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Objective:To observe the efficacy and safety of urokinase arterial thrombolysis in the treatment of central retinal artery occlusion (CRAO) at different time window.Methods:A retrospective study. From January 2014 to November 2019, 157 eyes (157 CRAO patients) in the Xi’an People's Hospital (Xi’an Fourth Hospital) were included in the study. There were 120 males and 37 females, with the average age of 54.87±12.12 years. The mean onset time was 65.66±67.44 h. All patients were tested with BCVA using international standard visual acuity chart, and the results were converted into logMAR visual acuity record. The arm-retinal circulation time (A-Rct) and the filling time (FT) of retinal arterial trunk-terminal filling time were measured by FFA. The mean logMAR BCVA was 2.44±0.46, the mean A-Rct and FT were 27.72±9.78 and 13.58±14.92 s respectively. According to the time window, the patients were divided into the onset 3-72 h group and the onset 73-240 h group, which were 115 patients and 42 patients respectively. There were no statistically significant difference between the 3-72 h group and the 73-240 h group in age, A-Rct and LogMR BCVA before treatment ( χ2=-0.197, -1.242, -8.990; P=0.844, 0.369, 0.369); the difference was statistically significant in FT comparison ( χ2=-3.652, P=0.000). Urokinase artery thrombolytic therapy was performed at different time window of 3-24 h, 25-72 h, 73-96 h, 97-120 h, 121-240 h after the onset of onset. Age and A-Rct of patients with different treatment time windows were compared, and the differences were not statistically significant ( χ2=6.588, 6.679; P=0.253, 0.246).In comparison of FT and logMAR BCVA, the difference was statistically significant ( χ2 =30.150, 71.378; P=0.000, 0.000). FFA was rechecked 24 hours after treatment, BCVA was rechecked 30 days after treatment. The changes of A-Rct, FT and BCVA before and after treatment were compared and analyzed. The occurrence of adverse reactions during and after treatment were observed. The two groups of measurement data were compared. The t test was used for those with normal distribution and χ2 test was used for those with non-normal distribution. Spearman correlation analysis was used to analyze the correlation between onset time and the difference of A-Rct, FT shortening time and logMAR BCVA after treatment. Results:At 24 h after CRAO treatment, A-Rct and FT of 157 cases were 19.64±6.50 and 6.48±7.36 s respectively, which were significantly shorter than those before treatment, and the differences were statistically significant ( χ2=-16.236, -14.703; P=0.000, 0.000). The logMAR BCVA at 30 d after treatment was 1.72±0.76, which was significantly higher than that before treatment. The difference was statistically significant ( χ2=-14.460, P=0.000). After CRAO urokinase arterial thrombolysis at different time window, there were statistically significant differences in A-Rct shortening time, FT shortening time, and logMAR BCVA difference ( χ2=12.408, 24.200, 104.388; P=0.030, 0.000, 0.000). There was no statistically significant difference between the 3-72 h group and the 73-240 h group ( χ2 =-1.042, P=0.297) in shortening time of A-Rct after treatment. The difference of FT shortening time was statistically significant ( χ2=-3.581, P=0.000). The difference of logMAR BCVA was statistically significant ( χ2=-9.905, P=0.000). The results of Spearman correlation analysis showed that there was no correlation between the onset time and the shortening time of A-Rct and FT after treatment ( rp=-0.040, -0.081; P=0.436, 0.115), and negative correlation with the logMAR BCVA difference ( rp=-0.486, P=0.000). One case of intracranial hemorrhage occurred after treatment, and it improved after dehydration to reduce cerebral edema, scavenging free radicals and brain protection. Conclusions:Urokinase arterial thrombolytic therapy is effective for CRAO within time window of 3-240 h, A-Rct, FT and LogMRA BCVA are all improved. However, with the prolongation of thrombolytic therapy time window, the therapeutic effect of urokinase arterial thrombolytic therapy is decreased. The therapeutic effect of Urokinase arterial thrombolytic therapy was better within 72 h.
