ABSTRACT
@#AIM: To study the postoperative incidence and related factors of high intraocular pressure after vitrectomy in patients with proliferative diabetic retinopathy(PDR). <p>METHODS: Selected in February 2014 to February 2016, 110 cases(160 eyes)of PDR patients were retrospectively analyzed; postoperative vision improvement, high intraocular pressure in patients with different stages of PDR were analyzed and related factors were detected. <p>RESULTS: Postoperative vision of PDR patients with stage Ⅳ, stage Ⅴ, and stage Ⅵ significantly improved(<i>P</i><0.01). A total of 47 eyes had high intraocular pressure, in which there were 7 eyes during 1-2mo after operation, 12 eye during 3-4mo, 13 eyes during 5-6mo and, 7 eyes during 7-8mo, 5 eyes during 9-10mo, 3 eyes during 11-12mo, the total incidence was 29.4%. There 21 eyes(44.7%)had controlled IOP after treatment with conventional drugs; IOP of 6 eyes(12.8%)with peripheral iridectomy for recommunication between anterior and posterior chamber returned to normal; IOP of 7 eyes(14.9%)returned to normal after releasing some gas; IOP of 6 eyes(12.8%)returned to normal after taking out some silicone oil; 7 eyes(14.9%)with surgical resection and local glucocorticoid hormone. Preoperative PDR staging, whether preoperative combined with retinal detachment, whether combined with intraoperative lens removal, whether with intraoperative intraocular filling, whether pan retinal photocoagulation were factors associated with postoperative high intraocular pressure(<i>P</i><0.05). After multiariable Logistic regression analysis, with retinal detachment and intraoperative intraocular filling was independent risk factors for high intraocular pressure after vitrectomy(<i>P</i><0.05). <p>CONCLUSION: Retinal detachment, intraoperative joint lens removal, intraoperative intraocular filling, pan retinal photocoagulation is correlated with high intraocular pressure after vitrectomy. Intraoperative joint lens removal, intraoperative intraocular filling and preoperative PDR staging are independent risk factors. In clinical works, standardized and personalized treatment should be given according to the patients' situation trying to avoid the high IOP after vitrectomy.
ABSTRACT
AIM: To study the influence of intravitreal injection of bevacizumab combined with photon dynamic treatment ( PDT ) in the treatment of central serous choroiretinopathy (CSC). METHODS:We selected 82 CSC patients treated in the hospital between February 2012 and April 2015, who were diagnosed by optical coherence tomography (OCT) and fundus fluorescein angiography (FFA) and all got the disease monocularly, and divided them into two groups called control group (n=35) and research group (n=47) by different methods, the patients of control group were treated by PDT method, while the patients of research group were treated by vitreous bevacizumab injection combined with PDT. Then compare the number of treatment times, the rate of flat pigment epithelial detachment(PED), macular subretinal fluid absorption, OCT indexes such as volume of the macular central hub, average thickness of central macular with diameter of 6mm and thickness of central macular region below 1mm range, the difference of corrected vision and clinical efficacy of two groups before and after the treatment. RESULTS:There were 32 eyes which were treated once, and 3 eyes which were treated twice in the control group, the average treatment times was 1.25士0.20; however, there were 9 eyes which were treated three times,10 eyes twice,28 eyes once, the average treatment number was 1.48士0.22, the treatment times of two groups had no statistical difference (t= 1.209, P>0.05). On the other hand,13 eyes' PED (37%) was flat in the control group,22 eyes (63%) which macular retinal subepithelial serous absorption;30 eyes' PED (64%) was flat in the research group,17 eyes (36%) which macular retinal subepithelial serous absorption. The rate of flat PED and macular retinal subepithelial serous absorption of two groups had obvious statistical difference (P<0.05). The OCT indexes such as volume of the macular central hub, average thickness of central macular with diameter of 6mm and thickness of central macular region bellow 1mm of two groups had no statistical difference before the treatment (P>0.05), in contrast these OCT indexes were all much lower than control group after the treatment, and the results had obvious statistical difference (P < 0. 05). Besides,these OCT indexes after treatment were all much lower than that of two groups before treatment respectively,and it also had obvious statistical difference (P< 0. 05). After 1 - month's treatment, the LogMAR corrected vision of two groups had no statistical difference (P>0.05). While the LogMAR corrected vision of research groups had statistical difference with control group after 3mo and 6mo (P<0.05). There were 6 invalid cases, 15 improvement cases, 8 excellence cases and 6 healing cases in the control group; the total effective rate of control group was 83%. While there were 3 invalid cases, 8 improvement cases, 20 excellence cases, 16 healing cases in the research group, the total effective rate of research group was 94%. The effective rate of two groups had obvious statistical difference (P<0.05). CONCLUSION: In the treatment of chronic CSC with PED patients, the method of vitreous bevacizumab injection combined with low dose PDT has better effect on PED flat, promoting macular subretinal serous absorption, reducing macular thickness and improving visual acuity.