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Clinical analysis of fundus fluorescein angiography in Takayasu arteritis

Jian, ZHANG ; Rongping DAI ; Youxin, CHEN ; Junjie, YE ; Fangtian DONG

Chinese Ophthalmic Research.2010;28(2):153-156. doi:10.3969/j.issn.1003-0808.2010.02.014

Background Takayasu arteritis is a non specificity inflammation of aorta and its branch.The incidence of Takayasu arteritis is low and its ocular secondary disease is rare.The correct diagnosis of Takayasu arteritis is very important for its early treatment in clinic.Objective This study is to analyze the fundus findings and characteristic of fundus fluorescein angiography (FFA) of Takayasu retinopathy.Methods The FFA and clinical data of 12 patients (24 eyes) with Takayasu arteritis were retrospectively reviewed.Written informed consent was obtained from all the patients before and initiation of any study protocol.Results In 12 patients,chronic ischemic retinopathy was found in 15 eyes of 9 patients.The arm to retina circulation time(A RCT) prolonged to (19.20±2.95) s in 5 eyes,and the retinal circulation time (RCT) delayed to 10.62±6.15 s in 5 eyes.Peripapillary arteriovenous anastomosis was found in 2 eyes of 2 patients.Macular arch ring was incomplete in 6 eyes of 4 patients.Eight patients (14 eyes) had telangiectasis and microaneurysm,and 2 eyes of 2 patients presented neovascularization on the disc or elsewhere.In 12 patients,hypertensive retinopathy was found in 4 eyes of 3 patients,showing narrow retinal artery,arteriosclerosis,hemorrhage,cotton wool spots and hard exudates.Ten patients were diagnosed as Takayasu arteritis before FFA examination,and 2 patients were determinedly diagnosed after FFA was performed.Conclusion The main features of Takayasu retinopathy are hypertensive retinopathy and chronic ischemic retinopathy.It is important for ophthalmologist to correctly recognize the clinical features of TA.

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The effects of recombinant human resistin on differentiation of orbital preadipocytes of TAO patients in vitro

Hongxia, LIU ; Lin, LUO ; Zhongyao WU

Chinese Ophthalmic Research.2010;28(2):167-170. doi:10.3969/j.issn.1003-0808.2010.02.017

Background The enhance of differentiation of orbital preadipocyte is a main factor for pathogenesis of thyroid associated ophthalmopathy(TAO).Experiment has proved that orbital preadipocyte can differentiate into mature adipocyte expressing resistin,and resistin is a adipocyte factor with biological activity.Objective The present study is to investigate the effects of recombinant human resistin on differentiation of orbital preadipocytes derived from TAO patients orbital tissues.Methods Orbital adipose tissue was obtained from 10 eyes with TAO during the orbital decompression surgery.Orbital adipose tissue of the normal group was obtained from 5 removed eyes during the surgery due to different reasons.Preadipocytes were isolated and cultured using expand culture method.The 2-5 generations of preadipocytes were identified by oil red O staining under the light microscope.0,10,25,50,100ng/mL of recombinant human resistin were added into medium in the first day after differentiation of cells.The expression of PPARγ mRNA in differentiated adipocytes were detected by reverse trancripaton PCR(RT PCR).Results The differentiation of preadipocyte presented the similar procedure and outcome between the TAO group and normal group.Differentiated adipocyte was stained into the jacinth by oil red O.The expression of PPARγ mRNA in differentiated cells was gradually declined with the increase of concentration of recombinant human resistin (F=241.341,P＜0.01).A dose dependent inhibitory effect was detected in the expression of PPARγ mRNA.The weakest expression of PPARγ mRNA in differentiated cells was 100ng/mL resistin group.Conclusion The recombinant human resistin has an inhibitory effect on the differentiation of orbital preadipocytes by reducing the expression of adipose related genes.Resistin is probably a new research approach to treatment of TAO.

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The effect mechanism of pharmacological vitreolysis with plasmin and hyaluronidase

Zhiliang WANG ; Wodong, SHI ; Xi, ZHANG ; Fang, WANG ; Xianqun, FAN ; Min, LUO

Chinese Ophthalmic Research.2010;28(2):149-152. doi:10.3969/j.issn.1003-0808.2010.02.013

