Background Open-globe injury of zone Ⅱ is a severe eyeball wound in the sclera area near 5mm from the corneal limbus.To accurately evaluate the local tissue structure after the wounding is very important for lessening the complications of eye injury.Ultrasound biomicroscope (UBM) has been proven useful in examining eyeball wall and vitreous at the wound in order to offer the useful information about whether secondary operation is needed for the injured eyes and when is the optimal timing for surgery.Objective The present study is to explore the clinical application of UBM in open-globe injury of zone Ⅱ. Methods This is an observational study of clinical cases.UBM examination was performed on 38 eyes of 38 cases received emergency repair surgery of open-scleral injury.The restore status of sclera,ciliary body and vitreous of injuried zone (zone Ⅱ) were evaluated under the UBM in 3-5 days after the operation.The comprehensive results of UBM,B-scan and ophthalmoscope examinations were analyzed to determine the further treatment.The oral informed consent was obtained from each subject before this trial.Results Vitreous surgery were performed on 15 cases,and all wounds were found by UBM and were proven in the surgery.The other 23 cases were followed up in out-patient department and no obvious complications were found.Conclusion UBM is a valuable and atraumatic examination for open-globe injury of zone Ⅱ.It offers important and appraisal information about ocular injury.

Background Heideberg retina tomography Ⅱ(HRTⅡ) can offer the quantitative description of optic disc topography and optic nerve fiber layer thickness.The normal optic disc parameter by HRT Ⅱ from Chinese has been reported,but the comparisons between males and females or the left and right eyes are lack.ObjectiveThe goal of this study is to measure the optic disc topography of healthy people with HRT-Ⅱ.Methods Four hundreds eyes from 108 healthy male subjects and 92 healthy female subjects aged 10-72 years were measured with HRT Ⅱ in this study.The parameters of optic disc including disc area,cup area,rim area,cup/disc area ratio,rim/disc area ratio,cup volume,rim volume,cup depth,maximal cup depth,height variation,mean RNFL thickness,and RNFL cross-sectional area were analyzed and compared between the gender or left and right eyes.Oral informed consent was obtained from all of the subjects before this procedure.Results There were no significant differences in measuring parameters by HRTⅡ between female and male subjects (P＞0.05) or between right eye and left eye (P＞0.05).Conclusion The results can be used as a normal reference of optic disc parameters of HRT Ⅱ.

Background Thyroid-associated ophthalmopathy (TAO) is characterized by increased amount of orbital fat tissue.Leptin is a specific adipocytokine,and it may play an important role in the pathogenesis of TAO.Objective The present study investigates the effect of rh-leptin on the differentiation of orbital preadipocytes in subjects suffering from thyroid-associated ophthalmopathy (TAO).Methods The orbital fatty tissue was obtained from 7 patients with TAO during orbital decompression surgery.Orbital preadipocytes were cultured using the explant method and differentiated cells were identified with oil red staining.The subcultured preadipocytes were incubated with different concentrations of rh-leptin,and no rh-leptin was added in the control group.The average optical density of cytoplasm/nucleolus in differentiated adipocytes was measured by oil-red staining to evaluate the influence of different concentrations of rh-leptin on lipid formation of orbital adipocytes.Results Cultured preadipocytes in vitro were identified to be of mesenchymal origin by immunohistochemical staining.The average optical density of cytoplasm/nucleolus was 1.07±0.22,0.80±0.17,0.56±0.11,0.25±0.10,and 0.17±0.08,respectively in the control group,10μg/L of leptin group,50μg/L of leptin group,100μg/L of leptin group and 500μg/L of leptin group,showing a significant difference among the five groups (F=20.64,P=0.00).Compared to the control group,the lipid formation of orbital adipocytes gradually declined in various concentrations of rh-leptin (P＜0.05,P＜0.01).Conclusion Rh-leptin may suppress the differentiation and lipid formation of TAO orbital preadipocytes in vitro in a dose-dependent manner.Leptin may be a feedback modulator in TAO pathogenesis.

