Comparison of autofluorescence and optical coherence tomography findings in acute and chronic central serous chorioretinopathy

AIM:To discuss and compare the fundus autofluorescence(FAF)and optical coherence tomography(OCT)in acute or chronic central serous chorioretinopathy(CSCR).METHODS:Medical records of 100 cases of CSCR were reviewed.Acute and chronic cases were evaluated according to the duration of decreased visual acuity,serous retinal detachment(RD)and focal leakage on fluorescein angiography(FA).Chi-square test was used for statistical analysis.RESULTS:Forty cases had acute and 60 cases had chronic CSCR.FAF showed focal hypo-autofluorescence in 34(85%)and iso-autofluorescence in 6(15%)of acute cases and hypo-autofluorescence in 51(85%),hyperautofluorescence in 6(10%)and iso-autofluorescence in3(5%)of chronic cases.OCT showed serous RD with distinct borders correlated with FAF findings(hypoautofluorescence)in all acute CSCR cases.In chronic CSCR group,OCT showed serous RD with indistinct borders correlated with FAF findings.The differences between the OCT and FAF findings of the two groups were significant(P=0.000).CONCLUSION:OCT and FAF findings can support the clinical observations in differential diagnosis of acute and chronic CSCR and help clinicians to evaluate retinal pigment epithelium,outer segments of photoreceptors and the components of serous RD.

Comparison of total/active ghrelin levels in primary open angle glaucoma,pseudoexfoliation glaucoma and pseudoexfoliation syndrome

AIM：To investigate the levels of ghrelin（Gh）,acylated ghrelin（AGh） and AGh/Gh ratio in the humor aqueous（HA） of cases with pseudoexfoliation syndrome（PXS）,pseudoexfoliation glaucoma（PXG）,primary open angle glaucoma（POAG） and to compare these with control subjects.METHODS：A prospective examination was made of the total Gh,and AGh levels in HA of 67 patients undergoing cataract surgery.Patients were divided into 4 groups.HA samples were aspirated at the beginning of the surgery,stored at -70℃.Gh and AGh quantification was performed with ELISA kits and the AGh/total-Gh ratios were calculated.ANOVA,Kruskal-Wallis,Chi-square and post-hoc tests were used for statistical analysis.RESULTS：Total Gh levels in HA were 189.2±45.6 pg/mL in the control group,199.2±32.9 pg/mL in PXS,180.6±20.9 pg/mL in PXG and 176.8±21.4 pg/mL in POAG groups（P〉0.05）.AGh levels in HA were 23.09±5.01 pg/mL in the control group,24.13±5.22 pg/mL in PXS,22.29±1.55 pg/m L in PXG and 19.69±2.93 pg/mL in POAG groups（P〉0.05）.The ratio of AGh/Gh was 10.3%±2.34% in the control group,13.03%±2.58% in PXS,12.3%±1.54% in PXG and 11.79%±1.41% in POAG groups（P=0.044）.The difference between the PXS and control groups was significant（P=0.03）.CONCLUSION：In spite of statistically insignificant results,the HA total Gh levels were lower than those of the control subjects but not parallel with the AGh levels in glaucoma patients.The relative increase in the AGh/Gh ratio in glaucoma cases supports the view that proportional increases of AGh might play a role in the pathogenesis of glaucoma.

Conjunctival impression cytology in non-proliferative and proliferative diabetic retinopathy

AIMTo examine the integrity of the ocular surfaces of subjects with and without diabetes with no conjunctival and dry eye signs and symptoms and compare conjunctival impression cytology findings in diabetics with non-proliferative and proliferative diabetic retinopathy.

Oxidant/antioxidant balance in the aqueous humor of patients with glaucoma

AIM： To evaluate total antioxidant status （TAS）, total oxidant status （TOS）, and the oxidative stress index （OSI） of the aqueous humor （AH） in patients with glaucoma. METHODS： The prospective study was composed of a study group （n-31） and a control group （n=31）. Fifteen patients in the study group were diagnosed with primary open angle glaucoma （POAG）, and 16 patients were diagnosed with pseudoexfoliation glaucoma （PEG）. The control group was composed of non-glaucomatous patients with cataracts. AH samples were collected and analyzed for TAS, TOS, and OSI levels. RESULTS： Mean AH TAS level was significantly higher in patients with glaucoma than that in the control group （P〈0.01）. Mean TOS and OSI levels tended to increase in patients with glaucoma. No significant differences in TAS, TOS, or OSI levels were observed between patients with POAG and PEG. CONCLUSION： High levels of TAS were observed in patients with glaucoma, which was likely a response to the increased oxidative stress observed in these patients.

