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HIV Associated Eye Diseases: Existing Cognitive and Possible Mechanisms HIV相关眼病:现有认知和可能机制
Pub Date : 2020-01-01 DOI: 10.35248/2155-9570.20.11.828
Tie Zhao
The Human Immunodeficiency Virus-1 (HIV-1) envelope protein gp120 is the major contributor to the pathogenesis of retinopathy and uveitis in HIV-1-related eye diseases. Disruption of the structure and function of the Blood-Retina Barrier (BRB) is the major contributor of HIV-1-related eye diseases and the molecular mechanism remains unknown. Our mini review revealed that retinopathy and uveitis are required for gp120- induced inflammation and epigenetic changes and suggest that gp120 regulate tight junction protein.
人类免疫缺陷病毒-1 (HIV-1)包膜蛋白gp120是HIV-1相关眼病中视网膜病变和葡萄膜炎发病的主要因素。血液视网膜屏障(BRB)结构和功能的破坏是hiv -1相关眼病的主要原因,其分子机制尚不清楚。我们的小型综述显示,gp120诱导的炎症和表观遗传变化需要视网膜病变和葡萄膜炎,并提示gp120调节紧密连接蛋白。
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引用次数: 0
Effectiveness of Argon Laser Peripheral Iridoplasty in Plateau Iris Syndrome Patients after Laser Peripheral Iridotomy 氩激光虹膜周围成形术治疗高原虹膜综合征激光虹膜周围切开术后的疗效
Pub Date : 2020-01-01 DOI: 10.35248/2155-9570.20.11.848
E. Klug, Marika Chachanidze, Abraham Nirappel, N. Hall, T. C. Chang, David Sol -Del Valle
Objective: There is controversy surrounding the next best step in treating plateau iris syndrome (PIS) patients with persistent angle dysfunction despite a patent laser peripheral iridotomy (LPI). The aim of this study was to examine the effectiveness of argon laser peripheral iridoplasty (ALPI) in PIS patients with a patent LPI. Methods: Retrospective review of medical records in consecutive patients that underwent ALPI to treat persistently narrow angles due to underlying PIS after a patent LPI. Patients in whom angle configuration could not be ascertained by review of medical records, those with less than 12 months follow-up at our institution, or those younger than 18 years of age were excluded. Kaplan-Meier survival analysis was used to determine treatment survival time. Paired t-tests were used to compare intraocular pressure (IOP), number of glaucoma medications, and bestcorrected visual acuity (BCVA) 12 months post-ALPI and at the last follow-up visit. Results: Fifty-one eyes of 51 patients were included in the analysis. The median survival time for a successful ALPI procedure was 1023 days (34.1 months). The majority of failure events were attributed to cataract extraction to open a persistently narrow angle, performed at approximately 934 (± 694) days (31.1 months) after ALPI. No changes in IOP, number of glaucoma medications, or BCVA from baseline were observed after 12 months or at last follow-up. Conclusion: ALPI is a potentially effective treatment for PIS following LPI. While angle dysfunction may re-emerge over time, ALPI can potentially delay the need for lensectomy in patients without visually significant cataracts.
