Comparison of focal macular cone ERGs in complete-type congenital stationary night blindness and APB-treated monkeys

Focal macular cone electroretinograms (ERGs) and multifocal ERGs were recorded to study the macular function in patients with the complete-type of congenital stationary night blindness (cCSNB). The waveforms of the focal macular cone ERGs and the on- and off-responses of the multifocal ERGs in the cCSNB patients were similar to those recorded from monkey retinas treated with L-2 amino-4-phosphonobutyric acid (APB), suggesting that patients with cCSNB have a complete defect of the on-pathway even in the central retina. The results also demonstrated that there was a paradoxical positive response in the central retina of cCSNB patients, as compared to the negative full-field ERGs in the same subjects.     

Asymmetry of focal macular photopic negative responses (PhNRs) in monkeys

The photopic negative response (PhNR) is a slow, negative-going wave of the photopic electroretinogram (ERG) that appears after the b-wave. Recent studies have shown that the PhNR originates from the spiking activities of inner retinal neurons including the ganglion cells and their axons. The aim of this study was to determine whether there is any asymmetry in the amplitude of the PhNR elicited from the upper and lower macular areas, and between the nasal and temporal macular areas in rhesus monkeys. To accomplish this, we recorded focal macular PhNRs that were elicited by red hemi-circular stimuli presented on a blue background. We show that the PhNR from the upper macular area was significantly larger than that of the lower macular area, and the PhNR of the nasal macula was significantly larger than that of the temporal macula. These asymmetries were present in the focal PhNR elicited by both brief and long duration stimuli, and the asymmetries were completely eliminated by an intravitreal injection of tetrodotoxin (TTX). These results suggest that the upper-lower and nasal-temporal asymmetries of PhNR in the primate retina are mainly caused by TTX-sensitive spiking activities of inner retinal neurons.     

脂肪干细胞体外诱导获得RPE样细胞及其治疗AMD相关研究进展

年龄相关性黄斑变性（age-related macular degeneration,AMD）是一种随年龄增长而发病率逐渐升高的黄斑部疾病.主要由视网膜色素上皮（retinal pigment epithelium,RPE）和视网膜退行性变引起的不可逆性中心视力下降.人类脂肪干细胞（adipose-derived stem cells,ADSC）具有多向分化潜能.近年研究发现,ADSC联合视网膜细胞诱导因子可体外诱导ADSC向RPE细胞分化,并表达RPE细胞的标志.相关动物模型显示,由ADSC分化而来的RPE样细胞移植后可参与视网膜重建及修复.ADSC移植为AMD的治疗提供了新思路.     

Effect of OCT volume scan density on thickness measurements in diabetic macular edema

Purpose

To evaluate the impact of reducing B-scan frame-sampling density on retinal thickness measurements using spectral domain optical coherence tomography (SD-OCT) in eyes with diabetic macular edema (DME).

Methods

We retrospectively collected OCT data for 64 eyes of 43 patients undergoing imaging for DME using the Cirrus HD-OCT 512 × 128 macular cube protocol. For each case, raw OCT data were imported into the 3D-OCTOR software, and retinal thickness maps were generated using all 128 B-scans and for lower densities of B-scans ranging from every other scan to only four scans (every 30-s B-scan). Maps were generated before and after manual correction of retinal boundary segmentation errors. The foveal central subfield (FCS) and total macular volume (TMV) values were used to compare thickness maps of varying densities.

Results

The mean difference in FCS retinal thickness and TMV increased as the B-scan density was reduced, particularly when the density was reduced to fewer than 16 B-scans over 6 mm. At a density of 16 B-scans, the mean absolute difference in FCS thickness was 2.43 μm (0.79%), with a maximum of 10.1 μm (4.09%). At this density, the mean difference in TMV was 0.012 mm³ (0.13%), with a maximum difference of 0.04 mm³ (0.47%). Manual correction of OCT segmentation errors resulted in a difference in FCS thickness of ≥10 μm in only 12.5% of cases, with a maximum difference of 115.7 μm.

