Longitudinal Changes in Peripapillary Retinal Nerve Fiber Layer and Macular Ganglion Cell Inner Plexiform Layer in Progressive Myopia and Glaucoma Among Adolescents.

Purpose: This study aimed to investigate the differences in longitudinal changes in the peripapillary retinal nerve fiber layer (pRNFL) and macular ganglion cell plus inner plexiform layer (GCIPL) caused by progressive myopia and glaucoma among adolescents. Design: This was a retrospective observational study. Methods: A total of forty-seven and 25 eyes of 47 and 25 adolescents with myopia progression (MP) and glaucoma progression (GP), respectively, who were followed up at the Zhongshan Ophthalmic Center for at least 3 years, were included in the study. The pRNFL and GCIPL that measured at the initial and last visits were analyzed. Results: The median follow-up period was 5 years for both two groups. During follow-up, the whole, superior, and inferior pRNFL decreased in both the MP and GP groups, (p < 0.001). Nasal pRNFL decreased in the MP group (p < 0.001) but had no significant difference in the GP group (p = 0.19). Temporal pRNFL was increased in the MP group (p < 0.001) but decreased in the GP group (p < 0.001). The average and sectoral GCIPL decreased in both groups (p < 0.001). The annual change rate of temporal pRNFL and pRNFL at 10-, 8-, 9-, and 7-clock-hour sectors and the inferotemporal GCIPL has better diagnostic value to differentiate glaucoma from myopia (the area under the receiver operating characteristic curve, AUC > 0.85). Conclusion: Glaucoma and MP could cause loss of the pRNFL and GCIPL in adolescents; however, the loss patterns were different between the two groups. The temporal quadrant and 7-, 8-, 9-, and 10-clock-hour sector pRNFL and the inferotemporal GCIPL can help distinguish pRNFL and GCIPL loss caused by glaucoma or MP.

Ocular Biometry of Primary Angle-Closure Disease in Younger Patients.

Background: The purpose of this study was to analyze the ocular biometric parameters of primary angle-closure disease (PACD) in younger patients and compare them with those of elderly patients. Methods: This clinic-based, cross-sectional study included 154 eyes of 154 patients with PACD, consisting of 77 eyes of patients aged 40 years or younger and 77 eyes of patients older than 40. The PACD case definition was compatible with the ISGEO definition. Anterior segment parameters were measured by ultrasound biomicroscopy, axial length (AL) and lens thickness (LT) were measured by A-scan ultrasonography measurements, and the thickness of the retina and choroid were measured by optical coherence tomography. The differences in ocular biometric parameters between different age groups were compared by independent sample t-tests or Mann-Whitney U tests, and the correlation between the parameters and age was analyzed. Results: Compared to older PACD patients, the lens vault(LV),LV/LT and subfoveal choroidal thickness (SFCT) of younger patients were larger, while the peripheral and mean iris thickness (IT), trabecular-ciliary angle (TCA), ciliary body thickness (CBT), AL and LT were smaller (all P < 0.01). There was no significant difference in anterior chamber depth, anterior chamber width, pupil diameter, angle opening distance at 500 µm from the scleral spur, anterior chamber angle and iris convexity between the two groups (all P > 0.05). AL, LT, IT, TCA and CBT were positively associated with age (all P < 0.001), while LV and SFCT were negatively associated with age (P = 0.027 and P < 0.001, respectively). Conclusions: Compared with elderly patients, younger PACD patients had more anteriorly positioned lenses, thinner and more anteriorly rotated ciliary bodies, thicker choroids, and shorter axial length. These characteristics might be important anatomical bases for the earlier onset of PACD and the higher risk of malignant glaucoma after filtering surgery.

Evaluation of the genetic association between early-onset primary angle-closure glaucoma and retinitis pigmentosa.

