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1.
Article in Chinese | WPRIM | ID: wpr-798749

ABSTRACT

Vascular endothelial growth factor(VEGF), also known as vascular permeability factor, can promote the proliferation and migration of vascular endothelial cells, and enhance vascular permeability.In addition, VEGF family is also related to lymphatic vessel formation, inflammatory response, hematopoiesis and neuroprotective effect.Under the circumstances of ischemia, hypoxia and oxidative stress, VEGF can exert neuroprotective effect by increasing tissue perfusion, inhibiting cell apoptosis and stimulating neurogenesis.Therefore, therapeutic effect of VEGF in neurological diseases, such as neurodegenerative diseases and stroke has increasingly received considerable attention.On the other hand, anti-VEGF therapy for ocular pathologic neovascular diseases may lead to corresponding adverse effect.In this review, the mechanism of neuroprotective effect of VEGF and its roles in neurological diseases and ocular diseases were discussed.

2.
Article in Chinese | WPRIM | ID: wpr-798748

ABSTRACT

Retinal vein occlusion(RVO) is the second common retinal vascular disease after diabetic retinopathy.The Management of Retinal Vein Occlusion-Consensus Document published in 2011 gave a comprehensive explanation of RVO diagnosis and treatment.While the European Society of Retina Specialists (EURETINA) updated the guideline for the management of RVO based on the 2011 consensus in August 2019.The current guideline summarized the latest clinical studies, and standardized the diagnosis and treatment of RVO based on stronger evidence-level data.The 2019 guidelines used the Rationale-Evidence-Recommendation structure to provide a comprehensive summary of RVO.

3.
Article in Chinese | WPRIM | ID: wpr-798747

ABSTRACT

Objective@#To evaluate the sensitivity and specificity of spectral domain optical coherence tomography (SD-OCT) for the differentiation of PCV from wet age-related macular degeneration (wAMD).@*Methods@#A cross-sectional study was conducted from Jun 2014 to Apr 2016 at Peking Union Medical College Hospital.The case series included 132 eyes of 126 patients with clinical diagnosis of PCV or wAMD.Eyes with three or more of the following SD-OCT findings were diagnosed with PCV: double layer sign, pigment epithelium detachment (PED), a sharp PED peak, a PED notch and a hyporeflective lumen representing polypoidal lesion.The sensitivity and specificity of the OCT-based diagnosis was estimated.Levels of agreement were determined by κ analyses.@*Results@#One hundred and twenty-six patients (132 eyes) with PCV or wAMD were enrolled in the study.In PCV patients, PED notch, a hyporeflective lumen representing polypoidal lesion, PED peak, double layer sign and PED were 38, 35, 48, 40 and 46, accounting for 67.9%, 62.5%, 85.7%, 71.4% and 82.1%, respectively.In wAMD patients, PED notch, a hyporeflective lumen representing polypoidal lesion, PED peak, double layer sign and PED were 12, 3, 11, 8 and 26, accounting for 14.5%, 10.5%, 34.2%, 15.8% and 3.9%, respectively, which were all lower than PCV, with statistically significant differences (all at P<0.001). SD-OCT detected PCV in 49 of 56 eyes and 10 PCV patients were misdiagnosed as wAMD.The sensitivity and specificity of SD-OCT for the differentiation of PCV from wAMD were 87.5% and 86.8%, respectively.The consistence between SD-OCT and imdocyanine green angiography (ICGA) was moderate (κ=0.738, P<0.001).@*Conclusions@#SD-OCT exhibits high sensitivity and specificity in PCV diagnosis.The presence of DLS, PED, a sharp PED peak, a PED notch, and a hyporeflective lumen representing polypoidal lesion is suggested to be a new diagnostic strategy for PCV.

