Endophthalmitis ; diagnosis ; etiology ; Humans ; Klebsiella pneumoniae ; pathogenicity ; Male ; Middle Aged ; Substance Abuse, Intravenous ; complications

AIM: To compare the effectiveness of diode transscleral cyclophotocoagulation(CPC)and transscleral cyclocryotherapy(CCT)for the intraocular pressure(IOP)control and postoperative complications of absolute glaucoma.

METHODS: This was a prospective case observation study. Totally 85 cases with absolute glaucoma which were admitted by Tianjin Eye Hospital were randomly assigned in 2 groups to receive either CPC or CCT. IOP, the numbers of anti-glaucoma medication, inflammatory reaction of anterior segment and postoperative ocular pain which was evaluated by Visual Analogue Scale(VAS)in two groups were recorded at eight points in time: the day before surgery and 1d, 3d, 1wk, 2wk, 1mo, 3mo and 6mo after surgery. The generalized estimated equation was used to compare all the indexes before and after operation and the difference of success rate between the two surgical methods.

RESULTS: Compared with CPC group, IOP of CCT group decreased less than that before surgery at 1, 3d, 1, 2wk, 1mo after surgery, VAS score decreased less than that before surgery at 3d, 1, 2wk, 1mo after surgery, and the number of anti-glaucoma drugs decreased less than that before surgery at 1, 3d, 1, 2wk after surgery(P<0.05). Compared with CPC group, the complete success rate of CCT group was higher than that at 1d after surgery at 3d, 1, 2wk, 1, 3, 6mo after operation, but only the difference of 3, 6mo after surgery was statistically significant(P<0.05). Compared with CPC group, anterior chamber flash grade of CCT group increased more than that before surgery at 3d, 1, 2wk, 1mo after surgery, conjunctival congestion grade increased more than that before surgery at 1, 3d, 1, 2wk after surgery, corneal edema grade increased more than that before surgery at 3d, 1, 2wk, 1mo after surgery(P<0.05).

CONCLUSION: Compared with CPC, the rate of IOP reduction after CCT was slower, the inflammatory reaction of anterior segment and discomfort of eyeball were more severe and lasted longer. Therefore, the duration of anti-inflammatory drugs and anti-glaucoma medications should be extended after the surgery.

Graves ophthalmopathy(GO)is the most common and relatively complicated orbital diseases, and the incidence rate is increasing year by year. Severe GO may present with exposure keratopathy, diplopia and compressive optic neuropathy, which seriously affects influences patients quality of life. At present, orbital decompression is an effective method in the treatment of moderate and severe GO, and with the continuous expansion of indications for orbital decompression, more and more patients with mild and moderate GO with exophthalmos require surgical treatment to improve the appearance. There are many different surgical techniques for orbital decompression, and which one can achieve patients' maximum benefit is a frequently encountered clinical problem for ophthalmologist. With the gradual increase of the amount of surgery, complications become increasingly prominent, which affect postoperative satisfaction of patients. In order to deepen the understanding of complications, avoid or reduce the occurrence of complications, and optimize the operation plan, this paper reviews the relevant literature at home and abroad in recent years, and summarizes the selection of operation methods and operation related complications of orbital decompression in GO patients.

Objective To discuss the etiology, clinical features, imaging manifestations, treatment principles and prognosis of the orbital infectious diseases. Methods Thirty-four patients with orbital infectious diseases hospitalized in Tianjin Medical University Eye Hospital from August 2011 to October 2017 were collected and retrospectively analyzed. We analyzed clinical data of patients including the etiologies, types of the infection, imaging manifestations, treatments and prognoses. Relsults There were 21 patients with orbital abscesses, 13 patients with orbital cellulitis only, no abscess formation. The main cause of the orbital infectious patients disease was related to paranasal sinusitis, others included furuncles of eyelid skin, dacryocystitis, trauma, entophthalmia, odontogenic infection, nosocomial infection and systemic diseases. Twenty-two cases were operated, and 12 cases were treated conservatively. Thirty (30/34) cases acquired well prognoses without serious complications, except 1 occurred central retinal artery and vein occlusion, and 3 were treated by ophthalmectomy and lost their visual function permanently. The CT imaging of orbital infectious diseases showed the swelling, increased density, diffuse inflammation and unclear boundaries of the involved tissues. The imaging of orbital abscesses showed that in addition to inflammation, the abscesses and the masses were obvious in the orbit. MR generally showed long T1 and long T2 signals. Conclusion There are many causes of orbital infectious diseases, and the course progresses rapidly. With the help of imaging examination, it can accurately locates the infection, and shows the type and range, and comprehensively evaluates the disease in combination with clinical features. Anti-infection and etiological therapy are crucial factors, if necessary, surgery and multiple department treatment should be combined to avoid serious complications.