Primary angle-closure glaucoma (PACG) and retinitis pigmentosa (RP) can co-occur, but the mechanism of their association is not yet established. The purpose of this study was to investigate the differences in ocular biometry parameters and molecular genetics in patients with PACG with or without RP, and to determine the association between PACG and RP. Patients with early-onset PACG (age of onset <45 years) with or without RP were selected from the glaucoma outpatient department after full ocular examinations by the same glaucoma specialist (LX). Ocular biometry parameters were statistically analyzed. Blood samples were collected from the probands, and genomic DNA was sent out for whole exome sequencing. Variants in 326 selected genes, were extracted from the whole exome sequencing data and filtered using multiple bioinformatics analysis. The 326 genes included 10 PACG-associated genes from two genome wide association studies; 45 genes associated with anterior segment dysgenesis, microcornea, and microphthalmia; and 271 RetNet genes. Potential pathogenic variants (PPV) were obtained and underwent further genotype-phenotype analysis. As a result, a total of 32 probands with early-onset PACG were collected; nine had accompanying RP. No significant differences were noted for ocular biometry parameters between patients with PACG with RP and with PACG alone. Systematic analysis of the variants revealed that 16 of 32 probands (50%) carried PPV in 15 of 326 genes, including 14 RetNet genes and one anterior segment dysgenesis-associated gene. Of these 16 probands with PPV, five (55.56%) were from the group of nine probands with both had PACG and RP and 11 (47.83%) were from the group of 23 probands with PACG alone. Of the 15 genes, five genes, CRB1, COL2A1, RHO, RP1L1, and PAX6, were reported to cause phenotypes including glaucoma. The variants in RetNet genes appeared to be associated with a significant proportion of PACG, especially in probands with both PACG and RP. These findings enrich the phenotype spectrum of RetNet genes and provide clues for genetic screening for glaucoma. Our study suggests a genetic association between PACG and RP, although the cause-effect relationship between them needs further validation.

Reproducibility of Foveal Avascular Zone and Superficial Macular Retinal Vasculature Measurements in Healthy Eyes Determined by Two Different Scanning Protocols of Optical Coherence Tomography Angiography.

PURPOSE: To assess the reproducibility of quantitative measurements of the foveal avascular zone (FAZ) and retinal vasculature determined by different scanning protocols of optical coherence tomography angiography (OCTA) in healthy volunteers. METHOD: All participants were scanned by two trained operators using an AngioPlex OCTA. Both angiography protocols (6 × 6 mm and 3 × 3 mm) were performed three times on the same eye by operator A and one additional time by operator B. The FAZ area and perimeter, retinal vessel length density (VLD) and perfusion density (PD) of different regions were analysed. RESULTS: Fifty-two eyes from 52 subjects were recruited for this study. The repeated measurements of FAZ, VLD, and PD parameters obtained by the same operator, as well as by different operators, were not significantly different when the same protocol was used (p > 0.05). The intra- and inter-operator intraclass correlation coefficients (ICCs) of the FAZ and central VLD and PD parameters (range, 0.99-0.95) were better than the intra- and inter-operator ICCs of VLD and PD in the inner and outer rings (range, 0.86-0.90). The FAZ area, perimeter, and VLDs obtained by the 3 × 3 mm protocol were larger than those obtained by the 6 × 6 mm protocol (p < 0.01), but the PDs obtained by the 3 × 3 mm protocol were smaller than those obtained by the 6 × 6 mm protocol (p < 0.001). All of the corresponding parameters obtained by the two protocols were positively correlated (r = 0.64-0.99, p < 0.001). CONCLUSION: Both the 6 × 6 and 3 × 3 mm protocols of the AngioPlex OCTA provide good reproducibility for assessing the FAZ and superficial retinal vasculature. However, the values obtained by these different protocols cannot be compared directly.

MEK inhibition prevents TGF­ß1­induced myofibroblast transdifferentiation in human tenon fibroblasts.

Subconjunctival fibrosis represents the primary cause of postoperative failure of trabeculectomy, and at present there is a lack of effective intervention strategies. The present study aimed to investigate the effect of the mitogen­activated protein kinase kinase (MEK) inhibitor U0126 on human tenon fibroblast (HTF) myofibrosis transdifferentiation, and to illuminate the underlying molecular mechanisms involved. It was demonstrated that U0126 significantly inhibited the proliferation, migration and collagen contraction of HTFs stimulated with TGF­ß1. In addition, U0126 largely attenuated the TGF­ß1­induced conversion of HTFs into myofibroblasts, as indicated by a downregulation of the mRNA and protein expression of α­smooth muscle actin and zinc finger protein SNAI1, and by ameliorating the 3D­collagen contraction response. Mechanistically, U0126 suppressed the TGF­ß1­stimulated phosphorylation of mothers against decapentaplegic homolog 2/3, P38 mitogen­activated protein kinase and extracellular signal­regulated kinase 1/2, indicating that U0126 may inhibit HTF activation through the canonical and non­canonical signaling pathways of TGF­ß1. Therefore, U0126 exhibits a potent anti­fibrotic effect among HTFs, and the inhibition of MEK signaling may serve as an alternative intervention strategy for the treatment of trabeculectomy­associated fibrosis.

