Anatomical configurations of the optic canal in the sphenoid sinus in a Hispanic population: computed tomography based study.

OBJECTIVE: The prevalence of the optic canal anatomical variants across the sphenoid sinus varies widely among different ethnic groups. This study aimed to analyse the anatomical variants of the optic canal and their relationship to sphenoid sinus pneumatisation in a Hispanic population. METHOD: A review of 320 sphenoid sinuses by high-resolution computed tomography was performed. DeLano's classification of the optic canal, presence of dehiscence, septa insertion, sphenoid sinus pneumatisation and presence of Onodi cells were established. RESULTS: Dehiscence of the optic canal was observed in 4.7 per cent (n = 15) of the analysed sinuses. Type 4 and 3 optic canals were significantly more frequent among postsellar sphenoid sinuses than other patterns of sphenoid sinus pneumatisation (p = 0.002 and p = 0.018). A type 4 optic canal has a higher tendency to present inserted septum than other optic canal types (p = 0.014). CONCLUSION: This study described the optic canal variants in a Hispanic population, which complements existing literature addressing other ethnicities.

Clinical, demographic characteristics, and treatment protocols of optic neuropathies: Three-year follow-up experiences from a tertiary hospital in Turkey.

Background: This study was conducted to review the demographic and clinical characteristics, treatment protocols, and visual outcomes of patients with optic neuropathy. Methods: This historical cohort study analyzed the clinical features of 91 patients with optic neuropathy followed up for three years at a university hospital in Turkey. Results: Non-arteritic anterior ischemic optic neuropathy (NA-AION) was the most common group among the optic neuropathy subgroups (47.2%), and optic neuritis (ON) was the second most common group (38.5%). The mean age of symptom onset for NA-AION was 64.97 ± 12.15 years, significantly higher than the mean age of onset for ON (40.28 ± 15.52 years). Most of the patients with NA-AION had at least one systemic disease causing microangiopathy [51.1% had diabetes mellitus (DM), 33.3% had hypertension (HTN)]. Among the patients with ON, 51.4% were idiopathic, and 25.7% were multiple sclerosis (MS)-related ON cases. Patients with ischemic optic neuropathy (ION), ON, and traumatic optic neuropathy received pulse intravenous (IV) corticosteroids, and eleven patients with NA-AION received acetylsalicylic acid (ASA) therapy in addition to corticosteroids. There was a statistically significant increase in visual acuity in NA-AION and ON groups (P = 0.019). It was observed that the cases of ON peaked in the winter months in Turkey. Conclusion: In the differential diagnosis between NA-AION and idiopathic ON, the presence of one or more vascular systemic diseases and mean age may be the main factors. IV steroid treatment given to patients with NA-AION in the acute phase may significantly improve visual acuity.

New paradigms of immune regulation in glaucoma during the whole clinical process / 中华实验眼科杂志

Glaucoma is an irreversible blinding eye disease caused by the structural and functional damage of optic nerve induced by pathological increase of intraocular pressure (IOP), characterized by multiple causes and strong heterogeneity.The control of IOP to reduce the risk of optic damage has been the main therapeutic strategy of glaucoma for many years.However, in clinical experience, some patients show progress of optic nerve damage despite the effectively controlled IOP, the mechanism of non-IOP-dependent secondary damage is still an urgent problem to be solved and a research hotspot in the pathogenesis of glaucoma.With the continuous innovation of molecular biological technology, breakthroughs have been made in the field of basic research.Partial visual recovery can be boosted by alleviating local immune and inflammatory responses.Due to a lack of symbolic clinical application results, it has become an immediate priority to attach importance to the combination of basic clinical research and facilitate the transformation of results.Starting from the theory of glaucoma-immune inflammation, understanding the importance of the immune homeostasis of eyes, paying close attention to the linkage of eyes and brain in physiopathological process and the progression of diseases in the whole visual pathway, and fully understanding and effectively making good use of the opportunities and implications brought by new techniques will have significant effect in formulating clinical diagnosis and treatment plans.

Management of Eye Trauma for the Primary Care Physician.

