The Evaluative Research To The Significance And Expression Of TORCH Serology In Hospital Patients With Congenital Cataract

Background&ObjectiveCongenital cataract is a kind of serious impact on children’s visual health including two types, one is the presence of lens opacity at birth, the other is lens opacity within one year after the birth of another. Most children require surgery, due to the special nature of the growth and development of children, they are prone to post-operative complications, in their:special visual development process, visual acuity and visual function are affected more or less, which becomes a problem in clinical ophthalmology. Therefore, it is an important issue of Ophthalmology to explore its causes and mechanisms to take effective preventive measures to reduce its incidence. In recent years, the majority of domestic and foreign researchers think that genetic, environmental and unknown factors (1/3respectively) are related to congenital cataracts. Leonard B. Nelson and Scott E. Olitsky considered that during embryogenesis, infection caused by viruses, parasites and other pathogens may give rise to the incidence of congenital cataracts. Virus, as an important gene mutation inducing pathogen, may cause displacement of gene rearrangements or deletions and other changes, generating induced cataract gene mutation results, in particular the transmission of information of embryogenesis, and therefore be the main reason of congenital cataract formation. Intracellular parasite Toxoplasma gondii also affect normal cells during the development of the mitochondria, leading to cataracts. TORCH pathogenic antibodies include five pathogens IgG and IgM such as Toxoplasma gondii(TOX), Cytomegalovirus(CMV), Herpes simplex virus Ⅰ and Ⅱ(HSV, HSⅦ), Rubella virus(RV) and, may reflect whether children had been subjected to in the embryo invasion of viruses and parasites or after birth-acquired infections. We carry out routine hospital outpatient cataract-related illness and hospitalization of children and non-cataract children TORCH test. This study tries to find a correlation between TORCH pathogen infection and the incidence of cataract by comparing a cataract group with a more positive rate of non-cataract patient group and according to the survey results to evaluate whether the existing TORCH has any actual clinical significance, and whether viruses and parasites could be further factors in the occurrence of congenital cataract proportion, to provide more evidence for further study of the pathogenesis of congenital cataracts. PurposeThe purpose is to find out whether infection of virus and parasite is related to congenital cataract and to evaluate the clinical significance of TORCH test in order to find better research methods. MethodRetrospective analysis.69cases of hospitalized children with congenital cataract as study group,289cases of a random sample at the same period of non-cataract hospitalized children and151cases of newboms as parallel group, these cases are hospitalized between May2006and September2013with11963outpatient cases as lateral group (As close to the trend of the control group of ordinary people), among which each case has a complete antibody serum TORCH pathogens including (TOX, CMV, HS V, HS Ⅶ, RV) IgG and IgM testing records and all cases come from the Children’s Hospital, Zhejiang University School of Medicine. Compared cataract group, parallel group and lateral group respectively. Detect TORCH serum IgG and IgM antibodies by ELISA. Statistical analysis using SPSS19.0software package, calculated to count data expressed as a percentage, proportion and measurement data are expressed as mean±standard deviation. Antibody positive rate were compared cataract and control groups using independentX2test.Results1. Compare cataract group, parallel control group of non-neonatal age, sex, etc.2. There was no statistically significance (p>0.05). Cataract serum HSV II IgG positive rate was7.20%, IgM positive rate was1.40%, a parallel control non-newborn group was2.10%group, and1.40%, respectively, IgG and IgM positive rate was no statistically significant (p>0.05).3. Cataract group HSV I IgG positive rate was10.10%, IgM positive rate was1.40%, a parallel control non-newborn group was9.00%and0.30%, respectively, of IgG and IgM positive rate was not statistically significant (p>0.05).4. Cataract group RV IgG positive rate was5.80%, IgM positive rate was1.40%, a parallel control non-newborn group was4.80%and1.40%, respectively, IgG and IgM positive rate was not statistically significant (p>0.05). 5. Cataract group TOX IgG positive rate was0.00%, IgM positive rate was0.00%, a parallel non-newborn control was0.30%and0.30%, respectively, of IgG and IgM positive rate was not statistically significant (p>0.05).6. Cataract group CMV IgG positive rate was23.20%, IgM positive rate was14.50%, a parallel non-newborn control group was23.50%and14.20%, IgG and IgM positive rate of the two groups had no statistical significance (p>0.05).7. Compared with the parallel control group and the lateral control group of non-neonates, HSV I, HSV II, TOX IgG and IgM positive rate was of no statistical significance, and RV, CMV IgM positive rate was of no statistical significance, but the RV, CMV IgG positive rate of parallel control group was statistically significantly higher than that of lateral control group of non-neonatal,8. Compared cataract group with lateral control group of non-neonatal, RV, CMV IgG positive rate was of no statistical significance, but HSV II IgG in control group was statistically significantly higher. Results of other antibodies were similar.9. Compare newborn and test results are non-neonatal, HSV II IgG IgM positive rate of neonatal higher but lower statistical significance; HSV I IgG and IgM-positive newborns increased significantly low and non-neonatal, with statistical significance; RV IgG have no difference but RV IgM positive rather than higher, with statistical significance; higher positive rate of TOX IgG but IgM have no difference between the newborn; higher positive rate of newborn CMV IgG but IgM positive rate is lower.10. There are some differences in positive rate between sexes, the performance of HSV ⅡIgG, HSV I IgG and CMVIgG is higher in girls but IgM positive rate, not statistically significantly different.11. Between monocular or binocular congenital cataract incidence, and cataract between simple and accompanied by other disorders in children, the results of testing positive rate of each antibody show no difference.ConclusionThe study found that the positive rate of HSV II IgG antibodies of congenital cataracts in children were detected higher and thereby the author proposed that HSV may be the virus cause of congenital cataracts in TORCH except RV.TORCH study found that serum positive rate of congenital cataract is similar with other adverse pregnancy diseases in children, and confirmed that the research group of children with congenital cataract should be an important part of the adverse pregnancy disease whose occurrence may be associated with TORCH pathogen infection.In this study, neonates with HSV II IgG, HSV I IgG, CMV IgG antibody positive rate is higher, but IgM antibodies is low, suggesting that maternal antibodies IgG class antibodies may be larger. It is also found that congenital cataracts in newborn screening and early detection of its TORCH can help find epidemiological clues. The same, TOX IgG antibody positive rate is higher, but IgM antibodies is no difference, Also with the above conclusions, just only low infection rate, therefore, the guide role in the etiology of congenital cataract studies was acted by TORCH.The study also found that there are differences between genders antibody expression, suggesting that there are some specific biological mechanisms to be studied in HSV II, HSV I and CMV IgG antibody.Monocular or binocular control the incidence of cataracts in the TORCH expression, studies have shown no correlation. It is not seconded the opinion which early scholars believe that the incidence of unilateral and bilateral congenital cataracts have some different causes.similarly, cataract between simple and accompanied by other disorders in children, the results of testing positive rate of each antibody show no difference. Consider the process of pathogenic virus may have some similar mechanisms in the homologous organization.Detection of serum TORCH is simple, high-risk groups undergoing elective and selective detection can be used as the etiology of congenital cataract detection index Further investigation combined with the results of serum samples before and during pregnancy may be specifically related to prophylactic immunotherapy to lower the risk of congenital cataracts.