4.
Journal of Chinese Physician ; (12): 55-58,63, 2019.
Article in Chinese | WPRIM | ID: wpr-734067

ABSTRACT

Objective To evaluate the optical coherence tomograghy (OCT) morphological parameters for predicting anatomical outcomes and postoperative visual acuity in idiopathic macular hole (IMH) after pars plana vitrectomy (PPV).Methods A retrospective study.A total of 26 eyes in 23 IMH patients underwent PPV,internal limiting membrane (ILM) peeling and gas filling surgery were included in this study.The patients included 8 eyes of 7 males and 18 eyes of 16 females,with the mean age of (63.9 ± 9.4).All patients received the best corrected visual acuity (BCVA),slit lamp microscope,indirect ophthalmoscopy and three-dimensional optical coherence tomography (3D OCT) examinations.The BCVA was measured using the international standard visual acuity chart,and the results were converted to the logarithm of the minimum angle of resolution visual acuity.According to the standard classification system of International Vitreomacular Traction Study (IVTS) Group,8 eyes were medium full-thickness macular hole (FTMH) and 18 eyes were large FTMH,none of which were with vitreomacular traction (VMT).The minimum diameter (MIN),base diameter (BASE),height (H),left and right arm length (LAL and RAL),diameter of ellipsoid zone absence (DEZA) were measured.Macular hole index (MHI),hole form factor (HFF),tractional hole index (THI),diameter hole index (DHI) were calculated.The average follow-up period were (9.2 ± 9.7) months.The postoperative DEZA were measure at the last time.Anatomical outcomes were divided into 3 groups.The multiple factors related with predicting anatomical outcome and visual acuity were analyzed.Results In the 26 eyes,the hole was closed in 16 eyes of type 1,7 eyes of type 2,3 eyes of type 3.The mean pre-and post-operative logMAR BCVA were 0.9 ± 0.3,0.7 ± 0.3 respectively.The MIN,BASE,H were (533 ± 176),(1 035 ±270),(462 ± 138) μm respectively.The MHI,HFF,THI,DHI were 0.46 ±0.15,0.72 ±0.19,0.95 ±0.37,0.52 ±0.11 respectively.The mean preand post-operative DEZA were (1 775 ± 486),(960 ± 138) μm respectively.Postoperative logMAR BCVA were correlated significantly with MHI,THI (all P ≤ 0.01),correlated weakly with MIN,BASE,HFF (all P ≤ 0.05),but not correlated with age,sex,DHI,pre-and post-operative DEZA (all P > 0.05).Anatomical prognosis types were significantly correlated with MHI,HFF,THI (all P ≤ 0.01),weakly correlated with MIN,DHI (all P ≤ 0.05),but not correlated with age,sex,BASE,pre-and post-operative DEZA (all P > 0.05).Conclusions For medium and large FTMH in IVTS classification system,MHI,THI have the best correlation with postoperative BCVA and can be considered as key indicators for predicting postoperative BCVA.MHI,HFF,THI have the best correlation with anatomical outcomes and can be considered as key indicators for predicting anatomical outcomes of IMH.

5.
Article in Chinese | WPRIM | ID: wpr-733632

ABSTRACT

Anti-vascular endothelial growth factor (VEGF) therapy is a major strategy for treating ocular neovascular diseases nowadays.It has revolutionarily improved the vision of many patients since its emergence.However,VEGF is essentially a protective growth factor that is compensatorily produced by human body.In the anti-VEGF treatment of the diseases,the physiological effects of VEGF are also inhibited,which may result in some related problems,such as retinal atrophy,retinal pigment epithelium (RPE) tears,systemic adverse effects,and so on.Retinal atrophy has become one of the major causes of visual loss in the late stage of the treatment.The specific mechanism underlying them is not completely known,we should pay enough attention to them.How to improve the anti-VEGF treatment strategy in order to reduce the incidence of these problems will be a great challenge.

