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Significant IOP reduction after combined phacoemulsification and micro-invasive glaucoma surgery (MIGS) 超声乳化联合微创青光眼手术(MIGS)术后IOP明显降低
Pub Date : 2019-01-01 DOI: 10.15761/nfo.1000231
U. Best, H. Domack
In a controlled clinical trial, we investigated long-term results after trabecular micro-bypass stent implantation in routine cataract surgery in eyes with chronic open angle glaucoma. Combined phacoemulsification and trabecular micro-bypass implantation proved to be an effective and safe treatment method to reduce intraocular pressure, reducing the burden on local drug treatment. Implantation offers a good option for additional pressure reduction. Microsurgical procedures to reduce intraocular pressure, which are minimally traumatic and are performed ab interno and characterized by efficiency, a high safety profile and a rapid healing process, should be used more frequently. Since decades, trabeculectomy is the gold standard in glaucoma surgery. Recently trabecular stents bypass the compromised trabecular meshwork, creating a direct route from the anterior chamber into Schlemm’s canal and improving aqueous outflow. In a prospective randomized clinical study, we investigated the long-term results, safety and efficacy of trabecular micro-bypass stent implantations as part of a routine cataract surgery in eyes with mild to moderate chronic open-angle glaucoma. In combined surgeries, phaco PC-IOL plus trabecular micro bypass implantation, has shown reasonable efficacy in lowering IOP and the necessary IOP reducing medications. Our results showed a favorable benefit-to-risk profile. canal. Examples are the iStent and the iStent inject. Both stents are implanted while being guided by gonioscopy into Schlemm’s canal. This is located at the level of the pigmented trabecular meshwork at the border to the non-pigmented trabecular meshwork. Suprachoroidal stents, such as the CyPass Micro-Stent (currently removed from the market), conduct the aqueous humor into the suprachoroidal space. The CyPass Micro-Stent is implanted more deeply, far below Schlemm’s canal, into the supraciliary space. Stents for use in the subconjunctival space are, for example, the XEN gel implants, which are implanted far above Schlemm’s canal, directly below the Schwalbe line, into the non-pigmented trabecular meshwork. The operating principle of subconjunctival outflow is similar to a small trabeculectomy. iStent inject is a trabecular micro-bypass system with two preloaded implants made of heparin-coated, non-ferromagnetic titanium. The implants are very small. At 360 µm x 230 µm, they are the smallest medical devices used in humans. They have two ends; at one end, the inlet opening protrudes into the anterior chamber, while the other end opens out into the Schlemm’s canal in a pointed conical shape wifth four lateral outlet openings. The middle part of the stent
在一项对照临床试验中,我们研究了慢性开角型青光眼常规白内障手术后小梁微搭桥支架植入术的远期效果。超声乳化联合小梁微搭桥植入术是一种安全有效的降低眼压的治疗方法,减轻了局部药物治疗的负担。植入提供了额外减压的好选择。降低眼压的显微外科手术创伤最小,可在室内进行,具有效率高、安全性高和愈合速度快的特点,应更频繁地使用。几十年来,小梁切除术一直是青光眼手术的金标准。最近,小梁支架绕过受损的小梁网,创造了从前房到施勒姆管的直接通道,改善了水流出。在一项前瞻性随机临床研究中,我们调查了小梁微搭桥支架植入术作为轻度至中度慢性开角型青光眼常规白内障手术的一部分的长期结果、安全性和有效性。在联合手术中,phaco PC-IOL联合小梁微搭桥植入术在降低IOP和必要的降低IOP药物方面显示出合理的效果。我们的结果显示了有利的收益风险比。运河。例如iStent和iStent注入。两种支架都是在阴道镜引导下植入施莱姆氏管的。它位于非色素小梁网边界的色素小梁网水平。脉络膜上支架,如CyPass微型支架(目前已退出市场),将房水导入脉络膜上空间。CyPass微型支架植入更深,远低于施勒姆管,进入上睫间隙。用于结膜下间隙的支架,例如,XEN凝胶植入物,植入远高于Schlemm管,直接低于Schwalbe线,进入无色素小梁网。结膜下流出的手术原理与小梁切除术相似。iStent inject是一种小梁微旁路系统,有两个由肝素包被的非铁磁性钛制成的预加载植入物。植入物非常小。尺寸为360 μ m x 230 μ m,是人类使用的最小的医疗器械。它们有两头;在一端,入口开口突出到前房,而另一端开放到施勒姆管的尖圆锥形,有四个侧面出口开口。支架的中间部分
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引用次数: 0
Chemerin promotes the development of diabetic retinopathy 趋化素促进糖尿病视网膜病变的发展
Pub Date : 2019-01-01 DOI: 10.15761/nfo.1000223
Mengyi Liu, Xiaoye Wang, Junhui Du
Diabetic retinopathy is a serious eye disease that leads to blindness, and its development is related to inflammation, oxidative damage, and various pro-angiogenic cytokines. Studies in recent years have found that chemerin plays an important role in the development of DR. And the chemerin is also involved in the formation of retinal neovascularization. Therefore, in this article, we expound the relationship between chemerin and DR and its role in the formation of RNV.
