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ABSTRACT: Müller cell gliosis, which is characterized by upregulated expression of glial fibrillary acidic protein (GFAP), is a universal response in many retinal pathological conditions. Whether down-regulation of inward rectifying K(+) (Kir) channels, which commonly accompanies the enhanced GFAP expression, could contribute to Müller cell gliosis is poorly understood. We investigated changes of Kir currents, GFAP and Kir4.1 protein expression in Müller cells in a rat chronic ocular hypertension (COH) model, and explored the mechanisms underlying Müller cell gliosis. We show that Kir currents and Kir4.1 protein expression in Müller cells were reduced significantly, while GFAP expression was increased in COH rats, and these changes were eliminated by MPEP, a group I metabotropic glutamate receptors (mGluR I) subtype mGluR5 antagonist. In normal isolated Müller cells, the mGluR I agonist (S)-3,5-dihydroxyphenylglycine (DHPG) suppressed the Kir currents and the suppression was blocked by MPEP. The DHPG effect was mediated by the intracellular Ca(2+)-dependent PLC/IP(3)-ryanodine/PKC signaling pathway, but the cAMP-PKA pathway was not involved. Moreover, intravitreal injection of DHPG in normal rats induced changes in Müller cells, similar to those observed in COH rats. The DHPG-induced increase of GFAP expression in Müller cells was obstructed by Ba(2+), suggesting the involvement of Kir channels. We conclude that overactivation of mGluR5 by excessive extracellular glutamate in COH rats could contribute to Müller cell gliosis by suppressing Kir channels.
Journal of Neuroscience 09/2012; 32(37):12744-55. · 7.11 Impact Factor
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ABSTRACT: The neurohormone melatonin is implicated in a variety of physiological processes. In the retina, a major source for melatonin production, melatonin is involved in modulation of neuronal activities. In this article we review recent advances in this research field, which is preceded by a concise account of general information about melatonin, melatonin receptors and intracellular signaling pathways for melatonin actions. Melatonin is mainly synthesized in and released from photoreceptors in the retina. Different subtypes of melatonin receptors are present on major types of retinal neurons, and the expression of these receptors is highly species- and neuron subtype-dependent. By activating different melatonin receptor subtypes, melatonin modulates activities of retinal neurons. In the outer retina, melatonin regulates the activity of photoreceptors. In addition, melatonin reduces the light responsiveness of cone-driven horizontal cells, but potentiates rod signal to rod-dominant ON type bipolar cells in teleost fish or inhibits the TEA-sensitive potassium channel of rod-driven ON type bipolar cells in rats. In the inner retina, melatonin potentiates inputs from glycinergic amacrine cells to ganglion cells in rats. These actions of melatonin on retinal neurons are mediated by distinct intracellular signaling pathways via different subtypes of melatonin receptors and all serve to improve visual performance in a world of changing ambient illumination. The topics, concerning allosteric action of melatonin, interplay between melatonin and dopamine systems, and potential interaction between melatonin and melanopsin systems, are also discussed. An in-depth discussion of future directions in this research field is presented.
Progress in Retinal and Eye Research 08/2012; · 9.45 Impact Factor
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ABSTRACT: To establish a method of purifying and characterizing adult astrocytes from optic nerve head (ONH).
Experimental study. The lamina cribiosa tissue from ONH of human eye was isolated under anatomic microscopy, and then 4 to 6 little explants were incubated in each culture plate containing culture medium DMEM/F12. After 8 to 10 weeks, the cells were removed by digesting cells with 0.25% trypsogen. Selective astrocyte culture medium is subsequently used. After two passages, astrocytes were identified by the observation of cell morphology and immunofluorescent staining of GFAP and NCAM.
After 2 to 3 weeks of explants planting, cells showed an obvious migration procession by crawling in succession from the verge of the explants and rapidly splitting. Most cells displayed a flat star shape or polygon after digested with trypsogen. Several cells are long fusiformis. Almost all cells presented a flat star shape and simultaneously expressed GFAP and NCAM when the cells cultured with selective astrocyte culture medium.
Cultured human ONH astrocytes can be obtained by precisely separating lamina cribiosa and placing the explants on the margin of culture medium, a method that promotes cell adherence. Using selective astrocyte culture medium is very effective and convenient in purifying primary astrocytes.
[Zhonghua yan ke za zhi] Chinese journal of ophthalmology 07/2012; 48(7):615-8.
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ABSTRACT: Glaucomatous optic neuropathy is a chronic disease accompanied by visual field loss, cupping of optic nerve head, and apoptosis of retinal ganglion cells (RGCs). The mechanism of glaucomatous optic neuropathy is unknown but glial cells play an important role in glaucomatous optic nerve damage and the repair process. We review the role of glial cells in the remodeling of optic nerve head, apoptosis of RGCs and immune reactions in glaucoma.
