Disruption and reacquisition of binocular vision in childhood and in adulthood

PURPOSE OF REVIEW: This article reviews the most recent studies that address the loss of and restoration of binocular vision in childhood and adulthood and summarizes recent changes in treatment approaches. RECENT FINDINGS: Studies during the last two years support the idea of continued plasticity of the binocular visual system throughout life. Children and adults with strabismus onset following binocular vision maturation are susceptibility to a permanent disruption of stereopsis and sensory fusion. Plasticity of the binocular visual system, however, also means continued restorability of function. Despite a rather short critical time interval for restoration of normal function (three months in children and 12 months in adults), peripheral or extramacular binocular visual function can be restored in most patients whose onset of disruption follows binocular maturation. SUMMARY: Stereoacuity loss can occur in the visually mature patient who develops strabismus later in life and delay of treatment can be deleterious to the restoration of normal macular binocular vision. However, despite any delay of treatment, most patients with strabismus acquired following binocular vision maturation will manifest some stereoacuity or sensory fusion following eye realignment. These findings suggest all patients with strabismus need to have their eyes aligned, either surgically or optically, to maximize their binocular vision outcome.     

Expression and characterization of SPARC in human lens and in the aqueous and vitreous humors

SPARC (secreted protein, acidic and rich in cysteine) is a matricellular glycoprotein that regulates morphogenesis, cellular proliferation, and differentiation. SPARC is a critical factor in the development and maintenance of lens transparency in mice. SPARC-null mice develop lenticular opacity at an early age that progresses gradually to mature cataract. Despite the high level of homology between the mouse and human genes, little is known about SPARC in the human lens. We have studied the expression of SPARC protein in human lens and surrounding ocular tissues from normal human donors (60-70 years old). Immunohistochemical and immunoblot analyses were conducted on lens, aqueous humor, vitreous, ciliary epithelium, pigment epithelium, cornea and retina. The epithelia and capsule of the lens contained SPARC, whereas the cortical and nuclear fibers did not. In contrast, the aqueous humor and vitreous, which provide nutrients to the lens and regulate its development and function, contained significant amounts of SPARC. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis of extracts of various ocular tissues revealed bands of 43 and 29 kD after disulfide bond reduction that were reactive with anti-SPARC IgG. Despite the presence of protease inhibitors during sample preparation, we observed cleavage of intact SPARC to a 29 kD fragment, a peptide reported in other tissues and attributed to endogenous proteolysis. In addition, bands of molecular mass 150 and 200 kD were present that appeared to be disulfide-bonded complexes of SPARC monomers. Human cornea, ciliary epithelium, pigment epithelium and retina also contained SPARC. The presence of SPARC in the aqueous humor and vitreous, as well as in the lens, indicates a functional importance of SPARC in adult human eye as well as in lens development.     

角膜和全眼高阶波前像差的特点及年龄相关性变化的研究

Objective To investigate age-related changes in corneal and ocular monochromatic high-er-order aberrations and elucidate the distribution of corneal primary spherical in Chinese. Methods Using Traeey-iTrace visual function analyzer (EyeSys corneal topography combined with a ray-tracing aberrometer),113 normal eyes of 59 Chinese,mean age of 33.81+20.50 years (range,5-73 years),were evaluated for corneal and ocular monochromatic total higher-order aberrations (HOAs), primary spherical aberration (Z40),total spherical (TS),total coma (TC),and total trefoil aberration (TT) in the central 6mm diameter. Correla-tion analysis was also performed to assess the association between age and both corneal and oeular higher-order aberrations. Results The mean Zemike coefficient of Z40 was (0.27±0.07) ?m (range,0.130～0.451). Al-though corneal Z40 increased slightly with age,the correlation was small and insignificant (r =0.172,p =0.069 ). However, ocular Z40 had a positive correlation with age (r =0.545,p =0.000 ). Analyzer showed positive correlations with age for both corneal (r=0.499,p =0.000) and ocular (r=0.427,p =0.000) HOAs. Positive correlations were also observed between age and both corneal (r=0.149,p =0.021 ) and ocular (r=0.253,p =0.007) TC. Corneal and ocular TT (r =0.344,p =0.000; r=0.185,p =0.050,respectively) were increased with age. No significant correlation was found between corneal TS and age (r =0.180,p =0.057 ), but TS of the whole eye in-creased with age (r =0.560,p =0.000). There was a positive correlation between corneal and ocular HOAs (r =0.327,p=0.000),TC (r=0.233 ,p=0.013),and TT (r=0.481 ,p=0.000) aberration. Conclusions These re-suits also suggest that the ocular HOAs,TC,and TT increase with age,mainly because of the increase in corneal HOAs,TC,and TT; and the ZAO aberration increases with age,mainly because of the increase in Z40 in the internal optics. Individual variability in corneal primary spherical aberration was observed in Chinese.Therefore, preoperative measurement of corneal Z40 is crucial to the selection of aspheric IOL.     

