Gene therapy in ocular diseases

Gene therapy is a novel form of drug delivery that enlists the synthetic machinery of the patient's cells to produce a therapeutic agent. Genes may be delivered into cells in vitro or in vivo utilising viral or non-viral vectors. Recent technical advances have led to the demonstration of the molecular basis of various ocular diseases. Ocular disorders with the greatest potential for benefit of gene therapy include hereditary diseases such as retinitis pigmentosa, tumours such as retinoblastoma or melanoma, and acquired proliferative and neovascular retinal disorders. Gene transfer into ocular tissues has been demonstrated with growing functional success and may develop into a new therapeutic tool for clinical ophthalmology in future.     

Anterior segment and external ocular manifestations of infectious diseases in children.

Anterior segment and external ocular manifestations of some infectious diseases which are particularly important to patients of the pediatric age group are discussed. A brief review of the various systemic diseases is given along with the ocular findings. Approaches to diagnosis, therapy, and management of both the systemic and ocular components of the illnesses are included.     

光动力学疗法在眼表疾病治疗中的应用

眼表疾病泛指损害眼睑及角结膜眼表结构与功能的疾病,传统的治疗方法主要有药物、手术等.光动力学疗法(PDT)近年来开始被应用于治疗眼表疾病.本文就PDT的作用原理、光敏剂的种类及其在眼表肿瘤、翼状胬肉、新生血管、圆锥角膜、角膜溃疡等眼表疾病治疗中的应用研究现状作一综述.     

Advances in the diagnosis and therapy for diseases of the ocular surface: dry eye and ocular allergies

The 77th meeting of the Association for Research in Vision and Ophthalmology (ARVO) presented the latest developments in clinical research and practice across a range of ophthalmic disciplines. Of particular interest was the current status of research in dry eye and ocular allergy. With these conditions being very common to ophthalmologists, and the fact that they are difficult to differentiate due to the number of overlapping symptoms, there remains a need for more rapid and accurate methods for their diagnosis. Therefore, a number of new tools were presented that have the potential for use in clinical trials and practice to improve the diagnosis and assessment of dry eye and ocular allergy. Some of these tools have been developed based on a greater understanding of the pathophysiology of dry eye and ocular allergy, and the various molecular pathways involved. Indeed, a greater understanding of the molecular mechanisms involved in the pathogenesis of dry eye and ocular allergy has identified potential targets for the treatment of these conditions. Continuing research into new agents can provide ophthalmologists with a number of options that will ultimately benefit the patient.     

Role of radiation therapy in the treatment of benign ocular diseases

Radiation therapy, although a prime treatment modality for malignant disease, has few definitive indications for some benign ocular diseases too. Orbital pseudotumour, Graves ophthalmopathy and pterygium are the conditions where the radiation oncologist has got an important role to play. This article reviews the current status of the role of radiation and its effectiveness in the management of these diseases.     

眼内液检测在眼部感染性疾病诊断与评估中的应用

病原学的精准判断在感染性疾病的诊治中十分重要。随着宏基因组测序技术和微量样本检测技术的发展,眼内液检测在眼部感染性疾病中的临床应用价值逐步升高。本文主要从眼内液的病原学检测、细胞因子检测、未来与展望等三个方面着手,介绍眼内液检测在眼部感染性疾病诊断与评估中的应用。     

慢病毒载体在眼科基因治疗的应用

随着分子生物学技术的进步和基因遗传学的发展,慢病毒载体系统不断地得到改良及优化,并以其特有的优势,逐渐成为眼科基因治疗的良好载体之一,由于其来源特殊,其生物安全性也备受关注。目前慢病毒已应用于多种眼科疾病的基因治疗研究中,并取得较好成果,为许多疾病的治疗带来了希望,但是我们要将其真正应用于临床,还任重而道远。     

New methods of therapy for ocular inflammatory autoimmune diseases

The authors review the current literature, regarding the efficacy and safety of new methods of therapy for ocular inflammatory autoimmune diseases: scleritis, pemphigoid and uveitis. Immunomodulation therapy is increasingly being used in various ocular inflammatory diseases, to avoid the effects of long-term steroid and immunosuppressive therapy and to induce remission in chronic disease. This therapy seems to be effective specially in treating resistant disease with relative safety. New approaches to therapy of intraocular inflammatory diseases will emphasize less immunosuppressive drugs and modification of the immune system with anti-MHC II, anti-adhesion molecules, anticytokines monoclonal antibodies, therapy with cytokines antagonists, intravenous immunoglobulin therapy, INF alpha therapy, antigen specific tolerating therapy and gene therapy. Advances in the understanding of pathogenesis and in diagnostic techniques in various ocular inflammatory entities, will serve as a driving force for these new methods of treatment.     

