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1.
International Eye Science ; (12): 357-362, 2022.
Article in English | WPRIM | ID: wpr-920398

ABSTRACT

@#AIM: To investigate the effects of simvastatin(Sim)on human retinal pigment epithelial cells(RPE-19)and the possible mechanisms <i>in vitro</i> under hypoxia. <p>METHODS: RPE-19 cells were divided into three group: control group, hypoxia group(the final concentration of CoCl2 in the medium was 125 μmol/L), and Sim treatment group(3 μmol/L Sim was added in the RPE cells' medium which contain 125 μmol/L CoCl2). After 24h, the morphology of RPE-19 cells were observed, the proliferation of cells were calculated by MTT, the secretion levels and protein expression of hypoxia-inducible factor 1-Alpha(HIF-1α)and vascular endothelial growth factor(VEGF)were detected by enzyme-linked immunosorbent assay(ELISA)and Western blotting. The expression level of autophagy protein was detected by Western blot and apoptosis was detected by TUNEL.<p>RESULTS: The morphology and activity of RPE-19 cells showed an apparent change under hypoxia. The expression of HIF-1α and VEGF protein were increased obviously in the hypoxia group and then significantly decreased after Sim treatment. Beclin1, and LC3B proteins were decreased in the CoCl2+Sim group, and the expression levels were lower than the control and CoCl2 group. Under hypoxia, Sim inhibited RPE cells' proliferation and promoted the apoptosis.<p>CONCLUSION:Sim inhibits RPE cells' proliferation, decreases HIF-1α and VEGF protein, and promotes apoptosis under hypoxia. Our results suggested that the mechanism by which Sim promoted apoptosis in RPE cells may be related to its inhibition of autophagy.

2.
Acta Pharmaceutica Sinica B ; (6): 2506-2521, 2022.
Article in English | WPRIM | ID: wpr-929382

ABSTRACT

Retinal pigment epithelial (RPE) is primarily impaired in age-related macular degeneration (AMD), leading to progressive loss of photoreceptors and sometimes choroidal neovascularization (CNV). mTOR has been proposed as a promising therapeutic target, while the usage of its specific inhibitor, rapamycin, was greatly limited. To mediate the mTOR pathway in the retina by a noninvasive approach, we developed novel biomimetic nanocomplexes where rapamycin-loaded nanoparticles were coated with cell membrane derived from macrophages (termed as MRaNPs). Taking advantage of the macrophage-inherited property, intravenous injection of MRaNPs exhibited significantly enhanced accumulation in the CNV lesions, thereby increasing the local concentration of rapamycin. Consequently, MRaNPs effectively downregulated the mTOR pathway and attenuate angiogenesis in the eye. Particularly, MRaNPs also efficiently activated autophagy in the RPE, which was acknowledged to rescue RPE in response to deleterious stimuli. Overall, we design and prepare macrophage-disguised rapamycin nanocarriers and demonstrate the therapeutic advantages of employing biomimetic cell membrane materials for treatment of AMD.

3.
International Eye Science ; (12): 1006-1009, 2022.
Article in Chinese | WPRIM | ID: wpr-924222

ABSTRACT

@#AIM: To compare the efficacy of intravitreal conbercept or ranibizumab for myopic choroidal neovascularization(CNV).<p>METHODS: A retrospective cohort study. This study included 46 patients(46 eyes)with myopic CNV who were treated with conbercept(conbercept group, 20 cases, 20 eyes)or ranibizumab(ranibizumab group, 26 cases, 26 eyes)from March 2015 to August 2019. Central macular thickness(CMT), the number of injections and complications measured by best-corrected visual acuity(BCVA)and optical coherence tomography(OCT)were compared between the two groups before treatment and 1, 3, 6mo after treatment.<p>RESULTS: Before treatment, the BCVA(LogMAR)of conbercept and ranibizumab groups were 0.81±0.51, 0.83±0.66(<i>P</i>=0.900). After treatment, the BCVA(LogMAR)in the conbercept group at 1, 3 and 6mo were 0.59±0.33, 0.49±0.34, 0.44±0.32, in the ranibizumab group were 0.53±0.54, 0.47±0.47, 0.40±0.43. The BCVA was significantly improved in both groups after treatment(all <i>P</i><0.001). Before treatment, the CMT of conbercept and ranibizumab groups were 242.30±73.27, 233.38±66.63μm(<i>P</i>=0.669). After treatment, the CMT in the conbercept group at 1, 3, and 6mo were 217.00±54.78, 208.65±55.38, 206.00±45.34μm, in the ranibizumab group were 197.42±50.47, 198.38±55.19, 192.15±51.97μm. The CMT was significantly decreased in both groups after treatment(all <i>P</i><0.05). There were no significant differences in the number of injections, BCVA and CMT at each follow-up time points between conbercept and ranibizumab groups(all <i>P</i>>0.05). Systemic adverse reactions and serious ocular complications were not found during the treatment period.<p>CONCLUSION: Intravitreal conbercept or ranibizumab provide similar efficacy to improve the BCVA and reduce the CMT in the patients with myopic CNV. Both conbercept and ranibizumab could be a choice of treatment for myopic CNV.

