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Focusing on the methodology shift in epidemiological study of eye diseases

Chinese Journal of Experimental Ophthalmology.2017;35(12):1057-1059. doi:10.3760/cma.j.issn.2095-0160.2017.12.001

As chronic diseases gradually become the primary threat to the health of Chinese population and the rapid increase in the need of high eye health quality,the population-based epidemiological study of eye disease in China should be conducted in the following mode:large-scale,multicenter,and prospective cohort studies in different gender,age,ethnicity and living habits population,with new analytical models similar to generalized linear and nonlinear mixed effects to better analyze the interaction between environmental causes and individual internal factors.The systematic epidemiology and spatial epidemiology concepts are suggested to be included in eye research,in order to deconstruct the cause of eye disease diversification.All these facilitate precision prediction,diagnosis and treatment of individual patient.

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Research progress of long noncoding RNAs in ocular proliferative diseases

Xiaobo HUANG

Chinese Journal of Experimental Ophthalmology.2017;35(12):1135-1138. doi:10.3760/cma.j.issn.2095-0160.2017.12.017

Ocular proliferative diseases,such as proliferative vitreous retinopathy (PVR),diabetic retinopathy (DR),choroidal neovascularization,corneal neovascularization and so on,often do harm to the structure and function of the eyes,and responses to treatments of late stage of these diseases are poor.Long noncoding RNAs (lncRNAs) with a length greater than 200 nucleotides can not directly encode a protein but can regulate the expression of protein coding genes through various pathways,and are widely involved in the regulation of body growth,as well as in cell apoptosis,proliferation and differentiation.More and more evidence suggests that lncRNAs are involved in the occurrence and development of a variety of ocular diseases.In the present paper,the concept,classification and mechanism of lncRNAs,and recent advances in the role of lncRNAs in PVR,DR,choroidal neovascularization and corneal neovascularization were reviewed.

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Advanced research on effective monomers of ophthalmological Chinese traditional medicine

Yingjun ZHANG

Chinese Journal of Experimental Ophthalmology.2017;35(12):1147-1152. doi:10.3760/cma.j.issn.2095-0160.2017.12.020

Traditional Chinese medicine is the treasure of China and the people of the world.With the standardization and internationalization of traditional Chinese medicine,the effective components or monomers of Chinese herbal medicines should be clarified and investigated.Although researches on effective components of Chinese herbal medicines have been increasing year by year,there is a lack of systematic induction.In this review,we summarized the traditional Chinese medicines which have therapeutic effects on the eye diseases recorded in Chinese Pharmacopoeia (2015 edition).According to the information from published books and literature reports,the relevant bioactive constituents of these Chinese medicines and the possible mechanisms of their pharmacological actions are summarized and categorized here in 5 aspects:antipathogenic microbial action,anti-inflammation and immunomodulation,anti-oxidation,neuroprotection,and vascular protection.We hope that this review will provide some theoretical basis and reference for the researchers who are dedicated to the treatment of ophthalmic diseases and the research and development of traditional Chinese medicines.

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Research progress on visual defects of amblyopia

Xubo YANG

Chinese Journal of Experimental Ophthalmology.2017;35(12):1139-1142. doi:10.3760/cma.j.issn.2095-0160.2017.12.018

Amhlyopia is a developmental disorder of visual system caused by abnormal visual experiences in critical period,whose characteristic is low monocular or binocular best corrected visual acuity and without ocular organic lesions.With the development of the research,more and more studies showed that amblyopia can not only lead to a reduction in corrected visual acuity,but also accompany by many other visual defects,such as visual crowd effect,impaired spatial contrast sensitivity,decreased vernier acuity,contour integration deficit,orientation discrimination deficit,temporal processing deficit and global processing deficit,which has become a common concern of a social problem.A comprehensive understanding of visual defects in amblyopia is of great significance on the diagnosis and treatment of amblyopia.This paper summarized the research progress of various visual defects of amblyopia,so as to provide references for the clinical diagnosis and treatment of amblyopia.

