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@#AIM:To compare the effectiveness and safety of intravitreal injection of conbercept(IVC)and intravitreal injection of ranibizumab(IVR)for type 1 retinopathy of prematurity(ROP).<p>METHORDS: A retrospective case series observation was carried out. Clinical data of patients with type 1 ROP treated with IVC(46 cases, 91 eyes)or IVR(55 cases, 109 eyes)from August 2018 to January 2020 in Xijing Hospital were collected. Regression, progression, recurrence, retreatment of ROP, the proportion of adverse outcomes and ocular and systemic complications were all analyzed.<p>RESULTS:All the 101 infants(200 eyes)with type 1 ROP treated with intravitreal injection of anti-vascular endothelial growth factor(VEGF)were enrolled, in which 20 eyes with aggressive posterior ROP(AP-ROP), 86 eyes with threshold ROP, and 94 eyes with type 1 pre-threshold ROP were included. There were no statistical differences in the basic conditions and the severity of ROP between the two groups before treatment(<i>P</i>>0.05). There was no difference in the primary cure rate between IVC and IVR groups(93.4% <i>vs</i> 87.2%, <i>P</i>>0.05). A total of 6 eyes(6.6%)developed ROP recurrence in the IVC group, in which 2 eyes received a second IVC, and 4 eyes were treated with laser photocoagulation(LP). In the IVR counterpart, 11 eyes(10.1%)developed ROP recurrence, among them 4 eyes underwent another IVR, and 11 eyes were treated with LP. The recurrence interval was 11.7±4.13wk and 9.82±4.02wk in the IVC and IVR groups. All these results of recurrence showed no significant statistical difference between these two groups(<i>P</i>>0.05). There was no progression of ROP appeared in IVC group. The progression of ROP developed in 3 eyes after initial ranibizumab injection, among them retinal fibrous proliferation and hemorrhage treated with LP in 2 eyes, and tractional retinal detachment treated with vitrectomy in 1 eye. No drug or injection related side effect was observed in infants of both groups. There were some adverse prognosis, such as temporal retinal folds, smaller angle between upper and lower temporal retinal vessel trunks caused by retinal vascular traction in 3 eyes in IVR group during the long-term follow up.<p>CONCLUSION: Both IVC and IVR are effective and safety choices for the treatment of ROP. There was no significant difference between the first cure rate and the recurrence rate. Some of the most severe cases treated by IVR were at risk for progression or poor prognosis that need to be followed up for a long time.
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Objective To explore the role of integrin αvβ3 in the promotion of the development of choroidal neovascularization (CNV) by SDF-1/CXCR4.Methods This study was divided into two parts in vitro and in vivo.As for the in vivo study,a CNV model was induced by laser on C57BL/6J mice,and then assigned into 4 groups:mice with solely CNV modeling as control group,with intravitreal injection of SDF-1 after immediate CNV modeling as SDF-1 group,with intravitreal injection of SDF-1 + CXCR4 inhibitor (AMD3100) after CNV modeling as SDF-1 + AMD3100 group,and mice with intravitreal injection of SDF-1 + αvβ3 inhibitor (SB273005) after modeling as SDF-1 + SB273005 group.CXCR4 and αvβ3 expression levels in laser-induced eyes were quantified by qRT-PCR at time points of day 1,3,5,7,10 and 14 after modeling,and immunofluorescence staining was applied to detect αvβ3 expression in regional CNV and its endothelial cells in the four groups.Finally,OCT was used to observe the height of retinal pigment epithelial (RPE) layers in CNV after treatment in the four groups.Moreover,in the experiment in vitro,Western blot was used to measure the expression of CXCR4 protein of RF/6A cells in normal control group,Si-CXCR4 knockdown group and Si-NC knockdown model group.Meanwhile,the expression of integrin subunit β3 protein was determined in the normal control group,SDF-1 group,SDF-1 + AMD3100group,SDF-1 + Si-NC group and SDF-1 + Si-CXCR4 group.Transwell assay was conducted to detect the migration ability of RF/6A cells in the normal control group,SDF-1group,SDF-1 +AMD3100 group,SDF-1 + SB273005 group.Results On the one hand,the study in vivo,qRT-PCR showed that the expression