4.
International Eye Science ; (12): 785-790, 2022.
Article in Chinese | WPRIM | ID: wpr-923412

ABSTRACT

@#AIM: To observe the efficacy of intravitreal anti-vascular endothelial growth factor(VEGF)injection treatment in chronic central serous chorioretinopathy(CCSC)combined with choroidal neovascularization(CNV)using multimodal imaging, to explore and evaluate the influence factors.<p>METHODS: In this retrospective study, 30 patients(30 eyes)were diagnosed as CCSC combined with CNV. Comprehensive ophthalmologic examinations were performed, including best corrected visual acuity(BCVA), enhanced-depth imaging(EDI)spectral domain optical coherence tomography(SD-OCT), fundus fluorescein angiography(FFA), Indocyanine green angiography(ICGA), and optical coherence tomography angiography(OCTA). Patients were treated with intravitreal ranibizumab(IVR)parallel 1+PRN schem for subretinal fluid(SRF)secondary to CCSC combined with CNV. All the patients were followed up at 1wk, 1mo after treatment and 3mo after consecutive treatment. The BCVA, central macular thickness(CMT), subfoveal choroid thickness(SFCT)and CNV flow area were compared.<p>RESULTS: All the patients were observed at baseline, 1wk, 1mo after treatment and 3mo after consecutive treatment. The difference at various time points of CMT(μm)were statistically significant(<i>F</i>=62.06, <i>P</i><0.01). CMT after treatment at each time point was compared with baseline, the difference among each time points was statistically significant(<i>t</i>=3.08, 6.57, 4.90; <i>P</i>=0.01, 0.02, <0.01). In which 46.7% of patients, SRF can be completely absorbed(14/30). The difference at various time points of BCVA(LogMAR)were statistically significant(<i>F</i>=87.21, <i>P</i><0.01). BCVA after treatment at each time point was compared with baseline, the difference between each group was statistically significant(<i>t</i>=6.52, 4.71, 6.01; <i>P</i>=0.03, <0.01, <0.01). The difference at various time points of SFCT(μm)were statistically significant(<i>F=</i>57.98, <i>P</i><0.01). SFCT after treatment at each time point was compared with baseline, the difference among each time points was statistically significant(<i>t</i>=5.11, 9.03, 4.2; <i>P</i>=0.03, <0.01, <0.01). The difference at various time points of CNV area(mm<sup>2</sup>)were statistically significant(<i>F</i>=70.78, <i>P</i><0.01). CNV area at 1wk and 1mo after treatment was compared with baseline, the difference was no statistically significant(<i>t</i>=7.01, 6.54; <i>P</i>=0.07, 0.05). CNV area at 3mo after the last treatment was compared with baseline, the difference was statistically significant(<i>t</i>=4.51, <i>P</i>=0.02). The change of CMT was positively correlated with the baseline CMT, BCVA and CNV area(<i>r</i>=0.43, 0.41, 0.41; <i>P=</i>0.02, 0.03, 0.03). The change of BCVA was positively correlated with the baseline BCVA and CMT(<i>r</i>=0.89, 0.43; <i>P</i><0.01, 0.02). <p>CONCLUSION: CCSC combined with CNV show different sensitivity to anti-VEGF therapy, the SRF can be completely absorbed after treatment in parts of patients. CNV may not be the only predictive factor leading to the SRF. The baseline BCVA, CMT and CNV area may be the factors that influence the final therapeutic effect of the intravitreal anti-VEGF injection therapy.

