The diameters of the optic nerves in 54 patients with high intracranial pressure(ICP)were checked and measured with B type ultrasonic tomography and the relationship between thewidth of optic nerve and the optic papiliedema was studied. The results showed that the average diameter (6. 324-0.53)mm of the optic nerves in patients with high ICP was wider than that(3.61 ~:0.29 )mm in health subjects (P(0.01). The rate of increasing width of optic nerve (87.00%)was higher than that (67.00~)of papilledema (P(0.05). In addition,in 19 patients with ICP between 1.97 and 2.50 kPa, the rate of increasing width of optic nerve (79. 00~)was higher than that (42.00%)of papilledema (P (0. 05). These results indicated that measuring the diameter of optic nerve might be more practical than observing tile presence of papilledema in diagnosing high ICP,especially in early stage. （Chin J Ocul Fundus Dis,1996,12: 86-87）
Objiective To observe the changes of angioarchitecture of the optic disc in cats eyes after radial optic neurotomy (RON). Methods Ten healthy adult cats underwent unilateral RON randomly in 10 eyes as an operative group in this trial, and the fellow eyes (10 eyes) were as the control group. The colophony samples of vascular angioarchitecture of 20 eyes were made 90 days after RON and scanning electron microscope was used for the observation. Results In the control group, the blood supply of optic disc mainly came from the short posterior ciliary artery, pial artery, and retinal ciliary artery; the choroidal capillary vessels around the optic disc didnprime;t take part in the blood supply in the anterior area; retinal central vascular system and complete arterial circle around the optic nerves were not seen. In the operative group, a V-shaped defect of the optic disc, retinal blood vessels and choroidal capillary vessels was found at the surgical incision; no injury of retinal blood vessels and choroidal large vascular layer was seen, and neovascularization at the incision were not found. Conclusions RON may cause the vascular defect of the optic disc and the peripheral local tissues. The depth of the incision doesnprime;t reach the Zinn-Hallers circle. (Chin J Ocul Fundus Dis, 2007, 23: 170-172)
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）
Objective To study the human optic canal and its inner structures, and provide anatomic knowledge of this area for optic nerve decompression and further study in pathologic mechanisms of indirect optic nerve injury. Methods Serial sections of the 18 optic canals of adults were made at orbital, middle and cranial parts. Quantitative measurements of the canal wall thickness, canal transverse area, dural sheath transverse area, optic nerve transverse area, and subarachnoid space transverse area were done by means of IMAGEPRO morphometric analysis system. Subarachnoid space transverse area to canal transverse area ratio (SSTA/CTA) and subarachnoid space transverse area to dural sheath transverse area ratio (SSTA/DSTA) were calculated. Results The middle portion of medial wall is the thinnest part of the canal (0.35plusmn;0.48)mm. The middle part of the optic canal was the narrowest part and the transverse area was (17.54plusmn;2.12)mm2. From cranial end to orbital end, SSTA/CTA, SSTA/DSTA and the subarachnoid space transverse area became smaller and smaller. Conclusion Since the potential space is limited, even a tiny amount of blood or sweling of the nerve may cause optic compression. Due to the potential space gradually decreases from cranial end to orbital end and the narrowest portion of the canal is in the middle part, the middle part and the anterior part of the optic canal are critical in optic narve decompression. (Chin J Ocul Fundus Dis,1999,15:24-26)
β thalassemia is a hereditary hemolytic disease caused by the defect of β globin gene. Transfusion-dependent β thalassemia patients need long-term blood transfusion to survive, and a series of systemic and ocular complications will occur in the disease itself and long-term blood transfusion. Retinal blood vessel density decreases, retinal thickness thinned and elastic pseudoxanthoxanoma syndrome are found in fundus due to long-term anemia and side effects of iron chelating agent. At present, there are few reports about eye changes in thalassemia patients, and the cognition is relatively scarce. Therefore, it is necessary to be vigilant for physicians, deeply explore the cause and symptomatic treatment, combined with individual disease characteristics, to provide a more scientific and accurate plan for clinical treatment.
Infiltrative optic neuropathy (ION) is characterized by the infiltration of tumor cells or inflammatory cells in the optic nerve and its sheath. ION is rare in clinic practice, and ION caused by direct infiltration or metastasis of malignant tumors is easily misdiagnosed as optic perineuritis or optic neuritis, which means delayed proper treatment and makes patients risking possible side effects of steroid therapy. Currently, ophthalmologists are lack of sufficient knowledge about ION, which contributes to the high rate of misdiagnosis and missed diagnosis of ION in clinical practice. The diagnosis and treatment of ION have not yet formed systematic standardized guidelines. Therefore, Neuro-ophthalmology Group of Ophthalmology Branch of Chinese Medical Association organized experts to propose consenus of opinions on definition, diagnosis and treatment of ION, which helps to guide clinical diagnosis and treatment of ION, as well as basic researches about ION.
