目的 研究玻璃体激光消融术治疗飞蚊症的效果及与患者自觉改善程度的相关因素分析.方法 分析2019年2月至2020年4月于北京京煤集团总医院眼科门诊以飞蚊症就诊并接受玻璃体激光消融术治疗、随诊时间3个月以上的玻璃体混浊患者95例95眼.以自设计量表评估患者一般人口学资料、飞蚊症持续时间、眼前黑影的形状、发病以来的变化、对于生活的干扰程度等,玻璃体激光消融术后1周收集患者自评治疗后混浊改善程度、视力、眼压、散瞳检查玻璃体及视网膜情况.用单因素比较和多因素logistic回归模型分析与治疗后患者自觉症状改善程度可能相关的各因素.结果 95例患者治疗后视力均无下降,术后1周飞蚊症状明显减轻或消失者58眼,占61.1％;眼前仍可见漂浮物但减小或自觉好转者29眼,占30.5％,8眼治疗后自觉症状无改善,占8.4％.单变量分析显示玻璃体激光消融术治疗后自觉明显改善的因素为:40岁以上患者(P=0.0003),眼前黑影形态为环形或"C"形等玻璃体混浊患者(P<0.0001),每日看手机等视屏产品时间≤5h的患者(P<0.0064),差异有显著性;多元logistic回归模型显示差异具有显著性的因素为玻璃体混浊形态4种类型中环形或"C"形混浊的患者自觉改善程度明显好于点丝状/索状片状混浊(OR=11.67,95％CI:4.05～33.65)和点丝状/弥漫遮挡混浊(OR=8.75,95％CI:2.11～36.26).结论 玻璃体激光消融术治疗飞蚊症安全有效,玻璃体后脱离相关的混浊是YAG玻璃体消融术的最佳适应证.40岁以上患者和每日看手机等视屏产品时间≤5h的患者行玻璃体激光消融术治疗后自觉明显改善的比例更多.

OBJECTIVE:To investigate the value of confocal microscopy in determining the morphology of the tarsal gland after cataract phacoemulsification.METHODS:A total of 74 patients (74 eyes) who underwent phacoemulsification for a monocular cataract and intraocular lens implantation (all were single eye surgeries) in our hospital from May 2018 to October 2018 were recruited as the study cohort, with 43 male patients and 31 female patients, and a mean age of (64.8±12.5) years old. All the patients were followed up for 6 months, of whom 25 cases with MGD were included in the MGD group and 49 cases without MGD were included in the control group. All the patients were examined within 30 days and underwent IVCM inspections of the acinar morphology of the tarsal glands (expansion and atrophy), the infiltration of the inflammatory cells in the tarsal gland tissue, and a classification of the fibrosis in the tarsal gland tissue.RESULTS:The longest and shortest acinar diameters in the MGD patients were significantly greater than they were in the control group, but the acinar areas were smaller than they were in the control group. The meibomian glandular vesicle densities, the average opening diameters, the fibrosis, and the inflammatory cell density in the MGD group were significantly increased.CONCLUSION:IVCM plays a vital role in the early diagnosis, in the severity grading, and in the evaluation of the clinical effectiveness of MGD-related diseases, by which the morphological changes of the tarsal gland after phacoemulsification can be observed in a timely manner to predict the occurrence of MGD.

目的 了解玻璃体混浊患者的焦虑症状严重程度及影响因素.方法 收集2019年1月至2020年1月北京京煤集团总医院、北京燕化医院和北京中能建医院眼科门诊收治的玻璃体混浊患者163例,在医师指导下完成自评广泛性焦虑障碍问卷-7(general anxiety disorder-7, GAD-7),GAD-7评分≥10分为焦虑筛查阳性.采用单因素logistic回归分析和多因素logistic回归分析进行焦虑障碍危险因素的筛查.结果 163例患者的焦虑筛查阳性率为36.8％,男性筛查阳性率(53.0％)显著高于女性(20.0％);年龄≤35岁的焦虑阳性率(48.9％)显著高于年龄＞ 35岁(21.9％).多因素logistic回归表明,男性(OR=2.57,95％ CI:1.15～5.75,P=0.022)、飞蚊症对生活的重度困扰(OR=13.59,95％ CI:4.25～43.43,P=0.001)是焦虑的危险因素,年龄＞35岁是保护性因素(OR=0.36,95％ CI:0.16～ 0.81,P=0.013).结论 玻璃体混浊患者焦虑障碍筛查阳性率高,男性焦虑发生率远高于女性,年轻患者更易焦虑.

