All examinations were carried out with natural pupil. The fundus features detected by OCT were compared between nanophthalmos and normal controls, and among nanophthalmos with or without secondary glaucoma.Independent-samples t test was used to analyze the difference of retinal thickness between nanophthalmoic eyes and controls and also between nanophthalmoic eyes with and without secondary glaucoma. Pearson correlation analysis was used to analyze the correlation between axial length and macular retinal thickness. RESULTS: The average age of 12 patients was (25.0 ± 13.1) years, and the mean axial length was (17.30 ± 1.66) mm. Thirteen eyes suffered from secondary glaucoma because of angle closure with average intraocular pressure (IOP) of (28.62 ± 9.18) mm Hg (1 mm Hg = 0.133 kPa). The average IOP of the other 10 eyes without secondary glaucoma was (14.96 ± 3.21) mm Hg.OCT images revealed thickening of the retina in macular fovea, with residual retinal nerve fiber layer, ganglion cell layer, inner plexiform layer, inner nuclear layer, outer plexiform layer, and broadened outer nuclear layer in 23 eyes with nanophthalmos. Pre-retinal folds were seen in 5 eyes with macular cysts.Shallow serous retinal detachment was found in 3 eyes, 2 of which showed focal thickening of retinal pigment epithelium as leopard spots. The cup were not obvious and retina around optic nerve head was thickened in 10 eyes without secondary glaucoma and 4 eyes with secondary early glaucoma, which seemed to be pseudopapilloedema. The other 9 eyes with secondary late glaucoma revealed enlarged cup . The mean macular foveal thickness of nanophthalmic eyes[ (335.65 ± 91.45) µm] was significantly thickened than normal control group [(192.72 ± 11.18) µm] (t = 10.50, P = 0.000) . The mean macular foveal thickness of nanophthalmos with glaucoma [(323.70 ± 104.09) µm] was thinner than those without glaucoma [(403.50 ± 130.24) µm] (t = 3.50, P = 0.002). Macular foveal thickness were negatively related with axial length in both nanophthalmos with and without secondary glaucoma (R = -0.797, P = 0.001). CONCLUSIONS: Macular hypoplasia and crowded optic nerve head are two important characteristic of fundus appearances in nanophthamos.SD-OCT can clearly reveal the changes of macular retina and optic nerve head. SD-OCT will be a very useful tool to help diagnose nanophthamos and evaluate its possible complications.

[Protection effect of sodium hyaluronate on ocular surface toxicity induced by Benzalkonium chloride-preserved brimonidine in rabbits].

OBJECTIVE: To investigate the protective effects of sodium hyaluronate on ocular surface toxicity induced by a prolonged use of benzalkonium chloride-preserved Brimonidine eye drops. METHODS: Experimental study. Thirty adult female New Zealand rabbits were divided into three groups with randomized numbers design. Ten rabbits were treated with 0.2% Brimonidine eye drops and PBS (PBS group), the other ten rabbits with 0.2% Brimonidine combined with sodium hyaluronate eye drops (SH group), and control group received no treatment for 60 days. Schirmer test, fluorescein (FL) and Rose Bengal (RB) staining, conjunctival impression cytology specimens collecting were performed on day 0, 31, and 61. Apoptosis of conjunctival epithelium was detected by in situ terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay on day 61. Conjunctival inflammation was observed by hematoxylin eosin staining. Histomorphological changes of cornea and conjunctiva were observed by light microscopy, and scanning and transmission electron microscopy at day 61. Fluorescein and Rose Bengal scores were analysed by Kruskal-Wallis test. Schirmer scores, goblet cell density and inflammatory cells infiltration were analysed by repeated measures analysis of variance. RESULTS: There were significant differences in fluorescein and Rose bengal (H = 22.031, 15.303, P < 0.01) staining among the groups on day 61. Compared with the control group (FL: 0, 0-1, RB: 0, 0-1), fluorescein and Rose Bengal scores were significantly (P < 0.001) increased in PBS group (FL: 1.5, 1-2, RB: 1, 1-2), whereas was significantly (P < 0.001) decreased in SH group (FL:0, 0-1 RB:1, 0-1) when compared to PBS group. There were significant differences in aqueous tear production and goblet cell density (F = 7.980, 14.545, both P < 0.01) among the groups on day 61. Compared with the control group [(9.43 ± 0.57) mm, (87.73 ± 2.34/HP)], Schirmer scores and goblet cell density were significantly (P < 0.01) reduced in PBS-treated group [(6.61 ± 0.38) mm, (68.06 ± 3.61)/HP], but significantly (P < 0.05) increased in SH-treated group [(8.75 ± 0.57) mm, (82.31 ± 1.64)/HP] compared with PBS-treated group. The number of inflammatory cells was significant difference (F = 56.306, P < 0.001) among the groups on day 61. Compared with the control group [(39.89 ± 2.03)/HP], inflammatory cells infiltration was significantly (P < 0.01) increased in both PBS [(73.18 ± 2.17)/HP] and SH groups [(48.79 ± 2.64)/HP], however, SH-treated group was significantly lowered when compared with PBS-treated group. In addition, decrease in apoptosis, complete microvilli and cell organelles were found in the corneal and conjunctival epithelial cells in SH-treated group. CONCLUSIONS: Our results demonstrate that topical application of SH reduces the ocular toxicity and protect the ocular surface in the long term anti-glaucomatous medical therapies and may be considered as a vehicles or neutralizing material for future ocular application.

[Comparison of anterior segment changes before and after laser peripheral iridectomy by anterior segment optical coherence tomography in eyes with primary acute angle closure glaucoma].

