AIM:To reveal the research hotspots,trends,and future prospects of lacrimal duct obstruction disease(LDOD)from 1900 to 2024 through the bibliometric and visualized analysis,providing a directional guidance for researc...AIM:To reveal the research hotspots,trends,and future prospects of lacrimal duct obstruction disease(LDOD)from 1900 to 2024 through the bibliometric and visualized analysis,providing a directional guidance for research in this field.METHODS:The Web of Science Core Collection database was used to retrieve relevant literature.Data analysis and visualization were conducted using VOSviewer 1.6.20 and CiteSpace 6.3.1,including annual publication volume,trends,research areas,country/region and institution distribution,journal and co-cited journal analysis,author and co-cited author analysis,keyword and burst keyword analysis,etc.RESULTS:The study included a total of 1481 articles,revealing an overall upward trend in research on LDOD,with ophthalmology being the predominant field.While the United States previously led research efforts,India and China have emerged as key contributors since 2015.Mohammad Javed Ali stands out as the most influential author in this research area.Ophthalmic Plastic and Reconstructive Surgery has published the highest number of related articles,whereas Ophthalmology has the highest co-citation.The current focal points of research include minimally invasive and precise modifications to dacryocystorhinostomy,along with intubation,new materials for stents,and disease pathogenesis.CONCLUSION:LDOD research has garnered widely attention and exhibits a steady upward trend.Since 1900,the United States,China,and India have been the leading contributors to this field.Ophthalmologists continue to be the primary driving force behind LDOD research.The findings of this study suggest that at the forefront of LDOD research,our focus has long been on refining and innovating surgical treatment.The minimally invasive and precise modification of lacrimal surgery,represented by dacryocystorhinostomy,is the ongoing developmental direction of this field.Rapid interdisciplinary integration and in-depth exploration of pathogenesis and allergic inflammation will lead to the emergence of new materials,innovative technologies,and safer clinical treatment protocols.展开更多
AIM:To analyze the clinical and pathological features of 89 patients presenting as lacrimal gland prolapse(LGP).METHODS:This retrospective study included 89 patients presenting as LGP.Magnetic resonance imaging(MRI)sc...AIM:To analyze the clinical and pathological features of 89 patients presenting as lacrimal gland prolapse(LGP).METHODS:This retrospective study included 89 patients presenting as LGP.Magnetic resonance imaging(MRI)scan was performed for all patients.Pathology and immunohistochemical staining of prolapsed tissue were performed during the surgery.The histopathological subtype was obtained,and the related clinical manifestations of different subtype were marked.RESULTS:Among the 89 patients involved,the histopathological subtype includes dacryoadenitis(43%;n=38),focal lymphocytes infiltration(20%;n=18),immunoglobulin G4(IgG4)-related lacrimal gland inflammatory disease(15%;n=13),lacrimal gland(13%;n=12),and extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue(9%;n=8).As for manifestations of different subtypes,eyelid swelling was found the most frequent of lymphocytes infiltration(44%,n=8),and palpable lacrimal gland mass of dacryoadenitis(55%,n=21).All the IgG4-related lacrimal gland inflammatory disease(100%,n=13)and most dacryoadenitis(97%,n=37)presented as bilateral.CONCLUSION:LGP has the histopathological subtype most commonly as inflammation,followed by structural and lymphoproliferative changes.Most of patients present as eyelid swelling.Clinical manifestations can be significant to differentiate the diagnosis.展开更多
AIM:To describe the anatomic characteristics of the lacrimal sac and its adjacent bone structures and to provide surgical recommendations for endoscopic dacryocystorhinostomy(EN-DCR).METHODS:This retrospective compara...AIM:To describe the anatomic characteristics of the lacrimal sac and its adjacent bone structures and to provide surgical recommendations for endoscopic dacryocystorhinostomy(EN-DCR).METHODS:This retrospective comparative study involved 118 sides with complete nasolacrimal duct obstruction and 83 unaffected sides from 126 patients.Computed tomographic-dacryocystography(CT-DCG)scans were performed before lacrimal surgery,and image reconstruction was used to obtain continuous 0.75-mm axial,coronal,and segmental sections for review.The morphology of the lacrimal sac and its relationship with adjacent bony structures were determined for measurement,as well as the obstructed location.RESULTS:The height of the lacrimal sac was 12.99±2.10 mm in this study.The operculum of the middle turbinate(OMT)was located vertically in the lower third of the lacrimal sac.Horizontally,the junction between the maxillary bone and the lacrimal bone(MB-LB)was close to,mostly(60.2%)posterior to,the lacrimal sac.The uncinate process was more frequently attached to the lacrimal bones(75.1%).The obstructions were generally located around the entrance of the nasolacrimal duct(NLD).However,some were placed higher,with 7.63%blocked not lower than the OMT.There was a negative correlation between the diameter of the lacrimal sac and the level of obstruction(r=-0.35,P<0.01).CONCLUSION:In this study,the OMT and MB-LB can be served as the landmarks in EN-DCR.Partial uncinectomy should be performed in most cases.The obstructions were generally located around the entrance of the NLD,but some extreme individual variations strongly implies the importance of CT-DCG scanning before surgery.展开更多
Objective The middle turbinate axilla(MTA)is a crucial anatomical landmark for localizing the lacrimal sac(LS)during endonasal dacryocystorhinostomy(En-DCR).Despite being a standard surgical procedure,En-DCR may lead ...Objective The middle turbinate axilla(MTA)is a crucial anatomical landmark for localizing the lacrimal sac(LS)during endonasal dacryocystorhinostomy(En-DCR).Despite being a standard surgical procedure,En-DCR may lead to severe complications,such as cerebrospinal fluid(CSF)leakage,which is closely associated with anatomical variations between the LS and the anterior skull base(ASB).This study aimed to investigate the anatomical location of the LS relative to the MTA and ASB in Chinese patients with nasolacrimal duct obstruction(NLDO)and analyze the influencing factors.Methods This cross-sectional study enrolled 227 Chinese patients who were diagnosed with NLDO and underwent computed tomographic dacryocystography(CT-DCG).Anatomical distances between LS and MTA,as well as LS and ASB,were measured using CT-DCG images.Results The mean distances from the superior and inferior edges of the LS to the MTA were 9.94±4.70 mm and−0.23±4.15 mm,respectively.Male patients showed significantly more superior–anterior displacement of the LS compared to female patients(P<0.001),while patients with chronic dacryocystitis(CD)had an inferior and posterior LS position relative to those with simple NLDO(P=0.005,P=0.001).The mean distance from the intersection(Point P)of the superior and posterior boundaries of the LS to the ASB(MP)was 18.35±4.48 mm,which was shorter in females and those with frontal sinus aplasia(P=0.001;P<0.001).A subgroup(28/227,12.3%)with a critical anatomical feature was identified,where the distance from Point Q(10 mm posterior to P)to the ASB(NQ distance)was≤10 mm.This subgroup had a higher prevalence of complete supra-MTA LS positioning(71.4%vs.41.2%,P=0.003).Conclusion Preoperative CT-DCG provides essential anatomical insights into the spatial relationship between the LS and MTA in Chinese patients with NLDO.The LS position varies significantly by gender and disease type,with males showing more superior–anterior and CD patients more inferior–posterior positioning relative to the MTA.Special attention should be paid to patients with frontal sinus aplasia or LS entirely above the MTA to minimize the risk of CSF leakage during En-DCR.展开更多
