Repeatability,interocular correlation and agreement of optic nerve head vessel density in healthy eyes:a sweptsource optical coherence tomographic angiography study

AIM:To assess the repeatability,interocular correlation,and agreement of quantitative swept-source optical coherence tomography angiography(OCTA)optic nerve head(ONH)parameters in healthy subjects.METHODS:Thir ty-three healthy subjects were enrolled.The ONH of both eyes were imaged four times by a swept-source-OCTA using a 3 mm×3 mm scanning protocol.Images of the radial peripapillary capillary were analyzed by a customized Matlab program,and the vessel density,fractal dimension,and vessel diameter index were measured.The repeatability of the four scans was determined by the intraclass correlation coefficient(ICC).The most well-centered optic disc from the four repeated scans was then selected for the interocular correlation and agreement analysis using the Pearson correlation coefficient,ICC and Bland-Altman plots.RESULTS:All swept-source-OCTA ONH parameters exhibited certain repeatability,with ICC>0.760 and coefficient of variation(CoV)≤7.301%.The obvious interocular correlation was observed for papillary vessel density(ICC=0.857),vessel diameter index(ICC=0.857)and fractal dimension(ICC=0.906),while circumpapillary vessel density exhibited moderate interocular correlation(ICC=0.687).Bland-Altman plots revealed an agreement range of-5.26%to 6.21%for circumpapillary vessel density.CONCLUSION:OCTA ONH parameters demonstrate good repeatability in healthy subjects.The interocular correlations of papillary vessel density,fractal dimension and vessel diameter index are high,but the correlation for circumpapillary vessel density is moderate.

Casein kinase-2 inhibition promotes retinal ganglion cell survival after acute intraocular pressure elevation

Intraocular pressure elevation can induce retinal ganglion cell death and is a clinically reversible risk factor for glaucoma,the leading cause of irreversible blindness.We previously demonstrated that casein kinase-2 inhibition can promote retinal ganglion cell survival and axonal regeneration in rats after optic nerve injury.To investigate the underlying mechanism,in the current study we increased the intraocular pressure of adult rats to 75 mmHg for 2 hours and then administered a casein kinase-2 inhibitor(4,5,6,7-tetrabromo-2-azabenzimidazole or 2-dimethylamino-4,5,6,7-tetrabromo-1H-benzimidazole)by intravitreal injection.We found that intravitreal injection of 4,5,6,7-tetrabromo-2-azabenzimidazole or 2-dimethylamino-4,5,6,7-tetrabromo-1H-benzimidazole promoted retinal ganglion cell survival and reduced the number of infiltrating macrophages.Transcriptomic analysis showed that the mitogen activated protein kinase signaling pathway was involved in the response to intraocular pressure elevation but was not modulated by the casein kinase-2 inhibitors.Furthermore,casein kinase-2 inhibition downregulated the expression of genes(Cck,Htrsa,Nef1,Htrlb,Prph,Chat,Slc18a3,Slc5a7,Scn1b,Crybb2,Tsga10ip,and Vstm21)involved in intraocular pressure elevation.Our data indicate that inhibition of casein kinase-2 can enhance retinal ganglion cell survival in rats after acute intraocular pressure elevation via macrophage inactivation.

Prevalence of intermittent exotropia among primary and secondary school students in Shantou,China

Background: Few prevalence studies on intermittent exotropia(IXT) based on Chinese populations. Furthermore, longitudinal change in this pattern within a local setting has not been reported in the past. This study aims to determine the profile of children with IXT in China.Methods: A total of 7,537 subjects from nine multi-layer primary and secondary schools participated in this investigation. The position of eyes was examined by using Hirschberg test and alternate cover test. The obtained results were classified according to respective features and analyzed statistically. Results: The prevalence of IXT among the participants was 7.98%, accounting for 73.04% of all types of strabismus. Junior high school students had a lower prevalence of IXT than elementary and senior high school counterparts. Logistic regression analysis showed that IXT was mainly found in male pupils at high grades in rural areas and in male secondary students at high grade in urban regions. Conclusions: IXT was shown to be more prevalent than other types of strabismus in Chinese children. Furthermore, the distribution and characteristics of IXT greatly varied among participants.