Fundus autofluorescence imaging of patients with idiopathic macular hole

AIM:To investigate the role of fundus autofluo rescence(FAF) both in the diagnosis and the preoperative and postoperative evaluation of patients with idiopathic macular hole(MH).METHODS:Forty eyes of 40 patients diagnosed as idiopathic MH between May 2010 and May 2011 were included in this retrospective study.All patients underwent full ophthalmologic examinations and imagings including fluorescein angiography,fundus autofluorescence(FAF) and optical coherence tomography.Thirty of these patients underwent MH surgery.FAF findings were associated with duration of symptoms,visual acuity at presentation,stage of MH,and postoperative anatomical correction.RESULTS:The mean duration of patients’ symptoms was 3.8±2.0(1-9) months.The MH was stage 2 in 4(10%),stage 3 in 24(60%) and stage 4 in 12(30%) eyes.The median preoperative best corrected visual acuity was 20/200(between 20/800 and 20/100).Twenty-eight of cases(70%) showed a stellate appearance with dark radiating striae.Having a visual acuity ≥20/200 was significantly more common in eyes with stellate appearance(P【0.001).The mean duration of symptoms was significantly shorter in eyes with stellate appearance(2.75±0.8 vs 6.33±1.61 months)(P【0.001).The frequency of stage 4 MH was significantly higher in eyes with nonstellate appearance(P【0.001).Anatomical correction of MH was achieved in 91.3%(21/23) of eyes with stellate appearance and 71.4%(5/7) of eyes without this appearance(P=0.225).CONCLUSION:Stellate appearance in FAF is associated with earlier stages of macular hole,better visual acuity at presentation,shorter duration of symptoms,thus more favorable prognosis.

白内障手术技巧对术源性散光的影响(英文)

目的:评估行普通白内障超声乳化术,手术经验对术源性散光(SIA)的影响。方法:选取患者50例53眼,平均年龄64.5±10.8a,随机分为两组,一组23眼,二组30眼。手术方式均采用透明角膜切口白内障超声乳化吸除联合人工晶状体植入术。第一组由白内障专家手术,第二组则由住院医师手术。术前所有患者均接受全面眼科检查,包括角膜曲率和自动屈光检测。SIA应用向量分析程序-Alpins法计算,于术后1d,1mo及2mo重复上述检查并记录结果变化。应用Shapiro Wilk和Mann-Whitney检验判断两组间SIA的统计学差异。结果:两组患者人口资料差异无统计学意义。组间分析显示,一组术后1d,1mo及2mo的SIA分别为0.79±0.41D,0.54±0.41 D及0.47±0.37 D;二组分别为1.27±0.66 D,0.98±0.56 D及0.94±0.54 D。可见一组术后1d(P=0.002),1mo(P=0.004)及2mo(P=0.001)的SIA更小。结论:手术经验是影响SIA的因素之一。住院医师应增加超声乳化术手术量以获取更多手术经验。

Corneal properties in children with congenital isolated growth hormone deficiency