Adenoid cystic carcinoma of the lacrimal gland(LGACC)is the most common type of malignant epithelial tumor of the lacrimal gland,which is characterized by a high recurrence rate,perineural invasion,and a propensity to...Adenoid cystic carcinoma of the lacrimal gland(LGACC)is the most common type of malignant epithelial tumor of the lacrimal gland,which is characterized by a high recurrence rate,perineural invasion,and a propensity to metastasize to distant sites.Due to its unclear pathogenesis,LGACC has a poor prognosis and a high mortality rate.In recent years,a range of radiotherapy and chemotherapy have been clinically applied,leading to a shift in the treatment approach for LGACC.This article discussed the advances being made in the treatment of LGACC and provides readers with an overview of the impact of LGACC treatment modalities on patient survival and prognostic levels.展开更多
AIM:To investigate the clinical profile of patients with acquired lacrimal sac mucocele(ALSM)and evaluate the efficacy of endoscopic dacryocystorhinostomy(En-DCR)for this condition.METHODS:En-DCRs were performed on 14...AIM:To investigate the clinical profile of patients with acquired lacrimal sac mucocele(ALSM)and evaluate the efficacy of endoscopic dacryocystorhinostomy(En-DCR)for this condition.METHODS:En-DCRs were performed on 141 patients with ALSM patients from January 2016 to March 2022.The clinical baseline information and magnetic resonance imaging(MRI)images were recorded and summarized.To assess the effectiveness of En-DCR therapy,both anatomical and functional success rate was assessed during a 12mo follow-up.RESULTS:A total of 141 patients,with a mean age of 57.70±14.11y,were enrolled in this study.Majority of the patients were female(n=91;64.54%)and all had unilateral disease.All patients had a previous history of epiphora and purulent secretion,and the duration from lacrimal duct obstruction to mucocele formation ranged from 6 to 120mo.MRI findings consistently revealed an enlarged sac diameter,fluid accumulation separated by a thin rim from adjacent tissues,which is indicative of lacrimal sac mucocele.En-DCR was performed with an anatomical success rate of 93.62%and a functional success rate of 81.56%.CONCLUSION:ALSM is more commonly seen in females and unilaterally.It is essentially a complication of lacrimal duct obstruction.MRI characteristics can be used for precise clinical diagnosis,while En-DCR emerges as an optimal therapy for this condition.Our results provide a comprehensive reference for the diagnosis and treatment of ALSM.展开更多
Correspondence to:Satoru Kase.Department of Ophthalmology,Faculty of Medicine and Graduate School of Medicine,Hokkaido University,N-15,W-7,Kita-ku,Sapporo 060-8638,Japan.kaseron@med.hokudai.ac.jp AIM:To evaluate the c...Correspondence to:Satoru Kase.Department of Ophthalmology,Faculty of Medicine and Graduate School of Medicine,Hokkaido University,N-15,W-7,Kita-ku,Sapporo 060-8638,Japan.kaseron@med.hokudai.ac.jp AIM:To evaluate the clinical features of primary lacrimal gland pleomorphic adenoma(LGPA).METHODS:This was a 2-center,retrospective,observational study of primary LGPA patients who underwent tumor resection.Ophthalmic examinations and orbital computed tomography(CT)and/or magnetic resonance imaging(MRI)were performed.RESULTS:Totally 18 patients(10 males and 8 females,mean age 56.3±13.8y)were enrolled.Initial symptoms were unilateral proptosis in 8 patients,diplopia in 3 patients,and pressure sensation and no chief complaint in 2 patients each.The best-corrected visual acuity of the affected eye was 0.26±0.44 logMAR,and the intraocular pressure(IOP)of the affected and healthy eyes was 20.1±9.9 and 15.8±4.3 mm Hg,respectively.The difference in degree of proptosis between the affected and healthy eyes was 4.1±2.2 mm based on the Hertel ocular protrusion meter.One case had a history of breast cancer.Seventeen of 18 patients with an orbital lacrimal gland origin underwent total tumor excision by anterior/lateral orbitotomy.CONCLUSION:Orbital LGPA can complicate IOP elevation,and require total tumor excision by orbitotomy.In rare cases,systemic malignancy may complicate LGPA,and in such cases total removal of the lacrimal gland tumor should be considered at the initial surgery.展开更多
AIM:To examine carcinoma ex pleomorphic adenoma(CXPA)and its development to provide information for its clinical assessment and prognosis.METHODS:The clinical data of 26 patients with pathologically diagnosed CXPA wer...AIM:To examine carcinoma ex pleomorphic adenoma(CXPA)and its development to provide information for its clinical assessment and prognosis.METHODS:The clinical data of 26 patients with pathologically diagnosed CXPA were included for analysis.The patients’medical histories and data(e.g.,gender,age,eye laterality,clinical manifestations,pathologic and immunohistochemical indices,treatments,and prognosis)were recorded.RESULTS:The average age of the 26 patients was 59.6±15.7y.There was no significant difference in the gender distribution.The incidence of CXPA bone destruction was approximately 57.7%,and the incidence of optic nerve involvement and extraocular muscle involvement was approximately 15.4%and 19.2%,respectively.The most common pathological type was adenocarcinoma(34.6%),followed by ductal carcinoma(26.9%).Five patients had recurrence or metastasis(19.2%).The 5-year recurrencefree survival rate was 59.0%.There were no significant differences in survival rates among patients with different pathologic types and stages(P>0.05).Bone destruction,nerve invasion,and peripheral tissue invasion did not significantly affect survival rate(P>0.05).Surgery combined with 125I radiation therapy leads to a better survival prognosis(P<0.05).CONCLUSION:CXPA has a variety of pathologic classifications,with characteristics of bone destruction and peripheral tissue invasion.Surgery combined with ^(125)I endoradiotherapy is a preferable treatment option.However,long-term follow-up and close observation for recurrence or metastasis should be performed.展开更多
AIM: To study the clinical and pathological characteristics of the lacrimal sac lymphoma, which is rare but it is the major type of non-epithelial malignant tumor in the lacrimal sac region. METHODS: Sixty-four cases ...AIM: To study the clinical and pathological characteristics of the lacrimal sac lymphoma, which is rare but it is the major type of non-epithelial malignant tumor in the lacrimal sac region. METHODS: Sixty-four cases of malignant lacrimal sac tumors in our hospital from 1986 to 2020 were retrospectively reviewed. Eight cases of lacrimal sac lymphoma were carefully reviewed. RESULTS: There were five mucosal-associated lymphoid tissue(MALT) lymphomas, one diffused large B-cell lymphoma, one NK/T cell lymphoma, and one mantle cell lymphoma. All eight patients represented symptoms of epiphora with swelling in the lacrimal sac for a certain period of time and showed no signs of systemic involvement at the first time of clinical visits. They had received either chemotherapy or radiotherapy after surgery. Long-term follow-up(from 11 to 220 mo) showed that, except one patient with MALT lymphoma died for unknown reasons at 104 mo after surgery, the other 7 patients were all alive with no signs of local recurrence, neither in other organs. CONCLUSION: Non-epithelial malignant tumors of the lacrimal sac are rare and lymphoma is the major subtype.展开更多
