经微创球结膜切口巩膜外加压术联合激光治疗单纯性孔源性视网膜脱离

目的:比较经传统球结膜切口和微创球结膜切口行巩膜外加压术对单纯性孔源性视网膜脱离手术效果及术后舒适度的影响。方法:随机对照临床试验。选择2016-08/2018-11在我院眼科接受手术治疗的单纯性孔源性视网膜脱离患者80例80眼,随机分成两组,均接受巩膜外加压术联合术后光凝封闭裂孔,对照组40例40眼采用传统球结膜切口,试验组40例40眼采取微创球结膜切口。记录手术用时,术后1d经裂隙灯检查视网膜复位情况,并采用视觉模拟评分法(VAS)评价疼痛情况,术后1、7、14、30d以问卷形式评价术后舒适度。结果:两组患者均顺利完成手术,试验组患者手术用时明显短于对照组(55.13±2.77min vs 56.63±3.69min,P=0.043)。术后1d,两组患者裂孔均位于术嵴中央或前坡上,裂孔周围视网膜复位良好,但试验组患者疼痛感明显小于对照组,且术后1、7d试验组患者舒适度明显高于对照组。结论:采用微创球结膜切口可以缩短手术时间,明显减少患者术后疼痛及不适感。

Effects of transforming growth factor β2 and connective tissue growth factor on induction of epithelial mesenchymal transition and extracellular matrix synthesis in human lens epithelial cells

AIM:To Investigate the effects of transforming growth factorβ2(TGF-β2)and connective tissue growth factor(CTGF)on transdifferentiation of human lens epithelial cells(HLECs)cultured in vitro and synthesis of extracellular matrix(ECM).METHODS:HLECs were treated with TGF-β2(0,0.5,1.0,5,10μg/L)and CTGF(0,15,30,60,100μg/L)for different times(0,24,48,72h)in vitro and the expression ofα-smooth muscle actin(α-SMA),the main component of the extracellular matrix typeⅠcollagen(Col-1)and fibronectin(Fn)were measured by using real-time polymerase chain reaction(PCR)and western-blot.RESULTS:TGF-β2 and CTGF significantly increased expression ofα-SMA mRNA and protein(P【0.05,P【0.001),Fn mRNA and protein(P【0.001),Col-1 mRNA and protein(P【0.001).TGF-β2 could induce HLECs expression of CTGF mRNA and protein in dosedependent manner(P【0.05,P【0.001).TGF-β2 and CTGF could induce HLECs to expressα-SMA,Fn and Col-1 in time-dependent manner.Each time of TGF-β2and CTGF induced HELCs expression ofα-SMA,Fn,Col-1 mRNA and protein was significant increase compared with control(P【0.05,P【0.001).CONCLUSION:TGF-β2 and CTGF could induce HLECs epithelial mesenchymal transition and ECM synthesis.

Effect of dihydrotestosterone on the expression of mucin 1 and the activity of Wnt signaling in mouse corneal epithelial cells

AIM： To explore the effects of the androgen dihydrotestosterone on the expression of mucin 1（MUC1） and the activity of Wnt signaling in mouse corneal epithelial cells.METHODS： Primary mouse corneal epithelial cells were isolated from the corneas of BALB/c mice. Quantitative real-time polymerase chain reaction, immunofluorescence and Western blot analysis were used to quantify the differential expression of selected genes. The androgen receptor was silenced by transfecting cells with androgen receptor sh RNAs. TOP-Flash and FOP-flash reporter plasmids were used to measure β-catenin-driven transcription. RESULTS： Dihydrotestosterone treatment increased MUC1 expression and activated the Wnt signaling pathway and led to the translocation of β-catenin and upregulation of the Wnt downstream target gene TATA box binding protein and urokinase plasminogen activator.These effects were prevented by downregulating the androgen receptor.CONCLUSION： Androgens may protect against dry eye by regulating the expression of MUC1 which is stimulated by the activation of Wnt signaling via the androgen receptor. An understanding of the mechanisms associated with androgen-mediated protection against dry eye is an important step in developing new therapies for this disease.