Eye trauma is frequently seen by non-ophthalmology providers. This article elucidates a methodological approach to eye trauma. The first step is to address any life-threatening conditions. Then a focused history and exam is discussed, starting externally. Then, key history, physical, pathophysiology, and basic management of common, serious eye injuries are discussed: chemical injury, orbital fractures, open globe, traumatic hyphema, retinal detachment, traumatic optic neuropathy, and eyelid laceration. Finally, we highlight the practicality of telemedicine for areas where ophthalmology coverage is lacking.

Identificação da velocidade anormal da dilatação de pupila como biomarcador de lesão cerebral em pacientes neurocríticos / Identification of abnormal pupil dilation velocity as a biomarker of cerebral injury in neurocritically ill patients

RESUMO Objetivo: Calcular as velocidades médias da dilatação de pupila para classificar a gravidade da lesão derivada da escala de coma de Glasgow, estratificada por variáveis de confusão. Métodos: Neste estudo, analisaram-se 68.813 exames das pupilas para determinar a velocidade normal de dilatação em 3.595 pacientes com lesão cerebral leve (13 - 15), moderada (9 - 12) ou grave (3 - 8), segundo a escala de coma de Glasgow. As variáveis idade, sexo, raça, tamanho da pupila, tempo de permanência na unidade de terapia intensiva, pressão intracraniana, uso de narcóticos, classificação pela escala de coma de Glasgow e diagnóstico foram consideradas confundidoras e controladas para análise estatística. Empregou-se regressão logística com base em algoritmo de classificação com aprendizado de máquina para identificar os pontos de corte da velocidade de dilatação para as categorias segundo a escala de coma de Glasgow. Resultados: As razões de chance e os intervalos de confiança desses fatores se mostraram estatisticamente significantes em sua influência sobre a velocidade de dilatação. A classificação com base na área sob a curva mostrou que, para o grau leve, na escala de coma de Glasgow, o limite da velocidade de dilatação foi de 1,2mm/s, com taxas de falsa probabilidade de 0,1602 e 0,1902 e áreas sob a curva de 0,8380 e 0,8080, respectivamente, para os olhos esquerdo e direito. Para grau moderado na escala de coma de Glasgow, a velocidade de dilatação foi de 1,1mm/s com taxas de falsa probabilidade de 0,1880 e 0,1940 e áreas sob a curva de 0,8120 e 0,8060, respectivamente, nos olhos esquerdo e direito. Mais ainda, para o grau grave na escala de coma de Glasgow, a velocidade de dilatação foi de 0,9mm/s, com taxas de falsa probabilidade de 0,1980 e 0,2060 e áreas sob a curva de 0,8020 e 0,7940, respectivamente, nos olhos esquerdo e direito. Esses valores foram diferentes dos métodos prévios de descrição subjetiva e das velocidades de dilatação previamente estimadas. Conclusão: Observaram-se velocidades mais lentas de dilatação pupilar em pacientes com escores mais baixos na escala de coma de Glasgow, indicando que diminuição da velocidade pode indicar grau mais grave de lesão neuronal.

ABSTRACT Objective: To calculate mean dilation velocities for Glasgow coma scale-derived injury severity classifications stratified by multiple confounding variables. Methods: In this study, we examined 68,813 pupil readings from 3,595 patients to determine normal dilation velocity with brain injury categorized based upon a Glasgow coma scale as mild (13 - 15), moderate (9 - 12), or severe (3 - 8). The variables age, sex, race, pupil size, intensive care unit length of stay, intracranial pressure, use of narcotics, Glasgow coma scale, and diagnosis were considered as confounding and controlled for in statistical analysis. Machine learning classification algorithm-based logistic regression was employed to identify dilation velocity cutoffs for Glasgow coma scale categories. Results: The odds ratios and confidence intervals of these factors were shown to be statistically significant in their influence on dilation velocity. Classification based on the area under the curve showed that for the mild Glasgow coma scale, the dilation velocity threshold value was 1.2mm/s, with false probability rates of 0.1602 and 0.1902 and areas under the curve of 0.8380 and 0.8080 in the left and right eyes, respectively. For the moderate Glasgow coma scale, the dilation velocity was 1.1mm/s, with false probability rates of 0.1880 and 0.1940 and areas under the curve of 0.8120 and 0.8060 in the left and right eyes, respectively. Furthermore, for the severe Glasgow coma scale, the dilation velocity was 0.9mm/s, with false probability rates of 0.1980 and 0.2060 and areas under the curve of 0.8020 and 0.7940 in the left and right eyes, respectively. These values were different from the previous method of subjective description and from previously estimated normal dilation velocities. Conclusion: Slower dilation velocities were observed in patients with lower Glasgow coma scores, indicating that decreasing velocities may indicate a higher degree of neuronal injury.

