Volume 41 ·  Issue 04 ·  2005

Premature retinopathy (ROP), previously known as "retrolenticular fibroplasia", is a retinal vascular proliferative lesion occurring in premature infants and low birth weight infants. ROP is the first cause of blindness in children in developed countries. With the continuous improvement of medical level in China, perinatal medicine has made great development, and the gradual improvement and perfection of various life support systems has obviously improved the survival rate of premature infants, and the incidence of ROP has also increased accordingly. The number of blind children caused by this has also increased, which should attract the attention of medical units at all levels. Therefore, it is necessary to analyze and comment on the incidence of ROP in different regions, the prevention and treatment of ROP, the development characteristics of retinal vasculature in premature infants, the characteristics of retinal histological changes in children with ROP, the international classification of ROP and the treatment time limit. The incidence of ROP reflects the national treatment level of neonatal intensive care and the soundness of relevant medical regulations to some extent. (Chinese Journal of Ophthalmology, 2005, 41: 289-291)

Objectively evaluate the advantages, disadvantages and main complications of surgery and photodynamic therapy for age-related macular degeneration; Aiming at the limitation of its indication and the safety of its limited efficacy, the importance of establishing an evaluation system based on evidence-based medicine and correctly evaluating its clinical efficacy with a scientific attitude is emphasized. (Chinese Journal of Ophthalmology, 2005, 41: 292-294)

Objective to investigate the systemic high risk factors of premature retinopathy (ROP). Methods Ocular examination was performed on premature infants with gestational age ≤34 weeks or body weight ≤2000g born in Beijing Obstetrics and Gynecology Hospital from July 1, 2002 to June 30, 2003, and the related factors of ROP were analyzed. Results of 98 premature infants in Beijing Obstetrics and Gynecology Hospital, 17 cases had ROP, the incidence of ROP was 17.3%, and 4 cases (7 eyes) had threshold lesions and needed laser treatment, accounting for 4.1%. The differences in gestational age, birth weight, oxygen inhalation time (>5d), maximum oxygen partial pressure and sepsis were statistically significant between the premature infants in ROP group and the normal fundus group (all P<The results of Logistic regression analysis showed that small gestational age and low birth weight were the basic factors of ROP, and long-term oxygen inhalation was the risk factor of ROP. Conclusion Small gestational age, low birth weight and long-term oxygen inhalation were related to the occurrence of ROP.

Objective to investigate the characteristics of color Doppler flow imaging (CDFI) ultrasound in patients with age-related macular degeneration (AMD). Methods CDFI ultrasound was used to detect the characteristics of CDFI in 98 patients with AMD. The characteristics of CDFI were observed and analyzed, and the characteristics of CDFI were differentiated from choroidal melanoma, choroidal metastatic carcinoma, choroidal melanocytoma, macular edema and other diseases. Results CDFI characteristics of patients with dry AMD: Most patients had no special findings by CDFI ultrasound, and some patients showed localized bulge of spherical echo in the macular area, but the height of bulge generally did not exceed 1.5mm in CDFI images, and there were strong punctate echoes with clear boundaries in the lesions, and the blood flow signal at the basal area was abundant. Abundant blood flow signals can be detected in the basal part of the lesion, dot and band blood flow signals can be detected on the surface, and there is no abnormal blood flow signal in the lesion. The key to using CDFI in the diagnosis of dry and wet AMD patients is the morphology, boundary, internal echo of the macular lesion, the presence or absence of vitreous opacity in the vitreous, etc. According to the imaging characteristics and blood flow morphology of AMD patients, CDFI can be distinguished from choroidal melanoma, choroidal metastatic carcinoma, choroidal melanocytoma, macular edema and other diseases. Conclusion CDFI is a simple and accurate method for detecting AMD patients, and it is worthy of clinical application. (Chinese Journal of Ophthalmology, 2005, 41: 300-304)

