Performance of the Plusoptix A09 photoscreener in detecting amblyopia risk factors in Chinese children attending an eye clinic.

PURPOSE: To assess the accuracy of the Plusoptix A09 photoscreener in detecting amblyopia risk factors in children and determine referral criteria when using Plusoptix A09 for a large-scale vision screening. METHODS: Pediatric patients attending our eye clinic underwent a comprehensive ophthalmic examination that included photorefraction, orthoptic examination, anterior segment assessment, fundus examination and cycloplegic retinoscopy. The measurements were collected for statistical analyses. RESULTS: One hundred and seventy-eight children (mean age ± SD: 6.2±2.4 years, range: 2.2 to 14.1 years) were included in the study. The mean spherical equivalent (SE) obtained using Plusoptix A09 (PSE) was 0.57 D lower than that obtained from cycloplegic retinoscopy (CRSE) (P = 0.00). However, there was no statistically significant difference of Jackson cross cylinder J0 and J45 between Plusoptix A09 (PJ) and cycloplegic retinoscopy (CRJ) (P = 0.14, P = 0.26). The relationship of SE obtained from Plusoptix A09 and SE obtained from cycloplegic retinoscopy was presented as the equation: CRSE = 0.358 + 0.776 PSE + 0.064 PSE2 + 0.011 PSE3. Based on the Receiver Operating Characteristic (ROC) curve, the Plusoptix A09 had an overall sensitivity of 94.9% and specificity of 67.5% for detecting refractive amblyopia risk factors. The sensitivity and specificity of the Plusoptix A09 for detection of strabismus were 40.7% and 98.3%, respectively; detection of amblyopia and/or strabismus was 84.7% and 63.2%, respectively. CONCLUSIONS: The Plusoptix A09 photoscreener underestimated hyperopia and overestimated myopia according to SE when compared with cycloplegic retinoscopy. The accuracy of the Plusoptix A09 in detecting amblyopia risk factors in children could be improved by the regression equation and optimized criteria for refractive amblyopia risk factors developed in the present study. Moreover, the Plusoptix A09 photoscreener is not suitable for a large-scale strabismus screening when it is applied solely.

[Killing effects of PWZL plasmid-mediated double suicide gene on human lens epithelium cells].

OBJECTIVE: To investigate the killing efficiency of PWZL plasmid-mediated herpes simplex virus-thymidine kinase (TK) and E. coli cytosine deaminase (CD) on human lens epithelium cells followed by the treatment of prodrugs. METHODS: PWZL plasmid was used as a vehicle, to transduce double suicide genes into the human lens epithelium in vitro, then the cells were treated with fluorocytosine (5-FC) and/or ganciclovir (GCV) at different concentrations. The cell growth of the lens epithelium cells was observed by light microscope. MTT analysis was used to estimate the cell survival rate and the bystander effect was analyzed simultaneously. The significance of difference between each group was treated by statistical tests. RESULTS: The CD and TK gene could be joined into PWZL plasmid successfully, and did not have any special effect on normal cells. There was no significant difference in cell viability between CD-TK transfected cells and control cells. Cell viability in cells treated with prodrugs was decreased in a time-dependent manner. At the end of the experiment, cell viability was lowest in GCV 10 mg/L +5-FC 60 mg/L group, GCV 10 mg/L + 5-FC 100 mg/L group and GCV 100 mg/L + 5-FC 100 mg/L group. There were no significant differences between these three groups (X2 = 1.25 , P > 0.01). Analysis of bystander effect indicated that the cell viability in GCV 100 mg/L + 5-FC 100 mg/L group and GCV 10 mg/L +5-FC 60 mg/L group was significantly lower than that in the controls (t = 10.26, 13.16; P < 0.01). CONCLUSIONS: PWZL plasmid can transfect the CD and TK genes into lens epithelium cells successfully and efficiently. CD and TK genes can be expressed steadily. Transfection of double suicide gene reduces the dosage of prodrugs required for killing cells. The combination of 5-FC with GCV shows the greatest killing effect and also has the bystander effect.

[Antiproliferative effect of sustained drug delivery system of all-trans retinoic acid implant into rabbit's vitreous cavity for treatment of proliferative vitreoretinopathy].

OBJECTIVE: To investigate the antiproliferative effect of different concentration of all-trans retinoic acid (atRA) in a drug delivery system (DDS) in an experimental proliferative vitreoretinopathy (PVR) model. METHODS: The PVR animal model was induced by central vitrectomy and homologous fibroblasts injected at the same time in pigmented rabbits. Fifty rabbits underwent the surgery. These rabbits were divided into 5 groups of 10 rabbits at random. Group A was the control group. In group B, C, and E, one DDS device was implanted into the vitreous cavity after the vitrectomy, each DDS contained atRA 420 microg, 650 microg and no drug, respectively. In group D, two DDS devices were placed into the vitreous cavity, the total atRA content was 1,070 microg (420 microg + 650 microg). Each group was observed for 8 weeks. The development and the severity of PVR were observed and recorded. The vitreous cavity fluid was aspirated each week for measurement of the concentration of the atRA, in order to estimate the relationship between PVR and concentration of atRA. After 8 weeks, the retinal toxicity was evaluated by histopathology. Statistical analyses were performed at the end of the experiment. RESULTS: Eight weeks after the operation, the incidence of PVR was lower in group C and group D, and there was a significantly statistical difference between these two groups and other groups. No intraocular toxicity was found by the histopathology examination. CONCLUSIONS: atRA DDS is a safe and convenient mode for intraocular administration. DDS containing 650 microg and 1,070 microg atRA can inhibit the cell proliferation in the vitreous cavity effectively after surgery. atRA at a lower concentration cannot eliminate the cell proliferation but may delay the occurrence of PVR.