Comparison and interchangeability of macular thickness measured with Cirrus OCT and Stratus OCT in myopic eyes

AIMTo investigate the difference of macular thickness measurements between stratus optical coherence tomography (OCT) and Cirrus OCT (Carl Zeiss Meditec, Dublin, CA, USA) in the same myopic patient and to develop a conversion equation to interchange macular thickness obtained with these two OCT devices.METHODSEighty-nine healthy Chinese adults with spherical equivalent (SE) ranging from -1.13 D to -9.63 D were recruited. The macular thickness was measured by Cirrus OCT and Stratus OCT. The correlation between macular thickness and axial length and the agreement between two OCT measurements were evaluated. A formula was generated to interchange macular thickness obtained with two OCT devices.RESULTSAverage macular thickness measured with Stratus OCT (r=-0.280, P=0.008) and Cirrus OCT (r=-0.224, P=0.034) were found to be negatively correlated with axial length. No statistically significant correlation was found between axial length and central subfield macular thickness (CMT) measured with Stratus OCT (r=0.191, P=0.073) and Cirrus OCT (r=0.169, P=0.113). The mean CMT measured with Cirrus OCT was 53.63±7.94 µm thicker than with Stratus OCT. The formula CMTCirrus OCT=78.328+0.874×CMTStratus OCT was generated to interchange macular thickness obtained with two OCT devices.CONCLUSIONMacular thickness measured with Cirrus OCT were thicker than with Stratus OCT in myopic eyes. A formula can be used to interchange macular thickness measured with two OCT devices in myopic eyes. Studies with different OCT devices and larger samples are warranted to enable the comparison of macular values measured with different OCT devices.

A Case of Corneoscleral Dellen after Medial Rectus Recession Combined with Pterygium Resection in Right Eye

Purpose:A case of corneoscleral dellen after medial rectus recession combined with pterygium resection was reported. Methods: Case report Results:A male patient aged 48 years had ghost for 1 year after acoustic neuroma resection.The patient was diagnosed with rectus paresis in the right eye. He successfully underwent medial rectus recession combined with pterygium resection. A corneoscleral dellen with a size of 2 ×2 mm was observed at 20 d postoperatively. The thinnest cornea was 147 um, diagnosed as corneoscleral dellen, which was cured after undergoing corneal limbal stem cell transplantation with conjunctival flap. Conclusion:Corneoscleral dellen is noninfectious corneoscleral ulcer caused by complex reasons.Most cases recovered by using artificial tears,antibiotic ointment and eye wrap,and other patients required corneal limbal stem cell transplantation with conjunctival flap, even keratoplasty. It is recommended that the patients with strabismus combined with pterygium underwent conjunctival flap transplantation at early stage to prevent the incidence of surgical complications.

Comparison of Corneal Thickness of Young People with Middle and High Myopia between Shantou and Zhengzhou

Purpose:To compare the corneal thickness of young subjects (aged 18 to 30 years).with moderate and high myopia living in Shantou and Zhengzhou.Methods:One hundred and forty myopic subjects from Shantou (Guangdong,southern China) and 101 from Zhengzhou (Henan,central China)were selected and divided into 2 groups (moderate-myopic group and high-myopic group).The participants were sex-and age-matched.The central corneal thickness (CCT) and thinnest corneal thickness (TCT) were measured by Orbscan and compared between the two groups.Results:In the high-myopic group,CCT (515.47±40.39 μm) and TCT (510.22±40.95 μm) of the Shantou subjects (mean spherical equivalent.[SE]-7.56±1.35),were thinner than those of their Zhengzhou counterparts.(mean SE-7.47 ±0.88).In the moderate-myopic group.(Shantou mean SE-4.52 ±0.83;Zhengzhou-4.67 ± 0.77),CCT and TCT did not differ between the two cities.Conclusion:The corneal thickness of high-myopic eyes may differ between Shantou and Zhengzhou.

