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1.
Ophthalmology ; 131(1): 66-77, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37661066

RESUMO

PURPOSE: To report on macular hole repair in macular telangiectasia type 2 (MacTel2). DESIGN: Global, multicenter, retrospective case series. PARTICIPANTS: Patients undergoing surgery for MacTel2-associated full-thickness macular hole (MTMH). METHODS: Standardized data collection sheet distributed to all surgeons. MAIN OUTCOME MEASURES: Anatomic closure and visual outcomes of MTMH. RESULTS: Sixty-three surgeries in 47 patients with MTMH were included from 30 surgeons. Mean age was 68.1 years, with 62% female, 72% White, 21% East or South Asian, 2% African American, and 2% Hispanic or Latino. Procedures included 34 internal limiting membrane (ILM) peeling alone, 22 ILM flaps, 5 autologous retinal transplantations (ARTs), 1 retinotomy, and 1 subretinal bleb. For ILM peeling, preoperative visual acuity (VA) was 0.667 ± 0.423 logarithm of the minimum angle of resolution (logMAR). Minimum hole diameter (MHD) was 305.5 ± 159.4 µm (range, 34-573 µm). Sixteen of 34 ILM peels (47%) resulted in MTMH closure. At postoperative month 6, VA was stable at 0.602 ± 0.516 logMAR (P = 0.65). VA improved by at least 2 lines in 43% and at least 4 lines in 24%. For ILM flaps, preoperative VA was 0.878 ± 0.552 logMAR. MHD was 440.8 ± 175.5 µm (range, 97-697 µm), which was significantly larger than for ILM peels (P < 0.01). Twenty of 22 ILM flaps (90%) resulted in MTMH closure, which was significantly higher than for ILM peels (P < 0.01). At postoperative month 6, VA improved to 0.555 ± 0.405 logMAR (P < 0.05). VA improved by at least 2 lines in 56% and at least 4 lines in 28%. For ARTs, preoperative VA was 1.460 ± 0.391 logMAR. MHD was 390.2 ± 203.7 µm (range, 132-687 µm). All 5 ARTs (100%) resulted in MTMH closure. At postoperative month 6, VA was stable at 1.000 ± 0.246 logMAR (P = 0.08). Visual acuity improved at least 2 lines in 25%. CONCLUSIONS: Surgical closure of macular holes improved VA in 57% of MTMHs. Internal limiting membrane flaps achieved better anatomic and functional outcomes than ILM peeling alone. Autologous retinal transplantation may be an option for refractory MTMHs. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.


Assuntos
Membrana Epirretiniana , Perfurações Retinianas , Telangiectasia Retiniana , Humanos , Feminino , Idoso , Masculino , Vitrectomia/métodos , Estudos Retrospectivos , Retina , Telangiectasia Retiniana/diagnóstico , Telangiectasia Retiniana/cirurgia , Telangiectasia Retiniana/complicações , Membrana Basal/cirurgia , Tomografia de Coerência Óptica , Resultado do Tratamento , Membrana Epirretiniana/cirurgia
2.
Graefes Arch Clin Exp Ophthalmol ; 262(6): 1755-1763, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38224344

RESUMO

PURPOSE: To compare the efficacy of brolucizumab, half-dose PDT, and aflibercept in treating chronic central serous chorioretinopathy (CSC). METHODS: A retrospective cohort study with chronic CSC patients who underwent intravitreal injection of one shot of brolucizumab or aflibercept in the first 3 months, followed by pro re nata regimens or a single session of half-dose PDT, was retrospectively reviewed. The primary outcome measure was the proportion of eyes that achieved complete absorption of retinal fluid without requiring any rescue treatment. Secondary outcomes included changes in best-corrected visual acuity (BCVA), central retinal thickness (CRT), and central choroidal thickness (CCT). RESULTS: A total of 54 consecutive patients were included in this study with 18 patients in each group. At months 1 and 2, the brolucizumab group exhibited the highest rate of complete retinal fluid resolution (61% and 77%), followed by the half-dose PDT group (56% and 72%), and lowest in the aflibercept group (28% and 33%), with statistically significant differences noted at month 2 (P = 0.012). The brolucizumab group also demonstrated the most significant reduction in CCT at months 1 and 2 among the three groups (P = 0.007 and 0.001). Recurrence of retinal fluid in the brolucizumab groups was predominantly observed at month 3. Conversely, the half-dose PDT group exhibited the most favorable anatomical results starting from month 3. Notably, mild vitritis was observed in one case from the brolucizumab group. CONCLUSIONS: Single injection of brolucizumab demonstrates trends of faster regression of persistent residual retinal fluid, greater CCT and CRT decline, and matched BCVA compared to half-dose PDT in the short term.


