青少年屈光不正眼在不同调节状态下晶状体的变化特点

目的:观察青少年远视眼与近视眼在不同调节状态下晶状体参数的动态变化,分析其差异并探讨晶状体变化的特点。方法:随机选取2019-01/10于我院门诊就诊的7~15岁青少年屈光不正患者50例86眼,分为近视组(29例46眼,平均等效球镜度-2.17±1.41D)和远视组(21例40眼,平均等效球镜度1.92±1.49D)。通过光学生物测量仪(IOL Master)测量眼轴长度(AL),通过眼前节光学相干断层扫描分析仪(SS-OCT)观察不同调节状态下(0、-3、-6D)晶状体厚度(LT)、晶状体前表面曲率半径(ALRC)、晶状体后表面曲率半径(PLRC)的动态变化。结果:调节放松状态下(0D),近视组LT显著小于远视组,ALRC与PLRC大于远视组(均P<0.01),且远视组眼轴短于近视组(22.49±1.12mm vs 24.48±0.82mm,P<0.01)。随着调节刺激的增大(-3、-6D),两组LT均显著增厚,ALRC与PLRC均显著减小(均P<0.01)。-3、-6D调节状态下,两组ALRC变化率均高于PLRC变化率(P<0.01),但两组间LT变化率及PLRC变化率均无显著差异(P>0.05),而远视组完成-6D调节时ALRC变化率显著大于近视组(P<0.05)。结论:调节刺激下青少年屈光不正眼晶状体厚度增加,形态变凸,其前表面的变化程度显著大于后表面,完成大幅度调节时,远视眼晶状体前表面的形变程度显著大于近视眼。

Anterior segment changes after pharmacologic mydriasis using Pentacam and optical coherence tomography in angle closure suspects

AIM: To compare the dynamic changes of anterior segment parameters especially iris morphology induced by pharmacologic mydriasis between angle closure suspects and normal controls. METHODS: The study group comprised 19 eyes of 19 angle closure suspects and 19 eyes of 19 age- and sexmatched normal open-angle eyes. Pentacam and optical coherence tomography measurements before and 30min after instillation of compound tropicamide eye drop were performed and compared. Biometric evaluations of iris tomography and anterior chamber angle were estimated by a customized image-processing software. RESULTS: Baseline axial length, iris cross sectional area and volume did not differ significantly between angle closure suspects and normal controls. Angle closure suspects had smaller pupil size, narrower anterior segment dimension and axial length, thinner iris with greater curve in comparison with normal controls. Pharmacologic mydriasis led to significant increments in iris thickness at 750 mu m, anterior chamber depth and volume, whereas significant decrements in iris curve, cross sectional area and volume in both groups. Angle opening distance at 500 mu M was increased significantly in normal controls (from 0.465 +/- 0.115 mm to 0.539 +/- 0.167 mm, P=0.009), but not in angle closure suspects (from 0.125 0.100 mm to 0.145 +/- 0.131 mm, P=0.326). Iris volume change per millimeter of pupil dilation (Delta IV/Delta PD) decreased significantly less in angle closure suspects than normal controls (-2.47 +/- 1.33 mm(2) vs -3.63 +/- 1.58 mm(2), P=0.019). Linear regression analysis showed that the change of angle opening distance at 500 mu M was associated most with the change of central anterior chamber depth (beta= 0.841, P=0.002) and Delta IV/Delta PD (beta=0.028, P=0.002), followed by gender (beta=0. 062, P=0.032). CONCLUSION: Smaller iris volume decrement per millimeter of pupil dilation is related significantly with the less anterior angle opening in angle closure suspects after pharmacologic mydriasis. Dynamic iris change may be as a prospective indicator of iris compressibility and angle closure glaucoma.

Analogs of microgravity: the function of Schlemm's canal, intraocular pressure and autonomic nervous during the head-down tilt test in healthy subjects

