Evaluation of hyperreflective foci as a prognostic factor of visual outcome in retinal vein occlusion

AIM：To evaluate the potential role of hyperreflective foci（HF） as a prognostic indicator of visual outcome in patients with macular edema（ME） due to retinal vein occlusion（RVO）.METHODS：We retrospectively reviewed 50 eyes of 50 patients with ME due to ischemic central retinal vein occlusion（CRVO）,non-ischemic CRVO and branch retinal vein occlusion（BRVO） who were treated with anti-vascular endothelial growth factor（anti-VEGF） at Beijing Tongren Eye Center from January 2013 to July 2016.All patients underwent best-corrected visual acuity（BCVA）,spectral domain optical coherence tomography（SD-OCT） at baseline and follow-up.Such factors were evaluated and compared among three groups as baseline and final BCVA,central retinal thickness（CRT）,external limiting membrane（ELM） status and the numbers of HF in different position.Multiple linear regression analysis was employed to analyze the relationship between baseline HF and final BCVA.Changes of HF before and after treatment were evaluated too.RESULTS：Among three groups,HF could be located in each retinal layers,as well as in vitreous cavity.The mean HF in outer retinal layer（ORL） at baseline was 5.29±8.48 in ischemic CRVO with intact ELM,1.93±2.76 in non-ischemic CRVO,and 1.75±2.05 in BRVO.With disrupted ELM,the mean HF in ORL increased.There was statistically difference of HF in ORL between intact and disrupted ELM.The numbers of HF in ORL were associated with poor visual outcome among three groups.However,HF in inner retinal layer（IRL） and vitreous cavity were not associated with poor visual outcome.Meanwhile,the baseline HF in ORL and vitreous cavity reduced significantly in nonischemic CRVO and BRVO after anti-VEGF treatment.CONCLUSION：The numbers of HF in ORL are prognostic factors associated with the final BCVA in patients with ME due to RVO after anti-VEGF treatment.

Inhibition of choroidal neovascularization by lentivirusmediated PEDF gene transfer in rats

AIM: To evaluate the effects of lentivirus-mediated pigment epithelium-derived factor (PEDF) gene transfer performed in treatment of rats with established choroidal neovascularization (CNV), and investigates the mechanism by which PEDF inhibits CNV in rats. METHODS: Brown Norway (BN) rats (n=204) were induced by exposure to a laser, and then randomly assigned to 3 groups: no treatment; treatments with intravitreal injection of lentivirus-PEDF-green fluorescent protein (GFP) or lentivirus-control GFP (free fluorescent protein). Following induction and treatment, the CNV tissue was assessed for form, size and vessel leakage by fluorescein fundus angiography (FFA), optical coherence tomography (OCT), histopathology, and examination of choroidal flat mounts. VEGF, Flk-1, and PEDF expression were evaluated by real-time polymerase chain reaction (PCR) and Western blot. RESULTS: A stable laser-induced rat model of CNV was successfully established, and used to demonstrate lentivirus-mediated REDO gene transfer by intravitreal injection. Expression of green fluorescence labelled PEDF was observed in the retina up to 28d after injection. An intravitreal injection of lentivirus-PEDF-GFP at 7d led to a significant reduction in the size, thickness and area of CNV showed by FFA, OCT and choroidal flat mounts. PEDF was up-regulated while VEGF and Flk-1 were down-regulated in the lentivirus-PEDF-GFP group. The differences in VEGF and Flk-1 expression in the control and lentivirus-PEDF groups at 7, 14, 21 and 28d after laser induction were all statistically significant. CONCLUSION: Lentivirus-mediated PEDF gene transfer is effective for use in treatment of laser-induced CNV, and PEDF exerts its therapeutic effects by inhibiting expression of VEGF and Flk-1.

Lycium barbarum polysaccharides promotes in vivo proliferation of adult rat retinal progenitor cells

Lycium barbarum is a widely used Chinese herbal medicine prescription for protection of optic nerve.However,it remains unclear regarding the effects of Lycium barbarum polysaccharides,the main component of Lycium barbarum,on in vivo proliferation of adult ciliary body cells.In this study,adult rats were intragastrically administered low-and high-dose Lycium barbarum polysaccharides（1 and 10 mg/kg）for 35 days and those intragastrically administered phosphate buffered saline served as controls.The number of Ki-67-positive cells in rat ciliary body in the Lycium barbarum polysaccharides groups,in particular low-dose Lycium barbarum polysaccharides group,was significantly greater than that in the phosphate buffered saline group.Ki-67-positive rat ciliary body cells expressed nestin but they did not express glial fibrillary acidic protein.These findings suggest that Lycium barbarum polysaccharides can promote the proliferation of adult rat retinal progenitor cells and the proliferated cells present with neuronal phenotype.