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Objective@#To compare the clinical effects of urokinase thrombolytic therapy for optic artery occlusion (OAO) and retinal artery occlusion (RAO) caused by facial microinjection with hyaluronic acid and spontaneous RAO.@*Methods@#From January 2014 to February 2018, 22 eyes of 22 patients with OAO and RAO caused by facial microinjection of hyaluronic acid who received treatment in Xi'an Fourth Hospital were enrolled in this retrospective study (hyaluronic acid group). Twenty-two eyes of 22 patients with spontaneous RAO were selected as the control group. The BCVA examination was performed using the international standard visual acuity chart, which was converted into logMAR visual acuity. FFA was used to measure arm-retinal circulation time (A-Rct) and filling time of retinal artery and its branches (FT). Meanwhile, MRI examination was performed. There were significant differences in age and FT between the two groups (t=14.840, 3.263; P=0.000, 0.003). The differecens of logMAR visual acuity, onset time and A-Rct were not statistically significant between the two groups (t=0.461, 0.107, 1.101; P=0.647, 0.915, 0.277). All patients underwent urokinase thrombolysis after exclusion of thrombolytic therapy. Among the patients in the hyaluronic acid group and control group, there were 6 patients of retrograde ophthalmic thrombolysis via the superior pulchlear artery, 6 patients of retrograde ophthalmic thrombolysis via the internal carotid artery, and 10 patients of intravenous thrombolysis. FFA was reviewed 24 h after treatment, and A-Rct and FT were recorded. Visual acuity was reviewed 30 days after treatment. The occurrence of adverse reactions during and after treatment were observed. The changes of logMAR visual acuity, A-Rct and FT before and after treatment were compared between the two groups using ttest.@*Results@#At 24 h after treatment, the A-Rct and FT of the hyaluronic acid group were 21.05±3.42 s and 5.05±2.52 s, which were significantly shorter than before treatment (t=4.569, 2.730; P=0.000, 0.000); the A-Rct and FT in the control group were 19.55±4.14 s and 2.55±0.91 s, which were significantly shorter than before treatment (t=4.114, 7.601; P=0.000, 0.000). There was no significant difference in A-Rct between the two groups at 24 h after treatment (t=1.311, P=0.197). The FT difference was statistically significant between the two groups at 24 h after treatment (t=4.382, P=0.000). There was no significant difference in the shortening time of A-Rct and FT between the two groups (t=0.330, 0.510; P=0.743, 0.613). At 30 days after treatment, the logMAR visual acuity in the hyaluronic acid group and the control group were 0.62±0.32 and 0.43±0.17, which were significantly higher than those before treatment (t=2.289, 5.169; P=0.029, 0.000). The difference of logMAR visual acuity between the two groups after treatment was statistically significant (t=2.872, P=0.008). The difference in logMAR visual acuity before and after treatment between the two groups was statistically significant (t=2.239, P=0.025). No ocular or systemic adverse reactions occurred during or after treatment in all patients.@*Conclusions@#Urokinase thrombolytic therapy for OAO and RAO caused by facial microinjection with hyaluronic acid and spontaneous RAO is safe and effective, with shortening A-Rct, FT and improving visual acuity. However, the improvement of visual acuity after treatment of OAO and RAO caused by facial microinjection with hyaluronic acid is worse than that of spontaneous RAO.
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Objective@#To summarize the clinical manifestations and treatment of retinal artery occlusion and cerebral infarction caused by facial injection of hyaluronic acid.@*Methods@#Fifteen cases (15 eyes) with vision lose caused by facial cosmetic injection of hyaluronic acid visited Xi＇an No.4 Hospital from December 2010 to January 2017. The clinical data were collected such as general medical history and treatment methods, and follow-up for 1 year.@*Results@#All patients were female, 22-41 years old, with average age of 33. All patients were injected with hyaluronic acid. For 8 patients the fillers were injected in the forehead, 3 patients were in the glabellar region, 3 patients were in the nasolabial fold, and 1 patient was in the temporal of left eye. All patients had vision lose after injection, the visiting time was 1 to 6 hours. 13 patients were central retinal artery occlusion (CRAO). 1 patient was retinal branch artery occlusion (BRAO), 1 patient was ischemic optic neuropathy (ION), 13 patients manifested as no light perception (NLP), 1 patient was 0.6, 1 patient was CF/30 cm, and 14 patients with cerebral infarction, manifested as headache, dizziness. All patients were given emergency treatment, and 9 patients had treated with interventional thrombolysis therapy. After treatment 11 patients, visual acuity had no significant improvement, but 4 patients improved. Headache, dizziness symptoms disappeared, but cerebral infarction lesions still existed on MRI.@*Conclusions@#Human face is a rich blood supply; vision loss and cerebral infarction could occur after injection of hyaluronic acid. After urgent treatment visual acuity is not improved obviously, eventually leading to irreversible visual impairment or even loss.
