Volume 46 · Issue 11 · 2010

Objective To discuss the relationship between corneal lymphangiogenesis and inflammation index (IF) in alkali burned corneas. Methods Experimental research. Rat corneal hemangiogenesis and lymphangiogenesis were examined by 5'-nase-alkaline phosphatase (5'-NA-ALP) double enzyme-histochemistry and whole mount immunofluorescence at 1 day, 3 days, and 1, 2, 3, 4, 5,6, 7, 8 weeks after alkaline burns, and the blood vessel counting (BVC) and the lymphatic vessel counting (LVC) were recorded. The state of corneal inflammation was observed under the slit lamp and evaluated by inflammation index (IF) grading at the same time. Then, the association of LVC with IF was examined. In addition, eleven human alkali burned corneas were obtained from 11 patients undergoing corneal transplantation in Zhongshan Ophthalmic Center from January 2005 to June 2008. Corneal lymphangiogenesis was examined by lymphatic vessel endothelial receptor ( LYVE-1 ) immunohistochemistry. The significance of the differences in IF, inflammatory cells counting, burn history, and age between two groups was analyzed by using paired student's t-test. Results New lymphatic vessels were present in rat alkali burned corneas.Corneal lymphangiogenesis developed 3 days after alkaline burns, reached the top 2 weeks after the injury,then decreased gradually, and disappeared at the end of the 5th week. Corneal lymphatics occurred behind corneal inflammation, but disappeared before corneal inflammation and hemangiogenesis. LVC was strongly and positively correlated with IF ( r = 0. 572, P ＜ 0. 01 ) after corneal alkaline burns. Among eleven human alkali burned corneas, corneal lymphatic vessels were present in 3 corneas. Compared with the other 8 cases without corneal lymphangiogenesis, the scores of IF was significantly higher ( t = 3. 28, P ＜ 0. 05 ), the inflammatory cells counting dramatically increased ( t = 2. 42, P ＜ 0. 05 ), but the age decreased significantly ( t =2.62 ,P ＜0. 05 ). However, the difference in burn history between two groups was not significant( t =1.28 ,P ＞ 0. 05 ). Conclusion Corneal lymphagiogenesis develops after alkaline-burns and correlates closely with inflammation index.

Objective To study the correlation of visual acuity and photoreceptor in eyes with persistent cystoid macular edema associated with branch retinal vein occlusion (BRVO). Methods It was a retrospective case series study. Medical records of 41 patients ( 41 eyes ) with persistent cystoid macular edema secondary to BRVO diagnosed in Department of Ophthalmology, Peking Union Medical College Hospital from January 2008 to January 2010 were studied retrospectively. On the images obtained by spectral-domain OCT, the thickness of foveal neurosensory retina and photoreceptor layer that was beneath the foveal cystoid spaces, and the transverse length and height of foveal cystoid spaces were measured. The status of the junction between inner and outer segments of the photoreceptors (IS-OS) in the fovea was also assessed. The correlations between the parameters above and visual acuity were analyzed. Results The average foveal neurosensory thickness was ( 484.71 ± 131.86) μm, the photoreceptor layer thickness was (92.04 : 45. 53 ) μm and the size of foveal cavity was 772.59 μm ×362.17 μm. By the Spearman's rank correlation analysis, among the parameters above, only photoreceptor layer thickness showed correlation with logMAR visual acuity (r = -0. 373, P = 0. 016 ), while other parameters showed no correlation with logMAR visual acuity. Cases were classified as three groups according to the status of IS-OS layer:continuous group(8 cases), discontinuous group( 19 cases) and interrupted group( 14 cases). LogMAR visual acuity in these eyes with an interrupted IS-OS line in the fovea was significantly worse than that in eyes with a continuous or discontinuous IS-OS line ( P = 0. 030 and 0. 003, respectively). There was no statistical difference between continuous and discontinuous group ( P = 0. 750 ). Conclusions In patients with persistent cystoid macular edema associated with BRVO, the thickness of the foveal photoreceptor layer are positively associated with visual acuity, and the eyes without IS-OS layer have worse visual acuity than eyes with IS-OS layer.