Conclusion

A minimum of 16 equally spaced B-scans appear necessary to generate retinal thickness measurements similar to those produced using all 128 B-scans in eyes with DME. Manual correction of segmentation errors appeared to have a clinically meaningful effect in a small minority of cases. These results may have implications for the design of SD-OCT imaging and grading protocols in clinical trials of DME, particularly when using multiple SD-OCT instruments that acquire varying numbers of B-scans.     

Effect of viagra on retinal vein diameter in AMD patients

The aim of the present study was to investigate the effect of sildenafil citrate (viagra) on retinal venous diameter in patients with age-related macular degeneration (AMD). We investigated 14 male patients in a double-masked, randomized, placebo-controlled, crossover study. In each subject, one eye with typical non-exudative AMD fundus features was studied. Each of the subjects received 100 mg dose of sildenafil or matching placebo on two separate study visits. Monochromatic fundus photographs were obtained in the study eye before dosing and then 30, 90, 180 and 300 min later. Measurements of the diameter of the major retinal veins from digitized negatives were carried out using "Vessel map" static vessel analysis program (IMEDOS GmbH, Weimar, Germany). Statistical analysis of the data comparing the effect of sildenafil and placebo on venous diameters was performed using analysis of variance (ANOVA) for repeated measures. An analysis of variance (ANOVA) comparing the effects of sildenafil citrate and placebo on retinal vein diameters showed a significant interaction between time and treatment (P = 0.03). In comparison to placebo, sildenafil citrate produced a statistically significant vasodilatation of major retinal veins of 4.7% at 90 min (P = 0.004), 5.5% at 180 min (P < 0.0001) and 5.8% at 300 min (P < 0.0001). At 30 min there was a 2.2% difference, which was not statistically significant (P=0.14). Our results suggest that in patients with age-related macular degeneration, sildenafil citrate (viagra) produces a statistically significant vasodilatation of major retinal veins that is similar to what has been reported in normal subjects. Whether this vasodilatation is associated with changes in retinal blood flow needs to be further investigated.     

康柏西普对RVO继发黄斑水肿患者黄斑区视网膜血管密度的影响

目的：评价视网膜静脉阻塞(RVO)继发黄斑水肿抗血管内皮生长因子(VEGF)治疗前后黄斑区视网膜血管密度的变化。

方法：回顾性病例对照研究。选取2018-04/06临床确诊为RVO继发黄斑水肿患者23例,给予玻璃体腔注射0.5mg/0.05mL康柏西普。对比治疗前后BCVA以及行OCTA检查,软件自动识别及测量治疗前后CMT和浅层视网膜毛细血管网血管长度密度和灌注密度的变化。

结果：随访时间为1mo,治疗后BCVA较治疗前提高(P<0.05),CMT较治疗前降低(P<0.05),治疗后浅层视网膜毛细血管网中位于中心凹、旁中心凹及总区域的血管长度密度和灌注密度与治疗前均无差异(P>0.05)。

结论：单次抗VEGF治疗RVO继发黄斑水肿在短期内BCVA和CMT明显好转,并且未加重黄斑缺血。     

Surgical outcome of full-thickness macular hole secondary to tractional retinal detachment in proliferative diabetic retinopathy

Purpose:To evaluate the surgical outcome of full-thickness macular hole (FTMH) secondary to active fibrovascular proliferation (FVP) and tractional retinal detachment (TRD) in eyes with proliferative diabetic retinopathy (PDR), and factors influencing the outcome.Methods:This retrospective study included the patients who underwent vitrectomy for FTMH secondary to PDR TRD from 2016 to 2020. Anatomical and visual outcomes were analyzed after six months along with the factors predicting the final outcome and duration of subretinal fluid (SRF) resolution.Results:Group A (macula-off combined RD, i.e., tractional and rhegmatogenous) included 10 eyes, while group B (macula-threatening TRD) included eight eyes. The mean best-corrected visual acuity improved from logMAR 1.21 (Snellen equivalent: 20/324) to logMAR 0.76 (Snellen equivalent: 20/115) (P = 0.008). Seventeen patients gained ≥1 line(s) of vision. Mean visual gain in groups A and B was 3.7 ± 1.9 and 1.9 ± 1.1 lines, respectively (P = 0.051). MH closed in 88.9% eyes. Type 1 anatomical closure was achieved in 88.9% of eyes. At 6 months, SRF and central macular thickness reduced from 479.6 ± 512.5 μm to 11.4 ± 23.5 μm (P = 0.002) and 874.3 ± 422.6 μm to 207.6 ± 81.7 μm (P = 0.0002), respectively. Finally, macular SRF resolved in all the patients. The mean duration for complete SRF resolution was 4.9 ± 3.2 months. Eyes with a shorter duration of diabetes mellitus (rho = −0.49, P = 0.040) and macula-off combined RD (P = 0.048) took a longer time for complete SRF resolution.Conclusion:Good anatomical and visual outcomes can be achieved in eyes with PDR TRD-associated FTMH. The residual macular SRF resolves slowly after the surgery and extra intervention is not required. Macula-off combined RD is associated with worse outcome and a slower SRF resolution rate.     