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Objective To observe the clinical characteristics of ophthalmic and cerebral artery occlusion after facial cosmetic injection.Methods A retrospective case study. Twenty patients (20 eyes) with ophthalmic and cerebral artery occlusion in Department of Ophtalmology, The Fourth Hospital of Xi'an from February 2014 to December 2016 were enrolled in this study. There were 2 males (2 eyes) and 18 females (18 eyes). They aged from 21 to 41 years, with the mean age of 29.8±1.4 years. The disease courses was ranged from 3.5 hours to 21 days, with the mean of 40 hours. Facial cosmetic injections of all patients were performed at out-of-hospital beauty institutions. The visual impairment was associated with eyelid pain 1 to 10 minutes after injection.There were 12 right eyes and 8 left eyes.The injection materials, 18 patients were hyaluronic acid and 2 patients were autologous fat, respectively. At the injection site, 13 patients were sacral, 4 patients were nasal, and 3 patients were frontal. The concentration and dose of the injected filler were not known. All patients underwent vision, slit lamp microscope, fundus color photography, visual field, FFA, OCT, and brain CT, magnetic resonance angiography (MRA) examination.Results The visual acuity was ranged from no light perception to 1.0. Among the 20 eyes, 3 eyes (15％) were obstructed by simple ophthalmic artery; 5 eyes (25％) were obstructed by ophthalmic artery combined with cerebral artery; 7 eyes (35％) were obstructed by simple retinal artery occlusion (RAO) alone, which including central RAO (CRAO, 4 eyes), hemi-lateral artery obstruction (1 eye) and branch RAO (2 eyes); 1 eye (5％) was CRAO with ciliary artery branch obstruction; 1 eye (5％) was branch artery occlusion with ischemic optic neuropathy; 2 eyes (10％) were CRAO with nasal dorsal artery occlusion; 1 eye (5％) was CRAO, posterior ciliary artery obstruction and right middle cerebral artery occlusion. Among 20 patients, 4 patients (20％) had eye movement disorder and eyelid skin bun; 2 patients (10％) had facial pain and nasal skin ischemic necrosis. MRA revealed 6 patients (30％) of new intracranial ischemic lesions. Among them, 5 patients of hyaluronic acid injection showed asymptomatic small blood vessel embolization; 1 patient of autologous fat injection showed ophthalmary artery occlusion, cerebral artery occlusion, ipsilateral eye blindness, eye movement disorder and contralateral limb hemiplegia.Conclusion Facial cosmetic injection can cause severe iatrogenic complications such as RAO, ciliary artery occlusion, ischemic optic neuropathy, ophthalmic artery occlusion, and cerebral artery occlusion.
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Objective To compare the clinical effects ofurokinase thrombolytic therapy for optic artery occlusion (OAO) and retinal artery occlusion (RAO) caused by facial microinjection with hyaluronic acid and spontaneous RAO.Methods From January 2014 to February 2018,22 eyes of 22 patients with OAO and RAO caused by facial microinjection of hyaluronic acid who received treatment in Xi'an Fourth Hospital were enrolled in this retrospective study (hyaluronic acid group).Twenty-two eyes of 22 patients with spontaneous RAO were selected as the control group.The BCVA examination was performed using the international standard visual acuity chart,which was converted into logMAR visual acuity.FFA was used to measure arm-retinal circulation time (A-Rct) and filling time of retinal artery and its branches (FT).Meanwhile,MRI examination was performed.There were significant differences in age and FT between the two groups (t=14.840,3.263;P=0.000,0.003).The differecens of logMAR visual acuity,onset time and A-Rct were not statistically significant between the two groups (t=0.461,0.107,1.101;P=0.647,0.915,0.277).All patients underwent urokinase thrombolysis after exclusion of thrombolytic therapy.Among the patients in the hyaluronic acid group and control group,there were 6 patients of retrograde ophthalmic thrombolysis via the superior pulchlear artery,6 patients of retrograde ophthalmic thrombolysis via the internal carotid artery,and 10 patients of intravenous thrombolysis.FFA was reviewed 24 h after treatment,and A-Rct and FT were recorded.Visual acuity was reviewed 30 days after treatment.The occurrence of adverse reactions during and after treatment were