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Importance of immunomodulation in trachoma-related tissue damage and tear function disorders 免疫调节在沙眼相关组织损伤和撕裂功能障碍中的重要性
Pub Date : 2018-04-26 DOI: 10.15406/aovs.2018.08.00284
C. Karaarslan
To put forward better prevention and treatment strategies in trachomatous tissue damage and tear function disorders, a field survey was performed in a village in the province of Turkey, which is a settlement with endemic trachoma according to the World Health Organization. Samples of tears, upper tarsal conjunctiva, and serum were taken from patients with 5 different stages of trachoma, including 13 patients in the initial stage and 15 in each of the other stages. Samples were also collected from 15 healthy control patients. We measured the levels of interleukin (IL)-1, IL-2, epidermal growth factor (EGF), and tumor necrosis factor (TNF) using enzyme-linked immunosorbent assays (ELISAs). We measured immunoglobulin M (IgM), IgA, and IgG levels in tears using immunodiffussion plates. EGF, human leukocyte antigen – antigen D related (HLA-DR), and interleukin -2 receptor (IL-2R) expression, and lymphocyte and monocyte infiltration were examine d using direct immunofluorescence of upper tarsal conjunctiva samples. Antichlamydial IgM, IgA, and IgG serum levels were also measured. The distribution of trachoma in this residential area and its complications according to age and genders were determine d using additional field scans. Data analysis revealed that the significant increase in the levels of neutrophils, IL -1, TNF, and cytotoxic T lymphocytes, which are the indicators of nonspecific immune response in the early stages of trachoma, results in suppression/dominance of IL-2, IL-2R, HLA-DR, helper T cells, and 13 lymphocytes and immunoglobulins as the disease progresses. EGF increases to very high levels in later stages.
为了提出沙眼组织损伤和撕裂功能障碍的更好的预防和治疗策略,在世界卫生组织列为地方性沙眼聚居地的土耳其省的一个村庄进行了实地调查。选取5期沙眼患者的泪液、睑上结膜及血清标本,其中初发期13例,后期各15例。同时还采集了15例健康对照患者的样本。我们使用酶联免疫吸附法(elisa)测量白细胞介素(IL)-1、IL-2、表皮生长因子(EGF)和肿瘤坏死因子(TNF)的水平。我们用免疫扩散板测定泪液中的免疫球蛋白M (IgM)、IgA和IgG水平。采用直接免疫荧光法检测上睑结膜标本EGF、人白细胞抗原-抗原D相关(HLA-DR)、白细胞介素-2受体(IL-2R)表达及淋巴细胞和单核细胞浸润情况。同时测定血清抗衣原体IgM、IgA和IgG水平。根据年龄和性别确定该居民区沙眼及其并发症的分布情况。数据分析显示,沙眼早期非特异性免疫反应指标中性粒细胞、IL -1、TNF和细胞毒性T淋巴细胞水平显著升高,导致随着病情进展,IL-2、IL- 2r、HLA-DR、辅助性T细胞、13淋巴细胞和免疫球蛋白的抑制/优势。EGF在后期阶段增加到非常高的水平。
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引用次数: 0
Optic nerve avulsion, ultrasound and MRI findings 视神经撕脱,超声及MRI表现
Pub Date : 2018-04-26 DOI: 10.15406/AOVS.2018.08.00285
SADIK TAJU SHERIEF, A. Connor, Cynthia, E. Hoven, W. Lam
Optic nerve avulsion is a rare but serious presentation of ocular trauma. It is characterized by disinsertion of the nerve fibers from the globe at?the level of the lamina cribrosa. It is usually associated with a decelerating injury of significant momentum and usually results in a severe and permanent visual loss.1,2 Here we report a patient with optic nerve avulsion secondary to a sporting injury and discuss the role of MRI and B- Scan ultra-sound.