目的 分析症状性玻璃体混浊疾病特征及其与自觉困扰程度的相关性.方法 选取2018年10月至2020年5月北京京煤集团总医院、北京燕化医院和北京中能建医院就诊的飞蚊症患者218例.记录飞蚊症出现的时间、眼前黑影形状、在眼前飘动的位置、每日发生频率、发病以来的变化、对于生活的干扰程度,以及可能影响玻璃体混浊的因素,包括近视、眼外伤及每日使用手机、电脑、电视的时间.结果 218例患者中有66例(30.3％)只在明亮环境中才注意到眼前黑影,不适感较轻;152例(69.7％)能在日常生活中感觉到,不适感较明显.患者眼前黑影形状为环形或C形70例(32.1％),点状或丝绒状105例(48.2％),条索状或片状22例(10.1％),弥漫的大范围眼前遮挡21例(9.6％).患者自觉飞蚊症对生活困扰程度为轻度不适74例(33.9％),中度不适110例(50.5％),严重不适34例(15.6％).多元logistic回归分析显示,察觉到黑影症状的环境(OR=20.5,95％CI:7.00 ～ 60.00,P＜0.001)、每日觉察频次(OR=14.0,95％CI:4.90～39.60,P＜0.0001)和症状自发病以来的变化(OR=2.29,95％CI:1.16～4.51,P=0.017)与飞蚊症对患者的困扰程度相关.结论 位于视轴区的玻璃体后脱离的Weiss环、条索状或片状混昆浊和弥漫性混浊会引起患者中重度不适,日常情况可觉察飞蚊症,每日觉察到飞蚊症的频率≥5次,症状自发病后有加重时会产生更严重的不适.

作为临床常见的眼科疾病,白内障主要指的是因晶状体混浊引起的视觉障碍疾病,在老年群体有着较高的发病率,患者多伴随营养障碍及代谢异常,致盲率高,严重影响患者生活质量[1].近年来,电子产品在人们生活中的作用日趋突出,其在为人们带来便利的同时,也增加了高度近视发生率,使得高度近视合并白内障人数增多,受到了临床的高度重视.文献报道,高度近视白内障患者眼轴长、巩膜及晶状体囊薄,手术难度大、风险高,容易出现前房不稳、晶状体后囊破裂等[2].随着现代医疗卫生技术的进步,超声乳化及人工晶状体植入术在高度近视白内障治疗中得以应用,其能够将混浊晶体摘除,实现对屈光不正的矫治[3].为探究其应用效果,收集2017年5月至2020年5月本院38例高度近视白内障患者作为研究对象,并总结汇报研究结果.

目的 检测色素失禁症相关性视网膜病变患儿的眼前房水多因子表达水平,并探讨其与视网膜病变发生的关系.方法 对2020年1月至2020年12月就诊于北京京煤集团总医院眼科11例(20只眼)色素失禁症相关性视网膜病变患儿作为研究组,行玻璃体腔抗血管内皮生长因子A(vascular endothelial growth factor,VEGF)治疗同时采用前房穿刺方法获取前房水;选取8例(15只眼)先天性白内障患儿的前房水作为对照组.通过多因子免疫检测Luminex-xMAP技术检测眼前房水中45种因子的表达.结果 色素失禁症相关性视网膜病变患儿前房水中白细胞介素(interleukin,IL)-6、IL-7、IL-8、胎盘生长因子(placental growth factor,PLGF)、VEGF-A显著高于对照组,差异有显著性(P<0.05).结论 色素失禁症相关性视网膜病变患儿的眼前房水中IL-6、IL-7、IL-8、PLGF,VEGF-A组明升高,提示其在视网膜病变发生发展中起到了一定作用.