Background Many ophthalmologists have proved that the intravitreal injection of plasmin can safely induce posterior vitreous detachment(PVD),but if it can generate the complete PVD need further to seek confirmation.Researches showed that the safe dose and toxicity dose of dispase are very near,so its application is limited.Whether hyaluronidase can induce PVD is still in controversy.Objective This study is to clarity the mechanism of pharmacological vitreolysis with plasmin and hyaluronidase.Methods Plasmin 4μmol/L,2μmol/L and 1μmol/L,plasmin 1μmol/L+ hyaluronidase 20μmol/L,hyaluronidase alone were intravitreally injected in lateral eye of 4 clean New Zealand white rabbits respectively,and 0.1mL BSS was injected as control group.Electron immunocytochemical technique was used to detect the laminin and fibronectin of interface between vitreous and retina in 7 days after intravitreal injection.Other 14 eyes of 7 clean New Zealand white rabbits were used in this study.Plasmin 1μmol/L + hyaluronidase 20μmol/L was intravitreally injected in the lateral eyes,and only plasmin 1μmol/L was injected in the fellow eyes.Plasmin activity in vitreous was evaluated in 15 and 30 minutes,1 hour,2,3,6,12 hours after intravitreal injection.The use of animals followed the Regulations for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission.Results The amounts of laminin and fibronectin in the vitreoretinal interface were decreased in 4μmol/L plasmin group,2μmol/L plasmin group,1μmol/L plasmin group,1μmol/L plasmin+20μmol/L hyaluronidase group compared with control group(P＜0.01).No significant difference was seen in the density of gold particles of anti FN between 20μmol/L hyaluronidase group and control group (P＞0.05).The change of amounts of fibronectin in the vitreoretinal interface was similar to that of laminin.Plasmin activity remained the highest level 1 hour after injection and thereafter gradually decreased and extincted in 12 hours and presented the same trend between plasmin 1μmol/L+hyaluronidase 20μmol/L group and only plasmin 1μmol/L group.Conclusion The mechanism of pharmacological vitreolysis is to dissolve laminin and fibronectin in the interface between vitreous and retina and therefore induce PVD.Combination of plasmin with hyaluronidase can increase the efficiency of pharmacological vitreolysis.The optimum selection of drug in inducing PVD should consider not only its role of lysis laminin and fibronectin but also the role of liquefying the vitreous.

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Effects of dexamethasone and latrunculin A on expression of protein in human trabecular meshwork cell

Xianchai LIN ; Minbin, YU ; Xuyang, LIU ; Xuan, QIU ; Kaili, WU

Chinese Ophthalmic Research.2010;28(2):145-148. doi:10.3969/j.issn.1003-0808.2010.02.012

Background Researches have demonstrated that dexamethasone (Dex) can induce the changes of the function and structure of trabecular meshwork cells,and latrunculin A (Lat A) can enhance the outflow of aqueous humour and therefore low the intraocular pressure.Objective The aim of the present study is to investigate the effects of Dex and Lat A on the expression of protein in human trabecular meshwork cells.Methods Human trabecular meshwork cells were primarily cultured in DMEM using expand culture method and the fifth generation of cells were used to this experiment.Dex and/or Lat A were added in medium as 10~(-6)mol/L Dex group(Dex treating for 24 hours),Dex+Lat A group(10~(-6)mol/L Dex+2mmol/L Lat A for 24 hours),Lat A group(2mmol/L Lat A for 24 hours) and DMEM culture group.Two dimensional gel electrophoresis(2 DE) was used to compare the protein expressions among these four groups.Subsequently protein spots with different intensity were selected for mass spectrometry analysis.Results Four gel patterns of two dimensional gel electrophoresis of human trabecular meshwork cells from Dex,Dex+Lat A,Lat A and control groups were obtained.A good isolated result for majority of proteins in human trabecular meshwork cells was found in all of the four groups.An obvious expression difference of proteins in human trabecular meshwork cells was seen among the different culture conditions.Twenty four kinds proteins were identified by GDPiMALDI TOF MS,including cytoskeleton related proteins,heat shock proteins,redox related proteins,and proteins participating in carbohydrate metabolism.The expressions of aldehyde dehydrogenase(ADLH)and Rab were increased in Lat A group and decreased in Dex group,but HSP27 and hCRMP2 showed the contrary outcome.Conclusion This study construct the pattern of protein expression in human trabecular meshwork cells by using 2 DE.Dex and Lat A impact the protein expressions in human trabecular meshwork cells.

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Advance in the study of complication of anti-vascular endothelial growth factor following intravitreal injection

Lizhu, MENG ; Song, CHEN

Chinese Ophthalmic Research.2009;27(11):1039-1043.

The efficacy of intravitreal injection of anti vascular endothelial growth factor(VEGF) drug has been recognized for the treatment of choroidal neovascularization(CNV) secondary to age-related macular degeneration(AMD), central exudative chorioretinopathy and pathological myopia, proliferative diabetic retinopathy (PDR), retinal vein occlusion, retinopathy of prematurity and neovascular glaucoma. The tendency of clinic application of anti-VEGF is increasing. Though the therapeutic effect of anti-VEGF has been confirmed, a variety of complications associated with its usage were reported. This review summared the advancement of the complication in the clinical application of anti-VEGF therapy such as its effect on normal structure and physiological function of eye, intraocular pressure elevation, rips of retinal pigment epithelium(RRPE), retinal detachment(RD), endophthalmitis and systemic side-effects.

