Wenbin Wei

Abstract:PURPOSE To describe characteristics of central serous chorioretinopathy (CSC) imaged by optical coherence tomography-assisted enhanced depth imaging (EDI-OCT). METHODS The prospective observational case series study consisted of patients with acute or chronic CSC. All subjects underwent fundus fluorescein angiography, indocyanine green angiography (ICGA), and EDI-OCT. RESULTS The study included 68 eyes (68 patients) with 35 eyes showing signs of acute CSC. Mean subfoveal choroidal thickness, 478 ± 114 μm, was larger than the normative value from the beijing eye study 2011 (254 ± 107 μm) on the same ethnic group. In the hyperfluorescent ICGA areas, EDI-OCT revealed a thinning of the inner choroidal layers and enlargement of the underlying hyporeflective lumina in all eyes. the diameter of the hyporeflective lumina (mean: 330 ± 103 μm) was significantly (P < 0.001) associated with subfoveal choroidal thickness (correlation coefficient [r]: 0.68). An RPE detachment was detected in 36 (53%) eyes. A double-layer sign defined as an undulated RPE layer and intact underlying Bruch's membrane (seen in 51 [75%] eyes) was significantly (P = 0.025) more often in the chronic CSC group (29/33; 87%) than in the acute CSC group (22/35; 63%). Prevalence of an RPE microrip (8/68 [12%] eyes) did not differ (P = 0.14) between the chronic CSC group (6/33; 18%) and the acute CSC group (2/35; 5.7%). CONCLUSIONS CSC is characterized by a thinned inner choroidal layer and enlarged underlying hyporeflective choroidal lumina in all eyes, in addition to a dome-shaped RPE elevation, a double-layer sign of the RPE/Bruch's membrane complex, and RPE microrips in some eyes. EDI-OCT may be helpful in the diagnosis of CSC.

Abstract:．目的:测量hyporeflective腔the choroid of patients with central serous choroidopathy (CSC) and to compare the diameter with that of a control group. Methods: The prospective comparative observational clinical study included patients with unilateral CSC and a control group of normal subjects, matched in age, gender and refractive error with the study group. Subfoveal choroidal thickness (SFCT) and the largest diameter of choroidal hyporeflective lumen as surrogates for the choroidal vessels were measured by enhanced depth imaging optical coherence tomography (OCT). Results: The study group included 15 Chinese patients and the control group 15 control subjects. Mean SFCT was significantly (p = 0.04) larger in the affected eyes (455 ± 73 μm) than in the contralateral unaffected eyes (387 ± 94 μm), in which it was significantly (p = 0.005) larger than in the control group (289 ± 71 μm). In a parallel manner, the mean diameter of the largest hyporeflective lumen was larger, but not significantly larger (p = 0.18) in the affected eyes (305 ± 101 μm) than in the in the contralateral unaffected eyes (251 ± 98 μm), in which it was significantly (p = 0.001) larger than in the control group (140 ± 40 μm). Largest vessel diameter was significantly (p < 0.001; correlation coefficient: 0.73) correlated with the thickness of the total choroid. Conclusions: In patients with CSC, the affected eyes show larger hyporeflective lumen than the contralateral clinically unaffected eyes and significantly larger than normal control eyes. Assuming these hyporeflective lumens to be choroidal vessels, macular swelling in CSC is markedly associated with vascular engorgement. As also the clinically unaffected eyes showed macular choroidal significant swelling, CSC may have a systemic component with usually asymmetric ocular involvement.