5.
International Eye Science ; (12): 673-676, 2022.
Article in Chinese | WPRIM | ID: wpr-922875

ABSTRACT

@#AIM:To observe the imaging features of optical coherence tomography angiography(OCTA)in the macular hemorrhage of pathologic myopia.METHODS:Designing a retrospective analysis collected clinical data of 100 patients(108 eyes)diagnosed as macular hemorrhage of pathological myopic in Nanjing Medical University Affiliated Eye Hospital from June 2016 to December 2020. All patients underwent refraction, eye axis,fundus photography, spectral-domain optical coherence tomography(SD-OCT), fundus fluorescein angiography(FFA), indocyanine green angiography(ICGA)and OCTA examination. All patients were divided into macular hemorrhage only with lacquer cracks and macular hemorrhage with choroidal neovascularization(CNV). All patients followed-up for more than 3mo by OCTA. RESULTS:There were 40 patients(42 eyes)diagnosed as macular hemorrhage only with lacquer cracks, OCTA showed bleed obscured by choroidal capillaries. After hemorrhage was being absorbed, lacquer cracks showed linear or stellate reflection completely in the choroidal capillary layer. B-scan image showed discontinuous retinal pigment epithelium(RPE), thinner choroid and an increased light. Penetrance into deeper tissues. After all macular hemorrhage only with lacquer cracks were absorbed, follow-up mode of OCTA found that 2 eyes(4.8%)without lacquer cracks, 28 eyes(66.7%)were linear and 12 eyes(28.6%)were stellate under the original hemorrhage. Follow-up mode also showed that 8 eyes of 8 patients(19.0%)relapsed macular hemorrhage only with lacquer cracks, and 4 eyes of 4 patients(9.5%)suffered secondary macular hemorrhage with CNV. There were 60 patients(66 eyes)diagnosed as macular hemorrhage with CNV,OCTA showed bleed obscured choroidal capillaries, the outer retinal and choroidal capillary layer also showed the shape of CNV around hemorrhage. B-scan showed CNV breaked through the RPE layer and blood flow signal in it. The area of CNV decreased after anti-vascular endothelial growth factor(VEGF)intravitreal injection treatment. Around all macular hemorrhage with CNV, OCTA found that 48 eyes(72.7%)had lacquer cracks, 28 eyes(42.4%)were linear and 20 eyes(30.3%)were stellate.CONCLUSION:OCTA has a great significance in the diagnosis of macular hemorrhage of pathological myopia, fast and non-invasive is the biggest advantage. Choroidal capillary layer can clearly observe the shape and location of hemorrhage,lacquer cracks and CNV. The follow-up mode can intuitively comprehend the changes of disease. To some extent, it can replace fundus angiography to directly judge the classification, and time to treat in the clinic.

6.
International Eye Science ; (12): 541-548, 2022.
Article in Chinese | WPRIM | ID: wpr-922848

ABSTRACT

@#AIM: To investigate the effect and mechanism of curcumin on inhibiting choroidal neovascularization(CNV)<i>in vitro</i>. METHODS: Human retinal pigment epithelial(ARPE-19)cells chemical hypoxia model was established by cobalt chloride(CoCl2). CCK-8 method was used to detect the effect of curcumin on the activity of ARPE-19 cells induced by CoCl2. RT-qPCR and Western blot were used to detect the expression of AKT, HIF-1α, VEGF mRNA and protein in ARPE-19 cells hypoxia model induced by CoCl2. Cell scratch test, transwell chamber migration test, transwell chamber invasion test and matrigel matrix hose lumen formation test were used to observe the effects of conditioned medium of curcumin in ARPE-19 cells on the proliferation, migration, invasion and lumen formation of human umbilical vein endothelial cells(HUVEC)in non-contact condition. RESULTS:Chemical hypoxia model of ARPE-19 cells can successfully establish by CoCl2 at 100μmol/L. CoCl2 at the final concentration of 100μmol/L can promote the expression of AKT, HIF-1α and VEGF mRNA and p-AKT, HIF-1α and VEGF protein in ARPE-19 cells. Curcumin at the final concentration of 100μmol/L can reduce the expression of AKT, HIF-1α and VEGF mRNA in ARPE-19 hypoxia model. Curcumin at the final concentration of 100μmol/L can reduce the expression of AKT, HIF -1α and VEGF proteins in ARPE-19 hypoxia model. The conditioned medium of low(6.25μmol/L), medium(25μmol/L)and high dose(100μmol/L)curcumin in ARPE-19 cells can significantly inhibit the level migration of HUVEC. The conditioned medium in high dose group can significantly inhibit the vertical migration and cell invasion of HUVEC. The conditioned medium of middle and high dose curcumin in ARPE-19 cells can inhibit the lumen formation of HUVEC. CONCLUSION:Curcumin at 100μmol/L can protect ARPE-19 cells from hypoxia induced by CoCl2. Curcumin can inhibit the formation of blood vessels at the cellular level.

7.
Rev. bras. oftalmol ; 81: e0016, 2022. graf
Article in English | LILACS | ID: biblio-1365729

ABSTRACT

ABSTRACT Reticular pigmentary retinal dystrophy, also known as Sjögren's reticular dystrophy, is a rare condition characterized by macular lesions with a reticular pattern, which are best seen on fluorescein angiogram. Choroidal neovascularization secondary to this type of dystrophy is even less common. This report describes a case of reticular pigmentary retinal dystrophy with vision loss due to neovascular membrane, which responded well to treatment with anti-vascular endothelial growth factor.


RESUMO A distrofia reticular pigmentar da retina, também conhecida como distrofia reticular de Sjögren, é uma doença rara, caracterizada por lesões maculares com um padrão reticular, que são mais bem visualizadas na angiografia com fluoresceína. A neovascularização de coroide secundária a este tipo de distrofia é ainda menos comum. Este relato descreve um caso de distrofia reticular pigmentar da retina, com perda de visão devido à membrana neovascular, que respondeu bem ao tratamento com fator de crescimento endotelial antivascular.