Assuntos
Inibidores da Angiogênese , Coriorretinopatia Serosa Central , Angiofluoresceinografia , Injeções Intravítreas , Fotoquimioterapia , Receptores de Fatores de Crescimento do Endotélio Vascular , Proteínas Recombinantes de Fusão , Tomografia de Coerência Óptica , Acuidade Visual , Humanos , Proteínas Recombinantes de Fusão/administração & dosagem , Receptores de Fatores de Crescimento do Endotélio Vascular/administração & dosagem , Coriorretinopatia Serosa Central/tratamento farmacológico , Coriorretinopatia Serosa Central/diagnóstico , Coriorretinopatia Serosa Central/fisiopatologia , Estudos Retrospectivos , Masculino , Feminino , Fotoquimioterapia/métodos , Doença Crônica , Inibidores da Angiogênese/administração & dosagem , Resultado do Tratamento , Pessoa de Meia-Idade , Seguimentos , Adulto , Fármacos Fotossensibilizantes/administração & dosagem , Fármacos Fotossensibilizantes/uso terapêutico , Anticorpos Monoclonais Humanizados/administração & dosagem , Anticorpos Monoclonais Humanizados/uso terapêutico , Fundo de Olho , Relação Dose-Resposta a Droga , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores , Retina/patologia
3.
Graefes Arch Clin Exp Ophthalmol ; 261(12): 3659-3670, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37314522

RESUMO

Pars plana vitrectomy (PPV) is the main treatment modality for patients with severe diabetic retinopathy. With the development of systems for microincision, wide-angle viewing, digitally assisted visualization, and intraoperative optical coherence tomography, contemporary PPV for diabetic retinopathy has been performed on a wider range of indications than previously considered. In this article, we reviewed, in conjunction with our collective experiences with Asian patients, the applications of new technologies for PPV in eyes with diabetic retinopathy and highlighted several important procedures and entities not generally reiterated in the literature, in order for vitreoretinal surgeons to optimize their approaches when facing the challenges imposed by the complications in diabetic eyes.


Assuntos
Diabetes Mellitus , Retinopatia Diabética , Descolamento Retiniano , Humanos , Vitrectomia/métodos , Retinopatia Diabética/complicações , Retinopatia Diabética/diagnóstico , Retinopatia Diabética/cirurgia , Acuidade Visual , Olho , Tomografia de Coerência Óptica , Descolamento Retiniano/cirurgia , Diabetes Mellitus/etiologia , Diabetes Mellitus/cirurgia
4.
BMC Ophthalmol ; 23(1): 86, 2023 Mar 06.
Artigo em Inglês | MEDLINE | ID: mdl-36879205

RESUMO

BACKGROUND: Poly-D, L-lactic acid is (PDLLA) a new cosmetic filler. We reported the first case of PDLLA-related devastating complication of multiple branch retinal artery occlusion (BRAO). CASE PRESENTATION: A 23-year-old female had sudden blindness after injection of PDLLA at the glabella. After emergency intraocular pressure-lowering medicine, ocular massage, steroid pulse therapy, heparin and alprostadil infusion, and subsequent treatments including acupuncture and 40 sessions of hyperbaric oxygen therapy, her best-corrected visual acuity improved from hand motion at 30 cm to 0.3 within 2 months. CONCLUSION: Although safety of PDLLA was evaluated in animal studies and in 16,000 human cases, it could still cause rare but devastating retinal artery occlusion as in the present case. Proper and immediate therapies could still improve patient's vision and scotoma. Surgeons should keep in mind the possibility of iatrogenic filler-related retinal artery occlusion.


