Recurrence risk factors of intravitreal ranibizumab monotherapy in retinopathy of prematurity: a retrospective study at one center.

AIM: To identify risk factors of recurrence of this disorder after intravitreal ranibizumab (IVR) monotherapy. METHODS: Totally 33 eyes of 19 patients who underwent initial IVR treatments for type 1 retinopathy of prematurity (ROP) at our center were retrospectively reviewed between April 1, 2016 and December 31, 2017. Patient demographics, the side of ROP, multiple gestations, Apgar scores, zone, stage, plus disease, postmenstrual age at injection, surfactant therapy, blood transfusion therapy, hemorrhage before IVR, hemorrhage after IVR, gestational diabetes mellitus, pregnancy-induced hypertension, anemia, intraventricular hemorrhage, sepsis, respiratory distress syndrome, carbohemia, and congenital heart defects were recorded. Adjusted hazard ratios (HRs) and 95% confidence intervals were determined after adjusting for potential confounders using multivariate proportional Cox regression. RESULTS: Of the 33 eyes, 12 (36.4%) had ROP recurrences 45.3 (5.1, 50.9)mo after initial IVR treatments. The independent risk factors for ROP recurrences were zone (II vs I, HR: 0.056, P=0.003) and gestational diabetes mellitus (no vs yes, HR: 0.095, P<0.001). The mean uncorrected visual acuity for four recurrence eyes was 0.46 logMAR (0.13, 0.70) at 55.0 (51.0, 58.9) mo after the initial IVR treatment. The mean uncorrected visual acuity for 10 eyes without recurrence was 0.46 logMAR (0.19, 0.63) at 48.0 (43.8, 58.4) mo after the initial IVR treatment. CONCLUSION: Two independent risk factors for type 1 ROP recurrence after IVR treatment involving zone I and gestational diabetes mellitus are identified, and the mean uncorrected visual acuity is 0.46 logMAR at 51.0 (44.0, 58.9)mo. The findings of this study are important for follow-up management and for improving the visual function of ROP patients.

Serum vaspin levels are positively associated with diabetic retinopathy in patients with type 2 diabetes mellitus.

AIMS/INTRODUCTION: Vaspin is linked to obesity and its metabolic abnormalities. However, the role of vaspin serum levels in diabetic retinopathy (DR) is unknown. In the present study, we investigated the association between serum levels of vaspin and both DR and vision-threatening DR. MATERIALS AND METHODS: This was a cross-sectional single-center observational study from December 2018 to September 2019. We evaluated circulating serum levels of vaspin in 372 participants with type 2 diabetes. DR was screened through detailed ocular examination. DR patients were also divided two groups: vision-threatening DR and non-vision-threatening DR. The relationship between vaspin and DR was investigated by univariate and multivariate logistic regression analyses, and the results are shown as odds ratios with 95% confidence intervals. RESULTS: The vaspin serum levels of 372 patients were obtained, with a median value of 1.50 ng/mL (interquartile range 0.94-2.18 ng/mL). The median age of those patients was 53 years (interquartile range 44-62 years), and 44.4% were women. Patients with DR and VDTR had significantly increased vaspin serum levels (P < 0.001 andP < 0.001). A multivariable regression model found that patients with high levels of vaspin were approximately 1.85-fold (odds ratio for per unit increase 1.85, 95% confidence interval 1.43-2.55; P < 0.001) more likely to experience DR, and 3.76-fold (odds ratio for per unit increase 3.76, 95% confidence interval 2.05-6.55; P < 0.001) more likely to experience VTDR. The predictive value of vaspin was stronger in women than in men. CONCLUSION: Higher vaspin serum levels were associated with an increased risk of DR and VDTR in patients with type 2 diabetes, which showed that vaspin is an important indicator factor for DR.

[The results and analysis of making corneal flaps with Moria M(2) microkeratome in LASIK].

OBJECTIVE: To investigate the results and technology of making corneal flaps with Moria M(2) microkeratome. METHODS: Eight hundred and six corneal flaps (in 409 cases) were made using Moria M(2) microkeratome in LASIK. The group consisted of 205 males (405 eyes), whose mean age was (23.61 +/- 5.44) years, mean refractive spherical equivalent was (-6.32 +/- 3.61) D, and mean corneal thickness was (542.72 +/- 29.54) micro m. The 130-micron head option was chosen, the pressure was less than 250 mm Hg (1 mm Hg = 0.133 kPa), the stop-ring was adjusted to the 8.0 mm position and the suction ring was chosen according to corneal curvatures. RESULTS: All 806 corneal flaps were made successfully at one time with suitable hinge size, and without ruptured or thin or incomplete flaps. Flaps could be turned and reattached easily. There was no breaking down during the surgical procedure. The flaps showed smooth edges with smooth keratectomy beds. COMPLICATIONS: (1) Free flaps occurred in 3 eyes (0.37%). (2) Island phenomenon occurred in 2 eyes (0.25%). (3) Failure to make the flaps occurred in 3 eyes (0.37%). CONCLUSION: All 806 corneal flaps were made successfully at one time with no serious complications. Choosing the suction ring according to corneal curvature, checking blades preoperatively and inserting blades correctly may help to avoid complications when making corneal flaps with Moria M(2) microkeratome.