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The importance of clinical application of full-field electroretinography in ophthalmology

Chinese Journal of Ocular Fundus Diseases.2009;25(6):409-412. doi:10.3760/cma.j.issn.1015-1005.2009.06.01

Full-field electroretinalgraphy (ffERG) is an indispensablemeans in assessment of retinal disease;it is invasive,effective,objective,quantifiable,and reproducible.Currently ffERG has been extensively applied domestically,but it also has disadvantages such as too few detected diseases,nonstandardised methodology,and inaccurate description of the results.It is important to place more emphasis on the internationalization,standardisation,and normalization of the application;obtaining the differences of indication,detection techiniques,and description of the results among ffERG,multifocal ERG and pattern ERG;expanding the new fields and methods of clinical applications.So that ffERG could play an more important role in the diagnosis and management for the patients with retinal disease.

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Blue light-induced replicative senescence of rat retinal pigment epithelial cells

Yifeng KE ; Song CHEN ; Rui HAO

Chinese Journal of Ocular Fundus Diseases.2009;25(6):462-465. doi:10.3760/cma.j.issn.1015-1005.2009.06.15

Objective To investigate the relationship between exposure intensity and illumination time of blue light and replicative senescence of rat retinal pigment epithelial (RPE) ceils.Methods Thirty-six 12-14 weeks Wistar rats were kept in the cage with a blue-light bulb [(450±10) nm],and were randomly divided into four groups (no light,nature light,500 lx light and 1000 lx light illumination),each has nine rats.The rats in each group were further divided into three subgroups according to illumination time (one month,two months or three months).Eyeballs were collected after intraperitoneal injection of 10% chloral hydrate.The right eye of each rat was embedded in paraffin and sectioned for hematoxylin-eosin (HE)staining,while frozen sections of the left eye were stained for the senescence-associated β-galactosidase (SA-β-Gal).The data were analyzed by SPSS11.5 statistical software.Results The amounts of SA-β-Gal positive RPE cells were significantly different between all groups under the same illumination time 17 (P=0.000),and between all subgroups of different illumination time with same exposure intensity (P＜0.01)except for the control group (no light).Conclusion Blue-light can induce replicative senescence in rat RPE cells in an intensity and time-dependent manner.

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Multifocal electroretinogram of rod and cone cells in patients with retinitis pigmentosa

Yong LIU ; Yanji YU ; Zhengqin YIN

Chinese Journal of Ocular Fundus Diseases.2009;25(6):433-436. doi:10.3760/cma.j.issn.1015-1005.2009.06.07

Objective To observe the mutifocal electroretinogram (mfERG) characteristics of rod and cone cells in patients with retinitis pigmentosa (RP) and to evaluate the function of photosensory cell.Methods The mfERG recording technique for rod cell in eight normal subjects (eight eyes) were established and the influence of different brightness lightstimulus in P1 wave amplitude were analyzed.The cone and rod cells mfERG of 38 eyes in 19 patients were recorded and then calculated positive ratio from local signal-noise ratio.The average visual acuity and P1 wave amplitude density of cone mtERG in different types were compared and statistically analyzed.Meanwhile,the changes in P1 wave amplitude of cone and rod mfERG in four quadrants also compared and analyzed.Results Rod cell mfERG in normal subjects can be recorded stably by using blue flashes with low light intensity as 0.04 cd/m~2.In patients with RP,the cone and rod cells mfERG can he detectd 65.790./00 and 10.51% respectively.P1 wave amplitude density in type I of cone cell mfERG was significantly higher than that in type Ⅱ (t=5.21,P=0.000).There were no differences in average visual acuity (t=1.15,P=0.612).P1 wave amplitude density in type Ⅰ was negatively related to IogMAR visual acuity (r=-0.48,P=0.04 ).The comparison of rod and cone cells mfERG in local wave characteristics showed that P_1 wave amplitude densities had spatial relationship in each area.Conclusions The results suggested highly variable central responses in cone cell in RP patients,higher positive recorded ratio in cone cell than rod cell and spatial correspondence between the function of reserved cone and rod cells.

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Macular holes: clinical research and therapeutic efficacy

Lin Lü

Chinese Journal of Ocular Fundus Diseases.2010;26(6):501-504. doi:10.3760/cma.j.issn.1005-1015.2010.06.01

Macular hole is a retinal hole locates in macular fovea, and can be idiopathic, traumatic and high myopic. Although its etiology, disease course, treatment and prognosis varied from case to case,enforcing macular-hole closure and retinal reattachment are challenges to all cases. Completely removal of premacular vitreous cortex is the key to successful repair, and inner limiting membrane (ILM) staining and peeling can greatly help the removal of those cortexes. Selections and usages of different dyes, methods of ILM peeling, and strategies to promote macular retina-choroidal adhesion warrant further study to improve treatment and prognosis of macular holes.