角膜和全眼高阶波前像差的特点及年龄相关性变化的研究

Objective To investigate age-related changes in corneal and ocular monochromatic high-er-order aberrations and elucidate the distribution of corneal primary spherical in Chinese. Methods Using Traeey-iTrace visual function analyzer (EyeSys corneal topography combined with a ray-tracing aberrometer),113 normal eyes of 59 Chinese,mean age of 33.81+20.50 years (range,5-73 years),were evaluated for corneal and ocular monochromatic total higher-order aberrations (HOAs), primary spherical aberration (Z40),total spherical (TS),total coma (TC),and total trefoil aberration (TT) in the central 6mm diameter. Correla-tion analysis was also performed to assess the association between age and both corneal and oeular higher-order aberrations. Results The mean Zemike coefficient of Z40 was (0.27±0.07) ?m (range,0.130～0.451). Al-though corneal Z40 increased slightly with age,the correlation was small and insignificant (r =0.172,p =0.069 ). However, ocular Z40 had a positive correlation with age (r =0.545,p =0.000 ). Analyzer showed positive correlations with age for both corneal (r=0.499,p =0.000) and ocular (r=0.427,p =0.000) HOAs. Positive correlations were also observed between age and both corneal (r=0.149,p =0.021 ) and ocular (r=0.253,p =0.007) TC. Corneal and ocular TT (r =0.344,p =0.000; r=0.185,p =0.050,respectively) were increased with age. No significant correlation was found between corneal TS and age (r =0.180,p =0.057 ), but TS of the whole eye in-creased with age (r =0.560,p =0.000). There was a positive correlation between corneal and ocular HOAs (r =0.327,p=0.000),TC (r=0.233 ,p=0.013),and TT (r=0.481 ,p=0.000) aberration. Conclusions These re-suits also suggest that the ocular HOAs,TC,and TT increase with age,mainly because of the increase in corneal HOAs,TC,and TT; and the ZAO aberration increases with age,mainly because of the increase in Z40 in the internal optics. Individual variability in corneal primary spherical aberration was observed in Chinese.Therefore, preoperative measurement of corneal Z40 is crucial to the selection of aspheric IOL.     

角膜和全眼高阶波前像差的特点及年龄相关性变化的研究

Objective To investigate age-related changes in corneal and ocular monochromatic high-er-order aberrations and elucidate the distribution of corneal primary spherical in Chinese. Methods Using Traeey-iTrace visual function analyzer (EyeSys corneal topography combined with a ray-tracing aberrometer),113 normal eyes of 59 Chinese,mean age of 33.81+20.50 years (range,5-73 years),were evaluated for corneal and ocular monochromatic total higher-order aberrations (HOAs), primary spherical aberration (Z40),total spherical (TS),total coma (TC),and total trefoil aberration (TT) in the central 6mm diameter. Correla-tion analysis was also performed to assess the association between age and both corneal and oeular higher-order aberrations. Results The mean Zemike coefficient of Z40 was (0.27±0.07) ?m (range,0.130～0.451). Al-though corneal Z40 increased slightly with age,the correlation was small and insignificant (r =0.172,p =0.069 ). However, ocular Z40 had a positive correlation with age (r =0.545,p =0.000 ). Analyzer showed positive correlations with age for both corneal (r=0.499,p =0.000) and ocular (r=0.427,p =0.000) HOAs. Positive correlations were also observed between age and both corneal (r=0.149,p =0.021 ) and ocular (r=0.253,p =0.007) TC. Corneal and ocular TT (r =0.344,p =0.000; r=0.185,p =0.050,respectively) were increased with age. No significant correlation was found between corneal TS and age (r =0.180,p =0.057 ), but TS of the whole eye in-creased with age (r =0.560,p =0.000). There was a positive correlation between corneal and ocular HOAs (r =0.327,p=0.000),TC (r=0.233 ,p=0.013),and TT (r=0.481 ,p=0.000) aberration. Conclusions These re-suits also suggest that the ocular HOAs,TC,and TT increase with age,mainly because of the increase in corneal HOAs,TC,and TT; and the ZAO aberration increases with age,mainly because of the increase in Z40 in the internal optics. Individual variability in corneal primary spherical aberration was observed in Chinese.Therefore, preoperative measurement of corneal Z40 is crucial to the selection of aspheric IOL.     