玻璃体黄斑粘连对视网膜分支静脉阻塞继发黄斑水肿行康柏西普治疗效果的影响

目的：观察玻璃体黄斑粘连对视网膜分支静脉阻塞(BRVO)继发黄斑水肿(ME)行康柏西普治疗效果的影响。

方法：回顾性病例研究。将2014-04/2016-05就诊于我院眼科门诊符合入选标准的BRVO继发ME患者58例60眼纳入本研究。通过光学相干断层扫描图像(SD-OCT)检查将是否合并有玻璃体黄斑粘连分为两组,合并玻璃体黄斑粘连组(A组)和不合并玻璃体黄斑粘连组(B组)。A组 23例24眼,平均年龄55.91±7.34岁,平均发病时间3.4±1.01mo。黄斑中心凹视网膜厚度(CMT)为463.26±53.73μm,平均最佳矫正视力(LogMAR)为0.63±0.11。B组 35例36眼,平均年龄56.33±5.34岁,平均发病时间2.82±1.33mo。CMT为482.90±37.43μm,BCVA为0.59±0.12。 两组患者均给予玻璃体腔内注射康柏西普0.5mg。根据BCVA及OCT检查结果按需进行同样剂量重复治疗,随诊6mo。记录两组患者治疗前及治疗后1、6mo BCVA、CMT、重复注射次数等。

结果： 合并玻璃体黄斑粘连组平均注射次数4.38±0.97次,未合并玻璃体黄斑粘连组平均注射次数3.56±0.71次,两组患者平均注射次数比较,差异有统计学意义(t=4.56,P<0.05)。治疗后1、6mo,两组患者的BCVA、CMT与治疗前相比,差异均有统计学意义(P<0.05)。两组组间比较,治疗后1、6mo时BCVA差异无统计学意义(t=2.13、5.32,P>0.05),但CMT比较差异有统计学意义(t=9.13、10.01,P<0.05)。所有患者随访期间均未出现高眼压、眼内炎、玻璃体积血、视网膜脱离及心血管疾病等眼部并发症和全身不良反应。

结论：玻璃体腔内注射康柏西普治疗BRVO继发的ME具有良好的临床效果,但是如果同时合并有玻璃体黄斑粘连,则在一定程度上会减弱抗VEGF的治疗效果。     

洛伐他汀与早期年龄相关性黄斑变性患者眼血流关系的临床研究

目的:探讨洛伐他汀对早期年龄相关性黄斑变性患者视网膜中央动脉和睫状后动脉血流动力学的影响。方法:收集临床确诊的未经治疗的早期年龄相关性黄斑变性(age-related macular degeneration,AMD)患者50例96眼,干性AMD50眼,湿性AMD46眼,随机分为两组。双盲法让患者口服洛伐他汀或安慰剂前后,用彩色多普勒超声检测视网膜中央动脉(central retinal artery,CRA)及睫状后动脉(pogterior ciliary artery,PCA)的血流动力学数据,并对其频谱血流资料进行分析。结果:治疗组口服洛伐他汀3mo后收缩期峰值血流速度升高,与用药前比较差异有显著性,舒张末期最低血流速度升高,阻力指数和搏动指数降低,与对照组比较均有显著性差异(P<0.05),湿性AMD各血流参数变化更为显著(P<0.01)。结论:洛伐他汀可能通过抑制一些炎症介质的释放和减少氧自由基的损伤来影响脉络膜及视网膜血流,从而参与新生血管的抑制。     