AIM:To evaluate the ocular outcomes and to elucidate possible mechanisms underlying intraocular pressure(IOP)change following the head-down tilt(HDT)test.METHODS:The study included 21 participants at the Department of Ophthalmology of Tongji Hospital.Subjects received the test of I-care tonometry,enhanced depth imaging optical coherence tomography and heart rate variability(HRV)analysis before and after 15 min HDT test.The lumen area of Schlemm’s canal(SCAR),IOP,HRV were calculated.RESULTS:IOP increased significantly after 20°head down position from 14.0±3.0 to 17.0±3.3 mm Hg(P<0.001).SCAR decreased from 13449.0±5454.9μm^(2) at sitting condition to 9576.6±4130.9μm^(2) post 15 min HDT test.High frequency(HF)indices increased significantly from 1462±865 Hz at baseline to 2128±824 Hz.Heart rate(HR)decreased significantly from 76±11.48 to 70±11.52 bpm after the HDT.The linear regression analysis showed that the difference of HF and SCAR significantly correlated with each other during the HDT(R^(2)=20%,P=0.04).CONCLUSION:These outcomes perform the first evidence of the activation of autonomic nervous system of HDT may cause the collapse of Schlemm’s canal lumen,which in turn leading to the increased IOP.

Autologous sclera-muscle flaps technique in evisceration with hydroxyapatite implantation

·AIM: To provide superior cosmetic results and reduce complications, unlike traditional evisceration coupled with implant insertion technique and its modifications,we have developed a novel and simple technique for anophthalmic patients.·METHODS: All patients who underwent the scleral-muscle flaps procedure in evisceration with the placement of hydroxyapatite implant were included in the study. Main outcome measures were complications such as exposure, infection, chemosis, conjunctival inclusion cysts, granulomas. Meanwhile, implant motility was indirectly measured and the results were collected and analyzed.· RESULTS: A total of twenty-eight patients were enrolled in the study. Eighteen were men(64.29%) and ten were women(35.71%). Ages ranged from 18 to 65y(mean age, 32 years old). Mean follow-up was 12.32mo(range, 9-16mo). All patients received a hydroxyapatite implant. The average diameter of the implant was 19.29 ±1.36 mm(range, 18-22 mm). Minor complications occurred in 3 patients, and a major complication was observed in 1 patient. Mean motility were 11.04 ±1.45 mm horizontally(range, 7-14 mm) and 8.57 ±1.50 mm vertically(range, 5-12 mm).·CONCLUSION: The sclera-muscle flaps technique in evisceration with hydroxyapatite implantation is simple and practical that eases the surgical procedure, enables a proper size hydroxyapatite implantation, distinctively reduces complications and provides superior surgery results, especially the motility of the implant.

Gene transfer to human trabecular meshwork cells in vitro and ex vivo using HIV-based lentivirus

AIM: To investigate whether the enhanced green fluorescent protein(EGFP) reporter gene could be transferred into human trabecular meshwork(HTM) cells by a HIV-based lentivirus both in vitro and ex vivo.METHODS: The HIV-based lentivirus that contains an EF1-α promoter driving EGFP expression cassette was constructed following the standard molecular cloning methods. The cultured HTM cells were transduced at a range of multiplicity of infection(MOI) with HIV-based lentivirus. EGFP positive cell populations were detected by flow cytometry. Human anterior eye segments were cultured with perfusion culture system and transfected by HIV-based lentivirus with a 1 ×108transducing unit(TU) virus in perfusion liquid. The intraocular pressure was recorded every 8h for 21 d. The expression of EGFP in the anterior segment of the human eye was detected by fluorescence microscopy. Furthermore, the distribution of EGFP expression was confirmed by anti-EGFP immunohistochemical staining.RESULTS: The HIV-based lentivirus which contains an EF1-α promoter driving EGFP expression cassette was constructed successfully. After HTM cells were transduced with HIV-based lentivirus containing EGFP in vitro, the ratio of EGFP positive cells to the total cell number reached 92.3%, with the MOI of 15. After the lentivirus containing EGFP were used to transduce human anterior eye segments, the EGFP could be directly detected by fluorescence microscopy in vivo.Immunohistochemistry staining revealed that 88.19%EGFP-positive trabecular meshwork(TM) cells were observed in the human anterior segment. Nevertheless,the intraocular pressure in the lentivirus-transduced group kept constant when compared with control group(P 】0.05).CONCLUSION: EGFP gene could be efficiently transferred into HTM cells both in vitro and ex vivo by using HIV-based lentivirus.