糖尿病视网膜病变是一种导致失明的严重眼病,其发展与炎症、氧化损伤和各种促血管生成细胞因子有关。近年来的研究发现,趋化素在dr的发展中起着重要的作用,它还参与了视网膜新生血管的形成。因此,本文将阐述趋化素与DR的关系及其在RNV形成中的作用。
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引用次数: 1
Donor preparation in descemet membrane endothelial keratoplasty 网膜内皮角膜移植术中的供体准备
Pub Date : 2019-01-01 DOI: 10.15761/nfo.1000227
P. Maharana, Pranita Sahay, Deepali Singhal, N. Sharma, J. Titiyal
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引用次数: 4
B-scan opthalmic Ultrasonography: a review corroborated with echograms b超眼超声检查:与超声图证实的回顾
Pub Date : 2019-01-01 DOI: 10.15761/nfo.1000233
Uduma Felix Uduma, Akpan Sylvia Iquo-Abasi, Njeze Ngozi Rosemary
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引用次数: 0
Ocular surface degenerative diseases studies in an isolated region of Argentine Patagonia 阿根廷巴塔哥尼亚偏远地区眼表退行性疾病研究
Pub Date : 2019-01-01 DOI: 10.15761/NFO.1000224
M. Suárez, N. Crim, Leandro J. Correa, J. P. Maccio, E. Knoll, Maria del Carmen Piqueras, A. Lisker-Cervantes, S. Bhattacharya, H. Serra
Aim: The aim of this study was to investigate the prevalence of Environmental proteinaceous corneal degeneration (EPCD), pinguecula and pterygium and any association among them, and to perform lipidomic studies in some samples of EPCD and pterygium. Materials and methods: It was a transversal/observational and analytical study; the sample was consecutive non-probabilistic. All patients examined resided all their lives in the department El Cuy (Río Negro). Corneal epithelium and conjunctiva tissue samples were taken to perform mass spectrometric lipidomic studies. Results: One hundred and fifty-nine patients were studied (52.83% male and 47.17% female). The prevalence of ophthalmoheliosis was: pinguecula 32.1%, EPCD 28.9%, and pterygium 13.2%. A statistically significant association was found between EPCD and male patients (21.4% vs 7.5%) (p <0.05). There was association between EPCD with pinguecula and with pterygium, both more frequent in males (p <0.05). Lipidomic studies in EPCD showed a decrease in the concentration of phospholipids in affected areas (15 times less). In pterygium, there was an increase in the concentration of phospholipids (6.67 times more). Conclusion: Our investigation shows important prevalence of EPCD, pinguecula and pterygium in individuals that live at El Cuy (Argentine Patagonia). As far as we know, this is the first work in the world that shows coexistences between these three ophthalmoheliosis. The decrease concentration of phospholipids in EPCD affected areas could be due to lipid peroxidation, as a consequence of oxidative stress. On the other hand, higher levels of PC and PS in pterygium samples could be explained by the increase in proliferation and angiogenesis.
