Neurodegenerative eye diseases, such as glaucoma, cause irreversible vision loss in millions of patients worldwide, creating serious medical, economic and social issues. Like other mammalian central nervous system tra...Neurodegenerative eye diseases, such as glaucoma, cause irreversible vision loss in millions of patients worldwide, creating serious medical, economic and social issues. Like other mammalian central nervous system tracts, optic nerve intrinsically lacks the capacity for axonal growth and its surrounding environment is also non-permissive to regeneration. Any axonal damage also triggers a vicious cycle of retinal ganglion cell （RGC） death. Exploring methods that can enhance RGCs survival and promote axonal regeneration will not only enable vision restoration for millions of patients, but also shed light on the treatment of other neurodegenerative diseases. In this review article, we will go through three current approaches to cure neu- rodegenerative eye diseases, including cell based therapy, neuro-regeneration and neuro-rejuvenation.展开更多
BACKGROUND： There is a growing research focus on the combination of blood oxygenation level dependent functional magnetic resonance imaging （BOLD-fMRI） and diffusion tensor imaging （DTI） to evaluate visual cortic...BACKGROUND： There is a growing research focus on the combination of blood oxygenation level dependent functional magnetic resonance imaging （BOLD-fMRI） and diffusion tensor imaging （DTI） to evaluate visual cortical function and structural changes in the cerebrum, as well as morphological changes to the white matter fiber tracks, after visual pathway lesions. However, the combined application of BOLD-fMRI and DTI in treating of visual pathway abnormalities still requires further studies. OBJECTIVE： To observe and evaluate the effects of hyperbaric oxygen on visual pathway abnormalities, and to evaluate the characteristics of cerebral function and anatomic structural changes by using BOLD-fMRI combined with DTI technique. DESIGN： Case contrast observation. SETTING： Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA. PARTICIPANTS： Sixteen patients （9 males and 7 females, 15-77 years old） with lateral or bilateral visual disorder induced by visual pathway lesions were selected from the Department of Neurology, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA from January 2006 to May 2007. These patients comprised the lesion group. Measures of interventional therapy： hyperbaric oxygen of two normal atmospheres for three courses （10 d/course） and routine internal medicine treatment. In addition, 12 healthy subjects of similar sex and age to the lesion group were regarded as the control group. The control group underwent routine ophthalmological and ocular fundus examinations; diagnostic results were normal. The experiment received confirmed consent from the local ethic committee, and all patients provided informed consent. METHODS： BOLD-fMRI and DTI manifestations in the lesion group were observed before and after hyperbaric oxygen intervention, and the results were compared with the control group. The subjects were positioned on their back, and BOLD-fMRI images were collected with the following GRE EPI sequence： TR = 2 000 ms, TE = 40 ms, layer thickness = 5 mm, and 20-layer successive scanning to cover the whole brain. While, DTI images were collected with SE EPI sequence of single excitation： TR=10 000 ms, TE = 112 ms, layer thickness = 4 mm, layer spacing = 0.5 mm, and a 30-layer successive scanning, matrix = 128×128. A diffusion gradient was applied at 13 directions, and one layer without diffusion weighted imaging was collected at b =1 000 s/mm^2. Numbers of activated voxels in cortical-activated regions, and fractional anisotropy in bilateral cerebral optical radiation regions, were calculated. Displacement, continuity, and destruction of fibrous tracts were analyzed. MAIN OUTCOME MEASURES： Results of BOLD-fMRI and DTI examinations. RESULTS： All 16 patients and 12 controls were included in the final analysis. ① Numbers of activated voxels through the use of BOLD-fMRI： prior to hyperbaric oxygen therapy, the number of activated voxels in the bilateral cortex of occipital lobe were significantly less in the lesion group than in the control group （t =3.23, P 〈 0.01）. In addition, the number of activated voxels significantly increased after treatment compared to before treatment （t = 2.46, P 〈 0.05）. ② Fractional anisotropy in optical radiation regions of bilateral cerebrum： fractional anisotropy in the lesion group was significantly less than the control group （t =2.89, P 〈 0.05）. In addition, fractional anisotropy after treatment was significantly higher than before treatment （t = 2.48, P 〈 0.05）. Moreover, fractional anisotropy of optical neuropathy was significantly higher in 6 patients in the lesion group than the occipital lobe optical central lesion （t = 2.35, P 〈 0.05）. CONCLUSION： BOLD-fMRI combined with DTI can indicate the occurrence, development, and therapeutic course of action for optical pathway lesions. The results acquired from these methods can provide information for function and structure, which can provide reliable verification in the treatment of cerebral function.展开更多
