The lack of axonal regeneration is the major cause of vision loss after optic nerve injury in adult mammals. Activating the PI3K/AKT/mTOR signaling pathway has been shown to enhance the intrinsic growth capacity of ne...The lack of axonal regeneration is the major cause of vision loss after optic nerve injury in adult mammals. Activating the PI3K/AKT/mTOR signaling pathway has been shown to enhance the intrinsic growth capacity of neurons and to facilitate axonal regeneration in the central nervous system after injury. The deletion of the mTOR negative regulator phosphatase and tensin homolog （PTEN） enhances regeneration of adult corticospinal neurons and ganglion cells. In the present study, we used a tyrosine-mutated （Y444F） AAV2 vector to efficiently express a short hairpin RNA （shRNA） for silencing PTEN expression in retinal ganglion cells. We evaluated cell survival and axonal regeneration in a rat model of optic nerve axotomy. The rats received an intravitreal injection of wildtype AAV2 or Y444F mutant AAV2 （both carrying shRNA to PTEN） 4 weeks before optic nerve axotomy. Compared with the wildtype AAV2 vector, the Y444F mutant AAV2 vector enhanced retinal ganglia cell survival and stimulated axonal regeneration to a greater extent 6 weeks after axotomy. Moreover,post-axotomy injection of the Y444F AAV2 vector expressing the shRNA to PTEN rescued ～19% of retinal ganglion cells and induced axons to regenerate near to the optic chiasm. Taken together, our results demonstrate that PTEN knockdown with the Y444F AAV2 vector promotes retinal ganglion cell survival and stimulates long-distance axonal regeneration after optic nerve axotomy. Therefore, the Y444F AAV2 vector might be a promising gene therapy tool for treating optic nerve injury.展开更多
AIM:To explore retinal displacement after surgical treatment for idiopathic macular hole(IMH)with different internal limiting membrane(ILM)peeling patterns.METHODS:Totally 22 eyes from 20 patients with IMH were random...AIM:To explore retinal displacement after surgical treatment for idiopathic macular hole(IMH)with different internal limiting membrane(ILM)peeling patterns.METHODS:Totally 22 eyes from 20 patients with IMH were randomly allocated into two groups,N-T group(11 eyes)and T-N group(11 eyes).For patients in N-T group,ILM was peeled off from nasal to temporal retina.For patients in T-N group,ILM was peeled off from temporal to nasal retina.Preoperative,postoperative 1,3,and 6 mo,autofluorescence fundus images were collected for manual measurement of distances of fixed nasal(N),temporal(T),superior(S),and inferior(I)retinal points(bifurcation or crossing of retinal vessels)around the macula to the optic disc(OD).These were respectively defined as N-OD,T-OD,S-OD,and I-OD.The retinal displacement,macular holeclosure rate,and best corrected visual acuity(BCVA)were compared between the two groups after surgery.RESULTS:At postoperative 1,3,and 6 mo,the macula slipped toward the OD,manifested by the decreased T-OD,N-OD,S-OD,and I-OD(P<0.05).No significant difference was found in the T-OD,N-OD,S-OD,and I-OD between N-T group and T-N group.IMH closure rate was 100%both in N-T group and T-N group.There was no significant difference in BCVA between two groups(P<0.05).CONCLUSION:The macula slips toward the OD after successful macular hole surgery.The two different ILM peeling pattern show similar visual outcome and retinal displacement,which means ILM peeling directions are not the influencing factor of postoperative retinal displacement.展开更多
Myopia,a worldwide condition,is a multifactorial disease resulting in many ocular complications.Early onset of myopia has a great tendency to develop high myopia and pathological myopia later in life.The pathophysiolo...Myopia,a worldwide condition,is a multifactorial disease resulting in many ocular complications.Early onset of myopia has a great tendency to develop high myopia and pathological myopia later in life.The pathophysiology and progression of myopia is still unclear.Owing to its involving in visual function,optic disc and peripapillary change in high myopia can＇t be neglected,and it may help in better understanding of the pathophysiology or mechanism of myopia progression.Recently,advanced imaging techniques have been developed,such as optical coherence tomography（OCT）,allowing for better detecting of optic disc and peripapillary change.OCT is a highresolution and noninvasive measurement for detection of ocular structure.Herein,we provide an updated review of optic disc and peripapillary change in OCT image,including its characteristics and clinical significance.We also propose some problems needed further investigation.展开更多