AIM: To compare the success rate of monocanalicular versus pushed monocanalicular silicone intubation(PMCI)of the nasolacrimal duct for congenital nasolacrimal duct obstruction(CNLDO).METHODS: In a prospective randomi...AIM: To compare the success rate of monocanalicular versus pushed monocanalicular silicone intubation(PMCI)of the nasolacrimal duct for congenital nasolacrimal duct obstruction(CNLDO).METHODS: In a prospective randomized clinical trial 53 eyes of 49 patients with CNLDO underwent either monocanalicular silicone intubation(MCI)(n =28 eyes) or PMCI(n =25 eyes). All procedures were performed by 1oculoplastic surgeon. Treatment success was defined as the complete resolution of epiphora at 3mo after tube removal.RESULTS: The surgical outcome was assessed in 20 eyes with MCI and 20 eyes with PMCI. The mean age of treatment was 26.25 ±10.08mo(range, 13-49mo) for MCI and 26.85±12.25mo(range, 16-68mo) for PMCI. Treatment success was achieved in 18 of 20 eyes(90.0%) in the MCI group compared with 10 of 20 eyes(50%) in the PMCI group(P =0.01). In the PMCI group, the tube loss(30%)was greater than the MCI group(5%), however the differences between the 2 groups proved to be not significant(P =0.91).CONCLUSION: Our results indicate that MCI has higher success rate in CNLDO treatment compared with PMCI in this small series of patients.展开更多
AIM:To analyze cases of obstruction of the nasolacrimal duct which creates a fertile environment for secondary bacterial Infection and can result in dacryocystitis,which is a constant threat to cornea and orbital soft...AIM:To analyze cases of obstruction of the nasolacrimal duct which creates a fertile environment for secondary bacterial Infection and can result in dacryocystitis,which is a constant threat to cornea and orbital soft tissue and a potential source of endophthalmitis following intraocular surgery.The majority of obstructions of the lacrimal excretory outflow system are acquired ones occurring in adulthood and involving the distal parts of the system.Acquired obstruction may be primary/idiopathic or secondary to a wide variety of infectious,inflammatory,traumatic,mechanical,toxic or neoplastic causes mimicking idiopathic inflammation.These cases are treated by dacryocystorhinostomy(DCR).METHODS:The present study was conducted to determine the histopathologic,immunohistochemical and current microbiologic characteristics of lacrimal sac specimens in patients undergoing external dacryocystorhinostomy.RESULTS:Non-specific lacrimal sac pathology was present in all 33 cases and 81.8%of the cases showed moderate chronic inflammation with a chronic inflammatory score(CIS)ranging between 4 and 6,whereas 12.12%showed severe inflammatory changes with a CIS of 7.Mild degree of inflammation was seen in6.06%with a CIS of 3.The total prevalence of grampositive,gram-negative,and culture-negative samples were 59.4%,37.5%,and 3%respectively.CONCLUSION:Non-specific chronic inflammation withfibrosis is indeed the most commonly reported histopathological finding in lacrimal sac wall biopsy specimens.展开更多
· AIM: To evaluate the application of ultrasound biomicroscopy(UBM) in the examination of lacrimal canalicular diseases, and to investigate UBM image characteristics of lacrimal canaliculi in disease states.·...· AIM: To evaluate the application of ultrasound biomicroscopy(UBM) in the examination of lacrimal canalicular diseases, and to investigate UBM image characteristics of lacrimal canaliculi in disease states.·METHODS: Sixty cases(63 eyes, 69 canaliculi) of lacrimal canalicular diseases were enrolled that included32 patients(32 eyes, 32 canaliculi) with chronic lacrimal canaliculitis, 18 patients(18 eyes, 18 canaliculi) with previous lacrimal canalicular laceration, 9 patients(12eyes, 18 canaliculi) with congenital absence of lacrimal puncta and canaliculi, and 1 case(1 eye, 1 canaliculus)of canalicular mass. The patients were examined using UBM, and disease-specific features of the UBM images were noted.· RESULTS: UBM imaging of lacrimal canaliculi in chronic canaliculitis patients showed obvious ectasia of the lacrimal canalicular lumen. Dot-like moderate echoic signals were detected on some ectatic lumina of the lacrimal canaliculus. Some lumen-like structures of the lower lacrimal canaliculus were observed in 2(2 eyes, 2canaliculi) of the 9 patients(12 eyes, 18 canaliculi) with congenital absence of the lacrimal canaliculus. Of the 18patients(18 eyes, 18 canaliculi) with previous lacrimal canalicular laceration, the lacerated end on the nasal side of the lacrimal canaliculus was detected only in 14patients(14 eyes, 14 canaliculi).·CONCLUSION: UBM can be used to evaluate lacrimal canalicular diseases and can provide an imaging basis for the diagnosis of lacrimal canalicular diseases.展开更多
AIM:To evaluate the differences between human lacrimal gland adenoid cystic carcinoma with high-grade transformation(LACC-HGT)primar y cells cultured by high-grade transformation tissue and non-high-grade transformati...AIM:To evaluate the differences between human lacrimal gland adenoid cystic carcinoma with high-grade transformation(LACC-HGT)primar y cells cultured by high-grade transformation tissue and non-high-grade transformation(non-HGT)primary cells cultured by non-highgrade transformation tissue in proliferation,metastasis,drug susceptibility,and genes.METHODS:LACC-HGT primary cells were established by tissue block culture,and the 4^(th)to 10^(th)generation primary cells were selected as research objects.The cells were preliminarily identified by immunofluorescent staining.The differences between non-HGT and LACC-HGT primary cells in terms of proliferation,metastasis,and drug susceptibility were compared by cell counting kit-8(CCK-8)assay,wound healing,and drug sensitivity experiments.Differentially expressed genes were screened using mRNA array.Gene expression was analyzed using real-time quantitative polymerase chain reaction(RT-qPCR).RESULTS:LACC-HGT primary cells were successfully cultured by tissue block culture.Immunofluorescence staining results showed that cytokeratin(CK)and CK7 expression levels were positive in LACC-HGT primary cells.CCK-8 results showed that the proliferation ability of LACCHGT cells was significantly higher than that of non-HGT cells.Wound healing experiment showed that the migration ability of LACC-HGT cells was significantly higher than that of non-HGT cells.LACC-HGT cells were also less sensitive to cisplatin and paclitaxel than non-HGT cells.Compared with non-HGT cells,9566 differentially expressed genes were found in LACC-HGT primary cells,of which 5162 were upregulated and 4404 were down-regulated.The expression of N-acetylneuraminate pyruvate lyase(NPL),MARVEL domain containing 3(MARVELD3),syntabulin(SYBU),and allograft inflammatory factor 1(AIF1)was higher in LACCHGT cells than in non-HGT cells,whereas that of periostin(POSTN)was lower.CONCLUSION:LACC-HGT primary cells have faster proliferation,stronger migration ability,and poorer sensitivity to chemotherapy drugs than non-HGT primary cells.The expression of mRNAs in non-HGT and LACC-HGT primary cells are significantly different.These features are speculated to be the reasons why high-grade transformation tissues exhibit higher malignant degree and poorer prognosis than their counterparts.展开更多