AIM: To develop a short,enhanced functional ability Quality of Vision(faVIQ) instrument based on previous questionnaires employing comprehensive modern statistical techniques to ensure the use of an appropriate respon...AIM: To develop a short,enhanced functional ability Quality of Vision(faVIQ) instrument based on previous questionnaires employing comprehensive modern statistical techniques to ensure the use of an appropriate response scale,items and scoring of the visual related difficulties experienced by patients with visual impairment. · METHODS: Items in current quality-of-life questionnaires for the visually impaired were refined by a multi-professional group and visually impaired focus groups. The resulting 76 items were completed by 293 visually impaired patients with stable vision on two occasions separated by a month. The faVIQ scores of 75 patients with no ocular pathology were compared to 75 age and gender matched patients with visual impairment. ·RESULTS: Rasch analysis reduced the faVIQ items to 27. Correlation to standard visual metrics was moderate(r =0.32-0.46) and to the NEI-VFQ was 0.48. The faVIQ was able to clearly discriminate between age and gender matched populations with no ocular pathology and visual impairment with an index of 0.983 and 95% sensitivity and 95% specificity using a cut off of 29.·CONCLUSION: The faVIQ allows sensitive assessment of quality-of-life in the visually impaired and should support studies which evaluate the effectiveness of low vision rehabilitation services.展开更多
In refractive surgery, the cubic spline fit for the transition zone breaks down for myopia and myopic meridians in mixed astigmatism as in many cases the cubic spline function runs into negative values. In this paper,...In refractive surgery, the cubic spline fit for the transition zone breaks down for myopia and myopic meridians in mixed astigmatism as in many cases the cubic spline function runs into negative values. In this paper, the complementary error function is proposed instead of the cubic spline function as the transition zone function, due to the availability of analytical expression of its derivatives and the nonnegativity fact. It is shown that with the use of the complementary error function, transition zones for all refractive types work correctly.展开更多
Virtual reality is a new technology that simulates a three-dimensional virtual world on a com- puter and enables the generation of visual, audio, and haptic feedback for the full immersion of users. Users can interact...Virtual reality is a new technology that simulates a three-dimensional virtual world on a com- puter and enables the generation of visual, audio, and haptic feedback for the full immersion of users. Users can interact with and observe objects in three-dimensional visual space without limitation. At present, virtual reality training has been widely used in rehabilitation therapy for balance dysfunction. This paper summarizes related articles and other articles suggesting that virtual reality training can improve balance dysfunction in patients after neurological diseases. When patients perform virtual reality training, the prefrontal, parietal cortical areas and other motor cortical networks are activated. These activations may be involved in the reconstruction of neurons in the cerebral cortex. Growing evidence from clinical studies reveals that virtual reality training improves the neurological function of patients with spinal cord injury, cerebral palsy and other neurological impairments. These findings suggest that virtual reality training can acti- vate the cerebral cortex and improve the spatial orientation capacity of patients, thus facilitating the cortex to control balance and increase motion function.展开更多
NFMAs are benign tumors that do not produce any biologically active hormones and exceed 10 mm (0.39 in) in size. Although NFMAs are benign in origin, mass effects may lead to serious clinical symptoms such as visual i...NFMAs are benign tumors that do not produce any biologically active hormones and exceed 10 mm (0.39 in) in size. Although NFMAs are benign in origin, mass effects may lead to serious clinical symptoms such as visual impairments, chronic headache, and pituitary insufficiency. The authors describe a 51-year-old woman who had a NFMA (35 × 24 × 25 mm). The vision was reduced to 7/10 in the both eyes. A transnasal transsphenoidal surgery was performed and the tumor was successfully resected. Postoperatively, the patient had visual (9/10) and headache improvement. This case highlights a rare presentation of non-functioning pituitary macroadenoma.展开更多