observed.The changes of logMAR visual acuity,A-Rct and FT before and after treatment were compared between the two groups using ttest.Results At 24 h after treatment,the A-Rct and FT of the hyaluronic acid group were 21.05 ± 3.42 s and 5.05± 2.52 s,which were significantly shorter than before treatment (t=4.569,2.730;P=0.000,0.000);the A-Rct and FT in the control group were 19.55 ± 4.14 s and 2.55± 0.91 s,which were significantly shorter than before treatment (t=4.114,7.601;P=0.000,0.000).There was no significant difference in A-Rct between the two groups at 24 h after treatment (t=l.311,P=0.197).The FT difference was statistically significant between the two groups at 24 h after treatment (t=4.382,P=0.000).There was no significant difference in the shortening time of A-Rct and FT between the two groups (t=0.330,0.510;P=0.743,0.613).At 30 days after treatment,the logMAR visual acuity in the hyaluronic acid group and the control group were 0.62± 0.32 and 0.43± 0.17,which were significantly higher than those before treatment (t=2.289,5.169;P=0.029,0.000).The difference of logMAR visual acuity between the two groups after treatment was statistically significant (t=2.872,P=0.008).The difference in logMAR visual acuity before and after treatment between the two groups was statistically significant (t=2.239,P=0.025).No ocular or systemic adverse reactions occurred during or after treatment in all patients.Conclusions Urokinase thrombolytic therapy for OAO and RAO caused by facial microinjection with hyaluronic acid and spontaneous RAO is safe and effective,with shortening A-Rct,FT and improving visual acuity.However,the improvement of visual acuity after treatment of OAO and RAO caused by facial microinjection with hyaluronie acid is worse than that of spontaneous RAO.
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Objective To observe the clinical effect of intravenous thrombolytic therapy for central retinal artery occlusion (CRAO) with poor effect after the treatment of arterial thrombolytic therapy.Methods Twenty-four CRAO patients (24 eyes) with poor effect after the treatment of arterial thrombolytic therapy were enrolled in this study.There were 11 males and 13 females.The age was ranged from 35 to 80 years,with the mean age of (56.7± 15.6) years.There were 11 right eyes and 13 left eyes.The visual acuity was tested by standard visual acuity chart.The arm-retinal circulation time (A-Rct) and the filling time of retinal artery and its branches (FT) were detected by fluorescein fundus angiography (FFA).The visual acuity was ranged from light sensation to 0.5,with the average of 0.04±0.012.The A-Rct was ranged from 18.0 s to 35.0 s,with the mean of (29.7±5.8) s.The FT was ranged from 4.0 s to 16.0 s,with the mean of (12.9±2.3) s.All patients were treated with urokinase intravenous thrombolytic therapy.The dosage ofurokinase was 3000 U/kg,2 times/d,adding 250 ml of 0.9％ sodium chloride intravenous drip,2 times between 8-10 h,and continuous treatment of FFA after 5 days.Comparative analysis was performed on the visual acuity of the patients before and after treatment,and the changes of A-Rct and FT.Results After intravenous thrombolytic therapy,the A-Rct was ranged from 16.0 s to 34.0 s,with the mean of (22.4 ±5.5) s.Among 24 eyes,the A-Rct was 27.0-34.0 s in 4 eyes (16.67％),18.0-26.0 s in 11 eyes (45.83％);16.0-17.0 s in 9 eyes (37.50％).The FT was ranged from 2.4 s to 16.0 s,with the mean of (7.4± 2.6) s.Compared with before intravenous thrombolytic therapy,the A-Rct was shortened by 7.3 s and the FT was shortened by 5.5 s with the significant differences （x2=24.6,24.9;P＜0.01).After intravenous thrombolytic therapy,the visual acuity was ranged from light sensation to 0.6,with the average of 0.08 ± 0.011.There were 1 eye with vision of light perception (4.17％),8 eyes with hand movement/20 cm (33.33％),11 eyes with 0.02-0.05 (45.83％),2 eyes with 0.1-0.2 (8.33％),1 eye with 0.5 (4.17％) and 1 eye with 0.6 (4.17％).The visual acuity was improved in 19 eyes (79.17％).The difference of visual acuity before and after intravenous thrombolytic therapy was significant (x2=7.99,P＜0.05).There was no local and systemic adverse effects during and after treatment.Conclusion Intravenous thrombolytic therapy for CRAO with poor effect after the treatment of arterial thrombolytic therapy can further improve the circulation of retinal artery and visual acuity.
