Nystagmus in suprasellar tumors: Recent advances in diagnosis and therapy

Congenital and acquired nystagmus, particularly pendular and jerk nystagmus, see-saw nystagmus and spasmus nutans, may be the presenting sign of a suprasellar mass lesion.¹ The large variety of different suprasellar mass lesions requiring quite different therapeutic measures necessitates exact histological diagnosis for optimal therapeutic strategy planning.² Stereotactic tumor biopsy has become a well-established diagnostic approach, combining minimal surgical trauma with a high degree of diagnostic safety. Particularly in the two most frequent suprasellar mass lesions – craniopharyngiomas and pilocytic astrocytomas – accurately planned stereotactic drainage of tumor cysts combined with radiotherapy and/or stereotactic radiosurgery allows successful decompression and tumor control as well as maximum preservation of visual and endocrinological functions when compared with conventional surgical procedures. 2–11     

神经眼科概念和新进展

神经眼科学涵盖所有原发性或继发性神经系统损害而临床表现为眼部症状的疾病。该领域近年来研究进展迅速，但很多临床问题尚待解决。本文仅重点概述几个常见的临床疾病研究进展。特发性脱髓鞘性视神经炎与多发性硬化关系密切，预防从前者向后者的转化非常关键。目前尚无大规模临床试验证明有效的治疗缺血性视神经病的方法。在更多的DNA点突变被发现与Leber遗传性视神经病（LHON）相关同时，成功的实验性基因治疗为未来临床治疗LHON提供了可能。特发性颅内高压和其视神经损害的治疗强调个体化。早期免疫治疗对于减少重症肌无力从眼肌型向全身型转化的作用目前仍在探讨中。     

Neuroprotection in glaucoma: recent advances and clinical translation

Intraocular pressure (IOP) reduction is currently the only evidence‐based treatment strategy for glaucoma. However, IOP control in some individuals is challenging. Despite optimal treatment, a significant proportion of individuals will progress, with loss of visual field, loss of driving vision and impaired quality of life. A new modality that could augment current treatment and reduce the rate of neurodegeneration to preserve vision throughout life would be a major breakthrough. A vast number of studies have reported effective neuroprotection in animal models of glaucoma; however, translation to the clinic remains a major hurdle. Herein, we explore the therapeutic advancements in non‐IOP‐dependent neuroprotection research based upon potential pathogenic mechanisms and propose strategies to improve the clinical translation of neuroprotective research in glaucoma.     

Ocular surface reconstruction: recent advances and future outlook

PURPOSE OF REVIEW: Ocular surface disorder underlies a diverse group of prevalent diseases in the United States, caused by biological aging, autoimmune conditions, trauma, or iatrogenic factors. Left untreated, these conditions can progress to vision loss or destruction of the globe itself. This review discusses the most recent and relevant clinical and experimental advances in the treatment options for ocular surface disorders. RECENT FINDINGS: Current literature suggests that recent progress in tissue bioengineering, and molecular and cellular biology research presents many potential interventional therapies for ocular surface diseases. Depending on the pathogenesis of each condition, treatment options include bioengineered amniotic membrane graft, limbal stem cell transplantation, conjunctival and extraocular tissue transplantation, multiagent immunosuppressant therapy, and bioartificial devices such as lacrimal gland microdevices and keratoprostheses, or tissue adhesives. SUMMARY: Much progress has been made in the fields of microbiology, stem-cell research, tissue engineering, and bioartificial devices for the treatment of the heterogeneous group of ocular surface disorders. Intensive efforts are underway to ensure the adaptation and accessibility of these therapeutic options to the general population.     

Retinopathy of prematurity: recent advances in our understanding

Retinopathy of prematurity (ROP) has been recognised as an important cause of childhood visual impairment and blindness since the 1940s when improved facilities and treatment increased the survival rate of premature infants. Although its incidence and severity have been decreasing in developed countries over the past two decades, both are increasing in developing nations. ROP is consequently targeted as an important but avoidable disease. This review provides an updated summary and discussion of much of the work that has been produced through population, animal, cell culture, and genetic research. The authors examine the prevalence, risk factors, and possible causes of the disease with a particular focus on genetic studies. They conclude that while significant reductions in the disease have occurred in developed countries, further research is required to fully understand and prevent the disease. In the meantime, development and implementation of appropriate screening and treatment strategies will be critical in reducing blindness in developing countries.     

