Risk factors for intraocular metastasis of primary liver cancer in diabetic patients:Alpha-fetoprotein and cancer antigen 125

BACKGROUND In rare instances,primary liver cancer can be associated with intraocular metastasis(IOM).AIM To investigate the correlation between a diverse range of clinical characteristics and IOM in diabetic patients with primary liver cancer,and to determine potential risk factors in predicting IOM.METHODS We recruited a total of 722 diabetic patients with primary liver cancer.The differences between the IOM and non-intraocular metastasis(NIOM)groups in these patients were assessed using the chi-squared test and Student’s t-test.Binary logistic regression analysis was subsequently used to determine risk factors.Finally,the diagnostic value of IOM in this cohort with primary liver cancer was analyzed by receiver operating characteristic(ROC)curve analysis.RESULTS In all,13 patients had IOM.There were no remarkable intergroup differences with respect to age,sex,histopathological sub-types,or blood biochemical parameters.However,the IOM group had significantly higher alpha-fetoprotein(AFP)and cancer antigen 125(CA125)values than the NIOM group.Binary logistic regression identified AFP and CA125 to be significant risk factors for IOM in diabetic patients with primary liver cancer.ROC curve analysis showed that the area under the curve values for AFP and CA125 were 0.727 and 0.796,with the cut-off values of 994.20 ng/mL and 120.23 U/mL,respectively.The sensitivity and speci
city for AFP were 92.3%and 59.9%,while those for CA125 were 84.6%and 70.1%,respectively.CONCLUSION Elevated AFP and CA125 represent significant risk factors for IOM in diabetic patients with primary liver cancer.

Altered spontaneous brain activity in patients with diabetic optic neuropathy:A resting-state functional magnetic resonance imaging study using regional homogeneity

BACKGROUND Diabetes is a common chronic disease.Given the increasing incidence of diabetes,more individuals are affected by diabetic optic neuropathy(DON),which results in decreased vision.Whether DON leads to abnormalities of other visual systems,including the eye,the visual cortex,and other brain regions,remains unknown.AIM To investigate the local characteristics of spontaneous brain activity using regional homogeneity(ReHo)in patients with DON.METHODS We matched 22 patients with DON with 22 healthy controls(HCs).All subjects underwent resting-state functional magnetic resonance imaging.The ReHo technique was used to record spontaneous changes in brain activity.Receiver operating characteristic(ROC)curves were applied to differentiate between ReHo values for patients with DON and HCs.We also assessed the correlation between Hospital Anxiety and Depression Scale scores and ReHo values in DON patients using Pearson correlation analysis.RESULTS ReHo values of the right middle frontal gyrus(RMFG),left anterior cingulate(LAC),and superior frontal gyrus(SFG)/left frontal superior orbital gyrus(LFSO)were significantly lower in DON patients compared to HCs.Among these,the greatest difference was observed in the RMFG.The result of the ROC curves suggest that ReHo values in altered brain regions may help diagnose DON,and the RMFG and LAC ReHo values are more clinically relevant than SFG/LFSO.We also found that anxiety and depression scores of the DON group were extremely negatively correlated with the LAC ReHo values(r=-0.9336,P<0.0001 and r=-0.8453,P<0.0001,respectively).CONCLUSION Three different brain regions show ReHo changes in DON patients,and these changes could serve as diagnostic and/or prognostic biomarkers to further guide the prevention and treatment of DON patients.

