AIM: To explore the anatomical changes of the optic nerve head in cats after radial optic neurotomy (RON).METHODS: The normal anatomic data were obtained from 12 healthy cats. A total of 18 healthy cats were used in the experiment, which were divided into four groups: each operative group was executed at the :Lst, 15th, 30th, 90th day after undergoing RON unilaterally.(six in 1st group). The enucleated eyes of each operative group were cut section routinely and embedded in paraffin, the cross sections were stained by special staining.RESULTS: At the 1st day after operation, the incision came into being and connected with cerebral subarachnoid space of orbital optic nerve. At 15th day, incision was fusiform and hyperplastic neuroglial cells and fibroblasts aggregated at the incision. At 30th day, there was obvious proliferation of type fibril at the neurotomy. The aligned texture of collagen fibril of the lamina cribrosa near the incision was moved close to each other. At the 90th day, a discrete scar was noted at the site which reached the cribriform and sclera.CONCLUSION: RON can cut scleral ring and piamater of optic nerve sharply. The incision of RON connects with subarachnoid space of orbital optic nerve and becomes broaden gradually at the site of scleral ring. The potential role of incision of RON is relevant to the subject.

AIM: To investigate the feasibility and efficacy of tissue plasminogen activator (tPA) injection into the optic nerve as a treatment for retinal vein occlusion in rabbits. METHODS: Rose Bengal-mediated laser-induced retinal vein occlusions were produced in rabbit eyes. Fluorescein angiography (FA) was performed on each eye 3 days before laser irradiation and 30 minutes after laser irradiation.The treatment group (n=20 veins) received intra-optic nerve injection of tPA (12.5μg in 0.05mL BSS) and the controls (n=24 veins) received 0.05mL BSS. FA was repeated to determine the recanalization of the vessel at 3 and 7 days after treatment, followed by histological examination.RESULTS: Rose Bengal-mediated laser-induced retinal vein occlusions were successfully developed and confirmed by FA. The incidence of the recanalization of the vessels in treatment animals was 70.0%, while 16.7% in the control animals (P=0.001). CONCLUSION: Intra-optic nerve tPA injection increased the incidence of recanalization of the occluded vessels. Although further studies are needed, our data suggested that injection of tPA into the optic nerve may have a potential benefit in the treatment of central retinal vein occlusion.

AIM: To investigate the safety of tissue plasminogen activator (tPA) intra optic nerve injection in rabbits. METHODS: Group 1 and 2 (6 eyes in each group) received injection of tPA 25μg and 12.5μg in 0.1mL balanced saline solution (BSS). Group 3 (6 eyes) received injection of 0 1mL BSS. Six eyes in group four as a normal control received no injection. The eyes were examined with slit lamp biomicroscope, indirect ophthalmoscope, visual evoked potentials (VEP) and electroretinography (ERG) at 1, 3, 7, 14 and 28 days after injection. RESULTS: No evidence of optic nerve or retinal toxicity or physical damage were revealed by ophthalmoscopy, VEP, and ERGs after the injection of tPA into the optic nerve. The means of the latency of the first peak of the VEP were 24.6±1.5, 24.1±1.9, 24.0±2.0 and 24.6±1.3mS respectively for the above specified groups (P=0.4112). The means of the amplitude of the first peak of the VEPs were 124±42, 145±41, 132±48 and 117±29μV respectively (P=0.0649). The means of the latency of a-waves were 6.0±0.4, 5.9±0.4, 5.9±0.5 and 5.8±0.3 mS respectively (P=0.6279). The means of the amplitude of a-waves were 110±14, 112±15, 110±16 and 108±11μV respectively (P=0.7248). The means of the amplitude of b-waves were 151±12, 148±14, 144±16 and 141±20μV respectively (P =0.0957).CONCLUSION: Injection of tPA upto 25μg in 0.1mL into optic nerve is well tolerated.

Objective To investigate and analyze the epidemiological characteristics of eye injury among military inpatients. Methods Data of eye injury among military inpatients from 15 military general hospitals during 2001 --2005 were recorded and statistically analyzed. Results There were 716 military inpatients with eye injuries, taking up 7.41% of the whole ocular trauma inpatients in corresponding time period. Military inpatients with eye injuries were admitted more in spring and summer; with sex ratio as 46.73:1 ; mean age as (24.99±8.40) years and 82.27% in 17-29 years while 7.82% were binocular injuries. A certain proportion of the complication appeared after the myoporthosis operations. Mechanical and non-mechanical eye injuries took up 92.49% and 7.51% respectively. Sports (17.62%), explosion (11.92%) and fighting (11.40%) related factors were the main causes of injuries. 51.55% of the accidents took place during working or training processes and 30.31% was on military training sites. At discharge, 22 eyeballs were removed mainly due to open globe injuries, 9 eyes with no light perception but vision acuity equalled to or more than 0.5 in 62.16% of the patients. Conclusion Of those eye injury inpatients, military training and construction for defense were the main causes related to occupational eye injuries among soldiers. Mutilation power of eye injury should not be ignored and epidemiological survey on military eye injuries need to be carried out more extensively.

