Idiopathic macular hole (IMH) refers to full thickness defects of retina in macular area with no clear reasons. The management of IMH includes vitrectomy combined with internal limiting membrane (ILM) peeling and pharmacological vitreolysis. But ILM peeling may damage the inner retina; novel techniques, such as inverted ILM flap technique and foveola non-peeling ILM surgery, autologous ILM transplantation had made the method of ILM peeling more diversified with less damage. Pharmacological vitreolysis targeting fibronectin and laminin is considered to work in a two-step mechanism, involving both vitreoretinal separation and vitreous liquefaction. Furthermore, IMH judgment and prognosis indicators like ellipsoid zone, macular hole index, hole formation factor, diameter hole index and tractional hole index based on spectral domain optical coherence tomography enriched the assessment of macular hole diameter, depth and shape. How to make full use of new interventions to reduce the incidence of macular hole and obtain a better visual acuity with closed holes is an important direction for future research.
ObjectivesTo evaluate the therapeutic effect of argon laser photocoagulation combined with intravitreous injection of triamcinolone acetonide (TA) on ischemic central retinal vein occlusion (CRVO).MethodsArgon laser photocoagulation combined with intravitreous injection of TA was performed on 17 patients (17 eyes) with CRVO between December 2003 and July 2004.ResultsDuring the follow-up of 4-10 months, the visual acuity improved in 16 patients, including alleviated or even disappeared cystoid macular edema (CME) in 5, and recurred macular edema in 5 with decreased visual acuity after 3 months. Six patients had increased ocular pressure after intra-ocular injection which alleviated after treated suitably. No neovascularization in angle or secondary neovascular glaucoma was found.ConclusionArgon laser photocoagulation combined with intravitreous injection of TA may improve the visual acuity and reduce complications in ischemic CRVO, though macular edema may recur in some cases. (Chin J Ocul Fundus Dis, 2005,21:224-225)
Objective To investigate the effect of topical treatment with antisense oligonucleotides（ASON）targeting tumor necrosis factor-alpha;（TNF-alpha;）on the pathological process of experimental herpes simplex virus type-Ⅰ（HSV-Ⅰ）induced chorioretinitis in mouse eye. Methods Fifty BALB/c mice were randomly divided into experimental and control group（twenty five mice in each group）.HSV chorioretinitis model was induced in each mouse by inoculating 1times;105 plaque-forming units （pfu） of HSV-Ⅰ（KOS strain）into anterior chamber of the right eye.In experimental group，Fluorescein isothiocyanate （FITC）-labeled ASON targeting TNF-alpha; 2 mu;l were injected sub-conjunctiva in the left eye1day before and 1 and 4 days after the infection;while phosphate buffer solution was injected in the same way in control group.The inflammation changes of the eyes in the 2 groups were observed and the clinical grades were assessed according to the extends of anterior-chamber inflammation，vasodilatation of cornea and iris，formation of cataract，and vitreous opacity. All of the mice were executed 10 days after the infection and were observed histologically. The contents of TNF-alpha; in retina and choroid were measured by enzyme-linked immunobsorbent assay（ELISA）. Results After the infection，acute inflammation appeared in the right eyes in both groups. The inflammation of the left eyes in experimental group was significantly milder than which in the control group.Twelve left eyes had necrotic chorioretinitis in different degrees in the control group while 2 left eyes had mild chorioretinitis in the experimental group. The difference of the number of inflammatory cells between the 2 groups was statistically significant in retina，choroid，and ciliary body（P＜0.05）and was not obvious in anterior chamber，vitreous cavity，and iris（P＞0.05）.The content of TNF-alpha; in choroid and retina was（60plusmn;1.25）pg in the experimental group and（305plusmn;1.03）pg in the control group（P＜0.05）. Conclusions TNF-alpha; ASON treating HSV-Ⅰinduced chorioretinitis may reduce the content of TNF-alpha; in affected mice eyes and decrease the inflammatory reaction. (Chin J Ocul Fundus Dis, 2006, 22: 245-248)
ObjectiveTo observe the effects of overexpression of S100A4 protein on retinal capillary cells and retinal ganglion cells (RGC) after retinal ischemia-reperfusion injury (RIRI). MethodsOne hundred healthy adult male C57BL/6 mice were randomly divided into normal control group (group C), RIRI group, adeno-associated virus (AAV2)-S100A4 green fluorescent protein (GFP) intravitreal injection group (group S), RIRI+AAV2-GFP intravitreal injection group (group GIR), and RIRI+AAV2-S100A4-GFP intravitreal injection group (group SIR), with 20 mice in each group. The RIRI model was established using the high intraocular pressure anterior chamber method in the RIRI, GIR and SIR groups of mice. Eyes were enucleated 3 days after modelling by over anaesthesia. The number of retinal capillary endothelial cells and pericytes in the retinal capillaries of mice in each group was observed by retinal trypsinised sections and hematoxylin-eosin and periodic acid-Schiff staining; immunofluorescence staining was used to observe endothelial cell, pericyte coverage and RGC survival; The relative expression of Toll-like receptor 4 (TLR4), p38 MAPK and nuclear factor erythroid 2-related factor 2 (NRF2) in retinal tissues was measured by Western blot. One-way analysis of variance was used to compare data between groups. ResultsThree days after modeling, the endothelial cell to pericyte ratio in group C was compared with group S and SIR, and the difference was not statistically significant (F=106.30, P＞0.05); the SIR group was compared with group RIRI and GIR, and the difference was statistically significant (F=106.30, P＜0.000 1). Comparison of endothelial cell coverage in each group, the difference was not statistically significant (F=3.44, P＞0.05); compared with the pericyte coverage in group C, the RIRI group and the GIR group were significantly lower, and the difference was statistically significant (F=62.69, P＜0.001). Compared with the RGC survival rate in group C, it was significantly lower in RIRI and GIR groups, and the difference was statistically significant (F=171.60, P＜0.000 1); compared with RIRI and GIR groups, the RGC survival rate in SIR group was significantly higher, and the difference was statistically significant (F=171.60, P＜0.000 1). The relative expression levels of TLR4, p38 and NRF2 proteins were statistically significant among all groups (F=42.65, 20.78, 11.55; P＜0.05). ConclusionsPericytes are more sensitive to ischemia than endothelial cells after retinal RIRI in mice, and early vascular cell loss is dominated by pericytes rather than endothelial cells. The overexpression of S100A4 protein protects against loss of pericytes and RGC after RIRI by inhibiting the TLR4/p38/NRF2 signaling pathway.
