Objective To investigate the effects of phacoemulsification on macula in diabetics． Methods Thirty eyes of cataract in diabetics were chosen randomly for measurement of the thickness of fovea of retina using OCT before phacoemulsification and 1 month after surgery ． The other eyes in these patients and 30 eyes of cataract in nondiabetic pati ents with phacoemulsification were as control． Results In 30 eyes of diabetics with phacoemulsification, the mean fovea thickness were (148．5plusmn;27．7) mu;m preoperatively and (219．4plusmn;68．23) mu;m postoperatively, and the difference was significant (Plt;0．05)． In 30 eyes of diabetics without surgery, the mean foveal thickness were (147.4plusmn;27.5) mu;m preoperatively and (148.2plusmn;27.3) mu;m postoperatively and the difference was not significant (Pgt;0．05)． In 30 eyes of cataract in nondiabetic patients, the mean fovea thickness were (142．37plusmn;12．7) mu;m preoperatively and (151．9plusmn;23．7) mu;m postoperatively and the difference was not significant (Pgt;0．05)． In 30 eyes of diabetic s with phacoemulsification, 11 eyes had new macula edema after surgery and 3 eye s had significant retinal thickening． In 6 eyes with macular edema before surgery, the macular edema were aggravated in 3 eyes after surgery． The macular stru ctural changes were not found in two control groups． Conclusion The thickness of retina is inreased after phacoemulsification in deabetics,and morbidity and its severity of postopevative macular edema are increas ed as well． (Chin J Ocul Fundus Dis, 2001,17:175-177)
Objective To compare the effectiveness of aspheric intraocular lenses(IOL) versus spherical IOL in the treatment of cataract. Method Randomized controlled trials comparing aspheric IOL with spherical IOL were identified by searching PubMed (2000 to October, 2008), EMbase (2000 to October, 2008), MEDLINE (2000 to October, 2008), and The Cochrane Library (Issue 3, 2008). Two reviewers independently assessed trials for eligibility and quality, as well as the extracted data. Data were synthesized using RevMan software (release 5) provided by the Cochrane Collaboration. Results A total of 14 trials (1383 eyes) were included for systematic review, and 11 out of 14 studies were included in the meta-analysis. Subgroup analyses were used according to different aberrations of aspheric IOL. The results showed a significant difference in the mean best corrected visual acuity at 3 months after cataract surgery in the AcrySof IQ IOL group with WMD -0.02, 95% CI -0.03 to -0.01(Plt;0.0001). It showed a significantly worse difference in the mean of the best corrected visual acuity at 3 months after cataract surgery in the AcrySof IQ IOL group with WMD –0.02, 95%CI –0.03 to –0.01 (Plt;0.000 1). It showed a significant worse in the mean the best corrected visual acuity in the Tecnis Z9000 IOL group with WMD 0.02, 95%CI 0.01 to 0.03 (P=0.002); and there was no significant difference between the two groups with WMD 0.00, 95%CI –0.02 to –0.03 (P=0.71). The results did display markedly less spherical aberration and total higher order aberrations than eyes implanted with the traditional spheric IOL in all subgroups (WMD –0.06, 95%CI –0.07 to –0.06, Plt;0.000 01, WMD –0.06, 95%CI –0.07 to –0.02, Plt;0.000 1, respectively). The majority of studies suggested significant improvement in the aspheric IOL group in contrast sensitivity, especially at mesopic low spatial frequencies, although some trials showed no significant difference. Conclusion The effectiveness of aspheric IOL is superior to spherical IOL during cataract surgery. No differences in aspheric IOL with different aberration are found in this series, and further study is required.
