Idiopathic macular hole (IMH) refers to full thickness defects of retina in macular area with no clear reasons. The management of IMH includes vitrectomy combined with internal limiting membrane (ILM) peeling and pharmacological vitreolysis. But ILM peeling may damage the inner retina; novel techniques, such as inverted ILM flap technique and foveola non-peeling ILM surgery, autologous ILM transplantation had made the method of ILM peeling more diversified with less damage. Pharmacological vitreolysis targeting fibronectin and laminin is considered to work in a two-step mechanism, involving both vitreoretinal separation and vitreous liquefaction. Furthermore, IMH judgment and prognosis indicators like ellipsoid zone, macular hole index, hole formation factor, diameter hole index and tractional hole index based on spectral domain optical coherence tomography enriched the assessment of macular hole diameter, depth and shape. How to make full use of new interventions to reduce the incidence of macular hole and obtain a better visual acuity with closed holes is an important direction for future research.
Objective To observe the effectiveness of combined therapy of intravitreal injections of ranibizumab and macular grid laser photocoagulation for branch retinal vein occlusion (BRVO) with macular edema (ME).Methods Forty-six patients of BRVO with ME were enrolled in this study. All the patients were examined for corrected visual acuity of Early Treatment Diabetic Retinopathy Study (ETDRS), slit lamp microscope, direct ophthalmoscope, intraocular pressure, fundus color photography, fundus fluorescein angiography and optical coherence tomography. The patients were divided into three groups by different treatments: injection group (18 eyes) received intravitreal injections of ranibizumab only, joint group (17 eyes) received intravitreal injections of ranibizumab combined with grid laser photocoagulation, and laser group (11 eyes) received laser photocoagulation only. The follow-up ranged from three to 15 months, with a mean of (8.0plusmn;3.2) months. The same equipment and methods were used to return visit in follow-up period. Repeated injections were adopted in injection group and joint group according to the results of subsequent visits. Then the repeated times of injection in two groups were compared. The visual acuity, macular retinal thickness (CRT) and ocular and systemic adverse reactions about drugs and treatments were followed up. The last follow-up time was considered as the judgment time for the therapeutic effects. Results The mean repeat times of injection in the injection group was 5.4plusmn;0.4, which more than that in the joint group 3.2plusmn;0.6 (t=12.17,P＜0.05). No ocular or systemic adverse events were observed in follow-up period. ETDRS visual acuity of injection group, joint group and laser group increased by 7.30plusmn;8.68,8.50plusmn;6.04,1.55plusmn;6.85 letters respectively after treatment. The differences were statistically significant before and after treatment in injection group and joint group (t=3.58, 5.78;P＜0.05), but there was no significant difference in laser group (t=0.75,P＞0.05). The difference was not statistically significant between injection group and joint group (t=0.45,P＞0.05). The difference was statistically significant between injection group and laser group, but also between joint group and laser group (t=2.13, 2.81;P＜0.05). CRT of injection group, joint group and laser group decreased by (110.56plusmn;43.08), (125.47plusmn;35.19), (50.73plusmn;19.68) mu;m respectively after treatment, with statistically significant differences (t=-10.89,-14.70, -8.55;P＜0.05). Conclusion In the treatment of BRVO with ME, intravitreal injection of ranibizumab combined with macular grid laser photocoagulation can reduce repeat times of injection, improve visual function and relieve ME.
Objective To observe the influence of cisplan on the expression of B7-H1 in retinoblastoma (RB) cells，and to investigate its mechanism. Methods Human RB cell line HXO-Rb44 cells were treated by 6 different concentrations of cisplan (0.000, 0.375, 0.750, 1.500, 3.000, 6.000 mu;g/ml), and their B7-H1 mRNA expression was determined by the reversetranscription polymerase chain reaction (RT-PCR) and fluorescence quantitative PCR (FQ-PCR); the B7-H1 protein expression was determined by immunofluorescence and flow cytometry. HXO-Rb44 cells were treated by 1.5 mu;g/ml cisplan for 0, 15, 30, 60, 120 min, then the phosphorylation of extracellular signal-regulated kinase 1/2 (ERK1/2) was detected by Western blot.Results The expression of B7-H1 mRNA and protein in the 0.375, 0.750, 1.500, 3.000, 6.000 mu;g/ml group were significantly higher than that of the blank control group (F=395.478，112.03; P=0.000）. Western blot showed that cisplan (1.5 mu;g/ml) could activate ERK1/2 by increasing its phosphorylation in HXO-Rb44 cells. After cisplan treatment, the phosphorylation of ERK1/2 increased gradually and reached its peak at 30 min, and then went down gradually.Conclusion Cisplan can promote the expression of B7-H1 and activate ERK1/2 in RB cells.
Objective To observe the effect of epidermal growth factor (EGF) on integrin alpha;5 expression and its influence on human retinal pigment epithelium (RPE) cells.Methods Human RPE cells were treated in vitro with 0.1,1.0,10.0,20.0 and 100.0 ng/ml of EGF, the mRNA and protein of integrin alpha;5 was measured by reverse transcription polymerase chain reaction（RT-PCR）and flow cytometry. Human RPE cells were cultured under 4 conditions including DMEM/F12,DMEM/F12+10 ng/ml EGF, DMEM/F12+10 ng/ml EGF+rabbit antihuman integrin alpha;5 antibody (1∶100)，DMEM/F12+10 ng/ml EGF+rabbit antihuman vimentin antibody (1∶100), and their proliferation and migration were measured by methylthiazole tetrazolium（MTT）and Boyden chamber.Results The integrin alpha;5 mRNA level of human RPE cells was not changed after 12 hours of EGF stimulation (F=0.618, P=0.687), however it was induced in a dosedependent manner after 24 and 48 hours of EGF stimulation (F=465.303, 212.340; P=0.000,0.000).The protein level of integrinalpha;5 was higher in 10 ng/ml EGF stimulation compared with the control group and 0.1 ng/ml group（P＜0.01）.MTT and Boyden chamber showed that the integrin alpha;5 expression increased the proliferation and migration of human RPE cells. Conclusion EGF can induce integrin alpha;5 expression,thus increase the proliferation and migration of human RPE cells.