[Zhonghua yan ke za zhi] Chinese journal of ophthalmology 01/2012; 48(1):85-8.
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ABSTRACT: Posterior capsular opacification (PCO) is a common long-term complication of modern cataract surgery. We have shown that Zebularine, an inhibitor of DNA methylation, suppresses transforming growth factor-β (TGFβ)-induced lens epithelial cells (LECs)-myofibroblasts transdifferentiation. The purpose of this study is to evaluate the role that Zebularine plays in the inhibition of PCO pathogenesis, including its effect on attachment, migration, and proliferation of LECs in vitro.
A tetrazolium dye-reduction assay (MTT test) was performed to determine cell proliferation. Cell attachment was assessed by modified MTT test. Migration was determined by the transwell method after incubation of LECs with Zebularine. The effect of Zebularine on DNA-methyltransferase 1 (DNMT1), phospho-p44/42 Map Kinase, and protein kinase B (Akt) were analyzed by western blot.
Zebularine was an effective inhibitor of human LEC proliferation, attachment, and migration in vitro. A Zebularine concentration of 100 μM accounted for the following: inhibition of cell proliferation of 57.2%, reduction in cell attachment to 29.6%, and inhibition of cell migration of 58.9%. All effects were dose dependent. Zebularine treatment resulted in dose-dependent decreases of DNMT1, phosphorylated p44/42 MAP Kinase, and phosphorylated Akt.
Zebularine is capable of inhibiting the crucial cellular events in PCO pathogenesis in vitro. Zebularine acts through the inhibition of DNMT1, and it consequently down regulation of the expression of proliferative and survival genes that relate to pathogenesis of PCO. These findings suggest that Zebularine may become a therapeutic approach for the prevention of PCO.
Molecular vision 01/2012; 18:22-8. · 2.20 Impact Factor
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ABSTRACT: To explore the morphological and expressional changes of Th1 cells and Th2 cells in retina of a rat model of glaucoma vaccinated by Cop-1 (Copolymer-1) and elucidate the possible neuroprotection roles played by Th1/Th2.
After modeling, the aqueous outflow from the right eyes was blocked by a ligation of three of four episcleral veins. There were 48 rats with elevated IOP (intraocular pressure) immunized by Cop-1 (Cop-1 group), 48 rats with elevated IOP immunized by PBS (phosphate-buffered saline) (PBS group) and 10 rats without any treatment (normal group). The experimental rats were immunized with Cop-1/PBS emulsified in a total volume of 0.4 ml complete Freund's adjuvant. The immunization was administered subcutaneously at the base of tail. Immunofluorescence was employed to test the distribution and activation of Th1 and Th2 cells in retina at Days 3, 7, 10, 17, 24 and 31 post-immunization respectively for each group. Western blot was selectively performed according to the results of immunofluorescence to verify if there was a similar variation of the retinal expression of IL-4 protein.
The results of immunofluorescence showed the numbers of Th1 cells peaked at Day 7 in both Cop-1 ((216 ± 21)/mm(2)) and PBS groups ((194 ± 27)/mm(2)). And no statistical significance existed between two groups (P > 0.05). The numbers of Th2 cells in the experimental groups peaked at Day 7 with statistical significance (Cop-1 group: 300 ± 28/mm(2) vs PBS group: 129 ± 27/mm(2)) (P < 0.01). With the prolongation of experimental period, the number of Th2 cells decreased gradually in the Cop-1 group but remained greater than that of the PBS group afterward (P < 0.05). The Western blot results showed that the expression of IL-4 in the Cop-1 group (1.91 ± 0.05) was significantly higher than that of the PBS group (0.51 ± 0.04) from Day 3 and peaked at Day 7 (2.11 ± 0.06 vs 0.57 ± 0.05). Then the IL-4 expression decreased gradually in the COP-1 group but still represented statistical significance versus the PBS group until Day 31 post-immunization (P < 0.001).
The retinal activation and accumulation of IL-4 are found in a rat model of chronic glaucoma immunized by Cop-1. Thus Th2 cells may play vital roles in the Cop-1-induced neuroprotective autoimmune responses.
Zhonghua yi xue za zhi 10/2011; 91(39):2789-92.
