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Stem Cell Ophthalmology Treatment Study(SCOTS) for retinal and optic nerve diseases: a case report of improvement in relapsing auto-immune optic neuropathy

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Neural Regeneration Research 2015年第6期10卷 1507-1515页

作者： Jeffrey N.Weiss Steven Levy Susan C.Benes Retina Associates of South Florida MD Stem Cells wilmer Eye Institute The Johns Hopkins Hospital

We present the results from a patient with relapsing optic neuropathy treated within the Stem Cell Ophthalmology Treatment Study （SCOTS）. SCOTS is an Institutional Review Board ap- proved clinical trial and has become the largest ophthalmology stem cell study registered at the National Institutes of Health to date （*** Identifier NCT 01920867）. SCOTS utilizes autologous bone marrow-derived stem cells （BMSCs） for treatment of retinal and optic nerve diseases. Pre-treatment and post-treatment comprehensive eye exams of a 54 year old female patient were performed both at the Florida Study Center, USA and at The Eye Center of Columbus, USA. As a consequence of a relapsing optic neuritis, the patient＇s previously normal visual acuity decreased to between 20/350 and 20/400 in the right eye and to 20/70 in the left eye. Significant visual field loss developed bilaterally. The patient underwent a right eye vitrectomy with injection of BMSCs into the optic nerve of the right eyeand retrobulbar, subtenon and in- travitreal injection of BMSCs in the left eye. At 15 months after SCOTS treatment, the patient＇s visual acuity had improved to 20/150 in the right eye and 20/20 in the left eye. Bilateral visual fields improved markedly. Both macular thickness and fast retinal nerve fiber layer thickness were maximally improved at 3 and 6 months after SCOTS treatment. The patient also reduced her mycophenylate dose from 1,500 mg per day to 500 mg per day and required no steroid pulse therapy during the 15-month follow up.

关键词： nerve regeneration stem cells optic nerve autoimmune optic neuropathy ophthalmology bone marrow-derived stem cells blindness visual loss Stem Cell Ophthalmology Treatment Study neural regeneration

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Using choroidal thickness to detect myopic macular degeneration

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International Journal of Ophthalmology(English edition) 2024年第2期17卷 317-323页

作者： Ran Liu Meng Xuan De-Cai Wang Ou Xiao Xin-Xing Guo Jian Zhang Wei Wang Monica Jong Padmaja Sankaridurg Kyoko Ohno-Matsui Qiu-Xia Yin Ming-Guang He Zhi-Xi Li State Key Laboratory of Ophthalmology Zhongshan Ophthalmic CenterSun Yat-sen UniversityGuangdong Provincial Key Laboratory of Ophthalmology and Visual ScienceGuangdong Provincial Clinical Research Center for Ocular DiseasesGuangzhou 510060Guangdong ProvinceChina New England College of Optometry BostonMassachusetts 02115USA wilmer Eye Institute Johns Hopkins UniversityBaltimoreMD 21231USA Brien Holden Vision Institute Sydney 2052Australia School of Optometry and Vision Science University of New South WalesSydney 2052Australia Department of Ophthalmology and Visual Science Tokyo Medical and Dental UniversityTokyo 113-8510Japan School of Optometry the Hong Kong Polytechnic UniversityHong Kong SARChina Research Centre for SHARP Vision the Hong Kong Polytechnic UniversityHong Kong SARChina Center for Eye and Vision Research(CEVR) 17W Hong Kong Science ParkHong Kong SARChina

AIM:To explore the usage of choroidal thickness measured by swept-source optical coherence tomography(SS-OCT)to detect myopic macular degeneration(MMD)in high myopic ***:Participants with bilateral high myopia(≤−6 diopters)were recruited from a subset of the Guangzhou Zhongshan Ophthalmic Center-Brien Holden Vision Institute High Myopia Cohort ***-OCT was performed to determine the choroidal thickness,and myopic maculopathy was graded by the International Meta-Analysis for Pathologic Myopia(META-PM)Classiﬁ*** of MMD was defined as META-PM category 2 or ***:A total of 568 right eyes were included for *** with MMD(n=106,18.7%)were found to have older age,longer axial lengths(AL),higher myopic spherical equivalents(SE),and reduced choroidal thickness in each Early Treatment Diabetic Retinopathy Study(ETDRS)grid sector(P<0.001).The area under the receiver operating characteristic(ROC)curves(AUC)for subfoveal choroidal thickness(0.907)was greater than that of the model,including age,AL,and SE at 0.6249,0.8208,and 0.8205,*** choroidal thickness of the inner and outer nasal sectors was the most accurate indicator of MMD(AUC of 0.928 and 0.923,respectively).An outer nasal sector choroidal thickness of less than 74μm demonstrated the highest odds of predicting MMD(OR=33.8).CONCLUSION:Choroidal thickness detects the presence of MMD with high agreement,particularly of the inner and outer nasal sectors of the posterior pole,which appears to be a biometric parameter more precise than age,AL,or SE.