Changes in Schlemm’s canal,trabecular meshwork,and relevant parameters in the early stage after SMILE of myopia patients

AIM:To observe the changes in Schlemm’s canal(SC),trabecular meshwork(TM),and anterior chamber relevant parameters after small incision lenticule extraction(SMILE) of myopia patients.METHODS:A total of 58 eyes from 30 patients who underwent SMILE were divided into a low and moderate myopia group(group A,32 eyes) and a high myopia group(group B,26 eyes).The diameter and area of the SC,the width and thickness of TM obtained by CIRRUS HD-OCT5000,and the related anterior chamber parameters obtained by Pentacam anterior segment analysis system,accommodation amplitude(AMP) were observed pre-and postoperatively.The preoperative intraocular pressure(IOP) and postoperative correction of intraocular pressure(IOPcc) were measured.RESULTS:The diameter and area of the SC in the two groups were significantly increased postoperatively(all P<0.01).The TM width of the patients in the two groups were increased at 1mo after surgery(both P<0.01),but the TM thickness did not change(P>0.05).The corneal curvature,central anterior chamber depth,and anterior chamber volume decreased after SMILE surgery(all P<0.01).There was a weak negative correlation between the SC area change and AMP change in group A(r=-0.362,P<0.01).The postoperative IOP decreased after correction by Shah formula(P<0.05).CONCLUSION:SC and TM in myopia patients change in the early postoperative stage of SMILE and the IOP is decline.

Ocular biometry in the adult population in rural central China: a population-based, cross-sectional study

·AIM: To describe the distribution and determinants of ocular biometric parameters and to ascertain the relative importance of these determinants in a large population of adults in rural central China.·METHODS: A population-based, cross-sectional study performed in rural central China included 1721 participants aged 40 or more years. Ocular biometrical parameters including axial length(AL), anterior chamber depth(ACD), radius of corneal curvature(K) and horizontal corneal diameter [white-to-white(WTW)distance] were measured using non-contact partial coherence interferometry [intraocular lens(IOL)-Master].·RESULTS: Ocular biometric data on 1721 participants with a average age of 57.0 ±8.7y were analyzed at last.The general mean AL, ACD, mean corneal curvature radius(MCR), WTW were 22.80±1.12, 2.96±0.36, 7.56±0.26 and 11.75 ±0.40 mm, respectively. The mean values of each parameter in 40 to 49, 50 to 59, 60 to 69, and 70 to91 years age groups were as follows: AL, 22.77 ±0.87,22.76 ±1.06, 22.89 ±1.41, 22.92 ±0.80 mm; ACD, 3.10 ±0.32,2.98 ±0.34, 2.86 ±0.36, 2.77 ±0.35 mm; MCR, 7.58 ±0.25,7.54 ±0.26, 7.55 ±0.26, 7.49 ±0.28 mm; WTW, 11.79 ±0.38,11.75 ±0.40, 11.72 ±0.41, 11.67 ±0.41 mm. The AL, ACD,MCR and WTW were correlated with age and the AL was correlated with height and weight.·CONCLUSION: Our findings can serve as an important normative reference for multiple purposes and may help to improve the quality of rural eye care.

In vivo quantification of human aqueous veins by enhanced depth imaging optical coherence tomography and optical coherence tomography angiography images

AIM:To investigate the aqueous vein in vivo by using enhanced depth imaging optical coherence tomography(EDI-OCT)and optical coherence tomography angiography(OCTA).METHODS:In this cross-sectional comparative study,30 healthy participants were enrolled.Images of the aqueous and conjunctival veins were captured by EDI-OCT and OCTA before and after water loading.The area,height,width,location depth and blood flow of the aqueous vein and conjunctival vein were measured by Image J software.RESULTS:In the static state,the area of the aqueous vein was 8166.7±3272.7μm^(2),which was smaller than that of the conjunctival vein(13690±7457μm^(2),P<0.001).The mean blood flow density of the aqueous vein was 35.3%±12.6%,which was significantly less than that of the conjunctival vein(51.5%±10.6%,P<0.001).After water loading,the area of the aqueous vein decreased significantly from 8725.8±779.4μm^(2)(baseline)to 7005.2±566.2μm^(2)at 45min but rose to 7863.0±703.2μm^(2)at 60min(P=0.032).The blood flow density of the aqueous vein decreased significantly from 41.2%±4.5%(baseline)to 35.4%±3.2%at 30min but returned to 45.6%±3.6%at 60min(P=0.021).CONCLUSION:The structure and blood flow density of the aqueous vein can be effectively evaluated by OCT and OCTA.These may become biological indicators to evaluate aqueous vein changes and aqueous outflow resistance under different interventions in glaucoma patients.