Assuntos
Face , Oclusão da Artéria Retiniana , Humanos , Animais , Feminino , Adulto Jovem , Adulto , Oclusão da Artéria Retiniana/induzido quimicamente , Oclusão da Artéria Retiniana/diagnóstico , Olho , Injeções , Ácido Láctico
5.
J Formos Med Assoc ; 122(8): 668-674, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37003913

RESUMO

Cytomegalovirus (CMV) uveitis, a type of herpetic uveitis, is a major cause of infectious uveitis. Anterior and posterior CMV uveitis have diverse clinical presentations and treatment modalities. Based on expert consensus in Taiwan, this article provides suggestions regarding clinical manifestations, diagnosis, and treatment strategies for CMV uveitis based on clinical practice experience in Taiwan. CMV uveitis may have a distinct clinical presentation. Polymerase chain reaction (PCR) is an essential diagnostic tool to confirm a diagnosis. Antiviral therapy is the mainstay of treatment. Different agents, routes, and other supplemental treatments have been summarized and discussed in this article. Early diagnosis and appropriate treatment of CMV uveitis are crucial to avoid irreversible complications and vision loss. This consensus provides practical guidelines for ophthalmologists in Taiwan.


Assuntos
Infecções por Citomegalovirus , Infecções Oculares Virais , Uveíte Anterior , Uveíte , Humanos , Citomegalovirus/genética , Infecções por Citomegalovirus/diagnóstico , Infecções por Citomegalovirus/tratamento farmacológico , Taiwan , Consenso , Uveíte Anterior/diagnóstico , Uveíte Anterior/tratamento farmacológico , Infecções Oculares Virais/diagnóstico , Infecções Oculares Virais/tratamento farmacológico , DNA Viral , Uveíte/diagnóstico , Uveíte/tratamento farmacológico , Uveíte/etiologia
6.
BMC Ophthalmol ; 22(1): 25, 2022 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-35033037

RESUMO

The management of neovascular age-related macular degeneration (nAMD) has taken a major stride forward with the advent of anti-VEGF agents. The treat-and-extend (T&E) approach is a refined management strategy, tailoring to the individual patient's disease course and treatment outcome. To provide guidance to implementing anti-VEGF T&E regimens for nAMD in resource-limited health care systems, an advisory board was held to discuss and generate expert consensus, based on local and international guidelines, current evidence, as well as local experience and reimbursement policies. In the experts' opinion, treatment of nAMD should aim to maximize and maintain visual acuity benefits while minimizing treatment burden. Based on current evidence, treatment could be initiated with 3 consecutive monthly injections. After the initial period, treatment interval may be extended by 2 or 4 weeks each time for the qualified patients (i.e. no BCVA loss ≥5 ETDRS letters and dry retina), and a maximum interval of 16 weeks is permitted. For patients meeting the shortening criteria (i.e. any increased fluid with BCVA loss ≥5 ETDRS letters, or presence of new macular hemorrhage or new neovascularization), the treatment interval should be reduced by 2 or 4 weeks each time, with a minimal interval of 4 weeks. Discontinuation of anti-VEGF may be considered for those who have received 2-3 consecutive injections spaced 16 weeks apart and present with stable disease. For these individuals, regular monitoring (e.g. 3-4 months) is recommended and monthly injections should be reinstated upon signs of disease recurrence.


Assuntos
Degeneração Macular , Degeneração Macular Exsudativa , Inibidores da Angiogênese/uso terapêutico , Consenso , Humanos , Injeções Intravítreas , Degeneração Macular/tratamento farmacológico , Ranibizumab/uso terapêutico , Taiwan/epidemiologia , Resultado do Tratamento , Degeneração Macular Exsudativa/tratamento farmacológico
7.
J Formos Med Assoc ; 121(10): 2020-2027, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35279311

RESUMO

BACKGROUND: The RENOWNED study investigated the treatment patterns, real-world effectiveness and safety of ranibizumab in Taiwanese patients with neovascular age-related macular degeneration (nAMD) treated with ranibizumab 0.5 mg in accordance with the first reimbursement scheme effective from 2012 to 2014. METHODS: This study was a Phase IV, 12-month, open-label, prospective, observational study conducted in Taiwan. Patients with visual impairment due to nAMD initiating treatment with ranibizumab 0.5 mg were included. The primary endpoint was mean change in best-corrected visual acuity (BCVA) from Baseline at Month 3. RESULTS: Overall, 202 patients with nAMD were included. Mean (standard deviation [SD]) BCVA Early Treatment Diabetic Retinopathy Study letters improved from Baseline (49.6 [21.5] letters) at Month 3 (+4.9 [11.8], P < 0.0001), and at Month 12 (+3.5 [14.1], P = 0.0043). The proportion of patients with nAMD who lost ≥5 letters at Months 3 and 12 was 13.6% (n = 27) and 26.6% (n = 37), respectively. Mean (SD) central retinal thickness decreased from Baseline (320.1 [127.2] µm) with a mean reduction of 49.1 (107.3) µm at Month 3 (P < 0.0001), but was not significant at Month 12 with a mean reduction of 11.6 (115.6) µm (P = 0.2861). Mean (SD) number of ranibizumab injections over 12 months was 3.1 (1.0). A mean treatment interval of 109.5 days was observed between the third and fourth injections. After limited reimbursed ranibizumab injections, 43.8% patients received other treatments. The safety findings are consistent with previous studies. CONCLUSION: Ranibizumab 0.5 mg treatment for 12 months under real-world settings improved visual outcomes in Taiwanese patients with nAMD.


