ObjectiveTo analyze the clinical characteristic, treatment and prognosis of traumatic macular holes resulted from ocular contusion. MethodsThe clinical data of 47 cases with traumatic macular hole was retrospectively reviewed. The general condition of the patients was summarized, optical coherence tomography and multifocal electroretinogram (mfERG) were used to evaluate anatomic and functional outcomes. The patients were divided into observation group and surgery group by the treatment they received, and the prognosis was evaluated. ResultsTraumatic macular hole occurs mainly in male. In the observation group, the mean diameter of macular hole was(490.0±86.9)μm. During the 12 month follow-up, the holes in 7 cases (33.3%) were closed spontaneously, Vision and diameters of 14 cases (57.1%) maintained stable for a long time, the vision of 1 case (3.3%) declined mildly and the diameter of 1 case (3.3%) enlarged slightly. Visual acuity was improved significantly at last follow-up (Z=-2.40, P < 0.05). The amplitudes of N1 wave of mfERG increased both in central fovea and macular area(t=13.30, 5.06;P < 0.05).These data suggests that the macular function was recovered well. In the surgery group, the mean diameter of macular hole was(643.3±125.0)μm and statistically larger than that of the observation group (t=-4.76, P < 0.05). At the last follow-up, visual acuity were not improved significantly (Z=-1.79, P > 0.05). The amplitudes of N1 wave in 6 cases (23.1%) improved merely and the difference was not statistically significant(t=1.98, P > 0.05).These data suggests that the macular function was recovered slightly only in a few patients. ConclusionsA part of the patients with smaller diameters of macular holes may close spontaneously, and they may get better visual acuity. Vitrectomy may help to close the macular holes in some severe cases, but the improvement of functional outcomes is not significant.
The therapeutic effect of anti-vascular endothelial growth factor (VEGF) for neovascular age-related macular degeneration (nAMD) was determined by a number of factors. Comprehensive thorough analysis of clinical features, imaging results and treatment response can predict the potential efficacy and possible vision recovery for the patient, and also can optimize the treatment regime to make a personalized therapy plan. Precise medicine with data from genomics, proteomics and metabolomics study will provide more objective and accurate biology basis for individual precise treatment. The future research should focus on comprehensive assessment of factors affecting the efficacy of anti-VEGF therapy, to achieve individualized precise diagnosis and treatment, to improve the therapeutic outcome of nAMD.
Objective To investigate the effect of bromocriptine on rats with experimental autoimmune uveoretinitis.Methods Tweenty-four Wistar rats were immunized by bovine soluble antigen and randomly divided into treatment and control group. The rats in treatment group took bromocriptine orally with the dosage of 5 mg/(kg·d), which could inhibit prolactin (PRL) deliverance, while the rats in control group took glucose solution orally with the dosage of 50 g/(L·d). The clinical changes of all the rats and the delayed type hypersensitivity (DTH) response were detected. The rats were anesthetized and killed after im munized for 21 days, and the eyes were removed and examined histologically.Results The occurrence of EAU and histology scores of rats in treatment group were lower than the controls (P＜0.05,P＜0.001). The DTH response of two groups had no statistic difference (P＞0.05). Conclusions Bromocriptine can generally inhibit PRL deliverance, and may also inhibit the occurrence of EAU in rats through neuroendocrine-immune regulating network. (Chin J Ocul Fundus Dis，2003，19：34-37)
Serpiginous choroiditis (SC) is infrequent, chronic and posterior uveitis displaying a geographic pattern of choroiditis easy to recur. Studies reveal that the active lesions of inflammatory processes are mainly localized to the choriocapillaris and retinal pigment epithelium cells. SC may manifest with variable features, although a creeping pattern of choroiditis, extending from the juxtapapillary area, with grayish yellow discoloration. Fundus fluorescein angiography, indocyanine green angiography, fundus auto-fluorescence and optical coherence tomography are helpful to diagnose atypical SC. In addition, these image examinations can evaluate the activity and progression of lesion, and detect any complication that might occur. SC is mainly distinguished from multifocal SC related with tuberculosis or virus and etc. Pathogenesis is unclear, an organ-specific autoimmune inflammation or infection seems likely to be the underlying process. It is mainly using glucocorticoid with immunosuppressant therapy at present. Timely and effectively control inflammation can effectively prevent vision loss, choroidal neovascularization and choroidal scar in SC patients.