Objective To investigate the mRNA expression of ciliary neurotrophic factor on the retina during injury and repair of optic nerves in rats. Methods Thirty-five healthy SD rats were randomly divided into 3 groups: 5 in the control group, 15 in the simply transected optic nerve group and 15 in the optic nerve-sciatic nerve anastomosis group. The simply transected and optic nerve-sciatic nerve anastomosed models were set up, and the retinal tissues of all of the rats were taken out after 3, 7 and 14 days, respectively; and the mRNA expression of CNTF in the 3 groups were observed by semiquantitative reversal transcription-polymerase chain reaction method. Results A minimum expression of CNTF mRNA was found in the retinae of the control group, and the increased rates of expression were found in the retinae of the simple transection of optic nerve group with the increase rate of 100%, 594%, and 485% on the 3rd, 7th, and 14th day respectively after the operation, while in optic nerve-sciatic nerve anastomosis group, the increase rates were found to be 258%, 752% and 515% on the 3rd, 7th, and 14th day respectively after the operation. Conclusion Retinal neurons can respond to axonal reaction of retinal ganglion cells by up-regulate endogenous CNTF after the injury of the optic nerves, which may provide a theoretic base for the application of the exogenous CNTF. (Chin J Ocul Fundus Dis，2004，20：355-357)
ObjectiveTo investigate the effect of DJ-1 encoded by Park7 gene on retinal ganglion cells (RGC) and visual function after optic nerve crush injury (ONC) in mice.MethodsThirty-seven and 116 healthy male C57BL/6J mice were randomly divided into group normal, group ONC 2d, group ONC 5d, group ONC 7d and group control, group Park7, group Park7-ONC, group ONC and group green fluorescent protein (GFP)-ONC. Group ONC 2d, group ONC 5d and group ONC 7d were sacrificed on the 2nd, 5th and 7th day after the establishment of ONC model, and the follow-up experiments were carried out. The mice in group Park7 and group Park7-ONC were injected 1 μ recombinant adeno-associated virus (rAAV) with knocking down Park7 gene into vitreous cavity, and 1 μ l rAAV with only GFP was injected into vitreous cavity of mice in group GFP- ONC, and virus transfection was observed 4 weeks after injection. The injury of ONC was perfomed at 23 days after vitreous injection in group ONC, group Park7-ONC and group GFP-ONC, and the samples were taken for follow-up experiment 5 days after modeling. The average density of RGC was observed by immunofluorescence staining, the latencies and amplitudes of a-wave, b-wave and photopic negative response (phNR) and the amplitude of oscillatory potential (OPs)were detected by full-field flash electroretinogram,and the visual acuity of mice was measured by optomotor response (OMR). The relative expression levels of DJ-1, Bax and B lymphoblastoma / leukemia-2 (Bcl-2) protein in the retina of mice in each group were detected by Western blot. One-way ANOVA was used to compare the data between groups, and t-test was used for pairwise comparison between groups.ResultsCompared with the normal group, the relative expression of DJ-1 protein in the retina of the ONC 2 d group and ONC 5 d group increased significantly, and the difference was statistically significant (t=16.610, 5.628, P＜0.01,＜0.05). Four weeks after virus transfection, strong GFP expression was seen in the RGC layer and inner plexiform layer of the retina of mice in the Park7 group. Compared with the control group, the RGC density of the retina in the ONC group decreased significantly, and the difference was statistically significant (t=16.520, P＜0.000); compared with the ONC group, the RGC density of the retina in the Park7-ONC group decreased significantly, and the difference was statistically significant (t=6.074, P＜0.01). With the increase of stimulus light intensity, the dark adaptation a wave and b wave latency of the mice in the control group gradually shortened, and the amplitude gradually increased. The stimulus light intensity was 3 cd·s/m2. There was no statistically significant difference in the dark adaptation a wave and b wave latency and amplitude of the control group, Park7 group, Park7-ONC group, ONC group, and GFP-ONC group (Incubation period: F=0.503, 2.592; P=0.734, 0.068. Amplitude: F=0.439, 1.451; P=0.779, 0.247). Compared with the control group, the Ops and PhNR amplitudes of the ONC group mice were significantly decreased (t=15.07, 12.80; P＜0.000,＜0.001). Compared with the ONC group, the Ops and PhNR amplitudes of the mice in the Park7-ONC group were significantly decreased (t=4.042, 5.062; P＜0.05,＜0.01); there was no statistically significant difference in the PhNR latency of the mice in each group (F=1.327, P=0.287). Compared with the control group, the visual acuity of the mice in the ONC group was significantly decreased, and the difference was statistically significant (t=23.020, P＜0.000); compared with the ONC group, the visual acuity of the mice in the Park7-ONC group was significantly decreased, and the difference was statistically significant (t=3.669, P＜0.05). Compared with the control group, Park7-ONC group and ONC group, the relative expression of DJ-1 protein in the mouse retina was significantly down-regulated, and the difference was statistically significant (t=47.140, 26.920; P＜0.000,＜0.000). There was no significant difference between ONC group and GFP-ONC group (t=0.739, P=0.983). Compared with the ONC group, the relative expression of Bax protein in the mouse retina of the Park7-ONC group was significantly increased, and the relative expression of Bcl-2 protein was significantly reduced. The differences were statistically significant (t=5.960, 9.710; P＜0.05,＜0.05); the relative expression ratio of Bcl-2/Bax in the Park7-ONC group was significantly lower than that in the ONC group, and the difference was statistically significant (t=13.620, P＜0.01).ConclusionThe expression of DJ-1 encoded by Park7 gene is down-regulated after Park7 gene was knocked down, which aggravates the RGC damage and the decrease of retinal electrophysiological response and visual function in ONC injury mice.