Abstract:Objectives To investigate vascular flow density in pathological myopia with optical coherence tomography (OCT) angiography. Design A prospective comparative study was conducted from December 2015 to March 2016. Setting Participants were recruited in Beijing Tongren Hospital. Participants A total of 131 eyes were enrolled, which were divided into three groups: 45 eyes with emmetropia (EM; mean spherical equivalent (MSE) 0.50D to −0.50D), 41 eyes with high myopia (HM; MSE ≤−6.00D, without pathological changes), and 45 eyes with pathological myopia (PM; MSE ≤−6.00D and axial length (AL) ≥26.5 mm, and with pathological changes). Main outcome measures Macular, choriocapillaris and radial peripapillary capillary (RPC) flow densities were measured and compared between groups, and their relationships with AL and best corrected visual acuity (BCVA) were analysed. Results Significant differences were found in macular, choriocapillaris and RPC flow densities among the three groups (p Conclusions Macular and RPC flow densities decreased in pathological myopia compared with high myopia and emmetropia. No significant decrease of retinal flow density in the macular and arcuate fibre region was found in high myopic eyes compared with emmetropic eyes. Moreover, macular and RPC flow densities were negatively related to AL, and macular flow density was positively related to BCVA.

Abstract:Purpose To observe the efficacy of intravitreal ranibizumab (IVR) combined with another ablative therapy, such as laser photocoagulation, for Coats' disease. Methods Patients younger than 16 years of age who were diagnosed with Coats' disease were included in this study. They were treated with IVR (0.5 mg, monthly in the first 3 months) as an initial treatment, which was combined with another ablative therapy, such as laser photocoagulation or cryotherapy, as needed. The main data evaluation and outcome measurements included best-corrected visual acuity (BCVA) before and after treatment, fundus photography, optical coherence tomography (OCT), the number of treatment sessions, and ocular and systemic side-effects during follow-up. Results Seventeen patients were included in this study; the average age was 7.9 ± 3.8 years, and the average follow-up time was 9.7 ± 3.3 months. The mean number of IVR treatments was 3.9 ± 1.0. Sixteen patients (94.1%) needed another treatment. Eleven patients (64.7%) were stable at the final follow-up. The BCVA at the last follow-up was significantly improved compared to baseline (p < 0.001). Telangiectasia regression was found in all patients. Partial and total retinal attached was found in 14 patients (82.4%), and exudate resolution was found in eight patients (47.1%). There were no severe ocular or systemic side-effects during the follow-up period. Conclusion Intravitreal ranibizumab combined with other ablative therapies as an initial treatment is an effective and safe treatment approach for Coats' disease that may improve the visual acuity and reduce the subretinal fluid, exudates and telangiectasia.

Abstract:Aim To reveal the insight mechanism of liver metastasis in uveal melanoma, we investigated cell functions of microRNA-21 in three different uveal melanoma cell lines and analyze the relationship of target gene p53 and its downstream targets. Methods Quantitative reverse transcription polymerase chain reaction (qRT-PCR) was used to detect microRNA-21 expression in normal uveal tissue and uveal melanoma cell lines. Lenti-virus expression system was used to construct OCM-1, MuM-2B and M619 cell line with stable overexpression and inhibition of microRNA-21. In vitro cell function tests such as cell proliferation, cell apoptosis, cell circle and abilities of migration and invasion were examined by MTT, BrdU assay, flow cytometry, transwell assay and Matrigel invasion assay respectively. The target gene was predicted by bioinformatics and confirmed by using a dual luciferase reporter assay. The expression of p53 and its suspected downstream targets LIM and SH3 protein 1 (LASP1) and glutathione S transferase pi (GST-Pi) were determined by qRT-PCR in mRNA level and Western blotting analysis in protein level. Finally, the effect of microRNA-21 in a xenograft tumor model was assessed in four-week-old BALB/c nude mice. Results Compared to normal uveal melanoma, expressions of microRNA-21 were significantly higher in uveal melanoma cell lines. Overexpression of microRNA-21 promoted proliferation, migration, and invasion of OCM-1, M619 and MuM-2B cells, while inhibition of microRNA-21 reveal opposite effects. Wild type p53 was identified as a target gene of microRNA-21-3p, and proved by dual luciferase reporter assay. Up-regulated microRNA-21 inhibited the expression of wild type p53 gene, and the increased expression of LASP1 in mRNA level and protein level, while down-regulated microRNA-21 presented opposite way. However, GST-pi showed the potential pattern as expected, but relative mRNA level showed no statistically significant difference in OCM-1 cells. Furthermore, the mRNA expression of GST-pi was decreased in microRNA-21 overexpressing MuM-2B, and increased in M619 cells with inhibition of microRNA-21. In vivo, inhibition of microRNA-21 reduced tumor growth with statistically significant difference. Conclusion These findings provide novel insight into molecular etiology of microRNA-21 in uveal melanoma cell lines, and suggest that microRNA-21 might be a potential candidate for the diagnosis and prognostic factor of human uveal melanoma.