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Prevalence of trachoma in children at primary school in Wuqiang County, China

Jiandong LI ; Yumei, ZHOU ; Jianling LI ; Shijing, DENG ; Zhiqun, WANG ; Xuguang, SUN

Chinese Ophthalmic Research.2009;27(11):1035-1038.

Objective Trachoma is a preventable infective eye disease worldwide. The incidence rate of active trachoma in children can reflect the epidemical degree of trachoma in the location. This study tried to assess the prevalence and risk factors of trachoma in students at primary school in Wuqiang County, China. Methods An epidemiological survey was carried out in Wuqiang County in 2006. The investigators were from Wuqiang County Hospital and Beijing Tongren Eye Center and received special training. Primary school children aged 6- to 16-years-old were selected by a cluster sampling with the class shift as the sampling unit. Trachoma was clinically examined under the slim lamp and assessed based on the simplified classification for trachoma proposed by the World Health Organization (WHO). The C. Trachomatis inclusion body was detected from conjunctival swab of patients with trachoma using enzyme immunoassay and polymerase chain reaction (PCR). The questionnaire was performed in the examinees and parents. The survey followed the Declaration of Helsinki and written informed consent was obtained from the examinees. Results A total 379 cases with trachoma were determined in 1622 primary school examinees with the prevalence 23. 4% (95% CI:25. 5% -21. 3%) .including follicular trachoma in 81% and intense trachoma in 19% . The overall prevalence of trachoma was higher in female students than male ones (25. 8% versus 20. 9%, P = 0. 020). No inclusion body of the conjunctiva was observed. Sixty-four cases (38. 1%) presented the positive response for C. Trachomatis antigen by enzyme immunoassay, and 109 cases (64. 9%) were positive response by PCR. The multiple factors logistic regression analysis showed the risk factors for active trachoma included living location, suburbs and female and age(0R =0.763, 1.299, 1. 147 respectively). Conclusion Trachoma showes a disseminating procedure among primary school children in Wuqiang County. The prevention strategy should be made for related risk factors.

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The analysis of estradiol content in tear and serum of postmenopausal women

Ru, BIAN ; Jianhua, LU ; Wenfang, ZHANG

Chinese Ophthalmic Research.2009;27(11):1031-1034.

Objective That decline of estradiol in serum of postmenopausal women can result in dry eye has been accepted at present. However, the change of estradiol in tear of postmenopausal women has been not reported ever. This study was to discuss the relationship between dry eye syndrome and estradiol in tears and serum of postmenopausal women. Methods Total 62 eyes of 62 women were collected in this trial. The aim of this trial was informed orally and the informed consent was obtained from all the subjects. The 32 right eyes were from menopausal women for more one year and 30 right eyes were from premenopause women. The dry eye was diagnosed based on the abnormalities of tear break-up time (BUT), Schirmer I test, corneal fluorescence and subjective symptom of patients. The periphery blood specimen was collected from all the subjects, and tear specimen was obtained and quantified using filter paper. Estradiol contents in tears and serum were determined by chemiluminescence method. The bulbar conjunctiva was obtained by impression cytology, and the microstructure of conjunctiva was observed under the scanning electron microscopy. Results In comparison to the premenopause group, the content of estradiol in tears and serum in menopause group was significantly reduced(73. 50 ±24.47 vs 17. 43 ± 10. 92) (U = -6. 396, P =0. 001). In the premenopause group, the estradiol content between tear and serum showed the positive correlation (r = 0. 838, P = 0. 001) . However, no statistical correlation was found in estradiol content between tears and serum in menopause group(r =0. 127, P = 0. 487). The maicrostructure changes were seen in the dry eyes of postmenopausal women, and decrease of goblet cell and loosen of intercellular junction were found under the electron microscope. Conclusion The content of estradiol in tears in menopause group is significantly lower than that in the premenopause group. Estradiol content in tears and serum of the postmenopausal women showes insignificant correlation. This result indicates that the topical substitute therapy with estradiol is possible in dry eye.

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Effect of topical bevacizumab on experimental corneal neovascularization in mouse

Feng, ZHAO ; Jianjiang XU ; Tianyu, ZHENG ; Xin, WANG ; Zhirong, LIN ; Gang, LI ; Wentao, WANG

Chinese Ophthalmic Research.2009;27(11):983-987.