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Application of RNA interference in posterior capsule opacification by interfering signaling pathway

Yahui XI

Chinese Journal of Experimental Ophthalmology.2017;35(12):1126-1129. doi:10.3760/cma.j.issn.2095-0160.2017.12.014

Posterior capsule opacification (PCO) is a common complication after cataract phacoemulsification with intraocular lens (IOL) implantation.The mechanism of lens epithelial cells (LECs) fibrosis,PCO and capsular wrinkle is mainly related with residual LECs migration,proliferation and epithelialmesenchymal transition (EMT) after cataract surgery.Transforming growth factor β2 (TGF-β2) has been proposed as the most important factor driving the EMT and pathologic fibrosis of LECs,TGF-β2 induces LECs EMT by the Smad signaling pathway.Besides,PI3K/AKT/mTOR signaling pathway was studied to participate in TGF-β2 induced EMT.As one of the gene regulation methods,RNA interference (RNAi) technology shows an important application prospect in inhibiting LECs fibrosis and proliferation by interfering signaling pathway.This review highlights RNAi effects on LECs biological behavior by interfering PI3K/AKT/mTOR and TGF-β2/Smad signaling pathways.

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Detection and analysis on serum antibodies for five common pathogenic microbes in patients with Posner-Schlossmarm syndrome

Wenchieh CHEN ; Jun ZHAO ; Tianhui ZHU ; Shiming PENG ; Xiaosheng HUANG ; Shaoyi MEI ; Yan WANG

Chinese Journal of Experimental Ophthalmology.2017;35(12):1115-1119. doi:10.3760/cma.j.issn.2095-0160.2017.12.012

Background Posner-Schlossman syndrome (PSS) is often recurrent and is a cause of blindness.The etiology of PSS remains to be elucidated.It is reported that there is a certain association between pathogenic microorganisms and PSS in rather small samples.Objective This study was to analyze the related serum antibody levels of cytornegalovirus (CMV),herpes simplex virus (HSV),rubella virus (RV),helicobacter pylori (HP) and anti-streptolysin O (ASO) and provide a clue for the study on pathogenesis and therapy of PSS.Methods A prospective cases-controlled study was carried out in Shenzhen Eye Hospital from December,2014 to December,2016 under the approval of Ethic Committee of this hospital and informed consent of each subject prior to initial of any medical examination.Peripheral blood samples were collected from 82 PSS patients as the PSS group and 100 age-and gender-matched healthy blood donors as the normal control group.The positive rates of serum CMV IgG,CMV IgM,HSV IgG,HSV IgM,RV IgG,RV IgM,HP IgG and HP IgM in the subjects were detected by indirect ELISA,and the positive rate of serum ASO antibody was determined by immuno-scatter turbidmetry.Results The positive rates of serum CMV-IgG,CMV-IgM,HP-IgG,HP-IgM and ASO antibody were 22.0％,17.1％,22.0％,17.1％ and 17.1％ in the PSS group,which were significantly higher than 5.0％,0.0％,10.0％,2.0％ and 7.0％ in the normal control group (x2 =11.726,18.496,4.943,12.766,4.479,all at P＜0.05).The positive rates of serum HSV-IgG,HSV-IgM,RV-IgG and RV-IgM in the PSS group were not significantly different from those in the normal control group (x2 =3.305,0.986,0.898,0.503,all at P ＞ 0.05).Conclusions CMV,HP and hemolytic streptococcal infection may participate in the occurrence and development of PSS.

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Effect of tear film stability on visual quality after femtosecond laser-assisted LASIK

Jing WANG ; Linnong WANG ; Xueqian CAO ; Lijing CHANG

Chinese Journal of Experimental Ophthalmology.2017;35(12):1109-1114. doi:10.3760/cma.j.issn.2095-0160.2017.12.011