Willingness to Pay for Cataract Surgery Provided by a Senior Surgeon in Urban Southern China.

PURPOSE: To study willingness to pay for cataract surgery and surgical service provided by a senior cataract surgeon in urban Southern China. METHODS: This study was a cross-sectional willingness-to-pay (WTP) interview using bidding formats. Two-hundred eleven persons with presenting visual impairment in either eye due to cataract were enrolled at a tertiary eye hospital. Participants underwent a comprehensive eye examination and a WTP interview for both surgery and service provided by a senior surgeon. Demographic information, socioeconomic status and clinical data were recorded. RESULTS: Among 211 (98% response rate) persons completing the interview, 53.6% were women and 80.6% were retired. About 72.2% had a monthly income lower than 1000 renminbi (US $161). A total of 189 (89.6%) were willing to pay for cataract and the median amount of WTP was 6000 renminbi (US$968). And 102 (50.7%) were willing to pay additional fees for surgery performed by a senior surgeon, and the median amount of WTP was 500 renminbi (US$81). In regression models adjusting for age and gender, persons with preexisting eye diseases other than cataract, were more likely to pay for cataract surgery and service provided by a senior surgeon (P = 0.04 for both). CONCLUSIONS: In urban China, cataract patients, especially those with preexisting eye conditions, are willing to pay additional fees for a senior surgeon. Moving to a system where the price of cataract surgery is proportional to the consultant' skill and expertise is possible and may have a potential impact on waiting list and quality of eye care. Further studies are needed to examine the impact of such pricing system on attitudes and choices of cataract patients.

Endoplasmic reticulum stress promotes amyloid-beta peptides production in RGC-5 cells.

Endoplasmic reticulum (ER) stress has been implicated in various neurodegenerative diseases, including Alzheimer's disease. We have previously observed amyloid production in the retina of the Tg2576 transgenic mouse model of Alzheimer's disease. In this study, we used tunicamycin-induced ER stress in RGC-5 cells, a cell line identical to the photoreceptor cell line 661W, to investigate the effect of ER stress on production of amyloid-beta (Abeta) peptides. We found that the mRNA level of amyloid-beta precursor protein (APP) remained stable, while the protein level of amyloid-beta precursor protein (APP) was decreased, the amyloid-beta precursor protein cleaving enzymes beta-site APP-cleaving enzyme 1 and presenilin 1 were upregulated, Abeta1-40 and Abeta1-42 production were increased, and reactive oxygen species production and apoptosis markers were elevated following induction of ER stress. The protein level of Abeta degradation enzymes, neprilysin, endothelin-converting enzyme 1, and endothelin-converting enzyme 2 remained unchanged during the prolonged ER stress, showing that the generation of Abeta did not result from reduction of proteolysis by these enzymes. Inclusion of group II caspase inhibitor, Z-DEVD-FMK, increased the ER stress mediated Abeta production, suggesting that they are generated by a caspase-independent mechanism. Our findings provided evidence of a role of ER stress in Abeta peptide overproduction and apoptotic pathway activation in RGC-5 cells.

Ten-year follow-up of familial nanophthalmos in three siblings.

PURPOSE: Nanophthalmos is a rare congenital disorder associated with a high incidence of angle-closure glaucoma. We followed the clinical manifestations of three siblings to evaluate their responses to various treatments. METHODS: Three sisters with nanophthalmos were followed from 2000 to 2013. Glaucoma and cataract treatments were performed whenever indicated. RESULTS: The oldest sister had chronic elevation of intraocular pressure (IOP) and underwent laser peripheral iridotomy (LPI) on both eyes, followed by uneventful phacoemulsification with intraocular lens (IOL) implantation on the left eye and phacotrabeculectomy with IOL implantation on the right eye. The middle sister had acute elevation of IOP and initially underwent phacoemulsification combined with implantation of two IOLs on her left eye and LPI on her right eye. Severe uveal effusion occurred when phacoemulsification was performed on her right eye 6 years later, but ultimately was completely resolved. In both sisters, stable IOP and visual results were achieved after lensectomy. The youngest sister, who had suspected angle-closure, achieved a stable IOP and visual results with prophylactic LPI alone. CONCLUSION: In nanophthalmic eyes, the severity of the disease may foreshadow the severity of surgical complications and responses to therapy.