视神经撕脱是一种罕见但严重的眼部外伤。它的特征是神经纤维在?筛板的水平。它通常与显著动量的减速性损伤有关,通常导致严重和永久性的视力丧失。在此,我们报告一例继发于运动损伤的视神经撕脱伤,并讨论MRI和B超扫描的作用。
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引用次数: 1
Case of angioid streaks treated with multiple different anti-vascular endothelial growth factor injection 多种抗血管内皮生长因子注射治疗血管样条纹1例
Pub Date : 2018-04-23 DOI: 10.15406/aovs.2018.08.00283
A. Altıntaş, Cagri Ilhan
Doyne was descripted angioid streaks (AS) in 1889 as spider-like irregular, bilateral, dark red to gray lines under the retina around optic disk.1 Histopathological studies showed that AS represents breaks and crack-like dehiscences in calcified, thickened both collagenous and elastic part of Bruch membrane. Both atrophy and hyperplasia were developed in retinal pigment epithelium (RPE) and destruction of choriocapillary layers were occurred.2 Diagnosis of AS is based on presence of the classical clinical appearance on fundus evaluation and optical coherence tomography (OCT). In fundus fluorescein angiography (FFA) hyperfluorescence were observed over the breaks due to RPE atrophy and hypofluorescence associated with RPE hyperplasia. Complications of AS such as choroidal neovascular membrane (CNV), subretinal hemorrhage and pigment epithelial detachment (PED) may cause legal blindness, especially in middleaged patients. While, laser photocoagulation, macular translocation surgery, transpupillary thermotherapy and photodynamic therapy were used to applied in treatment of AS patients with visual loss in last decades, intravitreal anti-vascular endothelial growth factor (VEGF) injection is the most effective and current treatment method for CNV due to AS.3–7 In this case report, we presented an AS with visual loss in one eye due to CNV which is followed-up 6-year and treated with multiple different anti-VEGF injection. We aimed to show the risk factor of developing CNV in case with AS, the long-term results of different anti-VEGF therapies, the superiority of them from each other and the effectiveness of switch therapy.
1889年,Doyne将血管样条纹(AS)描述为蜘蛛状不规则,双侧,视网膜下环绕视盘的暗红至灰色条纹组织病理学研究表明,AS表现为Bruch膜钙化、增厚的胶原和弹性部分的断裂和裂纹样开裂。视网膜色素上皮(RPE)出现萎缩和增生,绒毛毛细血管层被破坏AS的诊断是基于眼底评估和光学相干断层扫描(OCT)的经典临床表现。眼底荧光素血管造影(FFA)观察到由于RPE萎缩引起的裂口处高荧光和与RPE增生相关的低荧光。AS的并发症如脉络膜新生血管膜(CNV)、视网膜下出血和色素上皮脱离(PED)可导致法定失明,尤其是中年患者。近几十年来,激光光凝、黄斑移位手术、经乳头热疗、光动力疗法等都被用于治疗AS合并视力丧失的患者,而玻璃体内注射抗血管内皮生长因子(VEGF)是目前治疗AS所致CNV最有效的方法。我们报告了一例因CNV导致单眼视力丧失的AS患者,该患者随访6年并接受多种不同的抗vegf注射治疗。我们的目的是显示AS发生CNV的危险因素,不同抗vegf治疗的长期效果,它们之间的优势以及转换治疗的有效性。
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引用次数: 0
P-hacking: its implication for science and scientific research P-hacking:对科学和科学研究的启示
Pub Date : 2018-04-20 DOI: 10.15406/AOVS.2018.08.00282
Andrews Nartey
In a rapidly evolving scientifically and technologically savvy world, the globe never ceases to be inundated with revolutionary inventions and groundbreaking technology. The only way these inventions and discoveries would become endorsed and consequently patronized is by ascertaining their authenticity and validity through experimental research studies. Experimental research studies, thus, have become the fulcrum around which new interventions get to justify their inclusion through what I would metaphorically term as “preliminary stage competitions, following which successful experimental teams become seeded.” So yes, scientists are now in competition or better still, an intellectual rush to etch their names and products in the annals of scientific laurels. This arguably has led to the concept of what is now popularly known as “p-hacking.”