Subject(s)
Humans , Male , Aged , Retinitis Pigmentosa/complications , Choroidal Neovascularization/etiology , Choroidal Neovascularization/drug therapy , Retinal Dystrophies/complications , Ranibizumab/administration & dosage , Sjogren's Syndrome/complications , Follow-Up Studies , Choroidal Neovascularization/diagnosis , Angiogenesis Inhibitors/administration & dosage , Angiogenesis Inhibitors/therapeutic use , Intravitreal Injections , Ranibizumab/therapeutic use
8.
Rev. bras. oftalmol ; 80(3): e0009, 2021. graf
Article in Portuguese | LILACS | ID: biblio-1280121

ABSTRACT

RESUMO Este trabalho visou evidenciar a importância da detecção precoce da coroidite interna punctata e destacar sua fisiopatologia inflamatória e possíveis diagnósticos diferenciais dentro das white dot syndromes. O destaque foi dado principalmente à coroidite multifocal e à panuveíte, ao se demonstrar sua epidemiologia peculiar em mulheres jovens, caracterizar sua apresentação clínica típica na fundoscopia e explorar as vantagens e as desvantagens de realizar os exames complementares que fazem parte da análise multimodal útil para o diagnóstico (especialmente a angiografia fluoresceínica, a tomografia de coerência óptica e a indocianina verde). Descreve-se o caso de uma mulher de 28 anos diagnosticada com coroidite interna punctata com membrana neovascular coroidal em olho direito. O tratamento foi realizado com injeção intravítrea de aflibercepte e corticoterapia sistêmica 1mg/kg ao dia. Este relato é importante por permitir debater o manejo da coroidite interna punctata durante a gestação e a decisão de realizar o tratamento mediante uma diversidade de opções terapêuticas.


ABSTRACT This work aimed to demonstrate the importance of early detection of punctate inner choroidopathy, highlighting the pathophysiology of inflammation and the differential diagnoses among white dot syndromes. Special attention was given to multifocal choroiditis and panuveitis, by demonstrating the peculiar epidemiology in young women, characterizing the typical clinical presentation in ophthalmoscopy, and exploring the advantages and disadvantages of performing the complementary examinations, which are part of the multimodal analysis useful for diagnosis (particularly fluorescein angiography, optical coherence tomography, and indocyanine green). We report the case of a 28-year-old female, diagnosed as punctate inner choroidopathy with choroidal [N.T. no título aparece subretinal = subrretiniana] neovascular membrane in the right eye. She was treated with intravitreal injection of aflibercept and systemic corticosteroid 1 mg/kg/day. This case report is important for addressing the management of punctate inner choroidopathy during pregnancy, and the decision to carry out treatment considering diverse therapeutic options.


Subject(s)
Humans , Female , Adult , Choroiditis/complications , Choroiditis/diagnosis , Choroiditis/physiopathology , Choroidal Neovascularization/etiology , Angiogenesis Inhibitors/therapeutic use , Intravitreal Injections/methods , Fluorescein Angiography/methods , Tomography, Optical Coherence/methods
9.
International Eye Science ; (12): 648-651, 2021.
Article in Chinese | WPRIM | ID: wpr-873862

ABSTRACT

@#Optical coherence tomography angiography(OCTA)is a quick, non-invasive imaging technology which can both qualitatively and quantitatively analyze retinal blood perfusion that is now more widely used in clinical practice. Choroidal neovascularization(CNV)is the main cause of loss of vision in the elderly and is caused by neovascular age-related macular degeneration(nARMD). Therefore, the detection of CNV in nARMD is of extreme importance. In this paper, the research progress of OCTA in diagnosing and treating nARMD was reviewed by analyzing the diagnosis, morphology, area and blood perfusion of CNV.

10.
Article in Chinese | WPRIM | ID: wpr-905991

ABSTRACT

Objective:To observe the effects of artesunate (ART) on experimental choroidal neovascularization (CNV) and the expression of related proteins, and to explore the underlying mechanism. Method:Eighty BN rats were randomly divided into five groups: a normal group, a model group, a conbercept group, and low- (10.08 mg·kg<sup>-1</sup>·d<sup>-1</sup>) and high-dose (20.16 mg·kg<sup>-1</sup>·d<sup>-1</sup>) ART groups, with 16 rats in each group. A CNV model was established with 532 nm laser in rats of the groups except for the normal group. The rats in each group were treated with corresponding drugs by gavage for 14 days. The normal group, the model group, and the conbercept group received 1% CMC-Na solution at the same volume, while the conbercept group received an intravitreal injection (5 μL) once. On days 7 and 14, fundus fluorescein angiography (FFA) was used to evaluate the fluorescein leakage (gray value) of CNV. Hematoxylin-eosin (HE) staining was adopted to observe the histopathological changes of CNV. Western blot was employed to detect the protein expression levels of hypoxia-inducible factor-1<italic>α</italic> (HIF-1<italic>α</italic>) and vascular endothelial growth factor (VEGF) in the retina and choroid. Result:FFA results showed that compared with the normal group, other groups showed increased gray value on days 7 and 14 (<italic>P</italic><0.01). On day 7, the gray value of the high-dose ART group and the conbercept group decreased compared with that in the model group (<italic>P</italic><0.01). On day 14, the gray value of the ART groups and the conbercept group decreased in varying degrees compared with that in the model group (<italic>P</italic><0.05, <italic>P</italic><0.01). HE results showed that compared with the normal group, the model group showed increased thickness of CNV on days 7 and 14 (<italic>P</italic><0.01). Compared with the model group, the ART groups and the conbercept group displayed decreased thickness of CNV (<italic>P</italic><0.01). Western blot results revealed that the expression of HIF-1<italic>α</italic> and VEGF in the model group increased in varying degrees on the days 7 and 14 compared with that in the normal group (<italic>P</italic><0.05, <italic>P</italic><0.01), while compared with the model group, the ART groups and the conbercept group showed decreased expression (<italic>P</italic><0.01). Conclusion:ART can inhibit experimental CNV by down-regulating the expression of HIF-1<italic>α</italic> and VEGF in the early stage of experimental CNV formation.