6.
Article in Chinese | WPRIM | ID: wpr-756416

ABSTRACT

Retinal vein occlusion (RVO) is a vascular disease characterized by intraretinal hemorrhage,edema and hard exudation,which is caused by increased retinal vein pressure.OCT angiography (OCTA) has been widely used in the diagnosis of retinal vascular diseases including RVO by virtue of non-invasive,high resolution and stratified display of superficial,deep retinal vessels and quantification of retinal vessel density and non-perfusion area size.OCTA can provide information of retinal microvascular structure and blood perfusion under the condition of disease,it also can be used to evaluate the effect of treatment and changes of retinal circulation during the course of disease follow-up.Although OCTA cannot replace fundus angiography completely,it has brought us more information about the pathogenesis,disease progression and prognostic factors of RVO.It is believed that with the progress of technology,OCTA will bring us a new chapter in the study of retinal vascular diseases including RVO.

7.
Article in Chinese | WPRIM | ID: wpr-753216

ABSTRACT

Objective To evaluate the performance of an artificial intelligence ( AI ) assisted diagnosis system for diabetic retinopathy ( DR) based on deep learning theory. Methods Diagnostic performance of a robot assisted diagnosis system called SongYue for DR was trained by using 25297 retinal images tagged by fundus doctors from multiple hospitals in China. Four types of DR detection model consisting of abnormal DR,referable DR,severe non-proliferative and proliferative DR as well as proliferative DR according to fundus leisions identification were established. The ability of the system to distinguish DR was determined by using receiver operator characteristic (ROC) analysis,sensitivity and specificity of the system. Results SongYue system achieved an area under the ROC curve ( AUC) of 0. 920 for successfully distinguishing normal images from those DR with a sensitivity of 96. 0%at a specificity of 87. 9%. The AUC of SongYue for referable DR was 0. 925,sensitivity was 90. 4%,and specificity was 95. 2%. For severe non-proliferative and proliferative DR,AUC was 0. 845,sensitivity was 72. 7%,and specificity was 96. 2%. For proliferative DR, AUC was 0. 855, sensitivity was 73. 5%, and specificity was 97. 3%. Conclusions SongYue robot assisted diagnosis system has high AUC,sensitivity and specificity for identifying DR, showing good clinical applicable benefits.

8.
Article in Chinese | WPRIM | ID: wpr-746206

ABSTRACT

Objective To assess the efficacy and safety ofintravitreal aflibercept injection (IAI) compared with photodynamic therapy (PDT) in the treatment of Chinese patients with predominantly classic subfoveal choroidal neovascularization (CNV) lesions secondary to neovascular age-related macular degeneration (nAMD).Methods A randomized,double-blind,multi-center phase-3 clinical trial lasting for 52weeks (from December 2011 to August 2014).Subjects were randomized in a 3:1 ratio to either IAI group or PDT-to-IAI group.Subjects in the IAI group received 2 mg IAI at baseline and at week 4,8,16,24,32,40,48,with sham injection at week 28,36.Subjects in the PDT-to-IAI group were forced to receive PDT once at baseline and more time at week 12,24 if PDT retreatment conditions were met.Sham injections were given in PDT-to-IAI group at baseline and at week 4,8,16 and 24,followed by 2 mg IAI at week 28,32,36,40,48.The primary outcome of efficacy were the change in mean Best Corrected Visual Acuity (BCVA) from baseline to week 28,and that of week 52.Safety evaluation included the percentage of subjects who suffered treatment emergent adverse events (TEAEs).Results Among the 304 subjects enrolled,there were 228 and 76 cases in IAI group and PDT-to-IAI group respectively.At week 28,the changes of mean BCVA in IAI group,PDT-to-IAI group compared to baseline were +14.0,+3.9 letters,respectively.At week 52,the changes of mean BCVA in two groups were + 15.2,+8.9 letters respectively with the difference of +6.2 letters (95%CI 2.6-9.9,P=0.000 9).At week 52,the mean foveal retinal thickness in the two groups decreased by-189.6,-170.0 μm,respectively.Subjects with the most BCVA increase in IAI group were those aged <65,and those with active CNV lesion area <50% of total lesion area.The most common TEAEs in IAI group and PDT-to-IAI group are macular fibrosis [11.8% (27/228),6.6% (5/76)] and BCVA decline [6.6% (15/228),21.1% (16/76)].There were 3 cases of arterial thromboembolic events defined in the antiplatelet experimental collaboration group,but all were considered unrelated to interventions.Conclusions The efficacy of aflibercept is superior to that of PDT in nAMD patients in China.The therapeutic effect of aflibercept persisted to week 52 in all subjects.The rate of adverse events was consistent with the safety data of aflibercept known before.