Dear Editor,I＇m Dr. Qing-Huai Liu from Department of Ophthalmology, the First Affiliated Hospital of Nanjing Medical University,Nanjing, China. I write to present four cases diagnosed with the intraocular foreign bo...Dear Editor,I＇m Dr. Qing-Huai Liu from Department of Ophthalmology, the First Affiliated Hospital of Nanjing Medical University,Nanjing, China. I write to present four cases diagnosed with the intraocular foreign body （IOFB） at or near the ciliary body and to evaluate the effect of extracting IOFB with scleral indentation in direct visualization.展开更多
●AIM:To introduce a new method for suprachoroidal fluid drainage before 23-gauge pars plana vitrectomy.●METHODS:A 15o side-port blade was firstly used to create a sclerotomy into the suprachoroidal space for initial...●AIM:To introduce a new method for suprachoroidal fluid drainage before 23-gauge pars plana vitrectomy.●METHODS:A 15o side-port blade was firstly used to create a sclerotomy into the suprachoroidal space for initial drainage.A 30-guage needle was then applied to inject balanced saline solution through the existing sclerotomy for further drainage.After most of the suprachoroidal fluid was drained,standard 3-port 23-guage pars plana vitrectomy was performed.●RESULTS:We have succeeded in using this technique to treat five patients with retinal detachment and kissing choroidal detachment(KCD).The choroidal detachment was visibly recessed in all cases after drainage with no intraoperative complications.After removal of silicon oil at 3 mo follow-up,all patients obtained a reattached retina.No postoperative complications such as hypotony and endophthalmitis occurred.●CONCLUSION:The new technique is efficient and safe for suprachoroidal fluid drainage for patients with rhegmatogenous retinal detachment.In future,further larger series are needed to attest to its safety and efficacy.展开更多
AIM:To evaluate the effectiveness of rectangular 3-snip punctoplasty versus punch punctoplasty via Kelly punch with silicone intubation for the management of acquired external punctal stenosis(AEPS).METHODS:A prospect...AIM:To evaluate the effectiveness of rectangular 3-snip punctoplasty versus punch punctoplasty via Kelly punch with silicone intubation for the management of acquired external punctal stenosis(AEPS).METHODS:A prospective,randomized,comparative study was performed on 123 eyes of 94 patients with AEPS.Patients were recruited into either group of rectangular 3-snip punctoplasty(group A)or group of punch punctoplasty with silicone intubation(group B).Outcomes measured were Munk score,grade of punctal stenosis,fluorescein dye disappearance time test(FDDT)and tear meniscus height(TMH)6 and 12 mo after surgery.RESULTS:Twelve months after surgery,Munk score,FDDT and TMH significantly decreased in both groups compared with the baseline(all P<0.05),and grade of punctal stenosis increased significantly(P<0.05).The grade of punctal stenosis,Munk score,FDDT and TMH were better in group B compared with group A at 6 or 12 mo(all P<0.05).There was a positive correlation between TMH and Munk score(R=0.655,P<0.001).At the last followed-up,anatomical success was noted in 96.7%eyes in group A and 98.4%eyes in group B(P=0.613).CONCLUSION:Punch punctoplasty via Kelly punch with silicone intubation achieves better outcomes than rectangular 3-snip punctoplasty.The new technique is a simple,minimally invasive,with high anatomical and functional success in patients with AEPS.展开更多
基金supported by the Research Foundation of Jiangsu Provincial Commission of Health and Family Planning of China,No.H201653the Research Foundation of Changshu Science and Technology Bureau of China,No.CS201616
文摘The lack of axonal regeneration is the major cause of vision loss after optic nerve injury in adult mammals. Activating the PI3K/AKT/mTOR signaling pathway has been shown to enhance the intrinsic growth capacity of neurons and to facilitate axonal regeneration in the central nervous system after injury. The deletion of the mTOR negative regulator phosphatase and tensin homolog （PTEN） enhances regeneration of adult corticospinal neurons and ganglion cells. In the present study, we used a tyrosine-mutated （Y444F） AAV2 vector to efficiently express a short hairpin RNA （shRNA） for silencing PTEN expression in retinal ganglion cells. We evaluated cell survival and axonal regeneration in a rat model of optic nerve axotomy. The rats received an intravitreal injection of wildtype AAV2 or Y444F mutant AAV2 （both carrying shRNA to PTEN） 4 weeks before optic nerve axotomy. Compared with the wildtype AAV2 vector, the Y444F mutant AAV2 vector enhanced retinal ganglia cell survival and stimulated axonal regeneration to a greater extent 6 weeks after axotomy. Moreover,post-axotomy injection of the Y444F AAV2 vector expressing the shRNA to PTEN rescued ～19% of retinal ganglion cells and induced axons to regenerate near to the optic chiasm. Taken together, our results demonstrate that PTEN knockdown with the Y444F AAV2 vector promotes retinal ganglion cell survival and stimulates long-distance axonal regeneration after optic nerve axotomy. Therefore, the Y444F AAV2 vector might be a promising gene therapy tool for treating optic nerve injury.