玻璃体腔注射康柏西普治疗弥漫性糖尿病性黄斑水肿的眼表改变

目的:探究玻璃体腔注射康柏西普治疗弥漫性糖尿病性黄斑水肿(DDME)的眼表改变。方法:选取2019-01/06于我院眼科被诊断为DDME的患者20例,均为右眼发病,将右眼纳入试验组,左眼(未发生糖尿病性黄斑水肿)纳入对照组,试验组均行3次玻璃体腔注射康柏西普,对照组不采取任何治疗操作。观察治疗前和3次治疗后第1d矫正视力、眼压、浅表点状上皮糜烂情况、泪河高度、眼表症状及体征(OSDI)评分、泪液分泌试验(SⅠt)及角膜荧光素染色(CSF)评分。结果:治疗前,两组眼压、泪河高度、OSDI评分、SⅠt、CSF评分均无差异(P>0.05),且两组均未出现浅表点状上皮糜烂情况,但对照组矫正视力显著优于试验组(0.50±0.20 vs 1.65±0.35,P<0.05)。治疗后,试验组矫正视力、泪河高度、SⅠt明显低于对照组,OSDI和CSF评分明显高于对照组(均P<0.05),眼压升高幅度较对照组更大,但两组无差异(P>0.05),而试验组19眼出现了浅表点状上皮糜烂情况。与治疗前比较,试验组治疗后矫正视力明显改善,泪河高度和SⅠt明显降低,OSDI和CSF评分明显升高(均P<0.05),但眼压无明显变化(P>0.05);对照组各观察指标均无明显变化(P>0.05)。结论:玻璃体腔注射康柏西普治疗弥漫性糖尿病性黄斑水肿会损伤眼表。

桑色素滴眼液治疗围绝经期雌性兔干眼的实验研究

目的:探究桑色素滴眼液在围绝经期雌性兔干眼症中的治疗作用。方法:选取雌性新西兰大白兔36只,采用双侧卵巢切除术,术后饲养60d,制作围绝经期雌兔干眼症模型(36眼,均为右眼),其中24只随机分成对照组、实验组两组(各12只):对照组应用磷酸盐缓冲液(PBS),实验组应用桑色素滴眼液,另12只不使用任何滴眼液。治疗前,治疗后2、4、6wk对实验兔采取角膜荧光素染色(FL)、Schirmer Ⅰ试验(SⅠt)检查,同时测验溶菌酶含量、乳铁蛋白、淀粉酶活性和泪液总蛋白含量,并使用角膜共聚焦显微镜观察。结果:治疗前两组的SⅠt、FL、溶菌酶含量、乳铁蛋白、淀粉酶活性和泪液总蛋白量均无差异(P>0.05);治疗2、4、6wk后,对照组和实验组SⅠt和FL评分发生了不同的变化(P<0.05)。实验组溶菌酶含量、乳铁蛋白、淀粉酶活性和泪液总蛋白量较治疗前没有显著变化(均P>0.05),对照组溶菌酶含量、乳铁蛋白、淀粉酶活性和泪液总蛋白量都发生了程度不一的变化(均P<0.05)。治疗后2、4、6wk时两组SⅠt、FL评分、溶菌酶含量、乳铁蛋白、淀粉酶活性和泪液总蛋白量均有差异(P<0.05)。治疗6wk,对照组炎症细胞密度为321±91个/mm^2,上皮基底细胞密度为4436±289个/mm^2,实验组炎症细胞密度为36±11个/mm^2,上皮基底细胞密度为3219±223个/mm^2,两组均有差异(P<0.05)。治疗6wk后,对照组角膜上皮下多支神经纤维发生弯曲,密度显著减少(P<0.05),实验组神经弯曲度明显减小,密度较治疗前增加。结论:桑色素滴眼液对围绝经期雌性兔干眼症具有明确的治疗作用。

视网膜微循环检测技术及其临床应用

各种眼部疾病,尤其是视网膜疾病均可改变视网膜微血管状态。此外,涉及全身血管系统改变的疾病如心血管疾病等也存在视网膜微循环改变。因此视网膜微血管系统的改变除了主要作为眼部疾病的辅助诊断指标外,还有助于评价全身性疾病,是重要的疾病指标。本文简要综述了视网膜微循环检查的检测方法及各项检测方法的临床应用现状。