Ganglion cells apoptosis in diabetic rats as early prediction of glaucoma: a study of Brn3b gene expression and association with change of quantity of NO, Caspase-3, NF-κB, and TNF-α

AIM: To find a new concept to show whether or not apoptosis of retinal ganglion cells (RGCs) can be determined in the histology of acute hyperglycemia in the role of expressed Brn3b gene related to nitric oxide (NO), caspase-3, nuclear factor kappa-B (NF-κB), and tumor necrosis factor-α (TNF-α) as an early predictor of primary open angle glaucoma (POAG) eyes and their associations. METHODS: Experimental in vivo study was carried out using adult male, white Sprague-Dawley rats aged ≥2mo, weighing 150-200 g. The animals were divided into two groups, one group receiving intraperitoneal injection of STZ 50 mg/kg in 0.01 mol/L citric buffer and pH 4,5 and a comparison made with the control group. Retinal tissue was divided into two parts (both experimental and control groups respectively): a) right retina for IHC (caspase-3 and TNF-α); b) left retina was divided into two parts for the purpose of real-time PCR test (RNA extraction for Brn3b gene expression analysis) and ELISA test (NO and NF-κB). RESULTS: The experimental group showed a decrease in Brn3b gene expression compared to the control group (1,3-fold lower in 2nd month; 1,1-fold lower in 4th month and 2,5-fold lower in 6th month). However, there was a decrease of NO, caspase-3, and an increase of NF-κB and TNF-α quantity. CONCLUSION: The expression of mRNA Brn3b gene is inversely proportional to apoptosis in RGCs. The quantity of NO, caspase-3, NF-κB and TNF-α is influential in expression of Brn3b in RGCs caused by hyperglycemia in diabetic rats.     

Correlation between spatial frequency and orientation selectivity in V1 cortex: Implications of a network model

We addressed how spatial frequency and orientation selectivity coexist and co-vary in Macaque primary visual cortex (V1) by simulating cortical layer 4Cα of V1 with a large-scale network model and then comparing the model’s behavior with a population of cells we recorded in layer 4Cα. We compared the distributions of orientation and spatial frequency selectivity, as well as the correlation between the two, in the model with what we observed in the 4Cα population. We found that (1) in the model, both spatial frequency and orientation selectivity of neuronal firing are greater and more diverse than the LGN inputs to model neurons; (2) orientation and spatial frequency selectivity co-vary in the model in a way very similar to what we observed in layer 4Cα neurons; (3) in the model, orientation and spatial frequency selectivity co-vary because of intra-cortical inhibition. The results suggest that cortical inhibition provides a common mechanism for selectivity in multiple dimensions.     

雷珠单抗对视网膜分支静脉阻塞继发黄斑水肿患者视网膜血流密度的影响

目的 探讨雷珠单抗对视网膜分支静脉阻塞(BRVO)继发黄斑水肿患者视网膜深层和浅层血流密度的影响.方法 选取2019年7月至2020年7月洛阳市第三人民医院眼科收治的BRVO继发黄斑水肿患者62例(62眼)作为病例组,同期以年龄、性别等为匹配条件选取健康者36人(36眼)作为对照组.采用OCTA扫描模式对两组受试者黄斑...     