9.
Article in Chinese | WPRIM | ID: wpr-746199

ABSTRACT

For the past few years,artificial intelligence (AI) technology has developed rapidly and has become frontier and hot topics in medical research.While the deep learning algorithm based on artificial neural networks is one of the most representative tool in this field.The advancement of ophthalmology is inseparable from a variety of imaging methods,and the pronounced convenience and high efficiency endow AI technology with promising applications in screening,diagnosis and follow-up of ophthalmic diseases.At present,related research on ophthalmologic AI technology has been carried out in terms of multiple diseases and multimodality.Many valuable results have been reported aiming at several common diseases of ophthalmology.It should be emphasized that ophthalmic AI products are still faced with some problems towards practical application.The regulatory mechanism and evaluation criteria have not yet integrated as a standardized system.There are still a number of aspects to be optimized before large-scale distribution in clinical utility.Briefly,the innovation of ophthalmologic AI technology is attributed to multidisciplinary cooperation,which is of great significance to China's public health undertakings,and will be bound to benefit patients in future clinical practice.

10.
Article in Chinese | WPRIM | ID: wpr-699756

ABSTRACT

Objective To investigate the role of epigenetic regulations of peroxisome proliferator-activated receptor γ coactivator 1α (PGC-1α) in the development of diabetic retinopathy and the metabolic memory phenomenon after hyperglycemia was terminated.Methods Diabetic rat model was established by intraperitoneal injection of streptozotocin (STZ).Sixty diabetic rats were randomly divided into 3 groups,poor glycemic control group rats were maintained in poor glycemic control for 4 months;semi glycemic control group rats were maintained in poor glycemic control for 2 months,followed by good glycemic control for 2 additional months;good glycemic control group rats were maintained in good glycemic control for 4 months.Twenty normal rats served as control group.The mRNA expression of PGC-1α and superoxide dismutase 2 (SOD2) of retina were measured by real-time PCR;the expression of PGC-1α and manganese superoxide dismutase (MnSOD) protein were measured by Western blot;the situation of DNA methylation in the promotor region of PPARGC1A was measured by bisulfite sequencing.Results The body-weight in the control group was significantly higher than that in the poor glycemic control group,semi glycemic control group and good glycemic control group (all at P =0.000).The blood glucose value in the poor glycemic control group was significantly higher than that in the control group (P =0.000).The expression levels of PGC-1 α mRNA were significantly lower and the expression levels of SOD2 mRNA were significantly higher in the good glycemic control group,semi glycemic control group and poor glycemic control group than those in the control group (all at P<0.05).The expression levels of PGC-1α and SOD2 mRNA were significantly different between the good glycemic control group and poor glycemic control group (both at P<0.05).Compared with the control group,the expression levels of PGC-1α and MnSOD protein were decreased in the diabetic model groups,with significant differences between them (all at P<0.05).The expression level of PGC-1 α protein was significantly higher in the good glycemic control group than that in the poor glycemic control group (P<0.05).Diabetes increased DNA methylation in the promotor region of PPARGC1A gene of retina.The DNA methylation level was significantly higher in the poor glycemic control group and semi glycemic control group than that in the control group (P =0.008,0.031).No statistical difference was found between the poor glycemic control group and semi glycemic control group (P > 0.05).Conclusions The expressions of PGC-1o mRNA and protein and MnSOD protein in the retina of STZ induced diabetic rats are decreased,the expression of SOD2 mRNA is increased,the expression changes have metabolic memory characteristics.Increased DNA methylation in the promotor region of PPARGC1A when exposed to high glucose may have a role in the regulation of PGC-1 α expression and metabolic memory.