关键词： high myopia choroidal thickness myopic macular degeneration swept-source optical coherence tomography

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Risk factors for endophthalmitis following cataract surgery-our experience at a tertiary eye care centre in India

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International Journal of Ophthalmology(English edition) 2015年第6期8卷 1184-1189页

作者： Rohit C.Khanna Vanita Pathak Ray Madhavi Latha Sandra D Cassard Annie Mathai Garudadri C Sekhar LV Prasad Eye Institute Kallam Anji Reddy Campus wilmer Eye Institute Johns Hopkins University

AIMTo determine the risk factors for acute endophthalmitis after cataract extraction in a tertiary care centre in *** performed a nested case control study within a retrospective cohort. The surgical records of all patients with clinically diagnosed endophthalmitis within one month after cataract surgery, performed between January 2006 and December 2009, were reviewed. These were compared with randomly selected age and gender-matched controls, from patients having routine cataract surgery within ±1wk of the endophthalmitis case. Univariable and multivariable analysis were performed to identify risk factors for *** the total 33 856 cataract surgeries performed during this period, there were 57 cases of postoperative acute endophthalmitis that met our study criteria. Thus, the overall incidence of endophthalmitis in our cohort was 1.6 per 1000 cataract extractions performed. Mean age of cases was 55.9y (SD: 10.9y) and for controls was 55.6y (SD: 9.8y). Thirty-five cases (61.4%) and 133 controls (59.6%) were males. Median time of onset of endophthalmitis was 4d (IQR 2-9d; range: 1-30d). Thirty-nine cases (68.4%) presented within 7d and 27 cases (47.4%) were culture positive. Two hundred and twenty-three age and gender matched controls were selected. In multivariate analysis, endophthalmitis was associated with posterior capsular rupture (PCR) during surgery (OR 6.98, 95%CI: 2.22-21.98), phacoemulsification via scleral incision with a foldable intraocular lens (IOL) implantation (OR 3.02, 95%CI: 1.13-8.04) and ocular co-morbidity (OR 2.32, 95%CI: 1.11-4.87).CONCLUSIONPCR, presence of ocular co-morbidity, and phacoemulsification via scleral incision with foldable-IOL were found to be independent risk factors for acute endophthalmitis.

关键词： endophthalmitis incidence cataract surgery risk factors

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衣索比亚农村需行手术的倒睫患者的特征

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世界核心医学期刊文摘（眼科学分册） 2005年第12期1卷 36-37页

作者： Melese M West E.S Alemayehu W 韩静 116 wilmer building 600 N Wolfe Street Baltimore MD 21287 United States.Dr

Aims: To determine the characteristics of trichiasis patients presenting for surgery in Wolayta Zone of Ethiopia. Methods: Patients referred for trichiasis surgery by community health agents were evaluated by trained integrated eye care workers (IECWs) for the presence of trichiasis, locations of inturned lashes, severity of trichiasis, corneal opacity, and visual acuity. Results: 1635 individuals with trichiasis presented for surgery. 82% had bilateral trichiasis; 91% of patients reported trichiasis duration of > 2 years. Epilation was practised by over three fourths of the study subjects. A high proportion of patients tested positive for ocular Chlamydia trachomatis at presentation. 17% had monocular blindness and 8% were binocularly blind. Corneal opacity was highly associated with the trichiasis duration and severity and visual loss was associated with corneal opacity. Conclusion: Severe trichiasis reflects the magnitude of the trachoma problem in Ethiopia. Visual impairment due to trichiasis is highly associated with disease severity and duration. Early intervention to correct trichiasis before it become severe is recommended to prevent visual impairment.

关键词：比亚视力损害角膜混浊沙眼衣原体眼保健单眼盲社区保健持续时间

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The glaucoma service at Johns Hopkins University

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Eye Science 2011年第1期26卷 16-17页

作者： David Friedman wilmer Eye Institute and Johns Hopkins Bloomberg School of Public Health

Glaucoma service of Johns Hopkins University is currently involved in a range of research *** overview will cover the major clinical activities currently underway.

