Relationship of eye burns with calcifications of the cornea?

Introduction The clinical pattern of corneal calcification has been considered to be a part of chronic eye diseases, such as uveitis, severe glaucoma, keratitis and eye burns. Since, in some cases of eye burns, we have found corneal calcifications to be related to the initial calciferous caustic agents and to the use of phosphate-buffer-containing fluids, we have reviewed our files of clinical eye burns for the incidence and appearance of corneal calcification.Methods A total of 176 burnt eyes of 98 patients suffering from severe eye burns were retrospectively reviewed. The following data set was acquired: the type of caustic agent, the time of the burns, the delay and type of immediate treatment and the time and type of first aid, the subsequent medication, the clinical grading and the later results.Results Calciferous burning agents and corneal calcification are correlated (P<0.01). Initial single rinsing with phosphate does not produce corneal calcification (P=0.134). There is evidence that corneal calcifications are correlated with chronically administered phosphate-buffered eye drops (P<0.005).Discussion Eye burns followed by calcifications follow two different major patterns: the corrosive substance contained calcium or the continued therapy was applied with phosphate-buffered eye drops. We present case reports of three different types of eye burns and later therapy resulting in corneal calcification. Corneal calcifications are presumably related to longer-lasting phosphate application. One suspicious mechanism is the low content of calcium ion stabilizing proteins such as hyaluronate or fetuin in treatments for severe eye burns. The exceeding of the solubility product of Ca²⁺ and PO₄^– results in the precipitation of calcium phosphates. In cases of chronic corneal disturbance, we recommend the elimination of phosphate-buffered medications to prevent corneal calcification.     

Development of the Scale of Quality of Life for Diseases with Visual Impairment

Purpose :To describe the development of the of scale quality of life which can measure the quality of life of Chinese patients with visual impairment. Methods: Based on a thorough literature search and consultation with ophthalmologists and public health professionals, 20 items were selected to create a scale. Fifty-seven cataract patients with vision impairment and 60 glaucoma patients with vision impairment and visual field loss were measured by the scale to evaluate the validity, reliability and responsiveness of the scale.Results: The scale covered four domains of the quality of life(QOL). The criterion related validity of the scale: r = 0. 6865 (P=0. 001). The test-retest reliability of the scale: r = 0. 8959(P = 0. 001). Coronback's alpha was 0. 9359. The variance ratio (VR) of intra-individual variance to inter- individual variance was 0. 0551 for overall scores. The correlation coefficient of split-half method was 0. 9553. The responsiveness; T-test, T = 5. 95 (P = 0. 001), effect size statistic     

Cognitive evaluation of patients with glaucoma and its comparison with individuals with Alzheimer’s disease

Purpose

To evaluate the cognitive performance of patients with glaucoma and compare it to individuals with Alzheimer’s disease (AD).

Methods

This is a prospective, cross-sectional and case–control study. All subjects were assessed using the Mini-Mental State Examination (MMSE) and its subtests verbal fluency, word list memory, delayed recall of the word list, word list recognition test, Boston naming and constructive praxis from Consortium to Establish a Registry for Alzheimer’s Disease (CERAD). The results were compared among the groups.

Results

A total of 50 healthy elderly with a mean age of 71.2 ± 5.2 years; 41 patients with glaucoma (72.2 ± 4.4 years); and 21 patients with AD (79.0 ± 7.6 years) were included. There was a reduction in all cognitive assessment tests evaluated, both for patients with glaucoma, and for those with AD compared with controls (p < 0.001 for all). Comparing the patients with glaucoma and AD, it was noted that the last had lower cognitive function (p < 0.001), except for the CERAD tests Boston (p = 0.1) and praxis (p = 0.6). Glaucoma patients, however, presented results of cognitive tests similar to those described for patients with mild AD, including lower values for MMSE (21.9 ± 3.7), Boston (10.6 ± 2.6) and praxis (5.9 ± 2.3).

Conclusion

Glaucoma patients had reduction in cognition when compared to normal individuals. They were similar to the values reported in the literature for patients with mild AD, mostly, and also in some subjects with the presence of advanced AD.