Comparison of Intraoperative Ultrasound Pachymetry and Postoperative Optical Coherence Tomography of Anterior Segment in the Measurement of Flap Thickness in Eyes Receiving Laser in situ Keratomileusis

Purpose:To compare the measurement of flap thickness using intraoperative ultrasound pachymetry and postoperative visante anterior segment optical coherence tomography (Visante-OCT) in eyes receiving laser in situ keratomileusis (LASIK). Methods: Seventeen patients (34 eyes) received LASIK using a Technolas-217Z100 laser and AMADEUSⅡ mechanical microkeratome(140 μm head). Flap thickness was assessed with an ultrasound pachymeter intraoperatively and a Visante-OCT postoperatively at 1 week and 1 month. Results: The intraoperative mean flap thickness by ultrasound pachymetry was (124±13.9) μm (range: 96.5 to 160 μm), and mean flap thickness by Visante-OCT was (145±7.13) μm (range: 130 to 158 μm) and (143±5.32) μm (range: 132 to 155 μm) postoperatively at 1 week and 1 month respectively (F=63.52,P<0.01). Intraoperative subtraction pachymetry underestimated flap thickness compared with postoperative Visante-OCT.(P<0.01)..There was no significant difference between postoperative Visante-OCT measurements at 1 week and 1 month after LASIK.(P=0.16). The 95% limit of agreement.(LoA).of flap thickness between ultrasound Visante-OCT and pachymetry was -5.40 to 42.10 μm. Conclusion: OCT overestimates flap thickness compared with intraoperative ultrasound pachymetry when using the AMADEUSⅡ mechanical microkeratome.

Surgical treatment for proliferative diabetic retinopathy with ocular albinism

Dear Editor,We are writing to present an uncommon case of a45-year-old woman with bilateral proliferative diabetic retinopathy (PDR) and ocular albinism (OA).Albinism is a group of inherited disorders of tyrosinase activities and melanin biosynthesis resulting in little or no production of the pigment melanin。

Comparison of OA-2000 and IOL Master 500 using in cataract patients with high myopia

This study was designed to compare optical biometry measurements and predicted refraction in cataract patients with high myopia [axial length(AL) ≥26 mm] using OA-2000 and IOL Master 500. Ocular biometry measurements were performed using both biometers before surgery. Uneventful cataract surgery was performed in all patients. Postoperative manifest refraction was obtained 3 wk after surgery or later. A total of 67 eyes were examined. The AL, keratometry(K), and anterior chamber depth(ACD) of the two biometers showed excellent agreement. Predicted errors were similar and a strong positive correlation was observed(r=0.909). Out of 21 eyes(31.34%) with unsuccessful AL readings using the IOL Master 500, 20 eyes of them could be measured using OA-2000. Therefore, the biometric parameters measured by the two biometers showed good agreement. However, OA-2000 had a lower AL measurement failure rate.

The role of cell mediated immunopathogenesis in thyroid-associated ophthalmopathy

Currently, thyroid-associated ophthalmopathy (TAO) lacks effective treatment due to our lack of clarity in its immunopathogenesis. Orbital fibroblasts play a key role in altering inflammation and immune response in TAO, and are considered as the key target and effector cells in its pathogenesis. The orbit infiltrating CD34+ fibrocytes add on to the process by expressing high levels of autoantigens and inflammatory cytokines, while also differentiating into myofibroblasts or adipocytes. This review focuses on the role of orbital fibroblasts and CD34+ fibrocytes in the pathogenesis of TAO, highlighting the basis of emerging treatments.

Soft Bandage Contact Lenses in Management of Early Bleb Leak Following Trabeculectomy

Purpose: To investigate the efficacy of a soft bandage contact lens in the management of early bleb leak following trabeculectomy.Methods: Between October 2011 and April 2013, 11 patients with early bleb leak following fornix-based trabeculectomy were instructed to wear a soft bandage contact lens 14 mm in diameter continuously for 1-2 weeks. The daily visual acuity,intraocular pressure(IOP), anterior chamber situation, and healing condition were measured at 1, 3, and 7 d, after con tact lens removal,.and 3 months after trabeculectomy..The conditions of blebs,.sensation of wearing contact lens,.and adverse events were recorded.Results:.Bleb leaks were observed at 2-8 d after surgery,(4.09±1.10 d on average). The daily Log MAR visual acuity did not significantly differ before and after contact lens wear(P>0.05). The IOP was significantly raised after at 1, 3, and7 d after lens wear.(all P <0.05).The IOP at 3 months after lens wear did not significantly differ from that measured at lens removal(t=1.191, P=0.089). At 1 d after lens wear, 6cases had deeper anterior chambers..All patients presented with a significantly deepened anterior chamber at 3 d after lens wear,.and were restored to the preoperative conditions..The bleb leakage was successfully treated at 7 d after lens removal in 10 patients, while 1 patient had to wear the contact lens for another 7 d for full healing of the bleb leak. No ocular infection was noted throughout the management.Conclusion: A soft bandage contact lens of 14 mm diameter is a safe and efficacious therapy for an early bleb leak following fornix-based trabeculectomy.