Background Recently,the study on the cause of optic nerve damage induced by glaucoma is of concern in ophthalmology.Some research showed that the immune system is associated with glaucoma-induced optic neuropathy.Acute ischemia-reperfusion is an ideal model of studying optic neuropathy.ObjectiveThe present study investigates the effect of T and B lymphocyte deficiency on the retinal neurocytes of mice with acute intraocular hypertension.Methods Sixteen SPF CB-17/Icr.Cg-Prkdc~(scid)Lyst~(bg)/CrlVR mice 6-8 week-old (severe combined immunodeficiency mouse,SCID) were used in this study and 16 age-matched SPF wild type (C57BL/6) mice served as controls.The ischemia-reperfusion injury models were induced in the right eyes of 10 SCID mice and 10 C57BL/6 mice through intra-anterior chamber infusion of balanced saline solution for 45minutes to increase the intraocular pressure to 104mmHg,and the left eyes served as model controls.The other 6 SCID mice and 6 C57BL/6 mice served as normal control group.10g/L (2μL) of FlouroGold was injected into the brains of the mice for the labeling of surviving retinal ganglion cells 21 days after ischemia-reperfusion.The thickness of retinal inner nuclear layer was measured by H&E staining under the fluorescent microscope 21 days after ischemic insult.The use of the animals followed the Standard of Association for Research in Vision and Ophthalmology.Results In normal control mice,the morphology of retinal ganglion cells (RGCs) and retinal structure were similar between SCID mice and C57BL/6 mice.The differences in the numbers of RGCs and retinal thickness were insignificant between the two types of mice(P＞0.05).In the experimental mice,the surviving RGCs were strikingly increased in SCID mice (91%±5%) compared with C57BL/6 mice(78%±5%)(P=0.003).The thickness of the retinal inner nuclear layer was obviously thinner in the model eyes (22.44±1.70μm) compared to model control eyes (31.06±3.75μm) in C57BL/6 mice(P=0.004),but no statistically significant difference was found between the model eyes and model control eyes in SCID mice (33.52±2.13μm vs 34.06±3.00μm) 21 days after ischemia-reperfusion injury(P＞0.05).Conclusion T and B lymphocytes deficient mice show a better tolerance to acute intraocular hypertension than the wild type C57BL/6 mice.

Background It is well known that tissue factor (TF) is expressed in tumor cells and neovascular endothelial cells of tumor.It plays an important role in the formation of new blood vessels as well as the growth and metastasis of tumor.However,whether TF is expressed or not in choroidal melanoma(CM)is unclear.Objective This study is to investigate the expression of TF in a choroidal melanoma cell line and human choroidal melanoma.Methods The expression of TF was studied in the optimal choroidal melanoma-1 (OCM-1) cell line and ten specimens from CM patients using immunhistochemistry.Ten normal eye specimens from donators were used as controls.Results The TF protein was mainly expressed in the cytoplasm.It is over-expressed in OCM-1 cells with positive rate of 85.33±5.47%.Hyper-expression of TF also was found in human choroidal melanoma with a positive rate of 41.60±14.17%.The integrated optical density (IOD) of positive cells in CM was 33853.67±16445.30,and only 5.65±4.26% of positive cells was found in normal human choroidal tissue.The IOD of TF expression in normal human choroidal tissue was 426.43±316.62.Conclusion The overexpression of TF in CM cells may be a new immunotherapy target for CM treatment.

Background Various studies demonstrated that the apoptosis of lens epithelial cells(LECs) is associated with the overexpression of the c-myc gene in LECs induced by galactose.Inhibiting the abnormal expression of the c-myc gene in LECs is an effective approach to mitigate the pathogenesis and development of cataract.Objective The goal of this study is to investigate the inhibitory effects of c-myc antisense oligodeoxynucleotide(c-myc ASODN) on the apoptosis of LECs in the eye with galactose-induced cataract.Methods Galactose-induced cataract models were established by the retrobulbar injection of 0.2 mL of 20% galactose once per day.Lipo-antisense oligodeoxynucleotide(Lipo-ASODN,0.2 mL) was retrobulbarly injected 4 hours after the injection of galactose at one-day intervals.The animals were sacrificed and lenses were obtained to evaluate the apoptosis of LECs and the effect of c-myc ASODN on LECs apoptosis induced by galactose was examined by TUNEL assay after 7,14 and 24 days.The ultrastructural changes of LECs were examined under the transmission electron microscopy(TEM).Results A significant difference in the apoptotic rate of LECs was found among the 7 day,14 day and 24 day groups(F_(7 days)=3 418.495,P＜0.01;F_(14 days)=1137.555,P＜0.01;F_(24 days)=2198.871,P＜0.01).The apoptotic rate of LECs in the galactose group was markedly higher than that in the normal saline solution group 7 days,14 days and 24 days after the experiment(P＜0.01).The apoptotic rate of LECs in the galactose+lipo+ ASODN group significantly declined in comparison to the galactose group after 7 days,14 days and 24 days(P＜0.05).TUNEL assay showed the condensation,breakage and irregularity of the nuclei of apoptotic cells in the galactose group.The destruction of the ultrastructure of the cells and organelles were observed under the transmission electron microscope.Conclusion Galactose induces apoptosis of LECs in cataractogenesis.C-myc ASODN inhibits apoptosis of LECs induced by galactose.

