Ophthalmia Research Articles

Efficacy of ultrasound cyclo-plasty for the treatment of advanced glaucoma

Objective To evaluate the safety and efficacy of ultrasound cyclo-plasty (UCP) in patients with advanced glaucoma. Methods The clinical data of 14 eyes of 13 cases of advanced glaucoma from Aug. 2018 to Sep. 2018 whose IOP could not be managed were retrospectively analyzed. All cases received UCP. Before surgery BCVA was light perception in 2 eyes and no light perception in 12 eyes. Results All patients were followed up for 2 months. The surgery was completed within 5 minutes. The average IOP was (51.86+ 9.75) mmHg before surgery. The decrease rate of IOP in patients were 33.07%、47.41%、63.56% and 64.05%, respectively at 1 day, 1 week, 1 month and 2 months after surgery. At the lastest follow-up, IOP after local hypotensive drug treatment was <21 mmHg in 10 eyes, 22- 30mmHg in 2 eyes, 31- 40 mmHg in 2 eyes. The IOP average was (18.64±11.27)mmHg after UCP. The difference was statistically significant between before and after UCP (P<0.01). Visual acuity of all cases were not improved. No complication such as hyphema, ocular surface destruction, luxation of lens, retinal detachment, endophthalmitis or sympathetic ophthalmia occurred. Conclusion UCP can effectively and safely reduce uncontrolled IOP despite maximally tolerable anti-glaucoma medications of advanced glaucoma, and there is no obvious complication. Key words: Cyclo-plasty, ultrasound; Glaucoma, advanced; Introcular pressure

Clinical observation of modified intracystic ethanol irrigation on traumatic iris cyst patients

Objective To evaluate the efficacy and safety of modified intracystic ethanol irrigation for traumatic iris cyst eyes. Methods A retrospective analysis was designed.Twelve cases of traumatic iris cyst patients were observed from August 2016 to August 2018 in Xiamen Eye Centre of Xiamen University.After anterior chamber filled with DisCoVisc, cyst fluid was drained gently via a 30-gauge needle, and ethanol was irrigated into the cyst through 3-way T-extension until the cyst wall turned white.DisCoVisc was washed in the end.Patients were followed for cornea and anterior chamber condition, best-corrected visual acuity (BCVA), intraocular pressure (IOP) and endothelial cell density (ECD). The diameters of maximal length and width in maximal cross-sectional area were calculated by ultrasound biomicroscopy (UBM) preoperatively and postoperatively.The follow-up period was 3 to 24 months.Written informed consent was obtained from each patient before surgery. Results BCVA (LogMAR) and IOP had no significant changes after surgery in one week (t=1.30, P=0.22; t=-0.91, P=0.38). BCVA was elevated in 5 cases at the last follow-up, but declined in 3 cases, kept stable in 4 cases.Mean intensity of ECD before and 3 months after operation was (2 270.79±458.43)/mm2 and (2 111.52±483.46)/mm2, respectively, the mean loss of ECD was 159.27 cells/mm2, and there was a significant change between the two time points (t=3.76, P=0.00). Mean postoperative maximal length diameter before and 3 months after operation was (5.87±0.95)mm and (1.46±0.83)mm, mean postoperative maximal width diameter was (3.10±0.55)mm and (0.89±0.47)mm, respectively, the mean postoperative maximal length diameter was reduced by 5.33 mm, and the mean postoperative maximal width diameter was reduced by 2.22 mm, with significant changes between the two time points (t=18.55, P=0.00; t=11.75, P=0.00). All cysts were resolved and without recurrence at the last follow-up.No significant complications, such as cornea endothelial decompensation, endophthalmitis, sympathetic ophthalmia and retinal detachment were seen during the follow-up period. Conclusions Modified intracystic ethanol irrigation is a safe and effective procedure to treat traumatic iris cysts, which is more simple with less injury and low rate of complications. Key words: Iris cysts; Modified intracystic ethanol irrigation; Ocular trauma

Is Universal Prophylaxis for Gonococcal Ophthalmia Neonatorum Still Necessary

Infants born to mothers with untreated gonococcal infection have a 30% to 50% risk for developing gonococcal ophthalmia neonatorum (GON), which can

Clinical aralysis of electric ophthal mia with control foreign body

Clinical aralysis of electric ophthal mia with control foreign body

Study on characteristics of distribution of patients with ocular trauma in Wenzhou

