兔眼超声乳化吸出术后非手术眼房水及血清中TNF-α、IL-1β表达变化与该眼角膜知觉敏感度变化之间的关系

目的　探讨超声乳化吸出术后不同时间点兔非手术眼房水及血清中肿瘤坏死因子α（TNF-α）和白细胞介素-1β（IL-1β）表达变化与该眼角膜知觉敏感度变化之间的关系。方法　选取健康成年新西兰大白兔40只作为实验对象。采用随机数字表法将大白兔分为实验组与空白对照组,实验组25只,空白对照组15只。实验组:一眼行晶状体超声乳化吸出术,根据术后取材时间分为术后1 d、3 d、7 d、14 d、21 d共5组,每组5只动物。空白对照组:按照对应取材时间也分为5组,每组3只动物。术后观察并记录各组兔双眼的结膜充血、角膜混浊及前房炎症反应情况。实时定量PCR检测各组兔血清TNF-α mRNA和IL-1β mRNA表达水平,ELISA法检测房水中TNF-α、IL-1β蛋白浓度,角膜知觉计测量角膜知觉敏感度。结果　实验组非手术眼与空白对照组双眼在不同时间点,结膜充血、角膜混浊及前房炎症反应级别均为0级。术后1 d、3 d、7 d、14 d,实验组兔血清TNF-α mRNA和IL-1β mRNA表达水平均较基线值升高,术后7 d达高峰（TNF-α mRNA相对表达量为14.95±0.89,IL-1β mRNA相对表达量为7.56±>0.46）,之后逐渐下降,术后21 d降至术前水平。实验组各相邻取材时间点两两比较,血清TNF-α mRNA和IL-1β mRNA表达水平差异均有统计学意义(均为P<0.05)。术后1 d、3 d、7 d、14 d,非手术眼房水TNF-α和IL-1β蛋白浓度均较基线值升高,其中峰值出现于术后7 d［TNF-α蛋白浓度为（162.34±5.71） ng·L^-1,IL-1β蛋白浓度为（16.68±0.74）ng·L^-1］,之后逐渐下降,术后21 d降至术前水平。实验组相邻取材时间点两两比较,非手术眼房水TNF-α和IL-1β蛋白浓度差异均有统计学意义(均为P<0.05)。术后1 d、3 d、7 d、14 d,非手术眼角膜知觉敏感度较基线值升高,于术后7 d角膜知觉敏感度最高;之后角膜知觉敏感度逐渐下降,术后21 d基本恢复至基线水平。实验组非手术眼相邻时间点两两比较,角膜知觉敏感度差异均有统计学意义（均为P<0.05）。结论　实验兔第一眼晶状体超声乳化吸出术后早期,非手术眼角膜知觉敏感度升高,该变化可能与该眼房水及血清中TNF-α和IL-1β表达的动态变化相关。     

微视野生物反馈训练在黄斑疾病低视力康复中的研究进展

临床工作中,很多黄斑疾病如年龄相关性黄斑变性(ARMD)、Stargardt病在晚期因新生血管纤维瘢痕化或光感受器、视网膜色素上皮细胞受损形成中心暗点,从而出现视力下降、固视不稳定甚至旁中心注视,给患者的生活工作及心理带来很大困扰。长期以来,我们对该类患者的康复治疗手段有限,但近年来有不少文献指出,基于微视野计的生物反馈训练有望通过实现大脑皮层可塑性增强神经感觉适应能力,较大程度的利用残余视网膜功能来帮助那些伴中心暗点的低视力人群巩固或建立稳定的中心或旁中心注视,进而提高视力、阅读速度等视功能。为增进对该康复治疗手段的认识,本文将主要从微视野生物反馈训练(microperimetric biofeedback training,MBFT)机制及方案、优选视网膜位点的选择、在黄斑疾病中的临床应用及前景展开概述。     

单分子成像显示视网膜血管内皮细胞膜上血管内皮生长因子受体2聚集状态

目的:观察单个视网膜血管内皮细胞膜上血管内皮生长因子受体2 （VEGFR2）的聚集状态。方法:将猴视网膜血管内皮细胞（RF/6A）分为空白对照组（正常培养）、质粒转染组[转染VEGFR2-绿色荧光蛋白（GFP）重组质粒]。采用共聚焦显微镜观察质粒转染组GFP的表达;实时荧光定量聚合酶链反应（qPCR）、蛋白免疫印迹法（...     