Survival rate change of retinal ganglion cells following optic nerve injuries in mice / 中华创伤杂志

Objective:To investigate the survival rate change of retinal ganglion cells（RGCs）in a mouse of optic nerve crush（ONC）.Methods:Ninety-seven male C57BL/6J mice（6 to 8 weeks）were selected and divided into normal group（ n=5）, sham-operation group（ n=5）and ONC group（ n=5）according to the random number table. In normal group, both eyes of the mice did not receive any intervention. In sham-operation group, the right eye of the mice received sham operation, while the left eye reveived no intervention. In ONC group, the left eye received ONC, and the right eye received sham operation. In normal group, the density of RGCs in both eyes was quantified and compared. In sham-operatioin group, the density of RGCs in the sham operation eye was calculated and then compared to the average density of RGCs in normal group. In ONC group, the survival rate of RGCs was set as the ratio between the left eye（ONC eye）and the right eye（sham-operation eye）. The survival rate of RGCs in ONC group was compared after crush injury for 5, 10, 20, 30 seconds）（the sacrifice time was set at day 7）, and was compared after sampling on days 3, 4, 5, 7, 14, 30, 60, 90, 180（the duration of crush injury was set as 20 seconds）. Results:In normal group, the density of RGCs in the right eye was（5, 167.3±55.6）cell/mm 2, with no statistical difference from that in the left eye［（5, 199.6±44.8）cell/mm 2］（ P>0.05）. The density of RGCs in normal group and sham-operation group was（5, 183.5±33.4）cell/mm 2 and（5, 151.5±87.6）cell/mm 2, showing no statistical difference（ P>0.05）. The survival rate of RGCs in ONC group after crush injury for 5, 10, 20, 30 seconds was（37.6±1.1）%,（34.0±0.9）%,（33.6±1.6）% and（30.3±0.6）%（ P<0.01）. In comparison, there was statistical difference in the survival rate of RGCs between crush injury for 5 seconds and for 30 seconds（ P<0.01）, but not among other duration of crush injury（ P>0.05）. The survival rate of RGCs in ONC group after sampling on days 3, 4, 5, 7, 14, 30, 60, 90, 180 was（85.4±2.0）%,（67.6±3.1）%,（43.0±1.0）%,（33.6±1.6）%,（22.7±2.0）%,（12.8±0.6）%,（10.4±0.8）%,（8.6±0.5）% and（6.7±0.2）%（ P<0.01）, showing the most obvious drop from day 3 to day 5. Additionally, the curve became flattened after 30 days. Conclusions:In a mouse model of ONC, varying durations of crushing will lead to different damage to RGCs in a progressive mode, indicating that following the primary injury（ONC）, the RGCs suffer secondary injury as well. Therefore, effectively controlling the secondary injury may be the key point of treating optic nerve injuries.

Penetrating Orbital Injury; a Case Report and Treatment Algorithm.

Penetrating orbital trauma (POT) consists of high and low velocity penetrating injuries that may lead to severe consequences such as visual impairment and globe tearing. It has been reported to make up 30% to 50% of all orbital injuries. POT requires a multidisciplinary approach due to complex orbital injury, which involves eye function, brain injury, and facial aesthetics. In this report, we presented a case of POT due to knife injury in which the knife blade was removed and bleeding was controlled, the patient's general condition after surgery was good, but the vision of the right eye was lost.

Damage to the eye and optic nerve in seriously traumatized patients with concomitant head injury: analysis of 84,627 cases from the TraumaRegister DGU® between 2002 and 2015.