Objective To analyze the type and distribution of the patients with ocular trauma in Wenzhou. Methods The data of 7 530 eyes of 7 237 cases of ocular trauma were collected and analyzed retrospectively. The ratio of sex, age, time to visit and type of injury were analyzed. Results The ratio of male to female was 6.64∶1, ocular trauma were common in 30-49 years(51.5%). The peak of the visit occurred in October, November, December and the least visit in February. The top five types of ocular trauma were superficial foreign bodies(48.9%), perforation of eyeball(22.6%), rupture eyeball(13.0%), contusion(4.6%)and electric ophthalmia(3.5%). Conclusion The type of ocular trauma in Wenzhou is mainly superficial foreign bodies, followed by perforation of eyeball, rupture eyeball, contusion and electric ophthalmia. Key words: Trauma, ocular; Characteristics, distribution

Celastrol inhibits the secretion of interleukin-17 in peripheral blood mononuclear cells in patients with sympathetic ophthalmia

Objective To observe the effect of celastrol on the secretion of interleukin (IL)-17 in peripheral blood mononuclear cells in patients with sympathetic ophthalmia (SO), and its possible mechanisms. Methods Venous blood samples were extracted from 10 cases of sympathetic ophthalmia patients and 10 health objectives. The peripheral blood mononuclear cells (PBMCs) were isolated by density gradient centrifugation and then were divided into 4 groups. Group A (control group): PBMCs of health objectives; Group B: PBMCs of SO patients; Group C: PBMCs of SO patients with 0.5 μmol/L celastrol in the medium; Group D: PBMCs of SO patients with 1 μmol/L celastrol in the medium. After culturing the cells for 3 days, the supernatant of 4 groups was collected, and the levels of IL-23 and IL-17 were detected by enzyme-linked immuno sorbent assay (ELISA). Then, the 50 ng/ml rIL-23 was added into the medium of group A which was the group A1; the 50ng/ml rIL-23 and 1 μmol/L Cela were added into to the medium of group A which was the group A2. For the medium of group B, the 50 ng/ml rIL-23 was added into the medium which was the group B1; the 50 ng/ml rIL-23 and 1 μmol/L celastrol were added into to the medium of group B which was the group B2. After culturing for 3 days, the supernatant of cells of these 4 groups was collected, and the levels of IL-17 were detected by ELISA. Results In group A, the levels of IL-23 and IL-17 were (228.43±17.27) pg/ml and(220.55±31.15) pg/ml respectively. In group B, the levels of IL-23 and IL-17 were (513.85±36.46) pg/ml and (866.77±72.92) pg/ml respectively. In group C, the levels of IL-23 and IL-17 were (381.07±20.93) pg/ml and (517.43±54.87) pg/ml respectively. In group D, the levels of IL-23 and IL-17 were (237.14±17.97) pg/ml and (242.89±34.09) pg/ml respectively. Between group A and D, there was no statistically significant difference in IL-23 or IL-17 level (P>0.05); but when comparing other groups, the differences were statistically significant (P<0.05). The levels of IL-17 in group A1 and group A2 were (428.43±24.53) pg/ml and (229.15±23.28) pg/ml and the difference was statistically significant (P<0.05). The levels of IL-17 in group B1 and group B2 were (1373.39±89.51) pg/ml and (571.01±94.88) pg/ml and the difference was statistically significant (P<0.05). Conclusion Celastrol can inhibit the secretion of IL-17 by PBMCs in SO patients via inhibiting the secretion of IL-23. Key words: Ophthalmia, sympathetic/drug therapy; Tripterygium; Interleukin-17; Interleukin-23

Sympathetic ophthalmia in vater association combined with persisting hyperplastic primary vitreous after cyclodestructive procedure.

To report on the occurrence of histology-proven sympathetic ophthalmia in a patient with VATER association and persisting hyperplastic primary vitreous (PHPV) after a cyclodestructive procedure was performed to treat secondary angle-closure glaucoma. The left eye of a 13-year-old boy with VATER association was microphthalmic from birth and had been diagnosed with PHPV at age 1 year. It developed iris neovascularization and secondary angle-closure glaucoma, which was treated by combined cyclocryocoagulation and cyclophotocoagulation. Six weeks later, a bilateral fibrinous iritis developed. Despite intensive topical and systemic steroid treatment, the iritis persisted so that the left blind eye was enucleated. Histology of the enucleated eye showed a marked intraocular inflammation with lymphocytes, epithelioid cells, and multinuclear giant cells grouped around remnants of melanin-bearing cells. Sympathetic ophthalmia may occur in patients with VATER association and PHPV after a secondary angle-closure glaucoma is treated by a combined cyclocryocoagulation and cyclophotocoagulation. (Eur J Ophthalmol 2006; 16: 171-172).