Background The instability of tear film in dry eye often affects the visual quality after femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK).The prediction for visual quality following FS-LASIK was difficult in the past because of the limiting of examination method.OQAS-Ⅱ is a quantitative checking system of visual quality,which is helpful for the evaluation of the relationship between tear stability and visual quality following FS-LASIK.Objective This study was to investigate the predicting effects of the quality of tear film on visual quality after LASIK.Methods A prospective cohort study was performed.One hundred and twenty eyes of 120 myopic patients who wanted to receive FS-LASIK were enrolled in Nanjing First Hospital from August to December 2015 after informed consent.The objective scattering index (OSI) was 1.2 in the patients.The patients were divided into mild dry eye group (71 eyes) and non-dry eye group (49 eyes) based on the Expert Consensus on Clinical Diagnosis and Treatment of Dry Eye(2013).FS-LASIK was performed in the non-dry eye group,and 0.1％ sodium hyaluronate eye drops was topically administered for 1 month firstly and then the operation was carried out in the same way in the mild dry eye group.Slit lamp microscope,uncorrected visual acuity (UCVA),best corrected visual acuity (BCVA),spherical equivalent (SE) were examined,and the safety index and availability index were assessed.OQASTM Ⅱ analysis system was employed for the defection of Schirmer Ⅰ test (S Ⅰ t),breakup time of tear film (BUT),modulation transfer function cut-off frequency (MTF cut off) and mean OSI before and after surgery.Results The safety index was 1.05 ±0.11 and 1.03 ±0.09,and the availability index was 1.02±0.14 and 1.01 ± 0.12 in the non-dry eye group and mild dry eye group,respectively,showing significant differences between the two groups (t =0.391,0.147,both at P＞0.05).The BUT was evidently shortened 1 month and 3 months after surgery in comparison with before surgery in both non-dry eye group and mild dry eye group,and BUT in the mild dry eye group was shorter than that in the non-dry eye group in postoperative 3 months,with a significant differences between them (P＜0.05).The mean OSI was increased and MTF cutoff was reduced 1 month,3 months and 6 months after surgery in comparison with before surgery in both mild dry eye group and none-dry eye group,and mean OSI was higher and MTF cutoff was lower in the mild dry eye group than that in the non-dry eye group,with significant differences between them (all at P＜0.05).In postoperative 12 months,BUT,mean OSI and MTF cutoff were near normal in both groups.Conclusions FS-LASIK can improve objective visual quality,and preoperative tear film quality is associated with objective visual quality after FS-LASIK.The unstable tear film affects visual quality after FS-LASIK.OQASTM Ⅱ system can diagnose and monitor tear change of dry eyes,which is helpful for the screening of indicator of FS-LASIK and rational prediction of postoperative visual quality.

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Corneal epithelial remodeling and its related factors after transepithelial photorefractive keratectomy in treatment of myopia

Jie HOU ; Yan WANG ; Yulin LEI ; Xiuyun ZHENG ; Ying ZHANG

Chinese Journal of Experimental Ophthalmology.2017;35(12):1104-1108. doi:10.3760/cma.j.issn.2095-0160.2017.12.010

Background Corneal epithelial remodeling will happen after laser refractive surgery,But there have been few studies to evaluate the changes of the corneal epithelial thickness after integrated transepithelial photorefractive keratectomy (TranspRK).Objective This study was to evaluate the changes in epithelial thickness profile within the optical zone and its related factors following TransPRK for myopia.Methods In this retrospective non-randomized controlled study,forty-three patients (43 eyes) who underwent TransPRK with the spherical equivalent refraction-1.25 to-6.25 D from August 2014 to May 2015 in Jinan Mingshui Eye Hospital were included under the informed consent.Epithelial thickness was measured using spectral-domain optical coherence tomography in different corneal zones (central,2 mm;paracentral,2-5 mm,and mid-peripheral,5-6 mm) preoperatively at 1 week and 1,3,and 6 months postoperatively.Correlations between epithelial thickness changes and the amount of correction,optical zone,and Q-value changes (△Q) were analyzed 6 months postoperatively.Results The mean epithelial thickness in the central zone were (53.97±4.33),(51.03 ±4.11),(55.14±5.46) and (56.68 ± 5.09) μm at 1 week,1 month,3 months and 6 months after surgery,respectively.The epithelium were thicker at 3 months and 6 months after surgery compared to preoperative measurements ([52.37±3.42] μm),with significant differences between them (both at P＜0.05).Compared to preoperative values,the epithelial thickness at 6 months after surgery was (3.69 ±4.23),(5.19 ±3.88) and (6.23 ±3.91) μm thicker in the center,paracenter,and midperiphery zone,respectively,with significant differences between them (all at P ＜ 0.01).Epithelial thickness was positively correlated with programmed spherial equivalent correction and △Q (all at P＜0.05).A significant positive relationship was observed between epithelial thickening and ablation depth paracentrally and mid-peripherally (r=0.380,0.383;both at P＜0.05).Significantly negative relationships were observed between epithelial thickening and optical zone at the center,paracenter,and mid-periphery,respectively (r =0.405,0.485,0.384;all at P＜0.05).No correlation betwcen epithelial thickness change and ablation depth at the central zone was detected (P＞0.05).Conclusions The epithelial thickness shows a lenticular change with more thickening mid-Peripherally after TransPRK,which results in increased oblateness postoperatively.Epithelial remodeling may modify the profile after surface ablation.