11.
Article in Chinese | WPRIM | ID: wpr-912395

ABSTRACT

Objective:To investigate the clinical effects and influence factors of intravitreal injection of anti-vascular endothelial growth factor (VEGF) drugs in the treatment of idiopathic choroidal neovascularization (ICNV).Methods:This retrospective study involved 27 patients (27 eyes) with ICNV from July 2012 to July 2015. Patients received intravitreal bevacizumab (1.25 mg), ranibizumab (0.05 mg), additional injection was provided if it was needed. The average follow-up time was 168 weeks. The recovery of best corrected visual acuity (BCVA) and central foveal retinal thickness (CRT) of the affected eye was observed. Follow up once a month after the initial treatment until the lesion was completely absorbed or scarred (the first follow-up period). Follow up every 12 weeks was performed to observe the recurrence of the lesions (the second stage of long-term follow-up). One month after the last injection of the first follow-up period, according to the regression of choroidal neovascularization (CNV), the affected eyes were divided into a significant improvement group (significant improvement group) and an insignificant improvement group (non-significant improvement group)), to analyze the effects of age, course of disease, type of drugs, number of injections, baseline BCVA and CRT on the regression of CNV lesions. According to the results of long-term follow-up, the eyes were divided into recurrence group and non-recurrence group, and the factors affecting the recurrence of CNV lesions were analyzed. Measurement data between groups was compared by using independent sample t test or non-parametric test; count data was compared by using χ2 test. Logistic regression analysis was used to analyze the factors affecting the regression and recurrence of the lesion. Results:At baseline and 1 month after the last injection in the first stage, the average BCVA of the eyes were 55.70±15.21 and 73.59±12.08 letters; CRT was 338.3±89.32 and 264.5±47.47 μm, respectively. The BCVA and CRT of the affected eyes were compared at the two time points, and the differences were statistically significant ( Z= -3.886, -4.061; P<0.001). The BCVA of the eyes in the significant improvement group and the insignificant improvement group were 65.38±17.27 and 51.63±12.61 letters, respectively; the difference between the two groups of BCVA was statistically significant ( t=-2.316, P=0.029). The results of long-term follow-up showed that of the 27 eyes, 6 eyes had recurrence; the average recurrence time was 90.83±49.02 weeks. After another intravitreal injection of anti-VEGF drugs, the CNV lesions was resolved. The average injection times of the relapsed group and the non-relapsed group were 3.67±0.816 and 2.24±0.768, respectively. The average injection times of the relapsed group was significantly higher than that of the non-relapsed group, and the difference was statistically significant ( Z=-3.253, P<0.001). There was no statistically significant difference between the two groups of eyes at baseline and CRT at the last follow-up ( Z=-1.342,-1.313; P=0.195, 0.195). Conclusion:Intravitreal injection of anti-VEGF drugs can effectively increase the regression rate of BCVA and CNV lesions in ICNV eyes; high baseline visual acuity indicates better CNV lesion regression after treatment. Relapsed patients can be effectively improved after re-treatment with anti-VEGF drugs, and CNV recurrence has no significant effect on the final prognosis.

12.
International Eye Science ; (12): 1399-1403, 2021.
Article in Chinese | WPRIM | ID: wpr-882101

ABSTRACT

@#Choroidal thickening spectrum diseases include pachychoroid pigment epitheliopathy(PPE)central serous chorioretinopathy(CSC), pachychoroid neovascularization(PNV)and polypoidal choroidal-vasculopathy(PCV). PPE refers to permanent abnormal increase in choroidal thickness. It is manifested as dilatation of large choroidal vessels(Haller layer)oppressing the surrounding middle vascular layer(Sattler layer)and capillary layer(Choriocapillaris layer), resulting in insufficient blood supply to the retinal pigment epithelium and causing a series of retinitis pigmentosa. The other three diseases can progress from the pachychoroid pigment epitheliopathy. The study of the pathogenic characteristics and imaging changes of choroidal thickening spectrum diseases will help to explore the diseases' pathogenesis, providing reference for early clinical diagnosis, prevention and treatment.

