Proliferative diabetic retinopathy (PDR) is one of the most common cause of severe sight impairment in people with diabetes. When PDR develops to a severe stage, vitreoretinal surgery is needed to prevent its aggravation. The surgery for PDR is complicated and difficult. By deeply understanding the pathological mechanism and development law of PDR, and reasonably using various surgical techniques, assisted by emerging surgical equipment and drugs, the surgical efficacy of PDR can be continuously improved, so as to help patients improve or even restore visual function to a greater extent.

Objective To observe the influence of interleukin-1β (IL-1β) on the expression of phosphorylated signal transducers and activators of transcription 3 (pSTAT 3) in rat retinal MOiler cells. Methods For in vitro study cultured Mailer cells were treated with IL-1β of different concentrations (0, 0.1, 1, 5 and 10 ng/ml) for 24 hours. For in vivo study, 32 Sprague-Dawley(SD)rats were divided into 4 groups randomly (control group, 100,500 and 1000 ng/ml group) with 8 rats in each group. After 24 hours of injection with phosphate buffered solution (PBS), or 100, 500, 1000 ng/ml IL-1β into the vitreous treated retinas were evaluated by indirect immunofluorescence and western blotting. Results After 24 hours of incubation without IL-1β, pSTAT3 has little expression in cultured Muller cells, but was up-regulated by 1 ng/ml or higher IL-1β in a dosage-dependent manner (F=46.64, 43.78; P<0.01). pSTAT3 was not expressed in adult rat retina, but was up-regulated by vitreous injection of 100 ng/ml or higher IL-1β in a dosage-dependent manner (F=73.53, 43.70; P<0.01). pSTAT3 expressed mainly in inner nuclear layer and ganglion cell layer. Double-labeling showed that there was no co-staining of pSTAT3 and glial fibrillary treated with IL-1β. Conclusions Expression of pSTAT3 in MUller cells could be activated by IL-1β which may represent one pathway link to reactive gliosis.

Pathological myopic macular retinoschisis can be classified into 4 types based on optical coherence tomography (OCT) images: outer layer retinoschisis, outer + middle layer retinoschisis, outer + inner layer retinoschisis and muhilayer retinoschisis. Currently vitrectomy is the major option to treat this condition as it can remove the posterior vitreous cortex completely and peel the internal limiting membrane (ILM) around the posterior vessels arch. Vitrectomy benefits the visual function significantly for outer layer retinoschisis with foveal detachment, but has no or very little effects on muhilayer retinoschisis. The appropriate starting site for removal of posterior cortex and ILM should be the site without inner layer retinoschisis. The knowledge and understanding of the OCT classification of pathological myopic macular retinoschisis is important for us to chose correct operation methods and determine the prognosis after treatment.

In recent years,there are more and more cases of retinal infectious diseases in China,however,the diagnosis and management of those patients are still big challenges for our ophthalmicclinicians.It is our top priority to improve their capacity of early diagnosis for those diseases.We need toknow the relationship between retinal infectious diseases and systemic infections,their predisposingfactors.We also need to be familiar with the typical as well as atypical clinical features of those diseases.Vitreoretinal surgery already becomes a powerful tool to make diagnosis of retinal infectious diseases now;we need to make full use of this tool combined with modern technologies of microbiology,cytology,immunology and molecular biology to provide objective scientific evidences for the early diagnosis of retinalinfectious diseases.

Objective To investigate whether there is a thinning of the retinal nerve fiber layer (RNFL) in the eyes of diabetic patients and to analyze the relationship between RNFL thickness and several diabetic risk factors. Methods Forty-two type 2 diabetes mellitus patients aged 47-70 years were enrolled in this study. All the subjects underwent ophthalmologic examinations and glaucoma diagnosis (GDx) nerve fiber analyzer scanning with two different modes: variable cornea compensation (VCC) and enhanced cornea compensation(ECC).The GDx parameters included the temporal-superior-nasal-inferior-temporal average (TSNITave), superior and inferior averages, the TSNIT standard deviation and the nerve fiber indicator (NFI). The receiver operating characteristic (ROC) was applied to study the diagnostic ability of indices. The association between risk factors and the NFI was studied. Results The area under the curve for the ROC of the NFI was the largest for both the ECC and VCC modes. There was a significant relationship between age and RNFL thinning. However, there was no significant association between diabetic duration and fasting blood glucose with RNFL thinning. The influence of age on NFI was greater in diabetic patients than in control subjects. Conclusions Age has an important influence on the NFI of diabetic patients. Diabetic patients with normal ocular fundus may have RNFL thinning.

Objective To evaluate the association of age and retinal nerve fiber layer (RNFL) thickness by means of scanning laser polarimetry in a sample of healthy Chinese eyes. Methods One hundred and fifty eyes of 150 healthy subjects underwent RNFL scan in two different modes (Variable Cornea Compensation,VCC;Enhanced Cornea Compensation,ECC) of Glaucoma Diagnosis Variable Cornea Compensation Nerve Fiber Analyzer.The parameters included temporal-superior-nasal-inferior-temporal (TSNIT) average,superior average,inferior average,TSNIT standard deviation,and nerve fiber indicator (NFI). Results Mean values of TSNIT average,superior average,inferior average,TSNIT standard deviation and NFI in VCC mode were (57.12±6.26),(69.35±4.21),(67.59±7.06),(25.46±4.02),(17.35±7.59),while the parameters' values in ECC mode were (56.15±5.32),(68.24±6.63),(66.90±2.40),(24.80±6.76),(18.84±8.51),respectively.The differences between the values of VCC and ECC modes were not statistically significant.The parameters' values of total subjects were associated with age.But there were no significant associations between age and parameter values in the eyes of those older than 40 years old subjects. Conclusions There are no significant differences between the RNFL values detected by VCC and ECC modes in 150 healthy Chinese eyes.Age has influence on RNFL thinning in 21-70 years old healthy eyes,but not in the eyes of older than 40 years old people.