     

Detection of interleukin-1 β in the tear fluid of patients with corneal disease with or without conjunctival involvement

To investigate the role of Interleukin-1 (IL-1) in the pathobiology of the cornea, we measured IL-1 β concentration in tear fluid samples from patients with corneal disease. Twenty patients with unilateral corneal disease were included in the study. Tear fluid samples were collected during the active stages of the disease and following resolution. The fellow (unaffected) eyes served as controls. The concentration of IL-1 β in the tear fluid samples was measured using a sandwich ELISA method. IL-1 β was detected in tear fluid from five eyes (three eyes with chemical burns, one with a Pseudomonas aeruginosa corneal ulcer, and one with a peripheral corneal ulcer) at concentrations between 29 and 218 pg/mL. IL-1 β was not detected in tear fluid from the remaining 15 affected eyes, nor from the control eyes. The detection of IL-1 β in tear fluid correlated with limbal conjunctival involvement, but did not correlate with the type of disease, size of epithelial defect, or degree of stromal involvement. IL-1 β in the tear fluid may be one of the factors modifying the complex inflammatory process of the anterior ocular surface.     

Long-Term Outcomes of a Large Cohort of Patients with Eales’ Disease

Purpose: To analyze the long-term visual outcomes of Eales’ patients.

Methods: A retrospective review of Eales’ patients diagnosed between 1985 and 1995 with >10 years follow-up done.

Results: We included 500 patients (898 eyes) with mean follow-up duration of 15.8 years (10–25 years), and 81% patients had bilateral disease. Patients using oral steroid during acute stage disease had significantly better visual outcome at the final visit [0.42 logMar(6/18) ± 0.723 logMar(6/30)] compared to patients who did not receive oral steroids [(0.5907 logMar(6/24) ± 0.945 logMar(6/48)] (p = 0.004). Patients who received laser therapy had significantly better visual outcome at the final visit [(0.415 logMar(6/18) ± 0.66 logMar(6/30)] compared to those who did not undergo laser treatment [(0.9237 logMar(6/48) ± 1.31 logMar(6/120)] (p < 0.001). Poor presenting visual acuity and late stage of presentation were associated with poor visual outcome. Fifty-two percent of eyes had <5 recurrences over 10 years.

Conclusion: Eales’ disease is a bilateral recurrent retinal vasculitis disorder and timely treatment with steroid and/or laser photocoagulation result in better visual outcomes.     

Study of natural history of Chinese patients with choroideremia北大核心CSCD

Objective: To provide detailed clinical and molecular genetic findings and describe the characteristics of natural history in Chinese choroideremia (CHM) patients. Methods: The patients with CHM who met the inclusion criteria of at least two visits over a minimum period of 5 years were recruited on a voluntary basis at the Ophthalmic Genetics Clinic in Peking Union Medical College Hospital from April 2009 to August 2017.Molecular genetic analysis results, best-corrected visual acuity (BCVA), color fundus photograph, optical coherence tomography (OCT), visual field (VF), full-field electroretinography (fERG) were obtained. This study protocol was approved by the Institutional Review Board of Peking Union Medical College Hospital (S-K125). Written informed consent was obtained from each participant. Results: Ten Chinese Han patients from seven CHM families were included. The mutations were confirmed by molecular genetic analysis, and two novel mutations were found. The median age of 10 patients at first visit was 44 years (range 8-52 years). The mean first-last visit period was 6.08 years (range 5.03-7.24 years). The mean BCVA at first visit in logMAR equivalents was 0.56 (range 0.0-2.0) or approximately 0.28 decimal acuity. The correlation between BCVA at first visit and age showed that relative good vision remained until 35 years old and BCVA subsequently reduced rapidly.OCT showed a thickening of the central retinal thickness at early stage, followed by a thinning over decades. Outer retinal tabulation (ORT) was shown in some patients. There was a strong negative correlation (r=-0.861, P<0.001) between residual VF and age. Five patients did not need to record fERG because of serious fundus lesions. Two patients exhibited decreased amplitudes for both rod and cone-driven responses, and three patients exhibited no fERG amplitudes. Conclusions: The progression of CHM may be severer and faster in Chinese patients than that in Western patients.ORT is an important manifestation of OCT in CHM patients.VF and fERG are applicable to evaluate the condition of very-early phase of CHM. Copyright © 2018 by the Chinese Medical Association.     

