Chinese ophthalmology residency training is continuously evolving with an emphasis on standardization. In this article, we assess the current status of ophthalmology residency training in China compared with that in the United States through analysis of literature review and onsite data collection. We comprehensively review various aspects of the residency training structure in China, including accreditation, resident selection, clinical and surgical curricula, research requirements, and evaluation. Our report demonstrates significant regional differences among training programs due to the lack of a national standard, resulting in varying competencies of graduating Chinese ophthalmology residents. The Chinese ophthalmology community is determined to improve the standardization process and quality of training for their ophthalmologists, an important goal that will facilitate international fellowship studies, exchange scholars, and research collaboration.
Purpose:
Acanthamoeba keratitis (AK) is a severe vision-threatening ocular infection that is frequently a diagnostic challenge. Treatment course is lengthy and often not fully effective. Contact lens wear has been recognized as the prime risk factor for AK. In vivo confocal microscopy (IVCM) is a noninvasive imaging modality that allows direct visualization of potential causative pathogens in real time with an established utility in the diagnosis of AK. In this study, we aim to assess the utility of IVCM in monitoring disease progression in contact lens wearers with culture-confirmed keratitis.
Methods:
Fourteen eyes from 11 patients with culture-confirmed AK were included in this retrospective study. IVCM was performed during the patient's initial visit and all follow-up visits. All available confocal sequences were reviewed and graded in a masked fashion. Density of Acanthamoeba cyst infiltration and changes in the cyst density as a percentage of baseline cyst density measured at each patient's initial visit were calculated. A univariate regression analysis was performed to assess the association between treatment and changes in cyst density per month of treatment.
Results:
Acanthamoeba cysts were identified by IVCM in all of these culture-confirmed cases of keratitis. Mean cyst density in the central cornea at presentation was 99 ± 64.9 cells per square millimeter (range, 38–255/mm2). Cyst density in our study population significantly decreased by approximately 5.3% with each month of antiamebic treatment (P = 0.001; R
2 = 0.41).
Conclusions:
Reduction in Acanthamoeba cyst density with treatment can be monitored by IVCM, which in turn can be used clinically in prognostication and disease monitoring of AK.
Purpose:
To examine the short-term efficacy and safety of gonioscopy-assisted transluminal trabeculotomy (GATT) in a series of patients who developed glaucoma following vitreoretinal surgery.
Patients and Methods:
Retrospective case series of consecutive patients aged above 18 years with secondary open-angle glaucoma following vitreoretinal surgery who had undergone GATT between January 2015 and June 2019. Eyes were excluded if there is<1 month of follow-up or glaucoma before vitreoretinal surgery.
Results:
Eight eyes of 8 patients were included, with age range 18 to 72 years (median 43.5 y). Mean pretreatment intraocular pressure (IOP) was 32.7±5.1 mm Hg with a mean of 4.8±0.9 medications. Following GATT, mean IOP improved to 13.6±1.8 mm Hg (P<0.001) with a reduction to 1.6±1.4 medications after a mean follow-up of 8.6 months (range 1 to 25 mo). Five of the 8 eye (62.5%) had silicone oil in the vitreous cavity during GATT, none of which had concurrent oil removal.
Conclusions:
GATT is a safe and effective procedure for eyes with secondary open-angle glaucoma following vitreoretinal surgery. Further studies are needed to elucidate long-term benefits of angle surgery on eyes with high pressure following vitreoretinal surgery.
The neuromuscular junction, the synapse between motor neurons and muscle cells, serves as an excellent model for studying synapse formation. Agrin is believed to be released by motor neurons to induce postsynaptic differentiation at the neuromuscular junction. MuSK, a receptor tyrosine kinase, appears to be a key component of the agrin receptor complex. However, how agrin activates MuSK remains unclear. To address this question, we characterized the binding of the MuSK extracellular region to the muscle cell surface. The MuSK ectodomain was found to bind to muscle cells in a manner dependent on stimulation with neural agrin. Moreover, the binding was myotube specific and appeared to be mediated by two regions in the MuSK: one region containing the first and second immunoglobin domains and the other containing the cysteine-rich domain. Importantly, recombinant proteins containing the binding activity can block full-length MuSK binding to muscle cells and agrin-induced AChR clustering. These results suggest that the Ig1/2 domain of MuSK is involved in AChR clustering by binding to the muscle surface.
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