ObjectiveTo observe the longterm effect of suramin on the inhibition of proliferation of human retinal pigment epithelial (RPE) cells in vitro. MethodsRPE cells grown in 9 pieces of 96well plate (12 wells each plate) were divided into experimental and control group, with 6 wells in each group. The concentration of 0.1 ml RPE cells in each well is 5×104 cells/ml. After the change of the medium, RPE cells were treated with suramin (250 μg/ml) in experimental group while treated with nothing in the control group. The medium of the 2 groups were changed to the normal medium after 4 days. At the 1st, 2nd, and 4thday after the addition of suramin and at the 1st, 2nd, 3rd, 5th, 6th, 7th, 9th , 11th and 13th day after removing suramin, 1 plate was randomly selected to stop culturing, and the proliferation of RPE cells were detected by methyl thiazolyl tetrazolium (MTT) assay. ResultsUnder reversed microscope, RPE cells in control group were fused completely at the 7th day after inoculation. The extracellular space of RPE cells in experimental groups was larger than that in the control group, and remained unfused at the 13th day after inoculation. The inhibitory rate of proliferation of RPE cells at the first day after treated with suramin was 14.85% and increased to the highest 25.79% at the 4th day. The first day after the suramincontaining media was removed, the inhibitory rate decreased to 12.35%, and then raised gradually to over 20% at the 3rd to 5th day. Finally, the rate drop to 14.71%. ConclusionSuramin has the long-term effect on the inhibition of RPE cells induced by serum, especially the inhibitive effect after the remove of suramin, which indicates the specific double-peak inhibition during the whole process.(Chin J Ocul Fundus Dis, 2005,21:25-27)
ObjectiveTo assess the efficacy and safety of intravitreal aflibercept injection (IAI) compared with photodynamic therapy (PDT) in the treatment of Chinese patients with predominantly classic subfoveal choroidal neovascularization (CNV) lesions secondary to neovascular age-related macular degeneration (nAMD).MethodsA randomized, double-blind, multi-center phase-3 clinical trial lasting for 52 weeks (from December 2011 to August 2014). Subjects were randomized in a 3:1 ratio to either IAI group or PDT-to-IAI group. Subjects in the IAI group received 2 mg IAI at baseline and at week 4, 8, 16, 24, 32, 40, 48, with sham injection at week 28, 36. Subjects in the PDT-to-IAI group were forced to receive PDT once at baseline and more time at week 12, 24 if PDT retreatment conditions were met. Sham injections were given in PDT-to-IAI group at baseline and at week 4, 8, 16 and 24, followed by 2 mg IAI at week 28, 32, 36, 40, 48. The primary outcome of efficacy were the change in mean Best Corrected Visual Acuity (BCVA) from baseline to week 28, and that of week 52. Safety evaluation included the percentage of subjects who suffered treatment emergent adverse events (TEAEs).ResultsAmong the 304 subjects enrolled, there were 228 and 76 cases in IAI group and PDT-to-IAI group respectively. At week 28, the changes of mean BCVA in IAI group, PDT-to-IAI group compared to baseline were +14.0, +3.9 letters, respectively. At week 52, the changes of mean BCVA in two groups were +15.2, +8.9 letters respectively with the difference of +6.2 letters (95%CI 2.6−9.9, P=0.000 9). At week 52, the mean foveal retinal thickness in the two groups decreased by −189.6, −170.0 μm, respectively. Subjects with the most BCVA increase in IAI group were those aged ＜65, and those with active CNV lesion area ＜50% of total lesion area. The most common TEAEs in IAI group and PDT-to-IAI group are macular fibrosis [11.8% (27/228), 6.6% (5/76)] and BCVA decline [6.6% (15/228), 21.1% (16/76)]. There were 3 cases of arterial thromboembolic events defined in the antiplatelet experimental collaboration group, but all were considered unrelated to interventions.ConclusionsThe efficacy of aflibercept is superior to that of PDT in nAMD patients in China. The therapeutic effect of aflibercept persisted to week 52 in all subjects. The rate of adverse events was consistent with the safety data of aflibercept known before.
