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INTRODUCTION: We investigated the frequency of uveitic macular edema (UME) in patients with different types of noninfectious uveitis and present the primary treatment methods for UME at a specialized eye center in Shaanxi Province, China. METHODS: We conducted a retrospective, noninterventional, observational survey involving 1946 patients with noninfectious uveitis (2816 eyes). The collected data included sex, age of uveitis onset, age of UME onset, anatomical classification of uveitis, and the treatment administered to UME patients. RESULTS: Of the 1946 patients with noninfectious uveitis, 929 (47.74%) were male and 1017 (52.26%) were female. The average age of all participants in the study was 42.19 ± 15.34 years, with average age at uveitis onset of 39.50 ± 15.52 years. Among the patients, 1003 (51.54%), 239 (12.28%), 410 (21.07%), and 294 (15.11%) had anterior uveitis, intermediate uveitis, posterior uveitis, and panuveitis, respectively. UME was observed in 134 (6.89%) of the uveitis patients. The average age of UME patients was 47.33 ± 17.17 years, with average age at uveitis onset of 45.78 ± 17.20 years. Out of the 134 UME patients, 3 (0.30%), 15 (6.28%), 47 (11.46%), and 69 (23.47%) had anterior uveitis, intermediate uveitis, posterior uveitis, and panuveitis, respectively. Among them, 37 were lost to follow-up, 44 received adalimumab (ADA) combined with low-dose prednisone and with or without conventional immunosuppressants, 19 received interferon-α2a therapy, 14 received intravitreal corticosteroid injections (such as dexamethasone implant or fluocinolone acetonide), 11 received low-dose corticosteroids combined with conventional immunosuppressants, 5 received only oral prednisone, and 4 received repeated peribulbar or subconjunctival injections of triamcinolone acetonide. CONCLUSIONS: At our tertiary ophthalmic center in Shaanxi Province, China, only 6.89% of patients with noninfectious uveitis were diagnosed with UME. The primary treatment modality for UME in our center is ADA, in accordance with treatment guidelines and the Chinese medical insurance reimbursement system.
Macular edema is a common complication that can cause vision loss in patients with uveitis. However, there is limited information about the occurrence of uveitic macular edema in the past two decades, and existing data mainly focus on developed countries such as the Netherlands and Italy. There are no relevant data for Asian countries such as China or Japan. In this study, we examined the frequency of uveitic macular edema in 1946 patients (2816 eyes) with different types of noninfectious uveitis who received treatment at a specialized eye center in Shaanxi Province, China, between January 2021 and October 2022. Among the uveitis patients, only 134 (6.89%) had uveitic macular edema. Out of these 134 patients, 3 (0.30%), 15 (6.28%), 47 (11.46%), and 69 (23.47%) had anterior uveitis, intermediate uveitis, posterior uveitis, and panuveitis, respectively. Additionally, we analyzed the treatment methods used for uveitic macular edema patients. In our center, the primary treatment approach for uveitic macular edema is adalimumab, in accordance with treatment guidelines and the Chinese medical insurance reimbursement system. Other treatment strategies include interferon-α2a therapy, intravitreal dexamethasone implants, and low-dose corticosteroids combined with conventional immunosuppressants. Our research provides valuable insights into the occurrence of uveitic macular edema in noninfectious uveitis patients and the current treatment practices at a single medical center in Shaanxi, China.
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Objective:To explore the medication safety issues caused by unreasonable sugar-to-fat ratio in clinical practice of parenteral nutrition,providing a basis for the rational use of clinical nutritional drugs.Methods:From the beginning of the database construction until February 28,2023,relevant databases at home and abroad were searched to summarize and analyze the clinical adverse outcomes caused by unreasonable sugar-to-fat ratio prescriptions encountered in the included literature and clinical practice.Results:Eleven articles were included,and 1 case of patient discomfort was improved by adjusting the unreasonable sugar-to-fat ratio.A total of 86 patients were involved,including 51 males and 35 females,with an age range of 18 to 89 years.Among the 86 patients,there were 79 clinical adverse outcomes,including 8 deaths.The incidence rates of clinical adverse outcomes were as follows:abnormal liver function 46.8%(37/79),bile stasis 22.8%(18/79),fat overload syndrome 13.9%(11/79),liver steatosis 11.4%(9/79),platelet reduction 3.8%(3/79),and other 1.3%(1/79).Among the 86 patients,2 cases were clearly recorded to have improved clinical adverse outcomes after adjusting the sugar-to-fat ratio,and the others were not detailed.Conclusions:Inappropriate sugar-to-fat ratio may lead to safety issues related to parenteral nutrition medication and should be given clinical attention.