Objective to study the pathogenic gene mutation and clinical phenotype characteristics of a 4th generation autosomal dominant retinitis pigmentosa (RP) family in China. Methods All patients in RP family were examined by ocular and visual electrophysiology; The genome scanning and linkage analysis were carried out on all family members, and the candidate genes were sequenced directly, and the mutation sites were confirmed by restriction endonuclease reaction. Results the pathogenic genes of RP family patients were located in chromosome band 19q13.4, less than 4Mb between microsatellite markers D19S589 and D19S254. A new heterozygous mutation (G>C) was found at the first base of intron 8 of PRPF31 gene in all patients, and the split donor of intron 8 changed from GT to CT.The clinical phenotype of RP family patients was in line with the early onset and diffuse RP patients.Conclusion The patients in this four generations of RP family in China were caused by a heterozygous mutation of a new split site in PRPF31 gene (IVS8+1G>C). (Chinese Journal of Ophthalmology, 2005, 41: 305-311)

Objective to investigate the transcription and expression of hypoxia-inducible factor-1 α (HIF-1 α) in human retinal pigment epithelium (RPE) cells at different phases of hypoxia. Methods the primary cultured human RPE cells were identified, and the 3rd ~6th generation RPE cells were selected for hypoxia analysis. The transcription and expression of HIF-1 α in human RPE cells were detected by semi-quantitative RT-PCR and immunofluorescence assay at different phases of hypoxia at 6, 8, 16, 24 and 48 hours respectively. Results the results of semi-quantitative RT-PCR and immunofluorescence assay showed that hypoxia could induce the transcription and expression of HIF-1 α in human RPE cells significantly. The transcription and expression of HIF-1 α reached the peak at 8 hours of hypoxia and lasted until 24 hours later; Conclusion Hypoxia can induce the transcription and expression of HIF-1 α in human RPE cells, which may be an important initiating factor for choroidal neovascularization (Chinese Journal of Ophthalmology, 2005, 41: 312-316)

Objective to study the gene expression profile of choroidal neovascularization in rats induced by Krypton laser. Methods Total RNA was extracted from the choroidal tissues of BN rats induced by Krypton laser and the choroidal tissues of normal BN rats. The purified mRNA was reverse transcribed to prepare hybridization probes. The differential expression profiles of choroidal neovascularization in BN rats induced by Krypton laser and the choroidal tissues of normal BN rats were analyzed by expression profiling microarray containing 5705 oligoDNA.Results There were 46 differentially expressed genes in the gene expression profile of choroidal neovascularization in BN rats induced by Krypton laser, including 3 upregulated genes and 43 downregulated genes, which were related to substance transport, signal transduction, metabolism, development, differentiation and cell adhesion, respectively.Conclusion The occurrence and development of choroidal neovascularization induced by Krypton laser involves multiple gene changes.

Objective to investigate the early injury response of lateral geniculate neurons after optic nerve clamp injury in rats. Methods the right optic nerve of SD male rats was clamped with a microscopic non-invasive vascular clamp at 70g pressure for 30s. At 2h, 1d, 3d, 7d and 14d after injury, c-fos and calbindinD-28k antibodies were used to detect the localization of c-fos in lateral geniculate by immunohistochemistry and fluorescence double labeling, and the expression of c-fos in lateral geniculate was detected by Western blot. Results the c-fos positive cells were observed in the medial and intermediate nuclei of the ventral nuclei of the lateral geniculate on the same side of the injured eye. The cells started to appear at 2h after injury, reached the peak at 1d, slightly decreased at 3d, significantly decreased at 7d, and there were still a small number of c-fos positive cells at 14d. No c-fos positive cells were observed in the dorsal nuclei of the lateral geniculate and the control group. calbindinD-28k positive cells mainly appeared in the medial and intermediate nuclei of the ventral nuclei of the lateral geniculate. 75% ~83% of c-fos appeared in calbindinD-28k positive cells They may play an important role in the pathological process of acute optic nerve injury. (Chinese Journal of Ophthalmology, 2005, 41: 321-324)

