B型超声检查对渗出型老年性黄斑变性的诊断价值

目的:探讨渗出型老年性黄斑变性(Age-related macular degeneration,AMD)的B型超声影象特征。方法:采用NIDEKUS-3300型超声诊断仪,对31例(54只眼)渗出型AMD进行了观察。结果:视网膜色素上皮脱离时,眼内后极部出现膜状弧形回声,光带与眼球壁之间,可见一个梭形透声区;渗出或出血未完全吸收阶段,呈混合性回声;渗出或出血逐渐吸收并为瘢痕组织所替代时,可见实体性小隆起物,强回声,形状似凸透镜或三角形,凸起端指向球后,玻璃体腔面平坦。结论:B型超声在渗出型AMD的诊断、治疗随访观察中具有实用价值。眼科学报1999;15:233-235。     

年龄相关性黄斑变性的研究进展

年龄相关性黄斑变性(age-related macular degeneration,AMD)是目前全球主要致盲性眼病之一,发病率不断增加.其病因和发病机制尚未完全明确,尚无非常有效的治疗方法.近年来在发病机制、遗传因素、危险因素等方面又有了新的研究,治疗手段也有增加,但也存在很多问题.中医中药在治疗AMD方面积累了很多经验,取得了一定的疗效,并有其独特的优势,值得进一步研究.     

Phenotypic Expression of CFH Rare Variants in Age-Related Macular Degeneration Patients in the Coimbra Eye Study

PurposeTo determine the association between rare genetic variants in complement factor H (CFH) and phenotypic features in age-related macular degeneration (AMD) patients from the Coimbra Eye Study (CES).MethodsAMD patients from the Incidence CES ({"type":"clinical-trial","attrs":{"text":"NCT02748824","term_id":"NCT02748824"}}NCT02748824) underwent ophthalmologic examination and color fundus photography, spectral-domain optical coherence tomography (SD-OCT), fundus autofluorescence, and near-infrared imaging. Multimodal phenotypic characterization was carried out in a centralized reading center. The coding and splice-site regions of the CFH gene were sequenced through single-molecule molecular inversion probe–based next-generation sequencing in association with the EYE-RISK consortium. Variants with minor allele frequency <0.05 resulting in splice-site or protein change were selected. Differences in phenotypic features between carriers and noncarriers were analyzed using generalized estimated equations logistic regression models, considering intereye correlations.ResultsWe included 39 eyes of 23 patients carrying rare CFH variants and 284 eyes of 188 noncarriers. Carrier status was associated with having higher drusen burden in the macula in the inner Early Treatment Diabetic Retinopathy Study circle (odds ratio [OR], 5.44 [95% confidence interval {CI}, 1.61–18.37]; P = 0.006), outer circle (OR, 4.37 [95% CI, 1.07–17.77]; P = 0.04), and full grid (OR, 4.82 [95% CI, 1.13–20.52]; P = 0.033). In SD-OCT, a lower total macular volume and lower inner retinal layers’ volume (OR, 0.449 [95% CI, 0.226–0.894]; P = 0.023; OR, 0.496 [95% CI, 0.252–0.979]; P = 0.043) and pigment epithelial detachments (PEDs) (OR, 5.24 [95% CI, 1.08–25.44]; P = 0.04) were associated with carrying a rare CFH variant. Carriers with subretinal drusenoid deposits (SDD) had the rare variant P258L in all cases except one.ConclusionsWe identified in our cohort phenotypic differences between carriers and noncarriers of rare variants in the CFH gene. Carriers had more severe disease, namely superior drusen burden, PEDs, and thinner retinas. The rare variant P258L may be associated with SDD. Carriers are probably at increased risk of progression.     

柚皮素对ARPE-19和HUVEC细胞的抗氧化作用

目的：研究柚皮素对人视网膜色素上皮细胞（ARPE-19）和人脐静脉内皮细胞（HUVEC）的抗氧化作用。 方法：采用MTT的方法检测ARPE-19和HUVEC细胞的生存率及增殖率。 结果：3，10mg／L柚皮素能显著增加ARPE-19细胞的增殖率达10．8％和11．4％。10mg／L柚皮素能提高ARPE-19细胞在缺氧，0．3mmol／LNaN，及200μmol／L，H2O2条件下的生存率分别为55．2％，69．2％及50．3％。1mg／L柚皮素能提高ARPE-19细胞在50μmol／L t-BHP和30mg／LNaIO3条件下的生存率达20．2％和30．4％。30mg／L柚皮素能够促进ARPE-19细胞在50μmol／L t-BHP条件下的增殖率达32．2％，而1mg／L柚皮素可以提高30，100，300mg／LNaIO3处理的ARPE-19细胞的增殖率达30．3％，10．3％及18．5％。3，10及30mg／L柚皮素抑制HUVEC的增殖率分别为23．9％，70．4％及77．9％。1，3mg／L柚皮素能提高HUVEC细胞在缺氧条件下的生存率达10．7％和13．1％，以及提高在300mg／LNaIO3条件下的生存率达41．2％和37．7％。3mg／L柚皮素能提高HUVEC细胞在200，400μmol／L H2O2条件下的生存率达20．1％和21．5％． 结论：柚皮素能够促进ARPE-19细胞的增殖率，抑制HU-VEC生长，同时对这两种细胞均有抗氧化作用。因此，柚臾素是治疗老年黄斑变性的很有前景的候选药物。     