目的:尽管激光周围虹膜切开术(LPI)未闭,但对于平台虹膜综合征(PIS)患者持续角度功能障碍的下一步治疗仍存在争议。本研究的目的是检查氩激光周围虹膜成形术(ALPI)在PIS患者专利LPI的有效性。方法:回顾性分析连续患者的病历,这些患者在专利LPI后接受了ALPI治疗由于潜在的PIS而持续狭窄的角度。排除了无法通过医疗记录检查确定角度配置的患者、在我院随访少于12个月的患者以及年龄小于18岁的患者。Kaplan-Meier生存分析确定治疗生存时间。使用配对t检验比较alpi后12个月和最后一次随访时的眼压(IOP)、青光眼药物数量和最佳矫正视力(BCVA)。结果:51例患者51只眼纳入分析。ALPI手术成功的中位生存时间为1023天(34.1个月)。大多数失败事件是由于白内障摘除以持续开窄的角度,在ALPI后约934(±694)天(31.1个月)进行。12个月或最后一次随访后,IOP、青光眼药物数量或BCVA与基线相比没有变化。结论:ALPI是治疗LPI后PIS的有效方法。虽然角度功能障碍可能会随着时间的推移而重新出现,但对于没有明显白内障的患者,ALPI可能会延迟晶状体切除术的需要。
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引用次数: 0
Retro Pupillary Iris-Claw IOL the Treatment for Traumatic IOL Capsular Bag Complex Dislocation 外伤性人工晶状体囊袋复合脱位的治疗
Pub Date : 2020-01-01 DOI: 10.35248/2155-9570.20.11.852
C. Roșca
A 57-year-old male patient operated 5 years before for cataract, arrives in our emergency service complaining of sudden decrease of the visual acuity of the left eye. Slit lamp examination reveals aphakia, iridodonesis and nonreflective semi-mydriatic pupil. Volk ® lens examination of the fundus shows dislocation of the entire bag-IOL complex into the vitreous. Our approach was: pars plana posterior vitrectomy, IOL-capsular bag complex extraction and implantation of an iris-claw artificial IOL with good anatomical and functional results. Iris-Claw artificial IOL’s are in the authors’ opinion a good and less invasive method for treating afakia of any cause.
一名五十七岁男性病患因白内障手术五年,因左眼视力突然下降而来急诊科就诊。裂隙灯检查显示无晶状体、虹膜状瞳孔和无反射的半散瞳。眼底Volk®晶状体检查显示整个袋状人工晶状体脱位进入玻璃体。我们的方法是:后路玻璃体切割,人工晶状体-囊袋复合物提取,虹膜-爪形人工晶状体植入术,解剖和功能效果良好。虹膜-爪形人工晶状体在作者看来是一种治疗任何原因的先天性白内障的好方法。
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引用次数: 0
Dry eye syndrome: Therapeutic challenges and future trends 干眼综合征:治疗挑战和未来趋势
Pub Date : 2019-12-12 DOI: 10.29328/journal.ijceo.1001023
Araújo-Neto Irami, Rêgo Amália Cinhtia Meneses, Araújo-Filho* Irami
1Undergraduate Student of Medicine, UnP Potiguar University, Laureate International Universities, Natal, Brazil 2Postgraduate Program in Biotechnology at Potiguar University/ UnP Laureate International Universities, Natal, Brazil. Ph.D. Health Science, Natal, RN, Brazil 3Postgraduate Program in Biotechnology, Potiguar University/ UnP Laureate International Universities, Full Professor Department of Surgery, Federal University of Rio Grande do Norte. Full Professor, Department of Surgery, Potiguar University, Ph.D, Health Science, Natal, RN, Brazil More Information
2巴西纳塔尔市波提瓜尔大学/ UnP劳瑞德国际大学生物技术研究生课程。3波蒂瓜尔大学/ UnP Laureate国际大学生物技术研究生课程,北里奥格兰德联邦大学外科学系正教授。波提瓜尔大学外科学系正教授,健康科学博士,纳塔尔,RN,巴西
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引用次数: 0
Auckland Cataract Study IV: Practical application of NZCRS cataract risk stratification to reduce phacoemulsification complications 奥克兰白内障研究IV: NZCRS白内障风险分层在减少超声乳化并发症中的实际应用
Pub Date : 2019-12-05 DOI: 10.1111/ceo.13696
Jina V Han, Dipika V. Patel, Kevin Liu, Bia Z. Kim, T. Sherwin, C. McGhee
Reduction of intraoperative complications in phacoemulsification cataract surgery.
白内障超声乳化手术术中并发症的减少。
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引用次数: 14
Cardiovascular effects and safety of mannitol in treating raised intraocular pressure 甘露醇治疗眼压升高的心血管效应和安全性
Pub Date : 2019-12-05 DOI: 10.1111/ceo.13695
Alp Atik, Elsie Chan, C. Crock, G. S. Ang
argued that even when severe, they cause very few person-years of morbidity if implanted in elderly patients. Multifocal lenses, however, are frequently implanted in middle-aged people, when the longer time in situ may result in more severe and significant grades of glistenings. Sometimes laser assisted enhancement is required in order to achieve optimal refractive outcome. This puts patients at risk of dry eye which will exacerbate the optical aberrations of a multifocal IOL if glistenings occur. Surgeons may reflect on the life expectancy of patients receiving these lenses as well as the increasing prevalence of dry eye with age. Non-chromophore lenses may be a prudent choice for young patients, particularly given the apparent absence of benefit found in recent major reviews. In the presence of severe glistenings, IOL exchange should be considered before a posterior capsulotomy is performed.