Objective to investigate whether the morphology, activity and glutamate metabolism function of rat Müller cells cultured in vitro under pressure were changed, so as to determine the role of Müller cells in the process of glaucoma injury. Methods the rat Müller cells cultured in vitro were randomly divided into control group and pressurized group. The pressurized group was treated under 50mmHg (1mmHg =0.133kPa) for 1h, and then the cells of the two groups were cultured for 3 days. The morphology of the cells was observed by inverted microscope and electron microscope, the activity of the two groups was measured by MTT colorimetric assay, the expression of glutamine synthase mRNA in the two groups was detected by RT-PCR, and the absorbance value was measured by image analysis system. Results Compared with the control group, the changes of Müller cells cultured in vitro after pressure treatment were not obvious under inverted microscope, and the intracellular vacuoles increased and mitochondria swelled under electron microscope. MTT colorimetry showed that cell activity was decreased, and the difference was statistically significant (P<0.05); The expression of glutamine synthetase mRNA was decreased by RT-PCR, and the difference was statistically significant (P<Conclusion After pressure treatment, Müller cells cultured in vitro showed damage changes, and the ability of cells to metabolize glutamate decreased due to the decrease of glutamine synthase mRNA expression, which is a key enzyme in the glutamate-glutamine cycle, which may be one of the reasons for the increase of glutamate concentration in vitreous of glaucoma. (Chinese Journal of Ophthalmology, 2005, 41: 325-329)

Objective to investigate the causes, clinical manifestations and related factors of corneal dissolution after excimer laser in situ keratomileusis (LASIK), and to provide evidence for clinical prevention and treatment.Methods 11 cases (12 eyes) of corneal dissolution after LASIK were analyzed clinically, and the clinical manifestations were observed and recorded; Perform systemic examination, especially immunological examination, to confirm the diagnosis; Results 10 patients had the disease in one eye, and only 1 patient had the disease in both eyes. The corneal melting site was the edge of the corneal flap, and the lower side and nasal side were more common; Eight eyes (67%) had intraoperative corneal epithelial exfoliation, corneal flap thinning or postoperative corneal epithelial edema and corneal epithelial implantation. Six patients (55%) had systemic diseases, including 1 case of thyroiditis (1 eye), 2 cases of systemic lupus erythematosus (2 eyes), 2 cases of Sjogren's syndrome (2 eyes) and 1 case of rheumatoid arthritis (1 eye); There was a history of superficial scleritis in 1 case (1 eye), skin eczema and erythema in 1 case (1 eye), and foreign body under corneal flap in 1 case (1 eye); 2 cases (3 eyes) without other diseases were treated with cyclosporine A, glucocorticoid, antibiotics and corneal protectant combined with systemic diseases. All patients were cured; The course of the disease was 23~45d, with an average of 30.3d; Different degrees of pannus or pannus remain in the corneal lesions; Corneal astigmatism was ≥1.00D in 4 eyes (1.00~5.50D), and the actual corrected visual acuity was lower than the expected corrected visual acuity in 2 lines in 5 eyes, 1 line in 2 eyes, and no decrease in 5 eyes. Conclusion Corneal dissolution is a non-infectious corneal disease related to systemic diseases, and LASIK may be the predisposing factor. Detailed systemic examination before LASIK and standardized surgical operation during operation are very important to reduce the occurrence of corneal dissolution.

Objective to investigate the changes of axial length and refractive status of children with congenital cataract extraction and intraocular lens implantation. Methods 38 cases (76 eyes) with congenital cataract who had undergone cataract extraction, anterior and posterior circular capsulorhexis, anterior segment vitrectomy and intraocular lens implantation in the lens capsule were retrospectively studied. According to the operative age, they were divided into 4 groups: 2~3 years old (group A), 4~5 years old (group B), 6~7 years old (group C) and 8~12 years old (group D). The axial length and corneal refractive power of the eyes were measured before and 5 years after operation, and the refractive status at 1 month and 5 years after operation was analyzed. The relationship between visual acuity prognosis and the changes of axial length and refractive status was analyzed. Results The changes of mean refractive power in the four groups were-2.06, -1.81, -0.56 and-0.25d, respectively, and the differences were statistically significant (P<0.01); The average increase of axial length was 1.21, 1.13, 0.47 and 0.34mm, and the difference was statistically significant (P<The best corrected visual acuity of 50 eyes (65.8%) after operation was ≥0.5. There was no correlation between the best corrected visual acuity and the changes of refractive power and axial length (P>0.05). Conclusion Cataract extraction, anterior segment vitrectomy and intraocular lens implantation in lens capsule can safely and effectively treat congenital cataract in children; After operation, the refractive state tends to shift towards myopia, and the axial length of the eye is close to that of normal children of the same age. The changes of refractive power and axial length of the eye tend to be stable with the increase of the age of operation. The choice of intraocular lens power in 2~5 years old children should be low undercorrection. (Chinese Journal of Ophthalmology, 2005, 41:335-339)