Detection of Molecular Weight of PMCA Isoform with 20 cm SDS PAGE Electrophoresis：Compared with 8 cm SDS PAGE

Purpose: To compare the effect of 20 cm SDS-PAGE electrophoresis, which is most widely used in proteomic research, in identifying human lens epithelium B3 (HLE B3) cells plasma membrane calcium ATPase (PMCA) isoform's apparent molecular weight (MW), with that of 8 cm SDS-PAGE electrophoresis. Method: HLE B-3 cells were cultured and membrane protein sample was collected. Part of the sample is electrophoresised with 20 cm gel, 16 mA/gel for 1.5 hrs and then 24 mA/gel for 4~5 hrs. The same sample is electrophoresised with 8cm mini gel, 200V for 2 hrs. Protein marker of known MW was run with the sample in the same gel. The resulting separated proteins were transferred to polyvinylidene difluoride (PVDF) membrane and Western blot were used to identify the PMCA isoform with specific antibody against PMCA 1 , 2, 4. The apparent MW was calculated in reference to the known protein marker that was electrophoresised in the same gel. Result: In 8 cm gel the distance between 208 kDa and 126 kDa band was about 6.1 mm, while that of 20 cm gel was 32.8 mm. The distance between 126 kDa and 97 kDa was about 5.2 mm, while that of 20 cm gel was 20.2 mm. The migration distance differences of protein bands were significantly much longer in 20 cm gel than in 8 cm gel (P < 0.005 ). But the bands were generally more condensed in 8 cm gel. The apparent MW of PMCA1, 2, 4 were 153.8, 153.5 and 152.9 kDa respectively. In the 20 cm gel, the apparent MW for PMCA1, 2, 4 was 153.1, 125.5 and 147.4 kDa respectively. Conclusion: Both the 20 cm gel and 8 cm gel successful identified PMCA 1,2, 4 in HLE B-3 cells. The apparent MW for PMCA1, 2, 4 was 153.8, 153.5 and 152.9 kDa respectively in 8 cm gel,and 153.1,125.5 and 147.4 kDa respectively in 20 cm gel. PMCA2 probably had some kinds of degradation during the long electrophoresis time in 20 cm gel. Eye Science 2005;21:179-184.     

The surgical management of strabismus with large angle in patients with Graves’ ophthalmopathy

Background Strabismus with large deviation in Graves’ ophthalmopathy is relatively common in developing countries, such as China. However, little information is available in the literature on this condition. We report here our surgical results of strabismus with large deviation in Graves’ ophthalmopathy. Patients and methods The surgical management of strabismus in 27 patients with Graves’ ophthalmopathy with large angle (≥25°) were retrospectively analyzed. The strabismus surgery included recession or free tenotomy of involved rectus muscle, recession of rectus plus resection of ipsilateral antagonist, and recession of rectus plus recession of contralateral antagonist. The patients were followed up for an average of 1.2 years. Results Among 27 patients, 17 were male and 10 were female, with their age ranging from 28 to 68 years old (mean: 51.9 years). There were 12 cases with excellent results, 10 with good results, 3 with fair results, and 2 with poor results. Only one surgery was required in all cases except three who needed re-operation. Based on the rectus muscles involved, just one rectus muscle recession combined with traction suture could correct the strabismus with large angle in 20 patients; two muscles were required in 9 patients and three in 1 patient. Four patients had surgical overcorrection of strabismus. Eight patients had complicated eyelid retraction postoperatively. Conclusions The surgical management of strabismus with large deviation in patients with Graves’ ophthalmopathy was remarkably good. Just one rectus muscle recession combined with traction suture could correct the large angle strabismus in 74% (20/27) of cases. The choice of surgical procedure and some special attention in performing surgery are discussed.     

Clinical Observation of 126 Cases of Sutureless Phacoemulsification with PMMA Intraocular Lens Implantation

Objective: To observe the safety and effect of sutureless phacoemulsification with PMMAintraocular lens (IOL) implantation.Methods: One-hundred and twenty-six cases (126 eyes) of suturelessphacoemulsification with PMMA intraocular lens (IOL) implantation were retrospectedand evaluated. The surgeries were performed through a limbal tunnel incision. PMMAIOLs with 5. 5mm or 6. Omm in diameter were implanted.Results: The follow-up was 3 ~ 20 months. Visual acuity of 0. 5 or better was obtained in120 cases (95. 2% ), and that of 1. 0 or better was obtained in 89 cases (70. 6% ) .Intra-operative complications included posterior capsule rupture in 9 cases (7. 1% ) andiris injury in 7 cases(5. 6% ). Postoperative complications included early corneal edemain 96 cases(76. 2% ), transient intraocular pressure elevation in 5 cases(4. 3% ),remnant of cortex in 1 case and leakage of incision in 1 case. All were properly managedwith good results.Conclusion: Sutureless phacoemulsification with PMMA IOL implantation is     