视觉健康管理背景下眼视光教育的探索与实践

世界卫生组织及我国"健康中国"战略都将视觉健康管理提升到前所未有的高度,多方位、全周期保障民众视觉健康,增强人们视觉保健的意识是我国实现健康中国的战略重点.而人才培养是行业发展的命脉与基石,因此眼视光人才教育的探索与建设又是重中之重.本文以天津医科大学眼视光专业为例,就当今社会视觉健康管理的背景下,如何切实有效地开展眼...     

Blood IgMs from healthy donors and patients with systemic lupus erythematosus reduce the inflammatory properties of platelets from healthy donors

Uncontrolled inflammation is the underlining mechanism of many human diseases and the increasing prevalence of such diseases mandate to develop new anti-inflammatory treatments. Utilizing the anti-inflammatory properties as well as other protective/beneficial features of natural IgMs (nIgMs) for treatment of human disorders seems as an easily accessible goal by the use of blood-purified IgMs as an alternative for polyclonal nIgMs. Despite the other blood cells, the functions of platelets have not been inspected under the influence of blood IgMs adequately. However, platelets, the second most numerous blood cells, are involved in the pathology of many inflammatory disorders through the production/expression of many inflammatory molecules.Thus, in the present study, we purified IgMs from serum of healthy donors and plasma of patients with systemic lupus erythematosus (SLE). Subsequently, we carried out comparative analysis of the inflammatory functions of normal platelets (P-selectin expression, GPIIb/IIIa activation, and secretion of soluble CD40L and TNF-α) that were stimulated by SLE microparticles (as key endogenous inflammation-drivers) in the presence or absence of the two IgM preparations; one with normal level of nIgMs (healthy blood IgMs) and the other with likely altered nIgM content (SLE blood IgMs). Both blood IgM preparations could suppress the elevated activation parameters of platelets in response to SLE microparticles. Additionally, the impact of SLE blood IgMs on the platelets was not superior to that of normal blood IgMs.The anti-inflammatory effects of blood IgMs on the activated platelets have been shown for the first time in the present study. Thus, this study provides evidence in favor of use of healthy blood IgMs as an anti-inflammatory therapy in clinical settings.     

Abatement of cyclophosphamide-induced splenic immunosuppressive indoleamine 2, 3-dioxygenase and altered hematological indices in Wister rats by dietary quercetin

The immunotoxicity mediated by cyclophosphamide (CYP) was earlier reported. Quercetin, due to its anti-oxidative/inflammatory properties elicits a plethora of health benefits. However, the influence of quercetin on the splenic/immunotoxicity linked with CYP-induced indoleamine 2,3-dioxygenase (IDO) is unavailable in the literature. We investigated the effects of quercetin on the splenic immunosuppressive IDO and hematological indices of immune response in rats. Animals were treated with CYP (100 mg/kg) alone or co-treated (CYP + quercetin [100 mg/kg + 50 mg/kg respectively]) at days 1, 3, 5, and 7. Results revealed that CYP treatment alone significantly provoked an oxidative-inflammatory response, increased serum kynurenine concentration, and concomitantly increased immunosuppressive IDO and tryptophan 2, 3-dioxygenase (TDO), in the spleen as well as altering hematological indices. Quercetin co-treatment enhanced activities of antioxidant enzymes, inhibited myeloperoxidase (MPO) activity, lowered levels of nitric oxide, interferon-Υ (IFN-Υ), and interleukin-6 (IL-6), and reduced kynurenine concentration as well as IDO/TDO activities. Quercetin co-treatment augmented white blood cell (WBC), CD4-T cells, and other hematological indices of the immune response. In conclusion, quercetin prevented CYP-induced alterations in immune response in rats by lowering the activities of immunosuppressive IDO and TDO, inhibiting oxidative-inflammatory stress, diminution of kynurenine concentrations, and augmenting hematological parameters.     

神经血管单元在视网膜生理及病理过程中的作用研究进展

神经血管单元(NVU)是各神经细胞和血管的功能复合体,在维持视网膜环境稳态、满足视网膜代谢需求等方面发挥重要作用.生理状态下,视网膜NVU主要有两个方面的作用:(1)维持血视网膜屏障,从而维持视网膜内环境的稳态;(2)调节局部血流量,从而满足视网膜代谢和功能的需要.视网膜疾病的病理变化体现在NVU的各个功能环节,包括细...     