AIM: To assess the efficacy of intravitreal triamcinolone (IVTA) as an adjunct to the combination of anti-vascular endothelial growth factor (VEGF) for the management of diabetic macular edema (DME). METHODS: A total of 51 patients with visual disabilities causing by DME from two sites were retrospectively collected and assigned to two groups according to the therapeutic method: intravitreal conbercept (IVC) combined with focal laser (24 eyes) and IVC combined with focal laser and IVTA (27 eyes). Best-corrected visual acuity (BCVA), the required number of IVCs, central retinal thickness (CRT), the mean costs of treatment burden and safety were compared over 12mo. RESULTS: From baseline to month 1 through month 12, IVC combined with focal laser and IVTA improved the mean average change in BCVA superior to IVC combined with focal laser (+5.20 vs +2.71 letters). At month 12, 20.83% of the IVC combined with focal laser and 37.04% of IVC combined with focal laser and IVTA arms gained more than 10 BCVA letters. During the period, the mean CRT decreased significantly in the IVC combined with focal laser and IVTA arm (-245.9 μm) compared to the IVC combined with focal laser arm (-98.45 μm). The average of 6.45 and 1.25 conbercept injections performed in the IVC combined with focal laser and IVC combined with focal laser and IVTA arms, respectively. The mean cost of treatment burden for 12mo was $6247.44±4069.18 in the IVC combined with focal laser arm and $1679.19±542.73 in the IVC combined with focal laser and IVTA arm, with a statistically significant difference. Apart from occasional minor subconjunctival hemorrhage, no other significant ocular adverse events (AEs) were observed in either group during the12-month period. CONCLUSION: It is effective and cost-effective to treat DME by utilizing triamcinolone as an adjunct to the combination of anti-VEGF.

Objective To investigate whether Apelin-13 can promote angiogenesis of retina in rats.Methods After general anesthesia by intraperitoneal injection of pentobarbital sodium,retinal ischemia-reperfusion injury model was established in the rat with right eye and left eye.With vitreous injection technology,injection of 250 pmol/μl of Apelin-13 peptides was administered in the right eye (experiment group),and injection of phosphate buffer saline (PBS) was administered in the left eye(control group).Using mmunofluorescence staining method and the hierarchical scan function of confocal fluorescent microscopy to take a picture forblood vessels of retinal surface layer and deep layer,the retinal angiogenesis was detected and analyzed.The rats were killed two weeks after vitreous injection,and the retinal tissue was taken.Reversetranscription-polymerase chain reaction (RT-PCR)was used to detect Apelin-13 (Apln) and Apelin-13 receptor(Aplnr) mRNAs levels.Immunoblotting was used to detect glialfibrillaryacidicprotein(GFAP) expression.Periodic acid-schiff hematoxylin stain (PASH)was carried on in the retinal paraffin specimen longitudinal section.Under the magnification of 400 times,two vision fields at the outside and central areas on the same retina were taken,respectively to take pictures,and total number of cell nuclei in retinal ganglion cell layer (GCL) and the length of the retina in vision field were calculated.Results Intravitrealinjection of 250 pmol/μl of Apelin-13 can cause deep retinal angiogenesiswhich showed an increase of the number of branches of the deep retinal vessels and can cause the activation of retinal astrocytes,the rise of GFAP protein level and the loss of ganglion cells.Conclusion Apelin-13 peptides can cause deep retinal vascular hyperplasia to a certain degree,while this role in promoting vascular growth has no obvious performance in the retinal superficial blood vessels.

To investigate the components of the aqueous humor (AH) in patients with retinoblastoma (RB). We collected 0.1 ml AH of 35 children with RB and 20 patients with congenital cataracts as controls. Multiplex enzyme-linked immunosorbent assays (ELISAs) and Luminex xMAP technology were used to assess 45 cytokines/chemokines, matrix metalloproteinases (MMPs), and acute-phase proteins in the identification cohort. The concentrations of IL-6, IL-7, IL-8, IFN-γ, PIGF-1, VEGF-A, β-NGF, HGF, EGF and FGF-2 were significantly higher in the AH of patients with RB than those in the control group (P<0.05). The study showed that the higher levels of IP-10, IL-6, IL-7, IL-8, IFN-γ, PIGF-1, VEGF-A, β-NGF, HGF, EGF and FGF-2 in AH may be associated with RB. Our findings may facilitate a better understanding of the molecular pathways of tumors and solid molecular targets for new strategies for therapy and the earlier diagnosis of RB.

