Objective To isolate and purify the melanoma stem cells (MSC) in choroidal melanoma OCM-1 cells. Methods OCM-1 cells were resuscitated, and after cultured in standard Dubecco's modifided Eagle's medium (DMEM)/F12, they were cultured in serum-free medium (SFM). The cultured MSC were isolated and purified, and the positive rate of CD133, the specific markers of neurostem cells, was observed by flow cytometry (FCM). The 6th generation of the cells were stained by musashi-1 immunocytochemistry, and the rate of the positive cells was observed under the microscope. Results After the Adherent OCM-1 cells cultured in SFM, the number of the adherent number decreased obviously. The cells at the 6th generation grew as the suspended gobbets, which represented the typical grow manner of the stem cells. Positive CD133 could be found in the cells of different generations, which was 2.5％, 21.7％, and 57.8％ in the non-isolated OCM-1 cells, the 1st generation of isolated cells, and the 2nd generation cells, respectively. The positive rate of CD133 in the cells at the sixth generation was 79.8% with b positive expression of musashi-1. Conclusion MSC is in the human choroidal melanoma OCM-1 cells. The suspended stem cells may be purified by limited differentiation and serial passage in SFM. (Chin J Ocul Fundus Dis, 2007, 23: 87-90)
Objective To observe the inhibitory effects of construction of complement factor (CFB)small interference RNA (siRNA) on choroidal neovascularization（CNV）induced by photocoagulation in rats.Methods We constructed an expression vector of CFBsiRNA by cutting CFBsiRNA and plasmid pRNATU61/Neo. Experimental CNV was induced by photocoagulation in 42 Brown Norway rats. After the model was set up, the rats were randomly divided into tail intravenous injection, vitreous injection, subretinal injection, and control group; each group except the control one had a corresponding blank plasmid control group. CFBsiRNA was injected 1, 3, and 5 days respectively after photocoagulation in the injection groups; the dosage was 50, 20, and 10 mu;g in tail intravenous injection, vitreous injection, and subretinal injection group respectively, while no injection was give to the control group after photocoagulation. Before and 14 days after photocoagulation, fundus fluorescein angiograoph (FFA) was performed and CNV development was judged by the leakage; the expression of vascular endothelial growth factor (VEGF) and factor Ⅷ were detected by immunohistochemistry. Results The leakage of fluorescein was obvious lower in tail intravenous injection group than that in the control group (chi;2=15.1620,Plt;0.05). The expression of VEGF and factor VIII in tail intravenous injection group at different time points after photocoagulation didnprime;tdiffer much (F=20.35,18.33; Pgt;0.05); while was apparently lower than that in the other groups at different time points (F=77.96,55.68; Plt;0.05).All of the groups, except tail intravenous injection group, had higher expression of VEGF and factor VIII 14 days after photocoagulation compared with that 7 days after photocoagulation (F=60.89, 61.12; Plt;0.05).Conclusions Constructed CFBsiRNA can inhibite CNV by downregulating the expression of VEGF and factor Ⅷ.