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ABSTRACT: Regulator of G-protein signaling (RGS) proteins 2 (RGS2) and 4 (RGS4) play an important role in regulating G(i/o)- and G(q)-coupled receptors. In the present study, we investigated the possible impact of RGS2 and RGS4 on modulation of glycine currents of rat retinal ganglion cells (RGCs) mediated by the G(i/o)-coupled melatonin MT(2) receptor, using immunohistochemistry, Western blot analysis and whole-cell patch-clamp techniques. By immunofluorescence labeling the expression profiles of RGS2 and RGS4 proteins were basically similar. Both of them were widely expressed in the rat retina, particularly in the inner plexiform layer (IPL) and the ganglion cell layer (GCL). In addition, sparse signals of RGS2 and RGS4 were also detected in the inner nuclear layer (INL). Double immunofluorescence labeling further showed that all of RGCs retrogradely labeled expressed both RGS2 and RGS4. Western blot analysis confirmed the presence of RGS2 and RGS4 proteins in the rat retina. Intracellular dialysis of RGCs with the antibody against RGS2/RGS4 to block RGS2/RGS4 function gradually increased glycine current amplitudes of these cells. In the presence of the RGS2/RGS4 antibody melatonin-induced potentiation of glycine currents of RGCs was not observable. These results suggest that RGS2/RGS4 are coupled to melatonin receptor signaling in rat RGCs and these proteins may regulate the MT(2) receptor to change melatonin-induced modulation of glycine currents in rat RGCs.
Brain research 09/2011; 1411:1-8. · 2.46 Impact Factor
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ABSTRACT: A noninferiority trial was conducted to evaluate the efficacy of a single evening dose of fixed-combination latanoprost 50 μg/mL and timolol 0.5 mg/mL (Xalacom®; LTFC), in Chinese patients with primary open-angle glaucoma (POAG) or ocular hypertension (OH) who were insufficiently controlled on β-blocker monotherapy or β-blocker-based dual therapy.
This 8-week, randomized, open-label, parallel-group, noninferiority study compared once-daily evening dosing of LTFC with the unfixed combination of latanoprost, one drop in the evening, and timolol, one drop in the morning (LTuFC). The primary efficacy endpoint was the mean change from baseline to week 8 in diurnal intraocular pressure (IOP; mean of 8 AM, 10 AM, 2 PM, 4 PM IOPs). LTFC was considered noninferior to LTuFC if the upper limit of the 95% confidence interval (CI) of the difference was < 1.5 mmHg (analysis of covariance).
Baseline characteristics were similar for LTFC (N = 125; POAG, 70%; mean IOP, 25.8 mmHg) and LTuFC (N = 125; POAG, 69%; mean IOP, 26.0 mmHg). Mean diurnal IOP changes from baseline to week 8 were -8.6 mmHg with LTFC and -8.9 mmHg with LTuFC (between-treatment difference: 0.3 mmHg; 95%-CI, -0.3 to 1.0). Both treatments were well tolerated.
A single evening dose of LTFC was at least as effective as the unfixed combination of latanoprost in the PM and timolol in the AM in reducing IOP in Chinese subjects with POAG or OH whose IOP was insufficiently reduced with β-blocker monotherapy or β-blocker-based dual therapy. LTFC is an effective and well tolerated once-daily treatment for POAG and OH.
BMC Ophthalmology 08/2011; 11:23. · 1.00 Impact Factor
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ABSTRACT: To explore the morphological characteristics on cornea in patients with vernal keratoconjunctivitis (VKC) by the application of in vivo laser scanning confocal microscopy (LSCM).
The experimental design was retrospective observation case series (case control study). Twenty-six patients, each diagnosed as bilateral VKC, were enrolled in the study, among which 13 were tarsal form, 5 were bulbar form and the rest were mixed form. Nine patients had the clinical course less than one year, eight subjects longer than three years, and the rest between them. Another twenty-six healthy volunteers with matching age and gender were selected as normal control. All participants had their right eyes examined with the in vivo confocal microscopy (HRT II/RCM). Central cornea and superior peripheral cornea were chosen as the examination points. The images were recorded automatically and cellular density of each layer was analyzed by installed software. Software ImageJ was utilized to analyze the density, diameter, branch number and tortuosity of subbasal nerve fiber in VKC patients. Independent t test was performed to assess the differences on cellular density between VKC patients and normal control, as well as those between central and peripheral cornea in VKC patients. Fisher chi-square test was used to compare the infiltration rate of Langerhans cells in corneal epithelium between VKC patients and controls. ANOVA was applied to assess the differences in cellular density among three subtypes, as well as among different duration of VKC. Independent t-test and chi-square test were applied to analyze the parameters of subbasal nerve fiber.