BACKGROUND: To determine the prevalence and characteristics of prechiasmatic visual system injuries (VSI) among seriously injured patients with concomitant head trauma in Europe by means of a multinational trauma registry. METHODS: The TraumaRegister DGU® was searched for patients suffering from serious trauma with a Maximum Abbreviated Injury Scale (AIS) ≥ 3 between 2002 and 2015 in Europe. After excluding cases without significant head injury defined by an AIS ≥ 2, groups were built regarding the existence of a concomitant damage to the prechiasmatic optic system comprising globe and optic nerve. Group comparisons were performed with respect to demographic, etiological, clinical and outcome characteristics. RESULTS: 2.2% (1901/84,627) of seriously injured patients with concomitant head trauma presented with additional VSI. These subjects tended to be younger (mean age 44.7 versus 50.9 years) and were more likely of male gender (74.8% versus 70.0%) compared to their counterparts without VSI. The most frequent trauma etiologies were car accidents in VSI patients (28.5%) and falls in the control group (43.2%). VSI cases were prone to additional soft tissue trauma of the head, skull and orbit fractures as well as pneumocephalus. Primary treatment duration was significantly longer in the VSI cohort (mean 23.3 versus 20.5 days) along with higher treatment costs and a larger proportion of patients with moderate or severe impairment at hospital discharge despite there being a similar average injury severity at admission in both groups. CONCLUSIONS: A substantial proportion of patients with head injury suffers from additional VSI. The correlation between VSI and prolonged hospitalization, increased direct treatment expenditures, and having a higher probability of posttraumatic impairment demonstrates the substantial socioeconomic relevance of these types of injuries.

Importância do raciocínio etiológico e topográfico de lesões: relato de neuropatia óptica traumática conduzida como acidente vascular cerebral / Importance of etiological and topographic injury reactions: report of a traumatic optic neuropathy conducted as a cerebrovascular accident

Introdução: O trauma ocular ou periocular pode afetar o nervo óptico e causar baixa acuidade visual ou alteração de campo visual. Essa lesão, denominada neuropatia óptica, quando de etiologia traumática, pode ser classificada como direta, através da compressão, perfuração ou laceração do nervo óptico por ação de corpos estranhos, fraturas do assoalho da órbita ou hemorragias, e indireta, quando a partir de um trauma externo ao globo ocular há lesão por transmissão da onda de choque ou desaceleração, levando à lesão do nervo óptico pelo estiramento de suas fibras ou edema comprometendo sua vascularização, comum nos acidentes automobilísticos e nas quedas. Descrição do Caso: O presente estudo objetiva relatar um caso de neuropatia óptica traumática conduzida erroneamente como acidente vascular cerebral em uma paciente do sexo feminino de 29 anos, com história de queda da própria altura. Discussão: A investigação feita pela história clínica, evolução do quadro e novos achados fundoscópicos permitiu o diagnóstico correto e melhor orientação da paciente. Conclusão: O conhecimento da neuropatia óptica traumática e da anatomia da via óptica têm extrema importância no raciocínio topográfico e etiológico das lesões traumáticas que cursam com comprometimento visual, poupando o paciente de possíveis intervenções invasivas e desnecessárias (AU)

Introduction: Eye or periocular trauma can affect the optic nerve and cause low visual acuity or visual field alteration. This lesion, called optic neuropathy, when of traumatic etiology, can be classified as direct, through compression, perforation or laceration of the optic nerve by action of foreign bodies, fractures of the orbit floor or hemorrhages, and indirect, when from an external trauma to the eyeball there is injury by transmission of the shock wave or deceleration, leading to optic nerve injury by stretching its fibers or edema compromising its vascularization, common in automobile accidents and falls. Case Report: The present study aims to describe a case of traumatic optic neuropathy mistakenly conducted as a stroke in a 29-yearold female patient with a history of falling from his own height. Discussion: The investigation was possible because of the clinical history, evolution of the condition and new fundoscopic findings that allowed the correct diagnosis and better orientation of the patient. Conclusion: Knowledge of traumatic optic neuropathy and anatomy of the optical pathway have extreme importance in the topographic and etiological reasoning of traumatic lesions that present with visual impairment, saving the patient from possible interventions invasive and unnecessary. (AU)

Surgical Treatment for Traumatic Optic Neuropathy.