OBJECUIVE: To observe the therapeutic efficacy of gamma;-knife/lymphokine activated killing cells (LAK)in chorold malignant melanoma (CMM). METHODS:Five cases of CMM had keen treated by retrobulbar injection of LAK cells and gamma;-knife irradiation at multiple sites.Ophthalmologic,imageologic, fundus fluorescein angiographic and T lymphocyte subset examinations were done before and after treatment. Tile follow-up period of this series of cases was 6-24 months. RESUILS:Thc CMM of 4 in 5 treated cases became atrophic and withered up clinically after gamma;-kinfe/LAK therapy. Among the 4 cases,2 of them had been followed up for more than 2 years,and the other 2 for 20 and 14 months respectively. The tumor of the 5th patient wko was followed up for 6 months after treatment,reduced to 3/5 of the original size,and no blood flow was found within thee tumor mass under the clinical examination. CONCLUSION :The gamma;-knife/LAK therapy was effective in treating CMM in saving the affected eye from being enucleated. Chin J Ocul Fundus Dis,1997,13: 96- 98）
Purpose To evaluate the safety and efficacy of draining subretinal fluid with transchoroidal probing by using the traditional needling and diode endolaser probing. Methods The investigation included 70 consecutive patients(74 eyes) with rhegmatogenous retinal detachment undergoing scleral buckling surgery.Seventy cases were randomly divided into 2 groups,group A 34 cases(36 eyes)with the needle drainage procedure and group B 36 cases(38 eyes) with the diode probe respectively.The safety and efficacy were compared in between the 2 groups. Results No operative failure was found in these 2 groups.In group A,subretinal hemorrhage occurred in 3 eyes,and retinal incarceration,retinal preforation in one eye. No significant complication occurred in group B. Conclusion Diode laser drainage has the advantage in that it may reduce the incidence of operative complication with drainage.This technique might be used in any case requiring drainage of subretinal fluid especially of rhegmat ogenous retinal detachment in cases of shallow retinal detachment. (Chin J Ocul Fundus Dis,1998,14:202-203)
Objective To summarize the therapeutic effect and clinical characteristics of repetitive photodynamic therapy (PDT) for patients with exudative age-related macular degeneration (AMD). Methods The clinical data from 78 patients (94 eyes) with exudative AMD who had undergone PDT from July, 2002 to March, 2005 were retrospectively analyzed. The average age of the patients was 68.4, and the treated times was 132 (mean 1.4). Thirty eyes underwent PDT 68 times, including twice in 22 eyes (73.3%), 3 times in 7 eyes (23.3%), and 6 times in 1 eye (3.3%). The follow-up period lasted 3-32 months with the average of 16.7 months. Results In the final follow-up examination, the results of fundus fluorescein angiography or combined with indocyanine green angiography showed that the leakage of choroidal neovascularization (CNV) stopped in 14 eyes (46.7%), reduced in 12 (40%), and remained in 4 (13.3%). Compared with the condition before first PDT, the correct visual acuity increased ge;2 lines in 7 eyes (23.3%), changed plusmn;1 line in 14 eyes (43.3%), and decreased ge;2 lines in 9 eyes (30%) in the final examination. After first PDT, the best corrected visual acuity increased ge;2 lines in 13 eyes (43.3%), changed plusmn;1 line in 12 eyes (40%), and decreased ge;2 lines in 5 eyes (16.7%). During the follow-up period, the best corrected visual acuity occurred after first PDT in 24 eyes (80%), after second PDT in 5 eyes (16.7%), and after third PDT in 1 eye (3.3%). Conclusions In patients undergone repetitive PDT, CNV in most of the affected eyes completely or partly closed and the visual acuity improved or remained still in 67.8% of the patients in the final follow-up examination. The best correct visual acuity mainly happened after the first PDT, and as the times of PDT increased, the probability of the best correct visual acuity decreased. (Chin J Ocul Fundus Dis, 2006, 22: 220-223)
ObjectiveTo observe the efficacy and safety of combined photodynamic therapy (PDT) with intravitreal ranibizumab injection in patients with polypoidal choroidal vasculopathy (PCV). MethodsTwenty-four PCV patients (24 eyes) were enrolled in this retrospective case study.All patients were assessed by the examinations of Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity chart, color fundus photography, fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA) and optic coherence tomography (OCT). The mean visual acuity was (33.41±19.43) letters; the mean macular retinal thickness was (343.63±88.60) μm. Patients received PDT first, and intravitreal injected ranibizumab 0.5 mg (0.05 ml) 72 hours later. Treatments were repeated as a single intravitreal injection of ranibizumab combined with or without PDT if the monthly follow-up indicated that it was necessary. The average follow-up period was 13.1 months. The average treatment times were analyzed for each eye. Systemic and ocular adverse events were observed. Visual acuity, macular retinal thickness and leakage of PCV before and after the treatment were analyzed. ResultsIntravitreal ranibizumab injections was repeated (2.8±1.6) times per eye on average, and intravitreal injection of ranibizumab combined with PDT was repeated (0.4±0.5) times per eye on average. No systemic and ocular adverse effects were found during and after combined therapy. In the last follow-up, the mean visual acuity of ETDRS was (44.21±17.24) letters, improved by 10.8 letters (t=-4.77, P<0.01).Visual acuity was improved in 11 eyes (45.8%) and stable in 13 eyes (54.2%). FFA and ICGA showed complete closed PCV in 17 eyes (70.8%), partial closed PCV in 7 eyes (29.2%). OCT image showed that the retinal edema was disappeared in 19 eyes (79.2%) and alleviated in 5 eyes (20.8%). The mean macular retinal thickness was (171.33±38.06) μm, which was 172.30 μm less than that of pre-treatment values (t=11.96, P<0.05). ConclusionPhotodynamic therapy combined with intravitreal ranibizumab injections for PCV is safe and effective, with visual acuity improvement, reduction of retinal edema and PCV leakage.