The morphological changes in cornea included the absence of superficial hyperreflective polygonal epithelial cells, infiltration of Langerhans cells in and(or) underneath corneal epithelium and activation of keratocytes in anterior stroma. Corneal epithelium conjunctivalization and stromal neovascularization could be identified in patients with corneal neovascular epithelium. Longitudinal or oblique dark striae could be found in the posterior stroma in patients with complicated keratoconus. The density of epithelial cells at central and peripheral cornea in healthy controls were (6033.1 ± 998.7) cells/mm(2) and (6098.4 ± 298.3) cells/mm(2), while that in VKC patients were (5972.2 ± 1148.2) cells/mm(2) and (6178.5 ± 318.9) cells/mm(2) respectively, the differences being no statistical significant between them (t = 1.191, 1.011; P = 0.238, 0.318). However, it's found in VKC patients that cellular density at peripheral cornea was significantly higher than that at central area (t = 2.249, P = 0.03). The density of anterior stromal cells at central and peripheral cornea in healthy controls was (1001.4 ± 125.3) cells/mm(2) and (924.6 ± 201.4) cells/mm(2), while that in VKC patients was (1184.5 ± 115.3) cells/mm(2) and (1101.4 ± 151.1) cells/mm(2), the difference bearing no statistical significance (t = 6.617, 3.439; P = 0.001). The density of posterior stromal cells in normal subjects and VKC patients was (537.7 ± 42.6) cells/mm(2) and (548.7 ± 79.8) cells/mm(2), that of endothelial cells was (2985.7 ± 401.2) cells/mm(2) and (3021.5 ± 383.3) cells/mm(2), respectively, neither difference had statistical significance (t = 0.174, 1.112; P = 0.864, 0.282). Langerhans cell infiltration could be identified in 61.5% (16 cases) VKC patients, which was significantly higher than normal control (2 cases, 7.7%) (χ(2) = 12.49, P = 0.001). Furthermore, much intense Langerhans cells infiltration was found in bulbar form and mix form than tarsal form. (t = 6.617, P = 0.001). The density and diameter of subbasal nerve fiber in VKC patients decreased significantly than those in normal subjects, whereas the tortuosity increased significantly.
The morphological changes of cornea in VKC patients mainly involve corneal epithelium, subbasal nerve fiber and anterior stroma. In vivo LSCM is helpful in discriminating the subtypes of VKC.
[Zhonghua yan ke za zhi] Chinese journal of ophthalmology 05/2011; 47(5):416-22.
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ABSTRACT: To analyze the discipline of intraocular pressure (IOP) variation, through circadian intraocular pressure monitoring in primary open-angle glaucoma (POAG) patients and normal controls, with a view to provide basis for individualized treatment of glaucoma.
Subjects were enrolled from the outpatients of Shanghai Beizhan Hospital and Eye and ENT Hospital of Fudan University, which were diagnosed as primary open angle glaucoma, from April 2006 to April 2009. Totally there were 102 cases of patients and 83 cases of normal volunteers. All the subjects accepted 24-hour IOP measurements using non-contact tonometer every two hours starting from 8:00 am. And the IOP between 00:00 to 06:00 am was measured in sitting position immediately after wake up.
The differences of peak IOP [(16.0 ± 2.7) mm Hg of right eye and (16.2 ± 2.7) mm Hg of left eye in normal group; (25.3 ± 5.6) mm Hg of right eye and (24.8 ± 5.1) mm Hg of left eye in POAG group], valley IOP (11.1 ± 2.5) mm Hg of right eye and (11.0 ± 2.3) mm Hg of left eye in normal group; (16.3 ± 3.7) mm Hg of right eye and (16.2 ± 3.3) mm Hg of left eye in POAG group, average IOP (13.4 ± 2.5) mm Hg of right eye and (13.4 ± 2.5) mm Hg of left eye in normal group; (19.9 ± 4.3) mm Hg of right eye and (19.8 ± 3.8) mm Hg of left eye in POAG group), and IOP fluctuations (5.0 ± 1.6) mm Hg of right eye and (5.2 ± 1.7) mm Hg of left eye in normal group; (9.1 ± 3.6) mm Hg of right eye and (8.6 ± 3.8) mm Hg of left eye in POAG group between two groups were all of statistically significance (P < 0.01). Notably, the peak IOP of 59.6% in normal control group and 73.5% in POAG group were outside working hours, especially in the time period from 00:00 to 06:00 am. The peak value of 50% in normal group and 64.7% in POAG group located between 00:00 to 06:00 in the morning.
By comparison and analysis, 24-hour intraocular pressure measurement could provide us pre-treatment basic state, so as to provide detailed information for individualized treatment. If possible, it is suggested that 24-hour IOP monitoring should be added as a routine examination of primary open angle glaucoma.
Zhonghua yi xue za zhi 02/2011; 91(7):441-4.
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ABSTRACT: To compare the efficacy of latanoprost, travoprost and bimatoprost given in the evening on the 24-hour intraocular pressure (IOP) curve in open-angle glaucoma patients.
It was a case-control study. Patients with primary open-angle glaucoma were selected for the present study. Twenty-one, 22 and 20 patients were treated once daily with latanoprost, travoprost and bimatoprost for 4 weeks, respectively. Before and four weeks after the treatment, IOP was measured by masked evaluators at 8AM, 10AM, noon, 2PM, 4PM, 6PM, 8PM, 10PM, midnight, 2AM, 4AM and 6AM. Repeated measure analysis of variance was used to compare the IOP responses to the drug regimens for the entire circadian curve. Analysis of variance was used to compare the circadian variations of intraocular pressure.
