Objective To summarize the visual outcome of patients with severe ocular trauma treated with vitreous surgery. Methods Clinical data of 188(191 eyes) with severe ocular trauma treated with vitreous surgery in a period from November 1996 to April 1998 were analysed retrospectively. Results The study included penetrating injury in 56 eyes, foreign bodies in the posterior segment in 70 eyes, blunt injury in 41 eyes , and globe rupture in 24 eyes. Main complications included endophthalmitis in 35 eyes, choroidal bleeding in 20 eyes, retinal detachment in 60 eyes, and vitreous hemorrhage in 97 eyes. Post-opera-tively, out of 188 eyes, except for 3 of patients too young to examine, visual acuity improved in 133(70.7%), including 85(45.2%) with visal acuity 0.02-1.0, 46(24.5%) remained unchanged; and 9(4.8%) had worse vision. Among 34 with no-light-perception, 12 had light-perception or over. Conclusion A majority of severe trauma eyes can be salvaged with considerable visual recovery after adequate and timely vitreous surgery. (Chin J Ocul Fundus Dis,1999,15:4-6)
Objective To evaluate the indications, effectiveness and complications of vitreoretinal surgery using the 25G transconjunctival sutureless vitrectomy system (TSV25G) under the topical anesthesia. Methods The clinical and follow-up data of 22 eyes of 22 patients undergone vitreo-retinal surgery using TSV25G under the topical anesthesia were retrospectively analyzed. All of the patients were monocular sickened, including idiopathic macular hole in 10 eyes, idiopathic macular pucker in 6, vitreoretinal traction syndrome in 4, and vitreous hemorrhage associated with branch retinal vein occlusion in 2. Peeling of epiretinal membrane and/or internal limiting membrane, intra ocular laser coagulation, air-fluid exchange and tamponiding of C3F8 were performed according to the condition of diseases. The postoperative follow-up was 1-11 months, with the mean duration of 6.4 months. The effect of analgesia, cooperation with the patients, operative effect and complications in and after the surgery were observed. Results The operations finished successfully in all of the eyes under the topical anesthesia. The operation duration ranged from 20 to 25 minutes with average of 22 minutes. The patients cooperated with the doctor well without any discomfort. Two days after the surgery, edema of the wounded conjunctiva was found, and recovered 7 days later. A light pigment dot on the surface of the sclera could be seen at the first month. The complic ations included transient increasing of intraocular pressure in 2 eyes, feather-like opacity of lens in 5 eyes, vitreous hemorrhage in 1 eye, and air-bleb under conjunctiva in 2 eyes. No other complications related with the cut were fo und. The macular hole closed in 9 eyes with idiopathic macular hole, and the other 1 had the smaller but not closed hole. Idiopathic macular pucker, vitreoretinal traction syndrome, and vitreous hemorrhage associated with branch retinal vein occlusion were cured successfully. Conclusions Vitreoretinal surgery using the TSV25G under the topical anesthesia has many advantages such as simple procedure, short operation time, micro-invasion, less complications and rapid revovery, and mainly serves simple manipulation in some simple diseases such as idiopathic macular hole, vitreo-retinal traction syndrome, and simple hemorrhage. (Chin J Ocul Fundus Dis，2004，20：133-136)
A review of 426 patients with retinoblastoma(RB)who presented to Eye Hospital of Zhongshan Ophthalmic Center from 1966 to 1991 showed that 81(19.01%)patients were more than or equal to 5 years of age(median age 6.95 years)at the time of initial diagnosis.All patients are unilateral except 4 cases who are bilateral.The main presentations included leukocoria,exophthalmos,congertion and pain of the eye,drcreased vision,strabismus,oculare hypertension,vitreous opacity,hypopyon and hyphema,etc.Some atypical presentations in these older patients with RB were discussed and some problems that should be noticed in the diagnosis and management were presented.discussed and some problems that should be noticed in the diagnosis and management were presented. （Chin J Ocul Fundus Dis,1993,9:205-206）
Diabetic retinopathy is a vascular complication of diabetes, and homocysteine is an intermediate product of methionine metabolism. Hyperhomocysteinemia can directly or indirectly damage vascular endothelial cells, causing vascular endothelial cells dysfunction and participating in the occurrence and development of diabetic retinopathy. Uric acid is the final product of purine metabolism. Hyperuricemia can cause vascular endothelial dysfunction, oxidative metabolism, platelet adhesion and aggregation dysfunction, thus participating in the occurrence and development of diabetic retinopathy. In recent years, there have been many studies on the correlation between diabetic retinopathy and levels of homocysteine and uric acid. This article reviews the relevant literature at home and abroad in order to provide new information for the prevention and treatment of diabetic retinopathy.