AIM: To test the expression of erythropoietin (Epo) and its receptor EpoR in normal and neovascularized murine corneas induced by alkali burns, and to investigate whether Epo/EpoR is involved in the process of corneal angiogenesis.METHODS: The expression of Epo/EpoR was tested in normal and neovascularized murine corneas induced by alkali burns through immunohistochemistry of corneal frozen sections. Epo cloning, expression, and purification were carried out. Then Epo protein (6μL, 1μg) and control (6μ L of vector control or saline) were injected into the corneal stroma respectively, and the corneas were checked at the 14th day after injection to see whether corneal neovascuarization occurred.RESULTS: Epo/EpoR was expressed in epithelial cells, endothelial cells and stromal cells in normal and neovascularized corneas induced by alkaline burns, and also expressed strongly in neovascularized cornea. They were expressed at the same time in stromal inflammatory cells and new vessels. Corneal neovascularization was induced by Epo intrastromal injection in 5 out of 6 eyes ,but no new vessels were observed in all controls (n = 6) at day 14 after vector control or saline intrastromal injection in normal corneas.CONCLUSION: This paper first reported the expression of Epo and its receptor in normal and neovascularized cornea. Injection of Epo into the corneal stroma may induce the corneal neovascularization. Epo/EpoR is associated with the formation of corneal neovascularization.

OBJECTIVETo evaluate the outcome and analyze the methods of surgical treatment of traumatic endophthalmitis following penetrating eye injuries with retained eye foreign bodies.

METHODSA total of 62 consecutive cases (58 men, 4 women) from January 1999 to December 2001 with IOFBs following penetrating eye injuries were retrospectively studied. The ages ranged from 8 to 46 years (mean 23 years). Sixty patients (63 eyes) underwent pars plana vitreotomy and 1 patient underwent external magnet extraction. The follow-up ranged from 3 to 36 months (mean 12.5 months).

RESULTSTen eyes developed endophthalmitis, among which 7 (10.94%) were diagnosed preoperatively. The most frequently cultured organism was Staphylococcus epidermis (44.44%, 4/9). Postoperatively, retinal detachment due to vitreoretinal proliferation occurred in 5 patients with endophthalmitis and in 9 patients without endophthalmitis. All the retinal detachments were reattached with additional vitreoretinal surgery. Two eyes with endophthalmitis and two without endophthalmitis were eviscerated.

CONCLUSIONSPost-traumatic endophthalmitis with intraocular foreign bodies (IOFBs) deserves great attention because of its high incidence and poor prognosis. Vitrectomy is suggested for the treatment of IOFBs and its complications, and it should be performed as soon as possible. Routine intravenous administration of antibiotics combined with periocular injection and topical antibiotics postoperatively are recommended.

Adolescent ; Adult ; Anti-Bacterial Agents ; therapeutic use ; Child ; Endophthalmitis ; etiology ; Eye Foreign Bodies ; complications ; therapy ; Eye Infections, Bacterial ; drug therapy ; etiology ; Eye Injuries, Penetrating ; complications ; therapy ; Female ; Humans ; Injections ; Male ; Middle Aged ; Vitrectomy

Objective To investigate the effects of HLA-B27 in disease activity and the clinical features of axial spondyloarthritis(SpA). Methods Clinical data of 112 patients with axial SpA was collected and studied prospectively. Clinical manifestations and laboratory examination results of 82 HLA-B27 positive and 30 HLA-B27 negative patients with axial SpA were analyzed. Data source was from Chinese Rheumatism Data Center. Results (1)The average age of onset of HLA-B27 negative patients was significantly later than that of the positive patients , and there was no significant difference in the course of disease and the proportion of male and female patients. (2)The ratio of severe lesion of hip ,peripheral arthritis ,attachment inflammation and systemic symptoms of HLA-B27 negative group were significantly lower than those of HLA-B27 positive group. Familial aggregation phenomenon,uveitis and spine radiology changes in two groups had no significant difference.(3)The changes of disease activity index including erythrocyte sedimentation rate and C-reactive protein increased in HLA-B 27 negative group was significantly lower than those in HLA-B27 positive group. Conclusion There is strong correlation between axial SpA and HLA-B27. The average age of onset of HLA-B27 negative patients was significantly later than that of the positive patients. HLA-B27 negative patients manifested severe symptoms and worse prognosis.

BACKGROUNDSympathetic ophthalmia (SO), a rare, bilateral, diffuse granulomatous uveitis, usually occurs after open globe injury or intraocular surgery. We sought to identify the risk factors for the development of SO after open globe injury and describe their demographic and clinical features and outcomes of treatments.

METHODSA retrospective study of inpatients with globe injury in 15 tertiary referral hospitals of China from January 2001 to December 2005 was conducted. The information of demography, nature and mechanism of injury, time and ways of treatments and outcomes was reviewed. Diagnosis of SO was made based on a history of ocular trauma or surgery and subsequent development of bilateral or contralateral uveitis consistent with SO. Any association between related parameters and development of SO was analyzed.