The neural crest represents a dynamic population of embryonic stem cells, playing a pivotal role in the development of the eye. Through interactions with the surrounding neuroectoderm, superficial ectoderm and mesoderm, the neural crest contributes to the formation of numerous ocular structures, encompassing the corneal stroma and endothelium, trabecular meshwork, iris stroma, ciliary muscle, vitreous and choroidal vessels, and Müller cells. Aberrant migration and development of neural crest cells within the eye can instigate a complex series of ocular diseases. Such diseases include anterior segment like Axenfeld-Rieger syndrome, Peters anomaly, aniridia, primary congenital glaucoma, and Nail-Patella syndrome. Defects that impact the posterior segment may lead to CHARGE syndrome and Branchio-oculo-facial syndrome. Further, rare neurocristopathies such as Waardenburg syndrome, Treacher-Collins syndrome, and Char syndrome can also present with ocular abnormalities. In this review, we explore the ocular diseases that arise from abnormal neural crest cell development, and delve into the related genes involved in neural crest migration and development. We further discuss how mutations and defects in these genes can precipitate ocular diseases.

As the morbidity of myopia increasing gradually, the prevention-control of myopia has been given more attentions. Orthokeratology(OK-lens), is now widely approved and used in clinical treatment as a non-surgical measure. The OK-lens directly contact the corneal anterior surface, therefore having some effects on the morphology and biological characteristics of the cornea. The purpose of this paper is to put forward suggestions and advices for clinic, by reviewing the influence of OK-lens on the corneal sub-basal nerve plexus in the current studies.

Thymosin is a kind of protein that is widely distributed in many tissues. It has many biological activities. Thymosin is divided into three subtypes: thymosin α, thymosin β and thymosin γ. Thymosin β4(Tβ4)is the most widely distributed in normal human body. A large number of studies have confirmed that Tβ4 has the functions of anti-inflammatory, anti-apoptosis and promoting proliferation. Ocular surface diseases are mostly related to ocular surface injury and inflammation. Therefore, promoting wound repair and healing and anti-inflammatory are the key to the treatment of ocular surface diseases. The present review mainly introduces the distribution, structure, synthesis of Tβ4 and its protective effect on ocular surface.

High mobility group box 1(HMGB1), which belongs to a high mobility group box that known for high mobility in electrophoresis, has been researching most intensively. Recently, researches have revealed that extracellular HMGB1, as a damage-associated molecular pattern(DAMP), is involved in the pathophysiology of tissue damage repairin a variety of common ocular diseases, namely, dry eye, keratopathy, glaucoma, uveitis, diabetic retinopathy, and age-related macular degeneration, thereby negatively affecting the healing of the disease. Silencing the function of extracellular HMGB1 is expected to be a new way for these ophthalmic diseases. This thesis reviews the research progress of extracellular HMGB1 in common ophthalmic diseases.

Objective: To investigate the changes of anterior chamber profiles after small incision lenticule extraction(SMILE) and analyze the possible influencing factors. Methods: A case observation study was designed.Thirty-one patients(59 eyes) with myopia and myopic astigmatism who underwent SMILE surgery at the Refractive Surgery Center of Tianjin Eye Hospital from April to December 2015 were enrolled and examined preoperatively and at 1 month, 3 and 6 months postoperatively.The anterior chamber profiles, including anterior chamber depth (ACD), anterior chamber volume (ACV) and anterior chamber angle (ACA) were measured using the Pentacam.The correlations between parameters were analyzed and the differences of the parameters at different time points were compared.This study followed the Declaration of Helsinki.This study protocol was approved by Ethic Committee of Tianjin Eye Hospital (No.TJYYLL-2015-20). Written informed consent was obtained from each subject before the operation. Results: Compared with pre-operation, the central corneal thickness (CCT) was significantly decreased at 1 month, 3 and 6 months postoperatively (all at P<0.05). Three months after surgery, the CCT was significantly higher than that at one month after surgery (P<0.001), and no significant change of CCT was found between 3 months and 6 months after surgery (P>0.05). The posterior corneal elevation (PCE) at different time points before and after surgery was significantly different (F=19.249, P<0.001), compared with the preoperation, the PCE at 1 month, 3 and 6 months postoperatively moved slightly backward (all at P<0.05). The preoperative ACD was (3.33±0.25)mm, the preoperative ACV was (217.46±31.55)mm³, and the ACD was (3.31±0.25), (3.30±0.25) and (3.30±0.25)mm, the ACV was (214.71±33.09), (211.14±33.65) and (210.08±32.19)mm³, respectively at 1 month, 3 and 6 months postoperatively, with significant differences at different time points before and after surgery (F=12.477, 12.205; both at P<0.001), compared with the preoperation, the ACD at 1 month, 3 and 6 months postoperatively and ACV at 3 months and 6 months postoperatively were obviously decreased, with a significant difference between them (all at P<0.05). There was a significant positive correlation between ACD and ACV at different time points before and after surgery (r=0.870, 0.893, 0.886, 0.884; all at P<0.001). The preoperative ACD was negatively correlated with CCT (r=-0.286, P<0.05). Conclusions The ACD is decreased postoperatively, it is basically stable at (3.30±0.25)mm, which satisfies the requirements of the ACD required for implantable collamer lens.And the stable state of ACD is also important for keratoconus detection.