Objective To investigate the expression of costimulatory molecules, Fas/FasL, and major histocompatibility complex (MHC)-class II antigens in normal ocular tissues. Methods Twelve eyes were obtained from the eye bank of Zhongshan Ophthalmic Center within 16 to 24 hours postmortem. Six eyes were used for making the retinal wholemounts, and the tissues (iris and ciliary body, choroid, and retina) of the others were used for making the frozen sections. Immunohistochemical staining was carried out on these retinal wholemounts as well as on tissue sections to investigate the exprenion of B7-1 and B7-2 (costimulatory molecules), HLA-DR(MHC class II), CD68 (macrophages), Fas/FasL. Results The results of immunohistochemical staining showed the presence of B7-2, FasL, CD68 and HLA-DR in the iris and ciliary body. Expression of B7-1, FasL, CD 68, and HLA-DR was found in the choroid while HLA-DR, CD68 and FasL were detec table in the retina. Conclusion Expression of costimulatory molecu les, MHC-class II molecules and molecules related to apoptosis is different in the iris, ciliary body, choroid, and retina, which may play an important role in the stability of the immunological microenvironment of these tissues.(Chin J Ocul Fundus Dis，2003，19：109-112)
Objective To compare the axial length (AL) measured by Lenstar and contact AScan in the patients with idiopathic macular hole and study the correlation between the difference of the two measurements and the foveal thickness measured by optical coherence tomography (OCT). Methods Twenty-seven eyes of 26 idiopathic macular hole patients (IMH group) and 27 eyes of 25 patients with mild cataract (control group) were enrolled in this study. Foveal thickness was measured with 3D OCT. The AL was measured by Lenstar and contact A-Scan, and the consistency of the two measurements was determined by Bland-Altman analysis. The correlation between the difference of the two measurements and foveal thickness was analyzed by Pearson correlation analysis. Results Mean foveal thickness of IMH and control eyes were （372.85±60.02） μm and （243.44±22.50） μm, respectively. The difference between the foveal thickness of the two groups was highly significant (t=-10.490，P＜0.001). In the IMH group, the AL measured by Lenstar and contact A-Scan were (23.20±1.12) mm and (23.18±1.13) mm, respectively, the difference between the two measurements was not statistically significant (t=-0.549，P=0.588), whereas in the control group, the AL was (23.41±0.72) mm by Lenstar and (23.33±0.74) mm by contact A-Scan, the two measurements were significantly different (t=-4.832，P＜0.001). However, no correlation was found by Pearson correlation analysis between the difference of the two measurements and the foveal thickness in either IMH or control group (r=0.181，-0.141;P＞0.05). ConclusionsAlthough there is no difference of axial length measurements using Lenstar and contact A-Scan in IMH eyes, in clinical measurements the results of two instruments should be taken into comprehensive consideration.
Objective To establish a purified model of rat retinal ganglion cells （RGCs） cultured by serum-free medium，and provide a good cell model to investigate the damage of RGCs in glaucoma，retinal ischemia，and degenerative retinopathy. Methods Two monoclonal antibodies，anti-rat SIRP（OX-41）against rat macrophage and antibody against rat Thy-1（OX-7），were used to purify and characterize RGCs from 1-3-day old Sprague-Dawley（SD）rats by means of two-step filtration.Purified RGCs were cultured in serum-free neurobasal medium containing B27 and ciliary neurotrophic factor（CNTF） meeting the neuronal cellrsquo;s special requirements.Photomicrographs illustration，immunfluorescence staining of Thy-1，calcein-acetoxymethyl ester（calcein-AM）fluorescence images were used to observe and identify cultured retinal cells and purified RGCs. Results Among the primary cultured rat retinal cells，91% were retinal neurons.Protuberances of RGCs were seen after cultured for 24 hours.At the4th to 8th day，many cells had uniform configuration，large body，and long protuberances. At the 14th day，over 60% cells maintained viability.Immunoflurescence staining of Thy-1 showed the purity of RGCs was about 90%. The results of calcein-AM staining，which stained the living cells only，showed large cell body of RGCs and most of RGCs had a protuberance whose length was twice longer than the diameter of the cells. Conclusion RGCs cultured by serum-free medium has uniform size，good configuration，and high purity，which is adapt to the research of damage of RGCs caused by various factors and to evaluate the protective effects of neuroprotective agents. (Chin J Ocul Fundus Dis, 2006, 22: 200-203)
Objective To evaluate the variability of four parameters of multi-focal electroretinogram (mERG) a-wave amplitude, b-wave amplitude, awave latent period, b-wave latent period. Methods Sixty normal eyes of 46 volunteers were divided into 3 groups of different ages. RETIscan 3-12 system was used to carry out mERG examination. The stimulus matrix of 61 hexagonal elements spanning the central 24deg;of the visual field. These hexons were scaled with eccentricity and divide d into 5 rings. First-order kernel was selected. Results The variability of four parameters of mERG was great. The variability of b-wave latent period was the smallest, its coefficient of variatian was 4.52%～15.62%；that of a-wave latent period held the second place:10.29%~48.67%；that of b-wave amplitude was greater:25.92%~76.11%；that of a-wave amplitude was the greatest:43.82%~88.23%. The results of three groups showed that b-wave amplitude of ring 1 had the smallest variability. Conclusions The variability of latent period is smaller than that of amplitude; the variability of b-wave was smaller than that of a-wave. The longer the centrifugal distance, the lower the amplitude density of a-wave and b-wave. Physiological and anatomical factors might be important for the variability of parameters of multi-focal electroretinogram. (Chin J Ocul Fundus Dis, 2001,17:277-279)