Retinal microglia: Just bystander or target for therapy?

Resident microglial cells can be regarded as the immunological watchdogs of the brain and the retina. They are active sensors of their neuronal microenvironment and rapidly respond to various insults with a morphological and functional transformation into reactive phagocytes. There is strong evidence from animal models and in situ analyses of human tissue that microglial reactivity is a common hallmark of various retinal degenerative and inflammatory diseases. These include rare hereditary retinopathies such as retinitis pigmentosa and X-linked juvenile retinoschisis but also comprise more common multifactorial retinal diseases such as age-related macular degeneration, diabetic retinopathy, glaucoma, and uveitis as well as neurological disorders with ocular manifestation. In this review, we describe how microglial function is kept in balance under normal conditions by cross-talk with other retinal cells and summarize how microglia respond to different forms of retinal injury. In addition, we present the concept that microglia play a key role in local regulation of complement in the retina and specify aspects of microglial aging relevant for chronic inflammatory processes in the retina. We conclude that this resident immune cell of the retina cannot be simply regarded as bystander of disease but may instead be a potential therapeutic target to be modulated in the treatment of degenerative and inflammatory diseases of the retina.     

可疑青光眼患者视野指数与眼底血管变化的关系

目的探讨可疑青光眼者眼底血氧饱和度的基本特征及其与视野指数的关系。方法采用横断面研究设计,对可疑青光眼者及正常对照者应用视网膜血氧饱和度测量仪测量眼底血氧饱和度,同时进行中心30°阈值视野检测;统计分析平均视网膜光敏感度（ MS）、平均视野缺损度（MD）及丢失方差（LV）三个视野指数,以及视网膜血氧饱和度,并进行相关分析。结果可疑青光眼者与正常者MD存在统计学差异（P ＜0．05）;可疑青光眼者平均视网膜动脉血氧饱和度及视网膜鼻下支动脉血氧饱和度与正常者比较存在统计学差异（P ＜0．05）;可疑青光眼者视野检测的MD与NIA存在相关性,（r ＝0．368,P ＝0．045）。结论可疑青光眼者眼底血管可能发生了相应的变化,视网膜血氧饱和度状况与视野指数间存在一定联系。     

激光治疗闭角型青光眼日间病房管理模式的探讨

日间病房是一种以病人为中心,介于门诊与住院之间的诊疗模式,是对传统医疗模式的补充,具有提高床位周转率、缩短住院天数、降低费用、缓解医患矛盾等优点,其发展具有广阔前景。首都医科大学宣武医院眼科为适应医疗服务发展需要,开设了激光治疗青光眼日间病房,为医院取得了良好的社会效益和经济效益。     

干预护理在老年白内障合并青光眼患者手术中的应用效果

目的：探讨干预护理在老年白内障合并青光眼患者手术中的应用效果。方法选取2013年1月~2014年1月本院眼科收治的100例白内障合并青光眼患者作为研究对象,随机分为对照组和观察组。对照组采用常规护理,观察组采用干预护理方法进行护理,比较两组的术后焦虑、抑郁、疼痛评分,并发症发生率及护理满意度。结果观察组的焦虑、抑郁、疼痛评分及术后并发症发生率显著低于对照组,差异有统计学意义(P<0.05)。观察组的护理满意度显著高于对照组,差异有统计学意义(P<0.05)。结论干预护理在老年白内障合并青光眼患者手术中的应用效果显著,可减少患者的不良情绪,降低术后并发症发生率,提高护理满意度,值得临床推广应用。     

Neuroprotective Effect of Compound Anisodine in a Mouse Model with Chronic Ocular Hypertension

Background:

Compound anisodine (CA) is a compound preparation made from hydrobromide anisodine and procaine hydrochloride. The former is an M-choline receptor blocker with the function of regulating the vegetative nervous system, improving microcirculation, and so on. The latter is an antioxidant with the activities of neuroprotection. This study aimed to investigate the potential neuroprotection of CA, which affects the degeneration of the retinal ganglion cells (RGCs) in an animal model with chronic ocular hypertension.