11.
Article in Chinese | WPRIM | ID: wpr-508437

ABSTRACT

Autofluorescence is produced by lipofuscin in retinal pigment epithelium (RPE) cells which is induced by exciting light and enables the visualization of lipofuscin changes in the RPE cells, thus showing the function of RPE and photoreceptor cells. Fundus autofluorescence (FAF) imaging is a non-invasive imaging technique providing information of RPE and photoreceptor cells, which is not obtainable with other imaging modalities. The scope of applications includes identification of diseased RPE in retinal diseases, elucidating pathophysiological mechanisms, estimating disease progression and prognosis, guiding treatment protocols. Common fundus diseases have different pathological types, levels and causes, so they can cause various damages of RPE and photoreceptor cells which induce complicated FAF. It is worth further observing and investigating the common retinal diseases' FAF characteristics and clinical applications.

12.
Article in Chinese | WPRIM | ID: wpr-618050

ABSTRACT

Objective To evaluate the efficacy ofintravitreal injection (IVI) ofexpansile gas alone to treat idiopathic full-thickness macular hole (FTMH).Methods This is a prospective interventional case series.Twenty FTMH patients (26 eyes) who underwent IVI with expansile gas alone were enrolled in this study.There were 5 males (5 eyes) and 21 females (21 eyes),with the mean age of (59 ± 12) years.All patients received the best corrected visual acuity (BCVA),slit lamp microscope,indirect ophthalmoscopy,fundus color photography and three-dimensional optical coherence tomography (OCT) examinations.The BCVA was measured using the international standard visual acuity chart,and the results were converted to the logarithm of the minimum angle of resolution visual acuity.The diameters of macular holes and the interface between vitreous and macular were observed by OCT (Topcon,OCT-2000).Based on the diameter,the holes were classified as small FTMH (equal or lesser than 250 μm),medium FTMH (more than 250 μm but equal or lesser than 400 μm) and large FTMH (more than 400 μm).The mean BCVA was 0.85 ± 0.29.There were 7,10 and 9 eyes with small,medium and large FTMH.There were 10 eyes with vitreous-macular traction (VMT).All the eyes received IVI of 0.2 ml C3F8 followed facedown positioning for 7-14 days.The follow-up ranged from 1 to 23 months.The BCVA,FTMH closure and complications were observed.If holes failed to close at 1 month after IVI,vitrectomy combined with internal limiting membrane (ILM) peeling and C3F8 tamponade would be performed for these eyes.Results FTMHs was able to close in 17/26 eyes (65.4%) had hole closure,failed to close in 9/26 eyes (34.6%).All 10 eyes with VMT achieved vitreous-macula separation after IVI of gas.The eyes failed in the closure initially with IVI of gas alone,all succeed with hole closure after vitrectomy combined with ILM peeling and C3F8 tamponade.The closure rate of small (6 eyes),medium (8 eyes) and large FTMH (3 eyes) was 85.7%,80.0% and 33.3% respectively.The diameter of FTMHs in holes-closure eyes and failed-closure eyes was (307.8 ± 122.8),(431.6± 128.4) μm respectively,the difference was significant (t=-2.407,P=0.024).VMT was found in 6 eyes and 4 eyes in holes-closure group and failed-closure group,respectively,the difference was significant (t=-2.196,P=0.038).The mean preoperative BCVA was 0.51 ±0.36.There was a significant difference between pre-and postoperative BCVA (t=4.758,P< 0.05).Two eyes developed local retinal detachment,which achieved hole closure and retinal reattachment after vitrectomy.Conclusion IVI of expansile gas alone is an effective way in treating FTMH with a diameter smaller than 400 μm and with VMT before surgery.

