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)
Retinal degeneration mainly include age-related macular degeneration, retinitispigmentosa and Stargardt’s disease. Although its expression is slightly different, its pathogenesis is photoreceptor cells and/or retinal pigment epithelial (RPE) cel1 damage or degeneration. Because of the 1ack of self-repairing and renewal of retinal photoreceptor cells and RPE cells, cell replacement therapy is one of the most effective methods for treating such diseases.The stem cells currently used for the treatment of retinal degeneration include embryonicstem cells (ESC) and various adult stem cells, such as retinal stem cells (RSC), induced pluripotent stem cells (iPSC). and mesenchyma1 stem cells (MSC). Understanding the currentbasic and clinical application progress of ESC, iPSC, RSC, MSC can provide a new idea for the treatment of retinal degeneration.
Abstract:Five eyes of acute retinal necrosis(ARN)with multiple retinal breaks and retinal detachment were treated by closed vetrectomy combined with encircling buckle,gas/fluid exchange,nolaser and cryotherapy.After operation,the detached retinas reattached in 4eyes,and among them th visual acuity was 0.2 in 1 eye,and better than 0.05 in 3 eyes.The follow-up duration in 5 eyes was from 6 to18 months and recurrent retinal detachment was found in one eys. （Chin J Ocul Fundus Dis,1996,12: 20-21)
Fundus disease is a kind of common ophthalmic disease with high blindness rate and great harm. Although great breakthroughs have been made in medical treatment, laser photocoagulation, radiotherapy and gene therapy of fundus disease, with the further understanding of the essence of fundus disease, there are higher requirements for the treatment of fundus disease. To strengthen scientific research on the etiology, pathological mechanism and clinical treatment of fundus diseases, to control the quality of research, to develop reasonable treatment plans and explore new treatment methods under the guidance of evidence-based medicine theory, to further improve the level of medical treatment and benefit patients with fundus diseases will still be a formidable challenge in the future.
Objective To measure and compare the difference between the normal control and retinoschisis with multifocal electroretinography. Methods Nineteen cases (21 eyes) of normal control and 8 cases (15 eyes) of inherited retinoschisis were measured with VERIS ScienceTM 4.0.Three cases (6 eyes) of inherited retinoschisis were tested with Ganzfeld ERG. Results There was statistically significant difference of average response density and latencies in all 6 ring retinal regions between the normal control and retinoschisis. The topography of multifocal ERG showed that multifocal amplitude decreased with disappearing or decreasing of central peak amplitude in patients with retinoschisis. The P1/N1ratio of the multifocal ERG average response densities in 6 ring retinal regions was different from the b/a ratio of the Ganzfeld ERG. Conclusion Each of the multifoca l ERG and Ganzfeld ERG has its advantage in the diagnosis of the retinoschisis. (Chin J Ocul Fundus Dis, 2001,17:268-270)
ObjectiveTo observe the application value and therapeutic efficacy of wide-field digital pediatric retinal imaging system (RetcamⅢ) fundus fluorescein angiograms (FFA) assisted photocoagulation on familial exudative vitreoretinopathy (FEVR). MethodsThe study included 46 eyes of 34 patients with staging 2 FEVR. All patients received color fundus photography and FFA under general anesthesia. The blood vessel reliability of color fundus photography and FFA was comparatively determined. Binocular indirect ophthalmoscope laser photocoagulation was applied to peripheral retina with abnormal leakage as indicated by FFA, the wavelength was 532nm, the duration was 0.25 s and the energy was 200-280 mW. After laser photocoagulation, fundus imaging and FFA was repeated. Further laser photocoagulation was immediately added to areas with vessel leakage but missing the photocoagulation. After treatment, the mean follow-up duration was 14.4 months. The follow up focused on neovascularization, exudative lesions, vitreous traction and merging of photocoagulation spots within 3 months, and on fibrosis membrane resulting in macular traction, tractional retinal detachment, vitreous hemorrhage or Coats disease-like retinal exudates after 3 months. ResultsIt was hard to identify the blood vessels based on the color fundus images and some avascular zone maybe missed. Neovascularization can't be determined by shape of the blood vessels. On the other hand, those new blood vessels can be easily recognized by FFA as leakage sites at the boundary of avascular zone. The surgeon could quickly and accurately locate the FEVR area guided by the color fundus images and FFA from same angle under binocular indirect ophthalmoscope. During the treatment, there was no retinal FEVR area missed laser photocoagulation for all patients. There was no neovascularization, exudative lesions, vitreous traction within 3 months, and no fibrosis membrane, tractional retinal detachment, vitreous hemorrhage or Coats disease-like retinal exudates after 3 months. There were no ocular and systemic complications during and after the FFA and laser photocoagulation. ConclusionWide-field RetcamⅢFFA can help retinal specialists to identify abnormal neovascularization, locate the lesion area, and thus increase the success rate of laser photocoagulation, reduce the ocular and systemic complications for FEVR.