关键词：青光眼服务大学金

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Early activation of caspase-1 after retinal ischemia and reperfusion injury in mice

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Chinese Medical Journal 2004年第5期117卷 717-721页

作者：郑广瑛张成李志刚 Department of Ophthalmology wilmer Eye Institute

Background Caspases are important in the signaling pathway of cellular apoptosis Caspase-3 protein expression has been shown to increase and parallel to neuronal apoptosis in retinal ischemia injury This study was to determine whether caspase-1 is involved in neuronal cell death or in retinal ischemia and reperfusion injury Methods In twenty-one adult mice, ischemia was induced by increasing the intraocular pressure The animals were sacrificed at 1 hour, 3 hours, 6 hours, 1 day, 3 days and 7 days after reperfusion Frozen sections were used for caspase-1 immunostaining and TUNEL labeling Results In normal retina, no caspase-1 positive cells were seen One hour after ischemia, numerous positive cells were noted in the ganglion cell layer (GCL) and inner side of inner nuclear layer (INL) At 3 hours, caspase-1 positive cells continued to increase and peaked at 6 hours, then decreased significantly at 1 day TUNEL positive cells were detected at 3 hours and peaked at 1 day after ischemia Double labeling of caspase-1 and TUNEL only showed few cells with co-localization after ischemia Conclusion Caspase-1 immunoreactivity preceds to the TUNEL labeling in the GCL and INL after retinal ischemia and reperfusion injury and its early activation may play an important role in the initiation of neuronal apoptosis

关键词： caspase-1 · retinal ischemia · reperfusion · TUNEL · apoptosis

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Cumulative sum analysis score and phacoemulsification competency learning curve

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International Journal of Ophthalmology(English edition) 2017年第7期10卷 1088-1093页

作者： Gustavo Vedana Filipe G.Cardoso Alexandre S.Marcon Licio E.K.Araújo Matheus Zanon Daniella C.Birriel Guilherme Watte Albert S.Jun wilmer Eye Institute Johns Hopkins Medical Institutions Irmandade Santa Casa Misericórdia Federal University of Rio Grande do Sul

AIM： To use the cumulative sum analysis score（CUSUM） to construct objectively the learning curve of phacoemulsification ***： Three second-year residents and an experienced consultant were monitored for a series of 70 phacoemulsification cases each and had their series analysed by CUSUM regarding posterior capsule rupture（PCR） and best-corrected visual acuity. The acceptable rate for PCR was 〈5%（lower limit h） and the unacceptable rate was 〉10%（upper limit h）. The acceptable rate for bestcorrected visual acuity worse than 20/40 was 〈10%（lower limit h） and the unacceptable rate was 〉20%（upper limit h）. The area between lower limit h and upper limit h is called the decision interval. RESULTS： There was no statistically significant difference in the mean age, sex or cataract grades between groups. The first trainee achieved PCR CUSUM competency at his 22 nd case. His best-corrected visual acuity CUSUM was in the decision interval from his third case and stayed there until the end, never reaching competency. The second trainee achieved PCR CUSUM competency at his 39^ th case. He could reach best-corrected visual acuity CUSUM competency at his 22 ^nd case. The third trainee achieved PCR CUSUM competency at his 41 st case. He reached bestcorrected visual acuity CUSUM competency at his 14 ^th ***： The learning curve of competency in phacoemulsification is constructed by CUSUM and in average took 38 cases for each trainee to achieve it.

关键词： phacoemulsification learning curve cumulative sum analysis score posterior capsule rupture best corrected visual acuity cataract surgery

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Role of endoplasmic reticulum stress in the loss of retinal ganglion cells in diabetic retinopathy

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Neural Regeneration Research 2013年第33期8卷 3148-3158页

作者： Liping Yang Lemeng Wu Dongmei Wang Ying Li Hongliang Dou Mark O.M.Tso Zhizhong Ma Department of Ophthalmology Peking University Third HospitalKey Laboratory of Vision Loss and RestorationMinistry of Education wilmer Eye Institute Johns Hopkins University School of Medicine