角膜和全眼高阶波前像差的特点及年龄相关性变化的研究

目的 研究人眼角膜和全眼单色高阶波前像差特点及年龄相关性变化.方法 使用Tracey-iTrace视觉功能分析仪测量113只正常国人眼计59人,年龄5～73岁,平均(33.81±20.50)岁,角膜和全眼的球差(Z40)、总高阶像差(HOAs)、总彗差(TC)、总球差(TS)、总三叶草像差(TT).并对角膜和全眼高阶波前像差进行年龄相关性分析.结果 角膜Z40的均方根系数值平均为(0.27±0.07)μm(0.130～0.451)μm,虽然角膜Z40随年龄略呈增加趋势,但无统计学意义(r=0.172,p=0.069).全眼的Z40随年龄增加而增加(r=0.545,p=0.000).角膜的HOAs(r=0.499,p=0.000)、TC(r=0.149,p=0.021)、TT(J=0.344,p=0.000)和全眼的HOAs(r=0.427,p=0.000)、TC(r=0.253,p=0.007)、TT(r=0.185,p=0.050)均随年龄的增加而增加.角膜HOAs、TC、,TT.与全眼相对应像差呈正相关(r=0.327,p=0.000;r=0.233,p=0.013;r=0.481,p=0.000).角膜TS不随年龄而变化(r=0.180,p=0.057),但全眼的TS随年龄的增加而增加(r=0.560,p=0.000).结论 国人角膜的HOAs、Tc、1Tr随年龄的增加而增加,并导致了全眼的上述波前像差随年龄的增加而增高.角膜的TS和Z40不随年龄发生明显变化,全眼的TS和Z40随年龄增加是由于晶状体总球差和球差随年龄增加的结果.国人角膜球差具有较大个体差异性,手术前角膜球差的测量是非球面IOL选择的必要步骤.     

Ocular findings in hemodialysis and following kidney transplantation in childhood and adolescence

Between August 1980 and January 1987, 23 patients undergoing treatment for chronic renal failure underwent eye examinations. Hemodialysis and subsequent kidney transplants were performed in 18 patients; in two patients a kidney transplant was performed alone, and in three others hemodialysis without transplant. The interval between dialysis and transplantation averaged 23.1 months, the mean follow-up after transplantation 20 months. Patients who underwent hemodialysis alone were followed up for periods of two, three and 85 months. The patients' ages when hemodialysis treatment was first instituted ranged from six to 17 years (average 11.8 years). The mean age at the time kidney transplants were performed was 13.6 years (ranging from one to 17 years). Seventeen patients had conjunctival and corneal infiltrations in the area of the palpebral fissure. In two cases infiltrations were confined to the conjunctiva. Four patients had no pathologic changes, in either the cornea or the conjunctiva. Slitlamp examination revealed subcapsular losses of lens transparency in eight patients; these losses were manifested by delicate punctiform and patchy configurations. In nine cases fundus ophthalmoscopy revealed constricted retinal arteries. Within the period of observation all but one of the patients had unchanged vision. The one exception (cystinosis) had reduced visual acuity due to an accumulation of crystalline inclusions in the cornea.     