Objective To analyze the problems in the diagnosis of Coats disease and its main causes of misdiagnosis. Methods The clinical data of a group of patients with Coats diseases who had undergone indirect ophthalmoscopy, ocular fundus photography, fundus fluorescein angiography (FFA) and follow-up examination were retrospectively analyzed. The main causes of misdiagnosis were analyzed via reviewing the images of FFA and revising or confirming the initial diagnosis of Coats diseases according to the main features of abnormal dilation of retinal capillary vessels. Result In 68 patients (75 eyes), there were 45 cases whose initial diagnosis was Coats disease while the final diagnosis was not, in whom the final diagnosis was old retinal vein occlusion in 21, retinal vasculitis in 9, diabetic retinopathy in 3, old posterior uveitis in 3, congenital retinoschisis in 3, and proliferative vitreoretinopathy, familial exudative vitreoretinopathy, racemose hemangioma, old rhegmatogenous retinal detachment, macular epiretinal membrane, and idiopathic juxtafoveal telangiectasis in 1, respectively. There were 23 patients who was diagnosed as Coats disease in the final diagnosis but not the initial one. The initial diagnosis was old posterior uveitis in 6 patients, retinal vasculitis in 5, exudative age-related macular degeneration in 4, retinal main arterial tumor in 2, retinal angioma in 3, intraocular tumor in 2, and central serous chorioretinopathy in 1. Conclusions There are many problems in the clinical diagnosis of Coats disease. The main reason of misdiagnosis is that the clinicians can not comprehensively master the core of the definition of Coats disease and its clinical characters. (Chin J Ocul Fundus Dis, 2005, 21: 377-380)
Pyroptosis is a newly discovered form of cell death. Through the activation of inflammasome complexes, pyroptosis induces the production of interleukin (IL) -1β and IL-18, and the osmotic swelling of cells, thus induces cellular rupture and death. It plays a role in the pathological process of a variety of human diseases. The death of retinal cells including photoreceptor cells and retinal pigment epithelium (RPE) cells is the main reason leading to visual dysfunction in the pathogenesis in ocular fundus diseases. Researches have demonstrated that pyroptosis is closely related to the onset and progression of various retinal diseases. In age-related macular degeneration, pyroptosis directly causes apoptosis of RPE cells and upregulation of pro-inflammatory factors, enhancing toxic effect of lipofuscin. For retinitis pigmentosa, pyroptosis is the leading manner of death of secondary cone photoreceptor cells. In cytomegalovirus retinitis, pyroptosis is the main responding way to infection. This review presented the molecular mechanism of pyroptosis and its role in age-related macular degeneration, retinitis pigmentosa and cytomegalovirus retinitis and other retinal diseases.
ObjectiveTo investigate the relationship between optic disc hemorrhage and localized retinal never fiber layer defects (RNFLDs) in norma l tension glaucoma.MethodsIn 83 patients with normal-tension glaucoma, the cumulative frequency and quadrantal distribution of optic disc hemorrhages were retrospectively analyzed. The neighboring relation between optic disc hemorrhages and RNFLDs in a same quadrant and the changes of correspondin gretinal never fiber layer (RNFL) after the occurrence of optic disc hemorrhages were observed by tridimensional photochromy of ocular fundus.Results(1) The occurrences and distribution of optic disc hemorrhages: 29of83(34.94%) patients (33 eyes) had totally 58 occurrences, including 39 in infer iotemporal area, 14 in superiotemporal area, and 5 in other area. (2) The relati onship of neighborhood between optic disc hemorrhages and RNFLDs: in the availab le tridimensional photochrome, 23 occurrences in 15 patients (16 eyes) were foun d with cuneiform RNFLDs in the same quadrant, in which 22 was near the border of cuneiform RNFLDs. (3) The changes of corresponding retinal never fiber layer (R NFL) after the occurrence of optic disc hemorrhages: the photochromes of 24 occurrences in 20 patients (21 eyes) were kept well in the initial and the 2-year follow-up periods, while the changes of RNFL were found in each region correspon ding to the 19 occurrences (in inferiotemporal or superiotemporal area) in the initial photochrome, including 7 cuneiform defects with various sizes, and 12 developed localized RNFLDs next to the initial hemorrhages in the optic disc. No obvious localized RNFL corresponding to the other 5 occurrences (1 in inferiotempo ral, 1 in superiotemporal, and 3 in other areas) were found in the follow up period.ConclusionOptic disc hemorrhages in normal-tension glaucoma occur mostly in inferiotemporal area, and secondly in superiotemporal area of optic disc, and the appearance of optic disc hemorrhages may suggest that the localized RNFLDS would develop in the associated regions.(Chin J Ocul Fundus Dis，2004，20：339-342)
Purpose To investigate the expression of the interleukin-6(IL-6)and tumor necrosis factor alpha(TNF-alpha;) in epiretinal membranes(ERM) of eyes with proliferative vitreoretinopathy(PVR). Methods Nineteen epiretinal membranes were obtained form eyes undergoing vitrectomy for retinal detachment complicated with PVR and observed by immunohistochemical methods. Results Expression of IL-6 and TNF-alpha; were observed in 12 and 15 membranes respectively with positive staining mostly in extracellular matrix of epiretinal membranes.Only one membrane showed positive to IL-6 intracellularly,and expression for IL-6 and TNF-alpha; simultaneously in membranes. Conclusion The findings indicate that IL-6、and TNF-alpha;might be involved in the development of PVR. (Chin J Ocul Fundus Dis,1998,14:219-221)