BackgroundExcessive conjunctival scar formation is a main cause of filtering surgical failure in glaucoma.It has been reported that the failure rate of filtering surgery is a tough problem in the research of glaucoma.Research showed that tetrandrine (Tet) suppress the proliferation of cultured human fibroblasts of Tenons capsule (TCFs) in vitro,but its possible mechanism is still unclear up to now.ObjectiveThe aim of this study is to investigate the inducement effects of Tet on the apoptosis of fibroblasts of Tenons capsule and mechanism.MethodsThe Tenon's capsule was obtained from donor eyes of Zhongshan Eye Center Eye Bank for further use.Human Tenon's capsule fibroblasts were cultured by explant culture method in mixed medium in vitro and the third to seventh generations of cells were collected for the experiment.The subcultured cells were identified by morphology observation and Vimentin staining.The apoptosis of cultured fibroblasts in Tet-treated group and control group was studied by using TUNEL (TdT- mediated dUTP nick end labling,TUNEL),flow cytometry (FCM) and transmission electron microscope.The cell number in different cellular cycle was calculated in Ted-treated group and control group.Results The cultured cells reached confluence in two weeks after cultured and presented the spindle or triangle shape with the radial-like or vortexin-like arrangement .The cells showed the positive staining for Vimentin.Apoptosis changes of cultured cell and apoptosis bodies were seen under the transmission electron microscope.Apoptotic cell nuclei were observed in Tet group by TUNEL.FCM result showed that the cells at G_0/G_1 phase decreased by 22.2%,and the cells at S and G_2/M phases increased by 20.53% and 1.6% in Ted-treated group.Significant differences in the numbers of cells in different cellular cycles and cell numbers of apoptosis were found between Tet-treated group and control group(P=0.000).ConclusionTet can inhibit the proliferation of human TCFs by inducing apoptosis in vitro.

Fungal keratitis is the first common infectious corneal disease and has become the main cause of blindness in China.Along with the intensive explore for the pathogenic mechanisms,the significant progress has been achieved in the pharmacotherapeutics.For lowering its blindnessrate,it is imperative to the study on increasing therapeutic option and enhancing therapeutic efficacy.This review summarizes the current advance in clinical use in ophthalmology of novel antifungal agents,including new azoles such as voriconazole and posaconazole,and echinocandins such as caspofungin and micafungin.This article also reviews the progress of administration routes for the management of recalcitrant fungal keratitis,including subconjunctival,interstromal,intracameral and intravitreal injection.

Background Influence of weightlessness on visual function has been a hot topic in aerospace medicine field.Electroretinography (ERG) is valuable tool of evaluating visual function.Objective This study aims to observe the influence of head down tilt simulated weightlessness on ERG.MethodHead down tilt for 6° was adopted in 6 healthy volunteers.Flash ERG,including rod response,maxium response,cone response,oscillatory potentials (OPs) and 30 Hz flicker was recorded,and the latency and amplitude from each wave were analyzed before,two days and five days after trial.The record procedure followed the ISCEV standard for full field clinical electroretinography (2008 update).Oral informed consent was obtained from all the subjects prior to the trail.Results No significant differences were detected in the latencies and amplitudes of a,b waves of cone response and 30 Hz flicker among various time points(P＞0.05).The latencies were significantly prolonged in b wave of rod and a,b waves of maxim responses(P＜0.01),but no obvious change was found in amplitudes (P＞0.05).Both the latency and amplitude of all of the wavelets of OPs were considerably among the different time points(P＜0.05-0.01),and the ∑OPs was evidently different among the different time points(P＜0.05).Conclusion Head down tilt simulated weightlessness induce the abnormality of visual function in the early stage.

Background Toric intraocular lens (Toric IOL) is a well accepted method of correct of corneal astigmatism.Axial misalignment,including the error of intraocular lens alignment during surgery and rotation of Toric IOL,is the main barrier to the precise alignment of Toric intraocular lenses.Therefore,the angle of axial misalignment is a main index to evaluate the effectiveness of Toric IOL implantation.Objective The present study is to describe a method of precisely detecting Toric IOL misalignment using postoperative digital photograph.Methods A measuring template (polar coordinates) was constructed using Adobe Photoshop software.Minimum graduate to detect the Toric axis was 1° (maximum error 0.5°).The clinical data of 24 eyes undergone Toric IOL implantation was retrospectively analyzed.Corneal astigmatism was detected by rotating Scheimpflug camera (Pentacam) or slit scan (Orbscan).Digital retro illumination picture was photographed after mydriasis.The picture was analyzed by our derived template.The steepest corneal axis and the axis of Toric IOL were then determined.The misalignment of Toric IOL was determined as the angle between the steepest corneal axis and the axis of Toric IOL.Misalignment of Toric IOL and its distribution were analyzed by statistical means.Results A method using polar coordinates and digital photo to precisely detect Toric IOL misalignment was derived.Mean Toric IOL misalignment was 10.93±6.90 degrees (0-24 degrees) in the 24 cases.The axial misalignment in all of cases were within 25 degrees,including clockwise in 14 eyes(58.33%),anticlockwise in 10 eyes (41.67%).In this study,the misalignment angle of 4 eyes were within 5 degrees;11 eyes were 5 to 10 degrees;1 eye was 10 to 15 degrees;6 eyes were 15 to 20 degrees;2 eyes were 20 to 25 degrees.Conclusion The method is feasible to the direction of Toric IOL misalignment in clinic.