13.
Article in Chinese | WPRIM | ID: wpr-617972

ABSTRACT

Objective To compare the fast blood flow density (FBFD) of intermediate choroid between endogenous Cushing syndrome (ECS) patients and healthy control subjects.Methods Thirteen eyes of 7 eligible ECS patients (ECS group) and 13 eyes of 7 gender,age,axial length matched healthy volunteers (control group) were enrolled in this study.For each subject,macular radial scan with swept source optical coherence tomography (SS-OCT) was performed and subfoveal choroidal thickness (SCT) was measured.Then 3.0 mm× 3.0 mm macular scan with SS-OCT angiography was performed,and selected blood flow image at intermediate choroid level or 1/2 SCT beneath Bruch membrane.The grayscale images were then binarized for the analysis of FBFD.Results The SCT in ECS group was (394.7±77.7) μm,which was significantly thicker than (332.1 ± 68.1) μm in control group (t=2.923,P=0.008).The FBFD of intermediate choroid in ECS group were (76.35± 14.46)%,which were significantly greater than (63.57± 13.42)% in control group (t=2.775,P=0.01).Conclusion ECS patients had increased FBFD at intermediate choroid level compared with healthy controls.

14.
Article in Chinese | WPRIM | ID: wpr-617971

ABSTRACT

Objective To analyze the results of diagnostic pars plana vitrectomy (PPV) in patients with uveitis of unknown cause.Methods This is a retrospective case series study.Sixty-five patients (67 eyes) with uveitis of unknown cause were enrolled in this study.There were 31 males (32 eyes) and 34 females (35 eyes).The ages were from 6 to 84 years,with the mean age of (55.00± 18.56) years.All eyes were received PPV.Examination of vitreous samples consisted of microbial stains and culture,microbial DNA and antibody detection,cytokine measurement,cytology,flow cytometry and gene rearrangement detection.Results Vitreous analysis was positive in 40 of 67 eyes (59.7%).Positive results indicated bacterial endophthalmitis in 20 of 40 eyes (50.0%),lymphoma in 11 eyes (27.5%),viral IgM and IgG increased significantly in 3 eyes (7.5%),fungal endophthalmitis in 3 eyes (7.5%),IgG of toxocara increased significantly in 2 eyes (5.0%),IgG of toxoplasma Gondii increased significantly in 1 eye (2.5%).Conclusion The diagnostic yield of vitreous samples in uveitis eyes of unknown cause is 59.7%.

15.
Article in Chinese | WPRIM | ID: wpr-609630

ABSTRACT

Polypoidal choroidal vasculopathy (PCV) is a fundus disease characterized by choroidal anomalous branch vascular network and terminal polypoidal dilatation.According to its fundus feature,lesion location,imaging feature and disease progression,PCV can be divided into different types or stages.It can be divided into hemorrhage and exudation PCV according to the fundus features,into macular,peripapillary,periphery and mixed types according to the lesion locations.It can also be divided into type 1 and 2 according to the ICGA (indocyanine green angiography) manifestations,and can be classified as early stage and late stage according to disease progression.There were different correlations between different types of PCV and some risk genetic loci,such as ARMS2 (age-related macular degeneration factor 2)/HTRA1 (high temperature essential protein A1),C2,complement factor B,complement factor H,and elastin genes.The response to therapy and prognosis are also different between different types.It is important to further study the clinical classification of PCV,to explore the genetic characteristics,influencing factors and treatment or prognosis features of different types of PCV.The results will improve the differential diagnosis of PCV,and the effectiveness of individualized treatment.