The IOPs of all patients in these 3 groups decreased markedly after 4 weeks. The daily average IOP (mean ± standard deviation) in the latanoprost group decreased from (18.9 ± 2.1) mm Hg (1 mm Hg = 0.133 kPa) to (15.3 ± 2.7) mm Hg, and the extent of the decrease was 19.0%. IOP in the travoprost group decreased from (19.1 ± 3.1) mm Hg to (15.3 ± 2.1) mm Hg, with a decrease of 19.4%. IOP in the bimatoprost group decreased from (18.6 ± 1.9) mm Hg to (14.9 ± 1.9) mm Hg, with a decrease of 19.9%. The effectiveness of the treatments did not differ significantly between these three groups (F = 1.501, P = 0.110). The descending percentage compared with circadian variation ranges before treatment in patients with latanoprost, travoprost and bimatoprost was 31.0%, 31.1% and 31.9%, respectively. In comparison of these three groups, the circadian variations of intraocular pressure did not differ significantly (F = 0.286, P = 0.752).
This study demonstrated that latanoprost, travoprost and bimatoprost are all effective in reducing IOP over the 24-hour curve in primary open-angle glaucoma. On the basis of our data, there was no statistically significant difference in the IOP reduction between these three drugs.
[Zhonghua yan ke za zhi] Chinese journal of ophthalmology 02/2011; 47(2):109-13.
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ABSTRACT: Posterior capsular opacification (PCO) is a common long-term complication of modern cataract surgery. Remnant lens epithelial cells (LECs) undergo a myofibroblast transdifferentiation that is thought to be the initial step of PCO pathogenesis. The purpose of this study is to determine the effects of zebularine on transforming growth factor-β (TGFβ)-induced, LEC-myofibroblast transdifferentiation.
The expression levels of methyl CpG binding protein 2 (MeCP2) and α-smooth muscle actin (α-SMA) in human PCO membranes were evaluated by confocal microscopy. The role that MeCP2 played in TGFβ2-induced α-SMA expression was analyzed by western blotting both before and after MeCP2 knockdown with MeCP2-specific siRNA. The effect of zebularine on MeCP2 expression was analyzed over time using a variety of dosages. The effect of zebularine on TGFβ2-induced α-SMA expression was determined by western blot analysis.
MeCP2 and α-SMA co-localized in human PCO membranes. When MeCP2 was depleted, TGFβ2 could not induce α-SMA expression. Zebularine decreased MeCP2 expression in lens epithelial cells in a time- and dose-dependent pattern and reversed TGFβ2-induced α-SMA expression.
MeCP2 plays an important role in TGFβ2-induced α-SMA expression in lens epithelial cells. Zebularine could reverse the TGFβ2-induced α-SMA expression by inhibiting MeCP2 expression. Therefore, zebularine could potentially prevent PCO formation.
Molecular vision 01/2011; 17:2717-23. · 2.20 Impact Factor
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ABSTRACT: To investigate the differential expression of immediate-early genes c-jun and c-fos in primary visual cortex of rat early after acute optic nerve injury and the relationship between immediate-early gene expression and injury degree of optic nerve.
This was an factorial design of two factors. 55 male Sprague-Dawley rats were divided into groups randomized. Unilateral optic nerve crush injury or transection was performed in rats to obtain acute partial or complete monocular optic nerve injury models. Frozen sections through visual cortex were cut in normal rats and model rats respectively at 2 h, 1 d, 3 d, 1 week and 1 month after operation. Expression of c-Jun and c-Fos was detected in primary visual cortex by means of immunohistochemistry. Statistical comparisons were made using variance analysis of factorial design.
Statistically significant different of c-Jun expression existed between optc nerve crash injury and transection models (F = 50.344, P = 0.000). Increased expression of c-Jun in primary visual cortex could be observed at 2 h postoperation, and reached peak value at 1d postoperation. The extent of increased c-Jun expression was much higher in optic nerve transection models than crush injury models. Statistically significant different of c-Fos expression existed between optc nerve crash injury and transection models (F = 62.232, P = 0.000) Decreased expression of c-Fos in primary visual cortex could be observed at 2 h postoperation in optic nerve crush injury models, and reached bottom at 3 d postoperation. The extent of decrease of c-Fos expression was lower in optic nerve transection models than crush injury models and transient increased expression could be observed at 2 h postoperation.
The expression of immediate-early genes c-Jun and c-Fos changed shortly after optic nerve injury. They may act in opposite direction in the primary visual cortex.
[Zhonghua yan ke za zhi] Chinese journal of ophthalmology 09/2010; 46(9):810-4.
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ABSTRACT: Glaucoma is a most common irreversible blinding disease, which is also considered a typical psychosomatic disease. With the promotion of physical, mental and social medical care model, more and more attention has been paid to psychological changes in patients with glaucoma. The mental disturbance in patients with glaucoma is found to be different from ordinary persons in clinic using psychological assessment tools. The mood changes seen in these patients are closely related to the incidence of glaucoma, medication, surgery and quality of life. This review summarizes the research on the relationship between primary glaucoma and its psychological characteristics. A comprehensive and systematic understanding of the roles of the psychological characteristics in the occurrence and development of glaucoma will provide significant guidance in establishing a rational and standard treatment of psychological intervention.
