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）
Objective To observe the clinical manifestations and the effect factors of thyroid-associated ophthalmopath (TAO) with optic neuropathy. Methods The clinical data of 62 cases (120 eyes) of TAO with optic neuropathy diagnosed in 1994-2001 were retrospectively analyzed. Results The incidence of TAO with optic neuropathy was 18.3% in all the simultaneous TAO inpatients, and was more frequently found in the male than in the female ones. The incidence of TAO with optic neuropathy was correlated with orbitono-increase, ocular myopathy, hypertension, hyperlipemia, diabetes, and cardiopathy (P＜0.0000), but not with exophthalmos, intraocular pressure, and the disease course of TAO (Pgt;0.05). In 62 patients with the methylprednisolone pulse therapy, the visual acuity improved in 33 (29.0%), improved while the treatment but decreased after stop treating in 29 (24.2%), and no changes in 58 (46.8%). In 63 eyes undergone orbital decompression with methylprednisolone pulse therapy, 59 (93.7%) had better visual acuity. Conclusion The incidence of TAO with optic neuropathy was correlated with orbitono-increase, ocular myopathy, hypertension, hyperlipemia, diabetes, and cardiopathy. Met hylprednisolone pulse therapy and orbital decompression are the effective measures for TAO with optic neuropathy. (Chin J Ocul Fundus Dis，2004，20：142-144)
ObjectiveTo observe the protective effect of human umbilical cord blood stem cells (hUCBSC) transplantation on retinal ganglion cells (RGC) after optic nerve injury. Method48 adult Sprague-Dawley rats were randomly divided into group A and B, therefore 24 rats in each group. Calibrated optic nerve crush injury model was induced in the left eyes, the right eyes served as a control. Medicine was injected at seventh day after optic nerve injury. PBS was injected into the eyes of Group A rats by peribulbar injection. The hUCBSCs were injected into the eyes of Group B rats by peribulbar injection. Seven days before sacrifice, 5% fluorogold was injected into superior colliculi bilaterally. At 7, 14, 21, 28 days after labeled, retinal flat mounts were observed under fluorescence microscope and optical microscope to investigate the morphological and RGC changes in density during retinal degeneration. ResultsThe RGC number showed a tendency to decline gradually along with increases of the time in two groups, but the trend of decrease of Group B was evidently slower than that of Group A. The RGC number of the injury eye were less than the control eye in Group A and B (t=3.24, 3.15; P < 0.05). At 7, 14, 21, 28 days after labeled, the RGC number (t=4.78, 4.70, 3.98, 3.27; P < 0.05) and labeled RGC rate (t=4.39, 4.21, 4.36, 5.07; P < 0.05) in group B were more than those in group A. After optic nerve injury, there was karyopycnosis on ganglion cell layer of retina, thinning on each layer of retina, derangement of cell and decrease in RGC. There was different degree of the above change in different time after optic nerve injury. There were the swelling, the hemorrhage, derangement of spongiocyte and the denaturation like vacuole in the spot of optic nerve injury. Moreover, they were aggravating with increases of the time after optic nerve injury. There was no pathological changes in normal eyes. ConclusionThe hUCBSC can increase the survival rate of the RGC and can rescue and(or) restore the injujed RGC after transplanted into body of optic nerve crush rat model by peribulbar injection.