Comparison of combined phacotrabeculectomy with trabeculectomy only in the treatment of primary angle-closure glaucoma.

BACKGROUND: Trabeculectomy has become a mainstream treatment in intraocular pressure (IOP) reduction for primary angle-closure glaucoma (PACG); combined trabeculectomy and cataract surgery was reported to reduce IOP and simultaneously improve vision for patients with PACG and coexisting cataract. This study was specialized to compare the efficacy and safety of combined phacotrabeculectomy with that of trabeculectomy only in the treatment of PACG with coexisting cataract. METHODS: This is a comparative case series study. Thirty-one patients (31 eyes) with PACG and coexisting cataract were enrolled. Of these, 17 underwent phacotrabeculectomy and 14 underwent trabeculectomy alone. IOP, filtering blebs, and complications were compared at the final follow-up. Complete success was defined as a final IOP less than 21 mmHg without IOP-lowering medication. RESULTS: After 10 months of postoperative follow-up, the phacotrabeculectomy and trabeculectomy groups showed no significant differences regarding IOP reduction ((20.59 ± 7.94) vs. (24.85 ± 14.39) mmHg, P = 0.614), complete success rate (88% vs. 71%, P = 0.370), formation rate of functioning blebs (65% (11/17) vs. 93% (13/14), P = 0.094), and complications (41% (7/17) vs. 57% (8/14), P = 0.380). IOP-lowering medication was not required for most of the patients in both groups. Additional surgery interventions, including anterior chamber reformation and phacoemulsification, were needed in the trabeculectomy group, whereas no surgery was needed postoperatively in the phacotrabeculectomy group. CONCLUSION: Phacotrabeculectomy and trabeculectomy treatments exhibit similar IOP reduction, successful rates, and complications when it comes to treating PACG patients with coexisting cataract, although additional surgery intervention may be needed for a few cases with cataract and complications after trabeculectomy.

Long-term anatomic and visual outcomes of initially closed macular holes.

PURPOSE: To evaluate the anatomic and visual outcomes in patients with initially closed macular holes after vitreoretinal surgery and with 1 to 7 years of follow-up. DESIGN: Retrospective, noncomparative, consecutive case series. METHODS: Eighty-seven consecutive eyes of 79 patients with previous closure of the macular holes and with at least 1 year of follow-up were reviewed in this retrospective clinical study. Main outcome measures included the rate of macular hole reopening and visual acuity outcomes. RESULTS: The mean age of enrolled patients was 63.1 ± 6.2 years (range, 49 to 74 years); the mean duration of macular hole was 5.6 ± 9.7 months (range, 0.25 to 60 months); and the mean follow-up interval was 38.4 ± 19.7 months (range, 12 to 86 months). All eyes underwent internal limiting membrane peeling during the vitrectomy, and 64 (73.6%) of 87 eyes underwent cataract extraction. No reopening of initially closed macular holes was observed in any eyes. Slight perifoveal epiretinal membranes were observed by optical coherence tomography in 32.2% of cases (28/87). The final best-corrected visual acuity improved to 0.47 ± 0.39 logarithm of the minimal angle of resolution units, which was significantly higher than preoperative visual acuity of 1.01 ± 0.36 logarithm of the minimal angle of resolution units (t = -12.532; P = .000). Multiple linear regression analysis demonstrated that the final best-corrected visual acuity was affected by the macular hole stage, preoperative best-corrected visual acuity, and cataract exaction (F = 19.858; P = .000). CONCLUSIONS: The stable closure of macular holes is achieved after vitrectomy with internal limiting membrane peeling. Phacoemulsification cataract surgery with intraocular lens implantation for improvement of visual function is not responsible for the reopening of previously closed macular holes.

[Gene screening as the forewarning measure to predict glaucoma].