Objective To investigate the effects and cost of intravitreal injection of conbercept and retinal photocoagulation for diabetic macular edema.Methods This prospective case series comprised of 48 patients (50 eyes) with diabetic macular edema at Beijing Jingmei Group General Hospital.All patients were randomly divided into intravitreal injection of conbercept (IVC) group,focaVgrid/ pan retinal laser photocoagulation combined with intravitreal injection of conbercept (combine) group.The best corrected visual acuity (BCVA),slit-lamp,intraocular pressure,optical coherence tomography,fundus examination were performed at pre-operation and postoperative 1 months,6 months.Results The BCVA were improved in both groups in postoperative 1 month (8.26±17.32 and 8.05±18.48 ETDRS letter) and in postoperative 6 months (10.41±15.95) and (9.37±19.49)ETDRS letter (P ＜0.05).The macular thickness (CMT) were reduced in both groups in postoperative 1 month (228.26±135.32) and (219.05±142.45) μm and in postoperative 6 months (230.414145.62) and (226.37±139.63)μm (P ＜0.05).No significant difference was found between IVC group and combine group for BCVA and CMT (P ＞0.05).However,during 6 months,in order to stabilize the improvement of BCVA and CMT,compared with group B,obvious more repeated injection time were needed in IVC group.Conclusions Intravitreal injection of conbercept with or without retinal laser photocoagulation remarkably ameliorate the macular edema and improve the visual acuity in the short-term,intravitreal injeetion of conbercept with retinal laser photocoagulation is more costless to treat diabetic macular edema.

Objective To examine choroidal thickness and its relationship with axial length and spherical equivalence using spectral domain optical coherence tomography (SD-OCT) in patients with high myopic foveoschisis (MF).Methods Twenty-five patients with MF were prospectively recruited in the Beijing Jingmei Group General Hospital from November 2014 to February 2016.Fifty eyes of 50 age-and sex-matched people were used as controls.SD-OCT was used to measure choroidal thickness subfoveally and at 1.5 mm superiorly,inferiorly,nasally and temporally.A paired t test was used to assess the difference in spherical equivalence,axial length and choroidal thickness between the MF group and the controls.Logistic regression analysis was performed to evaluate the correlation between age,spherical equivalence,axial length,choroidal thickness and MF.Results The differences in spherical equivalence and axial length between the MF group and controls were not statistically significant (P＞0.05).Choroidal thicknesses subfoveally and at 1.5 mm superiorly,inferiorly,nasally and temporally were greater in the controls than in the MF eyes (t＝24.131,20.345,16.140,13.923,19.037,P＜0.01) and contralateral eyes (t＝22.033,18.066,14.818,13.049,17.247,P＜0.01).The differences were statistically significant.Subfoveal choroidal thickness was less in the MF group compared to the controls (130.3±27.8 μm vs.147.8±25.6 μm).The difference was statistically significant (t＝2.317,P＜0.05).Logistic regression demonstrated that decreased choroidal thickness at the subfoveal location was associated with MF (OR,1.78;95％CI,1.39-2.26,P＜0.05).Conclusion Subfoveal choroidal thickness was greatly decreased in the MF group,suggesting an association with the mechanism of this disease.

目的 研究JNK细胞信号通路在高压氧(hyperbaric oxygen,HBO)和过氧化氢(hydrogen peroxide,H2O2)影响晶状体上皮细胞活力和凋亡中的作用.方法 培养人晶状体上皮细胞系SRA01/04,实验分为对照组、SP600125组(20 μmol·L-1)、HBO组(体积分数95％O2+体积分数5％ CO2,600 Pa)、HBO+ SP600125组、H2O2组(200 μmol·L-1)和H2O2+ SP600125组,处理6h后收集细胞,应用MTT法检测各组细胞活力,Annexin V-FITC凋亡试剂盒处理细胞后用流式细胞仪检测各组细胞的凋亡率,通过Western-blot法检测各组细胞JNK、p-JNK、c-Jun、p-c-Jun、caspase 3、caspase 9的表达情况.结果 作用6h后,HBO和H2O2处理的晶状体上皮细胞A570分别为0.423±0.047和0.406±0.069,较对照组的0.824±0.065明显下降(P＜0.05),细胞凋亡率为(19.773±1.147)％和(29.206±1.678)％,较对照组的(2.184±1.015)％明显上升(P＜0.05),SP600125可部分抑制HBO和H2O2对晶状体上皮细胞活力和凋亡的影响,HBO和H2O2处理的晶状体上皮细胞p-JNK、p-c-Jun蛋白表达量及caspase 3、caspase 9蛋白表达量升高,Sp600125可部分抑制高压氧和H2O2诱导的晶状体上皮细胞p-JNK、p-c-Jun、caspase 3、caspase 9蛋白高表达.结论 HBO和H2O2可激活晶状体上皮细胞中JNK细胞信号通路,促使细胞凋亡,提示JNK细胞信号通路在HBO和H2O2诱导晶状体上皮细胞凋亡的发生发展中起重要作用.