Abstract:PURPOSE To measure macular choroidal thickness in normal eyes at different points using enhanced depth imaging (EDI) optical coherence tomography (OCT) and to evaluate the association of choroidal thickness and age. DESIGN Retrospective, observational case series. METHODS EDI OCT images were obtained in patients without significant retinal or choroidal pathologic features. The images were obtained by positioning a spectral-domain OCT device close enough to the eye to acquire an inverted image. Seven sections were obtained within a 5 x 30-degree area centered at the fovea, with 100 scans averaged for each section. The choroid was measured from the outer border of the retinal pigment epithelium to the inner scleral border at 500-microm intervals of a horizontal section from 3 mm temporal to the fovea to 3 mm nasal to the fovea. Statistical analysis was performed to evaluate variations of choroidal thickness at each location and to correlate choroidal thickness and patient age. RESULTS The mean age of the 30 patients (54 eyes) was 50.4 years (range, 19 to 85 years), and 14 patients (46.7%) were female. The choroid was thickest underneath the fovea (mean, 287 microm; standard deviation, +/- 76 microm). Choroidal thickness decreased rapidly in the nasal direction and averaged 145 microm (+/- 57 microm) at 3 mm nasal to the fovea. Increasing age was correlated significantly with decreasing choroidal thickness at all points measured. Regression analysis suggested that the subfoveal choroidal thickness decreased by 15.6 microm for each decade of life. CONCLUSIONS Choroidal thickness seems to vary topographically within the posterior pole. The thickness of the choroid showed a negative correlation with age. The decrease in the thickness of the choroid may play a role in the pathophysiologic features of various age-related ocular conditions.

Abstract:Central serous chorioretinopathy (CSCR) is a major cause of vision threat among middle-aged male individuals. Multimodal imaging led to the description of a wide range of CSCR manifestations, and highlighted the contribution of the choroid and pigment epithelium in CSCR pathogenesis. However, the exact molecular mechanisms of CSCR have remained uncertain. The aim of this review is to recapitulate the clinical understanding of CSCR, with an emphasis on the most recent findings on epidemiology, risk factors, clinical and imaging diagnosis, and treatments options. It also gives an overview of the novel mineralocorticoid pathway hypothesis, from animal data to clinical evidences of the biological efficacy of oral mineralocorticoid antagonists in acute and chronic CSCR patients. In rodents, activation of the mineralocorticoid pathway in ocular cells either by intravitreous injection of its specific ligand, aldosterone, or by over-expression of the receptor specifically in the vascular endothelium, induced ocular phenotypes carrying many features of acute CSCR. Molecular mechanisms include expression of the calcium-dependent potassium channel (KCa2.3) in the endothelium of choroidal vessels, inducing subsequent vasodilation. Inappropriate or over-activation of the mineralocorticoid receptor in ocular cells and other tissues (such as brain, vessels) could link CSCR with the known co-morbidities observed in CSCR patients, including hypertension, coronary disease and psychological stress.