Assuntos
Degeneração Macular , Ranibizumab , Inibidores da Angiogênese/uso terapêutico , Humanos , Injeções Intravítreas , Degeneração Macular/tratamento farmacológico , Estudos Prospectivos , Ranibizumab/uso terapêutico , Taiwan , Tomografia de Coerência Óptica , Resultado do Tratamento , Acuidade Visual
8.
Retina ; 41(11): 2246-2252, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-33958532

RESUMO

PURPOSE: To investigate the foveal movement in eyes with epiretinal membrane after vitrectomy and membrane peeling. METHODS: A retrospective review of 85 eyes with epiretinal membrane treated with vitrectomy, membrane peeling, and internal limiting membrane removal. Using a self-designed computer program to compare the preoperative and postoperative images of optical coherence tomography to measure the amount of foveal movement. Analyze the relationships between foveal displacement, preoperative and postoperative best-corrected visual acuity, central foveal thickness, and the stage of epiretinal membrane. RESULTS: Most of the fovea were nasally shifted. More movement happened in the first month and almost finished in the first year. The greater degree of foveal displacement was correlated with poorer initial visual acuity and thicker central foveal thickness. In considering with the ectopic inner foveal layer staging of epiretinal membrane by structural optical coherence tomography, the foveal realignment is greatest in Stage 4 (394.47 ± 171.44 µm), followed by Stage 1 (251.21 ± 135.40 µm), Stage 2 (235.70 ± 147.51 µm), and Stage 3 (219.86 ± 117.91 µm) at the postoperative 1 month. CONCLUSION: Most eyes of epiretinal membrane had the foveal moved nasally after membrane peeling and internal limiting membrane peeling. The larger amount of foveal movement was correlated with poorer initial best-corrected visual acuity. Dystopia fovea may be another factor affecting visual acuity in addition to other biomarkers in optical coherence tomography.


Assuntos
Membrana Basal/cirurgia , Membrana Epirretiniana/cirurgia , Fóvea Central/diagnóstico por imagem , Complicações Pós-Operatórias , Descolamento Retiniano/etiologia , Tomografia de Coerência Óptica/métodos , Vitrectomia/efeitos adversos , Idoso , Feminino , Humanos , Masculino , Descolamento Retiniano/diagnóstico , Estudos Retrospectivos
9.
J Formos Med Assoc ; 120(12): 2061-2071, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34274193

RESUMO

Neovascular age-related macular degeneration (nAMD) is a leading cause of irreversible vision loss. The present consensus provides suggestions on diagnosis, evaluation, treatment, and follow-up strategies for nAMD from a panel of 11 practicing ophthalmologists. The experts suggest that the baseline visit for nAMD management should include a comprehensive ophthalmologic examination via a multimodal approach consisting of visual and anatomical evaluation. Patients diagnosed with nAMD should be subjected to treatment with the goal of maintaining visual function while diminishing anatomical disease activity and minimizing treatment burden. Currently, anti-VEGF therapy is the main treatment strategy for nAMD, and evaluation involving comprehensive ophthalmologic examination within 1 month of completion of the loading phase comprising three monthly injections is recommended to guide subsequent management. Either a treat-and-extend or pro re nata regimen can be considered for the maintenance phase of anti-VEGF therapy, and the regimen should be chosen and adjusted according to disease activity, reimbursement criteria, financial burden, and patient preferences. In the event of inactive nAMD or poor treatment outcomes, after thorough evaluation and patient education, anti-VEGF therapy may be stopped. The consensus provides practical nAMD management guidelines for ophthalmologists and fellow healthcare professionals.