Objective The inhibitory effects of avastin on new blood vessels in nonproliferation diabetic retinopathy, age-related macular degeneration and neovascular glaucoma have been demonstrated. But only seldom report of avastin on corneal neovascularization(CNV) was seen. Present study was to evaluate the effect of topical bevacizumab (avastin) on experimental corneal neovascularization in mice. Methods Thirty eyes of 30 Balb/c mice were chemically cauterized by applying a 2 mm-diameter filter paper soaked 1 mol/L NaOH solution at the central cornea for 40 s. All animals were randomly assigned to five groups, including 1 mg/mL, 3 mg/mL and 5 mg/mL bevacizumab eye drops group respectively, 1 mg/mL dexamethasone sodium phosphate eye drops group (positive control) and normal saline solution group (negative control) . The drug was topically utilized twice per day. CNV was examined under the slim lamp on the 3rd, 7th and 14th day after alkali burn. Animals were killed on the 14th day after alkali burn. Area of CNV was calculated in terms of pixels on digital photographs. The use of animals followed the Regulations for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission. Results No significant difference was found in the grade of corneal injury among five groups (F = 0. 201, P = 0. 935). The area of neovascularization at the cornea surface was (37.11 ±3.17)% in 1 mg/mL bevacizumab group, (29.75 ±3.56)% in 3 mg/mL bevacizumab group, (18. 76 ± 2. 55) % in 5 mg/mL bevacizumab group, (20. 91 ± 2. 75) % in dexamethasone group and (41. 65 ±2. 11)% in normal saline group, showing a significant difference among groups(F = 71. 687, P =0. 000) with the further comparative decline in 5 mg/mL bevacizumab group compared with other groups (P ＜ 0. 01) . Conclusion The topical use of bevacizumab (avastin) inhibits alkali burn-induced CNV in mice.

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Research advance in application of stem cells in optic nerve regeneration

Jingxue, ZHANG ; Ningli, WANG ; Jianmin, MA

Chinese Ophthalmic Research.2009;27(11):1044-1047.

Lots of blinding diseases are caused by retinal ganglion cells apoptosis, but there is no the effective and ideal therapy in clinic currently. Recent study showed that stem cells can be an alternative renewable source of retinal ganglion cells, and they may be potential to repair the visual function. These results provide a new model of optic nerve regeneration for the treatment of these blinding diseases. But, some problems in clinical applications are waiting for further solving. Applications of stem cells in optic nerve regeneration is reviewed in this paper.

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The correlation of antiphospholipid antibody and factor Ⅻ deficiency in patients with retinal vein occlusion

Hongjing SUN ; Yumin, LI

Chinese Ophthalmic Research.2009;27(11):1019-1022.

Objective Antiphospholipid antibody and factor Ⅻ deficiency are among the coagulation disorders that have been implicated in many thrombembolic events. The aim of this study was to investigate the prevalence of antiphospholipid antibodies and factor Ⅻ deficiency in patients with retinal vein occlusion (RVO). Methods The investigation was a case control study. The periphery blood was collected from a cohort of 33 consecutive patients with RVO and 30 age- and gender-matched normal subjects. Anticardiolipin antibody (ACA) was detected by ELISA as binding index (BI) =A value/standard A value. The lupus anticoagulant antibody was examined by APTT test and the activity of factor Ⅻ was detected. This study was approved by The Human Research Ethics Committee of this hospital, and written informed consent was obtained from all the subjects before initiation of any study protocol. Results The total positive rate of APA in RVO group was 24. 24% (8/33), showing a insignificant difference in comparison with control group (6. 67%, 2/30) (P = 0. 085). The positive rate of anticardiolipin antibody in RVO group was 18.18% (6/33), presenting an obvious enhance in control group (P = 0. 025) . Three patients in RVO group disclosed positive response for IgG-anticardiolipin antibody, one patient for IgM-anticardiolipin antibody, two patients for both isotypes IgG and IgM anticardiolipin antibodies, and two patients revealed positive reaction for lupus anticoagulant antibody. The presence of lupus anticoagulant antibody among the patients with ≤ 50 years and ＞ 50 years was similar to that in age-matched controls (P =0. 160, P =0. 206). Factor Ⅻ deficiency was found in 14 of 33 patients(42. 42%) and in 4 of 30 controls(13. 33%) (P = 0. 013). The prevalence of factor Ⅻ deficiency among the patients with ≤50 years and ＞ 50 years was similar to that in age-matched controls (P = 0. 206, P = 0. 052) . Conclusion Our results indicate that the prevalence of ACA and factor Ⅻ deficiency in RVO patients appears to be correlated.

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