在一个科学技术迅速发展的世界里,全球永远充斥着革命性的发明和突破性的技术。这些发明和发现得到认可并因此得到赞助的唯一途径是通过实验研究来确定它们的真实性和有效性。因此,实验研究已成为新的干预措施的支点,我将其比喻为“初步阶段的比赛,随后成功的实验团队成为种子”。所以,是的,科学家们现在正处于竞争之中,或者更好的情况是,一场智力竞赛,以将他们的名字和产品铭刻在科学荣誉的编年史上。可以说,这导致了现在广为人知的“p-hacking”的概念。
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引用次数: 1
Trends in treating chronic persistent diabetic macular edema 慢性持续性糖尿病黄斑水肿的治疗趋势
Pub Date : 2018-04-18 DOI: 10.15406/AOVS.2018.08.00281
A. Marashi
Diabetic macular edema (DME) induced by increasing vascular leakage due to thickened basement membrane, thus will lead to early reduction of vision in working age group,1 DME previously treated with laser and intravitreal steroids (triamcinolone acetonide) in the pre Anti-VEGF era; however, intravitreal Anti-VEGF injection gained popularity due to easy administration, safe profile and good efficacy. Chronic persistent DME presents as long-standing DME usually more than 18 months, which features diffuse pattern, OCT may show photoreceptor layer loss, and usually responds poorly to Anti-VEGF. Usually response to Anti-VEGF treatment is poor when OCT fails to show reduction of retinal thickness of less than 10% or/and BCVA improvement after six injections, then DME deemed as chronic, and treatment should be changed to intravitreal steroids, because inflammatory mediators are the main driver of DME.
糖尿病性黄斑水肿(DME)是由于基底膜增厚导致血管渗漏增加,从而导致工作年龄组早期视力下降,1在抗vegf前曾用激光和玻璃体内类固醇(曲安奈德)治疗过;然而,玻璃体内抗vegf注射因其给药方便、安全性好、疗效好而受到广泛欢迎。慢性持续性DME表现为长期DME,通常超过18个月,表现为弥漫性,OCT可显示光感受器层丢失,通常抗vegf反应较差。通常,当6次注射后OCT未显示视网膜厚度减少小于10%或/和BCVA改善时,抗vegf治疗反应较差,则认为DME为慢性,应改为玻璃体内类固醇治疗,因为炎症介质是DME的主要驱动因素。
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引用次数: 0
Ophthalmic trainees' knowledge in ethics: a wake-up call to ophthalmic practitioners 眼科受训者的伦理知识:对眼科从业人员的警示
Pub Date : 2018-04-06 DOI: 10.15406/AOVS.2018.08.00280
Michel Pascal Tchiakpe, S. Ankamah-Lomotey, Andrews Nartey, Darko Kojo Denkyi, E. Nkansah, Philip Tetteh Djeagbo
Studies in recent times have shown that health trainees across the world usually report that they felt not properly positioned to deal with ethical issues or dilemmas they came across during clinical work. Medical code of ethics, etiquette and conduct of professionals are guidelines that have been stipulated to protect the patient. The main aim of this research was to assess the knowledge ophthalmic trainees had in ethics and also assess their observations made while under tutelage. A descriptive study with a cross-sectional design was used in this research. Fifty (50) final year ophthalmic trainees were sampled conveniently from the Kwame Nkrumah University of Science and Technology, University of Cape Coast and Korle-Bu Ophthalmic Nursing School. Questionnaires were administered to 80 respondents. About 53% of trainees recalled and could recite the principal elements of the ethical codes and 60% reported that the Patients’ Charter was easy to implement. Fifty percent (50%) of the trainees reported that practitioners sometimes informed patients on their conditions with the same percentage reporting that practitioners sometimes involved patients in decision making on their ocular health condition. It is recommended that the Ghana Health Service and the Ministry of Health should be more involved in the training of ophthalmic trainees and must include in their curriculum, a combination of lecture room work, community service and experiential learning. This would position the trainees in terms of confidence and know-how in handling issue regarding ethics.