Objective To study prospectively the morphological relations among hemorrhage of optic disc, defect of retinal nerve fiber layer, and peripapillary atrophy in normal-tension glaucoma (NTG). Methods Qualitative and quantitative methods were applied to evaluate the relations among hemorrhage of optic disc, defect of retinal nerve fiber layer, and peripapillary atrophy by using stereo ocular fundus photography and computer analyzer systems. Results In 37 patients (42 eyes) in NTG hemorrhage group, 50 hemorrhagic spots at optic disc was found, including coloboma of retinal nerve fiber layer in 35 eyes (83.3%)(35/42). In 35 patients (40 eyes) in non-hemorrahge group, partial coloboma of retinal nerve fiber layer was found in 21 eyes (52.5%)(21/40). The difference of incidence of coloboma of retinal nerve fiber layer between the two groups was not significant (chi;2=1.403, P=0.236). The incidence of atrophic arc in hemorrhage group differed much from which in non-hemorrhage group (chi;2=7.008, P=0.008). The area of atrophic arc at beta;section in hemorrhage group ［(2.05plusmn;0.88)mm2］ was significantly different from which in non-hemorrhage group［(1.42plusmn;0.53)mm2］(t=-2.618, P=0.012). In the follow-up period, the difference of incidence of disc-rim loss between hemorrhage and non-hemorrhage group was significant, (chi;2=5.802, P=0.016); while the difference of the incidence of visual field defect between the two groups was not. Conclusion In eyes with NTG, hemorrhage of optic disc, coloboma of retinal nerve fiber layer and atrophic arc are closely related. More disc-rim loss and changes of atrophic-arc area in hemorrhage group in the follow-up period suggests that hemorrhage of optic disc is the risk factor of development of NTG. (Chin J Ocul Fundus Dis, 2006, 22: 232-235)
Objective To observe the difference between blood brain barrier and blood optic nerve barrier. Methods Twenty normal male SD rat sprime; optic nerve including prelaminar region, lamina cribrosa, retro-laminar region, intraorbital portion, intracanalicular portion, and intracranial portion respectively,and cerebral cortex were removed separately. Ultrastructure of endothelial cells was observed by electron microscopy. Immunohistochemical staining was used to detect the expression of transferrin receptor (OX-26) and metalloproteinase inducer (OX-47) and extravasation of fibrinogen around microvessels. Results The results of electron microscopy showed that endothelial cells of microvessels in each portion of optic nerves and cerebral cortex did share the same tight junctions. However, the number of plasmalemmal vesicles in prelaminar region was significantly more than that in cerebral cortex(P＜0.05);there was no significant difference between other parts of optic nerves (lamina cribrosa, retro- laminar region, intraorbital portion, intracanalicular portion, and intracranial portion)and cerebral cortex in the number of the plasmalemmal vesicles(Pgt;0.05). By immunohistochemical staining，the endothelial cells of microvessels in the prelaminar region showed no expression of the OX-26 and OX-47,but extravasation of fibrinogen around microvessels was found; b positive expression of OX-26 and OX-47 was observed in the endothelial cells of the microvessels in other parts of optic nerves (lamina cribrosa, retro-laminar region, intraorbital portion, intracanalicular portion, and intracranial portion) andcerebral cortex, and no fibrinogen was seen aro und the microvessels. Conclusions There is a significant difference between the endothelial cells of the microvessels in prelaminar region and cerebral cortex in the ultrastructure, markers expression, and permeability, so the microvessel s in prelaminar region lacks the typical blood brain barrier characteristics.The microvessels in other parts of optic nerves (lamina cribrosa, retro-laminar region, intraorbital portion, intracanalicular portion, and intracranial portion) have blood brain barrier properties due to its similar specialties as which in cerebral cortex. (Chin J Ocul Fundus Dis, 2006, 22: 390-393)