Acupuncture may Improve Vision in Patients with Age-related Macular Degeneration (AMD): An Observational Study

Background and Aims

Age-related macular degeneration (AMD) is a disease associated with aging that gradually destroys sharp, central vision. Treatment options for AMD are limited and often vision loss cannot be prevented. The present study was performed to evaluate the effects of acupuncture treatment on vision in AMD patients.

Methods

A total of 328 patients with a clinical diagnosis of AMD were treated over a period of 2 weeks (Monday to Friday) with acupuncture given two times per day with a minimum time of 60 minutes between treatments. Vision was evaluated at baseline, after one and after two weeks of treatment by a distant (3 m) and at near (40 cm) standard reading test.

Results

Median visual acuity improved during the first treatment week at both distances (p < 0.001). Further improvement of visual acuity was observed during the second week (p < 0.001). From baseline examination to the final examination, vision at 3 m distance improved in 145 (44.2%) patients and vision at 40 cm distance improved in 290 (88.4%) patients.

Conclusion

We conclude that acupuncture may be a useful treatment option in patients with AMD. Double-blinded, randomized sham-controlled studies will be necessary for final proof of action.     

Patient-specific induced pluripotent stem cells (iPSCs) for the study and treatment of retinal degenerative diseases

Vision is the sense that we use to navigate the world around us. Thus it is not surprising that blindness is one of people's most feared maladies. Heritable diseases of the retina, such as age-related macular degeneration and retinitis pigmentosa, are the leading cause of blindness in the developed world, collectively affecting as many as one-third of all people over the age of 75, to some degree. For decades, scientists have dreamed of preventing vision loss or of restoring the vision of patients affected with retinal degeneration through drug therapy, gene augmentation or a cell-based transplantation approach. In this review we will discuss the use of the induced pluripotent stem cell technology to model and develop various treatment modalities for the treatment of inherited retinal degenerative disease. We will focus on the use of iPSCs for interrogation of disease pathophysiology, analysis of drug and gene therapeutics and as a source of autologous cells for cell transplantation and replacement.     

Quantitative evaluation of vitamin E in the treatment of angina pectoris.

Because of previous reports of the beneficial effect of vitamin E in angina pectoris patients, 48 patients, with both stable angina and positive (chest pain plus ishemic ST depression) maximal exercise treadmill tests, participated in a double-blind cross-over study of 6 months of vitamin E and 6 months of placebo therapy, separated by a 2 month no treatment period. All 48 patients had positive selective coronary arteriograms (75 per cent obstruction of at least a major coronary artery) and/or Q wave ECG evidence of previous myocardial infarction (Minnesota criteria). Evaluation of drug effectiveness was based on performance of serial maximal exercise treadmill tests, serial systolic time interval measurements, and daily angina diaries. No statistically significant differences between the two treatment studied. It is concluded that a large dose of vitamin E (1,600 I.U. of d-alpha-tocopherol succinate daily) for 6 months in patients with stable angina pectoris fails to increase the exercise capacity, improve left ventricular function, or reduce the frequency of chest pain.     

CXCR4 blockade and Sphingosine‐1‐phosphate activation facilitate engraftment of haematopoietic stem and progenitor cells in a non‐myeloablative transplant model

Both immunosuppressive and cytoreductive effects of γ‐irradiation contribute to engraftment of allogeneic haematopoietic stem and progenitor cells. We hypothesized that a release of host stem and progenitor cells from the niche prior to conditioning would permit engraftment after less intensive conditioning. Administration of AMD3100 and SEW2871 on days ?4 to ?2 followed by irradiation on day ?1 in a non‐myeloablative zebrafish transplant model resulted in a reduced radiation minimum dose of 10 Gy from 15 Gy being sufficient for engraftment. Targeting the SDF‐1 (CXCL12)/CXCR4‐ and S1P/S1P₁‐axis increased the efficacy of allografting in an experimental transplant model.