Myopic foveoschisis is a disease caused by abnormal vitreoretinal interface status and progressive posterior scleral staphyloma.Its occurrence and development are associated with centripetal traction (posterior vitreous cortex,internal limiting membrane and stiff retinal vessel)and centrifugal traction (increasing axial lengths and posterior scleral staphyloma).Currently vitrectomy is the major option to treat this condition as it can alleviate or eliminate centripetal and centrifugal traction.However as myopic foveoschisis is a life-long progressive degenerative disease,often with abnormalities in retinal pigment epithelium,choroid and sclera;the therapeutic effect of current surgical strategy (vitrectomy or scleral surgery,or combined surgery)is limited and unsatisfactory.A full assessment macular structure,function and related factors before surgery is helpful to predict the anatomical and functional prognosis.

Objective To observe the morphological changes of dendrite and soma in retinal ganglion cells (RGCs) which subsisted in early diabetic rats. Methods The RGCs of 3-months-course diabetic rats and coeval normal rats were marked by gene gun techniques. To collect RGCs photographs by Leica microscope with Z axis and CCD camera;to observe the changes of diameter, variance of structural features in dendritic field and somata after classification which according to the size and morphology. Thy-1 antibody marks on the retinal RGCs, taking a photograph under fluorescent microscope, counting the changes of retinal RGCs density in early diabetic rat. Results In three-month diabetic rats, the density of retinal RGCs was decreased obviously. Morphological changes of RGCs in the dendritic fields were observed with gene gun technique. There was no severe variation in all kinds of the bole of cell dendrite,in which some only showed crispation partially and sparseness also twisting in the dendritic ramus. The mean diameter of dendritic field and soma in class A of diabetic rats was (401±86)μm, the mean diameter of dendritic field in control group was (315±72) μm,compared with each other, there is statistically significant differences (t=21. 249, P<0. 001), the mean diameter of soma in class A of diabetic rats was (24±6) μm, the mean diameter of soma in control group was (22±5) μm, compared with each other,there is no statistically significant differences (t= 0. 927,P>0.05); the mean diameter of dendritic field and soma in class B of diabetic rats were (170±36). (14±2) μm respectively, in control group were (165±36), (16±2) μm, the mean diameter of dendritic field and soma in class C of diabetic group were (265±78),(17±5) μm respectively, in control group were (251±57),(17±4) μm , compared with each other,there are on statistically significant differences (t=1.357,0.798,0. 835,1.104 ,P>0.05). ConclusionsIn short-term diabetes, the survived RGCs show good plasticity in adult diabetic rats, especially in class A. The changes of dendrites were more sensitive than the soma, which could be the leading index of themorphologic changes of RGCs in the early stage. The good plasticity showed by the RGCs and the time window from changing in dendrite to cell death provide us many evidences not only for the research but also for the nerve protection in clinic.

Objective To observe the inhibitory effects and characteristics of intravitreal injection with bevacizumab on laser-induced choroidal neovascularization (CNV).Methods Twelve male brown norway (BN) rats were divided into the bevacizumab group and control group with six rats in each group.One eye of rats were received a series of 8 diode laser esions around optic disc to induce CNV,then the rats in bevacizumab group and control group underwent intravitreal injection with 2 μl bevacizumab and ringer's lactate.On days 7,14,and 21,the morphology and leakage of CNV were observed by fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA).On day 21 after photocoagulation,thephotocoagulated eyes were enucleated and processed for histopathologie examination,including hematoxylin and eosin (H&E) staining and immunohistochemistry staining for vascular endothelial growth factor (VEGF).Results On day 7 after photocoagulation,ICGA showed that CNV developed in the bevacizumab group and the control group.FFA showed that leakage intensity in the bevacizumab group was significantly lower than that in the control group,but the bevacizumab group gradually increased over time.The mean thickness of CNV significantly decreased in the bevacizumab group.The CNV in the bevacizumab group were negative for VEGF according to the result of immmuohistochemistry staining.Conclusions Early intravitreal injection with 2 μl bevacizumab can reduce the thickness of CNV and inhibit the leakage of CNV.However,bevacizumab could neither block the formation of CNV,nor suppress the permeability permanently.Combined other therapies with bevacizumab may be more potential to treat CNV effectively.

Objective To observe the proportion changes of CD4+CD25+FOXP3+ T cells in peripheral blood of patients with Vogt-Koyanagi-Harada disease(VKH)before and after one month of treatment. Methods The peripheral blood samples from 15 patients with VKH disease before and after one month of treatment by glucocorticoid,and from 15 healthy volunteers were collected,and lymphoeytes were separated from them.CD4+CD25+regulatory T cells were Iabeled by antibodies of cell surface marker CD4、CD25 and transcription factor FOXP3.The proportion of CD4+CD25+FOXP3+ T cells were detected by flow cytometry. Results Before the treatment,the percentage of CD4+ CD25+FOXP3+ T cells in periphery blood was(0.30±0.19)%of CD4+ cell in VKH patients,and(1.41±0.52)%in control group,the difference was statistically significant(t=7.665,P＜0.01);after one month of treatment,the VKH patients group was(1.28±0.54)%which close to the control group.However there were two patients whose CD4+ CD25+ T cells inereased extraordinarily after one month of treatment. Conclusions The proportion of CD4+ CD25+ FOCP3+ T cells in periphery blood in VKH patients were lower than control group obviously before treatment,but were close to eontrol group after treatment.Those results indicated that VKH diseases may be associated with the decreased proportion of CD4+ CD25+ regulatory T cells.