最近的研究表明,世界各地的卫生培训生通常报告说,他们觉得自己在处理临床工作中遇到的伦理问题或困境方面处于不适当的地位。医疗道德、礼仪和专业人员的行为准则是为保护病人而规定的准则。本研究的主要目的是评估眼科实习生在伦理方面的知识,并评估他们在监护期间所做的观察。本研究采用横断面设计的描述性研究。从Kwame Nkrumah科技大学、Cape Coast大学和Korle-Bu眼科护理学校方便地抽取了50名最后一年的眼科实习生。对80名受访者进行了问卷调查。约53%的受训者回忆并能背诵道德守则的主要内容,60%的受训者报告说《病人章程》很容易实施。50%的受训者报告说,医生有时会告知患者他们的病情,同样比例的人报告说,医生有时会让患者参与眼科健康状况的决策。建议加纳卫生服务处和卫生部更多地参与培训眼科受训者,并且必须在其课程中纳入课堂工作、社区服务和体验式学习的结合。这将使受训者在处理道德问题方面有信心和专业知识。
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引用次数: 0
Electrical stimulation of the retina: aspects arising from retinal noise 视网膜的电刺激:由视网膜噪声引起的方面
Pub Date : 2018-03-29 DOI: 10.15406/aovs.2018.08.00279
Zueva Marina
Various impacts of the spontaneous neuronal noise on visual processing in the brain and the retina are extensively studying and discussing. Highly variable behavior is characteristic of healthy physiological systems, but dynamics of functional activity is simplifying in pathology and became either very ordered or characterized by entirely uncorrelated random oscillations. It has been demonstrated by several research groups that in hereditary retinal degeneration, sensory deafferentation arising from the loss of photoreceptors increases the spontaneous activity throughout the visual system and leads an aberrant rhythmic activity of retinal ganglion cells. In patients blind due to retinitis pigmentosa, retinal prosthetic devices are currently applying to obtain visual sensations induced by the electrical pulses. The right choice of the parameters of electrical stimuli is of great importance for achieving reliable responses from the RGCs and transmittance of encoded visual information to the brain. The temporal parameters of stimulation are supposed to be crucial to provide the further innovation development of such approach. We hypothesize that the periodic pathological activity in retinal degeneration not only is a factor that hampers the encoding of information and visual images of more quality. It also can aggravate the impact of deafferentation and play the negative role of in a formation of abnormal synaptic contacts during retinal remodeling contributing to the distortion of the complexity of neural circuits in the retina and the brain in retinal degenerations. We guess that the optical flicker and electrical stimulation therapy using the complex-structured (fractal) signals can be the promising approach providing both tuning the temporal sensitivity of the visual system and activation of the neuronal plasticity throughout the visual pathway. Future strategies of vision restoration apparently must be aimed to avoid the rhythmic activity in retinal circuits and to increase the quality of image representation. Here, we present the arguments that the utilizing the fractal modulation of the stimulating pulses in amplitude or frequency as well as using fractal temporal patterns in the background electrical prestimulation may be one of the prospective ways in future elaboration successful retinal prosthesis.