OBJECTIVE: To investigate the effect of gene screening on forewarning and monitoring of familial open-angle glaucoma pedigree. METHODS: Comprehensive ophthalmic examinations were performed in all available family members. The genomic DNA was extracted from peripheral blood. The myocilin gene was amplified and screened for mutations using direct sequencing. All family members were followed up. RESULTS: Among 12 family members, 5 individuals carry a C to T transition in exon 3 resulting in the substitution of proline to leucine (Pro370Leu), and the other 7 individuals did not carry this mutation. Ophthalmic examinations did not show any abnormality in the optic disc, the thickness of RNFL, and visual field parameters in mutation-carriers. During the follow-up, all carriers were diagnosed as open-angle glaucoma. The mean time of presentation of the defect of visual field was 21.6 months and 14.4 months after the changes in RNFL thickness. CONCLUSION: Genetic diagnosis was proven to be a method with high specificity and sensitivity; and can be used for presymptom diagnosis and forewarning in familial open-angle glaucoma pedigree.

[Clinical observation of trabeculectomy for primary angle closure glaucoma].

OBJECTIVE: To evaluate the effect of trabeculectomy on intraocular pressure (IOP) and complications in eyes with primary angle closure glaucoma (PACG). METHODS: It was retrospective clinical study. PACG was classified as acute primary angle closure glaucoma (APACG) group and chronic primary angle closure glaucoma (CPACG) group. APACG was then divided into acute attack phase and chronic phase, and CPACG was divided into chronic phase and late phase. IOP, best corrected visual acuity were compared before and after trabeculectomy in different subgroup of PACG. In addition, the incidence of complications of trabeculectomy was assessed. Statistical analyses were performed using SPSS 12.0 statistics software. Categorical variables such as best corrected visual acuity were compared using nonparametric test, continuous variables such as age and IOP were compared between the two groups using independent two-sample t-tests. Pre- and postoperative IOP were compared using one-way analysis of variance of repeated measures. RESULTS: 40 eyes (37 cases) of APACG and 56 eyes (45 cases) of CPACG were enrolled in this study. The median follow-up period was 24 and 25 months, respectively. IOP was significantly decreased from (53.6 +/- 17.9) mm Hg (1 mm Hg = 0.133 kPa, preoperation) to (10.5 +/- 4.9) mm Hg (postoperation) at time of discharging from hospital and (14.0 +/- 10.3) mm Hg at time of final follow up in APACG (F = 100.783, P < 0.01), respectively, and from (36.8 +/- 13.8) mm Hg to (11.7 +/- 4.2) mm Hg at time of discharging from hospital and (13.8 +/- 4.5) mm Hg at time of final follow up in CPACG (F = 54.383, P < 0.01), respectively. The IOP remained controlled (< or = 21 mm Hg) without antiglaucomatous medication in 38 eyes (95.0%) of APACG and in 50 eyes (89.3%) of CPACG. Visual acuity was significantly (H = 12.316, P < 0.01) decreased after trabeculectomy in all sub-types of PACG by Kruskal-wallis analysis. Shallow anterior chamber was commonly occurred after trabeculectomy. CONCLUSIONS: Trabeculectomy is an effective method to control IOP in APACG and CPACG. However, the high proportion of impaired vision was found following trabeculectomy in this study and warranted further clinical investigation.

The study of retinal nerve fiber layer thickness of normal eyes using scanning laser polarimetry.

