Objective To review the distribution and shifting trends of cultured bacteria from the aqueous humor and the vitreous body. Methods A retrospective analysis on distribution of Gram′s stain, the distribution and change of isolates was performed in 522 specimens (aqueous humor,261 and vitreous body,261) of patients with suspected endophthalmitis during a 10-year period (1989-1998). Results The positive cultures were 119 (aqueous humor,44 and vitreous body,75) of 522 specimens. The average positive rate was 22.8%. Gram-positive cocci constituting 45.4%(54) of total isolates followed by Gram-negative bacilli,34.5%(41);Gram-positive bacilli, 20.2%(24). In the positive bacterial cultures, enterobacteriaceae was the most common isolate, 18.5%, and the next was micrococcus, 16.0%; coagulase-negative staphylococcus,12.6%; and pseudomonas,10.9%.Comparing the data from 1989 through 1993 with the data from 1994 through 1998, the frequency of Gram-positive cocci had no significant change, while the frequency of Gram-positive bacilli was decreased and the percentage of Gram′s-negative bacilli was increased. Conclusions Gram-positive cocci and Gram-negative bacilli are the predominant pathogens of bacterial endophthalmitis. The percentage of Gram′s-negative bacilli has increased for 5 years. It is very important to comprehend the distribution and shifting trends of these pathogenic bacteria for diagnosis, prevention and treatment of bacterial endophthalmitis. (Chin J Ocul Fundus Dis, 2002, 18: 104-105)
Vitreous is composed of transparent gel-like tissue with complex molecular structure, accounting for 80% of the volume of the eyeball. In addition to support the eye structure, vitreous has important functions such as regulating eye development, refraction and cellular barriers, participating in intraocular oxygen metabolism and the development of retinal diseases. Age, myopia and systemic diseases and other factors have an impact on vitreous function. Intra-vitreous injection and vitreous surgery may interfere with vitreous function, damage the intraocular metabolic balance. To better maintain intraocular metabolic balance and visual function, it is important to study vitreous metabolic function carefully and intervene it cautiously.
Objective To investigate the effect of retinectomy 360° for severe ocular rupture and evaluate the related factors associated w ith prognosis. Methods We retrospectively analyzed 28 consecutive patients (28 eyes), 18 men and 10 women, with severe ocular rupture admitted to the Chinese PLA General Hospital between January 1999 and October 2002. The patient′s ages ragned from 16 to 58 years, mean 29 years. According to the internation standardized classification of ocular trauma, the injuries located in zone I in 5 eyes, zone I-II in 8 eyes，zone II in 3 eyes, zone II-IIIⅢ in 5 eyes, zone III in 7 eyes, zone II in 3 eyes, zone II-III in 5 eyes and zone III in 7 eyes. The presenting visual acuity was in grade 4 (0.02 to light perception) in 19 eyes, and grade 5 in 9 eyes. In 28 patients, 13 had the total absence of iris and lens, 10 had iris deletion more than 1/2, and 15 had lens opacity or rupture. Ultrasound biomicroscopy and B-scan revealed ciliochoroidal detachment in 17 eyes. The B-scan revealed vitreous hemorrhage and retinal detachment in all paitents. The intraocular pressure was from 5 to 11 mm Hg in all patients. The therappeutic operative procedures which were performed by one surgeon in all of the affected eyes included standard 3-port pars plana vitrectomy with scleral encircling buckle, endophotocoagulation and tamponading with silicone oil in all patients; lensectomy in 15 eyes; 360° retinotomy and retinectomy at anterior equator in 16 patients, and posterior equator in 12 eyes.Results During the operation, all patients were confirmed with vitreous hemorrhage and retinal detachment, including hemorrhagic ciliary body detachment in 9 eyes, suprachoroidal hemorrha ge in 12 eyes, retinal twisting like morning glory in 11 eyes, and retinal incarceration in 17 eyes. Postoperative follow-up In 26 eyes who were followed up postoperatively from 6 months to 46 months, retinal reattachment was found in 20 patients (76.9%) in whom the retina of 3 was reattached after revitrectomy and the silicone oil of 8 was removed at the fourth month after operation. In 20 eyes with reattached retina, 14 (70.0%) had corrected visual acuity of 0.02 or more, including 7 (35.0%) had 0.05 or more, 3 had 0.1 or mor e, and 1 had the best visual acuity of 0.3.Conclusion Retine ctomy may improve the prognosis of severe ocular rupture and save the visual fun ction of some patients.(Chin J Ocul Fundus Dis，2003，19：333-404)