Assuntos
Degeneração Macular , Ranibizumab , Inibidores da Angiogênese/uso terapêutico , Consenso , Humanos , Injeções Intravítreas , Degeneração Macular/tratamento farmacológico , Ranibizumab/uso terapêutico , Taiwan , Tomografia de Coerência Óptica , Resultado do Tratamento , Fator A de Crescimento do Endotélio Vascular , Acuidade Visual
10.
Graefes Arch Clin Exp Ophthalmol ; 257(1): 23-30, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30361765

RESUMO

PURPOSE: To assess foveal microvascular structure and the correlation between foveal retinal thickness and best corrected visual acuity (BCVA) in children with retinopathy of prematurity (ROP). METHODS: This is a retrospective case-control study. A total 42 eyes in 23 patients with history of anti-vascular endothelial factor (VEGF) agent treatment and 51 eyes of 27 healthy age-matched subjects as the control group were analyzed. Foveal avascular zone (FAZ) and foveal vessel density (VD) were measured by optical coherence tomography angiography (OCT-A). Foveal thickness was measured by cross-sectional OCT. Correlations between FAZ area, foveal VD, foveal thickness, BCVA, gestational age (GA), and birth body weight (BBW) were performed. RESULTS: ROP children had a significantly smaller FAZ area and higher foveal VD, and the foveal thickness was significantly higher as compared to controls (all P < 0.0001). We noted a significant negative correlation between FAZ area and foveal thickness. In addition, a significant positive correlation between foveal VD and foveal thickness was identified. With regard to prematurity status, gestational age and birth body weight were both significantly correlated with FAZ area, foveal VD, and fovea inner retinal thickness. Multivariable analysis showed that thicker inner retinal thickness and higher superficial vascular density were associated with suboptimal visual acuity. CONCLUSION: By using OCT-A, we identified significant foveal microvascular anomalies in ROP children. The correlation between the microvascular anomalies, central foveal thickness, and suboptimal visual acuity was also noted. Because of the retrospective nature, more studies are necessary to further establish the relationship.


Assuntos
Angiofluoresceinografia/métodos , Fóvea Central/irrigação sanguínea , Vasos Retinianos/patologia , Tomografia de Coerência Óptica/métodos , Acuidade Visual , Estudos de Casos e Controles , Feminino , Fóvea Central/patologia , Fundo de Olho , Idade Gestacional , Humanos , Recém-Nascido , Masculino , Microvasos/patologia , Retinopatia da Prematuridade , Estudos Retrospectivos
11.
Ophthalmologica ; 242(4): 222-233, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31533121

RESUMO

PURPOSE: To report the surgical results and technique of perfluorocarbon-assisted neurosensory retinal flap transplantation into macular hole for concomitant macular hole and complicated retinal detachment. METHOD: This is a retrospective, consecutive case series of 7 cases with concomitant macular hole and complicated retinal detachment with proliferative vitreoretinopathy. All eyes had previous vitrectomy and internal limiting membrane peeling, or very large (>1,000 µm) macular holes. Perfluorocarbon liquid-assisted free neurosensory retinal flap transplantation into the macular hole, and subretinal fluid drainage through iatrogenic retinectomy/retinotomy were performed, followed by air-fluid exchange with gas or silicone oil tamponade. RESULTS: All eyes had retina reattached. Macular hole was closed in all eyes, with the graft visualized by optical coherence tomography. The best corrected visual acuity in logarithm of minimal angle of resolution improved from 2.80 ± 0.45 preoperatively to 1.40 ± 0.51 postoperatively (p < 0.01). CONCLUSIONS: Neurosensory retinal flap may be a good option in closing macular holes in eyes with concomitant macular hole and complicated retinal detachment. Because of its specific properties, the flap is easy to handle during the operation. Retinectomy or retinotomy serves to release traction, drain subretinal fluid, and provide retinal flap tissue.


Assuntos
Tamponamento Interno/métodos , Fluorocarbonos/farmacologia , Retalhos de Tecido Biológico , Retina/transplante , Descolamento Retiniano/cirurgia , Perfurações Retinianas/cirurgia , Vitrectomia/métodos , Idoso , Feminino , Seguimentos , Humanos , Macula Lutea/patologia , Masculino , Pessoa de Meia-Idade , Descolamento Retiniano/complicações , Descolamento Retiniano/diagnóstico , Perfurações Retinianas/complicações , Perfurações Retinianas/diagnóstico , Estudos Retrospectivos , Tomografia de Coerência Óptica , Resultado do Tratamento , Vitreorretinopatia Proliferativa/complicações , Vitreorretinopatia Proliferativa/diagnóstico , Vitreorretinopatia Proliferativa/cirurgia
12.
Ophthalmologica ; 240(3): 143-149, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29874671

