Objective lt;brgt;To evaluated the effect of transpupillary thermotherapy (TTT) on age-related macular degeneration (AMD). lt;brgt; lt;brgt;Methods lt;brgt;Sixty-two cases (62 eyes) of exudative AMD were managed with TTT. Before treatment, 58 cases underwent fundus fluorescein angiography(FFA),42 cases underwent simultaneous indocyanine green angiography (ICGA), and 56 cases underwent optic coherence tomography (OCT).TTT was delivered using a 810 nm diode laser with variable spot sizes 0.5-3.0 mm and power range 60-40 mW,60 seconds duration. Sixty-two cases were followed up for 1-10 months with 4.8 months average. lt;brgt; lt;brgt;Results lt;brgt;The visual acuities of last visit were compared with those before the treatment. The visual acuity was unchanged in 43 cases (69.3%), improved in 15 cases (24.2%), and declined in 4 cases (6.5%). OCT was re-done in 51 cases and compared with OCT images before TTT treatment. The height of macular edema was unchanged in 29 cases (56.9%), decreased in 18 cases (35.3%), and increased in 4 cases (7.8%). The amelioration of visual acuity was compatible with that of macular configuration in the majority of cases (74.5%). Only in 13 cases (25.5%) the amelioration of visual acuity lagged behind that of macular configuration. The re-treatment was performed in 18 cases (29.1%), probably due to insufficiency of laser power. No side-effect was found. lt;brgt; lt;brgt;Conclusion lt;brgt;TTT makes most of the cases of exudative AMD retaining or improving their visual acuity. The employment is secured. Further exploration is needed in order to obtain the parameters of the laser treatment. (Chin J Ocul Fundus Dis, 2002, 18: 180-183)
Microparticles are small vesicles that are released by budding of the plasma membrane during cellular activation and apoptotic cell breakdown. A spectrum of cell types can release microparticles including endothelial cells, platelets, macrophages, lymphocytes and tumor cells. Biological effects of microparticles mainly include procoagulant activity, inhibition of inflammation and cancer progression. The present study shows that vitreous microparticles isolated from proliferative diabetic retinopathy (PDR) stimulated endothelial cell proliferation and increased new vessel formation, promoting the pathological neovascularization in PDR patients. Oxidative stress induces the formation of retina pigment epithelium-derived microparticles carrying membrane complement regulatory proteins, which is associated with drusen formation and age related macular degeneration. Microparticles from lymphocyte (LMP) play an important role in anti-angiogenesis by altering the gene expression pattern of angiogenesis-related factors in macrophages. Besides, LMP are important proapoptotic regulators for retinoblastoma cells through reduction of spleen tyrosine kinase expression and upregulation of the p53-p21 pathway which ultimately activates caspase-3. However, how to apply the microparticles in the prevention and treatment of retinal diseases is a major challenge, because the study of the microparticles in the fundus diseases is still limited. Further studies conducted would certainly enhance the application of microparticles in the fundus diseases.