The safety and efficacy of modified minimally invasive trabeculectomy for the treatment of primary chronic angle-closure glaucoma

Background: Primary chronic angle-closure glaucoma(PCACG) is one of the main types of glaucoma in China. Trabeculectomy is the most commonly used glaucoma filtration surgery for glaucoma in the world. Conventional trabeculectomy is prone to anesthesia-related complications intraoperative and operationrelated complications postoperative in PCACG treatment. Modified minimally invasive trabeculectomy maybe can reduce the incidence of complications.Methods: We conducted a prospective case series study and performed modified fornix-based trabeculectomy in 27 patients(30 eyes) under topical anesthesia; we then observed intraoperative anesthesia and cooperation ef ect, intraoperative and postoperative complications, preoperative and postoperative visual acuity, intraocular pressure(IOP), visual field, and the use of ocular hypotensive drugs. The patients were followed up for at least 12 months.Results: All operations were completed successfully with no intraoperative complications. All 27 patients(30 eyes) were followed up for at least 12 months. No significant decrease in visual acuity was observed at days 1 or 7 and at months 1, 3, 6, and 12 after operation; however, a signii cant decrease in IOP was observed at days 1 and 7 and at months 1, 3, 6, and 12 after operation. Moreover, no significant progression in visual field mean defect was observed at month 12 after operation, and the number of ocular hypotensive drugs required was significantly reduced at months 6 and 12 after operation. By month 12 after operation, the overall success rate was 93.33%(28/30).Conclusions: Modii ed minimally invasive trabeculectomy is safe and ef ective for the treatment of PCACG.

Correlation between optical coherence tomography, multifocal electroretinogram findings and visual acuity in diabetic macular edema

AIM:To analyze the correlation between macular morphology and function in eyes with diabetic macular edema(DME).METHODS:Fifty-five eyes with different visual acuity(VA)of 32 patients who suffered from DME were analyzed using multifocal electroretinography(mfERG)and optical coherence tomography(OCT).The parameters of mfERG including implicit times and response amplitude were compared to those of 50 normal eyes of 36 age-matched subjects.Correlation analysis was performed between VA,the parameters of mfERG including implicit times and response amplitude,and the central macular thickness(CMT).RESULTS:The amplitude of N1 and P1 were significantly decreased and their latency were significantly increased in five ring regions of the retina in patients with DME.There was statistically significant correlation between logMAR BCVA and P1 amplitude densities in rings 1-4(r=-0.306,-0.536,-0.470,-0.362;P=0.023,<0.01,<0.01,0.007 respectively),N1 amplitude in ring 2 and ring 3(r=-0.035,-0.286;P=0.019,0.034 respectively).There was poor correlation between the CMT and best-corrected visual acuity(BCVA;r=0.288,P=0.033),but there was no significant correlation between CMT and amplitude or implicit time of N1 and P1(P>0.05)in the central macular ring.Multiple stepwise regression analysis showed that P1 amplitude density in ring 2 was the only contributor to the VA.CONCLUSION:It seems to be more appropriate of combining use of mfERG with OCT for the evaluation of macular function in eyes with DME.

Comparative Study of the Disinfection Effects of Three Types of Conjunctiva Sac Irrigations

Purpose:The antiseptic effectiveness of 5% anerdian Ⅲ, 0.016% gentamicin,and 0.5% tobramycin solutions in pre-surgical irrigation of conjunctival sac were compared. Methods:A total of 295 cataract patients (302 eyes) who had undergone phacoemulsification aspiration combined with intraocular lens insertion. (IOL).were recruited in this prospective study.Operative eyes were given 0.3% levofloxacin eye drops for 3 days and then were randomized into three treatment groups:anerdian. (A), gentamicin (B) and tobramycin (C).The patients received conjunctival sac irrigation using the respective solutions at 10 minutes preoperatively.Conjunctival sac sampling was performed before and after irrigation and the samples were used for subsequent bacterial culture and swab tests. The positive culture rate was used as the main outcome. Results:The positive rates of bacterial culture before conjunctival sac irrigationwere 17.31% (18 eyes) in group A, 13.86% (14 eyes) in group B and 17.3% (14 eyes) in group C.Post irrigation,the positive rates in the three groups decreased to 5.76% . (6 eyes),5.94% . (6 eyes) and 7.22% (7 eyes), respectively. The positive rates among the three groups did not differ significantly.However,the positive rate in group A only significantly differed before and after the irrigation (P<0.05). No toxic or allergic reactions were observed on the ocular surface of any patient after irrigation. Conclusion: The antiseptic effects of the three types of con junctival sac irrigations did not differ. (Eye Science 2013; 28: 20-23)