目的:探讨环境蛋白性角膜变性(EPCD)、斑马病和翼状胬肉的患病率及其相关性,并对部分EPCD和翼状胬肉进行脂质组学研究。材料和方法:采用横向/观察性和分析性研究;样本是连续的非概率的。所有接受检查的患者一生都住在El Cuy (Río Negro)部门。取角膜上皮和结膜组织样本进行质谱脂质组学研究。结果:共纳入159例患者,男性占52.83%,女性占47.17%。眼病患病率为:鸡冠病32.1%,EPCD 28.9%,翼状胬肉13.2%。EPCD与男性患者的相关性有统计学意义(21.4% vs 7.5%) (p <0.05)。EPCD与鸡冠病和翼状胬肉有相关性,且以男性多见(p <0.05)。EPCD的脂质组学研究显示,受影响区域的磷脂浓度下降(减少15倍)。在翼状胬肉中,磷脂浓度增加了6.67倍。结论:我们的调查显示,在阿根廷巴塔哥尼亚的El Cuy地区,EPCD、pinguecula和翼状胬肉的流行程度很高。据我们所知,这是世界上第一个显示这三种眼病共存的作品。EPCD影响区域的磷脂浓度降低可能是由于氧化应激引起的脂质过氧化。另一方面,在翼状胬肉样品中较高水平的PC和PS可以通过增殖和血管生成的增加来解释。
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引用次数: 1
A case of multifocal central serous chorioretinopathy from a progestin-only contraceptive device 单孕激素避孕装置引起的多灶性中央浆液性脉络膜视网膜病变1例
Pub Date : 2019-01-01 DOI: 10.15761/NFO.1000235
E. Shen, S. Tsao, B. Kuppermann, Stephanie Y Lu
Purpose: To present a novel case of central serous chorioretinopathy (CSCR) diagnosed in a woman three weeks after implantation of Nexplanon, a progestin-only contraceptive device. Methods: Case report. Results and Discussion: A 35-year-old healthy woman presented with one-week duration of headache and photopsias in the right eye, three weeks after implantation of a progestin-only contraceptive device. Imaging demonstrated subretinal fluid in the right eye suggestive of central serous chorioretinopathy. Removal of the device was associated with a rapid restoration of visual acuity as well as resolution and sustained absence of CSCR on imaging.
目的:提出一个新病例中心性浆液性脉络膜视网膜病变(CSCR)诊断在一名妇女三周后植入Nexplanon,孕激素避孕装置。方法:病例报告。结果和讨论:一名35岁的健康女性,在植入孕激素避孕装置三周后,出现右眼持续一周的头痛和光衰。影像显示右眼视网膜下积液提示中枢性浆液性脉络膜视网膜病变。移除该装置与快速恢复视力以及成像分辨率和持续无CSCR相关。
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引用次数: 1
Assessment of anterior segment parameters in children with obesity 肥胖症儿童前段参数的评估
Pub Date : 2019-01-01 DOI: 10.15761/NFO.1000226
Semra Koca, Melikşah Keskin, M. S. Sarıcaoğlu, S. Koca, Ayten Kocaman Bulut, Z. Aycan
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引用次数: 0
Efficacy of suture less and glue-free conjunctival autograft in pterygium surgery 少缝线和无胶自体结膜移植在翼状胬肉手术中的疗效观察
Pub Date : 2019-01-01 DOI: 10.15761/nfo.1000230
Nganga Ngabou Charles Géraud Fredy, M. Chantal, Adiba Fene Samuel, Onka Vissimy, Messe Ambia Koulimaya Reinette, Diatewa Benedicte, Lebonzo Eurydice, Gombe Eyissa
This study analyses the factors influencing the graft stability after a suture less and glue-free conjunctival autograft in pterygium surgery. Patients and method: A prospective study, all patients underwent pterygium surgery with suture less glue less conjunctival autografting. The parameters studied were: Intraoperative, evaluation of graft stability at the end of the procedure. Postoperative, the graft position on day 1 after surgery. Results: Sixty-four grafts remained stable at the end of the intervention, i.e. 83.12% while 16.88% were unstable. In the postoperative follow-up, 79.22% of grafts were well-positioned including 76.62% of grafts flattened in place and 2.60% of grafts retracted. Grafts displacements were observed in 20.78% of cases including 11.69% of minor displacements and 9.09% of major displacements. One patient had an excessive bleeding, which stopped on day one postoperative. Unstable grafts (84.62%) developed secondary displacements compared to stable grafts (7.81%). The difference was statistically significant, P=002. Out of the 7 cases with major displacement, 5 cases had unstable grafts (6.49%), and 2 cases had stable grafts (2.59%). Conclusion: It is an effective and safe technique