AIM： To evaluate the effectiveness of the Crawford tube in treating symptomatic epiphora without nasolacrimal obstruction. METHODS： A protocol was adopted for the management of symptomatic epiphora without nasolacri...AIM： To evaluate the effectiveness of the Crawford tube in treating symptomatic epiphora without nasolacrimal obstruction. METHODS： A protocol was adopted for the management of symptomatic epiphora without nasolacrimal obstruction. Patients who suffered symptomatic epiphora without nasolacrimal obstruction in both eyes were included in the study. One eye was treated with Crawford tube intubation and the other eye was treated with medication therapy. Degree of watering, patient satisfaction, and symptomatic improvement were carefully evaluated by one of the authors at the end of the follow-up period, after Crawford tube removal, to ascertain functional results. RESULTS： Thirty-seven adult patients （37 eyes） underwent Crawford tube intubation for functional epiphora. The mean follow-up time after removal of the tube was 14.8 ~4.8mo. The procedure was an overall success in 28 eyes （75.7%）, with symptoms improving significantly. Two eyes （5.4%） were relieved of indoor epiphora, two （5.4%） had minimal epiphora outdoors, but only with wind or cold, and five （13.5%） continued to experience tearing both indoors and outdoors. Thirty of the patients （81%） expressed satisfaction with the procedure. CONCLUSION： Crawford tube insertion is an effective, safe, simple, and relatively noninvasive treatment strategy for functional lacrimal system obstruction.展开更多
AIM:To investigate the variation of IGSF3 gene in three families with congenital absence of lacrimal puncta and canaliculi,and to lay a foundation for further research on the pathogenic gene of congenital lacrimal duc...AIM:To investigate the variation of IGSF3 gene in three families with congenital absence of lacrimal puncta and canaliculi,and to lay a foundation for further research on the pathogenic gene of congenital lacrimal duct agenesis.METHODS:The members of the three families were recruited.The ophthalmologic examinations in details,including slit-lamp biomicroscope,intraocular pressure and fundus examination,etc.were carried out.All patients were checked with paracentesis of puncta membrane and lacrimal duct probing,as well as the computed tomographydacryocystography(CT-DCG).Peripheral blood of 14 participants(3 normal)from three families were collected,4 mL each,for genomic DNA extraction,and 11 exon fragments of IGSF3 gene were amplified and sequenced by polymerase chain reaction(PCR)to determine whether there were IGSF3 genetic variation.RESULTS:A total of 14 members from three families were screened for 4 synonymous variants:c.930 C>T(p.Pro366=),c.1359 T>C(p.Ser709=),c.1797 G>A(p.Ser855=),c.1539 G>A(p.Ser769=),and 6 missense variants:c.l507 G>A(p.Gly759 Ser),c.1783 T>C(p.Trp851 Arg),c.1952 G>T(p.Ser 907 lle),c.3120 C>G(p.Asp1040 Glu),c.3123 C>G(p.Asp1041 Glu),c.3139_3140 insGAC(p.Asp1046_Pro1047 insAsp),and the latter three were only found in two patients with absence of lacrimal puncta and canaliculi combined with congenital osseous nasolacrimal canal obstruction from the first family.CONCLUSION:The same IGSF3 gene mutation c.31393140 insGAC is found in the patients with congenital absence of lacrimal puncta and canaliculi combine with osseous nasolacrimal canal obstruction.展开更多
We have treated 34 cases of epiphora due to dysfunction of the lacrimal duct with a warm needle puncturing at the Jingming (UB 1) point. The effect was significantly better than that of the control group treated with ...We have treated 34 cases of epiphora due to dysfunction of the lacrimal duct with a warm needle puncturing at the Jingming (UB 1) point. The effect was significantly better than that of the control group treated with lacrimal duct irrigation and norflaxacin eye drops (a total effective rate of 91.07% vs. 54.29%).展开更多
BACKGROUND Nasolacrimal duct obstruction leading to epiphora is a common ophthalmologic complaint,and it may derive from amyloidosis in rare cases.There are a few reports about localized amyloidosis,and amyloidosis wi...BACKGROUND Nasolacrimal duct obstruction leading to epiphora is a common ophthalmologic complaint,and it may derive from amyloidosis in rare cases.There are a few reports about localized amyloidosis,and amyloidosis with involvement and obstruction of the nasolacrimal duct is exceedingly rare.CASE SUMMARY A 54-year-old male presented with a 2-year history of a lump overlying the left lacrimal sac that had grown rapidly for nearly half a year.Physical examination touched a firm lump in the left lacrimal sac.Nasal endoscopy discovered lesions in appearance of sediments with easy bleeding at the entry of the nasolacrimal duct of the left inferior nasal meatus.Computerized tomography scan revealed speckle high density in the left lacrimal sac and the dilated nasolacrimal duct.During an endoscopic exploration and excision,a large number of dacryoliths were exposed.Pathology indicated amorphous pink material and multinucleated giant cell reaction in the fibrous tissue.CONCLUSION This case showed amyloidosis in localized form mimicking dacryolith with nasolacrimal duct obstruction.In clinical practice,we should be aware of the possibility of localized amyloidosis in the nasolacrimal excretory system.展开更多
Objective: to research the therapeutic effect and adverse reaction rate of lacrimal duct probing combined with tobramycin and dexamethasone eye ointment in treating congenital lacrimal duct obstruction. Methods: selec...Objective: to research the therapeutic effect and adverse reaction rate of lacrimal duct probing combined with tobramycin and dexamethasone eye ointment in treating congenital lacrimal duct obstruction. Methods: selecting a total of 43 children with congenital lacrimal duct obstruction from August 2018 to August 2020 as research subjects. Divide into two groups according treating plan: Control group (21 cases, lacrimal duct probing combined with normal saline irrigation) and observation group (22 cases, lacrimal duct probing combined with tobramycin and dexamethasone eye ointment). Analyzing the therapeutic effect, recurrence rate, incidence of adverse reactions, ocular surface disease index, and other indicators. Evaluating the clinical value of lacrimal duct probing combined with tobramycin and dexamethasone eye ointment. Results: in the observation group, the clinical treatment effect was good, there were fewer adverse reactions occurred, and the recurrence rate was low, the P value was less than 0.05;compared with the controlling group, the frequency of ocular discomfort in adverse environment, the influence of ocular discomfort on daily activities and the frequency score of ocular discomfort in observation group were shortened (the P value was less than 0.05). Conclusion: in treating children with lacrimal duct probing combined with tobramycin and dexamethasone eye ointment, not only the treatment effect is relatively significant, but also the clinical safety of treatment is high, and the children can grow up healthily.展开更多
AIMTo assess the effects of extract of Buddleja officinalis on tear secretion volume, tear film stability, expressions of TGF-β1, IL-1β, TNF-α in lacrimal gland of castrated rabbits with dry eye.