Novel circular RNA expression profile of uveal melanoma revealed by microarray

Objective: The present study aimed to investigate circular RNA(circRNA) expression in uveal melanoma(UM).Methods: First,we used microarray to compare the expression profiles of circRNA in five UM samples and five normal uvea tissues.Next,bioinformatics analyses,including gene ontology(GO) analysis and pathway analysis,were applied to study these differentially expressed circRNAs to predict pathogenic pathways that may be involved.Quantitative real-time polymerase chain reaction(qRT-PCR) in 20 UM samples and 20 normal uvea samples was used to confirm the circRNA expression profiles obtained from the microarray data.Finally,we analyzed the interaction between validated circRNAs and their potential cancer-associated miRNA targets.Results: In total,50,579 circRNAs [fold change(FC) ≥2.0; P<0.05],including 20,654 up-regulated and 29,925 down-regulated circRNAs,were identified as differentially expressed between UM tissues and normal uvea tissues.We used qRT-PCR to verify seven dysregulated circRNAs indicated by the microarray data,including hsacirc0119873,hsacirc0128533,hsacirc0047924,hsacirc0103232,hsa-circRNA10628-6,hsacirc0032148 and hsacirc0133460,which may be promising candidates to study future molecular mechanisms.Conclusions: This study explored,for the first time,the abnormal expression of circRNAs in UM and described the expression profile of circRNAs,providing a new potential target for the mechanism of UM and future treatment of UM.

The optic nerve head perfusion and its correlation with the macular blood perfusion in unilateral idiopathic macular hole： an optical coherence tomography angiography study

AIM： To compare the optic nerve head （ONH） perfusion in both eyes of unilateral idiopathic macular hole （IMH） with normal control group by using optical coherence tomography angiography （OCTA） and investigate its correlationship with the macular blood perfusion. METHODS： We performed a prospective and cross- sectional study that included 19 patients with full-thickness unilateral IMH and 24 age- and sex-matched controls. All participants received OCTA test. The ONH perfusion was evaluated by the regions of peripapillary and whole en face （the sum of peripapillary and optic disc）. The potential correlationship between ONH and parafovea were implied. All the data were performed using the nonparametric test. RESULTS： The mean values of ONH presented that normal control 〉IMH 〉unaffected eyes. A statistical variation was found between three groups in the region of temporal （P=-0.007）, Vessel density notablely decreased on the layers of superficial, deep and choroid of parafovea region in IMH group. The correlative coefficients showed that respectively whole en face and deep retina： r=0.528, peripapillary and deep retina： r=0.525, whole en face and choriocapillaries： r=0.569, peripapillary and choriocapillaries： t=0.504. CONCLUSION： Our study demonstrate a reduced ONH vessel density in both eyes of IMH patients and the vessel density of ONH in IMH eyes are positively correlated with both the retina capillary and choriocapillary in parafoveal. The reduction of vessel densities may indicate the hypoperfusion in IMH eyes,

Peptidome profiling of human serum of uveal melanoma patients based on magnetic bead fractionation and mass spectrometry

AIM： To find new biomarkers for uveal melanoma （UM） by analyzing the serum peptidome profile. METHODS： Proteomic spectra in patients with UM before and after operation were analyzed and compared with those of healthy controls. Magnetic affinity beads were used to capture serum peptides and matrix-assisted laser desorption/ionization time-of-flight （MALDI-TOF） mass spectrometer were used to compile serum peptide profiles. RESULTS： A panel of 49 peptides were differentially expressed between UM patients and controls, of which 33 peptides were of higher intensities in patient group and 16 peptides were of higher intensities in control group. Based on combined use of these potential markers, peptides with mean molecular masses of 1467 and 9289.0 Da provide high sensitivity （83.3%）, specificity （100%） and accuracy rate （93.0%） together to differentiate melanoma patients from healthy controls. At the time point of 6mo postoperatively, the levels of many peptides differentially expressed before surgery showed no more statistical difference between the patients and the control group. Fibrinogen o-chain precursors were identified as potential UM markers. CONCLUSION： We have shown that a convenient and fast proteomic technique, affinity bead separation and MALDI- TOF analysis combined with bioinformatic software, facilitates the identification of novel biomarkers for UM.