雷珠单抗治疗视网膜静脉阻塞合并黄斑水肿的疗效及影响视力恢复的因素分析

目的:观察玻璃体腔注射雷珠单抗治疗视网膜静脉阻塞合并黄斑水肿(RVO-ME)的效果,分析影响患者视力恢复的因素。方法:回顾性研究。选取2018-01/2019-06在我院眼科门诊接受治疗的RVO-ME患者106例106眼进行研究。所有患者均给予0.05mL雷珠单抗玻璃体腔注射患眼治疗,观察治疗效果。根据治疗3mo后患者的视力恢复程度将其分为良好组和不良组,应用二分类Logistic回归分析筛选影响患者视力恢复的因素。结果:治疗后1d, 1wk, 1、3mo时的患眼BCVA(LogMAR)较治疗前均明显改善,黄斑中心凹视网膜厚度(CRT)较治疗前均明显减小(均P<0.05),治疗前后患眼平均眼压比较无差异(P>0.05)。所有患者均未发生眼内炎、眼压升高、晶状体混浊、视网膜脱落等并发症。Logisitic回归分析显示,治疗前黄斑中心凹区毛细血管无灌注、黄斑中心凹区外界膜不完整、内丛状层结构不完整是影响视力恢复的因素。结论:玻璃体腔注射雷珠单抗治疗RVO-ME能有效减轻患眼ME,改善视力,治疗后眼压正常,而且具有操作方便、可重复进行、对组织损伤小、无明显不良反应。治疗前黄斑中心...     

抗VEGF治疗对不同类型DME患者黄斑中心凹无血管区的影响

目的 基于糖尿病性黄斑水肿(DME)的不同影像类型,采用OCTA探讨DME患者抗血管内皮生长因子(VEGF)治疗前后黄斑中心凹无血管区(FAZ)结构的变化。方法 回顾性分析2019年10月至2021年10月来我院就诊的经3+PRN抗VEGF治疗的51例62眼DME患者资料。根据黄斑水肿类型分为弥漫增厚型DME(DRT-DME)组30例(36眼)和黄斑囊样水肿型DME(CME-DME)组21例(26眼)。分别收集两组患者抗VEGF治疗前、治疗后3个月及治疗后6个月的临床资料和OCTA指标,包括最佳矫正视力(BCVA)、黄斑中心凹视网膜厚度(CRT)、FAZ面积、黄斑中心凹旁300μm范围内的视网膜血流密度(FD)和FAZ非圆度指数(AI),并对其进行比较分析。对CME-DME组患者抗VEGF治疗前后OCTA指标差值(治疗前与治疗后6个月差值)之间的相关性采用Spearman相关性分析。结果 与治疗前相比,DRT-DME组患者治疗后3个月和治疗后6个月各方位的CRT均下降、BCVA均改善(均为P<0.05),但FAZ面积、FD和AI的差异均无统计学意义(均为P>0.05)。与治...     

玻璃体内注射辅酶Q10对NaIO3诱导的AMD模型小鼠的保护作用

目的　探讨玻璃体内注射水溶性CoQ10对NaIO₃诱导的年龄相关性黄斑变性（age-related macular degeneration,AMD）的保护作用。方法　66只昆明小鼠分为3组:对照组、NaIO₃诱导组（小鼠尾静脉注射NaIO₃）和CoQ10修复组,小鼠尾静脉注射NaIO₃后玻璃体内分别注射高浓度（2.0 g·L^-1）和低浓度（0.1 g·L^-1）的CoQ10,注射平衡液做假处理组。在建模后第7天取材,行常规组织切片、HE染色、GFAP染色、Iba1染色,检测NaIO₃诱导的视网膜病变和CoQ10对该种病变的修复效果。结果　注射NaIO₃ 7 d后,HE染色结果显示,NaIO₃诱导组小鼠视网膜外核层每10 μm 长度的细胞数由正常水平（29.13±3.97）个减少至（17.50±4.03）个,差异有统计学意义（P<0.01）;GFAP染色结果显示,Müller细胞发生反应性胶质化,与对照组相比每250 μm×250 μm面积的细胞数由（21.17±4.26）个增加至（28.67±2.80）个,差异有统计学意义（P<0.01）;Iba1染色结果显示,小胶质细胞呈现出“阿米巴状”的激活形态,每250 μm×250 μm面积的细胞数由（6.71±2.29）个增加至（22.14±3.76）个,差异有统计学意义（P<0.01）。分别对NaIO₃诱导组小鼠玻璃体内注射高、低浓度的CoQ10（2.0 g·L^-1和0.1 g·L^-1）后,与假处理组相比,其中注射高浓度CoQ10（2.0 g·L^-1）组外核层细胞数目显著增加（P<0.05）,而低浓度CoQ10（0.1 g·L^-1）组没有显著差异（P>0.05）。并且,Müller细胞反应性胶质化程度减弱,GFAP阳性细胞数恢复至（23.83±3.87）个;小胶质细胞分枝增多,Iba1阳性细胞数恢复至（16.86±3.29）个,与NaIO₃诱导组相比,差异均有统计学意义（均为P<0.05）。结论　玻璃体内注射CoQ10可通过减轻Müller细胞的反应性胶质化和抑制小胶质细胞的激活而减缓视网膜感光细胞退化,对AMD起到保护作用。     