认为即使在严重的情况下,如果植入老年患者,它们也只会导致很少的人年发病率。然而,多焦点晶状体通常是在中年人身上植入的,在原位放置的时间越长,可能会导致更严重和更显著的闪烁。有时需要激光辅助增强,以达到最佳的屈光效果。这将使患者面临干眼症的风险,如果出现闪烁,将加剧多焦点IOL的光学像差。外科医生可能会考虑接受这些镜片的患者的预期寿命以及随着年龄增长而增加的干眼症患病率。对于年轻患者来说,非发色团晶状体可能是一个谨慎的选择,特别是考虑到最近的主要评论中发现的明显缺乏益处。如果存在严重的闪烁,在进行后囊膜切开手术前应考虑人工晶状体置换。
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引用次数: 0
Effective conservative management of locally advanced conjunctival melanoma using initial systemic therapy 采用初始全身治疗对局部晚期结膜黑色素瘤的有效保守治疗
Pub Date : 2019-11-26 DOI: 10.1111/ceo.13691
Hassan Hassan, R. Epstein, S. Cherepanoff, R. Conway
Conjunctival melanoma (CM) comprises 2% to 5% of all ocular tumours, and 5% to 7% of ocular melanomas. The annual incidence of CM is 0.2 to 0.8 per million amongst Caucasians, in which population the usual age range of presentation is 55 to 65 years. The standard of care for the initial management of localized CM is no-touch surgical excision with a minimum 2 to 4 mm margin. Locally advanced disease involving orbit invasion is more challenging to manage and has traditionally been regarded as an indication for radical curative-intent surgery (orbital exenteration). Here we report a case of locally advanced and recurrent CM that has been managed successfully for the last 3.5 years using systemic targeted therapy. A 53-year-old Caucasian male presented in January 2016 to the ocular oncology unit with a biopsy confirming locally advanced CM (AJCC stage T3B) of the right eye invading the anterior orbit and upper tarsal plate. The tumour had been excised in December 2015. Visual acuities were 6/7.5 and 6/6 in the right and left eye, respectively. Staging investigations including fluorodeoxyglucosepositron emission tomography scanning revealed no metastatic disease. Mutation testing (Ion Torrent Ampliseq Cancer Gene Panel v2.0) of formalin-fixed paraffin-embedded tissue confirmed a classical BRAF (V600E) mutation. During the multidisciplinary discussion, three aspects of the patient's own preferences were identified: first, ocular removal may affect his employment as a licensed occupational operator of heavy equipment; second, satisfactory binocular vision as an enthusiastic recreational cricket player; and third, importance of normal cosmesis for lifestyle reasons. On the other hand, it was explained to the patient that surgical exenteration could well represent the only plausible curative intervention. Against that reasoning, however, it was also conceded that even proceeding to exenteration would not guarantee a cure, since subsequent locoregional and/or metastatic recurrence remained a possibility. After informed discussion and consent, the patient was offered initial management using systemic therapy targeting V600E-mutant BRAF, consisting of dabrafenib and trametinib. Patient understood that the provisional plan would be for substitution of immunotherapy (eg, anti-PD1 plus ipilimumab) with the aim of achieving a further period of long-term control, albeit not necessarily a cure. The possibility of using initial immunotherapy was also discussed, though it was pointed out that a rapid initial tumour shrinkage might be more reliably achieved using mutation-targeting kinase inhibitors, and hence this approach was chosen. Fortunately, a complete clinical and radiologic remission of disease was evident by April 2016 (Figure 1A,B). From May 2016, the clinical course was complicated by drug-related fever and abnormal liver function tests, which was at first managed with a combination of treatment delay, dose reduction, and/or steroid cover. A small recurr
结膜黑色素瘤(CM)占所有眼部肿瘤的2%至5%,占眼部黑色素瘤的5%至7%。在白种人中,CM的年发病率为每百万人中0.2至0.8人,其中人群的通常表现年龄范围为55至65岁。局部CM的初始治疗标准是无接触手术切除,最小切距为2至4毫米。涉及眼眶侵犯的局部晚期疾病更具有挑战性,传统上被认为是根治性治疗目的手术(眼眶摘除)的指征。在这里,我们报告了一个局部晚期和复发性CM的病例,在过去的3.5年里,我们成功地使用了全身靶向治疗。一名53岁白人男性于2016年1月就诊于眼科肿瘤科,活检证实右眼局部晚期CM (AJCC T3B期)侵犯前眼眶和上睑板。该肿瘤于2015年12月切除。右眼视力为6/7.5,左眼视力为6/6。分期调查包括氟脱氧葡萄糖正电子发射断层扫描显示没有转移性疾病。福尔马林固定石蜡包埋组织突变检测(Ion Torrent Ampliseq Cancer Gene Panel v2.0)证实为典型BRAF (V600E)突变。在多学科讨论中,确定了患者自身偏好的三个方面:首先,摘除眼球可能会影响他作为重型设备持证职业操作员的就业;其次,作为一名热情的业余板球运动员,令人满意的双眼视力;第三,正常妆容对于生活方式的重要性。另一方面,医生向患者解释,手术切除可能是唯一可行的治疗干预措施。然而,与此推理相反,也承认即使进行切除也不能保证治愈,因为随后的局部和/或转移性复发仍然是可能的。在知情讨论和同意后,患者接受针对v600e突变BRAF的全身治疗,包括达非尼和曲美替尼。患者明白,临时计划是替代免疫疗法(例如,抗pd1 +易普利姆单抗),目的是实现进一步的长期控制,尽管不一定是治愈。使用初始免疫治疗的可能性也进行了讨论,尽管有人指出,使用靶向突变的激酶抑制剂可能更可靠地实现快速的初始肿瘤缩小,因此选择了这种方法。幸运的是,到2016年4月,疾病的临床和放射学完全缓解(图1A,B)。从2016年5月开始,临床过程中出现药物相关性发热和肝功能异常,最初采用延迟治疗、减少剂量和/或类固醇覆盖的联合治疗。在此期间切除了上眼睑的小复发,组织病理学证实CM复发(图1C)。到2017年初,持续发烧和肝功能异常引发了vemurafenib和cobimetinib的转换,这被证明是更好的耐受性。2017年7月12日复查结膜活检未发现黑色素瘤的组织学证据。2017年10月的FDG-PET成像和临床回顾同样没有显示局部或全身性疾病的证据。2019年3月的最后一次复查显示,临床和放射学均未发现疾病(图1D)。患者在上述方案下无症状,患眼视力为6/7.5,东部肿瘤合作组(ECOG)表现状态。本病例增加了局部晚期CM系统治疗的有限文献。最近的一项研究报告了三例局部晚期CM最初用药物治疗;其中一名患者的分子检测显示,BRAF、KIT或NRAS基因未发生体细胞突变,但在2019年8月15日接收:2019年11月18日
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引用次数: 1
Progressive intraluminal stent migration into the anterior chamber 进行性腔内支架移入前房
Pub Date : 2019-11-26 DOI: 10.1111/ceo.13692
C. Rowland, Graham A. Lee, Shabbir Mohamed, P. Shah
1. Ramenaden ER, Raiji VR. Clinical characteristics and visual outcomes in infectious scleritis: a review. Clin Ophthalmol. 2013;7: 2113-2122. 2. Oguz H, Sobaci G. The use of hyperbaric oxygen therapy in ophthalmology. Surv Ophthalmol. 2008;53(2):112-120. 3. Locher DH, Adesina A, Wolf TC, Imes CB, Chodosh J. Postoperative Rhizopus scleritis in a diabetic man. J Cataract Refract Surg. 1998;24(4):562-565. 4. Chong R, Ayer CJ, Francis IC, Coroneo MT, Wolfers DL. Adjunctive hyperbaric oxygen in pseudomonas keratitis. Br J Ophthalmol. 2007;91(4):560-561. 5. Bayer A, Mutlu FM, Sobaci G. Hyperbaric oxygen therapy for mitomycin C-induced scleral necrosis. Ophthalmic Surg Lasers. 2002;33(1):58-61.