OBJECTIVE: To evaluate the changes of anterior segment configuration after surgical peripheral iridectomy (SPI) in patients with primary acute angle closure glaucoma (PAACG) by using anterior segment optical coherence tomography (AS-OCT). METHODS: This retrospective self control study consisted of thirty-seven eyes of 37 patients with PAACG who were consecutively recruited in Zhongshan Ophthalmic Center. The peripheral anterior synechiae (PAS) of these patients was less than 5 clock time point. Central anterior chamber depth (ACD), angle opening distance (AOD), trabecular iris area (TISA), angle recess area (ARA), anterior chamber width (ACW), anterior chamber volume (ACV), and crystalline lens rise (CLR) were measured using AS-OCT before and one month after SPI. RESULTS: After SPI, AOD (0.125 ± 0.072) µm, TISA (0.091 ± 0.041) mm(2), ARA (0.095 ± 0.042) mm(2), ACA (14.230 ± 2.000) mm(2) and ACV (90.074 ± 16.796) mm(3) were significantly increased compared with before SPI AOD (0.088 ± 0.078) µm, TISA (0.050 ± 0.048) mm(2), ARA (0.059 ± 0.057) mm(2), ACA (12.332 ± 2.457) mm(2), ACV (73.131 ± 16.976) mm(3) (t = -8.015 to 1.066, P = 0.001 to 0.044), respectively. There were no significantly changes in ACD, ACW and CLR (t = -1.505 to 0.516, P = 0.102 to 0.609). CONCLUSIONS: PAACG can be controlled by SPI resulting in an increase of AOD, TISA, ARA, ACA and ACV, but not ACD or CLR.

[Changes of aspartate aminotransferase and alkaline phosphatase activities in gingival crevicular fluid during rapid palatal expansion].

PURPOSE: This study was designed to examine the changes of aspartate aminotransferase (AST) and alkaline phosphatase(ALP) activities in gingival crevicular fluid (GCF) during rapid palatal expansion, and to explore the relationship between these changes and periodontal tissue remodeling. METHODS: Thirty-eight patients (aged 10.5 to 12.8years) who required opening of the palatal suture as the first stage of their orthodontic treatment were included and studied. The patients were divided into two groups: control group (18 cases) and experimental group (20 cases). GCF samples were collected at 6 observation periods with filter paper strips: before activation, 24 hours and 7 days after activation, 7 days, 14 days, and 28 days in retention. AST and ALP activities were determined by a full automatic biochemical analyzer, and the results were expressed as total AST and ALP activities. The data was analyzed with SAS (r) Proprietary Software Version 9.00 for paired t test and two-sample t test. RESULTS: AST activity was significantly elevated after 24-hour activation in the test group (P<0.05), but after 7-day activation in the control group (P<0.01). Both in the control and experimental group, AST activity remained high until 28-day in retention (P<0.01). AST activity in the test group was significantly greater compared to the control group from 24-hour activation to 28-day in retention (P<0.05). ALP activity increased significantly from 7-day activation to 28-day retention in the control and experimental group (P<0.01), and there was statistically significant difference between the control and the experimental group from 7-day to 28-day in retention (P<0.01). CONCLUSION: Our results suggest that AST and ALP levels in GCF may reflect the tissue remodeling which occurs in the periodontium during rapid palatal expansion to some degree.

[Effects of first premolar extractions on third molar angulations].

OBJECTIVE: To compare the inclinations of third molars of patients treated orthodontically with and without premolar extractions. METHODS: Records of 37 first premolar extraction patients and 32 nonextraction patients were examined. The pretreatment and posttreatment panoramic radiographs were analyzed. The angles were measured between the long axis of the third molar and the occlusal plane and between the long axis of the third molar and the long axis of the second molar. Changes in third molar angulations from pretreatment to posttreatment for two groups were compared by Mann-Whitney U-test. RESULTS: There were statistically significant difference between the extraction and nonextraction groups in the median angle formed by the long axis of third molar angulation relative to the occlusal plane (P<0.05) and the second molar (P<0.05) in mandible but not in maxillary. In the extraction group, at the end of the orthodontic treatment, the mandibular third molars showed more uprighting than did the maxillary third molars. CONCLUSION: Orthodontic treatment involving premolar extractions improves mandibular third molar angulations.

[Study of the incisive alveolar structure in different vertical facial types between osteal Class III malocclusion and normal occlusion].

PURPOSE: To investigate the relationship of the incisive alveolar structure and vertical facial type between osteal Class III malocclusion and normal occlusion. METHODS: Forty-seven lateral cephalometrics of patients with osteal Class III malocclusion and forty-three lateral cephalometrics of controls with normal occlusion were randomly selected before treatment. Then the incisive alveolar structure was measured and analyzed, the results were analyzed with Student's t test. RESULTS: (1) In osteal Class III malocclusion; the UP value in the group of high mandibular angle decreased significantly than that in the groups of middle and low mandibular angle (P<0.05); the LA and MxAD value in the group of high mandibular angle decreased significantly than that in the group of middle mandibular angle (P<0.05). (2) In normal occlusion, the MdAD and LA value in the group of high mandibular angle decreased significantly than that in the groups of middle and low mandibular angle(P<0.05). (3) In patients with the same mandibular angle,the LA and MdAD value in normal occlusion increased significantly than those in osteal Class III malocclusion (P<0.05);the UP value, in normal occlusion increased significantly than osteal Class III malocclusion within the groups of middle and low mandibular angle (P<0.01). CONCLUSIONS: The incisive alveolar structure was different in different vertical facial type and the same vertical facial types between osteal Class III malocclusion and normal occlusion.