目的 观察VIPhybrid(一种非特异性血管活性肠肽拮抗剂)对红光诱导的近视眼生长发育的影响,并探讨巩膜组织中基质金属蛋白酶-2(matrix metalloproteinase-2,MMP-2)和组织金属蛋白酶抑制因子-2(tissue in-hibitor of metalloproteinase-2,TIMP-2)表达的变化,揭示红光诱导近视形成的可能蛋白通路.方法 建立长波长红光诱导的近视模型.将36只豚鼠随机分为3组,前2组右眼分别给予高(A组)、低(B组)浓度VIPhybrid玻璃体内注射饲养在红光中,后一组右眼高浓度VIPhybrid注射在白光中饲养为对照组(C组).观测3组豚鼠眼球生物学指标、巩膜形态改变、视网膜血管活性肠肽(vasoac-tive intestinal peptide,VIP)以及巩膜组织中MMP-2/TIMP-2表达情况.结果 实验4周后组间比较,红光明显诱导豚鼠眼轴变长,A组左眼眼轴长度为(8.10±0.09)mm、B组左眼为(8.13±0.08)mm,明显长于C组左眼的(7.78±0.07) mm(P＜0.05);A组右眼眼轴长度为(7.85±0.09)mm,B组右眼为(8.01±0.07) mm,B组抑制眼轴增长的幅度低于A组(P＜0.05),A组、B组右眼眼轴明显短于左眼(均为P＜0.05),但仍长于C组(7.76±0.08) mm.A组右眼后巩膜干质量相对较重,视网膜VIP表达明显抑制,后巩膜MMP-2表达降低,TIMP-2表达增高(均为P＜0.05);B组豚鼠右眼亦发生上述相同变化,但各指标变化幅度均低于A组(均为P＜0.05);另外与C组相比,A、B组后巩膜干质量、视网膜VIP及巩膜TIMP-2的表达均低于C组,而巩膜MMP-2表达高于C组(均为P＜0.05).结论 VIP参与红光诱导的豚鼠近视化作用,阻断VIP可部分延缓近视发展,且有浓度依赖关系.

Objective To observe the clinical effect of anterior capsule relaxing incisions with Nd:YAG laser in treating postop-erative anterior capsule contraction in high-risk cataract patients.Methods 120 high-risk cataract patients with postoperative ante-rior capsule contraction collected from December 2010 to November 2012 were divided into experimental group(performed the ante-rior capsule relaxing incisions on postoperative 3 d)and control group.The anterior capsule opening area was measured immediately after laser operation(baseline),in postoperative 1,3,6 months by using the Scheimpflug video photogeaphy system,and the descent rate of the opening area was simultaneously calculated.The decentration degree and tilt of intraocular lens(IOL),posterior capsule opacification and other complications were also assessed.Results Of the observed 120 cases,40 cases were pseudo posterior capsule stripping syndrome,40 cases were primary angle closure and 40 cases were diabetic retinopathy.There was no statistically signifi-cant difference in the baseline value of the opening area between the experimental group and the control group(P>0.05).In the ca-ses of primary angle closure 1,3,6 months after operation,the anterior capsule opening area in the experimental group was signifi-cantly increased compared with the control group(P<0.05)and the descent rate of the opening area was significantly diminished (P<0.05).In the cases of pseudo posterior capsule stripping syndrome or diabetic retinopathy,although there was no statistically significant difference in anterior capsule opening area between the experimental group and the control group(P>0.05),the descent rate of the opening area was significantly diminished(P<0.05).No significant differences were found in the aspects of IOL decen-tration and tilt,posterior capsule opacity,or other complications.Conclusion YAG laser anterior capsule relaxing incisions in the early period after cataract surgery is safe and effective in preventing anterior capsule contraction in high-risk patients.

