Trends and characteristics of congenital ectopia lentis in China

AIM： To elucidate the trends and characteristics of congenital ectopia lentis（CEL） in southern China.METHODS： CEL patients from China admitted to Zhongshan Ophthalmic Center（ZOC） from January 2006 to December 2015 were recruited in our study. Residence, gender, hospitalization time, age at surgery, and the presence of other ocular abnormalities and system disease were statistically analyzed in different subgroups.RESULTS： Four hundred and thirty-seven hospitalizations（306 in-patients） diagnosed with CEL from a total of 283 308 hospitalizations were identified, which accounted for 0.15% of the total in-patients. Of the identified CEL in-patients, the total ratio of boys to girls was 2.22：1. Based on a subgroup analysis according to age, patients aged 12-18 years old constituted the highest proportion（31.70%） of all hospitalized CEL patients, and those 0-3 year old constituted the lowest proportion（8.82%） of the total number. The number of CEL increased from 18 to 72 and the hospital based prevalence increased from 8.60% to 18.10% from 2006 to 2015, and the average age at surgery decreased from 9 years old in 2006 to 7.6 years old in 2015. CONCLUSION： The results reveal upward trends in both the number of CEL hospitalizations and hospital based prevalence of CEL in this 10-year study period, but a reduction in the age at surgery, which may reflect the increase of public awareness of children＇s eye care in China.

Inhibition of VEGF-A expression in hypoxia-exposed fetal retinal microvascular endothelial cells by exosomes derived from human umbilical cord mesenchymal stem cells

Objective:This study aimed to investigate the potential of human umbilical cord mesenchymal stem cell(hucMSC)-derived exosomes(hucMSC-Exos)in inhibiting hypoxia-induced cell hyper proliferation and overexpression of vascular endothelial growth factor A(VEGF-A)in immature human fetal retinal microvascular endothelial cells(hfRMECs).Methods:Exosomes were isolated from hucMSCs using cryogenic ultracentrifugation and characterized through various techniques,including transmission electron microscopy,nanoparticle tracking analysis,bicinchoninic acid assays,and western blotting.The hfRMECs were identified using von Willebrand factor(vWF)co-staining and divided into four groups:a control group cultured under normoxic condition,a hypoxic model group,a hypoxic group treated with low-concentration hucMSC-Exos(75μg/mL)and a hypoxic group treated with high-concentration hucMSC-Exos(100μg/mL).Cell viability and proliferation were assessed using Cell Counting Kit-8(CCK-8)assay and EdU(5-ethynyl-2′-deoxyuridine)assay respectively.Expression levels of VEGF-A were evaluated using RT-PCR,western blotting and immunofluorescence.Results:Hypoxia significantly increased hfRMECs’viability and proliferation by upregulating VEGF-A levels.The administration of hucMSC-Exos effectively reversed this response,with the high-concentration group exhibiting greater efficacy compared to the lowconcentration group.Conclusion:In conclusion,hucMSC-Exos can dose-dependently inhibit hypoxia-induced hyperproliferation and VEGF-A overexpression in immature fetal retinal microvascular endothelial cells.