16.
Article in Chinese | WPRIM | ID: wpr-489470

ABSTRACT

Objective To systematically review the efficacy and safety of photodynamic therapy (PDT) and intravitreal vascular endothelial growth factor (VEGF) inhibitors in the treatment of polypoidal choroidal vasculopathy (PCV),and to investigate the primary treatment tentatively.Methods A systematic search of Pubmed,Embase,the Cochrane Library and the Wanfang Data was performed to identify all comparative studies that compared the outcomes of PDT alone,intravitreal VEGF inhibitors alone and combined intravitreal VEGF inhibitors and photodynamic therapy.Outcomes of interest included the regression and recurrence rate of polypoidal lesions,best corrected visual acuity (BCVA),central retinal thickness (CRT),therapeutic times,and the occurrence rate of adverse events.2 randomized controlled trials (RCT) and 19 non-RTCs were identified.According to treatment methods,the data extracted was classified to 3 groups,analyzed with odds ratio (OR),weighted mean difference (WMD) and 95%confidence interval (95%CI).Results Meta-analysis suggests that the regression rate of polypoidal lesions (OR=0.34,0.07;95%CI=0.13-0.88,0.02-0.36) and BCVA (WMD=0.25,0.11;95%CI=0.14-0.36,0.01-0.21) in combined therapy group were significantly better than those in PDT group and intravitreal VEGF inhibitors group (P<0.05).The recurrence rate of polypoidal lesions in PDT group was significantly lower than intravitreal VEGF inhibitors group (OR=0.35,95%CI=0.16-0.74,P=0.006).BCVA (P=0.025) and the occurrence rate of adverse events (OR=60.36,95%CI=6.04-603.50,P=0.000 5) in intravitreal VEGF inhibitors group were significant better than PDT group.Conclusions Combined treatment appeared to be superior to PDT alone or intravitreal VEGF inhibitors alone.Combined treatment takes priority over all others in the primary treatment of PCV.

17.
Article in Chinese | WPRIM | ID: wpr-472967

ABSTRACT

Objective To observe the efficacy of adjuvant intravitreal injection of anti-vascular endothelial growth factor (VEGF) therapy for advanced Coats disease.Methods This study is a retrospective case series study.Fourteen patients (14 eyes),presenting Coats Stages 3B and 4 (8 and 6 eyes,respectively) were enrolled.All the patients were treated with adjuvant intravitreal anti-VEGF therapy.The intravitreal anti-VEGF injections varied from 1 to 7,with a median injections of 2.14.In 14 eyes,combined therapy was subretinal fluid drainage in 4 eyes,photocoagulation in 2 eyes,vitrectomy in 8 eyes.The follow-up period was ranged from 4 to 36 months,with a median follow-up of 18.8 months.Visual acuity and retinal reattachment were observed in follow up.Results At last follow up,global suvival was 100.0% with no enucleation performed in any patient because of disease progression.Except for 2 children who were unable to cope with the visual acuity test,visual acuity was improved in 2 patients,stable in 8 patients,and decreased in 2 patients.5 patients (35.7%) achieved in complete retinal reattachment,3 patients (21.4%) were succeed in partial retinal reattachment,and the remain 6 patients(42.8%) failed in retinal reattachment.Two patients developed cataract after vitrectomy,and no other adverse reaction was observed during follow-up.Conclusion Anti-VEGF therapy combined with classic treatments in advanced Coats disease can keep or impove the visual acuity in most patients by reducing of subretinal exudation.

18.
Article in Chinese | WPRIM | ID: wpr-472965

ABSTRACT

Objective To evaluate the efficacy and safety of half-dose verteporfin photodynamic therapy (PDT) for chronic central serous chorioretinopathy (CSC).Methods 35 eyes (35 patients) with chronic (or recurrent) CSC treated with half-dose verteporfin PDT.Best-corrected visual acuity(BCVA),central macular thickness (CMT) were measured before and after treatment (1,3 and 6 months).The mean BCVA was 0.28± 0.22,mean CMT was(384.5 ± 85.0) μm.The situation of subretinal fluids (SRF) absorption was observed.Results In 35 eyes,SRF of 29 eyes (82.9%) completely absorbed and 6 eyes (17.1%) not completely absorbed after one month of treatment.SRF of all eyes (100.0%) completely absorbed after three months of treatment.After 6 months of treatment,SRF of 3 eyes (8.6%) were recurrence,which might be completely absorbed when a half-dose maintenance therapy PDT was used again.The mean BCVA significantly improved to 0.14±0.13 at 1 months,0.05±0.11 at 3 months and 0.05± 0.12 at 6 months after PDT (t=5.410,7.830,7.758; P<0.05).The mean CMT decreased to (224.3± 61.4) μm at 1 months,(199.6±32.7) μm at 3 months and (205.3±39.6) μm at 6 months after PDT (t=11.856,11.781,11.900; P<0.05).The mean CMT of controlled 32 eyes after treatment was (198.5± 33.9) μm,much lower than the fellow eyes(232.3 ± 17.5) μm (t =-3.988,P<0.05).Conclusions Half-dose verteporfin PDT was safe and effective in treating chronic CSC,but may cause thinning of CMT.