Objective To observe the characteristics of indocyanine green angiography and fundus fluorescein angiography (ICGA amp; FFA) in anterior ischemic optic neuropathy ( AION ) , and to investigate the etiology of AION and the value of ICGA and FFA in the diagnosis and study of AION. Methods Simultaneous ICGA and FFA were performed on 32 eyes of 31 AION patients and 38 eyes of 38 non-AION patients. Results The eyes that all or a part of the optic disclies in the watershed zon es of the choroidal blood supply were significantly more in the AION group tha n those in the non-AION group (Plt; 0.005 ) . All the watershed zones through the optic disc were vertical in shape. The fluorescence filling of the inferior and superior choroidal blood vessels near the optic disc were all slower than that of the temporal and nasal choroidal blood vessels. The types of watershed zones in the AION group were highly correspondent to the ischemic areas of the optic disc . In early ICGA , no fluorescence appeared at the optic disc, and in later stage, the ischemic area revealed no fluorescence, and the other area showed mostly asymmetric fluorescence. Conclusion The onset of AION is correlative to the choroidal blood supply around the optic disc. ICGA is more valuable in the diagnosis and study of AION than FFA . (Chin J Ocul Fundus Dis, 2001,17:111-114)
Objective To observe the characteristics of changes of 24hour ambulatory blood pressure and heart rate of 50 patients with anterior ischemic optic neuropathy (AION). Methods Fifty patients with AION and the persons without in the control group, which had the same number, gender and age as the patients with AION, underwent 24-hour ambulatory blood pressure and heart rate measurement. Results Both groups had no difference in mean blood pressure and heart rate during the daytime (t=1.25,0.93; P＞0.05), higher than those in the nighttime (t=3.63,3.16; P＜0.05). Mean blood pressure and heart rate of AION group at night were lower than those of the control group (t=3.82,1.77; P＜0.01,0.05), especially diastolic pressure of AION group was lower than that of the control group from 2 am to 7 am (P＜0.01), as well as the heart rate from 2 am to 5 am (P＜0.05 or P＜0.01). The curves of blood pressure of AION group showed more gradual and fluctuant rising, while those of the control group showed sharper and less fluctuant rising. Conclusion According to the curves of blood pressure rising, the patients with AION may have some defects in auto-regulatory mechanism of blood pressure. The low spots of blood pressure and heart rate in early morning, which might be a critical point leading to AION. (Chin J Ocul Fundus Dis, 2002, 18: 259-261)
Objective To observe the ocular manifestations and therapeutic effect of multiple sclerosis (MS) and neuromyelitis optica (NMO) with ocular symptoms.Methods The clinical data of 107 patients who was diagnosed with MS and NMO with ocular symptoms in our hospital were retrospectively analyzed, including 81 MS patients and 26 NMO patients.The counting of erythocytes and leukocyte，protein content and oligoclonal bands were detected by MRI and cerebrospinal fluid (CSF) in order to ensure the clinical diagnosis with MS and NMO. All the patients had undergone regular ophthalmologic examination of visual acuity，slit lamp microscope and fundus examination.In addition，visual field and visual evoked potential (VEP) examination were performed to analyze the clinical characteristics of ocular manifestations.The patients were received therapy with large dose methylprednisolone or activating blood and dissolving stasis and trophic nerve by chinese medicine. The effects of three methods on ocular manifestations were analyzed. All the patients were followed up for one month to five years. Results Among 81 MS patients，retrobulbar neuritis occurred in 24 patients (29.6%), the other common symptoms included paralytic strabismus and diplopia（30.3%）. Among 26 NMO patients，acute papillitis occurred in 12（46.2%），while retrobulbar neuritis occurred in 14 (53.8%). The most common symptom of both MS and NMO was impaired vision and high abnormal rate. The results of MRI showed that demyelinating lesions beside ventricle was the most performance in MS patients，while abnormalities in spinal cord were found in NMO patients.The results of CSF showed that the positive oligoclonal bands was 75.3% and 19.2% in MS and NMO patients respectively. The potential time delay and (or) amplitude declination were observed by VEP. Large dose methylprednisolone can improve vision and diplopia in a short period.Conclusion The abnormal ocular manifestations of MS and NMO patients are common and complicated. Ocular symptoms has important reference value in the early diagnosis of MS and NMO.