with good graft position and stability despite intraoperative surgical adjustments as formerly described in the literature. The absence of postoperative irritation and suture related complications makes it a useful method for graft fixation in pterygium surgery. However, still some improvements are needed for better graft stability. Introduction Conjunctival autografting is giving good results in pterygium surgery [1,2]. The most commonly used means of fixating conjunctival autografts is by sutures or fibrin glue [3,4]. More recently, the use of autologous blood has been reported to be advantageous in minimizing the risk of postoperative infection, irritation and a reducing in the cost of surgery. However, the absence of suture or biological glue poses problem of graft fixation. Indeed, this graft fixation is potentialized by fibrin glue at the junction of the conjunctival autograft and the conjunctival bed [5]. In a review of the literature conducted in India, major displacement rates ranged between 0 to 12% while Boucher in Canada noted a 20% rate of graft loss [6,7]. Several studies have shown that on the first postoperative day the graft is already firmly fixed [6,8]. Most graft loss occurs before this time. This study presents some technical aspects aimed at improving the graft stability on the first postoperative day. Patients and method Patients Our study was conducted as part of a decentralized surgical activity in a transportable hospital. The primary target was patients with cataracts, but pterygium also was operated on. Thus 77 eyes of 77 patients were operated from 09-07-2018 to 08-08-2018 Inclusion criteria *Correspondence to: Nganga Ngabou Charles Géraud Fredy, Department of Ophthalmology, University Hospital of Brazzaville, Bra
本研究分析了翼状胬肉手术中少缝线和无胶自体结膜移植后影响移植物稳定性的因素。患者和方法:一项前瞻性研究,所有患者均行翼状胬肉手术,无缝线、无胶、无结膜自体移植。研究的参数有:术中,手术结束时移植物稳定性的评估。术后,术后第1天移植物位置。结果:64个移植物在干预结束时保持稳定,占83.12%,不稳定占16.88%。在术后随访中,79.22%的移植物定位良好,其中76.62%的移植物扁平到位,2.60%的移植物缩回。20.78%的病例发生移植物移位,其中轻微移位占11.69%,严重移位占9.09%。一名患者出现大量出血,但在术后第一天就止住了。与稳定移植物(7.81%)相比,不稳定移植物(84.62%)发生二次移位。差异有统计学意义,P=002。7例大位移患者中移植物不稳定5例(6.49%),稳定2例(2.59%)。结论:这是一种有效和安全的技术,尽管术中进行了手术调整,但移植物位置和稳定性良好。无术后刺激和缝合相关并发症,是翼状胬肉手术中有效的植骨固定方法。然而,为了获得更好的移植物稳定性,还需要一些改进。自体结膜移植在翼状胬肉手术中取得了良好的效果[1,2]。自体结膜移植最常用的固定方法是缝合或纤维蛋白胶[3,4]。最近,自体血液的使用在减少术后感染、刺激的风险和降低手术费用方面具有优势。然而,缝线或生物胶的缺失给移植物固定带来了问题。事实上,自体结膜移植物和结膜床[5]连接处的纤维蛋白胶使移植物固定成为可能。在印度进行的文献综述中,主要移位率在0 - 12%之间,而加拿大的Boucher指出移植物损失率为20%[6,7]。一些研究表明,在术后第一天,移植物已经牢固固定[6,8]。大多数移植物损失发生在这个时间之前。本研究提出了一些技术方面的问题,旨在提高移植术后第一天的稳定性。患者和方法患者本研究是在一家可移动医院进行的分散手术活动的一部分。手术的主要对象是白内障患者,但翼状胬肉也有手术。作者:Nganga Ngabou Charles g raud Fredy,刚果共和国布拉柴维尔大学医院眼科,E-Mail: fredygeraud@gmail.com
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引用次数: 2
TGF-β-target genes are differentially regulated in corneal epithelial cells and fibroblasts. TGF-β靶基因在角膜上皮细胞和成纤维细胞中有差异调控。
Pub Date : 2017-01-01 Epub Date: 2017-01-30 DOI: 10.15761/NFO.1000151
Xiaoqing Guo, Audrey E K Hutcheon, Jennifer A Tran, James D Zieske

Purpose: Transforming growth factor-beta (TGF-β) activates the canonical Smad pathway, which includes the Smad family of proteins and SARA (Smad Anchor for Receptor Activation) and other less understood pathways, including one involving p38MAPK. The goal of the current research was to determine if corneal epithelial cells and fibroblasts used the classical or alternative TGF-β-signaling pathways. To examine this question, we made use of Trx-SARA, which inhibits native SARA, thus blocking the Smad pathway.