RESULTSAmong 9103 patients (9776 eyes) of globe injury, SO occurred after open globe injury in 18 cases with an occurrence rate of 0.37%, vitrectomy of closed globe injury in 2 (0.37%) and perforation of burned eyes in another 2. For open globe injury, the median age ((36.72 +/- 13.59) years, P = 0.01) was higher in patients with SO; there were no significant effects of sexes, injury type, uvea proplaps, once or multi-intraocular surgery, once or multi-vitrectomy and endophthalmitis on incidence of SO; 0.70% endophthalmitis concurred with SO; 83.33% of SO occurred within 1 year after injury or last ocular surgery. SO developed in a fellow eye one week after evisceration of the perforating burned eye. Good final visual acuity was obtained in sympathizing eyes with prompt treatment.

CONCLUSIONSFor open globe injuries, SO sufferers were relatively older and any injury type could induce SO with equal possibility. The initial open globe injury was more likely to be the trigger of SO than subsequent intraocular surgeries including vitrectomy. Prophylactic enucleation after injury is not recommended.

Adolescent ; Adult ; Child ; Eye Enucleation ; adverse effects ; Eye Injuries ; complications ; surgery ; Female ; Humans ; Male ; Middle Aged ; Ophthalmia, Sympathetic ; epidemiology ; etiology ; Retrospective Studies ; Vitrectomy ; adverse effects ; Young Adult

OBJECTIVETo study the effect of Vaccinium uliginosum L., (VU) on the electroretinogram (ERG) and retinal pathological changes in rabbits after light-induced damage.

METHODSTwenty-eight Chinchilla rabbits were randomly divided into four groups: administration beforehand (A), administration after injury (B), light injury without administration (C), and blank (D) groups. After a 4-week administration of VU homogenate at 4.8 g/(kg·d) once a day in group A, ERG in groups A, B and C were recorded according to the standards set by the International Society for Clinical Electrophysiology of Vision (ISCEV). Except for group D, the groups were then exposed to strong light. Just after that, group A stopped receiving VU treatment and group B started to receive it. Then ERGs in all groups were recorded after 1 day, 1 week, and 2 weeks. Throughout the whole process groups which were not fed with VU were fed with normal saline. Finally, the tissues and structures of all the groups were observed and the thickness of the outer nuclear layers (ONL) was measured.

RESULTS(1) After 4-week feeding with VU, the latency time of ERG in group A became shorter than those in the other groups and the amplitude increased. After being exposed to strong light, the latency time lengthened and amplitude decreased in all the injury groups, but comparing at each time point, the measured values in group A were better than those in group C. With the accumulation of VU, the ERG in group B improved, and finally, all of the detected values became better than those in group C. (2) Retinae in group D were normal in histology and the layers were in order but those in group C became disarranged. The injuries in groups A and B were minor compared with those in group C. The thickness of the ONL in group C was significantly thinner than in the other groups (P=0.000), and that in groups A and B was thicker than that in group C, although thinner than in group D. That in group A was thicker than in group B.

CONCLUSIONSVU can relieve the injury to rabbit retinae exposed to normal day and night rhythm, alleviate the harm caused by light when used beforehand, and repair the light damage to the retina.

Animals ; Electroretinography ; Light ; Plant Extracts ; pharmacology ; Rabbits ; Retina ; drug effects ; pathology ; physiopathology ; radiation effects ; Retinal Cone Photoreceptor Cells ; drug effects ; pathology ; radiation effects ; Retinal Rod Photoreceptor Cells ; drug effects ; pathology ; radiation effects ; Time Factors ; Vaccinium ; chemistry

OBJECTIVETo investigate the effect of 360-degree retinectomy for severe ocular rupture and evaluate the related factors associated with prognosis.

METHODSA retrospective analysis was performed on 28 consecutive patients, 18 men and 10 women, with severe ocular rupture admitted to the Chinese PLA General Hospital between January 1999 and January 2002. The patients' ages ranged from 16 to 58 years, mean 29.5 years. All operations were performed by the first author. All patients underwent standard 3-port pars plana vitrectomy with scleral encircling buckle, endophotocoagulation, and tamponaded with silicone oil. Lensectomy were performed on 15 eyes. 360-degree retinotomy and retinectomy were performed at anterior equator on 16 eyes, and posterior equator on 12 eyes.

RESULTSDuring operation, all patients were confirmed to have vitreous hemorrhage and retinal detachment, in which hemorrhagic ciliary body detachment was found in 9 eyes, suprachoroidal hemorrhage in 12 eyes, retinal twisting like flower stalk in 11 eyes, and retinal incarceration in 17 eyes. Postoperative follow-up was conducted in 26 cases, ranged from 6 months to 46 months. Retinal reattachment achieved in 20 eyes (76.9%), in which three patients' retina was reattached after revitrectomy. The silicone oil was removed at the fourth month in 8 eyes postoperatively. Corrected visual acuity of 0.02 or more was in 14 eyes (70.0%) among the 20 patients with reattached retina. Visual acuity of 0.05 or more was in 7 eyes (35.0å), and 0.1 or more was in 3 eyes. The best visual acuity was 0.3 in 1 eye.

CONCLUSIONSRetinectomy may improve the prognosis of severe ocular rupture and save the visual function of some patients.