PURPOSE:Retinal microglia can be activated by retinal neuronal monocyte chemoattractant protein-1 (MCP-1) and play a pivotal role in early retinal degeneration. The current study investigates the pathways via which retinal neuronal MCP-1 stimulates tumor necrosis factor-α (TNF-α) expression in rat microglia.METHODS:Primary rat retinal neurons and microglia were separated and cocultured in a Transwell apparatus. The levels of TNF-α mRNA and soluble TNF-α produced by the microglia in response to advanced glycation end product (AGE)-induced retinal neuronal MCP-1 were measured with real-time PCR and enzyme-linked immunosorbent assay (ELISA). The ability of neuronal MCP-1 to stimulate microglia activation was examined by preexposing the retinal neurons to AGEs and an MCP-1 antibody or by pretreating microglia with AGEs and siRNA specific for CC-chemokine receptor 2 (CCR2) knockdowns. Additionally, we investigated the effects of microglial activation on neuronal MCP-1-induced nuclear factor-κB (NF-κB) activation and phosphorylation of mitogen-activated protein kinases (MAPKs).RESULTS:Stimulation with AGEs significantly increased the expression of TNF-α mRNA and soluble TNF-α in the microglial cells. Retinal neurons that had been pretreated with AGEs and an MCP-1 antibody or microglia that were CCR2 knockdowns displayed greatly reduced TNF-α secretion. Using signaling pathway-specific inhibitors, we showed that blocking the p38, extracellular signal-regulated kinase (ERK), and NF-κB signaling pathways significantly reduced the expression of TNF-α by retinal neuronal MCP-1-stimulated microglia.CONCLUSIONS:This study indicates that TNF-α was released from the activated microglia induced by retinal neuronal MCP-1 via the p38, ERK, and NF-κB pathways, but not c-Jun N-terminal kinase (JNK), which may be an important finding in diabetic retinopathy pathogenesis.

Background Light stimulation at different wavelength influences the development of eyes.It has been showed that blue light can inhibit the growth of eyeball.To study whether blue light exposure can delay the extension of myopia is an interested research project.Objective This study was to investigate the effect of blue light with short wavelength on ocular growth in form deprived myopia (FDM) in guinea pigs and provide a new option for the prevention and treatment of myopia.Methods Thirty-six 2-week-old guinea pigs were reared in the environment of white light.The right eyes of the animals were occluded to establish the FDM models.The models were randomized into the deocclusion + blue light exposure group,simple deocclusion group and continuous occlusion group according to the random number table.The right eyes of the models were deoccluded for 1 hour per day to give the blue light (430 nm) irradiation in the deocclusion + blue light exposure group,and the right eyes were deoccluded for 1 hour per day only in the simple deocclusion group.In the continuous occlusion group,the right eyes of the models were occluded until the end of this experiment.Anterior chamber depth (ACD),lens thickness (LT) and vitreous cavity depth (VCD) were measured by A-type sonography.The binocular diopter of the guinea pigs was detected using retinoscopy in the mydriatic condition.In the fourth week after experiment,the retinal sections were prepared for the regular histopathological examination,and the scleral tissues next to 1 mm from optical nerve were exacted to obtain the dry weight of scleral tissues.Results In the right eyes of the animals,no significant differences were found in the diopter,ACD,LT and VCD before experiment among the 3 groups (all at P＞0.05).At the end of experiment,the refraction of right eye in the deocclusion + blue light exposure group,simple deocclusion group and continuous occlusion group was (+1.11±0.17)D,(+0.90±0.15)D and (-2.73±0.19)D respectively,with a significant difference among them (F=1 445.470,P=0.000).The VCD in the three groups was (3.70±0.09) mm,(3.78±0.11) mm and (3.91 ± 0.08) mm,respectively,showing a significant difference (F =13.243,P＜0.01).In addition,the dry weight of sclera tissues was (0.61 ±0.09)mg in the deocclusion + blue light exposure group,(0.54± 0.08)mg in the simple deocclusion group and (0.43 ± 0.07)mg in the continuous occlusion group,with a significant difference among the 3 groups (F=10.458,P＜0.01).However,there were no significant differences in the ACD and LT among the 3 groups (F=0.203,0.084,both at P＞0.05).Moreover,in the left eyes,no significant differences were found in the diopter,ACD,LT and VCD before experiment among the 3 groups (all at P＞0.05);while at the end of the experiment,the diopter of the continuous occlusion group was significantly lower than that of the deocclusion + blue light exposure group and simple deocclusion group (all at P＜0.05).No significant differences were seen in the ACD,LT,VCD and dry weight of sclera among the 3 groups (all at P＞0.05).Retinal structure was normal in the left eyes of various groups.However,the retinas were thinner in the right eyes of the deocclusion + blue light exposure group with clear layers; while atrophy of the outer segment of photoreceptor and disorder of cell arrangement were seen in the right eyes of the continuous occlusion group.Conclusions During sensitive period of visual development,blue light stimulation can arrest the extension of posterior sclera and elongation of vitreous cavity,which restrains development of myopia.This blue light at the wavelength of 430 nm is safe to retina.