Adenocarcinoma of the nonpigmented ciliary epithelium manifested as an anterior chamber mass

Dear Editor,Adenocarcinoma of the nonpigmented ciliary epithelium（NPCE）is a rare malignant tumor which is not easy to be found in the early stage（[1]）.Herein,we report a case of adenocarcinoma of the NPCE in a Chinese boy and discuss its.

Epidemiology of hospitalized pediatric glaucoma patients in Beijing Tongren Hospital

Background No population-based assessment of the prevalence and incidence of pediatric glaucoma in China are available. Here we describe the spectrum of hospitalized pediatric glaucoma patients in Beijing Tongren Hospital in China.Methods We reviewed the charts of pediatric patients, from birth to 18 years old, with a discharge diagnosis of glaucoma in Beijing Tongren Hospital, from 2002 to 2008. All children were admitted for anti-glaucoma surgery, treating the sequelae of the glaucoma, or managing postoperative complications. We evaluated the demographic characteristics and the proportion of different glaucoma subtypes. Results Pediatric patients （n=1452） accounted for 12.91% of the total glaucoma in-patients from 2002 to 2008, and at last data of pediatric glaucoma were presented for 1055 children who came from 28 provinces, municipalities and autonomous regions in China. Boys were more common in all subtypes and at all ages, with a total ratio of boys to girls of 2.32：1. Congenital glaucoma was the most common subtype, accounting for 46.07% in all patients and accounting for 69.95% in children under 3 years of age. The median presenting age of congenital glaucoma patients was 2 years. Patients with traumatic glaucoma were the second most common group （n=128, 12.13%）, and presented at older age （the median presenting age was 11 years）. The majority of traumatic glaucoma occurred in children between 10 and 15 years of age （n=72, 56.25%）. Aphakic glaucoma was the third most common （9.19%） subtype. Conclusions Congenital glaucoma is the most prevalent glaucoma subtype in hospitalized pediatric patients in Beijing Tongren Hospital. The prevention and treatment of traumatic glaucoma can reduce the incidence of visual damage in developing countries. Close follow-up for glaucoma is important after pediatric cataract surgery.

Ophthalmology： potential future developments in China and worldwide

With a volume of about 6 ml and weight of approximately 6 g, the eye makes out only 1/10 000part of the body. Despite this minuscule proportion of the eye on the whole body, quality of life is profoundly influenced by the quality of vision. It shows the high importance of ophthalmology in the field of public health in general and in clinical medicine in particular.

Fundus artery occlusion caused by cosmetic facial injections

Background With the increasing popularity of cosmetic facial filler injections in recent years, more and more associated complications have been reported. However, the causative surgical procedures and preventative measures have not been studied well up to now. The aim of this stady was to investigate the clinical characteristics and visual prognosis of fundus artery occlusion resulting from cosmetic facial filler injections. Methods Thirteen consecutive patients with fundus artery occlusion caused by facial filler injections were included. Main outcome measures were filler materials, injection sites, best-corrected visual acuity （BCVA）, fundus fluorescein angiography, and associated ocular and systemic manifestations. Results Eleven patients had ophthalmic artery occlusion （OAO） and one patient each had central retinal artery occlusion （CRAO） and anterior ischemic optic neuropathy （AION）. Injected materials included autologous fat （seven cases）, hyaluronic acid （five cases）, and bone collagen （one case）. Injection sites were the frontal area （five cases）, periocular area （two cases）, temple area （two cases）, and nose area and nasal area （4 cases）. Injected autologous fat was associated with worse final BCVA than hyaluronic acid. The BCVA of seven patients with autologous fat injection in frontal area and temple area was no light perception. Most of the patients with OAO had ocular pain, headache, ptosis, ophthalmoplegia, and no improvement in final BCVA. Conclusions Cosmetic facial injections can cause fundus artery occlusion. Autologous fat injection tends to be associated with painful blindness, ptosis, ophthalmoplegia, and poor visual outcomes. The prognosis is much worse with autologous fat injection than hyaluronic acid iniection.