[Zhonghua yan ke za zhi] Chinese journal of ophthalmology 06/2010; 46(6):566-71.
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ABSTRACT: To evaluate the different efficacy and safety to the treatment of bacterial conjunctivitis between the fluoroquinolone antibiotics gatifloxacin and levofloxacin.
A multi-centre, random, double-blind and control trial was performed in six centers including Eye Ear Nose and Throat Hospital of Fudan University, Henan Eye Institute, Eye Hospital Affiliated to Wenzhou Medical College, the First Affiliated Hospital Of Nanjing Medical University, Xijing Hospital Affiliated to the Fourth Military Medical University, the Second Affiliated Hospital of Xi'an Jiaotong University between August 2006 and October 2007. The levofloxacin was set as the efficient control. Two hundred and thirty-five patients (235 eyes) that diagnosed as bacterial conjunctivitis were randomly divided into two groups by the method of randomized blocks, the test group (gatifloxacin) had 118 eyes and the control (levofloxacin) group had 117 eyes. The drug delivery into conjunctival sac was performed at a 7-day period (two drops per time, eight times per day at the first two days and two drops per time, four times per day at the following 5 days). All participants were given the conjunctival sac germ culture and drug sensitive test before and after the study. The combination score of signs and symptoms and evaluation of safety were conducted at the pre-delivery day, the (4 ± 1) and (7 ± 1) delivery day. The statistic analysis was conducted by CMH χ(2) test, Pearson χ(2) test and Fisher's exact probabilities test.
The efficacy of the two groups was 94.0% (110/117 eyes) in gatifloxacin group and 93.8% (106/113 eyes) in levofloxacin group with no significant difference (χ(2) = 0.052, P = 0.8201). There was also no difference in the bacteria clearance between the two groups [gatifloxacin versus levofloxacin, 94.1% (80/85 eyes) versus 92.5% (74/80 eyes), P = 0.3470]. The decrease of combination score of signs and symptoms at the (4 ± 1) delivery day was 4.436 ± 2.310 in the gatifloxacin group and 3.814 ± 1.962 in the levofloxacin group, the difference of which was significant (F = 7.280, P = 0.0075). This trend was also proved at the (7 ± 1) delivery day (gatifloxacin versus levofloxacin, 7.487 ± 2.821 versus 6.912 ± 2.911, F = 4.060, P = 0.0452). The visual acuity and the tolerance after local application of the eye drops between the two groups had no difference (the visual acuity F = 1.04, P = 0.3080; the tolerance after local admission χ(2) = 0.1372, P = 0.7111). According to the result of the germ culture, the major pathogenic bacteria were Gram-positive bacteria (totally 20 kinds of Gram-positive bacteria and 8 kinds of Gram-negative bacteria). The MIC and drug resistance of gatifloxacin to the Gram-positive bacteria was lower than that of the levofloxacin (Staphylococcus Epidermidis, Staphylococcus Aureus, coagulase negative Staphylococcus, α-hemolytic Streptococcus).
The gatifloxacin eye drop has a good therapeutic effect to the bacterial conjunctivitis. It can effectively clear the pathogen with fast and strong effect. Moreover, it has a low MIC in vitro, advance a prospect in drug resistance, safety and ocular tolerance.
[Zhonghua yan ke za zhi] Chinese journal of ophthalmology 06/2010; 46(6):525-31.
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ABSTRACT: Travoprost has been widely used for the treatment of patients with open-angle glaucoma (OAG) or ocular hypertension (OH). The aim of this study was to evaluate the intraocular pressure (IOP) lowering efficacy of travoprost 0.004% monotherapy in patients previously treated with other topical hypotensive medications, and in previously untreated patients.
This open-label, 12-week study in 1651 adult patients with ocular hypertension or open-angle glaucoma who were untreated or required a change in therapy (due to either inadequate efficacy or safety issues) as judged by the investigator was conducted at 6 sites in China. Previously treated patients were instructed to discontinue their prior medications at the first visit. All the patients were dosed with travoprost 0.004% once-daily at 8 p.m. in both eyes for 12 weeks. Efficacy and safety evaluations were conducted at week 4 and 12. IOP measurements were performed at the same time of day at the follow-up visits.
For patients transitioned to travoprost, mean IOP reductions from baseline in untreated and treated patients with different prior medications at week 12 were: latanoprost, (4.3 +/- 4.6) mmHg; beta-blocker, (6.3 +/- 4.0) mmHg; alpha-agonist, (7.5 +/- 4.3) mmHg; topical carbonic anhydrase inhibitors, (8.0 +/- 4.9) mmHg. All mean IOP changes from baseline were statistically significant (P < 0.001). No treatment-related serious adverse events were reported in this study.