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Objective To observe the effect of interventional thrombolytic therapy for central retinal artery occlusion (CRAO) with ipsilateral internal carotid artery occlusion via supratrochlear artery retrogradely or external carotid artery anterogradely.Methods Nine CRAO patients (9 eyes) were enrolled in this study,including 5 males and 4 females.The mean age was (45.2 ± 18.1) years.The mean onset duration was 24 hours.There were 4 eyes with vision of no light perception,3 eyes with light perception and 2 eyes with hand movement.Fundus fluorescein angiography (FFA) examination showed that the retinal artery was filled with delayed fluorescence.The peak of fluorescence was seen in the anterior part of the artery,and some of the eyes showed retrograde filling.The arm-retinal circulation time (A-Rct) was ≥35 s in 4 eyes,≥35 s-＜25 s in 5 eyes.The filling time of retinal artery and its branches (FT) was ≥ 15 s in 2 eyes,≥ 12 s-＜15 s in 3 eyes,≥9 s-＜ 12 s in 4 eyes.All the patients received the treatment of interventional thrombolytic therapy via supratrochlear artery retrogradely (8 eyes) or external carotid artery anterogradely (1 eye) according to the indications and contraindications of thrombolytic therapy in acute cerebral infraction patients.Urokinase (0.4 million U in total) was intermittently injected into the arteries.After artery thrombolysis,the changes of digital subtraction angiography (DSA),filling time of retinal artery and its branches on FFA within 24 hours and the visual acuity were observed.According to the A-Rct and FT on FFA,the therapeutic effects on retinal circulation were defined as effective markedly (A-Rct≤ 15 s,FT ≤2 s),effective (A-Rct was improved but in the range of 16-20 s,FT was in 3-8 s) and no effect (A-Rct was improved but ≥21 s,FT≥9 s).The related local or systemic complications were recorded.Results After the injection ofurokinase into the catheter,the ophthalmic artery and its branches were increased in 6 eyes (66.7％),and the development of the eye ring was significantly more than that of the eyes before thrombolysis.The circulation time in ophthalmic artery was speeded up for 2 s before thrombolysis in 3 eyes,3 s in 3 eyes,and 4 s in 2 eyes.Within 24 hours after thrombolysis treatment,the A-Rct was significantly decreased than that of before interventional therapy.The retinal circulation was effective markedly in 4 eyes (44.4％),effective in 4 eyes (44.4％) and no effect in 1 eyes (11.2％).The vision was improved 3 lines in 4 eyes (44.4％),2 lines in 3 eyes (33.3％),1 line in 1 eye (11.2％) and no change in 1 eye (11.2％).There were no abnormal eye movements,vitreous hemorrhage and incision hematoma,intracranial hemorrhage,cerebral embolism,and other local and systemic adverse effeetives during the follow-up.Conclusions The interventional thrombolytic therapy via supratrochlear artery retrogradely or external carotid artery anterogradely for CRAO with the ipsilateral internal carotid artery occlusion can improve retinal circulation and vision.There are no related local or systemic complications.
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Objective To evaluate the safety and effectiveness of a curved vertebroplasty (CVP) compared with traditional unipedicular approach vertebroplasty (UVP) in treating osteoporotic vertebral compression fractures (OVCF).Methods This was a retrospective case control study on the clinical data of 77 OVCF patients (12 males,65 females;aged 55-86 years,mean 70.8 years) admitted between July 2013 and December 2016.There were 6 injured vertebrae at T1 10,73 at T11 L2,and 12 at L3 5.The patients were divided into CVP group (36 patients,44 vertebrae) and UVP group (41 patients,47 vertebrae) with no significant difference in baseline clinical variables.Intraoperative and postoperative complications including neurovascular injury were recorded.Operation duration,fluoroscopy frequency,volume of cement per level,cement leakage rate per level treated,cement distribution,and refracture rate were compared between the two groups.Preoperative and postoperative visual analog scale (VAS) and Oswestry disability index (ODI) were compared both within the group and between the groups.Results No severe complications related to puncture were observed.No significant difference was observed for operation duration,fluoroscopy frequency,and cement leakage rate per level treated between the two groups (P ＞ 0.05).Compared with UVP group,CVP group had larger volume of cement per level [(5.0 ± 1.4) ml vs.(4.3 ± 1.6) ml],more uniform cement distribution (none vs.10 cases),and lower refracture rate (0 vs.10％) (P ＜ 0.05).The two groups were followed up for 6-49 months (mean,25.9 months).Significant improvements on the VAS and ODI were noted within each group (P ＜0.01),but there was no significant difference between the two groups (P ＞ 0.05).Conclusions Both CVP and UVP are safe and effective treatments for OVCF.Compared with UVP,CVP entails more uniform cement distribution and lower refracture rate.