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The influence of triamcinolone acetonide on the expression of pigment epithelium-derived factor

Meiqing REN ; Jie LUAN

Chinese Journal of Ocular Fundus Diseases.2010;26(6):544-547. doi:10.3760/cma.j.issn.1005-1015.2010.06.12

ObjectiveTo observe the influence of triamcinolone acetonide (TA) on the expression of pigment epithelium-derived factor (PEDF) of human retinal pigment epithelial (RPE) cells. Methods Cultured human RPE cells (4th - 6th generations) were treated with four different concentrations of TA (40, 400, 4× 103 and 4× 104 μg/L) for three different periods (12 or 24 or 48 hours), the levels of PEDF protein in the cell culture supernatant and cell lysates were determined by Western blot. After the initial experiment, RPE cells were treated with or without tumor necrosis factor-α (TNF-α, 20 ng/ml) for 24 hours, followed by TA (400 μg/L) treatment. The levels of PEDF and phospho-p38 mitogen activated protein kinase (p-p38MAPK) protein expression in cell culture supernatant and cell lysates were measured by Western blot. Results TA-treated RPE cells had higher PEDF expression, and 400 μg/L TA group had the highest effect (F= 16.98, P＜0. 05). 400μg/L TA treatment for one, six or 24 hours, with or without TNF-α pretreatment, could all promote the PEDF expression and inhibit the p-p38MAPK protein expression (F= 16.87, 10.28; P＜0. 01). TNF-α pretreatment alone could inhibit PEDF protein expression and promote p-p38MAPK protein expression (F= 16.87, 10. 28; P＜0. 01). Conclusions TA can up-regulate the expression of PEDF, and down-regulate the expression of p-p38MAPK in the cultured human RPE cells.

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Three-dimensional computed tomography reconstruction of the eyes before and after removing the scleral encircling buckles

Haiyan YING ; Fang WANG ; Xueqian XIE

Chinese Journal of Ocular Fundus Diseases.2010;26(6):536-539. doi:10.3760/cma.j.issn.1005-1015.2010.06.10

ObjectiveTo measure the changes of eye shape and axial length of the eyeball before and after removing the scleral encircling buckles. MethodsThis is a prospective and controlled study. Twenty eyes (20 patients) with rhegmatogenous retinal detachment and the fellow eyes were enrolled in this study.All patients underwent scleral encircling buckling, and the buckles were removed 2.0 - 3.5 years after the surgery. The eye shape and axial length of both eyes were measured by three-dimensional computed tomography (3D-CT) before and one, three, six months after the removing surgery. The axial length was also measured by intraocular lens (IOL)-Master. Results3D-CT showed that buckled eyeball depressed at the equator, resulting in a gourd-shaped eyeball.One month after removing the encircling buckle the depression disappeared.By 3D-CT scanning, the axial lengths of buckled eyes were (27.65 ± 1.22),(27. 3±1.56), (27. 29 ± 1.46) and (27. 12 ± 1.49) mm before and one, three, six months after the removing surgery respectively.The difference betweenbefore and after removing surgery was not statistically significant(t=2.89, P = 0.723). By IOL-Master, the axial length of operated eyes were (28. 32± 1.94), (28.17± 1.87), (28.21± 1.94), (28.25± 1.93) mm respectively.The difference between before and after removing the encircling band was not statistically significant (t = 3. 304, P =0.93). There was no significant difference in these two measuring modes (t= 3.705, P = 0.847).ConclusionsEncircling buckling can cause eyeball indentation, removing the encircling band can rescue the indentation. There are no changes in the axial length before and after removing the encircling buckles.

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Surgical results of complicated ocular trauma with cyclodialysis

Bin YU ; Xiaoguang DONG ; Jinyan WANG

Chinese Journal of Ocular Fundus Diseases.2010;26(6):517-520. doi:10.3760/cma.j.issn.1005-1015.2010.06.05

ObjectiveTo explore the surgical techniques, efficacy and the management of complicated ocular trauma with anterior-posterior segment complications such as cyclodialysis. Methods Fifty-five patients (55 eyes) with complicated ocular trauma were enrolled in this study. Among them, there were 35 cases with eyeball contusion and 20 cases of eyeball rupture. Preoperative visual acuity was from no light perception to 0. 15, intraocular pressure (IOP) ranged from one to 10 mm Hg (1 mm Hg=0. 133 kPa).Cyclodialysis, vitreous hemorrhage or retinal detachment were revealed by B-ultrasound and ultrasound biomicroscopy (UBM). Cyclodialysis clefts ranged from one to 12 clock-hours. All patients underwent 3-port pars plana vitrectomy with gas/silicone oil tamponade and ciliary body reattachment by cryotherapy (cyclodialysis clefts ≤ three clock-hours) or suture fixation ( cyclodialysis clefts ＞ three clock-hours).Healing after surgical trauma, visual acuity, intraocular pressure, intraocular hemorrhage, ciliary body and retinal reattachment were followed up. Results In one month after surgery, UBM showed 54 patients out of 55 patients had good ciliary body reattachment. Gonioscopy revealed cyclodialysis still existed in one patient, and this was cured by a second surgical suture fixation. In three months after surgery, ocular trauma healed in all 55 patients, the visual acuity ranged from no light perception to 0. 15, with a best corrected visual acuity of 0.8. The ciliary body and retina had good reattachment. IOP of 52 patients was normal; IOP of three patients was still lower than 10 mm Hg. Three patients had secondary glaucoma which was treated by glaucoma surgery. Conclusions Complicated ocular trauma with cyclodialysis can be treated with vitrectomy and cryotherapy or transscleral sutures. The procedure is safe and effective.