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Herein, the microRNA-141 electrochemiluminescence (ECL) bioassay was developed using the dual-ligand metal-organic framework (d-MOF) with ordered heterogeneity, which simultaneously contained the luminophore ligands (1,1,2,2-tetra(4-carboxylbiphenyl)ethylene, denoted as TCBPE) and the coreactant ligands (1,4-diazabicyclo[2.2.2]octane, denoted as DN2H2). The resultant d-MOF revealed significantly enhanced ECL intensity without any exogenous coreactants, which was 3.53 times higher in comparison with that of single-ligand MOF (only TCBPE as ligands) even with the addition of exogenous DN2H2. Thanks to the ordered heterogeneity in d-MOF, the intramolecular rotation of TCBPE was restricted via oriented coordination and the spatial location of DN2H2 was reasonably arranged due to the framework structure, which could not only enhance the excitation efficiency but also improve the electron-transfer efficiency based on the synergistic enhancement effect between structures and compositions in micro/nano confined space. Based on this, the proposed biosensor employed a novel DNA triangular prism (DNA TP) as signal switch to detect microRNA-141, achieving the low detection limit at the level of 22.9 aM and a broad linear ranging from 100 aM to 100 pM. The precise design of the ordered d-MOFs by co-assembling the luminophore and coreactant ligands holds a promise strategy to achieve ECL MOFs and construct the ECL biosensors in diagnostic analysis.
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Técnicas Biossensoriais , Nanopartículas Metálicas , Estruturas Metalorgânicas , MicroRNAs , Bioensaio , DNA , Técnicas Eletroquímicas , Etilenos , Ligantes , Limite de Detecção , Medições Luminescentes , Nanopartículas Metálicas/química , Estruturas Metalorgânicas/química , MicroRNAs/química , OctanosRESUMO
Retinal vein occlusion (RVO) is the second most common retinal vascular disease. Central RVO (CRVO), in which obstruction occurs posterior to the lamina cribrosa due to various causes, manifests with extensive venous tortuosity, dilatation of blood vessels in the four quadrants, and retinal hemorrhage. The presence of macular edema decreases visual acuity in patients with CRVO, especially in elderly patients with hypertension, hyperlipidemia, and diabetes. In the last decade, treatment modalities for CRVO have improved, with anti-vascular endothelial growth factor agents being widely used as treatment. However, there are cases of refractory or recurrent macular edema. Moreover, CRVO also occurs in young patients. This article reviews previous studies and case reports and summarizes the differences in etiological factors, clinical manifestations, treatment, and prognosis between young and elderly patients. Due to the low incidence of CRVO in young patients, clinical data from these age groups are limited. Hence, further studies are warranted to explore the differences between age groups to improve individualization of treatment of young patients.
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This study aimed to evaluate the efficacy and safety of the intravitreal injection of conbercept in the treatment of macular neovascularization (MNV) secondary to high myopia and to observe the application of optical coherence tomography angiography (OCTA) in the treatment follow-up. We reviewed the medical records of 20 patients (21 eyes) with MNV secondary to high myopia who were enrolled in the Department of Ophthalmology of the First Hospital of China Medical University between May 2018 and January 2020. Each patient received one or more intravitreal injections of conbercept (0.5 mg/0.05 mL). The treatment was conducted according to a 1 + PRN (pro re nata) regimen. The changes of best corrected visual acuity (BCVA), central macular thickness (CMT), and selected MNV and flow areas measured by OCTA were observed over a 6-month follow-up period. The mean logarithm of the minimum angle of resolution (logMAR) BCVA was 1.03 ± 0.61 before treatment and improved to 0.83 ± 0.59 (P = 0.007), 0.78 ± 0.62 (P = 0.001), 0.81 ± 0.73 (P = 0.027), and 0.79 ± 0.72 (P = 0.023) at 1 month, 2 months, 3 months, and 6 months after treatment, respectively. The mean CMT was 358.16 ± 206.11 µm before treatment and decreased to 295.38 ± 178.70 µm (P = 0.003), 288.34 ± 165.60 µm (P = 0.004), 284.36 ± 163.07 µm (P = 0.005), and 283.00 ± 160.32 µm (P = 0.004) at 1 month, 2 months, 3 months, and 6 months after treatment, respectively. Nineteen eyes (90.5%) had stable or improved vision at 6 months of follow-up. One month after conbercept injection, in OCTA images, the small-diameter blood vessels of the MNV decreased, the intertwined small blood vessels decreased or even disappeared, and the main or larger-diameter blood vessels were still present. The mean selected MNV and blood flow areas were 0.62 ± 0.81 and 0.22 ± 0.27 mm2, respectively, before treatment and decreased to 0.23 ± 0.33 and 0.07 ± 0.08 mm2 (P = 0.04 for both), respectively, 1 month after treatment. No drug-related systemic or ocular adverse effects were observed. Our results suggest that conbercept can effectively and safely improve BCVA and reduce CMT in patients with myopic MVN (mMNV). OCTA can be used to observe MNV area, blood flow area, and MNV morphological changes after treatment with conbercept, thus providing a reference for treatment follow-up.