Methods: A human corneal epithelial cell line (HCE-TJ), and stromal fibroblasts (HCF) were infected with retroviruses (RTV) containing either Trx-SARA or Trx-GA (a control plasmid). The effect of Trx-SARA on thrombospondin-1 (TSP-1) expression in both cell types, p15ink4b expression in HCE-TJ, and cellular fibronectin (cFN) expression in HCF was determined. In addition, the effect of p38MAPK inhibitor on TSP-1 and p15ink4b were examined.

Results: In HCE-TJ with TGF-β1, TSP-1-protein levels increased and peaked at 24 hours. Trx-SARA reduced TSP-1 expression in HCE-TJ, but had no effect on p15ink4b. With HCF, Trx-SARA failed to reduce TSP-1 expression; however, cFN expression decreased and proliferation was inhibited. By blocking the p38MAPK pathway, TSP-1 expression was reduced in HCF and p15ink4b expression was decreased in HCE-TJ.

Conclusions: Surprisingly, TSP-1 was regulated through the Smad pathway in HCE-TJ and the p38MAPK pathway in HCF. The p38MAPK pathway also induced p15ink4b in HCE-TJ. Our results indicate that not all TGF-β-target proteins require the Smad pathway, and it may be possible to block certain TGF-β-target proteins without blocking the expression of all the TGF-β-target proteins.

目的:转化生长因子-β (TGF-β)激活典型的Smad途径,包括Smad家族蛋白和SARA (Smad受体激活锚点)以及其他鲜为人知的途径,包括一个涉及p38MAPK的途径。本研究的目的是确定角膜上皮细胞和成纤维细胞是否使用经典的或替代的TGF-β-信号通路。为了研究这个问题,我们使用了Trx-SARA,它抑制了原生SARA,从而阻断了Smad通路。方法:用含有Trx-SARA或Trx-GA(对照质粒)的逆转录病毒(RTV)感染人角膜上皮细胞系(HCE-TJ)和间质成纤维细胞(HCF)。测定Trx-SARA对两种细胞类型中血小板反应蛋白-1 (TSP-1)表达、HCE-TJ中p15ink4b表达和HCF中细胞纤维连接蛋白(cFN)表达的影响。此外,还检测了p38MAPK抑制剂对TSP-1和p15ink4b的影响。结果:在TGF-β1作用的HCE-TJ中,tsp -1蛋白水平升高,并在24小时达到峰值。Trx-SARA降低了HCE-TJ中TSP-1的表达,但对p15ink4b无影响。在HCF中,Trx-SARA未能降低TSP-1的表达;而cFN表达降低,增殖受到抑制。通过阻断p38MAPK通路,HCF中TSP-1表达降低,HCE-TJ中p15ink4b表达降低。结论:令人惊讶的是,TSP-1在HCE-TJ中通过Smad途径和HCF中通过p38MAPK途径受到调节。p38MAPK通路也在HCE-TJ中诱导p15ink4b。我们的研究结果表明,并非所有的TGF-β靶蛋白都需要Smad通路,有可能阻断某些TGF-β靶蛋白,而不阻断所有TGF-β靶蛋白的表达。
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引用次数: 8
Genetic and epigenetic modifications in the pathogenesis of diabetic retinopathy: a molecular link to regulate gene expression. 糖尿病视网膜病变发病机制中的遗传和表观遗传修饰:调节基因表达的分子联系。
Pub Date : 2016-01-01 Epub Date: 2016-10-24 DOI: 10.15761/NFO.1000145
Priya Pradhan, Nisha Upadhyay, Archana Tiwari, Lalit P Singh