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Analysis of the results of multifocal visual evoked potential examination in patients with anterior ischemic opticneuropathy before and after treatment

Xiangqin LIU ; Xiaowen GUO ; Lixia ZHOU

Chinese Journal of Ocular Fundus Diseases.2009;25(6):437-439. doi:10.3760/cma.j.issn.1015-1005.2009.06.08

Objective To observe the results of multifocal visual evoked potential (mfVEP) examination in patients with anterior ischemic optic neuropathy (AION) before and ater treatment,and to probe its clinical significance.Methods A total of 90 patients (90 eyes) with AION were examined by mfVEP;the second-order reaction of mfVEP was analyzed.The reaction was divided into upper and lower hemi-field of visual field,or 1 / 4 quadrant visual field (superior nasal,inferior nasal,superior temporal,and inferior temporal).The sum of waves of each response was analyzed and the results in various regions were compared.The features of wave configuration was compared between the AION eyes and the contralateral eye,and between the AION eyes before and after treatment.Results The amplitude and latency of P-wave of mfVEP was 0.198±0.033 and 100.197±7.354 respectively in AION eyes before treatment,and was 0.271±0.024 and 98.567±6.794 in the contralateral eyes;the difference was significant (t=16.556,18.330;P＜0.01).The amplitude and latency of P-wave of mfVEP was 0.229±0.016 and 100.104±10.603 respectively in AION eyes after treatment,which differed much from that before the treatment (t=13.649,8.858;P＜0.01) and also from that of the contralateral eyes (t=13.649,8.858;P＜0.01).Conclusions The amplitude and latency of P-wave of mfVEP may accurately reflect the recovery of local optic nerve damage in AION eyes before and after treatment with good repeatability.AION can be used as a new method for AION diagnosis and detection of the prognosis.

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Multifocal electroretinogram of the fellow eye in patients with unilateral retinal vein occlusion

Yan LIU ; Wenbin WEI ; Cheng PAN

Chinese Journal of Ocular Fundus Diseases.2009;25(6):425-428. doi:10.3760/cma.j.issn.1015-1005.2009.06.05

Objective To measure the macular function of the fellow eye in patients with unilateral retinal vein occlusion (RVO).Methods A total of 24 cases of unilateral RVO were diagnosed by fundus fluorescein angiography (FFA),and multifocal ERG (mfERG) was recorded by RETI scan.The mfERG data of 24 fellow eyes of those RVO patients,and 18 normal control eyes were analyzed and compared.The parameters included the amplitude density,latency of the P1 and N1 wave in 6 concentric circles and 4quadrants of the mfERG graphics.Results The amplitude densities of P1 and N1 wave in first and second concentric circles of RVO fellow eyes were significantly lower than normal eyes (t=4.520,2.147;P＜0.05).There was no significant difference (P＞0.05) of P1/N1 latency in any concentric circles or quadrants between RVO fellow eyes and normal eyes.Conclusion The central fovea of the RVO fellow eyes was functionally impaired.

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Therapeutic effects of vitrectomy for persistent fetal vasculature

Ying HONG ; Zhizhong MA ; Changguan WANG

Chinese Journal of Ocular Fundus Diseases.2010;26(6):521-523. doi:10.3760/cma.j.issn.1005-1015.2010.06.06

ObjectiveTo observe the effects of vitrectomy for persistent fetal vasculature (PFV).Methods The clinical data of 11 patients (14 eyes) with PFV, including posterior PFV (one eye) and combined PFV (13 eyes), were retrospectively analyzed. Vitrectomy was performed for all patients,lensectomy was performed for seven eyes, retinotomy was performed for five eyes, retinotomy and scleral buckling was performed for one eye. Intraoperative and postoperative complications were observed. The follow-up period ranged from eight to 74 months, with the mean of 44 months. The visual acuity (VA) and intraocular pressure before and after surgery were comparatively analyzed. Results There were no intraoperative complications in all the patients. The surgery was performed successfully in 12 eyes (86.0 %)and failed in two eyes (14. 0%). The postoperative VA of five eyes (35.7%) increased, four eyes (28. 6%)didn't change and five eyes (35.7%) decreased. The postoperative intraocular pressure of two eyes (14. 3%) increased, 11 eyes (78. 6%) didn't change and one eye (7. 1%) decreased. There was one eye with persistent hypotension and one eye with recurrent retinal detachment after surgery. Conclusion Vitrectomy can prevent complications and improve visual acuity in some PFV patients.

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