基金supported by the National Glaucoma Research Program of the Bright Focus Foundationsupported by an unrestricted research grant from Research to Prevent BlindnessNIH center grant EY014801
文摘Neurodegenerative eye diseases, such as glaucoma, cause irreversible vision loss in millions of patients worldwide, creating serious medical, economic and social issues. Like other mammalian central nervous system tracts, optic nerve intrinsically lacks the capacity for axonal growth and its surrounding environment is also non-permissive to regeneration. Any axonal damage also triggers a vicious cycle of retinal ganglion cell （RGC） death. Exploring methods that can enhance RGCs survival and promote axonal regeneration will not only enable vision restoration for millions of patients, but also shed light on the treatment of other neurodegenerative diseases. In this review article, we will go through three current approaches to cure neu- rodegenerative eye diseases, including cell based therapy, neuro-regeneration and neuro-rejuvenation.
文摘BACKGROUND： There is a growing research focus on the combination of blood oxygenation level dependent functional magnetic resonance imaging （BOLD-fMRI） and diffusion tensor imaging （DTI） to evaluate visual cortical function and structural changes in the cerebrum, as well as morphological changes to the white matter fiber tracks, after visual pathway lesions. However, the combined application of BOLD-fMRI and DTI in treating of visual pathway abnormalities still requires further studies. OBJECTIVE： To observe and evaluate the effects of hyperbaric oxygen on visual pathway abnormalities, and to evaluate the characteristics of cerebral function and anatomic structural changes by using BOLD-fMRI combined with DTI technique. DESIGN： Case contrast observation. SETTING： Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA. PARTICIPANTS： Sixteen patients （9 males and 7 females, 15-77 years old） with lateral or bilateral visual disorder induced by visual pathway lesions were selected from the Department of Neurology, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA from January 2006 to May 2007. These patients comprised the lesion group. Measures of interventional therapy： hyperbaric oxygen of two normal atmospheres for three courses （10 d/course） and routine internal medicine treatment. In addition, 12 healthy subjects of similar sex and age to the lesion group were regarded as the control group. The control group underwent routine ophthalmological and ocular fundus examinations; diagnostic results were normal. The experiment received confirmed consent from the local ethic committee, and all patients provided informed consent. METHODS： BOLD-fMRI and DTI manifestations in the lesion group were observed before and after hyperbaric oxygen intervention, and the results were compared with the control group. The subjects were positioned on their back, and BOLD-fMRI images were collected with the following GRE EPI sequence： TR = 2 000 ms, TE = 40 ms, layer thickness = 5 mm, and 20-layer successive scanning to cover the whole brain. While, DTI images were collected with SE EPI sequence of single excitation： TR=10 000 ms, TE = 112 ms, layer thickness = 4 mm, layer spacing = 0.5 mm, and a 30-layer successive scanning, matrix = 128×128. A diffusion gradient was applied at 13 directions, and one layer without diffusion weighted imaging was collected at b =1 000 s/mm^2. Numbers of activated voxels in cortical-activated regions, and fractional anisotropy in bilateral cerebral optical radiation regions, were calculated. Displacement, continuity, and destruction of fibrous tracts were analyzed. MAIN OUTCOME MEASURES： Results of BOLD-fMRI and DTI examinations. RESULTS： All 16 patients and 12 controls were included in the final analysis. ① Numbers of activated voxels through the use of BOLD-fMRI： prior to hyperbaric oxygen therapy, the number of activated voxels in the bilateral cortex of occipital lobe were significantly less in the lesion group than in the control group （t =3.23, P 〈 0.01）. In addition, the number of activated voxels significantly increased after treatment compared to before treatment （t = 2.46, P 〈 0.05）. ② Fractional anisotropy in optical radiation regions of bilateral cerebrum： fractional anisotropy in the lesion group was significantly less than the control group （t =2.89, P 〈 0.05）. In addition, fractional anisotropy after treatment was significantly higher than before treatment （t = 2.48, P 〈 0.05）. Moreover, fractional anisotropy of optical neuropathy was significantly higher in 6 patients in the lesion group than the occipital lobe optical central lesion （t = 2.35, P 〈 0.05）. CONCLUSION： BOLD-fMRI combined with DTI can indicate the occurrence, development, and therapeutic course of action for optical pathway lesions. The results acquired from these methods can provide information for function and structure, which can provide reliable verification in the treatment of cerebral function.