Endoplasmic reticulum stress is closely involved in the early stage of diabetic retinopathy. In the present study, a streptozotocin-induced diabetic animal model was given an intraperitoneal injection of tauroursodeoxycholic acid. Results from immunofluorescent co-localization experiments showed that both caspase-12 protein and c-Jun N-terminal kinase 1 phosphorylation levels significantly in- creased, which was associated with retinal ganglion cell death in diabetic retinas. The C/ERB ho- mologous protein pathway directly contributed to glial reactivity, and was subsequently responsible for neuronal loss and vascular abnormalities in diabetic retinopathy. Our experimental findings in- dicate that endoplasmic reticulum stress plays an important role in diabetes-induced retinal neu- ronal loss and vascular abnormalities, and that inhibiting the activation of the endoplasmic reticulum stress pathway provides effective protection against diabetic retinopathy.

关键词： neural regeneration peripheral nerve injury endoplasmic reticulum stress diabetic retinopathy injury of retinal ganglion cells M011er cells astrocytes c-Jun N-terminal kinase caspase-12 protein C/ERB homologous protein retinal microcirculation glial fibrillary acidic protein grant-supportedpaper neuroregeneration

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Retinal ganglion cell death in a DBA/2J mouse model of glaucoma Microglial activation and intraocular pressure

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Neural Regeneration Research 2010年第4期5卷 273-281页

作者： Liping Yang Xiujuan Guo Lingling Wu Ying Li Lemeng Wu Dongmei Wang Mark O.M.TsoO Peking University Third Hospital Peking University Eye Center Beijing 100191 China wilmer Eye Institute JohnsHopkins University School of Medicine Baltimore MD 21287 USA

BACKGROUND： Retinal microglia has been shown to reactivate in a murine model of pigmentary glaucoma. However, the relationship between microglial activation and intraocular pressure （lOP） elevation and retinal ganglion cell （RGC） death is still unclear. OBJECTIVE： To verify that microglial activation and tumor necrosis factor alpha （TNF-α） expression is involved in RGC death with elevated lOP and prolonged time of glaucomatous optic nerve lesion in a DBA/2J mouse model of glaucoma. DESIGN, TIME AND SETTING： This randomized, controlled, animal experiment was performed at the Peking University Third Hospital, Peking University Eye Center, China between December 2006 and May ***： DBA/2J mice and C57BL/6J mice （Jackson Laboratory, USA）, rat anti-mouse CD11 b monoclonal antibody （Serotec, UK）, and goat anti-TNF-α polyclonal antibody （Sigma, USA） were used in this ***： A total of 100 female, DBA/2J mice at 3, 6, 9, 12, and 14 months of age （20 mice per age group） were used for the glaucoma model, and 18 C57BL/6J mice at 3, 9, 14 months of age （6 mice per age group） were used as normal controls. The anterior segment of the eye was observed using a slit-lamp biomicroscope, lOP was measured using a microneedle system. Morphology and number of retinal microglia were observed using immunohistochemistry. RGCs were quantified using Nissl staining. Co-localization of TNF-α and microglia was observed using double-labeling immunofluorescence. Excavation of the optic nerve head was observed utilizing hematoxylin-eosin staining. MAIN OUTCOME MEASURES： The following parameters were measured： lOP levels, numbers of RGCs and activated microglia, and TNF-α expression. RESULTS： In 6-month-old DBA/2J mice, dispersed pigment was observed, and some mice developed increased IOP. At 9 months of age, lOP levels reached a peak. In 3-month-old DBA/2J mice, microglia were activated. In 6-month-old DBA/2J mice, the number of activated microglia was significantly increased and

关键词： pigmentary glaucoma DBA/2J mice microglia retinal ganglion cell tumor necrosis factor-α

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A CONSERVATIVE VIEW OF RADIAL KERATOTOMY

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眼科学报 1991年第3期7卷 130-139页

作者： Steven Olkowski Walter J.Stark John D.Gottsch Gerri Goodman Daniel Goodman A.E.Maumenee Ivan Esente The wilmer Ophthalmological Institute The Johns Hopkins University School of MedicineBaltimoreMaryland 21205U.S.A.

It has been known for almost a century that radial keratotomy(RK)will flatten the cornea and reduce *** the introduction of radial keratotomy(RK)in the United States by Bores in 1978,there have been many published studies documenting the effects of this *** *** radial keratotomy today are not only quantitative but also qualitative in *** know this technique can flatten the cornea,but how reliably can the results be predicted?

关键词： RK A CONSERVATIVE VIEW OF RADIAL KERATOTOMY

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