Noemi Lois: recent advances on diabetic retinopathy

Introduction Noemi Lois (Figure 1) currently serves as a clinical professor in School of Medicine,Dentistry and Biomedical Sciences in Queen's University in UK.Dr.Lois leads a program of preclinical and clinical research into diabetic retinopathy and its complications (diabetic macular oedema and proliferative diabetic retinopathy.Prof.Lois has published over 100 articles in peer review journals,13 book chapters and is the editor of 3 textbooks,one on its second edition.     

真性小眼球研究现状与进展

真性小眼球是指眼球体积明显小于正常眼而不伴有其他眼部畸形或全身发育异常的先天性疾病,可为常染色体显性或隐性遗传。临床主要表现为眼轴明显缩短、高度远视、巩膜增厚等。该病临床虽罕见,但其常常合并有闭角型青光眼、葡萄膜渗漏综合征等严重并发症,危害十分严重。真性小眼球可以自发缓解或反复发作,对药物治疗反应较差。全身大剂量糖皮质激素治疗效果多不理想。而手术中及手术后又易发生出血、脉络膜脱离、视网膜脱离、恶性青光眼及葡萄膜渗漏等并发症,预后通常较差。深入了解真性小眼球的临床特征及其并发症和治疗进展,提高临床医生对该类疾病的认知,从而避免并发症的漏诊及误诊,选择正确的处理方案,对该类疾病的诊疗具有重要的指导意义。     

Nystagmus: diagnostic and therapeutic strategies

Nystagmus can have either a jerk (slow and quick phase) or a pendular waveform. Saccadic oscillations can either be back-to-back saccades or have an interval between two saccades. Both nystagmus and oscillations can decrease visual acuity and cause oscillopsia. Each type of nystagmus is attributable to instability or an inadequacy of specific ocular motor systems, including vestibular, optokinetic, smooth pursuit, fixation and the neural integrator. Saccadic oscillations are attributable to instability of the saccadic system. Nystagmus that develops during infancy will not decrease visual acuity if the foveation time within each slow phase is adequate (>60 msec). Infantile nystagmus also does not cause oscillopsia, possibly because the internal spatial visual map is reupdated before each phase of this type of nystagmus (efference copy). There is no foveation period or adequate efference copy reupdate in acquired nystagmus. Consequently, acquired nystagmus usually results in decreased visual acuity and oscillopsia. For most forms of treatment, the goal is directed toward stopping the oscillations or their visual consequences rather than towards the underlying mechanism. Several treatment modalities have been suggested. The most success has been found with gabapentin in the treatment of acquired pendular nystagmus and baclofen in the treatment for acquired periodic alternating nystagmus. There is a need for multicenter trials to evaluate systematically potential treatments of the other types nystagmus and oscillations.     

Epi-LASIK应用现状及进展

近几年表层角膜切削术越来越受到关注,由于无需制作角膜基质瓣,其安全性较LASIK高.LASEK采用体积分数20%乙醇制作角膜上皮瓣,术后haze明显少于PRK;EpiLASIK通过微型角膜上皮刀制作角膜上皮瓣,其上皮瓣的制作较LASEK更容易,且上皮瓣保留了较完整的基底膜,上皮瓣活性更高,初期的临床结果显示术后刺激症状更轻,haze发生率更低,是准分子激光屈光矫正手术的一大进步.     

Ophthalmological tumors in children: diagnosis and therapeutic strategy

Clinical aspects and diagnosis features of retinoblastoma are reported. The most important differential diagnosis are discussed. The diseases that can cause difficulties in diagnosis are uveitis and Coats disease. The principles of the treatment of retinoblastoma are exposed especially the side effects of radiotherapy that lead to a limitation of the use of external beam if possible. Treatments methods include external beam radiotherapy, chemotherapy, thermochemotherapy cryotherapy, curietherapy and photocoagulation. Results and indications of these treatments are given. We describe the diagnosis approach, for orbital tumors in children. The main orbital benign and malignant tumors and their treatment are listed: orbital cyst, neurofibroma; optic nerve gliomas; rhabdomyosarcomas, bone tumors and metastatic tumors.     

Nystagmus in Infancy and Childhood

Involuntary occular oscillations in infancy and childhood can be understood, diagnosed, classified and treated as a result of modern electrophysiology and neuroanatomical knowledge.