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Inhibitory effects of bevacizumab on corneal neovascularization and scarring in mice with herpes simplex keratitis

Hongwei ZHOU ; Tongsong WANG ; Songmei ZHANG ; Lixin XIE

Chinese Journal of Experimental Ophthalmology.2017;35(12):1085-1091. doi:10.3760/cma.j.issn.2095-0160.2017.12.007

Background Corneal neovascularization and inflammation occur in herpes simplex keratitis (HSK).Aciclovir (ACV) is an antiviral medication which is primarily used for the treatment of HSV infection.Bevacizumab is an angiogenesis inhibitor which has the ability to slow the growth of corneal neovascularization.However,whether bevacizumab play treating effects on HSK is worth studing.Objective This study attempted to study the effects of bevacizumab on cornea lesion in mouse models of HSK.Methods The solution containing herpes simplex virus type-1 (HSV-1) of Mckrae strain was induced by cultured and infectious Vero cells and prepared by ten-times step dilution with free-serum DMEM,and plaque assay was used to detect the viral titers.HSV-1 of 1 ×l07 plaque-forming unit (PFU) in 0.6 μl was injected into the corneal stroma of 6 to 8-week-old SPF male C57BL/6 mice using a microliter syringe to establish latent HSK mouse models.The models were examined under the slit lamp microscope at day 5,7,11,14 and 17 after modeling as well as day 0,2,4 and 6 after recurrence,and the central cornea touch sensitivity was recorded.The models were divided into ACV-injected group,ACV+bevacizumabinjected group and normal saline-injected group,and 5 μl normal saline with 50 μg ACV,50 μg ACV + 5 μl bevacizumab or 10 μl normal saline was subconjunctivally iujected according to grouping in 4 eyes of each group,respectively.Twelve model eyes were exposed to ultraviolet (UV)-B to induce the recurrent HSK.Corneal wholemounts were prepared at day 9 after modeling for the assessment of corneal neovascularization and nerve fiber distribution by immunofluorescence assay of CD31 and β Ⅲ Tubulin antibodies.The areas of corneal neovascularization and scarring were mcasured with Image J software.The change rate of lesion was calculated and described as a ratio of lesion size at day 8 with day 0 after induction recurrence.Results The modeling success rate was over 80％,and all infected mice showed latent period at day 45 after modeling.Corneal opacification was the most serious at day 7 after modeling and day 2 after recurrence,and the largest corneal neovascular area was seen at day 15 after modeling and at day 2 after recurrence,and the central cornea touch sensitivity was the worst at day 9 after initial infection.The mean corneal lesion area was 3.348 mm2 in the ACV+bevacizumab-injected group,which was smaller than 3.930 mm2 in the ACV-injected group (Z=-2.309,P =0.021).The central corneal sensitivity in the ACV+bevacizumab-injected group was significantly higher than that in the normal saline-injected group (5.50± 0.71 versus 0.50± 1.41,Z =-2.397,P =0.029).The increase rate of corneal lesion area in the ACV +bevacizumabinjected group was evidently lower than that in the normal saline-injected group ([167.10 ± 52.53]％ versus [312.30± 74.18] ％,Z =-1.992,P =0.046).At the 7th day after modeling,the relative expressing levels of thymidine kinase (TK) and infected-cell protein-27 (ICP-27) mRNA in the corneal tissue and trigeminal ganglion were significantly increased at day 7 and reduced at day 45 after modeling,and the factors raised again at day 2 and retreated at day 7 after induction of recurrence.In addition,the expression of LAT mRNA peaked at day 45 after modeling and reduced gradually at day 2 after recurrence until a new increasing peak at day 7 after recurrence (all at P＜0.01).Immunofluorescence showed that compared with the normal saliue-injected group,the corneal new vessels were lessened and corneal never fibers were increased in the ACV-injected group and ACV +bevacizumab-injected group.Conclusions The combination of bevacizumab with ACV can inhibit corneal neovascularization and scarring in HSK mice,and bevacizumab exhibits a synergistic effect with ACV in management of HSK.