自发神经元噪声对大脑和视网膜视觉加工的各种影响正在被广泛研究和讨论。高度可变的行为是健康生理系统的特征,但功能活动的动力学在病理学上正在简化,变得非常有序或以完全不相关的随机振荡为特征。几个研究小组已经证明,在遗传性视网膜变性中,由光感受器的丧失引起的感觉传入信号丧失增加了整个视觉系统的自发活动,并导致视网膜神经节细胞的异常节律活动。对于因视网膜色素变性而失明的患者,目前应用视网膜假体装置来获得由电脉冲诱导的视觉感觉。电刺激参数的正确选择对于获得可靠的RGCs响应和编码视觉信息向大脑的透射率具有重要意义。刺激的时间参数对该方法的进一步创新发展至关重要。我们假设视网膜变性的周期性病理活动不仅是阻碍信息编码和更高质量视觉图像的因素。在视网膜变性中,它还会加重神经分化的影响,并在视网膜重塑过程中形成异常的突触接触,从而导致视网膜和大脑神经回路复杂性的扭曲。我们推测,利用复杂结构(分形)信号的光闪烁和电刺激治疗可能是一种有前途的方法,既可以调节视觉系统的时间敏感性,又可以激活整个视觉通路的神经元可塑性。显然,未来的视觉恢复策略必须以避免视网膜回路中的节律性活动和提高图像表示质量为目标。在此,我们认为利用刺激脉冲的振幅或频率的分形调制以及在背景电预刺激中使用分形时间模式可能是未来制作成功的视网膜假体的有前景的方法之一。
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引用次数: 1
Iris prosthetic IOL implantation after strabismus surgery and 4-year follow-up in a case of long-standing traumatic aniridia 斜视术后虹膜人工晶状体植入术及长期外伤性无虹膜4年随访
Pub Date : 2018-03-21 DOI: 10.15406/aovs.2018.08.00278
C. Karaarslan
Post-traumatic iris defects, combined with crystalline lens abnormalities, are among the major complications of globe injuries.1 Individuals who lack adequate iris tissue suffer from glare, photophobia, visual field disturbances, and other visual disturbances that can cause social, mental, and psychological problems.2 Such patients suffer from severe visual impairment, secondary to aphakia.3 Herein, I describe an approach for the management of an aphakic, exophoric eye with traumatic aniridia, which was found in a patient who underwent transscleral fixation of an artificial iris prosthetic intraocular lens (IOL), 10 months after strabismus surgery.
创伤后虹膜缺损合并晶状体异常是眼球损伤的主要并发症之一缺乏足够虹膜组织的人会遭受眩光、畏光、视野障碍和其他视觉障碍,这些会导致社会、精神和心理问题这类患者患有继发于失视症的严重视力损害在此,我描述了一种处理无虹膜的无晶状眼的方法,该方法是在斜视手术后10个月接受经巩膜固定人工虹膜人工晶状体(IOL)的患者中发现的。
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引用次数: 0
UBM measured changes in anterior chamber depth following pediatric IOL surgery with optic capture UBM测量了小儿人工晶状体手术后前房深度的变化
Pub Date : 2018-03-12 DOI: 10.15406/AOVS.2018.08.00276
B. DeBroff, J. C. Esteban, J. Servat
Submit Manuscript | http://medcraveonline.com in IOL power calculation. Anterior chamber depth determined by postoperative IOL position can lead to an error in IOL power calculation and has been shown to be one of the principal errors in IOL power calculations.7,8 The purpose of this paper is to study changes in anterior chamber depth (ACD) with Ultrasound Biomicroscopy (UBM) before and after pediatric cataract surgery with the technique of posterior curvilinear capsulorhexis with optic capture and anterior vitrectomy, and compare to the fellow eye in which no surgery or an IOL was positioned in-the-bag without capture.
提交稿件| http://medcraveonline.com人工晶状体度数计算。由术后人工晶状体位置决定的前房深度可导致人工晶状体度数计算的误差,并且已被证明是人工晶状体度数计算的主要误差之一。7,8本研究的目的是利用超声生物显微镜(UBM)研究儿童白内障手术前后前房深度(ACD)的变化,并与不手术或不捕获人工晶状体放置在袋内的同侧眼进行比较。
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引用次数: 0
Ocular problems associated air traveling 眼部问题与空中旅行有关
Pub Date : 2018-03-09 DOI: 10.15406/AOVS.2018.08.00275
B. Turgut
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引用次数: 1
期刊
Advances in ophthalmology & visual system
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