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Objective To observe the characteristics of collateral circulation blood flow of ipsilateral ophthalmic artery in patients with internal carotid artery occlusion. Methods The imaging data of 20 patients with internal carotid artery occlusion were analyzed retrospectively. There were 11 males and 9 females, aged from 30 to 65 years, with an average age of (45±3) years. All the patients underwent digital subtraction angiography and transcranial Doppler examination, and 6 patients underwent simultaneous magnetic resonance angiography. The blood supply and collateral circulation of the ipsilateral ophthalmic artery were observed . Results All the patients had unilateral internal carotid artery occlusion. The blood supply of the ipsilateral internal carotid artery and ophthalmic artery comes from the collateral circulation between the middle meningeal artery branches of the external carotid artery and the ophthalmic artery in 18 patients (90.0%); it also comes from the anterior communicating artery of the contralateral internal carotid artery in 16 patients (80.0%); and the posterior communicating artery of the contralateral internal carotid artery in 12 patients (60.0%), respectively. Conclusion The blood flow of the ipsilateral ophthalmic artery mainly comes from the middle meningeal artery branch of the ipsilateral external carotid artery, also comes from the anterior and posterior communicating arteries of the contralateral internal carotid artery.
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Objective To observe the characteristics of collateral circulation blood flow of ipsilateral ophthalmic artery in patients with internal carotid artery occlusion. Methods The imaging data of 20 patients with internal carotid artery occlusion were analyzed retrospectively. There were 11 males and 9 females, aged from 30 to 65 years, with an average age of (45±3) years. All the patients underwent digital subtraction angiography and transcranial Doppler examination, and 6 patients underwent simultaneous magnetic resonance angiography. The blood supply and collateral circulation of the ipsilateral ophthalmic artery were observed . Results All the patients had unilateral internal carotid artery occlusion. The blood supply of the ipsilateral internal carotid artery and ophthalmic artery comes from the collateral circulation between the middle meningeal artery branches of the external carotid artery and the ophthalmic artery in 18 patients (90.0%); it also comes from the anterior communicating artery of the contralateral internal carotid artery in 16 patients (80.0%); and the posterior communicating artery of the contralateral internal carotid artery in 12 patients (60.0%), respectively. Conclusion The blood flow of the ipsilateral ophthalmic artery mainly comes from the middle meningeal artery branch of the ipsilateral external carotid artery, also comes from the anterior and posterior communicating arteries of the contralateral internal carotid artery.
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BACKGROUND:In the clinical treatment of diabetic retinopathy, the therapeutic effects of different filers on the retina and optic nerve after the removal of the vitreous are lack of comprehensive and detailed reports. OBJECTIVE:To observe the changes of retina and optic nerve in patients with diabetic retinopathy after filing cyclic polydimethylsiloxane. METHODS: Totaly 147 patients with diabetic retinopathy undergoing vitreous removal were enroled, including 77 males and 70 females, aged 35to70 years. The vitreous from 74 patients with diabetic retinopathy was filed with cyclic polydimethylsiloxane (test group). The cyclic polydimethylsiloxane was taken out at 3 months post-operation. The vitreous from another 73 patients with diabetic retinopathy was filed with the whole fluorine propane (control group). The changes of retina, optic nerve, intraocular pressure, and the occurrence of vitreous re-hemorrhage and cataract after operation were observed in these two groups. RESULTS AND CONCLUSION: After 7 days of folow-up, the intraocular pressure of patients in the test group was higher than that in the control group (P < 0.05). After 6 months of folow-up, there was no significant difference in the intraocular pressure between these two groups. After 6 months of folow-up, cyclic polydimethylsiloxane was successfuly removed in the test group, retinal blood vessels became thinning with the presence of white sheath, and the number of optic nerves was higher than the control group (P < 0.05). The incidence of vitreous re-hemorrhage and cataract in the test was higher than the control group (P < 0.05). These results demonstrate that after the removal of the vitreous, cyclic polydimethylsiloxane filing can lead to optic atrophy in patients with diabetic retinopathy.