RESUMO

PURPOSE: The aim of this paper was to evaluate the efficacy of multiple free internal limiting membrane (ILM) flap insertion in the management of macular hole-associated retinal detachment in high myopia. PROCEDURES: Eyes receiving operation for macular hole-associated retinal detachment were retrospectively recruited. Those in the study group received ILM peeling and multiple free ILM flap insertion, while those in the control group received ILM peeling only. Postoperative anatomical outcomes and best-corrected visual acuity were compared between the 2 groups. RESULTS: Twenty-seven eyes of 27 patients were recruited in this study (13 in the study group, 14 in the control group). After the operation, the retina was reattached in all cases in both groups. The macular hole closure rate was 100% in the study group but only 42.9% in the control group (adjusted p < 0.001). The eyes in the study group had better visual improvement (logMAR -0.58 ± 0.43) than those in the control group (logMAR -0.31 ± 0.50) with borderline significance (adjusted p = 0.078). CONCLUSIONS: For macular hole-associated retinal detachment in highly myopic eyes, the multiple free ILM flap insertion technique offers an effective way to close macular holes. Whether this result also means better visual outcome remains to be seen.


Assuntos
Membrana Epirretiniana/cirurgia , Miopia Degenerativa/complicações , Procedimentos Cirúrgicos Oftalmológicos , Descolamento Retiniano/cirurgia , Perfurações Retinianas/cirurgia , Retalhos Cirúrgicos , Idoso , Membrana Basal/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Descolamento Retiniano/etiologia , Perfurações Retinianas/etiologia , Estudos Retrospectivos , Tomografia de Coerência Óptica , Resultado do Tratamento , Acuidade Visual
13.
Int Ophthalmol ; 38(2): 747-756, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28393322

RESUMO

AIM: This study was to investigate the anti-angiogenic effect of hexahydrocurcumin (HHC) to evaluate gene (p-basic fibroblast growth factor (bFGF)-SAINT-18 & p-vascular endothelial growth factor (VEGF)-SAINT-18 complex)-induced corneal neovascularization (CorNV) in rats. METHODS: CorNV was induced in 24 eyes of 24 rats. Four groups (Group A: 0 µg, B: 0.01 µg, C: 0.1 µg, and D: 1 µg) of HHC were prepared and implanted into the rat subconjunctival substantia propria 1.5 mm from the limbus at temporal side. The 1 µg of p-bFGF-SAINT-18 & p-VEGF-SAINT-18 complex were prepared and implanted into the rat corneal stroma 1.5 mm from the limbus at the same side. Inhibition of CorNV was observed and quantified from day 1 to day 60. bFGF and VEGF protein expression were analyzed by biomicroscopic examination, western blot analysis, and immunohistochemistry. RESULTS: Subconjunctival injection by 1 µg HHC successfully inhibited gene-induced CorNV in rats. bFGF and VEGF protein expression were reduced after 6 days. Meanwhile, the reduction of HLA-DR expression was detected. CONCLUSIONS: Our study showed that the HHC might provide an important anti-angiogenesis factor to inhibit CorNV development at the corneal experimental angiogenesis model.


Assuntos
Inibidores da Angiogênese/uso terapêutico , Neovascularização da Córnea/tratamento farmacológico , Curcumina/análogos & derivados , Inibidores da Angiogênese/farmacologia , Animais , Western Blotting , Túnica Conjuntiva/efeitos dos fármacos , Túnica Conjuntiva/metabolismo , Neovascularização da Córnea/metabolismo , Curcumina/farmacologia , Curcumina/uso terapêutico , Modelos Animais de Doenças , Fator 2 de Crescimento de Fibroblastos/metabolismo , Antígenos HLA-DR/metabolismo , Masculino , Ratos , Ratos Sprague-Dawley , Fator A de Crescimento do Endotélio Vascular/metabolismo
14.
Graefes Arch Clin Exp Ophthalmol ; 255(12): 2337-2345, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28993905