Traumatic optic neuropathy (TON) is an important cause of severe visual loss after blunt or penetrating head and facial trauma. High-dose steroids and surgical interventions have been applied in the indirect TON. However, there is no convincing evidence that results of the treatment have any strong benefits in terms of improvement of visual acuity. Nevertheless, surgical decompression should be considered in the case of a direct bony compression to the optic nerve and a progressive visual loss in indirect TON. Neurosurgeon should be aware the surgical indication, optimal timing and relevant technique for the optic canal (OC) decompression. In this review article, we will focus on the surgical approaches to the OC and how to decompress it.

Flow Changes in Orbital Vessels Detected with Color Doppler Ultrasound in Patients with Early Dysthyroid Optic Neuropathy.

Thyroid-associated orbitopathy (TAO) is a common manifestation of Graves' disease. The aim of the study was to assess the six percent of patients with TAO that develop dysthyroid optic neuropathy (DON), which is the most serious complication of TAO. As DON can cause perma-nent damage, it is essential to detect DON early when visual loss is still reversible. Color Doppler ultrasound is a noninvasive diagnostic method, which may be useful in early detection of DON. Thirty-six patients with confirmed Graves' disease and active TAO were included, 21 (58%) of them with early DON (eDON) and 15 (42%) free from any signs of eDON. All study patients underwent Doppler ultrasound examination to determine the blood flow rates in the internal carotid artery, ophthalmic artery, and central retinal artery. Study results showed color Doppler ultrasound examination to have a potential to detect orbital blood flow changes in patients with eDON. Early detection of DON may result in earlier treatment and prevention of permanent optic nerve damage.

[Rational application of optical coherence tomography in examining glaucomatous optic neuropathy].

Glaucoma-related retinal imaging using frequency domain optical coherence tomography (OCT) has become an important but not the only basis for the diagnosis and follow-up of glaucoma. The circumpapillary retinal nerve fiber layer thickness and the macular ganglion cell thickness are two commonly used structural parameters in glaucoma. Their diagnostic efficacy is similar, but each has different influencing factors. Clinically, these two parameters should be analyzed together to improve the specificity and sensitivity for detecting glaucomatous optic nerve damage. Recently, there have been quite a few clinical studies on new OCT technologies and concepts related to glaucoma, but it is still necessary to further confirm the application value. Ophthalmologists should master the principle of glaucoma-related OCT retinal imaging, combining with other clinical evaluation methods, to improve early diagnosis and timely detection of glaucomatous progression.(Chin J Ophthalmol, 2018, 54: 801-805).

Traumatic Optic Neuropathy - Case Report with Discussion on Diagnostic Procedures and Therapy.

Traumatic optic neuropathy (TON) is a serious vision threatening condition that can be caused by ocular or head trauma. Indirect damage to the optic nerve is the most common form of TON occurring in 0.5% to 5% of all closed head trauma cases. Although the degree of visual loss after indirect TON may vary, approximately 50% of all patients are left with 'light perception' or 'no light perception' vision, making TON a significant cause of permanent vision loss. We present a 47-year-old male patient with a history of right eye keratoconus following a motorcycle crash. Visual acuity was of 'counting fingers at 2 meters' on the right eye due to keratoconus and 'counting fingers at 1 meter' on the left eye as a consequence of trauma. The Octopus visual field showed diffuse re-duction in retinal sensitivity and the Ishihara color test indicated dysfunction of color perception on the left eye. Relative afferent pupillary defect was also present. Computed tomography revealed multifragmentary fracture of the frontal sinus and the roof of the left orbit without bone displacement. Based on the findings, conservative corticosteroid therapy without surgery was conducted. The patient responded well to treatment with complete ophthalmologic recovery.

Human Periodontal Ligament-Derived Stem Cells Promote Retinal Ganglion Cell Survival and Axon Regeneration After Optic Nerve Injury.