Objective To evaluate the relationship between retinal nerve fiber layer thickness (RNFLT) measured by optical coherence tomography (OCT) and age, spherical equivalent (SE), axial length, and gender in myopic juveniles. Methods Cross-sectional observational study. One hundred and fifty-four juveniles (age range, 7-18 years) underwent ophthalmic examinations. Peripapillary Fast RNFL scans were performed by Stratus OCT with a nominal diameter of 3.46 mm centered on the optic disc on one randomly selected eye of each subject. Axial length was measured by A-ultrasound. The effects of several factors (age, SE, axial length, gender and eye) on RNFLT were investigated in univariate and multivariate stepwise regression analyses. Results The mean global RNFLT (-x ± s) was ( 114. 106 ± 11. 473) μm. The RNFLT was thickest superiorly (145.468 ±19.064) μm and inferiorly (138.091 ±20.464) μm, thinner temporally (94. 396 ± 18. 544) μm, and thinnest nasally (78. 558 ± 16. 981 ) μm. Both global and superior peripapillary RNFLT had no significant relationship with age(r =0. 129,0. 014;P ＞0. 05), SE(r =0. 006,0. 123 ;P ＞0. 05), axial length(r = -0. 067, -0. 141 ;P ＞0. 05), gender(r = -0. 095,0. 025 ;P ＞0. 05)and laterality( r = - 0. 148,0. 095; P ＞ 0. 05 ). In multivariate stepwise regression analyses, there was significant inverse linear correlation between temporal RNFLT and SE ( r = - 0. 465, P ＜ 0. 05 ). There was significant inverse linear correlation between nasal RNFLT and axial length and laterality( r = -0. 327, P ＜0. 05). There was significant inverse linear correlation between inferior RNFLT and axial length (r =-0. 276,P ＜0. 05), and direct linear correlation between inferior RNFLT and age (r =0. 276,P ＜0. 05).Conclusions When we assess the RNFLT in myopic juveniles, we should consider the influence of age,refraction, axial length, spherical equivalent and laterality comprehensively. (Chin J Ophthalmol, 2010,46:1011-1015)

Objective To investigate the preventive effect of vagus nerve block in cervical part on Oculocardiac Reflex (OCR). Methods Case control study. 40 patients undergoing prosthesis of right orbital wall bone fracture were randomly divided into two groups: experiment group (group Ⅰ ) and control group ( group Ⅱ ). Both of the group adopted vagus nerve block in cervical part before anesthesia. Group Ⅰaccepted 1% lidocaine and group Ⅱ received 0. 9% Sodium Chloride. The same anesthesia method was applied on both groups. We recorded the index change of mean arterial pressure ( MAP), heart rate (HR)and pulse oxygen saturation (SpO2 ) before (T0) and after vagus nerve block in cervical part 3 min (T1),5 min (T2), 10 min (T3) and 120 min (T4 ); the changes of MAP and HR when we oppressed the eyeball or drag muscular apparatus; the times of using atropine; adverse reactions and the alteration of Acetylcholine (ACh). Numerical data was carried on statistical analysis processing using the SPSS 13.0. Data among groups were compared by t test and numeration data were compared by chi-square criterion. P-value ＜ 0. 05was considered to be statistically significant. Results In group Ⅰ , we found that heart rate significantly increased after block 3 min to 120 min compared with before block (F=15.46, P = 0. 000); The incidence of OCR was lower, and the incidence of adverse effects in PACU such as nausea and vomiting had statistically significant( x2 = 8.28, P = 0. 004); Content of ACh in group Ⅰ changed significantly, it was lower after block than before block (t = 2. 935, P = 0. 003 ). Conclusion Vagus nerve block in cervical part significantly decreased the incidence of OCR and brought into preventive effect.