Sympathetic ophthalmia associated with uncomplicated retinal detachment surgery in a young male: An uncommon entity

Sympathetic ophthalmia (SO) is a rare, bilateral granulomatous panuveitis of unknown etiology that follows accidental or surgical trauma to the uveal tissue of one eye. We describe an unusual case of an 11-year-old male patient who developed SO following retinal detachment (RD) repair in conjunction with pars plana vitrectomy in the right eye (RE). Twenty days following surgery, the patient presented with a recurrent RD in RE and bilateral multifocal exudative RDs, inflamed optic nerve with characteristic changes of SO detected by fluorescein angiography, and ultrasound B-scan in the left eye (LE). Aggressive and effective management with topical and systemic immunosuppressive agents permitted control of the disease with good visual outcome in LE.

Severe sympathetic ophthalmia following evisceration of a perforated staphylomatous globe

Sympathetic ophthalmia (SO) is a rare bilateral panuveitis that follows a surgical or penetrating injury to one eye. The use of systemic corticosteroids and immunosuppressive drugs has greatly improved the outcome of this potentially blinding condition. It may, however, rarely run an aggressive course despite medical treatment with grave consequences. Herein, we report a severe case of SO in a 64-year-old man induced by the spontaneous perforation of a staphylomatous left eye. He presented with left panophthalmitis following a spontaneous perforation of the globe, and subsequently he had an evisceration. He, however, presented 18 days later with features of SO in the right eye. He was placed on systemic corticosteroid and immunosuppressive therapy but failed to respond to treatment and the eye eventually became phthisical.

Analysis on correlative factors of sympathetic ophthalmia after ocular trauma

Objective To analyse the correlative factors of sympathetic ophthalmia after ocular trauma. Methods The statistical data about 20 eyes of 20 cases of sympathetic ophthalmia secondary to ocular trauma were studied and the related factors were analyzed. Results The corneoscleral wound leading to sympathetic ophthalmia accounted for the highest proportion of 75.00%. The patients were aged 7-56 years old and patients aged 7-12 years accounted for 50.00%. The sex ratio of male versus female was 3∶1. Conclusion The corneal limbus wound is in the majority among patients with sympathetic ophthalmia secondary to ocular trauma .The ocular trauma in children should be paid more attention to because of its particularity. Key words: Sympathetic ophthalmia, ocular trauma; Analysis, correlative factors

The clinical significance of the changes of Th subgroup cytokines in patients with ocular trauma

Objective To investigate the clinical significance of the changes of Th subgroup cytokines in ocular traumatic patients. Methods The study objects include 30 eyes of 30 cases with ocular trauma. The patients were divided into group 1 (nonperforating eye injury) and group 2 (perforating eye injury) with 15 eyes of 15 cases in each group. And 15 healthy persons were enrolled as the control group. The dynamic changes of the concentration of serum cytokines IL-2, IFN-γ, IL-10, IL-17 were detected by ELISA. The results were compared among the three groups. Results In group 1, the concentration of IL-2 was higher than that in control group at early injury period, the difference was statistically significant (P<0.05); and the concentration of IFN-γ and IL-17 were lower than the control group, the difference was statistically significant (P<0.05). In group 2, IFN-γ and IL-17 decreased comparing with the control group, but the IL-2 and IL-10 increased (P<0.05). After treatment, all 5 cytokines in group 1 were decreased (P<0.05). Except for IL-17, the rest cytokines in group 2 decreased(P<0.05). Conclusion The dynamic changes of Th subgroup cytokines in ocular traumatic patients is closely related to disease progression.It can be an alterative inspection item for checking the validate of the anti-infection treatment.After anti-infection treatment, the secretion of Th1, Th17 decreased, the proliferation of white blood cells droped, which is benefit for reducing the risk of sympathetic ophthalmia. Key words: Trauma, ocular; Th subgroup; Cytokines

Clinical study on ocular evisceration combined with primary hydroxyapatite implantation after thermal burns

Objective To evalute the feasibility of ocular evisceration combined with primary hydroxyapatite implantation after thermal burn. Methods Ten cases of ocular thermal burns received ocular evisceration combined with primary hydroxyapatite implantation under microscope and the potential complications were observed after the operation. Results Early postoperative conjunctival redness, swelling and a few secretions were observed. Orbital motion was good and orbital cavity was full with bilateral symmetry. The outpatient follow-up was 2 years. No infection, implant exposure, conjunctival granuloma or sympathetic ophthalmia complications occurred. Conclusion Ocular evisceration combined with primary hydroxyapatite implantation is a considerable and sellected surgical method for severe ocular thermal burn. Key words: Orbital implantation; Ocular thermal burns; Evisceration

La prophylaxie des infections conjonctivales du nouveau-né est-elle justifiée dans les maternités françaises ?