基金the National Natural Science Foundation of China(No.81870669No.81900875)+1 种基金Jiangsu Provincial Natural Science(No.BK20191059)Jiangsu Provincial Commission of Health and Family Planning(No.H201608)。
文摘AIM:To explore retinal displacement after surgical treatment for idiopathic macular hole(IMH)with different internal limiting membrane(ILM)peeling patterns.METHODS:Totally 22 eyes from 20 patients with IMH were randomly allocated into two groups,N-T group(11 eyes)and T-N group(11 eyes).For patients in N-T group,ILM was peeled off from nasal to temporal retina.For patients in T-N group,ILM was peeled off from temporal to nasal retina.Preoperative,postoperative 1,3,and 6 mo,autofluorescence fundus images were collected for manual measurement of distances of fixed nasal(N),temporal(T),superior(S),and inferior(I)retinal points(bifurcation or crossing of retinal vessels)around the macula to the optic disc(OD).These were respectively defined as N-OD,T-OD,S-OD,and I-OD.The retinal displacement,macular holeclosure rate,and best corrected visual acuity(BCVA)were compared between the two groups after surgery.RESULTS:At postoperative 1,3,and 6 mo,the macula slipped toward the OD,manifested by the decreased T-OD,N-OD,S-OD,and I-OD(P<0.05).No significant difference was found in the T-OD,N-OD,S-OD,and I-OD between N-T group and T-N group.IMH closure rate was 100%both in N-T group and T-N group.There was no significant difference in BCVA between two groups(P<0.05).CONCLUSION:The macula slips toward the OD after successful macular hole surgery.The two different ILM peeling pattern show similar visual outcome and retinal displacement,which means ILM peeling directions are not the influencing factor of postoperative retinal displacement.
基金Supported by the National Key Project of Research and Development Plan(No.2017YFA0104101)
文摘Myopia,a worldwide condition,is a multifactorial disease resulting in many ocular complications.Early onset of myopia has a great tendency to develop high myopia and pathological myopia later in life.The pathophysiology and progression of myopia is still unclear.Owing to its involving in visual function,optic disc and peripapillary change in high myopia can＇t be neglected,and it may help in better understanding of the pathophysiology or mechanism of myopia progression.Recently,advanced imaging techniques have been developed,such as optical coherence tomography（OCT）,allowing for better detecting of optic disc and peripapillary change.OCT is a highresolution and noninvasive measurement for detection of ocular structure.Herein,we provide an updated review of optic disc and peripapillary change in OCT image,including its characteristics and clinical significance.We also propose some problems needed further investigation.
文摘Dear Editor,I＇m Dr. Qing-Huai Liu from Department of Ophthalmology, the First Affiliated Hospital of Nanjing Medical University,Nanjing, China. I write to present four cases diagnosed with the intraocular foreign body （IOFB） at or near the ciliary body and to evaluate the effect of extracting IOFB with scleral indentation in direct visualization.
基金Supported by the National Natural Science Foundation of China(No.81900875)Natural Science Foundation of Jiangsu Province(No.BK20191059)the National Key Project of Research and Development Plan(No.2017YFA0104101).
文摘●AIM:To introduce a new method for suprachoroidal fluid drainage before 23-gauge pars plana vitrectomy.●METHODS:A 15o side-port blade was firstly used to create a sclerotomy into the suprachoroidal space for initial drainage.A 30-guage needle was then applied to inject balanced saline solution through the existing sclerotomy for further drainage.After most of the suprachoroidal fluid was drained,standard 3-port 23-guage pars plana vitrectomy was performed.●RESULTS:We have succeeded in using this technique to treat five patients with retinal detachment and kissing choroidal detachment(KCD).The choroidal detachment was visibly recessed in all cases after drainage with no intraoperative complications.After removal of silicon oil at 3 mo follow-up,all patients obtained a reattached retina.No postoperative complications such as hypotony and endophthalmitis occurred.●CONCLUSION:The new technique is efficient and safe for suprachoroidal fluid drainage for patients with rhegmatogenous retinal detachment.In future,further larger series are needed to attest to its safety and efficacy.
文摘AIM:To evaluate the effectiveness of rectangular 3-snip punctoplasty versus punch punctoplasty via Kelly punch with silicone intubation for the management of acquired external punctal stenosis(AEPS).METHODS:A prospective,randomized,comparative study was performed on 123 eyes of 94 patients with AEPS.Patients were recruited into either group of rectangular 3-snip punctoplasty(group A)or group of punch punctoplasty with silicone intubation(group B).Outcomes measured were Munk score,grade of punctal stenosis,fluorescein dye disappearance time test(FDDT)and tear meniscus height(TMH)6 and 12 mo after surgery.RESULTS:Twelve months after surgery,Munk score,FDDT and TMH significantly decreased in both groups compared with the baseline(all P<0.05),and grade of punctal stenosis increased significantly(P<0.05).The grade of punctal stenosis,Munk score,FDDT and TMH were better in group B compared with group A at 6 or 12 mo(all P<0.05).There was a positive correlation between TMH and Munk score(R=0.655,P<0.001).At the last followed-up,anatomical success was noted in 96.7%eyes in group A and 98.4%eyes in group B(P=0.613).CONCLUSION:Punch punctoplasty via Kelly punch with silicone intubation achieves better outcomes than rectangular 3-snip punctoplasty.The new technique is a simple,minimally invasive,with high anatomical and functional success in patients with AEPS.