Abstract:采用广角光学相干tomography (WF-OCT) has provided newer insights in the imaging of peripheral choroid. We evaluated choroidal thickness (CT) and large choroidal vessel thickness (LCVT) of 20 eyes in horizontal and vertical meridians using WF-OCT. A high-definition line scan through the fovea in both horizontal and vertical meridian was captured in primary and extremes of gaze to obtain scans up to mid-equator. CT and LCVT measurements were done across predefined points in macular area and all quadrants. LCVT was calculated after identifying a large choroidal vessel near choroidoscleral interface. The main outcome measures were differences in CT and LCVT in macular and four quadrants. Mean CT (331.23 ± 76.34 µ) and LCVT (201.46 ± 54.31 µ) in vertical macular segment were significantly more than CT (245.79 ± 55.38 µ; p = 0.0002) and LCVT (150.48 ± 52.58 µ; p = 0.004) in horizontal macular segment. CT at peripheral points in all quadrants was significantly reduced as compared to subfoveal CT (all p values < 0.05) with maximum reduction in inferior quadrant (64.5%). Using linear regression, only quadrant had a significant effect on CT and LCVT (both p < 0.001). CT and LCVT are highest at the macular area with reduction towards the periphery. The contribution of LCVT to CT is less at the fovea compared to other peripheral points.

Abstract:Purpose To determine the proportion of shallow irregular pigment epithelial detachments in eyes with pachychoroid features that harbor neovascular tissue and to study the morphology of this tissue with optical coherence tomography (OCT) angiography. Design Prospective consecutive cohort study. Methods Patients with pachychoroid spectrum diagnoses and shallow irregular pigment epithelial detachment in at least 1 eye (study eye) were included. Charts and multimodal imaging were reviewed to determine a dye angiography detection rate for type 1 neovascularization in study eyes. All patients then underwent OCT angiography prospectively, followed by masked segmentation and grading. Results Twenty-two eyes of 16 patients were included. Mean age was 71 (range 57–95) years. Mean subfoveal choroidal thickness was 381 μm (standard deviation: 141 μm). Four out of 22 study eyes (18%) exhibited polypoidal lesions. Dye angiography demonstrated specific features of neovascularization in 5 out of 17 eyes (29%) with suspected nonpolypoidal pachychoroid neovasculopathy. With OCT angiography, type 1 neovascular tissue was visualized in 21 out of 22 study eyes (95%). Conclusions Our data suggest that, in eyes with pachychoroid features, the finding of a shallow irregular pigment epithelial detachment on OCT has greater diagnostic value for type 1 neovascularization than previously thought and that dye angiography may underestimate the prevalence of neovascularization compared to OCT angiography.

Abstract:目的探讨脉络膜血管指数(CVI) in eyes with central serous chorioretinopathy (CSC) using an image binarization tool on enhanced depth imaging using spectral domain optical coherence tomography scans. METHODS In this retrospective cohort study, enhanced depth imaging optical coherence tomography scans of both eyes of patients with CSC were taken at baseline; they were segmented and compared with enhanced depth imaging optical coherence tomography scans of fellow eyes without CSC as well as age-matched healthy subjects. Subfoveal choroidal area (1,500 μm) was segmented into luminal area and stromal area using image binarization. Choroidal vascularity index was defined as the proportion of luminal area to the total circumscribed subfoveal choroidal area. RESULTS Eyes with acute CSC (32 eyes) had significantly higher CVI compared with their fellow eyes (27 eyes) (P < 0.0001), 19 eyes with resolved CSC (P < 0.0001) and with 30 eyes of age-matched healthy eyes (P < 0.0001). Fellow eyes of subjects with acute CSC also had significantly higher CVI compared with eyes with resolved CSC (P < 0.0001) and age-matched healthy eyes (P < 0.0001). CONCLUSION Increased CVI suggests increased vascular component compared with the stromal component in acute CSC. Increased CVI was noted in fellow eye of the subjects with acute CSC in comparison with age-matched healthy subjects. The CVI could be a useful index for early diagnosis of CSC and to assess the treatment response after laser photocoagulation or photodynamic therapy.