In patients treated with other hypotensive medications or untreated, the IOP reduction with travoprost was significant. The results of this study demonstrated the potential benefit of using travoprost as a replacement therapy in order to ensure adequate IOP control. Travoprost administered once daily was safe and well tolerated in patients with glaucoma or ocular hypertension.
Chinese medical journal 06/2010; 123(11):1417-21. · 0.86 Impact Factor
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ABSTRACT: Optical coherence tomography (OCT) is being employed more and more often to facilitate the diagnosis and management of the anterior eye segment diseases. The cross-sectional imaging capability of its higher resolution allows OCT to measure and visualize clear anatomic structures, specifically in anterior chamber biometry, corneal pachymetric mapping, and anterior chamber angle. Fourier-domain OCT technique which achieves higher speed and higher resolution and time-domain OCT technique have driven their further application in ophthalmological practice. In this review, we describe the principles and characteristics of OCT, summarize the recent utility and the limitations of anterior segment OCT in the pathologies and surgical planning of anterior chamber, cornea and surrounding areas, and prospect its future development.
[Zhonghua yan ke za zhi] Chinese journal of ophthalmology 05/2010; 46(5):476-80.
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ABSTRACT: To evaluate goblet cell density (GCD) on conjunctiva and cornea in patients with ocular chemical burns by in vivo laser scanning confocal microscopy (LSCM) and impression cytology (IC) and to explore the correlation between two methods.
Fifty-four patients (58 eyes) with chemical burn were enrolled in the study. LSCM was applied to identify the goblet cells on conjunctiva and cornea under in vivo conditions, and GCD was analyzed with the customized software. Impression cytology was then performed, and the biopsy specimens were stained to visualize goblet cells in vitro and to measure the density. Statistical software was used to analyze the correlation between GCD taken by two methods.
Conjunctival goblet cells could be discriminated in 55 eyes and 57 eyes by in vivo LSCM and IC. They could be identified on the cornea in nine eyes and eight eyes by two methods. The positive rate of two methods had no significant difference. GCDs on conjunctiva measured by in vivo LSCM and IC were 136 +/- 79 cells/mm(2) and 121 +/- 66 cells/mm(2). Median GCDs on cornea detected by two methods were 30 cells/mm(2) and 23 cells/mm(2), respectively. A significant positive correlation was found between the GCDs on conjunctiva measured by these two methods as well as the GCDs on cornea.
GCD decreased in patients with chemical burns. A positive correlation was found between GCD measured by in vivo LSCM and IC after chemical burns. In vivo LSCM was a promising device to study goblet cells in vivo under pathologic conditions.
Investigative ophthalmology & visual science 03/2010; 51(3):1397-400. · 3.43 Impact Factor
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ABSTRACT: To analyze the morphology on the ocular surface of severe alkali burns patients by in vivo laser scanning confocal microscopy.
This research was a retrospective observation case series. From February to November 2008 in Eye Ear Nose and Throat Hospital of Fudan University, 39 alkali burns patients who classified as III or IV according to Roper-Hall classification were enrolled in this study. They were divided into four groups according to the course of disease: A (less than 3 months), B (3 - 6 months), C (6 - 12 months) and D (over 12 months). In vivo laser scanning confocal microscopic examinations were performed on the injured cornea, the limbus and the bulbar conjunctiva and the images were recorded. The morphology of the injured cornea, the limbus and the bulbar conjunctiva was analyzed and the densities of the inflammatory cells and dendritic cells in the limbus were calculated. One-way analysis of variance was used to compare the means of the inflammatory cells and dendritic cells. Subsequently the data between two groups were analyzed by least significant difference.
