ObjectiveTo observe the incidence of diabetic iridopathy and optic disc neovascularization in the contralateral eyes of proliferative diabetic retinopathy (PDR) with proliferative diabetic iridopathy (PDI). MethodsA retrospective case-control study. From February 2014 to May 2020, 72 eyes of 36 patients with PDR and PDI who underwent iris fluorescein angiography (IFA) combined with fluorescein fundus angiography (FFA) at the Henan Eye Institute were enrolled in the study. Among them, there were 34 eyes in 17 males and 38 eyes in 19 females; the average age was 62.3±4.7 years. All patients underwent best corrected visual acuity (BCVA), intraocular pressure, IFA combined with FFA examination. The BCVA examination was performed using the international standard visual acuity chart, which was converted into logarithm of the minimum angle of resolution BCVA for statistic analysis. According to PDI staging, patients were divided into early rubeosis iridis (RI) group and neovascular glaucoma (NVG) group, with 28 and 8 cases respectively. Compared with NVG group, RI group had better BCVA and intraocular pressure, and the difference was statistically significant (t=6.433, 10.619; P=0.000, 0.011). The incidence of PDI and the incidence of binocular optic disc neovascularization in the two groups were compared, and Fisher's exact probability method was used for comparison. ResultsThe results of the IFA examination showed that in the RI group, the pupil border and the iris surface of the iris of the affected eyes had strong neovascular bud-like or patchy fluorescence; the pupil border and the middle of the iris of the patients in the NVG stage had strong neovascular cluster-like fluorescence. Among the contralateral eyes in the RI group, 6 eyes (21.4%, 6/28) were with PDI (stage RI), 21 eyes (75.0%, 21/28) were with non-PDI (NPDI), and 1 eye (1/ 28, 3.6%) were absence of diabetic iris disease. Among the contralateral eyes in the NVG group, there were 5 eyes with PDI (62.5%, 5/8), including 4 eyes with RI stage, 1 eye with NVG stage (12.5%, 1/8); 3 eyes with NPDI. The image of IFA in patients with NPDI early showed as punctate fluorescence in the local small blood vessels of the iris itself. The incidence of PDI in the contralateral eye of the RI group was lower than that of the NVG group, and the difference was statistically significant (P=0.040). The results of FFA examination showed that 9 (32.1%, 9/28) and 8 (28.6%, 8/28) eyes of the affected eye and the contralateral eye in the RI group were combined with optic disc neovascularization. In NVG group, there were seperately 6 eyes (75.0%, 6/8) in the affected eyes and the contralateral eyes with optic disc neovascularization. The differences in the incidence of optic disc neovascularization between the two groups of the affected eyes and the contralateral eye were statistically significant (P=0.046, 0.040). ConclusionThe incidence of PDI and optic disc neovascularization in the contralateral eye of PDR and PDI, RI is lower than that of NVG.
Objective To evaluate ocular surface changes following minimal vitreoretinal surgery in postmenopausal women patients with proliferative diabetic retinopathy (PDR). Methods Sixty-one women PDR patients (61 eyes) underwent vitreous microsurgery were recruited in this prospective study, including 31 postmenopausal women (PMW group) and 30 non-postmenopausal women (non-PMW group). The contralateral eyes were considered as the control group. Corneal fluorescein (FL) staining, tear break-up time (TBUT), Schirmer I test (SIT), central corneal sensitivity and ocular surface disease index (OSDI) were estimated. All tests were carried out 1 day preoperatively and 1 day, 10 days, 1 month and 3 months postoperatively. The student’st test or Mann-WhitneyU and ANOVA for repeat measurements test were used. Results Preoperatively, TBUT of surgery and non-surgery eyes in PMW were shorter than non-PMW (t=−2.115, −2.035;P＜0.05), but higher OSDI scores were found in PMW (t=2.482, 2.208;P＜0.05). TBUT reduction rate (Z=−2.771, −1.993;P＜0.05) and OSDI rising rate (Z=2.539, 2.157;P＜0.05) of surgery eyes in PMW were higher than non-PMW 1 day and 10 days postoperatively. The lower SIT of surgery eyes in PMW were observed at 1 day and 10 days (t=−2.403, −2.029;P＜0.05) after surgery. At 10 days after surgery, FL and OSDI scores of surgery eyes in non-PMW returned to preoperative level (Z=−0.447, −0.513;P＞0.05), but in PMW, the recovery process experienced 1 month (Z=−1.500, −0.853;P＞0.05). TBUT and SIT of surgery eyes in two groups both reached preoperative level at 1 month following surgery (Z=−0.715, −1.266, −1.531, −0.522;P＞0.05). Conclusions PMW with PDR had ocular surface dysfunction, which resulted in aggravated dry eye after minimal vitreoretinal surgery.