1. Ramenaden ER, Raiji VR。传染性巩膜炎的临床特点和视觉效果:综述。中华眼科杂志,2013;7:2113-2122。2. 王志强,王志强。高压氧治疗在眼科中的应用。中华眼科杂志,2008;33(2):112-120。3.Locher DH, Adesina A, Wolf TC, Imes CB, Chodosh J.糖尿病患者术后根霉性巩膜炎1例。[J]中华白内障杂志,1998;24(4):562-565。4. Chong R, Ayer CJ, Francis IC, Coroneo MT, Wolfers DL。假单胞菌性角膜炎的辅助高压氧治疗。中华眼科杂志,2007;31(4):556 -561。5. 张建军,张建军,张建军,等。高压氧治疗丝裂霉素所致巩膜坏死的临床观察。眼科激光手术。2002;33(1):58-61。
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引用次数: 0
Novel use of adjunctive hyperbaric therapy for fungal scleritis 真菌性巩膜炎辅助高压氧治疗的新应用
Pub Date : 2019-11-25 DOI: 10.1111/ceo.13689
Harry Yip, Elsie Chan
for advanced local and systemic conjunctival melanoma: a clinical case series. J Immunother Cancer. 2019;7(1):83. https://doi. org/10.1186/s40425-019-0555-7. 4. Lake SL, Jmor F, Dopierala J, Taktak AFG, Coupland SE, Damato BE. Multiplex ligation-dependent probe amplification of conjunctival melanoma reveals common BRAF V600E gene mutation and gene copy number changes. Invest Ophthalmol Vis Sci. 2011;52:5598. https://doi.org/10.1167/iovs.10-6934. 5. Griewank KG, Westekemper H, Murali R, et al. Conjunctival melanomas harbor BRAF and NRAS mutations and copy number changes similar to cutaneous and mucosal melanomas. Clin Cancer Res. 2013;19:3143-3152. https://doi.org/10.1158/1078-0432.CCR-130163.
晚期局部和全身结膜黑色素瘤:临床病例系列。中华癌症杂志,2019;7(1):83。https://doi。org/10.1186/s40425 - 019 - 0555 - 7。4. Lake SL, Jmor F, Dopierala J, Taktak AFG, Coupland SE, Damato BE。结膜黑色素瘤多重结扎依赖探针扩增显示常见BRAF V600E基因突变及基因拷贝数改变。中华眼科杂志,2011;52:55 - 55。https://doi.org/10.1167/iovs.10 - 6934。5. 王晓明,王晓明,王晓明,等。结膜黑色素瘤含有BRAF和NRAS突变,拷贝数变化与皮肤和粘膜黑色素瘤相似。中国临床肿瘤杂志,2013;19(3):343 - 352。https://doi.org/10.1158/1078 - 0432. - ccr - 130163。
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引用次数: 1
Identification of novel variants in the FZD4 gene associated with familial exudative vitreoretinopathy in Chinese families 中国家族性渗出性玻璃体视网膜病变相关FZD4基因新变异的鉴定
Pub Date : 2019-11-25 DOI: 10.1111/ceo.13690
Huijuan Xu, Shanshan Zhang, Lulin Huang, Peiquan Zhao, Xiang Zhang, Zhenglin Yang, Lin Zhang
Familial exudative vitreoretinopathy (FEVR, OMIM 133780) is a severe hereditary retinal disease characterized by incomplete retinal vascular development and pathological neovascularization. It has been reported that variants in nine genes are associated with FEVR, but they can only explain approximately 50% of FEVR patients, suggesting that other FEVR‐associated variants or genes remain to be discovered.
家族性渗出性玻璃体视网膜病变(FEVR, OMIM 133780)是一种以视网膜血管发育不全和病理性新生血管为特征的严重遗传性视网膜疾病。据报道,9个基因的变异与FEVR相关,但它们只能解释大约50%的FEVR患者,这表明其他与FEVR相关的变异或基因仍有待发现。
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引用次数: 1
期刊
Journal of Clinical & Experimental Ophthalmology
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