Purpose To investigate the effects of human vitreous fluid on proliferation of cultured human retinal pigment epithelial (RPE) cells and vascular endothelial cell lines(VEC304). Methods Human RPE cells and VEC304 were cultured and treated in different human vitreous-conditioned medium (VCM) with or without serum, vitreous volume concentrations of VCM were 1∶8, 1∶4 and 1∶2. Cells proliferation was assayed by tetrazolium (MTT) colorimetry at the 2nd, 4th and 6th day respectively. Results In the presence of serum, 1∶4, 1∶2 VCM had a significantly stimulative effect on RPE cells proliferation compared with control group at the 2nd, 4th, and 6th day retrospectively (P＜0.01), but exerted a bly inhibitory effect on VEC304 proliferation compared with control group at the 2nd, 4th, and 6th day retrospectively (Plt;0.05). In the absence of serum, only 1∶2 VCM had a stimulative effect on RPE cells growth compared with control group at the 2nd day (P＜0.05) and obviously at the 4th and 6th day respectively (P＜0.01). Conclusion Human vitreous fluid influences human RPE cells and VEC304 growth in vitro. This result suggests that vitreous may play different role in proliferative vitreoretinopathy and intraocular neovascular disease. (Chin J Ocul Fundus Dis, 2002, 18: 140-142)
Objective To evaluate the effect of vitrectomy on traumatic retinal detachment combined with choroidal damage. Methods The data of 1075 traumatic eyes which underwent vitrectomy from 1995 to 2005 were retrospectively analyzed. Forty-one patients (41eyes, 3.8%) with different kinds of choroidal injuries, including traumatic retinal detachment combined with serous choroidal detachment, hemorrhagic choroidal detachment (including traum atic separation of choroid and sclera) or subretinal hemorrhage, underwent closed vitrectomy. The operative prognosis in different groups were analyzed statisti cally. Results The retina reattached in 38 eyes （92.7％）, in cluding 10 with the final visual acuity gt; 0.1（24.4％）；the visual acuity improved postoperatively in 29 (70.7％)，including 14 in subretinal hemorrhage group （87.5％, 14/16），12 in serous choroidal detachment group（75.0%, 12/16）and 3 in hemorrhagic choroidal detachment（33.3%, 3/9） (chi;2＝8.394, P＝0.015); amaurosis was found in 6 eyes, all of which were with hemorrhagic choroidal deta chment preoperatively. In 17 eyes with ocular hypotension, a persistent silicone oil tamponade was needed in 8（47.1％）, in which 5 were in the hemorrhagic choroidal detachement group (55.6％, 5/9). Conclusions Appropriate vitrectomy is helpful for traumatic retinal detachment combined with choroidal damage, and the operative prognosis of the patients combined with subretinal hemorrhage is good. The operative prognosis of hemorrhagic choroidal detachment is worse than that of the serous choroidal detachment. However, it doesnprime;t mean that all the hemorrhagic choroidal detachment eyes need ocular enucleation. The prognosis of eyes with severe traumatic choroidal detachment was poor, and the eyes are with ocular hypotension which needs a long-term silicone oil tamponade. (Chin J Ocul Fundus Dis, 2006, 22:295-298)
Objective To evaluate the indications, effectiveness and complications of vitreoretinal surgery using the 25G transconjunctival sutureless vitrectomy system (TSV25G) under the topical anesthesia. Methods The clinical and follow-up data of 22 eyes of 22 patients undergone vitreo-retinal surgery using TSV25G under the topical anesthesia were retrospectively analyzed. All of the patients were monocular sickened, including idiopathic macular hole in 10 eyes, idiopathic macular pucker in 6, vitreoretinal traction syndrome in 4, and vitreous hemorrhage associated with branch retinal vein occlusion in 2. Peeling of epiretinal membrane and/or internal limiting membrane, intra ocular laser coagulation, air-fluid exchange and tamponiding of C3F8 were performed according to the condition of diseases. The postoperative follow-up was 1-11 months, with the mean duration of 6.4 months. The effect of analgesia, cooperation with the patients, operative effect and complications in and after the surgery were observed. Results The operations finished successfully in all of the eyes under the topical anesthesia. The operation duration ranged from 20 to 25 minutes with average of 22 minutes. The patients cooperated with the doctor well without any discomfort. Two days after the surgery, edema of the wounded conjunctiva was found, and recovered 7 days later. A light pigment dot on the surface of the sclera could be seen at the first month. The complic ations included transient increasing of intraocular pressure in 2 eyes, feather-like opacity of lens in 5 eyes, vitreous hemorrhage in 1 eye, and air-bleb under conjunctiva in 2 eyes. No other complications related with the cut were fo und. The macular hole closed in 9 eyes with idiopathic macular hole, and the other 1 had the smaller but not closed hole. Idiopathic macular pucker, vitreoretinal traction syndrome, and vitreous hemorrhage associated with branch retinal vein occlusion were cured successfully. Conclusions Vitreoretinal surgery using the TSV25G under the topical anesthesia has many advantages such as simple procedure, short operation time, micro-invasion, less complications and rapid revovery, and mainly serves simple manipulation in some simple diseases such as idiopathic macular hole, vitreo-retinal traction syndrome, and simple hemorrhage. (Chin J Ocul Fundus Dis，2004，20：133-136)