Background Oxidative stress-induced apoptosis of human lens epithelial cells (LECs) is associated with c-Jun N terminal kinase (JNK) pathway.Quercetin possesses the antioxidation by inhibiting the JNK pathway.However,whether quercetin can protect LECs from the oxygen-induced damage is still not proved.Objective This study attempted to invatigate the effects and its mechanism of quercetin against hyperbaric oxygeninduced LECs apoptosis. Methods Human LECs line SRA01/04 was cultivated and passaged in MEM medium containing 10％ fetal bovine serum and 0.5％ non-essential amino acids for 2 hours,with or without 20 μmol/LSP600125 or 1 μmol/L quercetin prior to exposure to hyperbaric oxygen.Each exposure session remained 6 hours in 99％ O2 and 1％CO2 with a pressure chamber at 588 kPa.The viability of human LECs was detected by MTT.Cell apoptosis was assessed by flow cytometer using Annexin V-FITC apoptosis detection.The expression of JNK/p-JNK,c-Jun/p-c-Jun,caspase 3 and caspase 9 were detected by Western blot. Results LECs viability (A570 ) was 0.835 ±0.082,0.450±0.083,0.654±0.079,0.649±0.090 respectively in the blank control group,hyperbaric oxygen exposed group,hyperbaric oxygen+SP600125 group and hyperbaric oxygen+quercetin group.The A570 in the hyperbaric oxygen exposed group was significantly lower than the blank control group ( P =0.000),but those in hyperbaric oxygen + SP600125 group and hyperbaric oxygen+quercetin group were significantly higher than the hyperbaric oxygen exposed group ( P =0.003,0.002 ).The numbers of apoptosis cells were 3.17 ±0.74,19.77 ± 1.44,8.45 ±0.93,7.79 ±0.78 respectively in the blank control group,hyperbaric oxygen exposed group,hyperbaric oxygen+SP600125 group and hyperbaric oxygen+quercetin group.Apoptotic LECs were significantly increased in the hyperbaric oxygen exposed group compared with the blank control group ( P=0.000),but those in the hyperbaric oxygen+SP600125 group and hyperbaric oxygen+quercetin group were significantly reduced in comparison with hyperbaric oxygen exposed group (both P=0.000).In additional,expressions of p-JNK,p-c-Jun,caspase 3 and caspase 9 proteins in the cells were elevated in the hyperbaric oxygen exposed group compared with the blank control group (all P =0.000 ),however,those in the hyperbaric oxygen + SP600125 group and hyperbaric oxygen + quercetin group were declined when compared with the hyperbaric oxygen exposed group( all P＜0.05 ). Conclusions JNK pathway is involved in the apoptotic procedure of human LECs induced by oxygen stress.SP600125 and certain concentration of quercetin can interdict the JNK signal pathway and endogenous apoptosis of LECs and further alleviate hyperbaric oxygen-induced damage of LECs.