Quantitative parameter character of choroidal melanoma in contrast-enhanced ultrasound

Background Choroidal melanoma is the most common intraocular malignant tumor in adults. It threatens not only the visual function but also the patient＇s life. Therefore, it is important to find a non-traumatic, quantitative and repetitive diagnostic method. This study investigated the value of quantitative analysis of contrast-enhanced ultrasound （CEUS） in the diagnosis of choroidal melanoma. Methods CEUS were performed in 51 cases of choroidal melanoma, which were diagnosed either pathologically or clinically and in 14 cases of choroidal hemangioma. The characteristics of the time-intensity curve of the contrast agent were analyzed. For the quantitative analysis, the following parameters of the contrast agent in the lesion were included： rising time （RT）, time to peak （TTP）, maximum intensity （MI） and the mean transit time （MTT）. Results Choroidal melanoma had the following characteristics on CEUS： Choroidal lesions were completely filled with contrast agent. The typical filling pattern was centripetal, with the peripheral of the choroidal lesion filled with the contrast agent first and then the center of the lesion. In some cases, areas with contrast agent filling defect were obseved in the lesions. The contrast agent filled the lesion slower than the normal eye and orbital tissue but faded faster in the lesion. Quantitative analysis showed that in choroidal melanoma, MI of contrast agent （191.31%±146.90%） was significantly more than that of the normal tissue （100.00%±0.00%） （P 〈0.05） and MTT （（63.56±26.04） seconds） was significanly less than that of the normal tissue （（149.87±182.68）seconds） （P 〈0.05）. TTP （22.80±9.85） was less than that of the normal tissue （（29.57±24.76） seconds） and RT （（18.52±7.09） seconds） was less than that of the normal tissue （（26.45±21.83） seconds）. Both the differences of TTP and RT were not statistically significant though. Logistic regression showed that to predict choroidal melanoma and choroidal hemangioma with MI and MTT, the sensitivity was 90.5% and the specific degrees was 85.7%. Conclusions CEUS is a new method to diagnose tumors in the eye. Choroidal melanoma may be diagnosed objectively and accurately by combining the graphic characteristics on CEUS and the time-intensity curve quantitative analysis.

Mechanism of the reconstruction of aqueous outflow drainage

Glaucoma is the leading cause of irreversible blindness worldwide. The reconstruction of aqueous outflow drainage (RAOD) has recently been proposed to aid in restoring aqueous outflow drainage in primary open-angle glaucoma. However, the mechanism of RAOD remains to be fully understood. Based on literature review and research studies, the potential mechanisms of RAOD are the following: (i) Circumferential dilation of the Schlemm’s canal (SC) and surrounding collector channels. (ii) Instant formation of microcracks through RAOD procedures. (iii) Formation of more pores, and local detachment between the SC endothelium (SCE) and basement membrane. (iv) Activation of stem cells by constant mechanical stress caused by the tensional suture placed at the anterior part of the SC. (v) Reversal of trabecular meshwork (TM) herniation. (vi) Mobilization of the reserve of the aqueous drainage. (vii) Change of SCE phenotype. (viii) Mechanosensing and mechanotransducing of TM.

A review of trachoma history in China: research, prevention, and control

Trachoma is one of the most widespread blinding eye diseases, which is harmful to human visual health. The efforts to prevent and control trachoma in China can be divided into three periods, i.e., highly epidemic period, research on pathogenesis and control of trachoma, and blinding trachoma elimination and epidemiological evaluation. In 1956, Prof. Feifan Tang and Xiaolou Zhang first discovered and isolated Chlamydia trachomatis, which clarified the cause of trachoma, and kick-started a fresh chapter in trachoma research, prevention, and control around the world. Although, the prevalence of trachoma differed in different areas, the average prevalence once exceeded 50% and was as high as 90% in some areas before and at early liberation of China. Therefore, the government-led efforts were made to comprehensively prevent and control trachoma, including development of National Plan for the Prevention and Control of Trachoma, nationwide screening and treatment of trachoma, implementation of National Patriotic Health Campaign and improvement of water supply and lavatories. After decades of effort, China reached the goal of eliminating blinding trachoma in 2015. China has gained remarkable achievements in the prevention and treatment of trachoma, making outstanding contributions toward the goal of eliminating trachoma worldwide. The research, prevention, and control of trachoma in China were reviewed in this paper.