Diurnal macular choroidal area fluctuation in normal and primary open angle glaucoma groups

AIM： To assess and compare the diurnal macular choroidal area fluctuation in normal and primary open angle glaucoma （POAG） groups using enhanced depth imaging optical coherence tomography （EDI-OCT）. METHODS： Twenty-eight normal and 27 POAG eyes were enrolled in this study. EDI-OCT was used to measure the macular choroidal area every 3h from 9：00 a.m. to 21：00 p.m. RESULTS： Significant diurnal fluctuations of macular choroidal area were observed in both normal （P=-0.003） and POAG groups （P〈0.001）. But no significant macular choroidal area difference has been found between the two groups at all the five measurement time-points （512778＋166242 vs 455079：1：207278 pm2, P=-0.195 at 9：00 a.m.; 501526168953 vs 447846.：211147 pm2, P=-0.245 at 12：00 a.m.; 501982＋173158 vs 448024#.206653 pm2, P=-0.239 at 15：00 p.m.; 508912＋174589 vs 457783＋-207081 pm2, P=-0.252 at 18：00 p.m.; 503787＋171241 vs 453230＋_205955 pm2, P=-0.274 at 21：00 p.m.; respectively）. Furthermore, neither the fluctuation manners nor the change in macular choroidal area between the two adjacent measurement time points showed significant difference between normal and POAG groups （all P〉0.05）. In the meantime, significant diurnal intraocular pressure fluctuations were also observed in normal and POAG groups （both P〈0.001）. CONCLUSION： In diurnal time, the macular choroidal area in both normal and POAG groups fluctuated significantly; moreover, neither the value of macular choroidal area, nor the fluctuation of macular choroidal area in POAG group is significantly different from that in normal group.

Progression of myopia among undergraduate students in central China

AIM:To investigate the progression of myopia and risk factors among university students in central China.METHODS:A total of 7359 first-year undergraduate students at Huazhong University of Science and Technology in central China were recruited to the study and invited to a centralized clinic for medical examination,including optometry,and re-examined after one year.Correlation analyses were performed to assess the associations between one-year myopia progression and various parameters.RESULTS:The spherical equivalent refraction for the overall population was-3.14±2.28 D at baseline.The rate of myopia progression over 0.50 D after one year was 41.9%,and the 1-year progression of myopia was-0.47±0.58 D.There was no difference of mean 1-year myopia progression between male and female or difference among age group.The myopia progression of original myopia was severer than progression of new-onset myopia.There was also difference of mean myopia progression among different degrees of myopia at baseline.The under corrected eyes had a higher percentage of myopia progression than well corrected eyes(χ^(2)=7.90,P<0.01).There was no correlation between myopia progression and height,weight,body mass index,hemoglobin(Spearman correlation,ρ=-0.078,-0.152,-0.170,-0.096,respectively,all P>0.05).CONCLUSION:Myopes still progress in undergraduate students,especially in high myopes.

Imaging characteristics of orbital peripheral nerve sheath tumors:Analysis of 34 cases

BACKGROUND Peripheral nerve sheath tumors(PNSTs),a rare group of neoplasms in the orbit,comprise only 4%of all orbital tumors.At present,there are very few studies detailing the features of these tumors identified using imaging technology.AIM To compare the differences in location,morphology,magnetic resonance imaging(MRI)signal intensity/computed tomography(CT)value,and enhancement degree of tumors of different pathological PNSTs types.METHODS Clinical,pathological,CT,and MRI data were analyzed retrospectively in 34 patients with periorbital sheath tumors diagnosed using histopathology from January 2013 to August 2021.RESULTS Among 34 cases of orbital peripheral nerve sheath tumors,21 were schwannomas,12 were neurofibromas,and 1 was a plexiform neurofibroma.Common clinical symptoms presented by patients with these types of tumors include eyelid swelling,exophthalmos,and limited eye movement.Schwannomas mostly occur in the intramuscular space with small tumor volume and rare bone involvement.Neurofibromas develop in the extrapyramidal space with larger tumor volume and more bone involvement.Radiologically,schwannomas and neurofibromas are characterized by regular morphology and uneven density and signal.One case of plexiform neurofibroma showed tortuous and diffuse growth along the nerve,with a worm-like appearance on imaging.CONCLUSION Different pathological types of orbital peripheral nerve sheath tumors have unique imaging characteristics.Comprehensive consideration of the patient's clinical and imaging manifestations is of great value in the diagnosis of orbital peripheral nerve sheath tumors.