AIM: To investigate the regulatory roles of the members of the peroxisome proliferator-activated receptor(PPAR)family in lacrimal gland dysfunction under conditions of desiccating stress or diabetes.METHODS: Quantitat...AIM: To investigate the regulatory roles of the members of the peroxisome proliferator-activated receptor(PPAR)family in lacrimal gland dysfunction under conditions of desiccating stress or diabetes.METHODS: Quantitative polymerase chain reaction(qPCR) was used to examine the expression of PPARs in the cornea, conjunctiva, meibomian gland, and lacrimal gland in adult rats. The rats were divided into 3 groups:a control group, dry eye group, and diabetic group. The phenol red threads test, tear film break-up time(BUT) test and fluorescein staining were carried out to evaluate the development of dry eye. Based on bioinformatics research,qP CR was used to examine the expression level of PPARγ,tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β),interleukin-6(IL-6), sirtuin 1(Sirt1), myeloid differentiation factor 88(MyD88) and transforming growth factor-β(TGF-β)in the lacrimal glands.RESULTS: PPARα and PPARβ/δ were mainly expressed in the conjunctiva and the lacrimal gland, respectively.However, PPARγ was expressed in both the conjunctiva and lacrimal gland, at much higher levels than those measured for PPARα and PPARβ/δ. Dry eye rats and diabetic rats both showed decreased tear secretion, shortened BUT,and increased corneal staining. Significant changes in gene expression were observed compared with the control group. In the lacrimal glands of dry eye rats and diabetic rats, expression of PPARγ decreased(P<0.05), expression of Sirt1 also decreased(P<0.01), whereas expression of TNF-α, IL-1β, IL-6, MyD88, and TGF-β increased(P<0.05).CONCLUSION: Among PPARs, PPARγ might play a dominant role in the regulation of metabolic-and inflammatorysignaling pathways on the ocular surfaces and in lacrimal glands. Down-regulation of PPARγ is highly relevant to lacrimal gland dysfunction under desiccating-stress and diabetic conditions. PPARγ, thus, is a potential therapeutic target in the treatment of environment-or diabetes-induced dry eye diseases.展开更多
文摘AIM:To reveal the research hotspots,trends,and future prospects of lacrimal duct obstruction disease(LDOD)from 1900 to 2024 through the bibliometric and visualized analysis,providing a directional guidance for research in this field.METHODS:The Web of Science Core Collection database was used to retrieve relevant literature.Data analysis and visualization were conducted using VOSviewer 1.6.20 and CiteSpace 6.3.1,including annual publication volume,trends,research areas,country/region and institution distribution,journal and co-cited journal analysis,author and co-cited author analysis,keyword and burst keyword analysis,etc.RESULTS:The study included a total of 1481 articles,revealing an overall upward trend in research on LDOD,with ophthalmology being the predominant field.While the United States previously led research efforts,India and China have emerged as key contributors since 2015.Mohammad Javed Ali stands out as the most influential author in this research area.Ophthalmic Plastic and Reconstructive Surgery has published the highest number of related articles,whereas Ophthalmology has the highest co-citation.The current focal points of research include minimally invasive and precise modifications to dacryocystorhinostomy,along with intubation,new materials for stents,and disease pathogenesis.CONCLUSION:LDOD research has garnered widely attention and exhibits a steady upward trend.Since 1900,the United States,China,and India have been the leading contributors to this field.Ophthalmologists continue to be the primary driving force behind LDOD research.The findings of this study suggest that at the forefront of LDOD research,our focus has long been on refining and innovating surgical treatment.The minimally invasive and precise modification of lacrimal surgery,represented by dacryocystorhinostomy,is the ongoing developmental direction of this field.Rapid interdisciplinary integration and in-depth exploration of pathogenesis and allergic inflammation will lead to the emergence of new materials,innovative technologies,and safer clinical treatment protocols.
基金Supported by National Natural Science Foundation of China(No.82201214,No.82201221)Ophthalmic New Technology Incubation Fund Project of China Primary Health Care Foundation(No.2022 No.005)Shaanxi Key Research and Development Program(No.2021SF-156).
文摘AIM:To analyze the clinical and pathological features of 89 patients presenting as lacrimal gland prolapse(LGP).METHODS:This retrospective study included 89 patients presenting as LGP.Magnetic resonance imaging(MRI)scan was performed for all patients.Pathology and immunohistochemical staining of prolapsed tissue were performed during the surgery.The histopathological subtype was obtained,and the related clinical manifestations of different subtype were marked.RESULTS:Among the 89 patients involved,the histopathological subtype includes dacryoadenitis(43%;n=38),focal lymphocytes infiltration(20%;n=18),immunoglobulin G4(IgG4)-related lacrimal gland inflammatory disease(15%;n=13),lacrimal gland(13%;n=12),and extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue(9%;n=8).As for manifestations of different subtypes,eyelid swelling was found the most frequent of lymphocytes infiltration(44%,n=8),and palpable lacrimal gland mass of dacryoadenitis(55%,n=21).All the IgG4-related lacrimal gland inflammatory disease(100%,n=13)and most dacryoadenitis(97%,n=37)presented as bilateral.CONCLUSION:LGP has the histopathological subtype most commonly as inflammation,followed by structural and lymphoproliferative changes.Most of patients present as eyelid swelling.Clinical manifestations can be significant to differentiate the diagnosis.
基金Supported by the National Natural Science Foundation of China(No.81700807).
文摘AIM:To describe the anatomic characteristics of the lacrimal sac and its adjacent bone structures and to provide surgical recommendations for endoscopic dacryocystorhinostomy(EN-DCR).METHODS:This retrospective comparative study involved 118 sides with complete nasolacrimal duct obstruction and 83 unaffected sides from 126 patients.Computed tomographic-dacryocystography(CT-DCG)scans were performed before lacrimal surgery,and image reconstruction was used to obtain continuous 0.75-mm axial,coronal,and segmental sections for review.The morphology of the lacrimal sac and its relationship with adjacent bony structures were determined for measurement,as well as the obstructed location.RESULTS:The height of the lacrimal sac was 12.99±2.10 mm in this study.The operculum of the middle turbinate(OMT)was located vertically in the lower third of the lacrimal sac.Horizontally,the junction between the maxillary bone and the lacrimal bone(MB-LB)was close to,mostly(60.2%)posterior to,the lacrimal sac.The uncinate process was more frequently attached to the lacrimal bones(75.1%).The obstructions were generally located around the entrance of the nasolacrimal duct(NLD).However,some were placed higher,with 7.63%blocked not lower than the OMT.There was a negative correlation between the diameter of the lacrimal sac and the level of obstruction(r=-0.35,P<0.01).CONCLUSION:In this study,the OMT and MB-LB can be served as the landmarks in EN-DCR.Partial uncinectomy should be performed in most cases.The obstructions were generally located around the entrance of the NLD,but some extreme individual variations strongly implies the importance of CT-DCG scanning before surgery.
基金funded by grants from the Natural Science Foundation of Hubei Province(No.2022CFB199)the National Natural Science Foundation of China(No.82271127).
文摘Objective The middle turbinate axilla(MTA)is a crucial anatomical landmark for localizing the lacrimal sac(LS)during endonasal dacryocystorhinostomy(En-DCR).Despite being a standard surgical procedure,En-DCR may lead to severe complications,such as cerebrospinal fluid(CSF)leakage,which is closely associated with anatomical variations between the LS and the anterior skull base(ASB).This study aimed to investigate the anatomical location of the LS relative to the MTA and ASB in Chinese patients with nasolacrimal duct obstruction(NLDO)and analyze the influencing factors.Methods This cross-sectional study enrolled 227 Chinese patients who were diagnosed with NLDO and underwent computed tomographic dacryocystography(CT-DCG).Anatomical distances between LS and MTA,as well as LS and ASB,were measured using CT-DCG images.Results The mean distances from the superior and inferior edges of the LS to the MTA were 9.94±4.70 mm and−0.23±4.15 mm,respectively.Male patients showed significantly more superior–anterior displacement of the LS compared to female patients(P<0.001),while patients with chronic dacryocystitis(CD)had an inferior and posterior LS position relative to those with simple NLDO(P=0.005,P=0.001).The mean distance from the intersection(Point P)of the superior and posterior boundaries of the LS to the ASB(MP)was 18.35±4.48 mm,which was shorter in females and those with frontal sinus aplasia(P=0.001;P<0.001).A subgroup(28/227,12.3%)with a critical anatomical feature was identified,where the distance from Point Q(10 mm posterior to P)to the ASB(NQ distance)was≤10 mm.This subgroup had a higher prevalence of complete supra-MTA LS positioning(71.4%vs.41.2%,P=0.003).Conclusion Preoperative CT-DCG provides essential anatomical insights into the spatial relationship between the LS and MTA in Chinese patients with NLDO.The LS position varies significantly by gender and disease type,with males showing more superior–anterior and CD patients more inferior–posterior positioning relative to the MTA.Special attention should be paid to patients with frontal sinus aplasia or LS entirely above the MTA to minimize the risk of CSF leakage during En-DCR.