Features Associated with Recurrence of Idiopathic Orbital Inflammatory Pseudotumor

Purpose: To explore factors which lead to recurrence of idiopathic orbital inflam-matory pseudotumor (IOIP). Methods: Idiopathic orbital inflammatory pseudotumor in 209 cases between Jan 1, 1978 and Dec 31, 1999 in our hospital was evaluated retrospectively. The comparison of clinical and pathological parameters between patients with at least one episode of recurrence and those with no recurrence at all was performed and analyzed using logistic regression method. Results: Follow-up results (with a mean follow-up time of 3.4 years, ranging from 0.5 year to 21.0 years) showed that the recurrence rate of IOIP was 41%. Sex and proptosis were associated with the recurrence of IOIP. Male gender was more likely to relapse than female counterparts, with the male being 52% and female being 25%. The severer the proptosis is, the higher the rate of recurrence. Among the clinical subtypes of IOIP, the rate of recurrence (17%) in cases with dacryoadinitis was the lowest, followed by anterior local orbital mass (44%), posterior orbital mass (54%), myositis (75%) and diffuse subtype (100%). However, the clinical subtypes did not show significant relationship with the recurrence of IOIP. Conclusions: Male gender and severe proptosis are associated with a higher recurrent rate in patients with IOIP.     

PVEP in Patients with Different Types of Congenital Cataract

The preoperative and postoperative PVEP in 79 eyes of 45 patients with three types of congenital namely lamellar cataract, nuclear cataract and total cataract was studied. The results showed that visual acuity of patients who could be cooperatively examined was improved significantly after operation. The examination of PVEP revealed that more abnormal wave-formes were found in total cataract group before operation. P1 latencies of low and medium spatial frequencies (140‘, 70‘, and 35‘) became much longe...     

Removal of Intralenticular Magnetic Foreign Bodies with Intraocular Magnet

Purpose: To investigate the possibility of conservation of the lens after removal of intralenticular magnetic foreign bodies with intraocular magnet.Methods: Intralenticular magnetic foreign bodies of 15 patients were removed by using an intraocular magnet. The lens of each injury eye was conserved. Follow-up observation of these cases ranged from one to four years.Results: The intralenticular magnetic foreign bodies of 15 patients were successfully removed. The lens of each injury eye was conserved and the transparence of the lens was properly maintained. Sizes of these foreign bodies were measured, ranging from 0.3mm to 3mm in diameter. The follow-up observation showed that the corrected visual acuity of 14 cases was not changed after operation.Conclusions: The intraocular magnet is very helpful for removal of magnetic foreign bodies from the transparent lens. This magnet allows removing of the foreign body by the surgeon and no damage to the lens was induced during the operation. Thus, maintenance of     

Is serum cholesterol associated with progression of diabetic retinopathy or macular edema in persons with younger-onset diabetes of long duration?

PURPOSE: To quantitate the relationships of total cholesterol and high-density lipoprotein cholesterol to the incidence and progression of diabetic retinopathy and macular edema 5 years later in those with younger-onset diabetes of long duration. METHODS: Casual serum specimens for lipid values and fundus photography at the time of the lipid determinations were evaluated with regard to retinal lesions in photographs taken 5 years later during the course of a population-based cohort study. RESULTS: Univariable associations were significant for associations of incident retinal lesions with total cholesterol/high-density lipoprotein cholesterol, but multivariable associations considering covariates were not significant. CONCLUSION: Our data suggest that lowering cholesterol by therapeutic means may not be indicated for the sole purpose of decreasing the incidence or progression of these retinal lesions.     

Detection of Glutamate and -y-aminobutvric Acid in Vitreous of Patients with Proliferative Diabetic Retinopathy

Purpose:To study the levels of glutamate and γ-aminobutyric acid (GABA) in vitreous of patients with proliferative diabetic retinopathy(PDR) and to investigate their roles in retinal ischemia.Method: Vitreous samples were collected from 25 patients (27 eyes) with PDR and 14 patients (14 eyes) with idiopathic macular hole. Glutamate and GAB A detection were performed by high-performance liquid chromatography (HPLC).Results: Patients with PDR had significantly higher concentrations of glutamate and GA-BA than the control group. The glutamate level has a significantly positive correlation with GABA level.Conclusion: Detection of glutamate and GABA in vitreous provides biochemical support for the mechanism and treatment of ischemic retinal damage in patients with PDR. Eye Science 2000; 16: 199-202.     