Objective To investigate the effects of heparanase and vascular endothelial growth factor (VEGF) and their correlation in CoCl2 induced human retinal microvascular endothelial cells (HRECs) in an hypoxia model. Methods Human eyes were selected to establish CoCl2induced HRECs hypoxia model in this study. Four experimental groups were studied: normal control group, hypoxia group (CoCl2 100 μmol/L, 48 hours),PI-88 group (specific competitive inhibitor of heparanase: phosphomannopentaose sulfate, PI-88,5 μg/ml, combined with CoCl2 100 μmol/L, 48 hours) and PBS control group. Heparanase, VEGF and Pol Ⅱ expression in HRECs of normal and hypoxia group were analyzed with immunofluorescence. Western blot was used to evaluate the expression of heparanase and VEGF in HRECs of normal, hypoxia, PI88 and PBS control groups. ResultsImmunofluorescence studies showed that the expression of heparanase and VEGF in cytoplasm was intense in hypoxia HRECs, but faint in normal group. Heparanase was also observed in the nucleus of hypoxia HRECs. Western blot results showed that the expression of Hpa and VEGF protein was increased significantly in hypoxia group compared with normal group (Hpa：F=-4。005, P＜0.05；VEGF：F=-4.063, P＜0.05), and VEGF was decreased in HRECs treated with PI-88(F=5。963, P＜0.05). ConclusionsHeparanase is upregulated that resulted in increase of VEGF expression, therefore enhanced angiogenesis in CoCl2 induced hypoxia HRECs.
Objective To evaluated the efficacy of vitreoretinal surgery for X-linked retinoschisis (XLRS) and its complications. Methods Twentyone XLRS patients (27 eyes) with retinal detachment or vitreous hemorrhage who were treated by vitreoretinal surgery were enrolled in this study. There were microcystislike splitting in all the eyes. The mean visual acuity was 0.11±0.09 and the mean area of macular splitting was (1.09±0.56) mm2. Among the eyes, there were 12 eyes with rhegmatogenous retinal detachment, five eye with traction retinal detachment, six eyes with vitreous hemorrhage and four eyes with retinal detachment and vitreous hemorrhage. All the patients underwent a standard threeport pars plana vitrectomy. Internal limiting membrane peeling, laser photocoagulation, and C3F8 gas or silicone oil tamponade were carried out in different condition. The follow-up was 9-122 months (average 51 months). The preoperative visual acuity and anatomic structure of retina were observed. Results The mean visual acuity at last visit was increased to 0.26±0.15, the difference was significant (t=-6.320, P=0.000). It improved in 20 eyes (74.1%), remained unchanged in seven eyes (25.9%). The retina remained attached in 27 eyes. The mean area of macular splitting was decreased to (0.29±0.21) mm2, the difference was significant (t=10.358, P=0.000). The complications were found in four eyes (14.8%) which including two eyes with proliferative vitroretinopathy and traction retinal detachment six and eight months after surgery, one eye with cataract four months after surgery, and one eye with vitreous hemorrhage 15 months after surgery. The retina remained attached in these four eyes after reoperation. Conclusion Vitreoretinal surgery can significantly improve visual acuity, resume the anatomic structure of retina.
Objective To investigate the correlation between mutation genotypes and phenotypes of X-linked retinoschisis (XLRS) patients. Methods 33 male XLRS patients, 26 female carriers and 100 normal subjects were enrolled in this study. All 33 XLRS patients were bilateral, which included 18 patients from 8 families and 15 sporadic patients. Among 66 XLRS eyes, there are microcystis-like foveal splitting in 49 eyes (74.2%), lamellar macular splitting in 43 eyes (65.2%), peripheral splitting in 32 eyes (48.5%), retinal detachment in 17 eyes (25.8%), and vitreous hemorrhage in 8 eyes (13.6%). Electroretinogram was performed on 42 eyes which showed decreased amplitude of b-wave. The 6 exons of RS1 gene were amplified by polymerase chain reaction and then directly sequenced.The correlation analysis was performed between mutation genotypes and phenotypes. Results There were 19 RS1 gene mutations including 6 novel mutations (p.Gly70Cys, p.Trp112Arg, p.Arg156Trp, p.His207ProfsX56, p.Arg209AlafsX28, p.Cys223Tyr). There was no correlation between mutation genotypes and phenotypes (chi;2=0.731, 3.438, 0.820, 3.208, 1.992; P＞0.05 ).Conclusions RS1 gene mutation is a major cause of XLRS. The RS1 mutation genotype is not correlated with phenotype, so that the prognosis cannot be predicted by the genotypes.