Objective To investigate the inhibitory effects and possible related mechanism of OTX008 [a selective inhibitor of galectin-1 (Galectin-1)] on retinal neovascularization (RNV) in mouse model of oxygen-induced retinopathy (OIR). Methods 7-day-old (P7) C57BL/6J mice were randomly (according to random number table) divided into 4 groups including normal group, OIR group, OIR-OTX008 group and OIR-phosphate buffered saline (PBS) group. To establish the OIR mouse model, mice from all groups except normal group were expose to (75±2)% oxygen for 5 days and then to room air. OIR-OTX008 group received an intravitreal injection of 1 μl (0.25 μg/μl) OTX008 at P12, OIR-PBS group received the equal volume (1 μl) of PBS injection. Mice from 4 groups were euthanized at P17, and retinas were collected for molecular biological analysis and morphological study. RNV was evaluated by counting the number of pre-retinal neovascular nuclei and the whole-mount immunofluorescent staining of mouse retina. Cyrosections of retinas were imaged via confocal microscopy to observe the enrichment of staining of Galectin-1. Protein levels of Galectin-1, Neuropilin-1 and phosphorylation of vascular endothelial growth factor receptor 2 (pVEGFR2) were determined with Western blot. Results At P17, Galectin-1 expressed higher in retinal ganglion cell layer, inner plexiform layer and inner nuclear layer from OIR group and OIR-PBS group than normal group. Galectin-1 expressed less in cryosection retinas from OIR-OTX008 group than OIR group and OIR-PBS group. The numbers of pre-retinal neovascular cell nuclei from OIR group and OIR-PBS group were obviously more than that from normal group (t=9.314,P＜0.05). The number of pre-retinal neovascular cell nuclei from OIR-OTX008 group were obviously lower than those from OIR group and OIR-PBS group (t=8.038, 7.774;P＜0.05). The RNV tufts area (t=13.250, 12.570), non-perfusion area (t=15.590, 12.430) and hypoxic area (t=9.542, 9.928) from OIR-OTX008 group were significantly smaller than those in OIR group and OIR-PBS group (P＜0.05). Protein levels of Galectin-1 (t=24.800, 23.060), Neuropilin-1 (t=4.120, 3.530) and pVEGFR2 (t=25.880, 15.480) in the OIR-OTX008 group were significantly down-regulated than those from OIR group and OIR-PBS group (P＜0.05). Conclusion Intravitreal injection of OTX008 inhibits RNV and ameliorates retinal hypoxia in mice model of OIR possibly through down-regulating Galectin-1, Neurolinpin-1 and pVEGFR2.
ObjectiveTo observe the changes in physical properties of silicone oil after intraocular tamponade. MethodsThe silicone oil was removed from 99 patients (99 eyes) of primary retinal detachment with 23G vitreous cutter system. The upper silicone oil was collected after put the vitrectomy samples at room temperature for 3 days. According to the time of intraocular tamponade, the silicone oil samples were divide into six groups including group A (1 month, 12 samples), group B (2 months, 15 samples), group C (3 months, 25 samples), group D (6 months, 22 samples), group E (1-2 years, 13 samples) and group F (above 2 years, 12 sample). Fresh unused silicone oil was set as blank control group. Then the emulsion particles, kinematic viscosity, surface tension, density, transmittance and refractive index were measured. ResultsThe difference between group A-F and the control was statistical significant (P<0.05) in emulsion particles (F=89.337), kinematic viscosity (F=10.660), surface tension (F=11.810), density (F=13.497), transmittance of wavelengths (F=455.496, 566.105, 525.102, 767.573, 622.961, 601.539), but not statistical significant at refractive index (F=2.936, P>0.05). The number of silicone oil emulsion particles has no statistical difference between group A and the control (P>0.05), but was significantly different between group B-F (P<0.05). The kinematic viscosity of silicone oil has no statistical difference between group A, B and the control (P>0.05), but was significantly different between group C-F (P<0.05). The surface tension of silicone oil has no statistical difference between group A-D and the control (P>0.05), but is significantly different between group E and F (P<0.05). The density of silicone oil has no statistical difference between group A-D and the control (P>0.05), but was significantly different between group E and F (P<0.05). The transmittance of silicone oil has statistical difference between group A-F and the control(P<0.05). The refractive index of silicone oil has no statistical difference between all the groups and the controls significantly (P>0.05). ConclusionsThe physical properties of silicone oil will change during the intraocular tamponade. The emulsion particles number will increase and the transmittance will decrease after 2 months, the kinematic viscosity of silicone oil will decrease significantly after 3 months, and the density and surface tension will change significantly after 1 year of tamponade.