Objective To investigate the preoperative design and application of the minimum foveolar translocation distance and angle of macular translocation. Methods The fundus fluorescein and indocyanine green an giographies were performed on 53 eyes of 53 patients with classic subfoveal choroidal neovascularization （SCNV）, including 42 with exudative age-related macular degeneration and 11 with high myopic macular degeneration. The actual area of macular SCNV and the minimum foveolar translocation distance and angle were analyzed. Results The actual area of SCNV was 0.39~18.00 mm2 with the mean of (3.08±3.22) mm2. The designed minimum superior translocation distance was 67~2 240μm with the mean of (845.72±425.23) μm；the minimum designed minimum inferior translocation distance was 53~2 430 μm with the mean of (912.17±547.77) μm. The minimum designed superior translocation angle was 1~32°with the mean of (13.23±6.6 8)°；the minimum designed inferior translocation angle was 1~35°with the mean of (14.06±8.46)°. The individual difference of the minimum designed superior and inferior translocation distance was more than 500 μm in 16 eyes （30.19 % ）, and the difference of translocation angle was more than 10°in 11（20.75%）. Conclusion Preoperative design of minimum translocation distance and angle of macular translocation may be helpful to choose the operation program. (Chin J Ocul Fundus Dis，2004，20：75-77)
Objective To study the significance of detection the short-term fluctuation (SF) of macular light threshold detected by Octopus-123 automatic perimeter in suspected early age-related macular dege-neration (AMD). Methods SF of macular light sensitivity, Amsler chart and central visual acuity were examined in 51 patients(66 eyes) with suspected early AMD group and in 32 patients (40 eyes) in the control group. Results SF were significantly different in suspected early AMD group and control group. SF was more sensitive than the examination of central visual acuity and Amsler chart. SF was related to the quantity, location and quality of drusen. Conclusion Visual function of some suspected early AMD patients with drusen may be damaged, though the central visual acuity appears normal. (Chin J Ocul Fundus Dis, 2002, 18: 119-120)
The prevalence of diabetes mellitus in adults of China has reached 12.8%. Diabetic retinopathy (DR) accounts for approximately 1/4-1/3 of the diabetic population. Several millions of people are estimated suffering the advanced stage of DR, including severe non-proliferative DR (NPDR), proliferative DR (PDR) and diabetic macular edema (DME), which seriously threat to the patients’ vision. On the basis of systematic prevention and control of diabetes and its complications, prevention of the moderate and high-risk NPDR from progressing to the advanced stage is the final efforts to avoid diabetic blindness. The implementation of the DR severity scale is helpful to assess the severity, risk factors for its progression, treatment efficacy and prognosis. In the eyes with vision-threatening DR, early application of biotherapy of anti-vascular endothelial growth factor can improve DR with regression of retinal neovascularization, but whether it is possible to induce capillary re-canalization in the non-perfusion area needs more investigation. Laser photocoagulation remains the mainstay treatment for non-center-involved DME and PDR.
Purpose To clarify the relationship between diabetic retinopathy (DR) and maculopathy (DM) and explore the clinical implication of independent graduation of DM. Methods Fundus fluorescein angiography and routine ophthalmological examination were performed on 582 cases of diabetes.Their ocular fundi and macular impairments were graded. Results In general,the severity of diabetic macular impairment was accompanied by retinal involvement,but discrepancy existed between DM and DR.Degree I DM occurred in 5.4% (16/294) among cases without DR,in stage IV DR,degree Ⅲ DM accounted for the most part ,54.5% (116/213).There were still 5.1% (2/39) cases without DM in stage Ⅴ DR. Conclusion The degree of the macular lesions in DM is often not in parallel with the gradation of general affections in retinal tissue other than in macular region in DR,therefore,independentg radation of diabetic maculopathy has its clinical significance for choosing the optimal period of treating maculopathy and preserving the macular function. (Chin J Ocul Fundus Dis,2000,16:153-154)
The authom analysed the predisposing factors for macular pucker(MP) after retinal dotachment surgery.Thirteen clinlcal risk factors correlated with the development of MP were identified, As the incidence related to various factors was compared with reported in the literature,the most significant 3 risk factors of MP were: the obvious hemorrhage accumulated in maeular area, the macular hole treated with diathernly,and the patient lay on one's back for approximately 2 weeks during postoperative retard absorption of subretinal fluid in the eyes with preoperative PVR,This suggested that the direct or indirect damage of maeular area was the major cause of development of MP. （Chin J Ocul Fundus Dis,1993,9:8-10）