Objective to investigate the effects of laminin (Ln) and fibronectin (Fn) on the growth characteristics of human lens epithelial cells. Methods Twenty-eight human lens anterior capsules were inoculated into petri dishes coated with Ln (Ln group), Fn (Fn group) and 2% bovine serum albumin (control group) by tissue block method. The growth time and morphology of lens epithelial cells and the appearance time of fibroblasts around the tissue block were observed by inverted microscope. The expressions of connexin 43, Δ Np63 and integrin β 1 were observed by indirect immunofluorescence method. The mRNA levels of Δ Np63 and integrin β 1 were detected by reverse transcription polymerase chain reaction (RT-PCR). Results The growth time of lens epithelial cells in Ln and Fn groups was earlier [(2.4±0.2) d], and the number of cells was larger, and the growth time of Fn fibroblasts was significantly earlier [(7.6±0.4) d] than that in Ln group [(12.7±0.5) d] (P<The positive rate of connexin 43 expression in Ln group (23/28) was significantly higher than that in Fn group (14/28) and control group (12/28) (P<0.05), the positive rate of Δ NP63 (24/28) and integrin β 1 (25/28) expression in Fn group was significantly higher than that in Ln group and control group (P<The results of RT-PCR support the results of indirect immunofluorescence assay. Conclusion Ln can promote the proliferation of primary cultured human lens epithelial cells and maintain the homeostatic balance between normal cells and between cells and extracellular matrix. Fn can promote cell proliferation at the early stage of cell culture, but it can also promote the differentiation of epithelial cells and the growth of fibroblasts. (Chinese Journal of Ophthalmology, 2005, 41: 340-345)

Age-related macular degeneration (AMD) is a blinding eye disease that occurs in the elderly. For many years, many scholars at home and abroad have devoted themselves to the epidemiology, etiology and pathogenesis of AMD. However, due to the complexity of the disease itself and the lack of suitable animal models, many problems are still under debate. Therefore, it is necessary to briefly review the research situation of AMD abroad in recent years, so as to broaden the research ideas of domestic scholars on AMD (Chinese Journal of Ophthalmology, 2005, 41: 377-381)

In order to improve the ability of clinical ophthalmologists and technicians to analyze the results of microcomputer visual field detection, the editorial board of Chinese Journal of Ophthalmology is scheduled to hold a study class on modern microcomputer visual field detection results analysis in Shenzhen, Guangdong Province from December 20 to 26, 2005. Visual acuity (visual acuity) and visual field detection results are the two most important indexes to evaluate visual function, and visual field detection indexes can also measure visual function outside the macular region. Since the 1970s, the advent, development and application of computer automatic visual field meter has significantly improved the sensitivity of visual field examination, and made clinical visual field examination enter a new era. And Qualcomm resolution visual field inspection,

After three years of investigation and industry analysis, combined with the development status of China's medical industry, American Aolide Medical Investment Group and the "Chief Think Tank of Hospital Management"-Dean's Decision Research Center plan to invest 1 billion yuan in China within five years to build eight chain eye hospitals, so that more patients with ophthalmic diseases in China can enjoy international medical services. The plan has now been implemented. At present, six hospitals in Guangdong Province are located in six cities: Guangzhou, Zhanjiang, Zhongshan, Meizhou, Shaoguan and Huizhou. The investment targets outside the province are Beijing and Shanghai.