Association of three single nucleotide polymorphisms at the SIX1-SIX6 locus with primary open angle glaucoma in the Chinese population

This study investigated the genetic association of three single nucleotide polymorphisms(SNPs; rs10483727, rs33912345, and rs146737847) at the SIX1-SIX6 locus with primary open angle glaucoma(POAG) in the Chinese population. A total of 866 subjects with POAG(685 high-tension glaucoma(HTG) and 181 normal-tension glaucoma(NTG)) and 266 control individuals were included. Significant genetic association was identified for rs10483727 in HTG(P=0.02; odds ratio(OR)=1.31), NTG(P=7.41×10^(-6); OR=2.71), and POAG(i.e., HTG and NTG combined; P=0.001; OR=1.44). rs33912345 was also significantly associated with HTG(P=0.008; OR=1.36), NTG(P=2.72×10^(-6); OR=2.27), and POAG(P=3.84×10^(-4); OR=1.49). The rare SIX6 mutation, rs146737847, was not found in the subjects enrolled in this study. Stratification by patient age identified that both rs10483727 and rs33912345 were significantly associated with NTG in patients aged above 40 years(P=2.08×10^(-5); OR=2.28), whereas in patients aged between 20–40 years, rs33912345 was significantly associated with NTG(P=0.017; OR=2.06). In HTG, the genetic associations for both rs10483727 and rs33912345 were significant in patients aged between 20–40 years(P=0.006; OR=1.56) but not in those aged above 40 years(P=0.118, OR=1.21 and P=0.042, OR=1.29, respectively). This study replicated the association of POAG with two SNPs at the SIX1-SIX6 locus and demonstrated that SNPs, rs10483727 and rs33912345, are significantly associated with POAG, especially with NTG in patients aged above 40 years.

Axonal loss and blood flow disturbances in the natural course of indirect traumatic optic neuropathy

Background Indirect traumatic optic neuropathy （TON） is an acute injury of the optic nerve associated with severe visual dysfunction, which may be a result of secondary mechanical injury and vascular disorder of the optic nerve due to trauma. We analyzed the natural course of axonal loss and blood flow disturbances in patients with indirect TON to find a possible therapeutic window. Methods A cohort of 54 patients with indirect TON recruited between October 2008 and October 2010 at Beijing Tongren Hospital was retrospectively analyzed. The patients were divided into no light perception group （NLP） and better than NLP （btNLP） group. Specifically, the thickness of the retinal nerve fiber layer （RNFL） measured by spectral domain optical coherence tomography （SD-OCT）, and hemodynamic parameters of the ophthalmic artery （OA）, central retinal artery （CRA） and posterior ciliary artery （PCA） were determined. Results Two weeks after injury, there was a statistically significant decrease in the thickness of RNFL in the btNLP group as compared with the fellow control eyes （P 〈0.05）. In contrast, in the NLP group, RNFL thickness slightly increased for 2 weeks following injury, then overtly reduced after 4 weeks （P 〈0.05）. Peak systolic velocity （PSV） of CRA was significantly decreased 4 weeks after injury （P 〈0.05） in both the NLP group and btNLP group （P 〈0.05）. The thickness of RNFL in the NLP group was negatively correlated with PSV of CRA after 1 week of injury （P 〈0.05, r=-0.962）. Conclusions SD-OCT is a useful supplement in detecting the axonal loss in TON. The dynamic change of the thickness of RNFL appears to correlate with the hemodynamic disturbances in the natural course of TON. The first 2 weeks following an injury is critical and should be considered as the therapeutic window for TON patients.

Effect of the regimen of Gaoshan Hongjingtian on the mechanism of poly（ADP-ribose） polymerase regulation of nuclear factor kappa B in the experimental diabetic retinopathy