ObjectiveTo observe the clinical manifestations of a Wagner syndrome (WS) family. MethodsA retrospective clinical study. Four patients (the proband, his father, sister, and brother) and one family member (the proband's mother) from a WS family diagnosed by clinical examination in Chengdu Aidi Eye Hospital in June 2023 were included in the study. The proband's medical history was examined in detail, followed by best corrected visual acuity (BCVA), fundus color photography, optical coherence tomography (OCT), and OCT angiography (OCTA). The proband underwent full field electroretinogram (ERG) examination. The proband and his sister and brother underwent blood glucose, blood pressure, hearing, face, joint, exercise and general physical examination at the same time. Peripheral venous blood was collected from the proband and 4 other family members. The proband extracts genomic DNA samples, conducts target region capture, library construction and high-throughput sequencing after qualified quality control. The suspected pathogenic mutation sites were verified by Sanger. According to the selected mutation sites, other family members in this family were co-isolated and verified. The pathogenicity of the mutation site was analyzed using the guidelines of the American College of Medical Genetics and Genomics (ACMG). ResultsProband (Ⅱ-1) was 23 years old female. Both eyes BCVA were 0.1. The waveforms of ERG in both eyes were basically normal, and some amplitudes were reduced. Sister of the proband (Ⅱ-2) was 20 years old. Both eyes BCVA 1.0. Fundus examination showed no obvious abnormality. Brother of the proband (Ⅱ-3) was 19 years old. The left eye underwent pars plana vitrectomy combined with silicone oil filling 2 years ago due to retinal detachment and severe vitreous hyperplasia. BCVA light sensitivity, complicated cataract, and fundus opacity were observed. Right eye BCVA was 0.1. The lenses of the proband and his younger sister and brother were pointed and wedged, and the younger brother was heavier. Vitreous cavity of lens. The retina color of both eyes and the right eye of the younger brother of the protor was dark, with flaky dark areas on the side of the nose and the posterior pole, and the symmetrical retinal veil membrane hyperplasia and pulling on the periphery, showing small retinal splits. The choroidal retina showed focal and segmental symmetrically large atrophy. The optic disc was tilted. By OCT examination, the ellipsoid band was partially missing and broken, and the thickness of the choroid layer was reduced. Retinal cortical atrophy in 1 eye (younger brother of proband). By OCTA examination, the mesovascular layer of choroid was atrophied seriously and the blood density decreased. The results of laboratory and general examination of the three siblings showed no obvious abnormalities. The results of genetic testing showed that the proband, his father (Ⅱ-1), his sister and his brother carried a heterozygous mutation of the VCAN gene c.9264A>G (p.Pro3088=). According to ACMG guidelines, the pathogenicity of this variant was unknown. The mother of proband (Ⅰ-2) was wild type. ConclusionsThe abnormal manifestations of WS eyes are diverse, and both anterior and posterior segments could be involved. The pathogenicity of the heterozygous variation of VCAN gene c.9264A>G (P.RO3088 =) in this family is unknown.
Objective To analysis the effect of lens opacity on the measurement of retinal vessel oxygen saturation. Methods This was a cross sectional study. Forty four eyes of 44 patients with different degrees of lens opacity were enrolled. There were 23 males and 21 females. The patients aged from 48 to 84 years, with the mean age of (71.8±10.3) years. The mean best corrected visual acuity was 0.65±0.22. The mean intraocular pressure was (14.2±4.3) mmHg (1 mmHg=0.133 kPa). The mean equivalent spherical degree was (−0.05±2.10) D. The opitical quality analysis system was applied to measure intraocular objective scattering index (OSI) caused by lens opacity. According to the OSI, the opacity of lens was divided into four groups. Patients with OSI value ＜1.0 was grouped to level 1, which indicated that the lens were basically transparent; patients with OSI value between 1.0 and 3.0 was grouped to level 2, which indicated early cataract; patients with OSI value between 3.0 and 7.0 was grouped to level 3, which indicated progressive cataract; patients with OSI value ＞7.0 was grouped to level 4, which indicated the mature stage of cataract. The retinal oximeter Oxymap T1 was used to capture the fundus images under different wavelengths. Pearson correlation analysis was used to analyze the correlation between retinal oxygen saturation and age, intraocular pressure, equivalent spherical degree and OSI. One way ANOVA was used to analyze the difference of retinal oxygen saturation among groups. Results The mean retinal arterial oxygen saturation, venous oxygen saturation and arteriovenous difference was (90.70±6.46)%, (47.34±13.51)%, (43.36±10.09)%, respectively. The correlations of retinal arterial oxygen saturation, venous oxygen saturation and arteriovenous difference with age, intraocular pressure, equivalent spherical degree was not statistically significant (all P＞0.05). The retinal arterial oxygen saturation and venous oxygen saturation was negatively correlated with OSI (r=−0.462,−0.500; P=0.002, 0.001), the arteriovenous difference and OSI was positively correlated (r=0.373, P=0.013). According to lens opacity, there were 11 eyes in level 1, 9 eyes in level 2, 14 eyes in level 3, 10 eyes in level 4. There were significant differences of retinal artery and venous oxygen saturation among different lens opacity levels (F=5.340, 4.710; P=0.003, 0.007); meanwhile, the arteriovenous difference was not significantly different (F=2.048, P=0.123). The retinal arterial oxygen saturation and venous oxygen saturation was significantly lower in the level 4 lens opacity group than any other three groups (all P＜0.05), but there was no statistically significant difference among level 1 to level 3 lens opacity group. Conclusion The effect of lens opacity of level 1 to level 3 is limited on the measurement of retinal oxygen saturation, but level 4 lens opacity will cause decrease of retinal artery and venous oxygen saturation.
