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Thyroid associated ophthalmopathy (TAO) is an autoimmune inflammatory disorder which disfigures appearance, threatens vision, and results in a pronounced loss of quality of life. The diversity and ethnic difference of the disease manifestations have made it difficult to tailor therapies for each patient. Few studies have analyzed its characteristics in Chinese populations. We therefore enrolled 354 patients with moderate-to-severe TAO from February 2015 to July 2016. A single ophthalmologist consistently performed detailed ophthalmic examinations. Orbital computed tomography or magnetic resonance imaging scans were performed to verify enlarged extraocular muscles. Multiple linear regression was used to analyze the association between sex, age, smoking, family history of thyroid diseases, degree of proptosis and disease severity. The mean age of males (46.56±11.08 years) was significantly higher than that of females (41.39±years), with a female-to-male ratio of 1.09. The females and males between 31~40 and 41~50 years, respectively, had the highest incidence of TAO. 81.48% of the patients suffered hyperthyroidism. TAO was diagnosed either after (47.17%) or simultaneously with thyroid dysfunction (27.68%). Proptosis (91.24%), eyelid retraction (83.33%), together with eyelid swelling (79.38%) and extraocular muscle enlargement (75.42%), were the most common clinical sign. 19.77% of patients manifested lower eyelid retraction. The mean values of exophthalmos and asymmetry on proptosis were 19.94±3.45mm and 2.18±2.06mm, respectively in males, 18.58±3.31mm and 1.61±1.53mm, respectively in females. The severity of disease was significantly associated with male, older age, smoking, family history of thyroid diseases and degree of proptosis. We found several differences in Chinese compared with White. The female-to-male ratio and mean value of exophthalmos were significantly lower than the data of White. Inferior and superior rectus became the most common extraocular muscles. Lower eyelid retraction should be included in diagnostic criteria in Asian patients. Understanding these differences, may allow better identification and treatment for TAO in China.

PURPOSE.To compare the structural differences of the ciliary body in patients with acute primary-angle closure (APAC) and normal subjects. METHODS.Forty-four patients with APAC in one eye and 25 eyes from 25 age-matched normal subjects were consecutively recruited. A-scan ultrasound and ultrasound biomicroscopy (UBM) measurements were performed. Ciliary body parameters including maximum ciliary body thickness (CBTmax), ciliary body thickness at point of the scleral spur (CBT0) and 1000 lm from the scleral spur (CBT1000), anterior placement of ciliary body (APCB), and trabecular-ciliary process angle (TCA), as well as biometric measurements, were measured.RESULTS. Average CBTmax was 0.894 6 0.114, 0.967 6 0.110, and 1.053 6 0.103 mm in eyes with APAC, their fellow eyes, and normal eyes, respectively. Average CBT1000 was 0.616 6 0.111, 0.631 6 0.088, and 0.842 6 0.118 mm, respectively. Average TCA was 48.10 6 13.268, 50.60 6 9.088, and 87.11 6 20.718, respectively. CBTmax and CBT0 were thinner in eyes with APAC compared with their fellow eyes (P ¼ 0.002, P < 0.001). In addition, CBTmax, CBT1000, and TCA were smaller whereas APCB was larger in the fellow eyes of APAC patients compared with normal eyes (P ¼ 0.002, P < 0.001, P < 0.001, P < 0.001). The anterior chamber depth (ACD) was smaller whereas lens thickness (LT) was larger in eyes with APAC compared with their fellow eyes (P < 0.001, P ¼ 0.036). Smaller ACD and axial length and larger LT and lens vault were found in the fellow eyes of APAC patients compared with normal eyes (P < 0.001, P < 0.001, P ¼ 0.015, P ¼ 0.001).CONCLUSIONS. Ciliary bodies were thinner and more anteriorly rotated in eyes with APAC as well as in their fellow eyes. Further studies are needed to elucidate the relationship between ciliary body parameters and mechanism of APAC.

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Hesperidin is an abundant flavanone glycoside in citrus fruits and has been reported to possess a wide range of biological activities. However, hesperidin has poor bioavailability. Here, we tested the hypothesis that hesperetin found in chenpi will have a better bioavailability than hesperidin and that treatment of hesperidin with the glucosidase-like yeast Bg1A protein will increase its bioavailability. The results indicate that hesperidin in pure or extract form is hydrolyzed by BglA protein extracted from Sporobolomyces singularis or expressed in Escherichia coli BL21 (DE3). This biotransformation affected the plasma pharmacokinetics of total hesperetin in rats, in that the plasma T max was significantly shorter after administration of BglA protein-treated hesperidin than after administration of hesperidin extract. In addition, the area under the curve values for total hesperetin after administration of Bg1A-treated hesperidin were approximately 4-fold higher by oral administration and 3-fold higher by intravenous administration, respectively. In contrast, the plasma clearance value and volume of distribution after administration of Bg1A-treated hesperidin extract or pure hesperetin were significantly smaller than after administration of untreated hesperidin extract or pure hesperidin. This is the first study that systemically determines the absolute bioavailability of hesperidin and hesperetin simultaneously, shows clearly that hesperetin is more bioavailable than hesperidin regardless of the route of administration, and shows that prior transformation of hesperidin to hesperetin via fermentation should significantly increase its bioavailability because of the action of the yeast glycosidase-like protein BglA.