RESUMO

PURPOSE: To describe the technique and surgical outcomes of a modified large semicircular inverted internal limiting membrane (ILM) flap in the management of macular holes (MHs) in patients with high myopia. METHODS: We performed this retrospective study on consecutive patients with MH and high myopia (axial length ≥ 28 mm),who received vitrectomy, a large semicircular ILM flap 4 discs in diameter to cover the MH, incomplete air-fluid exchange, and SF6 gas tamponade. All of the patients maintained an upright position for 2 h postoperatively, followed by either a face-down or upright position for 1 week. Post-operative visual acuity was measured, and MH status was assessed using spectral-domain optical coherence tomography. RESULTS: Seventeen highly myopic eyes in 16 patients with a mean axial length of 30.49 ± 0.98 mm and mean age of 62.25 ± 9.40 years were included in this study, including five eyes with foveoschisis and four eyes with chronic MH, two with myopic choroidal neovascularization, and four with MH-associated retinal detachment. The MHs of all patients were successfully closed after a single operation. All of the patients were followed for at least 6 months. The average visual acuity in logarithm of minimal angle of resolution improved from 1.26 ± 0.52 preoperatively to 0.69 ± 0.45 6 months postoperatively (p = 0.01, paired t-test). CONCLUSION: A large semicircular inverted ILM flap can close a myopic MH efficiently without the need for a long-term face-down position.


Assuntos
Membrana Basal/cirurgia , Miopia Degenerativa/complicações , Refração Ocular/fisiologia , Perfurações Retinianas/cirurgia , Retalhos Cirúrgicos , Acuidade Visual , Vitrectomia/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Tamponamento Interno , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Miopia Degenerativa/diagnóstico , Miopia Degenerativa/cirurgia , Perfurações Retinianas/diagnóstico , Perfurações Retinianas/etiologia , Estudos Retrospectivos , Tomografia de Coerência Óptica , Resultado do Tratamento
15.
Graefes Arch Clin Exp Ophthalmol ; 254(4): 629-38, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26311257

RESUMO

PURPOSE: To report the clinical findings and surgical outcomes of lamellar macular holes (LMH) with or without lamellar hole-associated epiretinal proliferation (LHEP), and those of full-thickness macular holes (FTMH) presenting with LHEP. METHODS: From 2009 to 2013, consecutive cases of surgically treated LMH, and all FTMH cases with LHEP were reviewed, given a follow-up time over 1 year. RESULTS: In the LMH group (43 cases), those with LHEP (19 cases) had significantly thinner bases and larger openings than those without (24 cases). The rate of disrupted IS/OS line was higher in the LHEP subgroup preoperatively (68.4 % vs 37.5 %), but similar between subgroups postoperatively (36.8 % and 33.3 %). The preoperative and postoperative visual acuity showed no significant difference between two subgroups. In the FTMH group (13 cases), the average hole size was 219.2 ± 92.1 µm. Permanent or transient spontaneous hole closure was noted in 69.2 % of cases. An intact IS-OS line was found in only 23 % of cases at the final follow-up. CONCLUSION: In the LMH group, LHEP was associated with a more severe defect but didn't affect surgical outcomes. In the FTMH group, spontaneous hole closure was frequently noted. Despite small holes, disruption of IS-OS line was common after hole closure.


Assuntos
Membrana Epirretiniana/patologia , Perfurações Retinianas/diagnóstico , Perfurações Retinianas/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Membrana Basal/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Decúbito Ventral , Perfurações Retinianas/classificação , Perfurações Retinianas/fisiopatologia , Estudos Retrospectivos , Tomografia de Coerência Óptica , Acuidade Visual/fisiologia , Vitrectomia , Adulto Jovem
16.
Retina ; 36(1): 163-70, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26200509

RESUMO

PURPOSE: To report the clinical results of lens capsular flap transplantation in refractory macular hole (MH). METHODS: This retrospective, interventional, consecutive case series included 20 eyes with persistent MH after previous standard MH surgery. All eyes underwent vitrectomy, lens anterior or posterior capsule transplantation into the MH, gas tamponade, and a 1-week postoperative head down. Structural and functional changes were evaluated. RESULTS: The predisposing conditions to surgical failure included high myopia with MH and retinal detachment in four eyes, MH after myopic foveoschisis surgery in one eye, high myopia with a large MH in one eye, proliferative diabetic retinopathy with MH in three eyes, MH with severe retinal detachment in one eye, retinal detachment with concurrent peripheral breaks and MH in one eye, and large or chronic MH in nine eyes. Macular hole was closed in all the 10 eyes receiving anterior capsular flap transplantation. In the 10 eyes with posterior capsular flap transplantation, MH was closed in 5, partially closed in 3, and not closed in 2. Visual acuity in logarithm of minimal angle of resolution improved from 1.53 ± 0.39 preoperatively to 1.07 ± 0.35 postoperatively. CONCLUSION: Lens capsular flap transplantation may close the MH and improve visual outcome in the majority cases of refractory MH.


