Objective To analyze the pathogenesis of cystoid macular edema (CME) secondary to exudative age-related macular degeneration (AMD). Methods From October 2000 to December 2003, OCT images of 171 eyes of 140 patients with exudative AMD were evaluated. The CNV types were classified according to its location (above or below the RPE), and the correlation between the types of CNV and the development of CME were analyzed. Results Of the 171 eyes with AMD, 89 eyes (52.0%) had CME, and 82 eyes (48.0%) had no CME. Among the 89 eyes with CME, 76 eyes (85.4% ) had an active CNV lesion, and 13 eyes (14.6%) had a disciform scar. Among the 82 eyes without CME, 69 eyes (84.1%) had an active CNV lesion, and 13 eyes (15.9 %) had a disciform scar. In the 76 eyes with both CME and active CNV, 75 eyes (9 8.7%) had a subretinal CNV, which included 61 eyes (80.3%)with a combined CNV complex and 14 eyes (18.4%) with a Gass 2 type CNV, only 1 eye (1.3%) had a Gass 1 type CNV. Whereas, in the 69 eyes with active CNV but without CME, 57 eyes (82.6%) had a Gass 1 type CNV, only 12 eyes (17.4%) had a subretinal CNV. There was a significant difference in the incidence of subretinal CNV between eyes with or without CME (χ2=99.5838, P=0.0000). Conclusions CME formation was highly corre lated with the invasion of CNV into the subretinal space. Subretinal CNV might be the direct cause of CME secondary to exudative AMD.(Chin J Ocul Fundus Dis，2004，20：299-302)
Objective To evaluate the correlation between retinal-choroidal anastomosis (RCA) and pigment epithelium detachment (PED) secondary to exudative age-related macular degeneration (AMD). Methods From October 2000 to December 2003,75 eyes of 70 patients with active exudative AMD underwent OCT, fluorecein and/or indocyanine green angiography (FA/ICGA) examinations were analyzed to ascertain whether there was RCA. The correlations between RCA and PED were evaluated. Results Of 75 eyes with exudative AMD, 34 eyes (45.3%) had RCA, 41 eyes (54.7%) had no RCA. Among the eyes with RCA, 30 eyes (88.2%) had PED, the remaining 4 eyes (11.8%) had no PED. Among the eyes without RCA, 33 eyes (80.5%) had PED, and 8 eyes (19.5%) had no PED. There was no significant difference in the incidence of PED between eyes with or without RCA (χ2=0.83, P=0.5290). PED tear was found in 17 eyes (51.5%)out of 33 eyes with PED and without RCA, but in 26 eyes (86.7% ) out of 30 eyes with both PED and RCA. There was a significant difference in the incidence of PED tear between eyes with or without RCA (χ2=8.9612, P=0.0030). Conclusions RCA is not uncommon in exudative AMD. It often coexisted with PED, but there is no direct correlation between them. PED tear is highly correlated with RCA formation. (Chin J Ocul Fundus Dis，2004，20：295-298)
Objective To evaluate the relevant factors affecting prognosis of traumatic optic neuropathy. Methods Sixty-nine patients with traumatic optic neuropathy were enrolled. Multiple variable analysis was done to filter the risk factors to prognosis in traumatic optic neuropathy. Results At 3 months or more of followup,no light perception was found in 32 cases (46.4%); visual acuity were increased by≥1 lines in 33 cases (47.8%). The outcome of visual acuity was poorer in patients with the following conditions:no light perception after trauma （P=0.0031）, loss of consciousness （P=0.0262）, no pretreated common-dosage corticosteroids （P=0.0184）, and absence of VEP （P=0.0001）. Conclusion The initial visual acuity of no light perception, loss of consciousness, and no pretreated common-dosage corticosteroids were the risk factors to prognosis in traumatic optic neuropathy,and result of VEP was an effective prognosis indicator in traumatic optic neuropathy. (Chin J Ocul Fundus Dis, 2002, 18: 98-100)
ObjectiveTo investigate the gene expression spectrum of retina and optic nerve after partial injury of optic nerve.MethodsSixty SD rats were randomly divided into 4 groups. The optic nerves of the right eyes were clipped for 6 seconds with a pair of crossaction forceps. The retinae and optic nerves in the operation eye and contralateral sham operation eye were removed 3, 7, 14, and 21 days after the injury to detect gene expression patterns with high-density DNA microarrays.ResultsChanges of a mass of gene expressions were found after the optic nerve injury, and the positive rate of gene expression was 2.35%, 6.48%, 3.82% and 4.09% after 3, 7, 14, 21 days, respectively, and the total positive rate was 11.77%. The functions of positive expression of the gene involved cell survival, cytoskeleton, extracellular matrix and cell adhesion, free radicals and oxidative damage, energy and metabolism, inflammation, neurotransmission and ion transport, signal transduction, structural protein, transcription and translation. Up-or down-regulation of repaired genes was the main part of the changes of gene expression, while the alteredexpression destroy genes was the minor part in the whole gene expression spectrum, in which the up- and down-regulation of expression of repaired genes accounted for 13.98% and 24.73% respectively 7 days after the injury, and the downregulation of expression of repaired genes accounted for 17.20% 14 days after the injury.ConclusionsA mass of gene expression changes occurs after the optic nerve injury, and the comprehensive view on the gene expression pattern following the optic nerve injury is crucial to discover the mechanism of post-injury reaction and regeneration.(Chin J Ocul Fundus Dis, 2005,21:163-166)
Objective To study the human optic canal and its inner structures, and provide anatomic knowledge of this area for optic nerve decompression and further study in pathologic mechanisms of indirect optic nerve injury. Methods Serial sections of the 18 optic canals of adults were made at orbital, middle and cranial parts. Quantitative measurements of the canal wall thickness, canal transverse area, dural sheath transverse area, optic nerve transverse area, and subarachnoid space transverse area were done by means of IMAGEPRO morphometric analysis system. Subarachnoid space transverse area to canal transverse area ratio (SSTA/CTA) and subarachnoid space transverse area to dural sheath transverse area ratio (SSTA/DSTA) were calculated. Results The middle portion of medial wall is the thinnest part of the canal (0.35plusmn;0.48)mm. The middle part of the optic canal was the narrowest part and the transverse area was (17.54plusmn;2.12)mm2. From cranial end to orbital end, SSTA/CTA, SSTA/DSTA and the subarachnoid space transverse area became smaller and smaller. Conclusion Since the potential space is limited, even a tiny amount of blood or sweling of the nerve may cause optic compression. Due to the potential space gradually decreases from cranial end to orbital end and the narrowest portion of the canal is in the middle part, the middle part and the anterior part of the optic canal are critical in optic narve decompression. (Chin J Ocul Fundus Dis,1999,15:24-26)