La prophylaxie des infections conjonctivales du nouveau-né est-elle justifiée dans les maternités françaises ?

Clinical analysis of sympathetic ophthalmia after vitrectomy

Objective To analyse the chnical manifestations of sympathetic ophthalmia after pars plana vitretomy.Methods Retrospective study was performed in 13 cases with sympathetic ophthalmia who had undergone pars plana vitrectomy.Results The interval time from the last vitrectomy to the occurrence of sympathetic ophthalmia ranged from 10 days to 2 years,8 cases (61.5％) occurred within 4 months.The decrease of visual acuity took the first place in clinical manifestations,followed by opthalmalgia,spotted vision and visual distorsion.The visual acuity was from 0.04 to 0.6 in sympathetic eyes,and no light perception to counting finger in the exiting eyes.4 sympathetic eyes had exudative retinal detachment.The visual acuity increased partly in the sympathetic eyes and the exiting eyes after treatment with steroid.Three patients had undergone enucleation of exiting eyes because of total loss of visual acuity.Conclusion The incidence of sympathetic ophthalmia after vitrectomy is low,about 0.29％.It happened mainly within 4months after vitrectomy.Vitrectomy combined with lens-surgery,scleral buckling with cryopexy,preexisted eye injury and others surgeries,are the risk factors of sympathetic ophthalmia after vitrectomy. Key words: Ophthalmia,sympathetic; Trauma, ocular; Vitrectomy

Electric ophthalmia caused by metal halide lamp: a report of 26 cases

2012年7月,乌鲁木齐市某建筑工地26名上夜班的工人先后出现不同程度的眼部损伤.经调查,系金属卤化物灯悬挂位置不当造成的电光性眼炎,报告如下.1.事发经过:某道路工程建筑工地共有300多名施工人员.2012年7月23日3:00-4:00,工人张某首先出现眼部灼痛症状,至早8:00同一班组的26名夜班工人全部出现双眼刺痛、畏光、流泪等症状.其中8名工人症状较重,表现为结膜混合充血及水肿,角膜荧光素染色阳性.对8名症状较重的工人给予对症处理,冲洗双眼和泪囊,涂抗生素眼药膏治疗.抗生素眼药膏每天3次,连续使用3～5 d.其余18名症状较轻者给予复方硫酸新霉素滴眼液治疗,每天3次,连续使用3～5 d.5d后复诊,26名患者眼部刺痛、畏光、流泪等症状消失,角膜荧光素染色阴性,无一例发生角膜感染。

Laser scanning confocal microscopy findings of phlyctenular ophthalmia

Background Phlyctenular ophthalmia is a delayed hypersensitivity reaction to some microprotein and affected mainly by adolescent in high incidence.Objective This study was to investigate the microscopy findings of phlyctenular ophthalmia and evaluate the histological changes by laser scanning confocal microscope.Methods Twenty-nine eyes suffered from phlyctenular ophthalmia and twenty normal eyes were examined using laser scanning confocal microscope.The pictures were taken by a CCD camera.All the cases had initially chest X-ray,tuberculin test,bacterial and mycobacteria culture.Results Dendritic and inflammatory cells were increased and concentrated in conjunctiva,and epithelial cells were deformed and squamatizated.The capillaries engorged and the goblet cells were injured.The corneoscleral Vogt meshing of the phlyctenular keratitis was obscured and dendritic cells were intruded into the corneas.The corneal epithelium of phlyctenular keratitis was absent and the subepithelial nerve plexus were bended and fractured,and the dendritic and inflammatory cells were intruded.Scarring of corneal stroma was seen under the laser scanning confocal microscope.Conclusions Laser scanning confocal microscopy is valuable for basic research and clinical diagnosis of phlyctenular ophthalmia. Key words: Phlyctenular ophthalmia; Laser scanning confocal microscopy; Histological structure