角膜和全眼高阶波前像差的特点及年龄相关性变化的研究

Objective To investigate age-related changes in corneal and ocular monochromatic high-er-order aberrations and elucidate the distribution of corneal primary spherical in Chinese. Methods Using Traeey-iTrace visual function analyzer (EyeSys corneal topography combined with a ray-tracing aberrometer),113 normal eyes of 59 Chinese,mean age of 33.81+20.50 years (range,5-73 years),were evaluated for corneal and ocular monochromatic total higher-order aberrations (HOAs), primary spherical aberration (Z40),total spherical (TS),total coma (TC),and total trefoil aberration (TT) in the central 6mm diameter. Correla-tion analysis was also performed to assess the association between age and both corneal and oeular higher-order aberrations. Results The mean Zemike coefficient of Z40 was (0.27±0.07) ?m (range,0.130～0.451). Al-though corneal Z40 increased slightly with age,the correlation was small and insignificant (r =0.172,p =0.069 ). However, ocular Z40 had a positive correlation with age (r =0.545,p =0.000 ). Analyzer showed positive correlations with age for both corneal (r=0.499,p =0.000) and ocular (r=0.427,p =0.000) HOAs. Positive correlations were also observed between age and both corneal (r=0.149,p =0.021 ) and ocular (r=0.253,p =0.007) TC. Corneal and ocular TT (r =0.344,p =0.000; r=0.185,p =0.050,respectively) were increased with age. No significant correlation was found between corneal TS and age (r =0.180,p =0.057 ), but TS of the whole eye in-creased with age (r =0.560,p =0.000). There was a positive correlation between corneal and ocular HOAs (r =0.327,p=0.000),TC (r=0.233 ,p=0.013),and TT (r=0.481 ,p=0.000) aberration. Conclusions These re-suits also suggest that the ocular HOAs,TC,and TT increase with age,mainly because of the increase in corneal HOAs,TC,and TT; and the ZAO aberration increases with age,mainly because of the increase in Z40 in the internal optics. Individual variability in corneal primary spherical aberration was observed in Chinese.Therefore, preoperative measurement of corneal Z40 is crucial to the selection of aspheric IOL.     

Laser iris reconstruction in pupil deformities and dislocation in aphakia and pseudophakia

Up-to-date methods of laser iris reconstruction in pupil deformities and dislocation are presented (photomydriasis, corepraxia, synechiolysis).     

视网膜母细胞瘤治疗及研究进展

随着基础研究和临床实践的逐步深入,视网膜母细胞瘤（ RB）的治疗模式已发生改变。目前,RB的治疗方法包括局部治疗、化学治疗、放射治疗、手术治疗、基因治疗等,本文将就RB的治疗及研究进展进行综述。     

Effect of butyrate and corticosteroids on retinoblastoma in vitro and in vivo

The effect of sodium butyrate (NaB) alone and in combination with a glucocorticoid was studied on Y-79 retinoblastoma cells both in vitro and in vivo. Both NaB (0.5 and 4 mM) and hydrocortisone (1-100 microM) added separately to cells grown in suspension resulted in a small growth inhibition (less than 15%). A marked synergistic effect (75-77% growth inhibition) was observed in vitro when NaB and hydrocortisone were added in combination at all the concentrations tested. With in vivo experiments using the nude mouse model of retinoblastoma, the combination of NaB and methylprednisolone did not inhibit tumor growth.     

Sclerosing inflammation in the orbit and in the pterygopalatine and infratemporal fossae

PURPOSE: To describe two cases with sclerosing inflammation in the orbit and in the pterygopalatine and infratemporal fossae and to review the literature of head and neck idiopathic inflammation. METHODS: Interventional case series. Two clinical case reports of sclerosing inflammation in the orbits and in the pterygopalatine and infratemporal fossae are presented. A review of the literature and discussion was performed. RESULTS: Both patients had histologic findings typical of chronic orbital sclerosing inflammation, including mature lymphocytes associated with dense collagen deposition and occasional lymphoid follicles. Bone erosion was present in one patient. CONCLUSIONS: The clinical findings of this case series concur with the literature that idiopathic inflammation can be found simultaneously in the orbit and in the infratemporal and pterygopalatine fossae. These cases of idiopathic inflammation are often clinically indistinguishable from malignant neoplasms.     

Buoyancy of human and intraocular lenses in air and in aqueous humor

The weights of seven human lenses in air and in aqueous humor were determined and compared to those of ten intraocular lens implants (IOLs). All IOLs tested were found to be significantly lighter than the human lenses in both air and in the aqueous humor.     

Fibrin: mediator of in vivo and in vitro injury and inflammation

We examined the role that fibrin deposition and fibrin-associated factors (FAF) play in acute anterior segment inflammatory responses in the rabbit eye. It was demonstrated by immunofluorescence that fibrin represented a major component of the exudative meshwork deposited within the anterior chamber and on leukocyte surfaces therein. Using our in vivo model of endocular inflammation we next demonstrated that fibrin and fibrinogen-derived peptides, but not thrombin, induced inflammatory responses characterized by both leukocyte influx and endothelial cell injury. Fibrin formation within the anterior chamber induced a leukocyte influx consisting primarily of PMN's. Fibrinogen-derived peptides induced primarily a monocyte influx. This dichotomy suggests that multiple inflammatory mediators are elaborated or released during endocular fibrinogenesis and fibrinolysis. To investigate direct effects of fibrin deposition on the corneal endothelial cells (CEC) an in vitro "corneal cup" organ culture model was next developed. Studies comparing various types of mediators demonstrated that only fibrin- derived preparations directly induced CEC injury. Fibrin deposition may thus play multiple roles in endocular inflammation, including the modulation of leukocyte influx, and the direct mediation of corneal endothelial cell injury.     