目的:研究巯基转移酶(thioltransferase,TTase)在年龄相关性白内障患者晶状体上皮细胞中的表达和活性,探讨白内障的发病机制。方法:利用RT-PCR技术检测白内障组和正常对照组晶状体前囊膜下上皮细胞TTase mRNA,以β-actin为参照标化检测指标含量,并比较各组之间TTase表达的差异。结果:RT-PCR结果显示,白内障组晶状体前囊膜下上皮细胞TTase mRNA表达低于正常对照组;白内障皮质组与后囊膜下组差异无显著性,其余各组间差异有显著性。结论:TTase在年龄相关性白内障晶状体前囊膜下上皮细胞中有表达且比正常人低,不同临床类型的表达不同,存在着发病机制的差异。
Purpose To explore the characteristics of eyes after congenital cataract surgery and to evaluate the methods of different retinal detachment surgery in those eyes． Method We retrospeetively reviewed the cli ncal data of 44 eyes with rhegmatogenous retinal detachment (RRD) after congenital cataract surgery,and compared the surgical results between scleral buckling and vitrectomy in those eyes．The mean interval between the congenital cataract surgery and RRD of the affectde eyes was 14．8 years and most of the techniques of cataract surgery was irrigation-aspiration and capsulotomy was performed in nearly all eyes． The mean axis length in 16 eyes was （26.8plusmn;1.90） mm． Results The success rate was 80．3% in scleral buckling and 85．7% in vitrectomy． Conclusion There is a long interval between congenital cataract surgery and RD．The pupil of these eyes is often small and immobile,causing diffculty in visualizing the peripheral retina ,decreasing the success rate of scleral buckling operation．Vitrectomy is an ideal chocie for such eyes． (Chin J Ocul Fundus Dis，2000，16：71-138)
ObjectiveTo observe the changes of macula in patients with high myopia after phacoemulsification. MethodsIn 20 patients with high myopia with ocular axial length≥27 mm, optical coherence tomography (OCT) was performed on the operative and contralateral eyes 1 week before and after monocular phacoemulsification, respectively, and the OCT images of macula of the operative eyes were observed and compared.ResultsOne week before and after phacoemulsification, the mean macular fovea thickness of the patients with high myopia was (131.6±16.37) μm and (189.75±45.69) μm, respectively, with a significant difference (t=2.805, P=0.01). Simultaneously, the mean macular fovea thickness of the contralateral eyes was (133.5±15.12) μm and (133.5±14.63) μm, respectively, with a non-significant difference (t=1.367, P=0.853). In 20 operative eyes 1 week after phacoemulsification, 3 had vitreous strand around the macula with retinal thickening, 1 had retinoschisis in macular area, and 2 had obvious retinal thickening with slight retinal edema.ConclusionRetinal thickening occurs in the patients with high myopia after phacoemulsification. Traction of retina by vitreous strand or subclinical retinoschisis may occur in some patients.(Chin J Ocul Fundus Dis, 2005,21:90-92)