基金Supported by National Key R&D Program of China(No.2023YFC2410203)Beijing Hospitals Authority Clinical medicine Development of Special Funding Support(No.ZLRK202503).
文摘Adenoid cystic carcinoma of the lacrimal gland(LGACC)is the most common type of malignant epithelial tumor of the lacrimal gland,which is characterized by a high recurrence rate,perineural invasion,and a propensity to metastasize to distant sites.Due to its unclear pathogenesis,LGACC has a poor prognosis and a high mortality rate.In recent years,a range of radiotherapy and chemotherapy have been clinically applied,leading to a shift in the treatment approach for LGACC.This article discussed the advances being made in the treatment of LGACC and provides readers with an overview of the impact of LGACC treatment modalities on patient survival and prognostic levels.
文摘AIM:To investigate the clinical profile of patients with acquired lacrimal sac mucocele(ALSM)and evaluate the efficacy of endoscopic dacryocystorhinostomy(En-DCR)for this condition.METHODS:En-DCRs were performed on 141 patients with ALSM patients from January 2016 to March 2022.The clinical baseline information and magnetic resonance imaging(MRI)images were recorded and summarized.To assess the effectiveness of En-DCR therapy,both anatomical and functional success rate was assessed during a 12mo follow-up.RESULTS:A total of 141 patients,with a mean age of 57.70±14.11y,were enrolled in this study.Majority of the patients were female(n=91;64.54%)and all had unilateral disease.All patients had a previous history of epiphora and purulent secretion,and the duration from lacrimal duct obstruction to mucocele formation ranged from 6 to 120mo.MRI findings consistently revealed an enlarged sac diameter,fluid accumulation separated by a thin rim from adjacent tissues,which is indicative of lacrimal sac mucocele.En-DCR was performed with an anatomical success rate of 93.62%and a functional success rate of 81.56%.CONCLUSION:ALSM is more commonly seen in females and unilaterally.It is essentially a complication of lacrimal duct obstruction.MRI characteristics can be used for precise clinical diagnosis,while En-DCR emerges as an optimal therapy for this condition.Our results provide a comprehensive reference for the diagnosis and treatment of ALSM.
文摘Correspondence to:Satoru Kase.Department of Ophthalmology,Faculty of Medicine and Graduate School of Medicine,Hokkaido University,N-15,W-7,Kita-ku,Sapporo 060-8638,Japan.kaseron@med.hokudai.ac.jp AIM:To evaluate the clinical features of primary lacrimal gland pleomorphic adenoma(LGPA).METHODS:This was a 2-center,retrospective,observational study of primary LGPA patients who underwent tumor resection.Ophthalmic examinations and orbital computed tomography(CT)and/or magnetic resonance imaging(MRI)were performed.RESULTS:Totally 18 patients(10 males and 8 females,mean age 56.3±13.8y)were enrolled.Initial symptoms were unilateral proptosis in 8 patients,diplopia in 3 patients,and pressure sensation and no chief complaint in 2 patients each.The best-corrected visual acuity of the affected eye was 0.26±0.44 logMAR,and the intraocular pressure(IOP)of the affected and healthy eyes was 20.1±9.9 and 15.8±4.3 mm Hg,respectively.The difference in degree of proptosis between the affected and healthy eyes was 4.1±2.2 mm based on the Hertel ocular protrusion meter.One case had a history of breast cancer.Seventeen of 18 patients with an orbital lacrimal gland origin underwent total tumor excision by anterior/lateral orbitotomy.CONCLUSION:Orbital LGPA can complicate IOP elevation,and require total tumor excision by orbitotomy.In rare cases,systemic malignancy may complicate LGPA,and in such cases total removal of the lacrimal gland tumor should be considered at the initial surgery.
基金Supported by National Key R&D Program of China(No.2023YFC2410203)Beijing Hospitals Authority’Ascent Plan(No.DFL20190201)+1 种基金Beijing Hospitals Authority Clinical Medicine Development of Special Funding Support(No.ZLRK202503)Natural Science Foundation of Beijing(No.7222025).
文摘AIM:To examine carcinoma ex pleomorphic adenoma(CXPA)and its development to provide information for its clinical assessment and prognosis.METHODS:The clinical data of 26 patients with pathologically diagnosed CXPA were included for analysis.The patients’medical histories and data(e.g.,gender,age,eye laterality,clinical manifestations,pathologic and immunohistochemical indices,treatments,and prognosis)were recorded.RESULTS:The average age of the 26 patients was 59.6±15.7y.There was no significant difference in the gender distribution.The incidence of CXPA bone destruction was approximately 57.7%,and the incidence of optic nerve involvement and extraocular muscle involvement was approximately 15.4%and 19.2%,respectively.The most common pathological type was adenocarcinoma(34.6%),followed by ductal carcinoma(26.9%).Five patients had recurrence or metastasis(19.2%).The 5-year recurrencefree survival rate was 59.0%.There were no significant differences in survival rates among patients with different pathologic types and stages(P>0.05).Bone destruction,nerve invasion,and peripheral tissue invasion did not significantly affect survival rate(P>0.05).Surgery combined with 125I radiation therapy leads to a better survival prognosis(P<0.05).CONCLUSION:CXPA has a variety of pathologic classifications,with characteristics of bone destruction and peripheral tissue invasion.Surgery combined with ^(125)I endoradiotherapy is a preferable treatment option.However,long-term follow-up and close observation for recurrence or metastasis should be performed.
基金Supported by the National Natural Science Foundation of China(No.81970835)the Science and Technology Commission of Shanghai Municipality,China(No.20Y11911200)。
文摘AIM: To study the clinical and pathological characteristics of the lacrimal sac lymphoma, which is rare but it is the major type of non-epithelial malignant tumor in the lacrimal sac region. METHODS: Sixty-four cases of malignant lacrimal sac tumors in our hospital from 1986 to 2020 were retrospectively reviewed. Eight cases of lacrimal sac lymphoma were carefully reviewed. RESULTS: There were five mucosal-associated lymphoid tissue(MALT) lymphomas, one diffused large B-cell lymphoma, one NK/T cell lymphoma, and one mantle cell lymphoma. All eight patients represented symptoms of epiphora with swelling in the lacrimal sac for a certain period of time and showed no signs of systemic involvement at the first time of clinical visits. They had received either chemotherapy or radiotherapy after surgery. Long-term follow-up(from 11 to 220 mo) showed that, except one patient with MALT lymphoma died for unknown reasons at 104 mo after surgery, the other 7 patients were all alive with no signs of local recurrence, neither in other organs. CONCLUSION: Non-epithelial malignant tumors of the lacrimal sac are rare and lymphoma is the major subtype.