AIM:To compare the corneal parameters of children with congenital isolated growth hormone deficiency and healthy subjects.METHODS:In this cross-sectional,prospective study,50 cases with growth hormone(GH)deficiency treated with recombinant GH and 71 healthy children underwent a complete ophthalmic examination.The corneal hysteresis(CH),corneal resistance factor(CRF),Goldmann-correlated intraocular pressure(IOPg)and corneal-compensated intraocular pressure(IOPcc)were measured with the Ocular Response Analyzer(ORA).Central corneal thickness(CCT)was measured by a ultrasonic pachymeter.RESULTS:The mean age was 13.0±3.0 years in the GH deficiency group consisting of 21 females and 29 males and 13.4±2.4 years in the healthy children group consisting of 41 females and 30 males.There was no statistically significant difference between the groups for gender or age(Chi-square test,P=0.09;independent ttest,P=0.28,respectively).The mean duration of recombinant GH therapy was 3.8±2.4y in the study group.The mean CH,CRF,IOPg and IOPcc values were 11.0±2.0,10.9±1.9,15.1±3.3,and 15.1±3.2 mm Hg respectively in the study group.The same values were 10.7±1.7,10.5±1.7,15.2±3.3,and 15.3±3.4 mm Hg respectively in the control group.The mean CCT values were 555.7±40.6,545.1±32.5μm in the study and control groups respectively.There was no statistically significant difference between the two groups for CH,CRF,IOPg,IOPcc measurements or CCT values(independent t-test,P=0.315,0.286,0.145,0.747,0.13 respectively).CONCLUSION:Our study suggests that GH deficiency does not have an effect on the corneal parameters and CCT values.This observation could be because of the duration between the beginning of disease and the diagnosis and beginning of GH therapy.

原发性开角型青光眼和高眼压患者及正常人群结膜印迹细胞学检查的比较（英文）

目的：比较原发性开角型青光眼和高眼压患者及拥有健康眼球表面的正常人群的泪膜功能和印象细胞学检查的数值。 方法：此前瞻性研究中纳入了原发性开角型青光眼患者11例11眼（平均年龄：62.7±6.1岁）,高眼压患者12例12眼（平均年龄：62.8±6.4岁）及健康人12例12眼（平均年龄：62.9±6.03岁）。这些患者均是最近被诊断出患有原发性开角型青光眼及高眼压,且之前未接受过抗青光眼方面的治疗。均行结膜印迹细胞学检查、泪膜破裂时间和基础泪液分泌试验。每组印迹细胞学检查的样本根据Nelson分级法分为0-3级。应用Kruskal-Wallis检验和Dunn多重比较检验进行统计分析。 结果：原发性开角型青光眼患者,高眼压患者及正常人群平均基础泪液分泌值分别为10.4±1.3,10.9±1.2和11.1±1.1 mm/5min,其差距没有统计学意义（P=0.33）；三组的泪膜破裂时间分别为11.2±1.1,11.3±1.1和11.8±1.2s,其差距没有统计学意义（P=0.35）。原发性开角型青光眼患者中6眼（54.5%）为0级,5眼（45.5%）为1级。高眼压患者中6眼（50%）为0级,6眼（50%）为1级,健康人中6眼（50%）为0级,6只眼（50%）为1级（P=0.97）。 结论：氧化应激可能会导致青光眼,眼表疾病,泪腺功能障碍及机体杯状细胞所分泌的黏液减少。原发性开角型青光眼患者,高眼压症患者及健康人群间的印象细胞学检查数值并无显著差异。

Electron Microscopic Investigation of Anterior Lens Capsule and Epithelium in Patients with Diabetes Mellitus

Purpose: To evaluate the histopathologic alterations of organelles in the epithelium of the anterior lens capsule. Methods: The interventional study included 26 eyes;of which 11 had non-proliferative diabetic retinopathy (diabetic group) and cataract, and 15 had age-related cataract (control group). We investigated the anterior lens capsule in patients with diabetes mellitus by using electron microscopy and to compare it between diabetic eyes and healthy eyes. Anterior capsule samples were obtained by circular continuous capsulorhexis during phacoemulsification procedures. All the samples were fixed and conventionally processed for electron microscopy analysis. Results: Demographic characteristics of the diabetic group and the control group were similar (p > 0.05). In the diabetic group, electron dense cells with an apoptotic appearance were seen and these cells had an apoptotic nucleus and prominent mitochondrial crystalysis. In addition, there was dilatation of the endoplasmic reticulum cistern. In the control group, lens epithelial cells and all their elements had a normal pattern. Neither cells with an apoptotic appearance nor mitochondrial crystalysis was seen, but there was dilatation of the endoplasmic reticulum cistern. Conclusions: Diabetes mellitus can engender structural abnormalities of organelles in the epithelium of the anterior lens capsule including mitochondrial crystalysis, dilatation of the endoplasmic reticulum cistern and apoptotic dense nucleus. It can be suggested that diabetes mellitus affects organelles of anterior lens epithelium in eyes with cataracts, while it causes non-proliferative changes in the retina.