ObjectiveTo evaluate the macular visual function of patients with myopic choroidal neovascularization (MCNV) before and after intravitreal injection of conbercept.MethodsA prospective, uncontrolled and non-randomized study. From April 2017 to April 2018, 21 eyes of 21 patients diagnosed as MCNV in Shanxi Eye Hospital and treated with intravitreal injection of conbercept were included in this study. There were 9 males (9 eyes, 42.86%) and 12 females (12 eyes, 57.14%), with the mean age of 35.1±13.2 years. The mean diopter was −11.30±2.35 D and the mean axial length was 28.93±5.68 mm. All patients were treated with intravitreal injection of conbercept 0.05 ml (1+PRN). Regular follow-up was performed before and after treatment, and BCVA and MAIA micro-field examination were performed at each follow-up. BCVA, macular integrity index (MI), mean sensitivity (MS) and fixation status changes before and after treatment were comparatively analyzed. The fixation status was divided into three types: stable fixation, relatively unstable fixation, and unstable fixation. The paired-sample t-test was used to compare BCVA, MI and MS before and after treatment. The x2 test was used to compare the fixation status before and after treatment.ResultsDuring the observation period, the average number of injections was 3.5. The logMAR BCVA of the eyes before treatment and at 1, 3, and 6 months after treatment were 0.87±0.32, 0.68±0.23, 0.52±0.17, and 0.61±0.57, respectively; MI were 89.38±21.34, 88.87±17.91, 70.59±30.02, and 86.76±15.09, respectively; MS were 15.32±7.19, 21.35±8.89, 23.98±11.12, 22.32±9.04 dB, respectively. Compared with before treatment, BCVA (t=15.32, 18.65, 17.38; P＜0.01) and MS (t=4.08, 3.50, 4.26; P＜0.01) were significantly increased in the eyes 1, 3, and 6 months after treatment. There was no significant difference in the MI of the eyes before treatment and at 1, 3, and 6 months after treatment (t=0.60, 2.42, 2.58; P＞0.05). Before treatment and at 1, 3, and 6 months after treatment, the proportion of stable fixation were 28.57%, 38.10%, 38.10%, 33.33%;the proportion of relatively unstable fixation were 47.62%, 47.62%, 52.38%, 57.14% and the proportion of unstable fixation were 23.81%, 14.28%, 9.52%, 9.52%, respectively. The proportion of stable fixation and relatively unstable fixation at 1, 3 and 6 months after treatment were higher than that before treatment, but the difference was not statistically significant (x2=1.82, 1.24, 1.69; P＞0.05).ConclusionBCVA and MS are significantly increased in patients with MCNV after intravitreal injection of conbercept.
Objective To investigate the effects and the safety of compound anisodine injection on treatment of primary and secondary ischemic optic neuropathy and choroidoretinopathy. Methods A multicentered,random,controlled study was applied on 403 patients,including 217 patients of primary ischemic optic neuropathy and choroidoretinopathy,and 186 patients of secondary ischemic optic neuropathy and choroidoretinopathy.All the patients were assigned into 3 groups randomly:112 patients in control group and treatment group respectively,179 patients in open group.Compound anisodine 2 ml was injected subcutaneously around superficial temporal artery to the patient in treatment and open group once every day,while tolazoline 25 mg was given in the same way to the patient in control group for 21 days.Visual acuity,visual field and fundus condition are examined to evaluate the effects of treatment,and intraocular pressure,blood pressure,electrocardiography,blood and urine routine examination,blood test for renal and liver function are taken to study the safety of the treatment.The main subjects of the control and treatment group before treatment were comparable (Pgt;0.05) Results The difference of effective rate between treatment group (82.14%) and control group (36.61%) was significant (chi;2=48.14,P=0.0000).The effective rate of open group is 80.45%.The effects on both primary and secondary patients in treatment group (87.04% and 77.59%) were better than those in control group (35.19% and 37.93%),and the difference was significant (P=0.0000) .The difference of the results in different centers was not significant according to Ridit analysis.There was few side effect except temporary dry mouth in some patients and the parameters of safety had no significant change before and after treatment. Conclusion Compound anisodine is a safe and effective drug to treat primary and secondary ischemic optic neuropathy and choroidoretinopathy. (Chin J Ocul Fundus Dis,2000,16:71-74)