文摘AIM: To compare the success rate of monocanalicular versus pushed monocanalicular silicone intubation(PMCI)of the nasolacrimal duct for congenital nasolacrimal duct obstruction(CNLDO).METHODS: In a prospective randomized clinical trial 53 eyes of 49 patients with CNLDO underwent either monocanalicular silicone intubation(MCI)(n =28 eyes) or PMCI(n =25 eyes). All procedures were performed by 1oculoplastic surgeon. Treatment success was defined as the complete resolution of epiphora at 3mo after tube removal.RESULTS: The surgical outcome was assessed in 20 eyes with MCI and 20 eyes with PMCI. The mean age of treatment was 26.25 ±10.08mo(range, 13-49mo) for MCI and 26.85±12.25mo(range, 16-68mo) for PMCI. Treatment success was achieved in 18 of 20 eyes(90.0%) in the MCI group compared with 10 of 20 eyes(50%) in the PMCI group(P =0.01). In the PMCI group, the tube loss(30%)was greater than the MCI group(5%), however the differences between the 2 groups proved to be not significant(P =0.91).CONCLUSION: Our results indicate that MCI has higher success rate in CNLDO treatment compared with PMCI in this small series of patients.
文摘AIM:To analyze cases of obstruction of the nasolacrimal duct which creates a fertile environment for secondary bacterial Infection and can result in dacryocystitis,which is a constant threat to cornea and orbital soft tissue and a potential source of endophthalmitis following intraocular surgery.The majority of obstructions of the lacrimal excretory outflow system are acquired ones occurring in adulthood and involving the distal parts of the system.Acquired obstruction may be primary/idiopathic or secondary to a wide variety of infectious,inflammatory,traumatic,mechanical,toxic or neoplastic causes mimicking idiopathic inflammation.These cases are treated by dacryocystorhinostomy(DCR).METHODS:The present study was conducted to determine the histopathologic,immunohistochemical and current microbiologic characteristics of lacrimal sac specimens in patients undergoing external dacryocystorhinostomy.RESULTS:Non-specific lacrimal sac pathology was present in all 33 cases and 81.8%of the cases showed moderate chronic inflammation with a chronic inflammatory score(CIS)ranging between 4 and 6,whereas 12.12%showed severe inflammatory changes with a CIS of 7.Mild degree of inflammation was seen in6.06%with a CIS of 3.The total prevalence of grampositive,gram-negative,and culture-negative samples were 59.4%,37.5%,and 3%respectively.CONCLUSION:Non-specific chronic inflammation withfibrosis is indeed the most commonly reported histopathological finding in lacrimal sac wall biopsy specimens.
文摘· AIM: To evaluate the application of ultrasound biomicroscopy(UBM) in the examination of lacrimal canalicular diseases, and to investigate UBM image characteristics of lacrimal canaliculi in disease states.·METHODS: Sixty cases(63 eyes, 69 canaliculi) of lacrimal canalicular diseases were enrolled that included32 patients(32 eyes, 32 canaliculi) with chronic lacrimal canaliculitis, 18 patients(18 eyes, 18 canaliculi) with previous lacrimal canalicular laceration, 9 patients(12eyes, 18 canaliculi) with congenital absence of lacrimal puncta and canaliculi, and 1 case(1 eye, 1 canaliculus)of canalicular mass. The patients were examined using UBM, and disease-specific features of the UBM images were noted.· RESULTS: UBM imaging of lacrimal canaliculi in chronic canaliculitis patients showed obvious ectasia of the lacrimal canalicular lumen. Dot-like moderate echoic signals were detected on some ectatic lumina of the lacrimal canaliculus. Some lumen-like structures of the lower lacrimal canaliculus were observed in 2(2 eyes, 2canaliculi) of the 9 patients(12 eyes, 18 canaliculi) with congenital absence of the lacrimal canaliculus. Of the 18patients(18 eyes, 18 canaliculi) with previous lacrimal canalicular laceration, the lacerated end on the nasal side of the lacrimal canaliculus was detected only in 14patients(14 eyes, 14 canaliculi).·CONCLUSION: UBM can be used to evaluate lacrimal canalicular diseases and can provide an imaging basis for the diagnosis of lacrimal canalicular diseases.
基金Supported by the Tianjin Key Medical Discipline(Specialty)Construction Project(No.TJYXZDXK-037A)Tianjin Medical University Eye Hospital。
文摘AIM:To evaluate the differences between human lacrimal gland adenoid cystic carcinoma with high-grade transformation(LACC-HGT)primar y cells cultured by high-grade transformation tissue and non-high-grade transformation(non-HGT)primary cells cultured by non-highgrade transformation tissue in proliferation,metastasis,drug susceptibility,and genes.METHODS:LACC-HGT primary cells were established by tissue block culture,and the 4^(th)to 10^(th)generation primary cells were selected as research objects.The cells were preliminarily identified by immunofluorescent staining.The differences between non-HGT and LACC-HGT primary cells in terms of proliferation,metastasis,and drug susceptibility were compared by cell counting kit-8(CCK-8)assay,wound healing,and drug sensitivity experiments.Differentially expressed genes were screened using mRNA array.Gene expression was analyzed using real-time quantitative polymerase chain reaction(RT-qPCR).RESULTS:LACC-HGT primary cells were successfully cultured by tissue block culture.Immunofluorescence staining results showed that cytokeratin(CK)and CK7 expression levels were positive in LACC-HGT primary cells.CCK-8 results showed that the proliferation ability of LACCHGT cells was significantly higher than that of non-HGT cells.Wound healing experiment showed that the migration ability of LACC-HGT cells was significantly higher than that of non-HGT cells.LACC-HGT cells were also less sensitive to cisplatin and paclitaxel than non-HGT cells.Compared with non-HGT cells,9566 differentially expressed genes were found in LACC-HGT primary cells,of which 5162 were upregulated and 4404 were down-regulated.The expression of N-acetylneuraminate pyruvate lyase(NPL),MARVEL domain containing 3(MARVELD3),syntabulin(SYBU),and allograft inflammatory factor 1(AIF1)was higher in LACCHGT cells than in non-HGT cells,whereas that of periostin(POSTN)was lower.CONCLUSION:LACC-HGT primary cells have faster proliferation,stronger migration ability,and poorer sensitivity to chemotherapy drugs than non-HGT primary cells.The expression of mRNAs in non-HGT and LACC-HGT primary cells are significantly different.These features are speculated to be the reasons why high-grade transformation tissues exhibit higher malignant degree and poorer prognosis than their counterparts.
基金Supported by the National Natural Science Foundation of China (No.81070705 No.81270974)+1 种基金Zhejiang Provincial Natural Science Foundation of China (No. LY13H120002)Science and Technology Department of Zhejiang Province (No. 2014KYB111)
文摘AIM： To evaluate the effectiveness of the Crawford tube in treating symptomatic epiphora without nasolacrimal obstruction. METHODS： A protocol was adopted for the management of symptomatic epiphora without nasolacrimal obstruction. Patients who suffered symptomatic epiphora without nasolacrimal obstruction in both eyes were included in the study. One eye was treated with Crawford tube intubation and the other eye was treated with medication therapy. Degree of watering, patient satisfaction, and symptomatic improvement were carefully evaluated by one of the authors at the end of the follow-up period, after Crawford tube removal, to ascertain functional results. RESULTS： Thirty-seven adult patients （37 eyes） underwent Crawford tube intubation for functional epiphora. The mean follow-up time after removal of the tube was 14.8 ~4.8mo. The procedure was an overall success in 28 eyes （75.7%）, with symptoms improving significantly. Two eyes （5.4%） were relieved of indoor epiphora, two （5.4%） had minimal epiphora outdoors, but only with wind or cold, and five （13.5%） continued to experience tearing both indoors and outdoors. Thirty of the patients （81%） expressed satisfaction with the procedure. CONCLUSION： Crawford tube insertion is an effective, safe, simple, and relatively noninvasive treatment strategy for functional lacrimal system obstruction.