Ferulic acid prevents liver injury and increases the anti-tumor effect of diosbulbin B in vivo

The present study is designed to investigate the protection by ferulic acid against the hepatotoxicity induced by diosbulbin B and its possible mechanism, and further observe whether ferulic acid augments diosbulbin B- induced anti-tumor activity. The results show that ferulic acid decreases diosbulbin B-increased serum alanine transaminase/aspartate transaminase （ALT/AST） levels. Ferulic acid also decreases lipid peroxide （LPO） levels which are elevated in diosbulbin B-treated mice. Histological evaluation of the liver demonstrates hydropic degeneration in diosbulbin B-treated mice, while ferulic acid reverses this injury. Moreover, the activities of copper- and zinc-containing superoxide dismutase （CuZn-SOD） and catalase （CAT） are decreased in the livers of diosbulbin B-treated mice, while ferulic acid reverses these decreases. Further results demonstrate that the mRNA expressions of CuZn-SOD and CAT in diosbulbin B-treated mouse liver are significantly decreased, while ferulic acid prevents this decrease. In addition, ferulic acid also augments diosbulbin B-induced tumor growth inhibition compared with diosbulbin B alone. Taken together, the present study shows that ferulic acid prevents diosbulbin B-induced liver injury via ameliorating diosbulbin B-induced liver oxidative stress injury and augments diosbulbin B-induced anti-tumor activity.

Development of LC–MS method for analysis of paclitaxel-inhibited growth and enhanced therapeutic response in human glioblastoma cells

Glioma stem cells are considered responsible for drug resistance and glioma relapse resulting in poor prognosis in glioblastoma multiforme. SU3 glioma cell is a highly invasive glioma stem cell line from the patients with glioblastoma multifrome. It is of great significance to study the efficacy and molecular mechanism for anticancer drug effects on SU3 glioma cells. In this work, we develop a liquid chromatography–mass spectrometry（LC–MS） method for direct analysis of the role of drugs（paclitaxel）on SU3 glioma cells at the molecular level. We use the specific fluorescence dyes to evaluate cell viability,the levels of ROS and GSH when the cells were treated with drugs. In addition, the LC–MS platform was successfully employed to detect the amount of 6-O-methylguanine, demonstrating that it is effective to induce cell apoptosis and enhance the cytotoxic response of SU3 glioma cells. The analytical linear equals are Y = 9.49 ？ 105 X ＋ 2.42 ？ 104 for 6-O-methylguanine（R2= 0.9998） and Y = 4.72 ？ 104 X ＋ 2.21 ？ 103（R2= 0.9996） for 7-methylguanine. Thus, the combination of cell-specific fluorescence dyes and LC–MS method enables us to reveal the molecular mechanism of paclitaxel-inhibited growth and enhanced therapeutic response in the chemotherapy for glioma multiforme.

Coercivity enhancement of hot-deformed Nd-Fe-B magnets with Pr-Cu alloy addition

Effects of low-melting Pr-Cu alloy addition on the microstructure and magnetic properties of the hot-deformation Nd-Fe-B magnets were investigated.A small amount of Pr-Cu addition enhances the coercivity of the hot-deformation Nd-Fe-B magnets obviously.The coercivity of the hotdeformation Nd-Fe-B magnets with 4.0 wt%Pr_(85)Cu_(15)addition increases to 1271 kA·m^(-1),75.69%higher than that of Pr-Cu-free magnet(723 kA·m^(-1)),and then decreases with5 wt%Pr_(85)Cu_(15)addition.It is observed that there a uniform RE-rich phase is formed wrapping the Nd2Fe14B main phase in the sample with 4.0%Pr_(85)Cu_(15)addition by scanning electron microscopy(SEM),which promotes the coercivity.The angular dependence of coercivity for the hot-deformation Nd-Fe-B magnets indicates that the coercivity mechanism is nucleation combined with domain wall pinning.The domain wall pinning is weakened,while the nucleation is enhanced after Pr-Cu addition.Theremanence,intrinsic coercivity,and maximum magnetic energy product of the original Nd-Fe-B magnet are 1.45 T,723 kA·m^(-1),and 419.8 kJ·m^(-3),respectively,and those of the sample with 4.0%Pr_(85)Cu_(15)alloy addition are 1.30 T,1271 kA·m^(-1),and 330.0 kJ·m^(-3),respectively.