Assuntos
Tamponamento Interno , Cápsula do Cristalino/transplante , Perfurações Retinianas/cirurgia , Retalhos Cirúrgicos , Vitrectomia , Idoso , Feminino , Fluorocarbonos/administração & dosagem , Humanos , Masculino , Pessoa de Meia-Idade , Miopia Degenerativa/complicações , Decúbito Ventral , Descolamento Retiniano/complicações , Perfurações Retinianas/etiologia , Perfurações Retinianas/fisiopatologia , Estudos Retrospectivos , Fatores de Risco , Hexafluoreto de Enxofre/administração & dosagem , Acuidade Visual/fisiologia
17.
Retina ; 35(2): 231-7, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25099218

RESUMO

PURPOSE: To investigate peptic ulcer disease and other possible risk factors in patients with central serous chorioretinopathy (CSR) using a population-based database. METHODS: In this population-based retrospective cohort study, longitudinal data from the Taiwan National Health Insurance Research Database were analyzed. The study cohort comprised 835 patients with CSR and the control cohort comprised 4175 patients without CSR from January 2000 to December 2009. Conditional logistic regression was applied to examine the association of peptic ulcer disease and other possible risk factors for CSR, and stratified Cox regression models were applied to examine whether patients with CSR have an increased chance of peptic ulcer disease and hypertension development. RESULTS: The identifiable risk factors for CSR included peptic ulcer disease (adjusted odd ratio: 1.39, P = 0.001) and higher monthly income (adjusted odd ratio: 1.30, P = 0.006). Patients with CSR also had a significantly higher chance of developing peptic ulcer disease after the diagnosis of CSR (adjusted odd ratio: 1.43, P = 0.009). CONCLUSION: Peptic ulcer disease and higher monthly income are independent risk factors for CSR. Whereas, patients with CSR also had increased risk for peptic ulcer development.


Assuntos
Coriorretinopatia Serosa Central/epidemiologia , Úlcera Péptica/epidemiologia , Adulto , Distribuição por Idade , Estudos de Coortes , Bases de Dados Factuais , Feminino , Humanos , Incidência , Renda , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Taiwan/epidemiologia
18.
Retina ; 35(4): 667-74, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25462435

RESUMO

PURPOSE: To compare the effect and the treatment outcomes of bevacizumab and ranibizumab in the treatment of Type 1 retinopathy of prematurity (ROP). METHODS: This was a bicentered retrospective case series performed at institutional referral centers. Seventy-two eyes of 37 patients who had intravitreal injections of either bevacizumab or ranibizumab as the primary treatment for Type 1 ROP were included. Outcomes' measures included regression and recurrence of ROP, the surgical complications, and refractive errors at a corrected age of 1 year. RESULTS: All but one eye in the bevacizumab group had retinal neovascularization and plus disease regression after anti-vascular endothelium growth factor treatment. Neither recurrence of ROP nor major ocular complications, including cataract, retinal detachment, and endophthalmitis occurred in any of the treated eyes. There were no significant differences in mean refractive errors between the patients treated with intravitreal injections of bevacizumab or ranibizumab at the corrected age of 1 year. A significantly higher chance of high myopia was noted in the bevacizumab group (P = 0.03). CONCLUSION: Both bevacizumab and ranibizumab showed similar efficacy in the regression of ROP with minor mean refractive errors at 1 year of corrected age. However, high myopia was more prevalent in the bevacizumab-treated eyes.


Assuntos
Inibidores da Angiogênese/uso terapêutico , Anticorpos Monoclonais Humanizados/uso terapêutico , Retinopatia da Prematuridade/tratamento farmacológico , Comprimento Axial do Olho , Bevacizumab , Feminino , Idade Gestacional , Humanos , Lactente , Injeções Intravítreas , Masculino , Ranibizumab , Recidiva , Erros de Refração/diagnóstico , Neovascularização Retiniana/tratamento farmacológico , Retinopatia da Prematuridade/classificação , Retinopatia da Prematuridade/diagnóstico , Estudos Retrospectivos , Resultado do Tratamento , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores
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