Despite recent improvements in IOL design, posterior capsule opacification (PCO)remains a significant clinical problem after cataract surgery. The Perfect Capsule device ( Milvella, Ltd. ,Epping, Australia) permits the introduction and subsequent removal of potentially toxic agents into the closed capsular bag. The present purpose was to detect the effectiveness of arsenic trioxide ( As2O3 ) to cultured human lens cells and cells within the human capsular bag. Methods All experiments were carried out with 2 minutes exposure to As2O3. Effect of As2O3 on FHL124 cells growth was tested by MTT. Changes in cell calcium levels induced by high concentration of As2O3 were measured by real-time fluorometric single-cell digital imaging techniques after Fura-2 incorporation. In vitro human capsular bags were also tested after a sham surgery was performed using the Perfect Capsule device to form a closed system. As2O3 (10、30、100、300、1000 μmol/L ) were used with donor match-pairs treated with medium alone. (n =3 in all cases). Ongoing observations were by phase-contrast microscopy. Cellular architecture was examined by fluorescence cytochemistry. Results As2O3 of 100 μmol/L and above inhibited the growth of FHL 124 cells in a dosedependent manner with 2 minutes exposure( t = 5. 217, P ＜ 0. 01, IC5o is 130 μmol/L)As2O3 depleted the

Eye is a chronic disease with tear and corneal conjunctival epithelial damage caused by various reasons, accompanied by ocular discomfort and abnormal visual function [1]. Because the complaints of dry eye are similar to those of allergic and inflammatory conjunctival diseases, it is easy to cause clinical misdiagnosis of dry eye. Besides insufficient understanding of dry eye, the accuracy of diagnostic criteria and variability of diagnostic methods of dry eye are the main reasons for misdiagnosis [2]. Therefore, it is particularly important to find a repeatable and convenient diagnostic method of dry eye.

Congenital erythropoietic porphyria is a disease belonging to porphyria. It is a disease caused by the abnormal metabolism of congenital porphyrin, which leads to the increase of the production and abnormal excretion of porphyrin and porphyrin precursors, and accumulates in skin and other tissues, resulting in a series of clinical manifestations such as photosensitive rash. This disease can also lead to eye lesions.

A 25-year-old male patient was injured in his left eye and whole body by mixed lye (ammonia plus sodium hydroxide solution). He was directly rinsed with tap water for less than half a minute without any treatment. Two days later, when he went to the First Affiliated Hospital of the People's Liberation Army General Hospital, the visual acuity of his left eye was manual/60 cm. The conjunctiva of his left eye was congested and edema, and the conjunctiva near the limbus was pale from 7:00 to 10:30 at the clock position. The cornea was white and turbid, the epithelium was completely lost, the anterior chamber was unclear, the iris was vaguely visible, and the pupil was indistinguishable.

Choroidal hemangioma combined with tumors of different nature in the same eye is very rare. In this paper, in a sample of choroidal hemangioma, secondary glaucoma and ocular blindness, the eyeball was removed. Besides the isolated choroidal hemangioma in the posterior pole of the eyeball, a small melanocytoma was found at the root of the iris and the anterior part of the ciliary body.

A 58-year-old male was admitted to the Department of Ophthalmology of Xijing Hospital of the Fourth Military Medical University on June 13, 2009 due to red eyes, pain and blurred vision. Ocular examination showed that the visual acuity was 0.6 in the right eye and 0.8 in the left eye. The conjunctiva of both eyes was congested, the temporal bulbar conjunctiva was congested with purple-red color, the cornea was transparent, the retrocorneal deposition (-), the chamber angle was flashing (-), the pupil was round, 3 mm in diameter, sensitive to light, the lens was not opaque, and the fundus was normal. There was no joint redness, swelling, pain and skin ulceration in the whole body. Ocular A/B ultrasound showed thickening of choroid and local sclera in both eyes, mainly in the anterior part, and hypoechoic areas were visible around it.