Comparison of Dextran Perfusion and GSI-B4 Isolectin Staining in a Mouse Model of Oxygen-induced Retinopathy

Purpose: Oxygen-induced retinopathy(OIR) is a robust and widely used animal model for the study of retinal neovascularization(NV). Dextran perfusion and Griffonia simplicifolia isolectin B4(GSI-B4) staining are two common methods for examining the occurrence and extent of OIR. This study provides a quantitative comparison of the two for OIR detection.Methods: At postnatal day 7(PN7), fifteen C57 BL / 6J mice were exposed to a 75% hyperoxic condition for 5 days and then returned to room air conditions. At PN17, the mice received intravitreal injection of GSI-B4 Alexa Fluor 568 conjugate. After 10 hours, they were infused with FITC-dextran conjugate via the left ventricle. Retinal flat mounts were photographed by confocal microscopy. Areas with fluorescent signals and the total retinal areas were quantified by Image J software.Results:Both GSI-B4 and dextran detected the peripheral neovascular area. The mean hyper fluorescence area was 0.33 ±0.14% of whole retinal area determined by GSI-B4 staining and 0.25±0.28% determined by dextran perfusion. The difference between the two measures was 0.08%(95% CI:-0.59%,0.43%)..The Pearson correlation coefficient between the two methods was 0.386,P =0.035..The mean coincidence rates were 14.3 ±13.4% and 24.9 ±18.5% for GSI-B4 and dextran staining, respectively.Conclusion:.Both methods can complement each other indemonstrating and quantitatively evaluating retinal NV. A poor agreement was found between the two methods;.GSI-B4 isolectin was more effective than FITC-dextran perfusion in evaluating the extent of retinal NV in a mouse model of OIR.

Reliability of Tonolab measurements in rats

AIM: To assess the repeatability and reproducibility of Tonolab tonometer in rats with high intraocular pressure(IOP) and evaluate its ability to detect IOP changes in rats with general anaesthesia.METHODS: Left eyes of adult Fischer rats(F344) were photocoagulated by 532 nm diode laser to induce high IOP. Hypertensive eyes of 30 conscious rats were randomly chosen to measure IOP on a single occasion.Two observers independently and alternately undertook IOP measurements consecutively for three times using the same Tonolab tonometer blind to the other observer’s IOP measurements. The within subject standard deviation(Sw), coefficient of variation(CVw)(100 ×Sw/overall mean), and intraclass correlation coefficient(ICC) were calculated to evaluate intra-observer repeatability. Inter-observer difference was analysed by using 95% limits of agreement described by Bland-Altman and paired sample t- test. Also, another13 normal F344 rats were intraperitoneally administrated with ketamine/xylazine or chloral hydrate, and IOPs of both eyes were measured by a single operator once every 5min until animals came to conscious. IOPs at various time points were compared by using one-way ANOVAs.RESULTS: Mean IOP was 35.58 mm Hg(range 17.33 to65.33 mm Hg). For intraobserver repeatability, the Sw,CVw and ICC of high IOP for two observers were 5.20 mm Hg/3.41 mm Hg, 9.98% /8.08% and 0.820/0.928 respectively.The inter-observer difference was 14.76% ±19.76% of the mean IOP of two observers, with a 95% limits of agreement-23.97% to 53.50%, and the difference between mean IOP of these two observers was statistically significant(P =0.001). IOPs dropped slightly during the first 15 min post-aneathesia, with a IOP change between0.17 and 1.17 mm Hg. IOPs changed from basline of11.75 ±2.05 mm Hg(n =12) to 8.75 ±1.06 mm Hg 20 min post-anesthesia(P =0.001), and this hypotensivecondition persisted until 80 min post-anesthesia. CONCLUSION: In this sample of hypertensive rats,Tonolab measurements demonstrated high levels of intraobserver repeatability, however, its interobserver reproducibility was poor. Longitudinal changes of IOP caused by genral anaesthesia can be sensitively detected by Tonolab. So we suggested that measurements of IOP using Tonolab are best measured by a single observer,and it could be included in experimental glaucoma.