Optic neuropathies are the leading cause of irreversible blindness and visual impairment in the developed countries, affecting more than 80 million people worldwide. While most optic neuropathies have no effective treatment, there is intensive research on retinal ganglion cell (RGC) protection and axon regeneration. We previously demonstrated potential of human periodontal ligament-derived stem cells (PDLSCs) for retinal cell replacement. Here, we report the neuroprotective effect of human PDLSCs to ameliorate RGC degeneration and promote axonal regeneration after optic nerve crush (ONC) injury. Human PDLSCs were intravitreally injected into the vitreous chamber of adult Fischer rats after ONC in vivo as well as cocultured with retinal explants in vitro. Human PDLSCs survived in the vitreous chamber and were maintained on the RGC layer even at 3 weeks after ONC. Immunofluorescence analysis of ßIII-tubulin and Gap43 showed that the numbers of surviving RGCs and regenerating axons were significantly increased in the rats with human PDLSC transplantation. In vitro coculture experiments confirmed that PDLSCs enhanced RGC survival and neurite regeneration in retinal explants without inducing inflammatory responses. Direct cell-cell interaction and elevated brain-derived neurotrophic factor secretion, but not promoting endogenous progenitor cell regeneration, were the RGC protective mechanisms of human PDLSCs. In summary, our results revealed the neuroprotective role of human PDLSCs by strongly promoting RGC survival and axonal regeneration both in vivo and in vitro, indicating a therapeutic potential for RGC protection against optic neuropathies. Stem Cells 2018;36:844-855.

Optic neuropathy after anterior communicating artery aneurysm clipping: 3 cases and techniques to address a correctable pitfall.

Brain shifts following microsurgical clip ligation of anterior communicating artery (ACoA) aneurysms can lead to mechanical compression of the optic nerve by the clip. Recognition of this condition and early repositioning of clips can lead to reversal of vision loss. The authors identified 3 patients with an afferent pupillary defect following microsurgical clipping of ACoA aneurysms. Different treatment options were used for each patient. All patients underwent reexploration, and the aneurysm clips were repositioned to prevent clip-related compression of the optic nerve. Near-complete restoration of vision was achieved at the last clinic follow-up visit in all 3 patients. Clip ligation of ACoA aneurysms has the potential to cause clip-related compression of the optic nerve. Postoperative visual examination is of utmost importance, and if any changes are discovered, reexploration should be considered as repositioning of the clips may lead to resolution of visual deterioration.

Optic Nerve Crush Induces Changes of Hydrogen Sulfide Synthases Expression in the Rat Retina.

OBJECTIVES: To investigate the expression changes of the hydrogen sulfide synthases cystathionine γ-lyase （CSE）, cystathionine ß-synthase （CBS）, and 3-mercaptopyruvate sulfurtransferase （3-MST）, after optic nerve crush （ONC） in rat the retina. METHODS: The rat model of ONC was established. Rats were divided into normal control, ONC, and sham control groups. Histopathologic changes in retina, the number of retinal ganglion cells （RGC） and retinal thickness of inner part （RTIP） were measured. The changes of CSE, CBS and 3-MST mRNA expression were detected with quantitative real-time PCR. RESULTS: The retinal histostructure was normal in normal controls and with minor changes in sham controls, respectively. Compared with sham group, significant retina damages were found in the ONC group： a time-dependent reduction of RGC number and RTIP. Expressions of CSE, CBS and 3-MST mRNA in rat retina were detected in normal control. Compared with normal controls, the expressions of CSE, CBS and 3-MST mRNA did not show any significant changes in the sham controls. Compared with sham controls, CBS mRNA expressions showed a time-dependent increase at 3 d, 7 d and 14 d after crush in the ONC group; CSE mRNA expressions increased to the peak at 3 d and then slightly reduced at 14 d after crush; 3-MST mRNA expressions showed the trend of increase at 3 d and 7 d and then enhanced remarkably at 14 d after crush. CONCLUSIONS: Hydrogen sulfide synthases CSE, CBS and 3-MST expressions were up-regulated in rat retina following ONC, which may cause an increase in local endogenous hydrogen sulfide production in the retina and a compensatory protective effect.