The Changes of Quality of Life in the Patients after Phacoemulsification with IntraocularLens Implantation

Cataractistheleadingcauseofworldwideblindness,whichcanresultintheimpairmentofvisionfunctionandthedecreaseofqualityoflife.Aftercataractextractionwithintraocularlensimplantation,thevisionfunctionandotherfunct鄄ionsrecover.Asaresult,thequalityoflifeimp鄄rove.Becauseofthesmallincision,visualacuitywillrecoverquicklyafterphacoemulsifecationwithintraocularlensimplantation.Afewreportshavebeenfoundabouttheearlychangesofquali鄄tyoflifeafterthiskindofprocedure.Thisprospe鄄ctivestudyinvestigatestheearlyp…     

The Experiment Research of Subconjunctival Injections with Etoposide for the Treatment of Retinoblastoma Mice

Purpose: To evaluate the efficacy of subconjunctival injections of Etoposide for retinoblastoma(RB) mice. Method: Twenty-five RB mice were divided into 5 groups for the study(G0-G4). GO for control group received 0.9% sodium chloride injection subconjunctival. G1: 5 RB mice for systemic delivery received 6 systemic administration of Etoposide 150 μg and Cyclosporin A (CSA )1.0mg at 3 days intervals, respectively. G2-G4: 5 RB mice in each group received 6 subconjunctival delivery of Etoposide in 50、75、150μg at 3 days intervals, respectively .To observe the changes of the volume of RB in anterior chamber and the part of conjunctiva for injections of chemotherapeutic drugs. All eyes and conjunctiva and scleras of the part for drugs injections were obtained at 6 weeks after experiment for histopathologic examination. The findings under the light microscope were analysed with software to measure the areas of RB in anterior chambers and the tumor inhibition rate. Results:The volume of RB in anterior chambers for G1 and G2 increase quickly and none of the mice exhibited tumor control. The RB volume increase slowly in G3 and exhibit tumor control in G4. The areas of tumors in G0-G4 are 0.710,0.659,0.634, 0.515,0.235 mm2, respectively. The rate for tumor inhibition in G0-G4 are 0.0%, 7.18%, 10.70%,27.43%,66.90%, respectively. There are statistical significant difference between the G1 and G4 for the volumes of tumors and the rate of tumor inhibition. The pathologic examination of subconjunctiva and sclera for the injective sites showed no pathologic changes. Conclusions: There are significant effects for the method of subconjunctival delivery of Etoposide in RB control, demonstrating a positive dose-related relationship. Subconjunctival injection of Etoposide reached better efficacy in controlling and inhibiting RB cells than systemic delivery of Etoposide for the same dose. The pathologic results showed the subconjunctival delivery of etoposide were safety for conjunctiva and sclera. It would be one of effective and safety method of chemotherapy for RB. Eye Science 2005;21:169-174.     

Needle revision of dysfunctional blebs with subconjuncitval injection of interferon α-2b

Objective To study the efficacy and safety of needle revision with subconjunctival interferon injection in eyes with dysfunctional blebs.Methods A series of 23 cases(27eyes)underwent trabeculotomy were determined as dysfunctional blebs with the form and function with slit-lamp and AS-OCT.Primary needling with 5×105 IFN α-2b injection was performed for the dysfunctional blebs.All cases were followed up for at least 6 months.Results Dysfunctional blebs developed 51.04±23.09d(19d-89d)after the surgery.The mean intraocular pressure(IOP)decreased significantly from 22.77±8.65mmHg(10-45mmHg)at diagnosis of dysfunctional blebs to 16.68±3.37mmHg(7.70-21mmHg)at the lavs visit(P=0.002).Of the 27 eyes,18(66.7%)achieveda successful result,7(25.93%)were qualified successes.The most frequent complicatiom were Conjunctival hemorrhage(37%)and Conjunctiva tears(22.22%).No serious complications happened.Conclusions The needling procedure associated with subconjuctival injection of IFN α-2b is a safe and effectivc method in treating dysfunctional blebs.