Objective To explore the influencing factors of visual prognosis of macular edema secondary to branch retinal vein occlusion (BRVO-ME) after treatment with ranibizumab, and construct and verify the nomogram model. MethodsA retrospective study. A total of 130 patients with BRVO-ME diagnosed by ophthalmology examination in the Department of Ophthalmology, Liuzhou Red Cross Hospital from January 2019 to December 2021 were selected in this study. All patients received intravitreal injection of ranibizumab. According to the random number table method, the patients were divided into the training set and the test set with a ratio of 3:1, which were 98 patients (98 eyes) and 32 patients (32 eyes), respectively. According to the difference of logarithm of the minimum angle of resolution (logMAR) best corrected visual acuity (BCVA) at 6 months after treatment and logMAR BCVA before treatment, 98 patients (98 eyes) in the training set were divided into good prognosis group (difference ≤－0.3) and poor prognosis group (difference ＞－0.3), which were 58 patients (58 eyes) and 40 patients (40 eyes), respectively. The clinical data of patients in the two groups were analyzed, univariate and multivariate logistic regression analysis were carried out for the different indicators, and the visualization regression analysis results were obtained by using R software. The consistency index (C-index), convolutional neural network (CNN), calibration curve and receiver operating characteristic (ROC) curve were used to verify the accuracy of the nomogram model. ResultsUnivariate analysis showed that age, disease course, outer membrane (ELM) integrity, elliptical zone (EZ) integrity, BCVA, center macular thickness (CMT), outer hyperreflective retinal foci (HRF), inner retina HRF, and the blood flow density of retinal deep capillary plexus (DCP) were risk factors affecting the visual prognosis after treatment with ranibizumab in BRVO-ME patients (P＜0.05). Multivariate logistic regression analysis showed that course of disease, ELM integrity, BCVA and outer HRF were independent risk factors for visual prognosis after ranibizumab treatment for BRVO-ME patients (P＜0.05). The ROC area under the curve of the training set and the test set were 0.846[95% confidence interval (CI) 0.789-0.887) and 0.852 (95%CI 0.794 -0.873)], respectively; C-index were 0.836 (95%CI 0.793-0.865) and 0.845 (95%CI 0.780-0.872), respectively. CNN showed that the error rate gradually stabilized after 300 cycles, with good model accuracy and strong prediction ability. ConclusionsCourse of disease, ELM integrity, BCVA and outer HRF were independent risk factors of visual prognosis after ranibizumab treatment in BRVO-ME patients. The nomogram model based on risk factors has good differentiation and accuracy.
Immunogammopathy maculopathy is a newly discovered retinopathy associated with macroglobulinemia in recent years. The main manifestations were retinal vein convulsion and dilation caused by high blood viscosity, retinal interlaminar effusion and macular serous detachment. With the prolongation of the course of disease, the photoreceptor layer and RPE layer in the detachment area showed atrophic changes. The pathogenesis of ophthalmopathy is still unknown. Understanding the clinical features, diagnosis, differential diagnosis and treatment of ophthalmopathy is of great significance for understanding this kind of disease and improving the level of diagnosis and treatment of ophthalmopathy.
ObjectiveTo seek the evidencebased medicine (EBM) evidences of curative effects of intravitreous injection with triamcinolone acetonide (TA) for macular edema.MethodsAll articles of intravitreous injection TA for macular edema published in English or Chinese were picked up from databases of MEDLINE and CNKI and then evaluated according to EBM standard. The data in accord with research standard were selected by using excluding and including criteria, and classified according to the appraisal standard of clinical therapeutic documents. ResultsIn the selected papers, none in gradeⅠevidence; 1 in gradeⅡevidence; 7 in grade Ⅲ evidence; 24 in grade Ⅳ evidence; and 19 in gradeⅤevidence. Forty-two papers reported that intravitreous injection with TA had significant effect for macular edema within 3 months, and the improvement of visual acuity was recorded in these papers. Regression of macular edema was recorded in 23 papers. Among 20 papers, side-effect was found in 93 eyes (31.41%) and the serious sideeffect in 4 eyes (1.35%).ConclusionsIntravitreous injection with TA has some curative effects for macular edema in short term, but the quality of current study has not been encouraging. There are no grade I document and lack of the study of validity in long term and essentiality and validity of retreatment. The special attention should be payed on the increasing persistency of efficacy and preventing the serious side-effects in the future investigation.(Chin J Ocul Fundus Dis, 2005,21:220-223)