19.
Article in Chinese | WPRIM | ID: wpr-447191

ABSTRACT

The pathogenesis of polypoidal choroidal vasculopathy (PCV) is still controversial.More evidence of clinical and basic research is needed to distinguish PCV from an independent disease to a subtype of age-related macular degeneration.Not only that,there are also many puzzles in the diagnosis,treatment options and prognosis of PCV.In addition to these common problems,we also face a large population with risk factors,a large number of PCV patients with multiple and complex challenges in China.There is a long way to go to reduce the damage effects of PCV on visual function.To fulfil this goal,we need make full use of the huge resources of PCV patients and turn these challenges into opportunities,and contribute the improvement of diagnosis and better understanding of PCV pathogenesis.

20.
Article in Chinese | WPRIM | ID: wpr-636284

ABSTRACT

Background Central retinal vein occlusion (CRVO) causes macular edema.The treatment options are limited.There have been a series of randomized controlled trials (RCTs) to investigate the effectiveness of anti-vascular endothelial growth factor (VEGF),but the systematic review of the literature to assess the strength of evidence supporting the interventions is lack.Objective This study was to evaluate the effectiveness of anti-VEGF therapy for improving vision and reducing macular edema in patients with CRVO associated with macular edema.Methods A systematic review and Meta-analysis was performed.According to guidelines of Cochrane collaboration,the literature of RCTs for anti-VEGF therapy treating CRVO with macular edema was searched from Cochrane Library,Pubmed,Embase,Wanfang databases and conference documents without the limiting of language or date.The literature was screened independently by two searchers,and the methodology quality of the included papers was estimated.The proportion of patients with the best corrected visual acuity (BCVA) ≥ 15 ETDRS letters,the change ranges of BCVA (LogMAR) and central fovea thickness (CFT) were analyzed.The overall effect size was analyzed using Review Manager 5.1 in The Cochrane Collaboration as weighted mean difference (WSD).Fixed effect mode was used to evaluate and compare the treating effectiveness between the anti-VEGF group and sham treating group.Results Six RCTs were incorporated with 948 eyes and generated 3 comparisons in the study,including 5 multi-central studies and 1 single central study.Pegaptanib was administered in 1 study,and ranibizumab was used in 2 studied,bevacizumab in 1 study and VEGF Trap-Eye in 2 studies.The results demonstrated that anti-VEGF therapy resulted in more patients who gained 15 ETDRS letters or more during one-year duration (Z =8.43,P<0.000 01) in the 6th month after intravitreous injection.BCVA logMAR was significantly improved in the anti-VEGF therapy group in comparison with sham treating group during the initial 6 months of trial (Z=28.27,P<0.000 01) with the maximal difference in the 6th month.CFT value was significantly lower in the anti-VEGF therapy group than that of the sham treating group during the first 6 months (Z=35.38,P<0.000 01) in the 3rd month.Topical adverse events occurred occasionally,including vitreous hemorrhage in 19 eyes,cataract in 16 eyes,endophthalmitis in 8 eyes and iris neovascularization in 2 eyes.No system adverse event was found after administration of the drugs.Conclusions Anti-VEGF therapy is efficient in CRVO with macular edema with little side effect.However,in order to maintain the effect,multiple injections are needed.Early onset treatment of anti-VEGF drugs is recommended,but the delayed onset is still beneficial.

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