The corneal epitheliums of the patients in Group A manifested large irregular features with hyperreflective cytoplasm and hyporeflective nuclei, sometimes losing cell features. There were numerous small hyperreflective inflammatory cells in groups beneath the superficial epitheliums. Shallow corneal stroma was edema, and it was hard to discriminate the morphology of the stromal cells. Deep stromal cells were in the activated state. The images of the endothelial layer were unclear. In Group B and Group C, there were the same manifestation of the superficial epitheliums as the group A and it disappeared in Group D. The inflammatory cells beneath the superficial epitheliums reduced and some residual basal epitheliums and hyperreflective conjunctiva-like epitheliums were visible in Group B and Group C. In Group D, there were small oval tight-arranged cells with punctiform hyperreflective nuclei instead of normal corneal basal epitheliums. In Group B, it was still hard to discriminate the morphology of the shallow stroma cells. Deep stromal cells were still in the activated state. In Group C and Group D, corneal stroma was replaced by the fibrous tissues. The images of the endothelial layer were still unclear in the other groups. The Vogt palisades in the limbus of the severe alkali burns patients were destroyed in all groups. There were rich vascular nets in the limbus. The densities of the limbal inflammatory cells in four groups were (4023 +/- 343), (2975 +/- 246), (2652 +/- 375), (2679 +/- 299) cells/mm(2), respectively. Significant difference in inflammatory cell density was found among groups (F = 40.001, P = 0.000). The densities of the limbal dendritic cells in four groups were (106 +/- 19), (132 +/- 35), (141 +/- 26), (98 +/- 24) cells/mm(2), respectively. Significant difference in dendritic cell density was found among groups (F = 8.053, P = 0.000). When the injured area of the conjunctiva was limited, it was hard to discriminate the morphology of the conjunctival epitheliums in both Group A and Group B. Numerous inflammatory cells infiltrated in the conjunctival lamina propria and goblet cells were invisible. In Group C and Group D, the conjunctival epitheliums were almost normal. There were still some inflammatory cells and dendritic cells in the conjunctival lamina propria, and there were residual goblet cells visible in parts of the patients. When the injured area of the conjunctiva was large, the conjunctivas in four groups displayed hyperreflective stripe fibrous tissues instead of normal conjunctival epitheliums.
The application of laser scanning confocal microscopy indicates that there is much difference on the cellular morphology of the ocular surface of severe alkali burns patients among diverse courses of the disease. The technique is a useful tool to the observation on the ocular surface of severe alkali burns patients.
[Zhonghua yan ke za zhi] Chinese journal of ophthalmology 01/2010; 46(1):18-24.
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ABSTRACT: To study the changes of CD4(+)CD25(+) and CD8(+)CD103(+) regulatory T cells and their relevant cytokines in corneal allograft transplantation in mice.
BABL/c (H-2(d)) mice received corneal allografts from C3H/He (H-2(k)) mice were served as the experimental group. BABL/c (H-2(d)) mice received corneal from BABL/c (H-2(d)) mice were used as the control group. Corneal graft survival time was recorded pre-, 3rd day, 7th day, 4th week, 8th week post-operatively. Infiltration of inflammatory cells and corneal neovascularization were evaluated by histopathologic examination. The percentage of CD4(+)CD25(+) and CD8(+)CD103(+) T cell in peripheral blood and spleen was determined by flow cytometry. The expression of interleukin-10 (IL-10), IL-4, gamma-interferon (IFN-gamma) and IL-1beta in serum and aqueous humor was measured by enzyme-linked immunospecific assay (ELISA).
The graft rejection in experimental group occurred at 7 days to 4 weeks after the operation, averaged (14.79 +/- 1.02) days. The grafts in the control group remained clear within 8 weeks observation and the survival time is much longer than that of the allografts (chi(2) = 46.934, P = 0.000). Flow cytometry showed that the percentage of CD4(+)CD25(+) T cell in peripheral blood in the control group after surgery was (3.36 +/- 0.29)%, (4.09 +/- 0.44)%, (5.44 +/- 0.35)%, (5.73 +/- 0.53)% at day 3, day 7, 4th week, and 8th week, respectively, which was significantly higher than that in the experimental group [(2.50 +/- 0.39)%, (3.24 +/- 0.25)%, (4.20 +/- 0.45)%, (4.18 +/- 0.14)%; t = 3.828, 2.898, 3.780, 4.892; P < 0.05]. On the other hand, CD8(+)CD103(+) T cell in peripheral blood in the experimental group after surgery was (2.20 +/- 0.33)%, (2.79 +/- 0.57)%, (4.55 +/- 1.03)%, (4.31 +/- 0.07)% at different periods, which was much higher than that in the control group (t = 7.133, 4.876, 5.196, 19.960; P < 0.05). The changes of CD4(+)CD25(+) and CD8(+)CD103(+) T cells in the spleen was earlier than those in peripheral blood. ELISA showed the expression of IL-10 and IL-4 in the serum in experimental group after surgery was much lower than that in the control group (t = 3.203, 3.141, 3.012, 2.869 and 2.340, 6.681, 8.839, 8.574; P = 0.011, 0.012, 0.013, 0.019 and 0.053, 0.000, 0.000, 0.000). The serum levels of IFN-gamma and IL-1beta in experimental group were higher than that in the control group (t = 3.508, 3.265, 4.402, 5.539 and 3.630, 5.796, 1.728, 0.660; P = 0.006, 0.011, 0.002, 0.000 and 0.005, 0.000, 0.115, 0.524). Furthermore, the cytokine levels in the aqueous humor behaved similarly with those in the serum.
The down-regulation of CD4(+)CD25(+) Treg, IL-10 and IL-4 and the up-regulation of CD8(+)CD103(+) Treg, IFN-gamma and IL-1beta in mice allograft corneal rejection may play an important role in allograft rejection.
[Zhonghua yan ke za zhi] Chinese journal of ophthalmology 12/2009; 45(12):1118-26.
