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Ocular venous air embolism(OVAE)is a rare and fatal complication in vitrectomy. Due to the proximity of the surgical site to the heart and its level above the heart, OVAE may be the most severe complication in the venous air embolism(VAE)caused by surgery. With the development of vitrectomy, perfusion cannulas in the suture-free state may slide outward, and the perfused gas can enter the suprachoroidal space, which results in tearing of the vortex veins. Choroidal vascular wounds resulting from trauma and endoresection of choroidal melanoma can expose directly in the perfused gas during vitreous cavity gas-liquid exchange. This makes it possible that the pressurized gas enters the circulatory system through the torn vortex veins or the anomalous choroidal venous openings, which leads to OVAE. Nowadays, the definition, pathogenesis, clinical presentation and prevention of OVAE are being refined. However, most vitreoretinal surgeons and anesthesiologists are still unaware of this iatrogenic complication. It will be helpful to detect this complication early and make emergency management in time by increasing the awareness of OVAE and develop effective prevention strategies. The prevention and control principles of OVAE can be continuously optimized by the combination of clinical and laboratory studies. It will be conducive to the establishment and improvement of emergency treatment and preventive measures of OVAE to fully understand the pathogenesis and clinical characteristics of OVAE, to pay attention to the characteristics of secondary lesions of OVAE, and to attach importance to multi-disciplinary cooperation.
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Objective To explore the changes in the serum periostin (PN) and vascular endothelial growth factor (VEGF) level in patients with diabetic retinopathy (DR) and the clinical significance.Methods The serum samples from 53 patients with diabetes mellitus (DM) as case group and 50 healthy subjects as control group were collected and compared in this study.And the DM patients included 15 patients with DM without fundus lesions (DM group),18 patients with non-proliferative diabetic retinopathy (NPDR,NPDR group) and 20 patients with proliferative diabetic retinopathy (PDR,PDR group).The serum levels of PN and VEGF were analyzed by ELISA assay,and the correlation of DR with serum PN and VEGF levels was evaluated.Results The differences in serum PN and VEGF between the case group and control group were statistically significant (both P ＜ 0.05).And there were significant difference in PN and VEGF levels among the DM group,NPDR group,PDR group and control group (all P ＜ 0.05).Meanwhile,there was no significant difference in serum PN between the DM group and NPDR group (P ＞ 0.05),but there were statistically significant differences among the other groups (all P ＜ 0.05).There were statistically significant differences in serum VEGF among the four groups (all P ＜ 0.05).And finally,positive correlations were found between PN and VEGF in the NPDR group and PDR group (r =0.483,0.509,both P ＜ 0.05).Conclusion PN and VEGF play an active role in the initiation and development of DR,and they have a close correlation with the neovascularization and fibrovascular membrane of the advanced stage of DR.
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· AIM:To investigate the clinical effect of Ranibizumab combined with photodynamic therapy (PDT) for wet type age-related macular degeneration (wAMD) and the effect on the serum neovascularization factors.· METHODS:Totally 68 cases (68 eyes) of wAMD patients treated with PDT in our hospital from January 2014 to June 2016 were analyzed retrospectively.Among them,34 patients were treated by photodynamic therapy (control group) and 34 patients were treated by combination of photodynamic therapy and ranibizumab (treatment group).Comparison of BCVA,mean retinal thickness and central macular thickness (CMT) and serum neovascularization regulatory factors before and after treatment were taken between the two groups.· RESULTS:Before treatment,there was no significant difference on the BCVA,the average retinal thickness and the CMT value between the two groups (P＞0.05).At 3,6 and 12mo after treatment,the BCVA,average retinal thickness and CMT in both groups were significantly lower than those before treatment (P＜0.05).At 3,6 and 12mo after treatment,the BCVA,the average retinal thickness and the CMT value of the patients in the treatment group were significantly lower than those in the control group (P＜0.05).There was no significant difference of vascular endothelial growth factor (VEGF),platelet derived growth factor (PDGF),matrix metallo-proteinase inhibitor (TIMP)-1 and endostatin (ES) between the two groups before treatment (P＞ 0.05).Three months after treatment,VEGF,PDGF and ES in both groups were significantly lower than those before treatment (P＜0.05).Three months after treatment,the levels of VEGF,PDGF and ES in the treatment group were significantly lower than those in the control group (P＜0.05).· CONCLUSION:The wAMD patients treated with ranibizumab combined with photodynamic therapy can achieve a more significant clinical effect,and more effectively reduce the level of serum neovascularization regulators.
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<p><b>BACKGROUND</b>Myopia is a common disorder and the incidence has increased yearly, but its pathogenesis remains unclear. The aim of this study was to investigate the possible role of hepatocyte growth factor (HGF) and its receptor c-Met in the development of lens-induced myopia in guinea pigs.</p><p><b>METHODS</b>Sixty one-week-old guinea pigs were chosen. The right eyes were treated with -10.0 diopters (D) lenses as the lens-induced myopia group; the left eyes remained untreated as the control group. Six weeks later, refractive status and axial length were determined by streak retinoscopy and A-scan ultrasonography, respectively. The guinea pigs were killed and both eyes collected. Morphological changes were observed by hematoxylin and eosin staining. The expression levels of HGF, c-Met, and matrix metalloproteinase 2 (MMP-2) mRNA and protein in the posterior sclera were analyzed by RT-PCR and Western blotting, respectively.</p><p><b>RESULTS</b>The lens-induced myopia group became myopic with a significant increase in axial length and a significant decrease in refraction. Compared with the control group, the posterior retina and sclera were thinner in the lens-induced myopia group. The expression levels of HGF and MMP-2 mRNA and protein and of phosphorylated c-Met protein were significantly higher in the posterior sclera of the lens-induced myopia group than in the control group (all P < 0.05). In the lens-induced myopia group, the expression level of MMP-2 in the posterior sclera positively correlated with the expression level of HGF (r = 0.902, P < 0.05) and phosphorylated c-Met (r = 0.885, P < 0.05).</p><p><b>CONCLUSION</b>HGF/c-Met might play a role in the development of lens-induced myopia in guinea pigs by upregulating the expression of MMP-2.</p>