Postoperative severe visual impairment: surgical outcome of 165 patients with orbital tumours in the muscle cone

ObjectiveThis study aimed to evaluate the risk factors of postoperative severe vision impairment (PSVI) for a primary orbital tumour in the muscle cone.MethodsA retrospective analysis of the patients who underwent orbitotomy for primary intraconal tumours at the Tianjin Medical University Eye Hospital from January 2010 to December 2015.ResultsA total of 165 cases of orbitotomy for primary orbital tumours in the muscle cone were included in the study. Postoperatively, 12 cases with vision acuity ≤20/400 or ≥4 rows of vision decline and without any corrected effect were analysed as PSVI, including no light perception (NLP) for 3 cases. The multivariate logistic regression indicated that the tumour in orbital apex (P = 0.048, OR = 4.912, 95% CI: 1.011–23.866), severe optic nerve displacement (P = 0.030, OR = 6.007, 95% CI: 1.184–30.473) and intraoperative tight adhesion (P = 0.003, OR = 12.031, 95% CI: 2.282–63.441) were the independent risk factors for PSVI.ConclusionsThe incidence of PSVI for the intraconal tumour was 7.3%, and the incidence of NLP was 1.8%. The tumour in orbital apex, severe optic nerve displacement and intraoperative tight adhesion were independent risk factors for PSVI.Subject terms: Risk factors, Vision disorders, Surgery     

Ultrasound elastography for evaluating stiffness of the human lens nucleus with aging: a feasibility study

AIM:To investigate the significance of ultrasound elastography for evaluating stiffness of the human lens nucleus in volunteers with different ages.METHODS:A total of 90 volunteers(lens transparency,uncorrected visual acuity≥0.5,intraocular pressure:14-19 mm Hg)were divided into 3 groups according to age:Group A(30 people,median age:82±3.5 y,mean axial lengths 23.7±0.5 mm);Group B(30 people,median age:46±2.1 y,mean axial lengths 23.9±0.4 mm);and Group C(30 people,median age:22±3.5 y,mean axial lengths 24.0±0.4 mm).Lens nuclear stiffness was measured by Free-hand qualitative elastography by independent operators.Strain gray scale and color-coded elastography maps were recorded.In each case,three consecutive detections were performed and strain ratio was used for statistical analysis.RESULTS:Elastography analysis showed excellent diagnostic performance for lens sclerosis.Lens strain ratio was lowest(0.03±0.01)%in Group A and highest(2.03±0.43)%in Group C.Lens strain ratio was moderate(0.64±0.10)%in Group B.There were significant differences between these three groups(P<0.05).The lens nucleus strain rate changes with age.With aging,the lens nucleus strain rate and resilience decrease,demonstrating harder texture.CONCLUSION:The relationship between human lens stiffness and age is demonstrated by ultrasound elastography.Older age is associated with lower strain ratio and less resilience of the lens.     

Protective effects of upregulated HO-1 gene against the apoptosis of human retinal pigment epithelial cells in vitro

AIM: To assess the correlation between disorganization of the retinal inner layers (DRIL) and best-corrected visual acuity (BCVA) in patients with uveitis and macular edema (UME) who underwent systemic treatment using optical coherence tomography (OCT). METHODS: A retrospective clinical study of 23 patients (30 eyes) with DRIL and 23 patients (31 eyes) without DRIL secondary to UME were included. All patients underwent comprehensive ophthalmic examinations at baseline, 3, 6, and 12mo after local and systemic treatment. The OCT-based parameters included: foveal center point thickness (FCPT), mean thickness (MT), and diameters of DRIL in horizontal and vertical directions. BCVA and OCT-based parameters were compared between the two groups. The relationship between each OCT parameter and BCVA was evaluated using linear correlation and regression analysis. RESULTS: At the initial visit, the mean baseline FCPT was 441.03±128.68 μm in the eyes with DRIL and 337.26±99.31 μm in the eyes without DRIL (P=0.001). No significant differences were observed in MT (P=0.357). The mean size of transverse and vertical diameters of DRIL was 684.07±267.51 μm, and 267.07±104.61 μm at baseline, respectively. There was significant improvement in BCVA and OCT-based parameters at baseline, 3, 6, and 12mo in all cases (P<0.001 for each timepoint). In addition, significant differences were detected in BCVA and OCT parameters between eyes with and without DRIL at each time point (P<0.01 for each timepoint). A greater DRIL range at baseline was associated with a worse baseline BCVA (transverse diameter of DRIL: r=0.875, P<0.001; vertical diameter of DRIL: r=0.622, P<0.001). The transverse diameter of baseline DRIL was found to be significantly correlated with the final BCVA (P=0.003). CONCLUSION: The improvement in BCVA is associated with DRIL in patients with UME. DRIL is an easy-to-determine and robust imaging biomarker that could help predict BCVA prognosis in eyes with UME.