Objective To establish and evaluate a rat model of nonarteritic anterior ischemic optic neuropathy (NAION). Methods The rats were randomly divided into control group (n=13), sham laser group (n=11) and NAION group (n=23). The right eye was set as the experimental eye. NAION model was induced by directly illuminating the optic nerve (ON) of the right eye with 532 nm green laser, after intravenous infusion with the photosensitizing agent Rose Bengal. Sham laser treatment consisted of illuminating the ON region with 532 nm laser without Rose Bengal injection. Rats in control group underwent no intervention. The appearance of optic disc was observed with funduscope at 12 hours, 1, 3, 7, 28 days post-illumination. The histologic changes in the retina and ON of the NAION model were evaluated qualitatively with hematoxylin and eosin (HE) staining and transmission electron microscopy. The retrograde-labeled retinal ganglion cells (RGC) were counted on photographs taken from retinal flat mounts in a masked fashion. Results The optic disc in NAION eyes were swollen 3 days after photodynamic treatment. HE-stained longitudinal ON sections of NAION revealed vacuolar degeneration on day 3 after induction. Besides, ultrastructural study showed axonal edema and collapsed sheaths in the ischemic optic nerve at the same time point after modeling. ON edema resolved 7 days after induction. The final results revealed optic disc atrophy, extensive axonal loss, severe glial scar, and RGC death in large numbers 4 weeks after modeling. There were no aforementioned manifestations in control and sham laser group. The RGC density of the right eyes was statistically significantly lower in NAION group than that in control group and in sham laser group (t=?14.142, ?14.088; P=0.000, 0.000). The survival rate of RGC was statistically significantly lower in NAION group than in control group and in sham laser group (t=?17.048, ?16.667; P=0.000, 0.000). There was no difference of RGC density and survival rate of RGC between control and sham laser group (t=0.050, 0.348; P=0.961, 0.731). Conclusion A rat model of NAION was established successfully by photodynamic treatments with Rose Bengal, which induce optic nerve damage and RGC death.
Noninfectious uveitic macular edema (NIU-ME) is a major cause of visual impairment in patients with uveitis. Intravitreal route can control inflammation rapidly, reduce macular edema, and improve vision with relatively lower doses of the drug. Currently, several intravitreal injection drugs have been used for the treatment of NIU-ME. Cataract and elevated intraocular pressure are the major complications. Due to its efficacy and safety, intravitreal drugs have gradually become an effective alternative to systemic treatment, especially in patients with unilateral disease. However, more studies are needed on drug selection, timing of injection and combination therapy in clinical practice. There are various treatments for NIU-ME, and the ultimate treatment should be individualized based on the severity of the disease, the risk/benefit ratio of each therapy, and the patient's tolerance.
ObjectiveTo observe the clinical characteristics of children with leukemia combined with ocular fundus lesions, and analyze the related risk factors. MethodsA retrospective clinical study. A total of 126 children with leukemia who were diagnosed and underwent fundus examination in Hunan Children's Hospital, from February 2022 to June 2025 were included. Posterior pole fundus images of both eyes were obtained using a handheld non-mydriatic fundus camera. Optical coherence tomography and fluorescein fundus angiography were performed when necessary. Outcomes were analyzed on a per-patient basis. Fundus involvement was defined as the presence of abnormalities in either eye, and the main lesion type was classified according to the more severe eye. According to the presence or absence of fundus lesions, the patients were divided into the lesion group (38 cases, 30.15%, 38/126) and non-lesion group (88 cases, 69.85%, 88/126). Differences in age, sex distribution, hematological parameters, and leukemia subtype were compared between the two groups. Binary logistic regression was used to identify independent risk factors. ResultsAmong the 126 children, 66 were male and 60 were female. The mean age was (7.62±3.13) years. Seventy-eight patients had acute lymphoblastic leukemia, and 48 patients had acute myeloid leukemia , including 11 patients with acute promyelocytic leukemia (APL). Compared with the non-lesion group, the lesion group had a significantly higher peripheral blood white blood cell count (WBC) level and significantly lower hemoglobin and platelet levels, with statistically significant differences (t=8.210, ?6.940, ?11.040; P＜0.05). Among the 38 patients with fundus lesions, retinal hemorrhage was observed in 28 cases (73.68%, 28/38), optic disc edema in 6 cases (15.79%, 6/38), cotton-wool spots in 3 cases (7.89%, 3/38), and choroidal lesions in 1 case (2.63%, 1/38). Multivariate logistic regression analysis showed that WBC count, per 10×109/L increase [odds ratio (OR)=2.13, 95% confidence interval (CI) 1.35-3.41, P=0.002], early-stage chemotherapy (OR=1.96, 95%CI 1.12-3.15, P=0.010), and APL subtype (OR=2.74, 95%CI 1.28-5.89, P=0.008) were independent risk factors for fundus lesions. ConclusionsFundus lesions are relatively common in children with leukemia and are predominantly characterized by hemorrhagic changes. Elevated WBC count, per 10×109/L increase, early-stage chemotherapy, and APL subtype indicate a high risk of fundus involvement.