PURPOSE: To evaluate retinal nerve fiber layer (RNFL) thickness measurements in local normal Chinese subjects of different age groups and analyse the correlation of RNFL thickness with age using scanning laser polarimetry (SLP, GDxVCC). To assess the reproducibility of RNFL thickness measurement with GDxVCC. METHODS: The RNFL thickness of 67 normal subjects (123 eyes) were measured by GDxVCC. The average TSNIT parameters were calculated. The differences of RNFL thickness between sex, right and left eyes, superior and inferior were compared. The relationship between RNFL thickness and age was analyzed with correlation analysis and linear regression analysis. The intraclass correlation coefficients (ICC) of three images in every eye were calculated. RESULTS: The average peripapillary RNFL thickness at the superior, inferior and whole ellipse regions in 123 eyes of 67 normal subjects were (70.30 +/- 6.76) microm, (67.35 +/- 6.77) microm and (56.87 +/- 4.53) microm, respectively. The average TNSIT standard deviation was 23.68 +/- 4.61 and the average inter-eye symmetric value was 0.86 +/- 0.11. There were significant difference of RNFL thickness between superior and inferior (t = 4.952, P < 0.001). There were significant difference of inferior RNFL thickness and TNSIT standard deviation between right and left eyes (P = 0.005 and 0.002), while not significant difference of superior RNFL thickness and whole mean RNFL thickness between right and left eye (P = 0.086 and 0.529). There was no significant difference in TSNIT parameters between different genders. There was a slight negative correlation average RNFL thickness in superior sector with age (decreased approximately 0.15 microns per year, P = 0.047) in the subjects aged below 60 years old. The ICC values of RNFL thickness were > 0.8 in superior, inferior and global. CONCLUSIONS: The RNFL thickness can be measured accurately by GDxVCC and the reproducibility of RNFL thickness measurement by GDxVCC is good. There was a slight negative correlation between average RNFL thickness in superior with age. More researches on the effects of age on RNFL thickness by GDxVCC are needed.

[The in vitro electrical parameters of the isolated porcine ciliary epithelium].

PURPOSE: To study the characteristics of ion transport across the isolated porcine ciliary epithelium to offer the good model for human ciliary epithelium study. METHODS: Fresh isolated pig ciliary epithelium was mounted in a modified Ussing-type chamber to measure the electrical parameters and the effect of 0.1mM ouabain was investigated. RESULTS: The potential difference (PD) across the preparations was (-0.6 +/- 0.1) mV and was consistently negative at the aqueous side. The short circuited current (SCC) and resistance (R) were found to be (-10.9 +/- 1.2) microA/cm2 and (54.6 +/- 1.6) omegacm2 respectively. Both PD and SCC were firstly hyperpolarized (stimulation) and then depolarized when 0.1 mM ouabain was applied to the aqueous side. CONCLUSION: The polarity of transepithelial PD of the isolated porcine ciliary epithelium was negative at the aqueous side, implying an anion transport may be important in the aqueous humor formation (AHF). Na+, K+ -ATPase is located on the PE and NPE cells of the porcine ciliary epithelium and plays an important role in

[The measurement of central corneal thickness of normal subjects and glaucomatous patients with optical coherence tomography].

OBJECTIVE: To evaluate central corneal thickness (CCT) of normal subjects, patients with primary open angle glaucoma (POAG), normal tension glaucoma (NTG) and ocular hypertension (OHT) using optical coherence tomography (OCT). METHODS: One hundred and forty-three eyes of 143 normal subjects, 36 eyes of 36 patients with POAG, 39 eyes of 39 patients with NTG and 40 eyes of 40 patients with OHT were enrolled. CCT were measured by OCT3 and analyzed using ANOVA. The relationship of CCT and intraocular pressure (IOP) measured by Goldmann applanation tonometry were analyzed by linear regression. The inter-observer and intra-observer agreement of CCT measurement by OCT were analyzed by interclass correlation coefficient (ICC). RESULTS: The average CCT of normal subjects, patients with POAG, NTG and OHT were (525.31 +/- 32.18) microm, (531.87 +/- 31.58) microm, (507.61 +/- 21.56) microm and (574.09 +/- 27.84) microm, respectively. There was no significant difference between normal subjects and patients with POAG (P = 0.099). The average CCT of OHT patients was larger than those of other groups (P < 0.001). The average CCT of patients with NTG was less than those of other groups (P < 0.001). There was positive relationship between CCT and IOP in normal subjects (r = 0.318, R2 = 0.101, P < 0.001). The ICC of inter-observer and intra-observer agreement of CCT measurement by OCT were 0.995 and 0.996 respectively. CONCLUSIONS: Central corneal thickness could be measured by OCT accurately. The average CCT in the patients with NTG was thinner, but the average CCT in the patients with OHT was thicker than that of normal subjects. CCT could affect IOP measurement in the application of Goldmann applanation tonometry but with little significant.

[The action of dexamethasone on trans epithelial electrical resistance and the expression of aquaporin-1 in immortalized trabecular cells].