13.
Article in Chinese | WPRIM | ID: wpr-908550

ABSTRACT

Objective:To analyze the imaging etiology of patients having vision loss with pathological myopia.Methods:A cross-sectional study was conducted.The clinical data of 110 cases (138 eyes) who had vision loss with pathological myopia diagnosed in Xiamen Eye Center of Xiamen University from June 1st, 2016 to May 31st, 2017 was collected and analyzed.Fundus photography was used to observe lacquer cracks; spectral domain optical coherence tomography (SD-OCT), fundus fluorescein angiography, indocyanine green angiography and optical coherence tomography angiography (OCTA) were employed to evaluate the choroidal neovascularization (CNV) and punctate inner choroidopathy (PIC). The macular retinoschisis (MRS), macular atrophy, macular hole and epiretinal membranes were assessed by SD-OCT.The proportion and age distribution of different fundus lesions of pathological myopia complicated with vision loss were analyzed.The study protocol was approved by an Ethics Committee of Xiamen Eye Center of Xiamen University (No.XMYKZX-2016-KY-010). Written informed consent was obtained from each patient before study.Results:Among the imaging causes of visual impairment caused by pathological myopia, there were 87 (63.0%) eyes of myopic CNV (MCNV) with the highest proportion, followed by 53 (38.4%) eyes of lacquer cracks, 48 (34.8%) eyes of MRS, 44 (31.9%) eyes of macular atrophy, 42 (30.4%) eyes of epiretinal membranes, 14 (10.1%) eyes of macular lamellar hole, 19 (13.8%) eyes of full-thickness macular hole (FTMH), and 3 (2.2%) eyes of PIC.The average age was (53.00±1.51) years of MCNV, (53.00±1.77) years of lacquer cracks, (58.00±1.64) years of MRS, (57.00±1.76) years of macular atrophy, (59.00±1.48) years of epiretinal membranes, (61.00±3.90) years of macular lamellar hole, (59.00±3.39) years of FTMH with retinal detachment (RD), and (67.00±0.50) years of FTMH without RD.The average age of PIC patients was (31.00±8.50) years, which was significantly smaller than that of the other groups (all at P<0.05). Conclusions:The main cause of visual impairment resulted from pathological myopia is the obvious abnormality of macular structure, and MCNV is the most common type.

14.
International Eye Science ; (12): 1213-1220, 2021.
Article in Chinese | WPRIM | ID: wpr-877387

ABSTRACT

@#AIM: To evaluate the diagnostic value of optical coherence tomography angiography(OCTA)in detecting the choroidal neovascularization(CNV)of wet age-related macular degeneration(wARMD).<p>METHODS: PubMed, Embase, Web of science, Cochrane library, CNKI, Wanfang, CBM and VIP databases were searched from inception to October 27, 2020 in diagnosing CNV of wARMD by OCTA. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies by QUADAS-2 standard. Meta-analysis was performed by Meta-Disc 1.4 and Stata 16.0 softwares.<p>RESULTS: A total of 11 studies involving 995 eyes were included. The results of Meta-analysis showed that the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic ratio, the AUC of sROC and the positive post-test probability were 0.88 \〖95%<i>CI </i>(0.83, 0.92)\〗, 0.95 \〖95%<i>CI </i>(0.85, 0.99)\〗, 18.45 \〖95%<i>CI </i>(5.36, 63.52)\〗, 0.12 \〖95%<i>CI </i>(0.08, 0.18)\〗, 152.73 \〖95%<i>CI </i>(36.39, 641.05)\〗, 0.95 \〖95%<i>CI </i>(0.92, 0.96)\〗 and 0.96 respectively.<p>CONCLUSION: OCTA has significant diagnostic value for CNV of wARMD, especially for patients with early wARMD.

15.
Arq. bras. oftalmol ; 83(6): 552-561, Nov.-Dec. 2020.
Article in English | LILACS | ID: biblio-1153080

ABSTRACT

ABSTRACT Age-related macular degeneration is the leading cause of vision loss in elderly individuals, as well as a medical and socio-economic challenge. The treatment of dry age-related macular degeneration is based on vitamin supplementation. New treatment studies are focused on preventing the progression of degeneration and repopulating the atrophic macula. Recently, research on the treatment of neovascular age-related macular degeneration experienced a breakthrough with the advent of anti-vascular endothelial growth factor inhibitors. Nevertheless, despite the fact that ranibizumab, aflibercept, and bevacizumab are effective in reducing severe visual impairment, patients usually lose some vision over time. Therefore, the search for new therapies and diagnostic methods is fundamentally important. Current studies are focused on new anti-vascular endothelial growth factor drugs, nucleoside reverse transcriptase inhibitors, antibody against sphingosine-1-phosphate, anti-platelet-derived growth factor, gene therapy, and RNA interference. The results of ongoing clinical studies may improve the therapy of age-related macular degeneration.