Clinical analysis of sympathetic ophthalmia

Objective To study the diagnosis and treatment of sympathetic ophthalmia.Methods 24 cases of sympathetic ophthalmia were retrospectively analyzed to observe the clinical effect of the treatment and the preventive measures.Results All cases had good effect and no recurrent cases were detected.Conclusion Early diagnosis,standard and active treatment,active treatment of traumatic eyes,controlling inflammation can prevent the recurrence of sympathetic ophthalmia and avoid the visual impairment. Key words: Ophthalmia, sympathetic ; Diagnosis ; Treatment

The clinical observation of keratoconjunctivitis induced by toxic gas of paint

Objective To explore the diagnosis and treatment of keratoconjunctivitis induced by toxic gas of paint.Methods The clinical features and treatments were concluded and analyzed about 29 cases (58 eyes) of keratoconjunctivitis induced by toxic gas of paint.Results All cases had clinical manifestion similar with electric ophthalmia.Most cases had corneal endothelial edema,some of which had delay healing of epithelia and epithelial infection.Clinical treatments included irrigation,pupil dilation by 1％ atropine,local and systemic application of antibiotics,vitamin C and dexamethason,pressure dressing with antibiotic ointment in severe cases.All the therapeutic measures had good effects.Conclusion Patients with similar electric ophthalmia features and corneal endothelial edema or delayed healing of epithelia should be asked about toxic gas history to avoid misdiagnosis.These patients should be treated as chemical ophthalmia. Key words: Gases, toxic, paint; Keratoconjunctivitis, chemical

Expression of suppressor of cytokine signaling in peripheral blood monocular cells of patients with sympathetic ophthalmia

Objective To investigate the mRNA and protein expression of suppressor of cytokine signaling (SOCS) in peripheral blood mononuclear cells(PBMC) of patients with sympathetic ophthalmia.Methods Blood samples were taken from 14 sympathetic ophthalmia patients with active uveitis,13 quiescent patients,and 15 healthy individuals.IFN-γ,IL-12 and IL-4 in the serum were measured by ELISA.PBMC were subjected to analysis of SOCS mRNA and protein expression using quantitative RT-PCR and western blot,respectively.Results The level of IFN-γ,IL-12 and IL-4 were all significantly higher in the serum of sympathetic ophthalmia patients with active uveitis than that in controls and quiescent patients(P ＜0.05).There were no significant differences between the quiescent patients and the controls(P ＞ 0.05).Compared to healthy volunteers,the expressions of cytokine inducible SH2 containing protein (CIS),SOCS1,SOCS3 and SOCS5 mRNA and protein were significantly increased.There were no significant differences in expression of CIS,SOCS1,SOCS3 mRNA and protein in quiescent patients,but SOCS5 mRNA and protein were significantly increased.Conclusion Up regulation of SOCS1 and SOCS5 expression may involve in the development of a Th1 mediated immune response in sympathetic ophthalmia patients with active uveitis.CIS and SOCS3 may play important roles in mitigating the pathogenic effects of proinflammatory cytokines.It were kept balance in quiescent patients,and up-regulation of SOCS5 may have protective functions. Key words: Suppressor of cytokine signaling; Sympathetic ophthalmia

The experimental study of sympathetic ophthalmia in rat induced by intraocular foreign body injury model

Objective To investigate whether sympathetic ophthalmia could be induced by setting up the rat model of unilateral mechanical ocular trauma.And to discuss the mechanism of sympathetic ophthalmia.Methods 36 Wistar rats were randomly divided into three groups.In group Ⅰ,one piece of stone embeded in one eye (n =16) ; group Ⅱ,with a piece of blade embeded in one eye (n =16) ; groupⅢ,normal eye as control group (n =4).In group Ⅰ and group Ⅱ,intraocular foreign bodies were embeded from pars plana into the vitreous of the right eyes.All the eyes were observed with the loupe.The histopathological changes were observed under HE stain and microscopy 2 weeks,4 weeks,6 weeks and 8 weeks after the establishment of injury model.Results In group Ⅰ and group Ⅱ,abnormal secretions,the conjunctiva congest and oedema were main manifest in the right eyes.The number of atrophy of eyeballs increased with the time past.Histopathology showed lymphocytes and neutrophilic granulocytes infiltration in the eyeball.And abnormal changes were not found in group Ⅲ.It was failed to evocate the sympathetic ophthalmia in the injury models.Conclusion The pathogenesis of sympathetic ophthalmia is complex.Sympathetic ophthalmia were not evocated by setting up rat models of mechanical eye injury. Key words: Sympathetic ophthalmia; Intraocular foreign body; Histopathology