Background Poly（ADP-ribose） polymerase （PARP） plays an important role in the death of retinal capillary cells in diabetic retinopathy （DR） partly via its regulation of nuclear factor kappa B （NF-κB）. The current study investigated the effect of the regimen of Gaoshan Hongjingtian （RG） on the mechanism of PARP regulation of NF-κB, and demonstrated the possible impact of the RG and Gaoshan Hongjingtian （Rhodiola sachalinensis, RS） on diabetic retinopathy. Methods Wistar rats were made diabetic by administering streptozotocin. They were then assigned to three groups at random. After 2 months, the three groups of these diabetic rats were treated with RS or RG, or untreated. Analyses of expression levels of PARP, NF-κB, and intercellular adhesion molecule-1 （ICAM-1） in the retinas of rats in different groups were performed by Western blotting and immunohistochemical assays, and mRNA levels of NF-κB and ICAM-1 were determined by real-time polymerase chain reaction （PCR）. In addition, the basement membranes of capillaries in the rats＇ retinas were observed using electron microscopy, and diabetes-induced capillary degeneration （ghost pericytes and acellular capillaries） were quantitated. Results From the third month after the injection of streptozotocin, the diabetic rats were given daily RG, RS or tap water separately. The diabetic rats failed to gain weight compared with normal age-matched rats, whereas their glycated hemoglobin levels were significantly increased. After 5 months, the mRNA levels of NF-KB and ICAM-1 and the protein expression of PARP, NF-κB, and ICAM-1 were significantly increased in the retinas of diabetic rats in the untreated group compared with the nondiabetic controls. After 8 months, the number of degenerated retinal capillaries （ghost pericytes and acellular capillaries） was significantly increased in the diabetic rats in the untreated group compared with normal age-matched rats. RG and RS inhibited diabetes-induced over-expression of PARP, NF-KB, and ICAM-1 in the retinas of diabetic rats at the end of 5-month diabetic duration. Treatment using RG and RS significantly inhibited increases in the number of acellular capillaries and pericyte ghosts and suppressed the basement membrane thickening in the retinas of rats with diabetes for 8 months compared with the control diabetic rats. Conclusions These results indicate that PARP plays an important role in the pathogenesis of diabetic retinopathy. RS and RG may have acted on the mechanism of PARP regulation of NF-κB, which suppressed the expression of NF-KB and ICAM-1, and led to the inhibition of retinal capillary degeneration.

Comparison of the flaps made by femtosecond laser and automated keratomes for sub-bowman keratomileusis

Background Thin-flap laser in situ keratomileusis （LASIK） is the new trend of refractive error correction surgery, the formation of corneal flap is crucial for a success of LASIK surgery. This study aimed to assess and compare the variations of LASIK flap created by the IntraLase femtosecond laser, Moria One Use-Plus SBK and Moria M2 Single-Use 90 pm- head microkeratome using Anterior segment optical coherence tomography （Visante OCT）. Methods One hundred and sixty-one eyes of 81 consecutive patients were enrolled in this prospective study and randomly divided into three groups depending on the flap creation method： flap creation with the the IntraLase femtosecond laser （IntraLase group, 59 eyes）, flap creation with the Moria One Use-Plus SBK （SBK group, 44 eyes）, and flap creation with the Moria M2 Single-Use 90 pm-head microkeratome （M2SU90 group, 58 eyes）. The nominal flap thickness was 110 m for all patients and for the three devices. One month after surgery, Visante OCT was used to measure the flap thickness at 20 locations on each cornea and the results were assessed for uniformity, regularity, and accuracy. Results At 1 month after surgery, the mean central flap thickness was （111±3） pm in the IntraLase group, （114±8） pm in the SBK group, and （118±13） pm in the M2SU90 group respectively. The flaps in the IntraLase group and the SBK group were more regular, showing an almost planar configuration, than the meniscus-shaped flaps in the M2SU90 group. The maximum deviation from the intended flap thickness （110 pm） was 6 pm in the IntraLase group, 10 pm in the SBK group, and 20 pm in the M2SU90 group respectively. A difference greater than 20 pm was observed in 0.42% of measurements in the IntraLase group; 2.95% of the measurements in the SBK group and 21.12% of measurements in the M2SU90 group. Conclusions The flaps created by the IntraLase femtosecond laser and Moria One Use-Plus SBK are more uniform; more regular, and more accurate than those created by the Moria M2 Single-Use 90 pm-head microkeratome. The first two methods can make precise flaps for Sub-Bowman Keratomileusis.

Auto-mobilized adult hematopoietic stem cells advance neovasculature in diabetic retinopathy of mice