Surgical Treatment for Traumatic Optic Neuropathy / 대한신경손상학회지

Traumatic optic neuropathy (TON) is an important cause of severe visual loss after blunt or penetrating head and facial trauma. High-dose steroids and surgical interventions have been applied in the indirect TON. However, there is no convincing evidence that results of the treatment have any strong benefits in terms of improvement of visual acuity. Nevertheless, surgical decompression should be considered in the case of a direct bony compression to the optic nerve and a progressive visual loss in indirect TON. Neurosurgeon should be aware the surgical indication, optimal timing and relevant technique for the optic canal (OC) decompression. In this review article, we will focus on the surgical approaches to the OC and how to decompress it.

Optic Nerve Crush Induces Changes of Hydrogen Sulfide Synthases Expression in the Rat Retina / 法医学杂志

Objective To investigate the expression changes of the hydrogen sulfide synthases cystathionineγ-lyase (CSE), cystathionineβ-synthase (CBS), and 3-mercaptopyruvate sulfurtransferase (3-MST), after optic nerve crush (ONC) in rat the retina.Methods The rat model of ONC was established.Rats were divided into normal control, ONC, and sham control groups.Histopathologic changes in retina, the number of retinal ganglion cells (RGC) and retinal thickness of inner part (RTIP) were measured.The changes of CSE, CBS and 3-MST mRNA expression were detected with quantitative real-time PCR.Results The retinal histostructure was normal in normal controls and with minor changes in sham controls, respectively.Compared with sham group, significant retina damages were found in the ONC group:a time-dependent reduction of RGC number and RTIP.Expressions of CSE, CBS and 3-MST mRNA in rat retina were detected in normal control.Compared with normal controls, the expressions of CSE, CBS and 3-MST mRNA did not show any significant changes in the sham controls.Compared with sham controls, CBS mRNA expressions showed a time-dependent increase at 3 d, 7 d and 14 d after crush in the ONC group;CSE mRNA expressions increased to the peak at 3 d and then slightly reduced at 14 d after crush;3-MST mRNA expressions showed the trend of increase at 3 d and 7 d and then enhanced remarkably at 14 d after crush.Conclusion Hydrogen sulfide synthases CSE, CBS and3-MST expressions were up-regulated in rat retina following ONC, which may cause an increase in local endogenous hydrogen sulfide production in the retina and a compensatory protective effect.

Research progress in treatment of traumatic optic nerve injury / 中华创伤杂志

Traumatic optic nerve injury is common in patients with traumatic brain injury,mainly in young adults.The optic nerve has no regenerative function,leaving problems of visual field defect and loss of vision and causing high disability rate among patients with traumatic brain injury.The current clinical treatments of traumatic optic nerve injury are hormonotherapy and decompression of optic nerve canal,lacking definite clinical efficacy and treatment norm.In recent years,a series of brand new treatments,such as neuroprotective drugs,neurotrophic factor therapy,nerve transplantation,stem cell therapy and gene therapy,have offered new perspectives for solving the problem of high disability rate of traumatic optic nerve injury clinically.This article attempts to summarize the status quo and latest progress in clinical treatment of traumatic optic nerve injury based on relevant literature in recent years,which can serve as reference for clinicians in choosing the optimal therapeutic regimen.

Evolution of optic nerve and retina alterations in a child with indirect traumatic neuropathy as assessed by optical coherence tomography / Evolução das alterações no nervo óptico e na retina em criança com neuropatia traumática indireta avaliadas com tomografia de coerência óptica

ABSTRACT Herein, we describe the case of a 4-year-old child with indirect traumatic optic neuropathy and serial changes of the optic nerve head and retinal nerve fiber layer (RNFL) documented using optical coherence tomography (OCT). Visual acuity improved despite progressive RNFL thinning and optic disc pallor. We concluded that OCT may be useful for monitoring axonal loss but may not predict the final visual outcome.

RESUMO Descrição do caso de uma criança de 4 anos de idade com neuropatia óptica traumática indireta, cujas alterações no nervo óptico e na camada de fibras nervosas da retina foram documentadas com tomografia de coerência óptica seriadas. A acuidade visual apresentou melhora apesar da diminuição progressiva da camada de fibras nervosas e da palidez do disco óptico. Em conclusão, a tomografia de coerência óptica pode ser útil para monitorar a perda axonal na neuropatia óptica traumática indireta, sem no entanto, predizer o desfecho visual.