The First Affiliated People's Hospital of Shanghai Jiaotong University will hold the "National Symposium on Retinal Detachment and Diabetic Retinopathy and New Ophthalmology Technology Application and Continuing Medical Education Study Class" in the rapidly changing Shanghai in early July 2005. Nationally renowned experts will be invited to teach during the course. Main content: (1) Recent progress in vitreoretinal surgery; (2) surgical treatment of retinal detachment; (3) Pathological characteristics, grading and surgical progress of diabetic retinopathy; (4) the concept and application of integrated Chinese and Western medicine treatment in ophthalmology; (5) New progress in the treatment of uveitis, strabismus and complex cataract;

With the development of cataract extraction surgery and the improvement of people's living standards, ophthalmologists and cataract patients have put forward higher requirements for the visual quality after cataract extraction surgery. Multifocal intraocular lens (IOL) can make patients have clear vision after surgery. In order to evaluate the surgical effect, we conducted a retrospective study on the visual function of multifocal IOL implants from the perspective of optometry. The results are reported as follows.

According to the requirements of the ten-year work plan of blindness prevention and primary eye care formulated by the Ministry of Health [1], Kaiyuan City of Yunnan Province is listed as one of the advanced cities for blindness prevention. In order to accurately grasp the distribution of blindness and low vision among the population in the city and formulate prevention and treatment measures, we conducted a general survey of blindness and low vision among the population in Kaiyuan City from June 1996 to April 1997, and arranged and analyzed the general survey data of blindness and low vision among children aged 3~12 years old.

The patient was a 47-year-old female who came to our hospital on May 10, 2003 due to a fall causing a flower branch to be inserted into her right eye for 3h. The whole body examination showed no abnormalities. The eye examination showed that the visual acuity was 0.15 in the right eye and 0.4 in the left eye. The right eyelid was highly swollen, and plant foreign bodies of different sizes were inserted between the medial canthus and the eyeball, and the skin surface, with mud attached to it (Figure 1,2). The left eye showed no abnormalities. Incomplete fractures of the upper wall of the maxillary sinus and the outer lower wall of the ethmoid sinus (FIGS. 3, 4); CT sagittal reconstruction of the right eyeball showed that the eyeball was intact, without penetrating injury, and the foreign body entered the upper wall of the maxillary sinus and the outer lower wall of the ethmoid sinus from the inferior wall of the orbit from top to bottom. No intracranial abnormalities were found (Figure 5,6). Fractures of the superior wall of the maxillary sinus and the outer inferior wall of the ethmoid sinus.

In recent 10 years, with the rapid development of perinatal medicine and neonatology in China, and the general establishment of neonatal intensive care unit (NICU), the survival rate of premature infants and low birth weight infants after rescue has improved obviously. Some problems that have appeared in developed countries, such as retinopathy of prematurity (ROP) and broncho-pulmonary dysplasia (BPD), are on the rise in China. Premature retinopathy (ROP) is an eye disease that occurs in premature infants, and can lead to blindness in severe cases. Its causes are many, which are closely related to premature birth and immature retinal vascular development. Oxygen use is an important measure of rescue and a common cause of disease. The smaller the gestational age and body weight, the higher the incidence rate. With the improvement of neonatal rescue level in China, the incidence of ROP increases correspondingly when premature infants who can't survive survive.

A scientific research work consists of three stages from beginning to end: planning, implementation and summarization. Scientific research design is the basic prerequisite for the smooth progress and final completion of scientific research work, and academic papers are the concentrated embodiment of scientific research process and achievements. There is a close relationship between the two. If there are defects in scientific research design itself, they can't be compensated when the paper is written. While we subjectively emphasize advancement and even innovation, there may be such a concept in our subconscious mind that "the scientific nature of scientific research is unquestionable". However, in fact, there are often problems of scientific deficiency in our scientific research activities, which are reflected in academic papers as scientific research summarization. If we analyze it a little, we will find that most of the problems are related to the defects in scientific research design in the planning stage. Combining several related basic concepts and easily neglected problems, the author briefly expounds the constituent elements of the two and their logical relationship in form from the theoretical level, It is hoped that it will help to understand and master the basic contents and methods of medical research design and thesis writing.