Background Hematopoietic stem cells （HSCs） can be used to deliver functionally active angiostatic molecules to the retinal vasculature by targeting active astrocytes and may be useful in targeting pre-angiogenic retinal lesions. We sought to determine whether HSC mobilization can ameliorate early diabetic retinopathy in mice.Methods Mice were devided into four groups： normal mice control group, normal mice HSC-mobilized group, diabetic mice control group and diabetic mice HSC mobilized group. Murine stem cell growth factor （murine SCF） and recombined human granulocyte colony stimulating factor （rhG-csf） were administered to the mice with diabetes and without diabetes for continuous 5 days to induce autologous HSCs mobilization, and subcutaneous injection of physiological saline was used as control. Immunohistochemical double staining was conducted with anti-mouse rat CD31 monoclonal antibody and anti-BrdU rat antibody.Results Marked HSCs clearly increased after SCF plus G-csf-mobilization. Non-mobilized diabetic mice showed more HSCs than normal mice （P=0.032）, and peripheral blood significantly increased in both diabetic and normal mice （P=0.000）.Diabetic mice showed more CD31 positive capillary vessels （P=0.000） and accelerated endothelial cell regeneration. Only diabetic HSC-mobilized mice expressed both BrdU and CD31 antigens in the endothelial cells of new capillaries.Conclusion Auto-mobilized adult hematopoietic stem cells advance neovasculature in diabetic retinopathy of mice.

Magnetic resonance imaging of the extraocular muscles and corresponding cranial nerves in patients with special forms of strabismus

Background With the technical advances, magnetic resonance imaging （MRI） is now sensitive enough to detect subtle structural abnormalities of ocular motor nerves arising from the brainstem and orbits of living subjects. This study was designed to delineate the MRI characteristics in patients with special forms of strabismus. Methods A total of 29 patients with special forms of strabismus underwent orbital and intracalvafium MRI. Imaging of the ocular motor nerves in the brainstem was performed in 0.8 mm thickness image planes using the three-dimensional fast imaging employing steady-state acquisition （3D-FIESTA） sequence. Nerves to extraocular muscles （EOMs）, EOMs and their associated connective tissues were imaged with T1 weighting in tri-planar scans by dual-phased coils within 2.0 mm thick planes. Results Patients with congenital fibrosis of the extraocular muscles exhibited hypoplasia of the oculomotor （CN3）, abducens （CN6）, trochlear （CN4） nerves, and the EOMs; hypoplasia of CN6 in the brainstem and an extra branch of the inferior division of CN3 to the lateral rectus were the most common but not the only presentation of Duane＇s retraction syndrome. Hypoplasia of CN6, facial （CN7） and hypoglossal （CN12） nerves were revealed in patients with MSbius syndrome. In a rare case of bilateral synergistic convergence and divergence, an enlarged branch of CN3 to the medial rectus and a questionable branch of CN3 to the inferior rectus bilaterally were found. Conclusion MRI can reveal subtle structures of the ocular motor nerves and their corresponding EOMs. This can provide valuable information regarding pathogenesis in some special forms of strabismus.

Analysis of post-operative endophthalmitis after pars plana vitrectomy： a 10-year experience at a single center

Background Endophthalmitis can be a devastating complication after pars plana vitrectomy. The incidence of post- vitrectomy endophthalmitis is significantly lower than that of endophthalmitis occurring after other intraocular operations. However, normal post-operative pain and inflammation may mask endophthalmitis and lead to delayed diagnosis and grave visual consequences. This study aimed to summarize the outcomes of cases that underwent pars plana vitrectomy over a 10-year period and to analyze the characteristics of post-vitrectomy endophthalmitis. Methods A retrospective observational case study was conducted on all the cases who underwent pars plana vitrectomy in the Beijing Tongren Hospital between January 1, 2002 and March 31, 2012. All cases of endophthalmitis that occurred during a period of 10 years and 3 months were reviewed, and the possible risk factors, clinical findings, causative organism（s）, and the sources of infection were analyzed. Results Within the 10-year observational period, 14 patients developed endophthalmitis after pars plana vitrectomy. The incidence of post-vitrectomy endophthalmitis （0.05%） was lower than that reported previously from the same center （0.12%）. Staphylococcus epidermidis （five patients, 35.71%） was the most common organism identified in aqueous or vitreous cultures. Eight patients （57.14%） had diabetes mellitus. There was no statistically significant difference （P 〉0.05） in the incidence of endophthalmitis between period 1 （with antibiotic pretreatment） and period 2 （without antibiotic pretreatment）. Surgical procedures for the treatment of endophthalmitis were performed in 10 patients （71.43%）. Conclusions This series of cases showed that the incidence of endophthalmitis after pars plana vitrectomy is lower than what was previously reported in our hospital. A variable degree of corneal edema with relatively normal or mildly increased intraocular pressure was one of the commonly observed characteristics of post-vitrectomy endophthalmitis. Staph. epidermidis was the most common causative organism, and antibiotic pretreatment did not lower the incidence of post- vitrectomy endophthalmitis.