载抗感染药物的眼内缓释给药系统的应用

眼内感染性疾病对视功能危害极大,常规治疗方法存在着许多局限性.缓释给药系统具有高效、低毒以及患者易于接受等优点,载抗感染药物的眼内缓释给药系统有可能成为治疗眼内感染性疾病的有效手段,已成为近年来眼科学相关领域的研究热点.     

Challenges in the management of ocular snake-bite injuries

Ocular snake-bite injuries are quite rare away from natural habitats. However, when exotic animals are kept in captivity, the injuries sustained and their management can pose challenges when they present to their local eye department. This report describes an atypical eye injury inflicted by a python and its successful management involving surgical, laser and medical interventions. The case highlights the possible pitfalls resulting from the unusual mechanism of injury and the steps to avoid them. The article goes on to discuss the background of the injuries that can be caused by venomous and non-venomous snakes.     

水通道蛋白与眼科疾病

水通道蛋白(aquaporin,AQP)是一类广泛存在于哺乳动物上皮和内皮细胞膜上的特异性转运水蛋白,在眼部组织中大量存在,并参与包括维持眼压、促进上皮修复等在内的一系列病理生理过程.近年研究发现,其与眼科疾病的发生发展也密不可分,AQP0广泛大量存在于晶状体中,其基因突变导致先天性白内障发生,其后天表达改变会导致年龄相关性白内障的加速发展;眼内介导水分运输的AQP表达失调,会导致糖尿病视网膜病变的黄斑水肿、青光眼的高眼压及葡萄膜炎、视神经炎等一系列与水分子运输失衡相关的眼病.如果在眼内可以使用安全有效的技术手段从数量及空间分布上改变AQP的表达,这很可能成为治疗眼科疾病的一个新靶点.     

乙酰肝素酶及其与眼病的关系

乙酰肝素酶(hepranase,HPSE)是哺乳动物细胞中唯一能切割细胞外基质中硫酸乙酰肝素蛋白多糖侧链-硫酸乙酰肝素(heparan sulfate,HS)的一种葡萄糖醛酸内切酶.HPSE为单拷贝基因,可促进肿瘤转移和浸润、血管生成,维持晶状体囊膜结构,促进凝血活性以及参与胚胎组织发育等.关于HPSE与眼科疾病的关系报道较少,目前研究发现其与角膜炎症、新生血管形成,晶状体疾病、视网膜生理结构及新生血管形成以及视网膜色素上皮细胞增生、迁移等方面有关.     

Pericytes and ocular diseases

Pericytes are vascular mural cells which play multiple roles in angiogenesis and maintenance of blood vessel morphology and stability. In this review, we analyze recent data on the participation of pericytes in the pathogenesis of proliferative and non-proliferative diabetic retinopathy, as well as an emerging role in other angiogenic ocular diseases such as retinopathy of prematurity. Ways to exploit pericytes as targets for treatment of ocular diseases are discussed.     

常见眼部疾病干细胞治疗进展

干细胞移植技术作为一种新的疾病治疗手段,近年来受到越来越多关注。在眼科领域,干细胞移植技术同样得到了一定的研究和应用。在治疗眼部疾病,尤其是治疗与血管和神经退化相关的疾病方面,干细胞移植治疗技术发挥着积极的作用。本文对常见眼部疾病干细胞移植治疗的研究进展作一综述。     

Assessing the ocular surface microbiome in severe ocular surface diseases

PurposeThere is growing evidence for a critical role of the microbiome in ocular health and disease. We performed a prospective, observational study to characterize the ocular surface microbiome (OSM) in four chronic ocular surface diseases (OSDs) and healthy controls.MethodsSterile swabs were used to collect samples from each eye of 39 patients (78 eyes). Sterile technique and multiple controls were used to assess contamination during DNA extraction, amplification and sequencing. Concurrent use of topical antibiotics, steroids, and bandage contact lenses (BCLs) was documented.ResultsDespite the low biomass of the ocular surface, 47/78 (60%) eyes sampled had positive sequencing reads. We observed that half of patients (8/17, 47%) had distinct microbiomes in each eye. Healthy controls had a Lactobacillus/Streptococcus mixture or significant Corynebacterium. Staphylococcus predominated in 4/7 (57%) patients with Stevens-Johnson Syndrome (SJS) in at least one eye, compared to 0/10 healthy controls. Interestingly, 8/11 (73%) eyes with SJS were using BCLs, including 4/5 (80%) eyes dominated by Staphylococcus. Lax eyelid syndrome (LES) and Dry Eye Disease (DED) patients had similar OSMs, with Corynebacterium being the most prevalent bacteria. Alpha diversity was higher in controls and ocular graft-vs-host (oGVHD) patients compared to the other OSDs.ConclusionsOnly 50% of the 39 patients had similar microbiomes in each eye. A majority of healthy eyes had a Lactobacillus/Streptococcus mix or Corynebacterium microbiome. Staphylococcus predominated in SJS, Lactobacillus in oGVHD, and Corynebacterium in DED and LES. There may be an association between different OSDs and the microbiome.