ObjectiveTo observe the concentration of plasma endothelin (ET-1) in patients with nonarteritic anterior ischemic optic neuropathy(NAION) and investigate the relationship between ET-1 and NAION.MethodsThe plasma levels of ET-1 in 41 patients with NAION and 15 age-matched normal control subjects were measured by radioimmuoassay (RIA). The patients with NAION were divided into high papilloedema group, light papilloedema group, and recovery group according to the degree of papilloedema; and were divided into group1 (within 14 days), 2 (within 15-30 days), 3 (within 31-60 days), and 4 (within 61-180 days) according to the disease course. The plasma levels of ET-1 in different groups were detected and compared.ResultsThe plasma level of ET-1 in patients with NAION was significantly higher than that in the normal subjects (t=5.02，P＜0.05）and there was no obvious difference in NAION patients with different genders.There were significant differences of the plasma level among the groups with different degree of papilloedema（F=4.65，P＜0.05）. ET-1 plasma level gradually decreased as the disease course increased, and there were significant differences among the groups with different disease course（F=4.29，P＜0.05）. The difference of plasma level of ET-1 between Group 13 with corresponding disease courses and the control group was significant respectively(t1=5.92，t2=3.47，t3=2.18， P1lt;0.01, P2lt;0.05, P3lt;0.05)ConclusionThe plasma level of ET-1 in patients with NAION may be related to the degree of papilloedema lesion and disease courses. (Chin J Ocul Fundus Dis, 2005,21:156-158)
Objective To investigate the major types and clinical manifestations of mitochondrial DNA (mtDNA)mutations in Chinese patients with Leber′s hereditary optic neuropathy(LHON). Methods A total of 119 patients with bilateral optic neuropathy from 117 pedigrees, including 37 with determinate diagnosis of LHON(group A) and 82 with suspected LHON(group B),were tested for mtDNA mutations by using single-strand conformational polymorphism, mutation-specific primer polymerase chain reaction and sequencing. Pertinent clinical data and history of the patients with the 11778 mutation were collected. Results Nucleotide positions(np)11778 mutation and np 14484 mutation was found in 33 (89.2%) and 3 (8.1%) patients respectively in group A, while np 11778 mutation was obtained in 26（31.7%）in group B. No 3460 mutation was found in group A or B. The clinical manifestations of 59 patients with np 11778 mutation were as follows: acute or chronic visual loss，no ophthalmalgia, the age of onset of 10-25, and either a central or paracentral scotoma in perimetry. The visual recovery rate was 8.6%～11.6%. Conclusion Chinese patients with LHON have a very high incidence of np 11778 mutation and the clinical manifestations of the patients with np 11778 mutation are similar to those of Caucasian patients. (Chin J Ocul Fundus Dis，2004，20：78-80)
Objective To analyze the new primary mutation in Chinese people with Leberprime;s hereditary optic neuropathy (LHON). Methods Genomic DNA was collected from 260 suspected LHON patients and 100 normal healthy persons. The mitochondria DNA mutation at nucleotide position (NP) 15257 and the hot spot (14452-14601 bp) of ND6 gene which include the mutations at NP (14482, 14498, 14568, 14596, 14495, and 14459) were screened by using polymerase chain reaction (PCR), heteroduplex-single strand conformation polymorphism (HA-SSCP) and restriction fragment length polymorphism (RFLP) analysis and sequencing. Primary mutation spectrum of Chinese race was analyzed. Results Eight kinds of polymorphism of mitochondria DNA were found in 260 suspected LHON patients and 100 normal healthy persons, including NP 14488C, 14518G, and 14617G which hadnrsquo;t been reported (http://www.mitomap.org/). No mutation at NP 15257, 14482, 14498, 14568, 14596, 14495, and 14459 was found. Conclusion The NP 15257A may not be the primary mutation in Chinese. Because of the race difference, 14452-14601 bp in ND6 gene may not be the hot spot in Chinese patients with LHON, and other hot spots may exist. (Chin J Ocul Fundus Dis, 2006, 22: 82-85)
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)