角膜和全眼高阶波前像差的特点及年龄相关性变化的研究

Objective To investigate age-related changes in corneal and ocular monochromatic high-er-order aberrations and elucidate the distribution of corneal primary spherical in Chinese. Methods Using Traeey-iTrace visual function analyzer (EyeSys corneal topography combined with a ray-tracing aberrometer),113 normal eyes of 59 Chinese,mean age of 33.81+20.50 years (range,5-73 years),were evaluated for corneal and ocular monochromatic total higher-order aberrations (HOAs), primary spherical aberration (Z40),total spherical (TS),total coma (TC),and total trefoil aberration (TT) in the central 6mm diameter. Correla-tion analysis was also performed to assess the association between age and both corneal and oeular higher-order aberrations. Results The mean Zemike coefficient of Z40 was (0.27±0.07) ?m (range,0.130～0.451). Al-though corneal Z40 increased slightly with age,the correlation was small and insignificant (r =0.172,p =0.069 ). However, ocular Z40 had a positive correlation with age (r =0.545,p =0.000 ). Analyzer showed positive correlations with age for both corneal (r=0.499,p =0.000) and ocular (r=0.427,p =0.000) HOAs. Positive correlations were also observed between age and both corneal (r=0.149,p =0.021 ) and ocular (r=0.253,p =0.007) TC. Corneal and ocular TT (r =0.344,p =0.000; r=0.185,p =0.050,respectively) were increased with age. No significant correlation was found between corneal TS and age (r =0.180,p =0.057 ), but TS of the whole eye in-creased with age (r =0.560,p =0.000). There was a positive correlation between corneal and ocular HOAs (r =0.327,p=0.000),TC (r=0.233 ,p=0.013),and TT (r=0.481 ,p=0.000) aberration. Conclusions These re-suits also suggest that the ocular HOAs,TC,and TT increase with age,mainly because of the increase in corneal HOAs,TC,and TT; and the ZAO aberration increases with age,mainly because of the increase in Z40 in the internal optics. Individual variability in corneal primary spherical aberration was observed in Chinese.Therefore, preoperative measurement of corneal Z40 is crucial to the selection of aspheric IOL.     

角膜和全眼高阶波前像差的特点及年龄相关性变化的研究

Objective To investigate age-related changes in corneal and ocular monochromatic high-er-order aberrations and elucidate the distribution of corneal primary spherical in Chinese. Methods Using Traeey-iTrace visual function analyzer (EyeSys corneal topography combined with a ray-tracing aberrometer),113 normal eyes of 59 Chinese,mean age of 33.81+20.50 years (range,5-73 years),were evaluated for corneal and ocular monochromatic total higher-order aberrations (HOAs), primary spherical aberration (Z40),total spherical (TS),total coma (TC),and total trefoil aberration (TT) in the central 6mm diameter. Correla-tion analysis was also performed to assess the association between age and both corneal and oeular higher-order aberrations. Results The mean Zemike coefficient of Z40 was (0.27±0.07) ?m (range,0.130～0.451). Al-though corneal Z40 increased slightly with age,the correlation was small and insignificant (r =0.172,p =0.069 ). However, ocular Z40 had a positive correlation with age (r =0.545,p =0.000 ). Analyzer showed positive correlations with age for both corneal (r=0.499,p =0.000) and ocular (r=0.427,p =0.000) HOAs. Positive correlations were also observed between age and both corneal (r=0.149,p =0.021 ) and ocular (r=0.253,p =0.007) TC. Corneal and ocular TT (r =0.344,p =0.000; r=0.185,p =0.050,respectively) were increased with age. No significant correlation was found between corneal TS and age (r =0.180,p =0.057 ), but TS of the whole eye in-creased with age (r =0.560,p =0.000). There was a positive correlation between corneal and ocular HOAs (r =0.327,p=0.000),TC (r=0.233 ,p=0.013),and TT (r=0.481 ,p=0.000) aberration. Conclusions These re-suits also suggest that the ocular HOAs,TC,and TT increase with age,mainly because of the increase in corneal HOAs,TC,and TT; and the ZAO aberration increases with age,mainly because of the increase in Z40 in the internal optics. Individual variability in corneal primary spherical aberration was observed in Chinese.Therefore, preoperative measurement of corneal Z40 is crucial to the selection of aspheric IOL.