RESUMO Degeneração macular relacionada à idade (DMRI) é a principal causa de perda de visão em pessoas idosas. É também um desafio médico e socioeconômico. O tratamento da degeneração macular relacionada à idade seca baseia-se na suplementação vitamínica. Novos tratamentos estão focados na prevenção da progressão da degeneração e tentativas de repovoar a mácula atrófica. A degeneração macular relacionada à idade neovascular experimentou um grande avanço com o advento dos inibidores do fator de crescimento endotelial anti-vascular (anti-VEGF); no entanto, apesar do ranibizumab, aflibercept e bevacizumab serem eficazes na redução do comprometimento visual grave, os pacientes geralmente per­dem visão ao longo do tempo. Portanto, a busca por novas terapias, tratamentos e diagnósticos é de fundamental importância. Os estudos estão focados em novos fármacos sobre fator de crescimento endotelial anti-vascular, inibidores nucleosideos da transcriptase reversa, anticorpos contra esfingosina-1-fosfato, fator de crescimento derivado de plaquetas, terapia genética e RNA de interferência. A terapia para degeneração macular relacionada à idade está prestes a melhorar como resultado desses estudos clínicos em andamento.


Subject(s)
Humans , Aged , Angiogenesis Inhibitors , Macular Degeneration , Recombinant Fusion Proteins/therapeutic use , Visual Acuity , Angiogenesis Inhibitors/therapeutic use , Receptors, Vascular Endothelial Growth Factor/therapeutic use , Vascular Endothelial Growth Factor A , Intravitreal Injections , Bevacizumab/therapeutic use , Ranibizumab/therapeutic use , Macular Degeneration/drug therapy
16.
Rev bras oftalmol ; 79(3): 199-202, May/June 2020. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1137955

ABSTRACT

Abstract The purpose is to report a case of laser pointer-induced maculopathy and to describe its characteristics using spectral-domain optical coherence tomography (SD-OCT), further the outcome of treatment with intravitreal injections. A 35-year-old man presented with a 6-day history of central vision loss in his right eye (RE) after an accidental laser pointer discharge (wavelength of 532 nm). He underwent a full ophthalmologic examination, including SD-OCT, which suggested the presence of subfoveal choroidal neovascularization (CNV). This was not confirmed due to the unavailability of tools such as fluorescein angiography, indocyanine green angiography and OCT angiography. Best-corrected visual acuity (BCVA) was inicially 20/400 in the RE. Thus, considering a presumed CNV, three intravitreal injections of bevacizumab (the first one combined with triamcinolone acetonide) were performed in the RE. BCVA acuity in his RE improved to 20/25 at 3 months after the first intravitreal injection, with complete resolution of exudation. Over the following 12 months, BCVA remained stable, and no evidence of progression or development of neovascularization was observed. Laser pointer may cause subfoveal CNV when accidently directed toward the eye. In this case, the presumed CNV induced by laser had an excellent response to bevacizumab and triamcinolone acetonide injections.


Resumo O objetivo é relatar um caso de lesão macular induzida por laser pointer e descrever suas características utilizando a tomografia de coerência óptica de domínio espectral (SD-OCT), assim como o resultado do tratamento com injeções intravítreas. Um homem de 35 anos apresentou uma história de perda da visão central no olho direito (OD) de 6 dias de evolução após um disparo acidental de laser (comprimento de onda de 532 nm). O paciente foi submetido a exame oftalmológico completo, incluindo SD-OCT, que sugeriu a presença de neovascularização coroidal (CNV) subfoveal. Isso não foi confirmado devido à indisponibilidade de ferramentas como angiografia fluoresceínica, angiografia com indocianina verde e angiografia por OCT. A acuidade visual (AV) com melhor correção foi inicialmente de 20/400 no OD. Assim, considerando uma CNV presumida, três injeções intravítreas de bevacizumabe (a primeira combinada com triancinolona acetonida) foram realizadas no OD. A AV melhorou para 20/25 aos 3 meses após a primeira injeção intravítrea, com resolução completa da exsudação. Nos 12 meses seguintes, a AV permaneceu estável e nenhuma evidência de progressão ou desenvolvimento de neovascularização foi observada. O laser pointer pode causar CNV quando acidentalmente direcionado para o olho. Nesse caso, a suposta CNV induzida por laser teve uma excelente resposta às injeções de bevacizumabe e triancinolona acetonida.

17.
International Eye Science ; (12): 398-400, 2020.
Article in Chinese | WPRIM | ID: wpr-780628

ABSTRACT

@#AIM: To investigate the diagnostic value of optical coherence tomography angiography(OCTA)in choroidal rupture and evaluate the imaging features. <p>METHODS: We selected 25 patients(25 eyes)whom were diagnosed as choroidal rupturein in this retrospective observational case. All patients underwent fundus photography, fundus fluorescein angiography(FFA), indocyannine green angiograph(ICGA), spectral domain optical coherence tomography(SD-OCT)and OCTA examinations.<p>RESULTS: All the patients showed the lesions were mostly located in the macular area or on the temporal side of the optic disc, with a yellow-white arc hyperreflexia with stripes shape, it can be accompanied by retinal choroidal edema and subretinal hemorrhage. In the early stage of FFA, it showed a curved shape window defect of choroidal rupture, and fluorescent staining in the late stage. When secondary to choroidal neovascularization(CNV), the active CNV showed a hyperfluorescence leakage. SD-OCT showed the reflex of outer retina and choroidal capillary layer were ruptured, the reflex of the surrounding tissue were reinforced, the subretinal small cluster hyperreflexia can be seen. The granulation tissue showed an arc hyperreflexia with “stripe shape” in the outer retinal and choroid capillary layer of OCTA angiogram image. On the B-scan, it showed an inwardly bulge or outwardly recess shap, with blood flow signal inside. When secondary to CNV, vascular morphology can be seen clearly, most of them were cluster shape, which is different from the granulation tissue.<p>CONCLUSION: Although the granulation tissue and CNV of choroid rupture showed cluster shap and blood flow signal on OCTA, there were significant differences in morphology and tissue composition between them. Through the display of OCTA stratification and the detailed observation of the lesion, the diagnosis rate of secondary CNV in choroidal rupture can be improved.