Optical coherence tomography characteristics of responses to intravitreal bevacizumab in idiopathic choroidal neovascularization

AIM： To investigate factors associated with responses to intravitreal bevacizumab （IVB） in naive idiopathic choroidal neovascularization （iCNV） by high domain optical coherence tomography （OCT）. METHODS： We retrospectively reviewed clinical data of 40 eyes of iCNV patients who received a single or multiple IVB on an as-needed basis （1.25 mg/0.05 mL）. One month after the first injection, subretinal fluid （SRF） volume was evaluated and the eyes were divided into 3 groups based on responses to IVB. Good, moderate, and poor responses were defined as 61%-99%, 30%-60%, and 〈30% resolution of SRF on OCT after IVB in iCNV, respectively. OCT findings were analyzed to find factors associated with difference in response levels. Comparisons were made using Wilcoxon＇s matched- pairs signed-rank test, the Mann-Whitney U test for means with continuous data and Fisher＇s exact test for categorical data. RESULTS： The mean number of IVB was 1.28±1.50 and mean follow up time was 3.60±1.20mo. At postoperative 1too, there were 8 （20%） eyes in good response, 20 （50%） in moderate response and 12 （30%） eyes in poor response group and at last visit there were 28 good responders （70%）, 8 （20%） moderate responders and 4 （10%） poor responders. Statistically significant difference was detected between good responders and non good responders in choroidal neovessels thickness （P=0.029）, SRF height （P=0.049） and SRF volume （P=0.031） at post treatment 1 mo. CONCLUSION： OCT is a valuable diagnostic tool. Decrease in choroidal neovessels thickness, SRF height and volume predicts favorable response of iCNV to IVB therapy.

Clinical research of EX-PRESS drainage device and modified trabeculectomy combined with intravitreal conbercept treatment for neovascular glaucoma

AIM:To evaluate the efficacy and safety of modified trabeculectomy(experimental group) and implantation of EX-PRESS drainage device(control group),combined with intravitreal conbercept injection for neovascular glaucoma(NVG).METHODS:Totally 30 patients with NVG were selected from June 2014 to June 2017,and randomly divided into experimental group and control group.All patients were underwent intravitreal conbercept(0.5 mg/0.05 mL) treatment before surgery.Modified trabeculectomy was performed in MT group,while EX-PRESS drainage device implantation was performed in EX group.The success rates,best corrected visual acuity(BCVA),intraocular pressure(IOP),filtering bleb and complications were observed and compared.RESULTS:The differences of success rate,BCVA and filtering bleb were not statistically significant 12mo after the surgery(P>0.05),however,the difference of IOP at 1d,1wk,1,3,and 6mo after surgery was statistically significant(F_(time)=390.64,P_(time)<0.0001) between two groups.The interactions between two groups in the given time showed no significant difference(F_(intergroup×time)=0.181,P_(intergroup×time)=0.57),and also there was no significant difference in IOP between the two groups(F=3.16,P=0.09).The results of pairwise comparison at each time point showed no significant difference in IOP between 1d and 1wk,3 and 6,3mo and 12mo after surgery(P>0.05),while the results at other time point indicate statistical differences(P<0.05).CONCLUSION:The modified trabeculectomy and the implantation of EX-PRESS drainage device have clinical application value in reducing IOP and postoperative complications of refractory NVG.

Effects of Low-dose Triamcinolone Acetonide on Rat Retinal Progenitor Cells under Hypoxia Condition

Background： Retinal degenerative diseases are the leading causes of blindness in developed world. Retinal progenitor cells （RPCs） play a key role in retina restoration. Triamcinolone acetonide （TA） is widely used for the treatment of retinal degenerative diseases. In this study, we investigated the role of TA on RPCs in hypoxia condition. Methods： RPCs were primary cultured and identified by immunofluorescence staining. Cells were cultured under normoxia, hypoxia 6 h, and hypoxia 6 h with TA treatment conditions, For the TA treatment groups, after being cultured under hypoxia condition for 6 h, RPCs were treated with different concentrations of TA for 48-72 h. Cell viability was measured by cell counting kit-8 （CCK-8） assay. Cell cycle was detected by flow cytometry. Western blotting was employed to examine the expression ofcyclin D 1, Akt, p-Akt, nuclear factor （N F）-KB p65, and caspase-3. Results： CCK-8 assays indicated that the viability of RPCs treated with 0.01 mg/ml TA in hypoxia group was improved after 48 h, comparing with control group （P 〈 0.05）. After 72 h, the cell viability was enhanced in both 0.0l mg/ml and 0.02 mg/ml TA groups compared with control group （all P 〈 0.05）. Flow cytometry revealed that there were more cells in S-phase in hypoxia 6 h group than in normoxia control group （P 〈 0.05）. RPCs in S and G2/M phases decreased in groups given TA, comparing with other groups （all P 〈 0.05）. There was no significant difference in the total Akt protein expression among different groups, whereas upregulation of p-Akt and NF-KB p65 protein expression and downregulation of caspase-3 and cyclin DI protein expression were observed in 0.01 mg/ml TA group, comparing with hypoxia 6 h group and control group （all P 〈 0.05）. Conclusion： Low-dose TA has anti-apoptosis effect on RPCs while it has no stimulatory effect on cell proliferation.