基金Supported by the Royal National Institute of the Blind,UK(No.226227)
文摘AIM: To develop a short,enhanced functional ability Quality of Vision(faVIQ) instrument based on previous questionnaires employing comprehensive modern statistical techniques to ensure the use of an appropriate response scale,items and scoring of the visual related difficulties experienced by patients with visual impairment. · METHODS: Items in current quality-of-life questionnaires for the visually impaired were refined by a multi-professional group and visually impaired focus groups. The resulting 76 items were completed by 293 visually impaired patients with stable vision on two occasions separated by a month. The faVIQ scores of 75 patients with no ocular pathology were compared to 75 age and gender matched patients with visual impairment. ·RESULTS: Rasch analysis reduced the faVIQ items to 27. Correlation to standard visual metrics was moderate(r =0.32-0.46) and to the NEI-VFQ was 0.48. The faVIQ was able to clearly discriminate between age and gender matched populations with no ocular pathology and visual impairment with an index of 0.983 and 95% sensitivity and 95% specificity using a cut off of 29.·CONCLUSION: The faVIQ allows sensitive assessment of quality-of-life in the visually impaired and should support studies which evaluate the effectiveness of low vision rehabilitation services.
文摘In refractive surgery, the cubic spline fit for the transition zone breaks down for myopia and myopic meridians in mixed astigmatism as in many cases the cubic spline function runs into negative values. In this paper, the complementary error function is proposed instead of the cubic spline function as the transition zone function, due to the availability of analytical expression of its derivatives and the nonnegativity fact. It is shown that with the use of the complementary error function, transition zones for all refractive types work correctly.
基金supported by the National Natural Science Foundation of China,No.30973165 and 81372108Guangdong Province College Students Innovative Research Projects in 2013
文摘Virtual reality is a new technology that simulates a three-dimensional virtual world on a com- puter and enables the generation of visual, audio, and haptic feedback for the full immersion of users. Users can interact with and observe objects in three-dimensional visual space without limitation. At present, virtual reality training has been widely used in rehabilitation therapy for balance dysfunction. This paper summarizes related articles and other articles suggesting that virtual reality training can improve balance dysfunction in patients after neurological diseases. When patients perform virtual reality training, the prefrontal, parietal cortical areas and other motor cortical networks are activated. These activations may be involved in the reconstruction of neurons in the cerebral cortex. Growing evidence from clinical studies reveals that virtual reality training improves the neurological function of patients with spinal cord injury, cerebral palsy and other neurological impairments. These findings suggest that virtual reality training can acti- vate the cerebral cortex and improve the spatial orientation capacity of patients, thus facilitating the cortex to control balance and increase motion function.
文摘NFMAs are benign tumors that do not produce any biologically active hormones and exceed 10 mm (0.39 in) in size. Although NFMAs are benign in origin, mass effects may lead to serious clinical symptoms such as visual impairments, chronic headache, and pituitary insufficiency. The authors describe a 51-year-old woman who had a NFMA (35 × 24 × 25 mm). The vision was reduced to 7/10 in the both eyes. A transnasal transsphenoidal surgery was performed and the tumor was successfully resected. Postoperatively, the patient had visual (9/10) and headache improvement. This case highlights a rare presentation of non-functioning pituitary macroadenoma.