OBJECTIVE: To study the effect of dexamethasone on trans epithelial electrical resistance (TEER) and the expression of AQP-1 in immortalized trabecular cells. METHODS: Immortalized human trabecular cells were cultured on PET membrane in 24 wells plate. The cells were treated with Dexamethasone in concentration of 10(-7) mol/L. After the cultured cell became confluence, TEER of the cells was detected to evaluate the resistance of outflow pathway at different time points. Western blot was used to analyze the expression of AQP-1 in the trabecular cells. RESULTS: The TEER and the expression of AQP-1 were much higher in the cells treated by Dexamethasone in comparison to control without dexamethasone exposure. CONCLUSIONS: The TEER and expression of AQP-1 in immortalized trabecular cells can be enhanced by Dexamethasone. AQP-1 upregulation induced by Glucocorticoid may relate with the increased resistance of outflow pathway in glaucoma.

[The study on culture and trans epithelial electrical resistance of human trabecular cells on filter].

PURPOSE: To establish the culture system of human trabecular cells on filter and detect their TEER (trans epithelial electrical resistance). METHODS: Immortalized human trabecular cells are cultured on filter. 3.5 days and 1.2 weeks after they were confluent, the TEER were detected to evaluate the resistance of outflow pathway. RESULT: Immortalized human trabecular cells grew well on filter. 3.5 day and 1.2 weeks after their confluence, the average of the TEER were respectively (36.4 +/- 1.4)omega, (35.0 +/- 1.7)omega, (36.1 +/- 2.9)omega, (39.3 +/- 3.0)omega, and the difference between them was not statistically significant (P = 0.305). CONCLUSION: After immortalized human trabecular cells cultured on filter were confluent, their TEER were basically stable at different time. So the culture system of cells on filter and detection of their TEER with EVOM can be used as a good model to study the characteristics of human trabecular cells. Eye

[A preliminary study on gene mutation and its function in a large family (GZ.1 pedigree) with open-angle glaucoma].

OBJECTIVE: To determine the causative mutation of myocilin gene and to investigate its pathogenic function in a large Chinese pedigree (GZ.1) with familial open-angle glaucoma. METHODS: Genome-wide scanning was performed and the Lod scores were calculated. Candidate gene was amplified and screened for mutations using direct sequencing. To elucidate its expression, distribution and cytotoxicity of mutant myocilin, human trabecular cells (HTM) cells were transfected with pcDNA-wild-type and mutant myocilin vectors using liposomes. RESULTS: Mutation analysis of the myocilin gene showed a C-to-T transition at the 1, 109 th nucleotide in exon 3 resulting in a change of amino acid from proline to leucine (Pro370Leu). This mutation cosegregated with all affected individuals (16/16) and never presented in unaffected individuals (0/8). In transfected HTM cells, the mutant myocilin protein was not correctly processed in ER and accumulated as aggresome-like structures in the cytoplasma instead of being secreted. In addition, the expression of mutant protein also led to apoptosis of trabecular cells and the occurrence of. CONCLUSION: The mutation of Pro370Leu in myocilin gene could cause the accumulation of misfolding myocilin protein in HTM cells, which might lead to glaucoma in GZ.1 pedigree.

[Observation of early closure of idiopathic macular hole after vitrectomy surgery with internal limiting membrane peeling].

PURPOSE: To observe the early closure of idiopathic macular hole after vitrectomy surgery with internal limiting membrane (ILM) peeling. METHODS: Retrospectively, 25 eyes of idiopathic macular hole in 25 patients were performed vitrectomy surgery with ILM peeling from January of 2001 to October of 2003. All patients maintained the prone position at least 2 weeks after surgery. Slit-lamp examination and optical coherence topography (OCT) were performed to observe the closure of macular hole during 1 month post-operatively. RESULTS: All but 2 eyes of the ILM around the macular hole were peeled successfully. Slit lamp examination showed the configurations of macular hole disappeared in 23 eyes in 24-48 hours post-operatively and OCT confirmed the macular holes were closed in these eyes during 1 month after surgery. The anatomical closure rate was 92%. The repaired macular holes were classified by the OCT images as being of "simple closure" or "bridge shape". CONCLUSIONS: The majority of the idiopathic macular holes were closed in the early stage after surgery. It suggests that there are no or very little tissue loss in the process of idiopathic macular hole, after dismissing the mechanic traction caused by vitreous especially ILM, the hole could be closed.