锶板近距放射治疗渗出性老年性黄斑变性:3年随机研究结果

Objective: To determine the efficacy of strontium plaque (Sr90) brachytherapy for age-related macular degeneration (AMD) with subfoveal choroidal neovascular ization (CNV). Design: Randomized clinical trial. Participants: Eighty-eight eyes of 86 patients with subfoveal CNV secondary to AMD were randomized either to plaque radiotherapy or to observation. Intervention: Radiotherapy was given as episcleral brachytherapy using Sr 90 plaques. Two different plaque types were used. Plaque I had a diameter of 8mm and delivered a dose of 15 Gy at a depth o f 1.75 mm in 54 minutes. With plaque II, the corresponding values were 4 mm, 12. 6 Gy, and 11 minutes. The control group was observed without any treatment. Main Outcome Measures: The primary outcome measure was visual acuity at 6, 12, 24, a nd 36 months. Other outcome variables were contrast sensitivity, fluorescein ang iographic, and clinically evaluated changes in the macula. Results: Eighty-two patients (84 eyes [95%]) completed the 1-year follow-up, and 80 (93%) and 74 (86%) patients completed the 2-and 3-year follow-ups, respectively. At 6 mo nths, visual loss of < 3 lines occurred in 20%of treated patients and 42%of co ntrol patients (P=0.031). At 12 months, a visual loss of < 3 lines occurred in 4 5%(treated) and 56%(controls) (P=0.325); at 24 months, in 73%and 71%(P=0.914 ); and at 36 months, in 80%and 84%of patients (P=0.591), respectively. Patient s irradiated with plaque I had better results: a visual loss of < 3 lines occurr ed in 6%at 6 months (P=0.008, relative to controls), in 18%at 12 months (P=0.0 07), in 59%at 24 months (P=0.348), and in 71%at 36 months (P=0.212). In patien ts treated with plaque II, the corresponding values were 29%(P=0.032), 65%(P=0 .459), 83%(P=0.317), and 80%(P=0.687) at 6, 12, 24, and 36 months, respectivel y. Conclusions: The short-term clinical course of exudativeAMD is affected by S r90 brachytherapy, but by 12 months, there was no treatment benefit.

老年性黄斑病变患者眼底自发荧光的变化及其与视功能的相关性:一项前瞻性研究

Background: As members of the Fundus Autofluorescence in Age-related Macular Degeneration Study Group (FAM Study Group), we report changes of fundus autofluo rescence (AF)-in patients with multiple soft drusen in correlation to visual fu nction. Methods: Inclusion criteria were age > 50 years, the presence of soft dr usen, visual acuity of 20/100 or better, and no previous laser treatment in the study eye. All patients underwent a detailed ophthalmological examination includ ing ETDRS visual acuity, binocular funduscopy, and color fundus photography. AF imaging was performed with a confocal scanning laser ophthalmoscope following a standard protocol. We used the classification of the International Fundus Auto- fluorescence Classification Group (IFAG) for the description of the AF patterns. Results: One hundred and twenty-five patients (81 women, 44 men) aged from 55 to 86 years (mean 70±7 years) were included in this prospective study. During f ollow-up (mean 18±6 months), 6 of 35 eyes with patchy AF pattern developed exu dative changes, as well as 2 eyes with focal-plaque-like AF pattern and 1 eye with reticular pattern at baseline. Geographic atrophy was seen in two eyes with focal AF pattern and one eye with focal-plaque-like pattern at baseline. A to tal of 11 eyes presented with severe visual loss (6 ETDRS lines). Ten (91%) o f these had patchy AF pattern. Conclusion: Imaging of fundus AF in patients with age-related maculopathy allows identification of different patterns of fundus AF. Our preliminary data suggest that a patchy pattern of AF indicates a relativ ely high risk of progression to age-related macular degenerationwith visual los s.

屈光、眼轴长度与老年性黄斑病变

Purpose: To study the relationship between age-related maculopathy (ARM)/age -related macular degeneration (AMD) and phakic refraction and between ARM/AMD a nd axial length. Methods: The study was a point prevalence study that included 6 63 randomly selected persons aged over 65 years. We measured axial length and re fraction. Fundus images were graded for ARM according to a modified Wisconsin Ag e-related Maculopathy Grading System standard. Data from both eyes were availab le from most participants. We analysed the results for both individual eyes and pairs. Results: The mean axial length was 23.22mm for right eyes and 23.21mm for left eyes. Women had a 0.57-mm shorter mean axial length than men. The mean re fraction was +1.0 dioptres (D) for right eyes and +0.9 D for left eyes. At 70 years of age women were more hypermetropic than men by 0.66 D. There was no sign ificant difference in refraction or axial length among the groups with different ARM stages. Conclusion: We found no statistically significant relationship betw een axial length/refraction and AMD/ARM. There was a statistically significant s ex difference in axial length and refraction, where women had shorter axial leng ths and were more hypermetropic than men.