Decreased retinal microvasculature densities in pterygium

AIM:To investigate the retinal vascular network alterations in eyes of patients with pterygium.METHODS:Totally 18 left eyes from 18 female pterygium patients and 18 left eyes from 18 female healthy control subjects were enrolled.Optical coherence tomography angiography(OCTA)images were generated of the superficial retinal layer and deeper retinal layer of the macular retina for each eye.The microvascular(MIR)and macrovascular(MAR)densities were calculated and MIR,MAR,and total microvascular(TMI)density was compared in the healthy control and pterygium groups.RESULTS:In pterygium group,in the superficial retinal layer,the vascular density in superficial MIR,superior right(SR),inferior right(IR),right(R),superficial central annuli(SC)1,SC2,and SC3 decreased significantly in the macular area(P<0.05).Furthermore,the vascular density in all those decreased regions except R,was significantly and negatively correlated with the disease course(r=-0.6038 to-0.7762,P=0.0008),and the area size of pterygium(r=-0.6043 to-0.9508,P<0.05).For the deeper retinal layer,the density of deep total microvessel(DTMI),deeper MIR,SR,IR,R,DC2,and DC3 decreased significantly in macular area of pterygium patients(P<0.05).Furthermore,the vascular density in all those decreased regions was significantly and negatively correlated with the disease course(r=-0.6901 to-0.7795,P=0.0015),and the area size of pterygium(r=-0.6043 to-0.9563,P<0.05).No statistically significant differences and correlation was found in other region density(|r|<0.47,P>0.05).CONCLUSION:OCTA findings suggest that pterygium patients present with decreased retinal MIR density,and the major vascular alterations occurr mainly on the bitamporal side.The vascular density of the superficial SC1,SC2,SC3 adjacent to the foveal and deep layer of DC2,DC2 regions,significantly decreased.

Surgical correction of recurrent epiblepharon in Chinese children using modified skin re-draping epicanthoplasty

AIM:To evaluate the clinical efficacy of the modified skin re-draping epicanthoplasty procedure for correction of recurrent lower lid epiblepharon in Chinese children.METHODS:From 2016 to 2018,18 children(10 males and 8 females,average age 6.2±1.7 y;30 eyes)with recurrent epiblepharon who attended Beijing Children’s Hospital were included in the study.All the children had undergone lower eyelid surgery for epiblepharon.Surgical design included using an additional incision along the upper palpebral margin,to avoid vertical scarring on the upper lid.The re-draping method was used to correct recurrent epiblepharon.Follow-up ranged from 3 to 24 mo.Postoperative surgical outcomes,complications,and subjective satisfaction were evaluated.RESULTS:Complete correction of cilia touching the cornea was observed in all patients during an average follow-up of 7.1 mo.No"dog ears"or obvious scars were formed after surgery.All parents were satisfied with the cosmetic results and none complained.Mean astigmatism decreased from 2.39±0.79 diopter(D)preoperatively to 2.19±0.79 D at 6 mo after surgery;however,the difference was not significant.Best-corrected visual acuity improved,although the change in mean visual acuity was not significant.No recurrence occurred during the follow-up period.CONCLUSION:This surgical modified skin re-draping technique is effective and highly satisfactory for correction of recurrent epiblepharon.The approach is characterized by a simple design,a straightforward procedure,inconspicuous scarring,and good postoperative appearance.

Altered spontaneous brain activity patterns in patients with hyperthyroidism exophthalmos using amplitude of low-frequency fluctuation:a resting-state fMRI study

AIM:To assess changed spontaneous brain activity in hyperthyroid exophthalmos(HE)patients by the amplitude of the low-frequency fluctuation(ALFF)method,and to analyze the correlation between brain activity and ALFF values in these patients.METHODS:Totally 18 HE and 18 hyperthyroid nonexophthalmos(HNE)patients were enrolled.The participants were tested by resting-state functional magnetic resonance imaging,and receiver operating characteristic(ROC)curves were generated to classify the ALFF values of the study population.Pearson’s correlation analysis was utilized to evaluate the relationship between the ALFF values obtained from different brain areas and clinical manifestations.RESULTS:Contrary to HNE patients,we observed lower ALFF values in the left calcarine fissure and surrounding cortex(LCFSC)in HE patients.In the ROC curve analysis of the LCFSC,the area under the curve reflected a high degree of accuracy.In addition,there was positive correlation between mean ALFF values of the LCFSC and the bestcorrected visual acuity of the affected eyes.CONCLUSION:The study displays abnormal brain activity in LCFSC in patients with HE,which might suggest pathological mechanism of visual impairment of HE patients.