ObjectiveTo observe the macular choroidal and retinal pigment epithelium (RPE) thickness in tilted disc syndrome (TDS). MethodsThis is a descriptive study. Thirty eyes of 22 TDS patients (TDS group) and 30 eyes of 15 normal subjects (control group) were analyzed. Among TDS group, there were 8 males (11 eyes) and 14 females (19 eyes), the average age was (9.00±2.78) years old. The best corrected visual acuity (BCVA) was 0.3-1.0, and the average spherical equivalent degree was (-3.44±2.22) DS. Among the control group, there were 8 males (16 eyes) and 7 females (14 eyes), the average age was (9.33±1.11) years old. The best corrected visual acuity (BCVA)≥1.0, and the average spherical equivalent degree was (-3.18±1.13)DS. The difference of the spherical equivalent degree between two groups was not statistically significant (t=-1.648, P=0.110). Enhanced depth imaging techniques of frequency-domain optical coherence tomography was used to measure the thickness of choroid and RPE at totally 17 sites. There sites included subfoveal, 4 sites each (500, 1000, 1500 and 2000 μm from the fovea) at the horizontal (nasal/temple) and vertical (superior/inferior) directions. ResultsThe subfoveal choroidal thickness was (235.53±51.77) μm and (273.45±60.3) μm in TDS patients and control respectively, the difference was significant(t=-2.612,P=0.011). The difference of the choroidal thickness of the other 8 horizontal sites (F=24.180) and 8 vertical sites (F=23.390) in TDS group was statistically significant (P=0.000). The TDS choroidal thickness of all horizontal sites except nasal 1000 μm site was thinner than corresponding sites of the control group (P<0.05). The TDS choroidal thickness of the subfoveal site and 4 inferior vertical sites was thinner than corresponding sites of the control group (P<0.05). The subfoveal RPE thickness was (32.56±5.00) μm and (36.58±3.60) μm in TDS patients and control respectively, the difference was significant(t=-3.567,P=0.001). The subfoveal RPE thickness was the thickest among other 16 sites in both groups, and the TDS RPE thickness of all sites was thinner than control group, the difference was statistically significant (P<0.05). ConclusionThe choroidal and RPE thickness of TDS patient was thinner than normal subjects.
With the rapid development of ophthalmic imaging methods, there are many ways of examination in the diagnosis and treatment of fundus diseases, such as FFA, ICGA, FAF, OCT and emerging blood vessels by OCT angiography in recent years. Multi-model image can understand the changes of anatomical structure and function of different levels and parts of the fundus from different aspects. A variety of imaging examinations are combined and complemented each other, which makes us have a further understanding of the location and pathological changes of many fundus diseases. But at the same time, the emergence of multi-modal images also brings a series of problems. How to standardize the use of multi-modal imaging platform to better serve the clinic is a problem that ophthalmologists need to understand.