Methods:

Female C57BL/6J mice (n = 24) were divided randomly into four groups: Normal control group without any treatment (Group A, n = 6); CA control group with feeding the CA solution (Group B, n = 6); microbeads (MBs) control group with injecting MB into the anterior chamber (Group C, n = 6); CA study group with MB injection and with feeding the CA solution (Group D, n = 6). Intraocular pressure (IOP) was measured every 3 days after MB injection. At the 21^st day, neurons were retrograde-labeled by Fluoro-Gold (FG). Animals were sacrificed on the 27^th day. Retinal flat mounts were stained immunohistologically by β-III-tubulin. FG-retrograde-labeled RGCs, β-III-tubulin-positive RGCs, and β-III-tubulin-positive nerve fibers were quantified.

Results:

Mice of Groups C and D expressed the incidence of consistent IOP elevation, which is above the IOP level of Group A with the normal one. There is no significant difference in IOP between Groups A and B (P > 0.05). On the 27^th day, there were distinct loss in stained RGCs and nerve fibers from Groups C and D compared with Group A (all P < 0.001). The quantity was significantly higher in Group D as compared to Group C (all P < 0.001) but lower than Group A (all P < 0.001). There was no significant difference in the quantity of RGCs and nerve fibers between Groups A and B (all P > 0.05).

Conclusions:

These findings suggest that CA plays an importantly neuroprotective role on RGCs in a mouse model with chronic ocular hypertension.     

Eye Tumors Misdiagnosed as Glaucoma

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青光眼暗室激发试验与患者虹膜的相关因素分析

目的探讨和分析青光眼暗室激发试验阳性与患者虹膜的相关性。方法根据排除标准选取2013年2月至2013年8月在福田人民医院就诊的156例单眼患者,暗室激发试验阳性患者96例作为阳性组,60例暗室激发试验阴性患者为阴性组。比较两组的试验结果。结果两组试验前的眼压、虹膜的膨隆度及虹膜的厚度比较差异未见统计学意义(P0.05)。两组患者试验前的眼压、周边虹膜厚度的变化值比较差异均有统计学意义(P0.05)。同时分析所有患者眼压、虹膜的膨隆度及虹膜的厚度的相关性。结论虹膜参数与青光眼暗室激发试验结果相关。其中,虹膜的厚度与眼压压升高幅度呈正相关,虹膜的膨隆度与眼压升高幅度呈负相关。     

青光眼视神经保护治疗的研究进展

青光眼是以特征性视神经损伤和视功能损害为特点的一类疾病,病理性高眼压是主要危险因素。在青光眼治疗方面,既要降低眼压,又要保护视神经。视神经损伤的机制是神经节细胞的凋亡,能阻止或延缓神经节细胞凋亡的方法称为青光眼的视神经保护治疗。青光眼视神经保护治疗是目前研究的热点,主要包括抗青光眼药物、热激蛋白、神经干细胞、神经营养因子及基因治疗和中医药等研究。     

40例青光眼白内障联合手术治疗的临床探讨

目的：探讨巩膜瓣下隧道式小切口白内障囊外摘除、人工晶体植入、联合小梁切除术(以下简称联合手术)治疗青光眼合并白内障的临床疗效。方法选取该院40例青光眼合并白内障患者,随机分队对照组和观察组,每组20例。对照组采取常规手术治疗,观察组采取联合手术治疗。观察患者视力、眼压及前房角变化情况。结果观察组患者术后视力(0.5±0.3),眼压(17.2±5.0)及前房角(3.8±1.3);对照组患者术后视力(0.08±0.04),眼压(38.5±12.0),前房角(1.9±0.9);组间数据对比差异有统计学意义(P<0.05)。结论采用小切口非超声乳化青光眼白内障联合手术治疗青光眼白内障患者,术后患者视力显著提高,眼压和前房角明显改善,是治疗青光眼合并白内障的有效方法。