Intensification in the frequency of diabetes and the associated vascular complications has been a root cause of blindness and visual impairment worldwide. One such vascular complication which has been the prominent cause of blindness; retinal vasculature, neuronal and glial abnormalities is diabetic retinopathy (DR), a chronic complicated outcome of Type 1 and Type 2 diabetes. It has also become clear that "genetic" variations in population alone can't explain the development and progression of diabetes and its complications including DR. DR experiences engagement of foremost mediators of diabetes such as hyperglycemia, oxidant stress, and inflammatory factors that lead to the dysregulation of "epigenetic" mechanisms involving histone acetylation and histone and DNA methylation, chromatin remodeling and expression of a complex set of stress-regulated and disease-associated genes. In addition, both elevated glucose concentration and insulin resistance leave a robust effect on epigenetic reprogramming of the endothelial cells too, since endothelium associated with the eye aids in maintaining the vascular homeostasis. Furthermore, several studies conducted on the disease suggest that the modifications of the epigenome might be the fundamental mechanism(s) for the proposed metabolic memory' resulting into prolonged gene expression for inflammation and cellular dysfunction even after attaining the glycemic control in diabetics. Henceforth, the present review focuses on the aspects of genetic and epigenetic alterations in genes such as vascular endothelial growth factor and aldose reductase considered being associated with DR. In addition, we discuss briefly the role of the thioredoxin-interacting protein TXNIP, which is strongly induced by high glucose and diabetes, in cellular oxidative stress and mitochondrial dysfunction potentially leading to chromatin remodeling and ocular complications of diabetes. The identification of disease-associated genes and their epigenetic regulations will lead to potential new drugs and gene therapies as well as personalized medicine to prevent or slow down the progression of DR.

糖尿病及相关血管并发症发生率的增加已成为全世界失明和视力损害的根本原因。其中一种血管并发症是导致失明的主要原因;糖尿病视网膜病变(DR)是1型和2型糖尿病的一种慢性并发症。同样清楚的是,人群中的“遗传”变异不能单独解释糖尿病及其并发症的发生和进展,包括DR。DR经历了糖尿病的主要介质,如高血糖、氧化应激和炎症因素,这些因素导致涉及组蛋白乙酰化、组蛋白和DNA甲基化的“表观遗传”机制失调。一组复杂的应激调节和疾病相关基因的染色质重塑和表达。此外,升高的葡萄糖浓度和胰岛素抵抗对内皮细胞的表观遗传重编程也有很强的影响,因为内皮细胞与眼睛有关,有助于维持血管的内稳态。此外,一些关于该疾病的研究表明,表观基因组的修饰可能是代谢记忆的基本机制,即使在糖尿病患者达到血糖控制后,也会导致炎症和细胞功能障碍的基因表达延长。因此,本文将重点讨论与糖尿病相关的血管内皮生长因子和醛糖还原酶等基因的遗传和表观遗传改变。此外,我们还简要讨论了高糖和糖尿病强烈诱导的硫氧还蛋白相互作用蛋白TXNIP在细胞氧化应激和线粒体功能障碍中的作用,TXNIP可能导致糖尿病的染色质重塑和眼部并发症。疾病相关基因及其表观遗传调控的识别将导致潜在的新药和基因治疗以及个性化医疗,以预防或减缓DR的进展。
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引用次数: 17
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New frontiers in ophthalmology (London)
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