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Lowing-intraocular pressure and improving aqueous humor dynamic effects of qingguangan drug granules in spontaneous glaucoma mice

Da LONG ; Yasha ZHOU ; Ping LI ; Jiaqi LIU ; Jun PENG ; Hanyu TAN ; Qinghua PENG

Chinese Journal of Experimental Ophthalmology.2017;35(12):1079-1084. doi:10.3760/cma.j.issn.2095-0160.2017.12.006

Background Researches showed that the increase of intraocular pressure (IOP) in glaucomatous eye is associated with the increasing resistance to aqueous humor outflow effects of transforming growth factor-β (TGF-β) and CD44.Qingguangan is a traditional Chinese medicine and used to treat glaucoma.However,its mechanism of lowing-IOP effect is not elucidated.Objective This study was to investigate the lowing-IOP effect and mechanism of qingguangan granule in DBA/2J mouse,a spontaneous glaucoma model mice.Methods Ten 3 month-old female DBA/2J mice with normal IOP were chosen as control group,and 20 spontaneous ocular hypertension mice aged 9 months were randomized into high IOP group and qingguangan-treated group,with 10 mice for each group.The qingguangan (2.5 g/kg) was administered by gavaging twice per day for consecutive 15 days in the qingguangan-treated group,and normal saline solution was used in the same way in the control group and high IOP group.IOP was measured by anterior chamber injection/suction system at a perfusion rate of 2.5 and 5.0 μl/min,respectively,and the coefficient of aqueous outflow facility (C value) and outflow resistance (R value) were calculated.Another 60 3-month-old DBA/2J mice were randomized into blank control group gavaged with normal saline solution and high-,middle-and low-dose qingguangan groups gavaged with 25.00,12.50 and 6.25 g/kg drugs,respectively,and the mouse serum containing drugs was extracted 7 days after treatment.The scleral tissue with trabecular meshwork were obtained for the culture of trabecular meshwork cells and the cells were identified by immunohistochemistry of fibronectin (FN),laminin (LN) and neuronspecific enolase (NSE).TGF-β was added into the medium for 24 hours with the final concentration of 0,5,10,20,50 and 100 ng/ml,and MMT chromatometry was employed to detect the cell vitality.The cells pre-treated with 20 ng/ml TGF-β were treated with different concentration of drug serum for 24,48 and 72 hours,and the level of TGF-β2 receptor in cell supernatant and the expression of CD44 protein in the cells were detected by ELISA and Western blot assay,respectively.Results The IOPs with perfusion both 2.5 μl/min and 5.0μl/min in the qingguangan-treated group and the control group were significantly lower than those in the high IOP group (all at P＜0.01).Compared with the high IOP group,the C value was significantly reduced (2.35±1.34 vs.1.08±0.36) and the R value was evidently elevated (0.64±0.55 vs.1.05± 0.47) in the qingguangan-treated group (all at P＜0.01).Cultured cells were spindle-shaped with the positive response to FN,LN and NSE antibody.The cell vitality was lower in the 5,10 and 20 ng/ml TGF-β group than that in the 0 ng/ml TGF-β group (all at P＜0.05).Compared with the blank control group,the TGF-β2 receptor content in the supernatant and the related expression level of CD44 protein in the cells were elevated in the TGF-β-treated group (all at P＜0.01),and TGF-β2 receptor contents and CD44 expression levels in the TGF-β+high dose drug serum group was significantly lower than those in the TGF-β group and TGF-β +low dose drug serum group 24,48 and 72 hours after culture (all at P＜0.01).Conclusions Qingguangan can lower IOP of spontaneous glaucoma mice by affecting aqueous humor dynamics.Serum containing qingguangan down-regulates the expressions of TGF-β2 receptors and CD44 in trabecular meshwork cells in vitro.

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