Objective To observe the histological changes and apoptosis of retinal cells in pigmented rabbits treated by transpupillary thermotherapy (TTT) with different laser power. Methods Fourteen pigmented rabbits (28 eyes) were divided averagely into seven groups（control group, 50, 70, 90, 110, 130, and 150 mW group）according to different laser power of TTT. Light microscopy was performed to observe the histological changes, and TDT-mediated biotin-dUTP nick-end labeling (TUNEL) technique and flow cytometry (FCM) examination were used to detect the apoptotic cells 24 and 48 hours after photocoagulation, respectively. Results The color of retinal burn speckles changed from offwhite to white and super white with the diameter enlarged gradually as the laser power of TTT increased. The results of light microscopy revealed that compared with the control group, the retinal tissue did not change much in 50-70 mW group; in 90-130 mW group, the retinal structure was integrated, but the cone and rod cells became swollen and condensed nuclei and cytoplasmic vacuolization were seen in the inner nuclear layer. The difference of retinal structure in 50-130 mW group 24 and 48 hours after photocoagulation and control group was not significant. In 150 mW group, tumefaction and degeneration were observed in each layer of retina and the inner and outer segments of photoreceptor cells lost 24 hours after photocoagulation, and obvious necrosis and cell loss of retinal tissues were detected hours after photocoagulation. The results of TUNEL examination indicated that positive cells were found in outer nuclear layer in each photocoagulation group which increased as the laser power of TTT was enhanced; the apoptosis gradually involved the inner nuclear layer and ganglion cell layer. The results of flow cytometry (FCM) examination showed the peak of apoptotic cells in each photocoagulation group 24 hours after photocoagulation. Conclusion Under certain subthreshold photocoagulation (50-70 mW), retinal tissue of rabbits does not change much but apoptosis of photoreceptor cells increase significantly. As the laser power of TTT increases, the retinal tissues become swollen, degenerated and even necrotic; cellular apoptosis gradually involves the inner nuclear layer and ganglion cell layer. (Chin J Ocul Fundus Dis, 2006, 22:249-252)
Objective To observe the characteristics of pupillary light reflex in the patients with retrobulbar neuritis, and to evaluate the effects of pupi llary light reflex on the diagnosis and treatment of retrobulbar neuritis. Methods Thirtyfive patients (thirtyfive eyes with the retrobulbar neuritis and thirtyfive fellow eyes) aged from 10 to 58 years and 50 healthy individuals (100 eyes) who didnlsquo;t differ from the patients in age and sex were examined by a automatic pupillometer. The pupillary area and response amplitude, latency and speed of papillary reflex were recorded. Results The latency of the pupillary light reflex delayed and the maximum amplitude decreased in patients with retrobulbar neuritis during the diseas eperiod, and the differences were highly significant compaired with the control group. After the treatment, as the symptoms were alleviated and the visual acuity improved, the latency of the pupillary light reflex and the maximum amplitude recovered. The statistic differences were both found between the results after treatment and those at the onset stage, and the results after treatment and those in the control group.Before the onset of the disease of the involued eyes and after the treatment, the papill ary light reflex and the maxium amplitude decreased, but didnamp;#146;t differe much from which in the control group. Conclusions The latency of the pupillary light reflex delayes and the maximum amplitude decreases in patients with retrobulbar neuritis. The examination of pupillary light reflex is helpful to diagnose retrobulbar neuritis early and inspect the condition of the disease. (Chin J Ocul Fundus Dis,2006,22:370-372)
We reported 42 cases of indirect optic nerve trauma in craniofaeial injuries. Mydriasis in affected eyes was found in 30 cases with absence or diminish of direct pupillary reflex but presence of indirect pupillary reflex. Imaging examination revealed optic canal fracture in 24 eases. Seven of 9 patients in whom the diagnosis of optic trauma was comfirmed received operation of optic nerve decompression from cranial and superior orbital wall approach within 10 days following injuries ,resulting in improvement of visual loss. While the other 2 patients operated on 15 days after trauma,obtained no relieve in their visual impairemenl. And 7 of 21 presumed cases of indirect optic trauma in this series treated with steroids became blind. We suggested that pupillary examination,imaging analysis,as well as early diagnosis and operation were essential to diagnosis and management of indirect optic trauma complicating craniofacial injuries. （Chin J Ocul Fundus Dis,1994,10:210-212）
ObjectiveTo explore the therapeutic effect of transpupillary thermotherapy (TTT) on patient with circumscribed choroidal hemangioma (CCH). MethodsThe clinical data of 16 patients (16 eyes) with circumscribed choroidal hemangioma (CCH) from December 2011 to December 2012, which had been diagnosed by clinical general examination, fundus fluorescein angiography (FFA), and B-scanning ultrasound examination were retrospectively analyzed. The follow-up period was 6-24 months (mean 14 months). ResultsAmong the 8 eyes with peripheral retinal detachment in 16 cases of CCH, the peripheral subretinal fluid was completely absorbed in 6 eyes, and partially absorbed in 2 eyes after TTT. The resultant visual acuity after treatment improved in 12 eyes, and maintained no change in 4 eyes. The results of B-scanning ultrasound examination showed that the thickness of tumor went down in 12 eyes obviously. The results of FFA revealed a significant decrease of the leakage in tumor in all of 16 cases and no complication was observed. ConclusionTTT is an effective therapy for CCH.
ObjectiveTo observe the neuro-ophthalmological features of intracranial aneurysm. Methods169 patients with intracranial aneurysm were retrospectively studied. 45 patients, including 18 men and 27 women, had neuro-ophthalmological symptoms or signs. Their average age was (56.21±16.11) years and 32 (71.11%)patients' age was more than 50 years. The onset time ranged from 30 minutes to 20 years. 20 (44.44%) patients' onset time was among 24 hours. CT, CT angiography, MRI, MRI angiography and cerebral digital subtraction angiography were performed alone or combined in all 45 patients. Visual acuity, pupil reflex and eye movement were examined. Clinical data including general condition, initial symptoms, neuro-ophthalmological changes, imaging data and treatment effects were recorded. Results26.63% of the 169 patients had neuro-ophthalmological symptoms or signs. There were 6 patients (13.33%) with neuro-ophthalmological changes as their first manifestation and 39 patients (86.67%) with neurologic changes as first manifestation. Neuro-ophthalmological symptoms included vision loss (10 patients, 22.22%), diplopia (4 patients, 8.89%) and ocular pain (2 patients, 4.44%). The most common neuro-ophthalmological sign was pupil abnormality which was found in 31 patients (68.89%). The second most common sign was eye movement disorder (16 patients, 35.56%).The other signs included ptosis (8 patients, 17.78%), nystagmus (2 patients, 4.44%), exophthalmos (1 patient, 2.22%) and disappeared corneal reflection (1 patient, 2.22%). Imaging examination indicated that intracranial hemorrhage happened in 29 patients (64.44%). The most common neuro-ophthalmological features were pupil abnormality, eye movement disorder and vision loss in both patients with or without intracranial hemorrhage. The incidence of pupil abnormality was higher in patients with intracranial hemorrhage than that without intracranial hemorrhage, the difference was statistically significant(χ2=7.321, P=0.007). Pupil abnormality and vision loss were common in patients with internal carotid artery aneurysm, and eye movement disorder was common in patients with internal carotid artery aneurysm and posterior communicating aneurysms. ConclusionsPatients with intracranial aneurysm have different neuro-ophthalmological features. The most common features are pupil abnormality, eye movement disorder and vision loss.