ObjectiveTo assess the occurrence of CNV in patients presenting with flat irregular pigment epithelial detachments (FIPED). MethodsForty-five patients (49 eyes) with FIPED on OCT were enrolled in this retrospective study. There were 25 males (28 eyes) and 20 females (21 eyes). The mean age was 61.022±9.292 years. FFA, ICGA, spectral domain OCT and OCT angiography (OCTA) were performed in all patients during the same period. The FIPED was defined as an irregular elevation of the RPE allowing distinct visualization of Bruch’s membrane on OCT B-scan. The abnormal vascular signals from the deep retinal layer to the choroid layer on OCTA was defined as CNV. The CNV was classified into a type 1 CNV and a type 2 CNV according to the OCT characteristics. The CNV was classified into a typical and occult CNV according to the characteristics of the FFA image. Of all 49 eyes, fundus angiography revealed 18 eyes (36.7%) with CNV, and 31 eyes (63.3%) with no characteristic signs of CNV. FFA examination found that CNV in 8 eyes (classic CNV in 1 eyes, occult CNV in 7 eyes), which confirmed by OCT were type 1 CNV; transmitted fluorescence in 41 eyes. ICGA examination showed that CNV-like hyperfluorescence spots in 18 eyes, suspicious hyperfluorescence spots in late stage in 20 eyes, and choroidal high permeability in 11 eyes, respectively; and 18 CNV eyes were confirmed to be type 1 CNV by OCT. To compare the detection of CNV by OCTA and fundus angiography. ResultsOf the 49 eyes with FIPED, OCTA detected 36 eyes (73.5%) of type 1 CNV, and full or partial strong reflex signals were seen in FIPED; 13 eyes (26.5%) were not associated with CNV, and some strong reflection signals were found in FIPED in 9 eyes, 4 eyes with weak reflection signal. The FFA was examined for 1, 7 eyes of the classic and occult CNV, which confirmed to be type 1 CNV by OCTA. Among the 18 eyes with CNV which detected by ICGA, OCTA also found type 1 CNV. Among the 20 eyes with ICGA’s late suspicious strong fluorescent spots, OCTA showed 17 eyes of type 1 CNV; in 11 eyes with high choroidal permeability, OCTA showed type 1 CNV in 1 eye. Among the 36 eyes with CNV which detected by OCT, there were SRD in 32 eyes, no SRD in 2 eyes and retinal interlamellar cavities in 2 eyes. ConclusionOCTA can detect 73.5% of FIPED eyes with CNV. Compared with traditional fundus angiography, OCTA has a higher detection rate of CNV under FIPED. The FIPED of the internal strong reflection signal has a certain diagnostic value for the type 1 CNV.
Objective To evaluate the effect of transpupillary thermo therapy (TTT) on the treatment of intraocular tumors. Methods A total of 50 patients with intraocular tumors, including 37 choroidal hemangioma, 2 retinal capillary hemangioma, 5 choroidal osteoma, 4 choroidal melanoma, and 2 retinoblastoma (RB) underwent TTT and were followed up for 1～20 months. Results In 30 patients with choroidal hemangioma (average follow-up was 5.1 months), 29 (96.7%) had pigment scarring in different levels and the retinal detachemnts were partly or completely recovered; 1 had no obvious improvement. The visual acuity was unchanged in 24 (80.0%) patients, improved in 41 (13.3%) and declined in 2 (6.7%). In 2 patients with retinal capillary hemangioma, no effect was found. In 5 eyes (4 patients) with choroidal osteoma (average follow-up was 6 months), no change of the tumor was found in 1 and the atrophic spots were seen in 4; the visual acuity was unchanged in 3, improved in 1 and declined in 1. In 4 patients with choroidal melanoma (average follow-up was 8 months), the tumor was shrunken in 1, unchanged in 2, and enlarged in 1; the visual acuity was unchanged in 2 and declined in 2. In 2 patients with RB, RB was totally shrunken in 1 and partly shrunken in 1. Visual acuity of one child patient who was followed up for 20 months could not be examined, and was unchanged in another one who was followed up for 3 months. No severe complications were found in the patients during the treatment and the follow-up. Conclusions TTT is effective for the treatment of some intraocular tumors except retinal capillary hemangioma. It is a kind of potential treatment for intraocular tumors with few side-effect. (Chin J Ocul Fundus Dis，2003，19：144-148)