Objective To investigate the visual function of idiopathic macular hole before and after macular surgery. Methods Vitreous-retinal surgery was performed in 19 patients(19 eyes) with idiopthic macular hole.Among them,3 eyes belonged to stage 2，10 eyes stage 3 and 6 eyes were stage 4. The visual function including international standard visual acuity,laser retinal visual acuity,photopic ERG intensity responses- and Humphrey 30deg;-2 visual field were tested and compared before and after the surgery. Results (1)International standard visual acuity was from 0.01 to 0.1 preoperatively,and from 0.04 to 0.4 post operatively,the difference was not significant(P＞0.0 5).(2)Laser retinal visual acuity was from 0.12 to 0.4 preoperatively,and from 0.2 to 0.63 postoperatively,the difference was significant (P＜0.05).(3)In photopic ERG intensity responses:the Log K value of bwave decreased after surgery (P＜0.05),but no obvious change found in Rmax and n Value after operation.(4)Humphrey visual field examination revealed the thresholds for 0-10deg; increased after surgery(P＜0.05),but not obvious for 15-30deg;． Conclusion The visual function of the macular cones are increased by macular surgery for IMH. (Chin J Ocul Fundus Dis，2000，16：213-284)
Objective To observe the effect of the treatment of neodymium-yttrium aluminum garne (Nd:YAG) vitreolysis for the anterior vitreous opacity after implantation of intraocular lens.Methods Forty-nine eyes of 47 patients with the anterior vitreous opacity after implantation of intraocular lens received the slitlamp examination, optical coherence tomography (OCT), and B-scan. The anterior vitreolysis and posterior capsulotomy were performed simultaneously with Nd :YAG laser. The outcomes of visual acuitiy changes and complications were studied.Results In 49 eyes, 46 had anterior vitreous opacity associated with posterior capsule opacification, and the other 3 without obvious posterior capsule opacification. In all patients, the visual acuity improved significantly without any complications after the laser procedure (t=32.50, P=0.007). After Nd:YAG laser treatmen, transparent area was found in anterior opaque vitreous in 21 eyes (42.86%) within 15 minutes, and in 47 eyes (95.92%) within 24 hours. No complication occured in or after the operation.Conclusions In the patients with visual deterioration after implantation of intraocular lens, the prescence of anterior vitreous opacity should be concerned. Opening the opaque anterior vitreous with Nd:YAG vitreolysis is effective for the patients with the anterior vitreous opacity after implantation of intraocular lens.(Chin J Ocul Fundus Dis，2003，19：106-108)
Objective To explore the correlation between retinal extracellular edema and vitreous contraction in rabbits. Methods Seventeen pigmented rabbit models with retinal vein occlusion (RVO)was set up by laser photocoagulation. Retinal vascularity area was pathologically examined 1 month later.The vitreous gellength under the gravity condition and the percentage of its weight in the rabbits with extraeellular edema was observed. The mechanisms were investigated by Western immunoblotting of type II collagen.Results Extracellular edema was found in 13 experimental eyes 1 month after the formation of RVO (76.5~) with contracted vitreous gel and released watery liquid, and the a component of type II collagen was cross-linked together to form high-molecular-weight components of 1] and 7, which weakened the stability of collagen net structure.Conclusions Vitreous contraction and retinal extracellular edemawere correlated. The main reason may be the cross-links of vitreous collagen that damages the stability of collagen structure. (Chin J Ocul Fundus Dis，2004，20：2-32)
Objective To observe the efficacy of vitreoretinal surgery in the treatment of early traumatized eyes with no light perception. Methods We performed vitreoretinal surgery on 17 eyes of early traumatized eyes with no light perception.The patients were followed up for 2～14 months. Results Retinal reattachment was achieved in 11 eyes after srugery.8 eyes got visual acuity better than light perception postoperatively.Visual acuities of 5 eyes were better than 0.05 and the best one reached to 0.2. Conclusion Timely vitreoretinal surgery is valuable to the early traumatized eyes with no light perception.Retinal reattachment is the most important thing for the treatment of this kind of cases. (Chin J Ocul Fundus Dis，2000，16：213-284)