18.
International Eye Science ; (12): 263-266, 2020.
Article in Chinese | WPRIM | ID: wpr-780593

ABSTRACT

@#Punctate inner choroidopathy(PIC)is an infrequent idiopathic chorioretinopathy, frequently affecting young myopic women. There are multiple, small, round, yellow-white or gray punctate lesions in the retinal pigment epithelium and the choroidal lining, in the absence of anterior ocular segment or the vitreous body inflammation. In general, most patients have good prognosis and a few patients will be caused severe vision loss if complicated by choroidal neovascularization(CNV)and subretinal fibrosis. This article reviews the etiology, pathogensis, clinical manifestations, diagnosis and differential diagnosis and treatment of PIC.

19.
International Eye Science ; (12): 2019-2022, 2020.
Article in English | WPRIM | ID: wpr-829697

ABSTRACT

@#AIM: To evaluate the one-year outcome of intravitreal conbercept injections for the treatment of choroidal neovascularization secondary to pathological myopia(pm-CNV)by optical coherence tomography angiography(OCTA).<p>METHODS: The medical records of 26 consecutive eyes of 23 patients who received intravitreal injections of conbercept for pm-CNV with a follow-up of 1y were retrospectively reviewed. All the patients were diagnosed by fundus fluorescein angiography(FFA)and OCTA at the first visit. All approaches were performed as “1+PRN” treatment. Outcomes included best-corrected visual acuity(BCVA), central foveal thickness(CFT)and the mean CNV area by OCTA.<p>RESULTS: Mean BCVA improved from(0.66±0.51)at baseline to(0.39±0.38)at 1y(<i>t</i>=3.528, <i>P</i>=0.004). The CFT before treatment and after 1y after were(275.08±48.74)μm and(205.15±43.74)μm respectively(<i>t</i>=4.630, <i>P</i>=0.001). The mean pm-CNV areas before treatment and after 1y treatment were(0.48±0.24)mm<sup>2</sup> and(0.15±0.11)mm<sup>2</sup> respectively, with a significant difference among them(<i>t</i>=5.329, <i>P</i>=0.000). Twenty-one eyes had no needs after the first treatment. Four eyes received 2 injections and only one eye received 3 injections. No severe adverse events were noted relevant to the therapy.<p>CONCLUSION: Intravitreal conbercept can improve the vision and relieve CFT and CNV area for the treatment of pm-CNV with “1+PRN” by OCTA for 1y, however, long-term follow-up still need to be performed.

20.
International Eye Science ; (12): 1071-1074, 2020.
Article in Chinese | WPRIM | ID: wpr-821590

ABSTRACT

@#AIM: To observe the changes of selected area of choroidal neovascularization(CSA)and flow area of choroidal neovascularization(CFA)before and after the treatment of anti-vascular endothelial growth factor(VEGF)by optical coherence tomography angiography(OCTA), and to explore the advantages of OCTA in the treatment and prognosis of wet age-related macular degeneration(wAMD). <p>METHODS: A retrospective analysis was performed on 22 patients(27 eyes)who were diagnosed with wARMD and received the first anti-VEGF drug treatment and subsequent treatment in the Department of Ophthalmology of our hospital from 2018-02 to 2019-07. All patients were treated with anti-VEGF drugs according to the 3+prn regimen. The best corrected visual acuity(BCVA),macular foveal retinal thickness(CMT), CSA, and CFA were compared before and after treatment. We analyzed the correlation between BCVA(LogMAR)and CMT, CSA, CFA by Pearson correlation analysis. <p>RESULTS: After 3mo of the treatment, the mean LogMAR BCVA(0.512±0.367), CMT(223.271±17.795μm),CSA(0.085±0.113mm2)and CFA(0.015±0.008mm2)were significantly lower than those before treatment(<i>P</i><0.05). The results of correlation analysis showed that the post- BCVA was positively correlated with pre-CMT, post-CMT, pre-CSA, post-CSA, pre-CFA and post-CFA(<i>P</i><0.05).<p>CONCLUSION: OCTA can directly display and quantify the changes of CSA and CFA before and after anti-VEGF treatment of wAMD, and provide a reference for the evaluation of wAMD treatment effects.

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