Background Monocyte chemotactic protein-1 (MCP-1)plays an important role in the tumor,inflammation,diabetic retinopathy and other neovascular disease,but the expression and the role of MCP-1 in the oxygen induced retinopathy(OIR) model have rarely been reported. Objective This study was to investigate the expression of MCP-1 in the retina development of newborn mouse and in mouse models with OIR. Methods C57BL/6J newborn mice were divided into two groups and 60 mice in each group.Mice in OIR group were exposed to 75％ oxygen for 5 days and then to room air.All mice in normal control group exposed to room air only.Ten mice in each group were randomly chosen and sacrificed at postnatal 5,7,12,14,17,21 days.The expression of MCP-1 in mouse retina was detected with the method of immunohistoehemistry and reverse transcription polymerase chain reaction(RT-PCR). Results MCP-1 positive cells were seen in normal mouse retina.Up-regulation of MCP-1 positive cells was detected both in 12 days in normal control group and in 14 days in OIR group.MCP-1 mRNA was detected in mouse retina at 5 days,and a transient up-regulation of MCP-1 mRNA was observed in 12 days in normal control group.MCP-1 mRNA in OIR group significantly increased in 14 days in comparison with the normal control group( P =0.028,P =0.001 ). Conclusions Expression of MCP-1 is detectable in whole retinal development procession of mice.A transient up-regulation of MCP-1 expression is detected in the critical period of retinal vascular development in mice models with OIR,which is closely related to the retinal vascular development and progression of retinal new vessels.

患者男性,57岁.因左眼视物模糊3个月余于2008年7月22日就诊于北京大学人民医院眼科门诊.患者曾于外院诊断为左眼脉络膜黑色素瘤,既往患扩张性心肌病1年,呼吸暂停综合征5年,否认糖尿病、高血压等全身疾病.眼科检查:视力右眼远视力1.2,近视力Jr5,左眼远视力0.25,近视力Jr7不见;眼压:右眼9 mm Hg(1 mm Hg=0.133 kPa),左眼7mm Hg;双眼结膜无充血,角膜透明,巩膜未见肿物及色素,前房中等深度,虹膜色素正常未见肿物,晶状体清。

Objective To observe the effects of monochromatic lights with similar luminance on the preditable changes in eye growth and expression of vasoactive intestinal polypeptide(VIP) in guinea pigs and to discuss the relative mechanism.Design Experimental study.Participants Thirty-six 1 week old British species of tri-color male guinea pigs.Method 36 guinea pigs were randomly divided into A,B and C groups,each with 12,which were respectively raised in red light(610 nm,long wave-length),bule light(430 nm,short wave-length) and white light(broad spectrum) with same luminance(200 lux).At the time of 0 w,3 w and 6 w of experiment,refraction and axial length were measured.Besides,4 guinea pigs of each groups were randomly selected to be removed eyes at the 6th w.The eyes removed were fixed 48 h in 4% Paraformaldehyde phosphate buffer solution,and then separated sclera from retina and choroids.Calculated dry weight of sclera obtained.While the left retina tissues were made into paraffin sections to HE staining and detect expression of VIP with immunohistochemistry(SP three steps).Main Outcome Measures Refraction,axial length,dry weight of sclera,counts of retina VIP-immunoreactive cells and the value of retina VIP integrated optical density(IOD).Results At the end of study,refraction of red,blue,and white light groups was respectively 2.696±0.171 D,5.139±0.151 D,and 3.161±0.122 D(F=605.169,P=0.000),whereas the corresponding axial length of three groups was repectively 8.273±0.165 mm,8.019±0.151 mm,and 8.161±0.120 mm(F=6.009,P=0.009).Average dry weight of sclera in each group was 0.609±0.088 mg,0.716±0.101 mg,and 0.680±0.041 mg with no statistic difference(F=2.292,P=0.126) yet,there was a significant variation between that of Group A and Group B(F=1.256,P=0.048).VIP was most expressed in inner plexiform layer,ganglion cell layer and nerve fiber layer of retina,with scattered expressed in inner nuclear layer and photoreceptor cells layer.In addition,the expression of VIP in retina was most in Group A,the number of retina VIP-immunoreactive cells and the value of retina VIP IOD were respectively 43.250±9.939 and 1.622±0.119;while that was least in Group B,corresponding results of the two measurements mentioned above were 27.500±4.928 and 1.273±0.127 respectively.There existed great difference among three groups(F=8.478,5.082;P=0.002,0.000).Conclusions Red light(long wave-length) could promote eye growth and myopia occurrence,while blue light(short wave-length) was on the opponent.VIP,a potential signal molecular,may be involved in the regulation of monochromatic lights on eye growth,by affecting scleral metabolism and morphological structure.