基金Supported by High-Level Talents Training Foundation of the Armed Police Force(No.GCCRC-02)。
文摘AIM:To investigate the variation of IGSF3 gene in three families with congenital absence of lacrimal puncta and canaliculi,and to lay a foundation for further research on the pathogenic gene of congenital lacrimal duct agenesis.METHODS:The members of the three families were recruited.The ophthalmologic examinations in details,including slit-lamp biomicroscope,intraocular pressure and fundus examination,etc.were carried out.All patients were checked with paracentesis of puncta membrane and lacrimal duct probing,as well as the computed tomographydacryocystography(CT-DCG).Peripheral blood of 14 participants(3 normal)from three families were collected,4 mL each,for genomic DNA extraction,and 11 exon fragments of IGSF3 gene were amplified and sequenced by polymerase chain reaction(PCR)to determine whether there were IGSF3 genetic variation.RESULTS:A total of 14 members from three families were screened for 4 synonymous variants:c.930 C>T(p.Pro366=),c.1359 T>C(p.Ser709=),c.1797 G>A(p.Ser855=),c.1539 G>A(p.Ser769=),and 6 missense variants:c.l507 G>A(p.Gly759 Ser),c.1783 T>C(p.Trp851 Arg),c.1952 G>T(p.Ser 907 lle),c.3120 C>G(p.Asp1040 Glu),c.3123 C>G(p.Asp1041 Glu),c.3139_3140 insGAC(p.Asp1046_Pro1047 insAsp),and the latter three were only found in two patients with absence of lacrimal puncta and canaliculi combined with congenital osseous nasolacrimal canal obstruction from the first family.CONCLUSION:The same IGSF3 gene mutation c.31393140 insGAC is found in the patients with congenital absence of lacrimal puncta and canaliculi combine with osseous nasolacrimal canal obstruction.
文摘We have treated 34 cases of epiphora due to dysfunction of the lacrimal duct with a warm needle puncturing at the Jingming (UB 1) point. The effect was significantly better than that of the control group treated with lacrimal duct irrigation and norflaxacin eye drops (a total effective rate of 91.07% vs. 54.29%).
基金The National Natural Science Foundation of China,No.61931013,No.61527807 and No.62041103Nanjing Medical Science and technique Development Foundation,No.QRX17207.
文摘BACKGROUND Nasolacrimal duct obstruction leading to epiphora is a common ophthalmologic complaint,and it may derive from amyloidosis in rare cases.There are a few reports about localized amyloidosis,and amyloidosis with involvement and obstruction of the nasolacrimal duct is exceedingly rare.CASE SUMMARY A 54-year-old male presented with a 2-year history of a lump overlying the left lacrimal sac that had grown rapidly for nearly half a year.Physical examination touched a firm lump in the left lacrimal sac.Nasal endoscopy discovered lesions in appearance of sediments with easy bleeding at the entry of the nasolacrimal duct of the left inferior nasal meatus.Computerized tomography scan revealed speckle high density in the left lacrimal sac and the dilated nasolacrimal duct.During an endoscopic exploration and excision,a large number of dacryoliths were exposed.Pathology indicated amorphous pink material and multinucleated giant cell reaction in the fibrous tissue.CONCLUSION This case showed amyloidosis in localized form mimicking dacryolith with nasolacrimal duct obstruction.In clinical practice,we should be aware of the possibility of localized amyloidosis in the nasolacrimal excretory system.
文摘Objective: to research the therapeutic effect and adverse reaction rate of lacrimal duct probing combined with tobramycin and dexamethasone eye ointment in treating congenital lacrimal duct obstruction. Methods: selecting a total of 43 children with congenital lacrimal duct obstruction from August 2018 to August 2020 as research subjects. Divide into two groups according treating plan: Control group (21 cases, lacrimal duct probing combined with normal saline irrigation) and observation group (22 cases, lacrimal duct probing combined with tobramycin and dexamethasone eye ointment). Analyzing the therapeutic effect, recurrence rate, incidence of adverse reactions, ocular surface disease index, and other indicators. Evaluating the clinical value of lacrimal duct probing combined with tobramycin and dexamethasone eye ointment. Results: in the observation group, the clinical treatment effect was good, there were fewer adverse reactions occurred, and the recurrence rate was low, the P value was less than 0.05;compared with the controlling group, the frequency of ocular discomfort in adverse environment, the influence of ocular discomfort on daily activities and the frequency score of ocular discomfort in observation group were shortened (the P value was less than 0.05). Conclusion: in treating children with lacrimal duct probing combined with tobramycin and dexamethasone eye ointment, not only the treatment effect is relatively significant, but also the clinical safety of treatment is high, and the children can grow up healthily.
基金National Natural Science Foundation of China (No.30772824)Special Fund from Doctoral Program in Colleges and Universities Affiliated to Ministry of Education,China(No. 200805410004)+2 种基金Natural Science Fund of Hunan Province of China(No.07JJ3049)Science & Technology Department of Hunan Province fund of China(No.2009FJ3001)Graduate student's innovative fund of Hunan Province of 2008,China(2008 No.68)
文摘AIMTo assess the effects of extract of Buddleja officinalis on tear secretion volume, tear film stability, expressions of TGF-β1, IL-1β, TNF-α in lacrimal gland of castrated rabbits with dry eye.
基金Supported by the National Natural Science Foundation of China(No.81970769,No.81770890,No.81900891)。
文摘AIM: To investigate the regulatory roles of the members of the peroxisome proliferator-activated receptor(PPAR)family in lacrimal gland dysfunction under conditions of desiccating stress or diabetes.METHODS: Quantitative polymerase chain reaction(qPCR) was used to examine the expression of PPARs in the cornea, conjunctiva, meibomian gland, and lacrimal gland in adult rats. The rats were divided into 3 groups:a control group, dry eye group, and diabetic group. The phenol red threads test, tear film break-up time(BUT) test and fluorescein staining were carried out to evaluate the development of dry eye. Based on bioinformatics research,qP CR was used to examine the expression level of PPARγ,tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β),interleukin-6(IL-6), sirtuin 1(Sirt1), myeloid differentiation factor 88(MyD88) and transforming growth factor-β(TGF-β)in the lacrimal glands.RESULTS: PPARα and PPARβ/δ were mainly expressed in the conjunctiva and the lacrimal gland, respectively.However, PPARγ was expressed in both the conjunctiva and lacrimal gland, at much higher levels than those measured for PPARα and PPARβ/δ. Dry eye rats and diabetic rats both showed decreased tear secretion, shortened BUT,and increased corneal staining. Significant changes in gene expression were observed compared with the control group. In the lacrimal glands of dry eye rats and diabetic rats, expression of PPARγ decreased(P<0.05), expression of Sirt1 also decreased(P<0.01), whereas expression of TNF-α, IL-1β, IL-6, MyD88, and TGF-β increased(P<0.05).CONCLUSION: Among PPARs, PPARγ might play a dominant role in the regulation of metabolic-and inflammatorysignaling pathways on the ocular surfaces and in lacrimal glands. Down-regulation of PPARγ is highly relevant to lacrimal gland dysfunction under desiccating-stress and diabetic conditions. PPARγ, thus, is a potential therapeutic target in the treatment of environment-or diabetes-induced dry eye diseases.