H2O2对体外培养视网膜色素上皮细胞中BMP-6及其相关受体的影响

目的观察氧化应激对视网膜色素上皮(retinal pigment epithelium,RPE)细胞的损伤作用以及对骨形态发生蛋白(bone morphogenetic protein,BMP)-6及其相关受体的影响。方法 RPE细胞随机分为对照组:正常培养的RPE细胞;H₂O₂组:加入200μmol·L^-1H₂O₂处理的RPE细胞;实验组:加入200μmol·L^-1 H₂O₂和0.1 ng·L^-1 BMP-6的RPE细胞。采用活性氧(reactive oxygen species,ROS)检测试剂盒运用流式细胞仪检测对照组与H₂O₂组RPE细胞内ROS的变化,运用PCR及Western blot法检查对照组与H₂O₂组BMP-6基因及蛋白水平的变化;TUNEL染色法观察三组细胞凋亡的变化,并运用PCR及...     

OCT测量视盘及黄斑区相关参数在早期原发性开角型青光眼中的诊断价值

目的：分析光学相干断层扫描技术(OCT)测量黄斑区神经节细胞复合体(mGCC)、视盘周围视网膜神经纤维层(pRNFL)、黄斑区视网膜神经纤维层(mRNFL)和黄斑区神经节细胞层+内丛状层(GCIP)厚度对早期原发性开角型青光眼(POAG)的诊断价值。

方法：采用病例对照研究设计,收集2019-01/2020-01于我院收治的早期POAG患者82例82眼,选择同期健康志愿者40例40眼(左右眼各20眼)为对照组,所有受检者均检查裸眼视力(UCVA)及最佳矫正视力(BCVA)及等效球镜度数,比较两组受检者上方、下方、鼻侧、颞侧及平均的pRNFL厚度及上、下方、平均的mGCC、黄斑区视网膜神经纤维层(mRNFL)、黄斑区神经节细胞层+内丛状层(GCIP)厚度,采用Spearman分析各指标平均厚度之间的相关性,采用ROC曲线分析mGCC、pRNFL、mRNFL和GCIP厚度参数诊断早期POAG的价值。

结果：早期POAG组患者上方、鼻侧、下方、颞侧、平均pRNFL厚度和上方、下方及平均mGCC、mRNFL、GCIP厚度均低于对照组(均P<0.05)。平均pRNFL厚度与平均mGCC厚度、平均mRNFL厚度及平均GCIP厚度正相关(r_s=0.582、0.632、0.456,均P<0.05); 平均mGCC厚度与平均mRNFL厚度及平均GCIP厚度正相关(r_s=0.583、0.851,均P<0.05); 平均mRNFL厚度与平均GCIP厚度正相关(r_s=0.528,均P<0.01)。ROC曲线分析得出不同部位mGCC厚度及平均值AUC值均在0.8以上,其诊断效能最高。

结论：OCT测量mGCC诊断早期POAG具有一定价值。     

视网膜深层血流密度对康柏西普治疗糖尿病性黄斑水肿预后的影响:基于OCTA的评价

目的 研究糖尿病性黄斑水肿(DME)患者视网膜深层毛细血管丛(DCP)的血流密度(VD)与康柏西普治疗预后的关系.方法 回顾性分析2020年1月至2021年7月就诊于潍坊医学院附属医院眼科中心的46例非增生型糖尿病视网膜病变(NPDR)期DME患者(DME组)和同期37例无DME的NPDR患者(对照组)资料.DME组患...