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Objective To observe the cilioretinal artery and its relationship with central visual loss in central retinal artery occlusion(CRAO) patients.Methods A total of 140 CRAO patients (140 eyes) were enrolled in this study.The patients included 83 males and 57 females.The age was ranged from 42 to 75 years old,with an average of (55.70 ± 22.20) years.All the patients were affected unilaterally,including 79 right eyes and 61 left eyes.The disease duration was from 1 to 10 days,with a mean of (4.7±3.9)hours.Central vision and fluorescence fundus angiography were measured for all patients.The central visual loss was divided into 3 types:mild (≥0.1),moderate (finger counting to 0.08) and severe (no light perception to hand movement).The number,length and location of cilioretinal artery were observed.The correlation between cilioretinal artery and central visual loss was analyzed.Results There were 41 eyes (29.3％) with cilioretinal artery,which including 13 eyes (31.7％) with ≥3 cilioretinal arteries,23 eyes (56.1％) with 2 cilioretinal arteries,5 eyes (12.2％) with 1 cilioretinal arteries.The cilioretinal artery was within 1 disk diameter (DD) in length and not reached the macular area in 37 eyes (90.2％),was more than 1DD in length and reached the macular foveal area in 4 eyes (9.8％).The cilioretinal artery located in the temporal side of optic disk in 29 eyes (70.7％),and in other quadrant in 12 eyes (29.3％).The distribution of central visual loss degree as follow:mild in 15 eyes (10.7％),moderate in 50 eyes (35.7％),severe in 75 eyes (53.6％).The difference of central visual loss in the eyes with or without cilioretinal arteries was not significant (x2=0.16,P＞0.05).Conclusions Cilioretinal artery exists in 29.3％ CRAO eyes.There was no close correlation between cilioretinal artery and central visual loss.
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The characteristics of non-arteritic anterior ischemic optic neuropathy (NAION) include sudden decline of visual acuity, sector-shaped visual field defect connected with the physiological blind spot or hemi-visual field defect, and optic disc edema. Early angiographic abnormalities of optic disc and peripapillary choroidal circulation are important cues for the diagnosis. Angiography combined with visual field test can make the diagnosis more accurate. The pathological mechanism and process of NAION and ischemic cardiovascular/cerebrovascular disease are essentially the same. There are several critical issues in this field we need focus on, including strengthening the cooperation with relevant professional disciplines; improving the ocular ischemia through drugs, intervention and other means; preventing more serious cardiovascular events and intervening in a number of high-risk populations to reduce the incidence of AION.
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Objective To observe the concentration of plasma endothelin (ET-1) in patients with nonarteritic anterior ischemic optic neuropathy(NAION) and investigate the relationship between ET-1 and NAION. Methods The plasma levels of ET-1 in 41 patients with NAION and 15 age-matched normal control subjects were measured by radioimmuoassay (RIA). The patients with NAION were divided into high papilloedema group, light papilloedema group, and recovery group according to the degree of papilloedema; and were divided into group1 (within 14 days), 2 (within 15-30 days), 3 (within 31-60 days), and 4 (within 61-180 days) according to the disease course. The plasma levels of ET-1 in different groups were detected and compared. Results The plasma level of ET-1 in patients with NAION was significantly higher than that in the normal subjects ( t=5.02,P
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Objective To evaluate the effective method for treatment of premacular hemorrhage. Methods In 36 cases (36 eyes) of premacular hemorrhage (2PD),25 cases were treated with medicine, and 11 cases were treated with laser surgery and medicine. Results In 25 patients treated with medicine, the average time of vision recovery was 24 days and the average time of clearance of vitreous hemorrhage was 40 days; in the other 11 patients treated with laser surgery and medicine,10 were treated successfully, and in these 10 patients, the average time of vision recovery were 5 days and the average time of clearance of premacular hemorrhage were 11 days in 10 cases which were operated successfully with laser in 11 cases. Conclusions Laser surgery of inducing preretinal hemorrhage to vitreous body is an effective method for treatment of premacular hemorrhage to relieve the impaired central vision.
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0.05), higher than those in the nighttime (t=3.63,3.16;P