Growth hormone-releasing hormone receptor signaling in experimental ocular inflammation and neuroprotection

Both inflammation and anti-inflammation are involved in the protection of retinal cells.Antagonists of the hypothalamic growth hormone-releasing hormone receptor(GHRHR)have been shown to possess potent anti-inflammatory properties in experimental disease models of various organs,some with systemic complications.Such effects are also found in ocular inflammatory and neurologic injury studies.In experimental models of mice and rats,both growth hormone-releasing hormone receptor agonists and antagonists may alleviate death of ocular neural cells under certain experimental conditions.This review explores the properties of growth hormone-releasing hormone receptor agonists and antagonists that lead to its protection against inflammatory responses induced by extrinsic agents or neurologic injures in ocular animal models.

Visual impact of sub-Tenon anesthesia during combined phacoemulsification and vitrectomy surgery

AIM:To investigate the visual impact of sub-Tenon anesthesia during combined phacoemulsification and vitrectomy surgery.METHODS:In this prospective case series, consecutive patients who underwent combined phacoemulsification and pars plana vitrectomy(PPV) under sub-Tenon anesthesia between October 2008 and September 2009 were enrolled. The patients were asked whether they could see the light of the operating microscope or not between various surgical steps with their contralateral eye being covered.RESULTS:A total of 163 eyes of 163 patients were enrolled in this study. After their contralateral eyes were covered, 152(93.3%) patients said that they could not see any light at least during one of the surgical steps. All eyes recovered to at least light perception on the first postoperative day. The incidence of no light perception during the surgery was not related to demographic factors, including age, gender, or type of ocular diseases.CONCLUSION:The incidence of no light perception during combined phacoemulsification and vitrectomy under sub-Tenon anesthesia was high in our study.Patients should be duly informed about this temporary but potential intraoperative event.

Genetic and Phenotypic Investigation of a Chinese Pedigree with Lattice Corneal Dystrophy ⅢB Subtype

Purpose:.To investigate phenotypes and disease-causing mutation in the transforming growth factor b-induced gene(TGFBI) in a Southern Chinese pedigree with lattice corneal dystrophy(LCD) IIIB with complicated cataract.Methods:.A Southern Chinese pedigree with lattice corneal dystrophy IIIB with complicated cataract was recruited. Comprehensive ophthalmic investigations were performed before and after cataract surgery of phacoemulsification and intraocular lens implantation in the proband's both eyes..Peripheral blood was collected from the proband,.and genomic DNA was extracted..All exons of the TGFBI gene were sequenced to screen possible mutations.Results:.A bilateral LCD IIIB subtype was observed in the proband..Optical coherence tomography further revealed superreflective changes in the subepithelial and stroma layers of the cornea,.with reduced central corneal thickness..Notably,bilateral cataract was found in the proband..Direct sequencing detected a recurrent heterozygous missense c.1877A>G mutation in exon 14 of the TGFBI gene,.resulting in substitution of histidine with arginine(p.H626R).Conclusion:.The current study was the first report of the TGFBI p.H626R mutation in Southern Chinese,.suggesting that it could be a mutation hotspot across populations..Moreover,.the mutation was associated with LCD IIIB subtype with complicated cataract,.which had not been reported before,pointing to clinical heterogeneity of the mutation.

Mantle Cell Lymphoma in a Lacrimal Gland in a Female and a Review of the Literature

Purpose:To report a rare case of Mantle cell lymphoma in lacrimal gland and review of the literature Case report:.We report a case of a 59-year-old female who presented with an upper eyelid mass in the right eye for 3months, without pain and irrigation. A computerized tomography(CT) scan showed a mass in the bilateral lacrimal gland region, more significant in right eye. The patient underwent a lacrimal gland mass excision surgery and diagnosis of mantle cell lymphoma by histopathology..Immunochemistry for CD20, CD79 a, CD5, and Cyclin D1 was positive. She was recommended to the Shantou cancer hospital for chemotherapy.Conclusion:.Mantle cell lymphoma is a rare type of malignant lymphoma,.over expressing CD5 and cyclin D1 antigens,which distinguishes it from other B cell lymphomas.