Objective To evaluate the efficacy and safety of dexamethasone intravitreal implant (Ozurdex) in the treatment of macular edema (ME) secondary to retinal vein occlusion (RVO). Methods Thirty-nine patients (39 eyes) with ME secondary to RVO were enrolles in this study. Of the patients, 27 were male and 12 were female. The mean age was (41.9±16.3) years. The mean course of disease was (5.0±5.3) months. The best corrected visual acuity (BCVA), intraocular pressure and optical coherence tomography (OCT) were performed. BCVA was measured by Early Treatment Diabetic Retinopathy Study charts. Central macular thickness (CMT) was measured by OCT. The mean BCVA was (13.4±15.3) letters. The mean intraocular pressure (IOP) was (14.1±2.8) mmHg (1 mmHg=0.133 kPa). The mean CMT was (876.1±437.9) μm. Of the 39 eyes, 33 were central RVO, 6 were branch RVO. Patients were categorized into ischemic (18 eyes)/non-ischemic (21 eyes) groups and previous treatment (22 eyes)/treatment naïve (17 eyes) groups. All eyes underwent intravitreal 0.7 mg Ozurdex injections. BCVA, IOP and CMT were assessed at 1, 2, 3, 6, 9, 12 months after injection. Three months after injection, intravitreal injections of Ozurdex, triamcinolone acetonide or ranibizumab could be considered for patients with ME recurrence or poor treatment effects. Change of BCVA, IOP and CMT were evaluated with paired t test. The presence of ocular and systemic adverse events were assessed. Results BCVA, IOP significantly increased and CMT significantly decreased at 1 month after injection compared to baseline in all groups (t=3.70, 3.69, 4.32, 3.08, 4.25, 6.09, 6.25, 4.02, 5.49, 8.18, 6.54, 5.73; P＜0.05). Two months after injection, change of BCVA, IOP and CMT was most significant (t=4.93, 6.80, 6.71, 5.53, 4.97, 5.89, 5.13, 7.68, 7.31, 8.67, 8.31, 5.82; P＜0.05). Twelve months after injection, there was no statistical difference regarding BCVA of ischemic RVO group and previous treatment group, compared to baseline (t=1.86, 0.67; P＞0.05); BCVA of non-ischemic RVO group and treatment naïve group significantly increased compared to baseline (t=2.27, 2.30; P＜0.05); there was no statistical difference regarding IOP in all groups (t=0.30, 0.13, 0.64, 1.53; P＞0.05);however, CMT significantly decreased in all groups (t=4.60, 3.26, 3.00, 4.87; P＜0.05). Twenty-seven eyes (69.2%) experiences ME recurrence (4.5±1.5) months after injection. Most common side-effect was secondary glaucoma. 41.0% eyes had IOP more than 25 mmHg, most of which were lowered to normal range with use of topical IOP lowering drugs. Four eyes (10.3%) presented with significant cataract progression and needed surgical treatment, all were central RVO eyes. No serious ocular or systemic adverse events such as vitreous hemorrhage, retinal detachment or endophthalmitis were noted. Conclusions Intravitreal injection of Ozurdex for patients with ME secondary to RVO is effective in increasing BCVA and lowering CMT in the first few months. Significant treatment effect could be seen at 1 month after injection and was most significant at 2 months after injection. The long-term vision of eyes in non-ischemic RVO group and treatment naïve group are better. 69.2% eyes experience ME recurrence at 4 months after injection. Short term adverse events were mostly secondary glaucoma and long term adverse events are mostly cataract progression.
OBJECTlVE:To evaluate the value of inhibiting effect of the verapamil(Ver)on human selcral fibroblast (HSF). METHODS:The rate al inhibition of Ver,5-Fu,heparin(Hep)and dexamethasone(Dex)to cultured HSF was respectively determined by MTT method and enzyme linked immunosorbent assay. In addition,the rate of inhibition of Ver associated with 5-Fu Hep and Dex to cultured HSF was respectively determined. RESULTS:The rate of cellular proliferation of cultured HSF was found to be significantly reduced(Plt;0.05),when the concentration of Ver was 20mg/L,and further reduced when 5-Fu,Hep or Dex was added even in smaller dose (5~10mg/L)of Ver. CONCLUSION: Tbe effect of inhibition of cellular proliferation of 5-Fu, Hep and Dex in eye could be enbenced by Ver. （Chin J Ocul Fundus Dis,1996,12: 98-100）