of CXCR4 and integrin subunit β3 mRNA was up-regulated at first,and then down-regulated with time passed after CNV induction,with the highest expression level of CXCR4 mRNA (4.263 ± 0.464) on day 3,and the peak expression of β3 mRNA (3.678 ±0.364) on day 7 after CNV modeling.The results of immunofluorescence staining showed that the β3 fluorescence intensity of SDF-1 group was significantly enhanced,and the ratio of β3/CD31 was also significantly increased,which both were significantly higher than those of the control group (P ＜ 0.01).However,the β3 fluorescence intensity and β3/CD31 ratio of SDF-1 +AMD3100 group and SDF-1 + SB273005 group were significantly weakened and decreased,respectively (P ＜0.05).OCT showed that the elevation level of RPE layer inSDF-1 group was significantly higher than that in the control group [(135.503 ± 10.301) μm vs.(94.443 ± 12.156) μm](P＜0.05).The height of RPE uplift in SDF-1 + AMD3100 group [(95.283 ±20.062) μm] and SDF-1 + SB273005 group [(99.807 ± 10.403) μm] was significantly decreased (P ＜ 0.05).On the other hand,in experiment in vitro,Western blot showed that the expression levels of integrin β3 in SDF-1 group and SDF-1 + Si-NC group were significantly higher than those in the control group [(1.301 ± 0.043) and (1.273 ± 0.077) vs.(0.244 ± 0.069)] (P ＜ 0.01).The levels of integrin subunit β3 protein in SDF-1 + si-CXCR4 group (0.322 ± 0.042) and SDF-1 + AMD3100 group (0.336 ± 0.077) were significantly down-regulated (P ＜ 0.01).Transwell assay showed that the amount of migrating cells in SDF-1 group increased,which was significantly higher than that of the control group (P ＜ 0.01),while the number of migrating cells in SDF-1 +AMD3100 group and SDF-1 + SB273005 group was significantly decreased.Conclusion Integrin αvβ3 can promote the development of CNV by mediating SDF-1/CXCR4 signaling in endothelial cells.
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AIM:To investigate the natural course and adverse event of branch retinal vein occlusion (BRVO) rat model induced by laser photochemical method. METHODS: Thirty SD (Sprague Dawley) rats were administrated Bangladesh via tail vein. Then 532nm laser (80mW, 100μ m and 100ms) was performed on retinal vein secondary bifurcation of bitamporal optic disk for 50 spots. Electroretinogram (ERG), fundus fluorescein angiography ( FFA), optical coherence tomography (OCT) and fundus (fluorescein) photograph were applied on 1, 3, 5, 7, 10, 14 and 21d after BRVO model constructed. Two rats were sacrificed, respectively, on 1, 5 and 21d after photocoagulation to carry on HE (Hematoxylin - Eosin stain) and VEGF - α (vascular endothelial growth factor - α) immumohistochemical staining. RESULTS: There were three rats died, three rats with severe retinal detachment for excessive bleeding,one rat with retinal sunken, and one rat with cataract. FFA and fundus ( fluorescein) photograph showed that the successful BRVO rat model was 73% (22/30). It was found that the near-end photocoagulation vein became coarse, far - end became diminution on 1d and the photocoagulation vein total recanalization was on 3-7d. ERG showed the amplification of b wave (dark -adaptation 3.0 response) decreased to 0.694士0.042 of control eyes and on 5-7d decreased to rock bottom about 0.487士0.064 of control eyes. Then it increased Aii the time to 0.708士0.0465 of control eyes on 21d. OCT and HE staining found that retinal ganglion cells and outer nuclear layer became edema on 1d in vivo and in vitro.It was observed that the thickness of retina on photocoagulation vein (0μ m or 250μ m) decreased from 5d and there were 3-4 layer cells in ONL on 21d. The expression of VEGF-α at injured site were significantly more than control eyes on 1d and there were no significant difference on 5d;But the expression of VEGF-α were slightly less than control eyes on 21d. CONCLUSION: Photochemical method was a feasible method to establish BRVO rat model. The evolution and development of the BRVO model could partly mimic human BRVO phenomenon. At the same time, it should be improved to increase the successful model rate.
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@#AIM:To explore clinical characteristics of supracho-roidal hemorrhage(SCH)complicated by intraocular surgery and to observe visual prognosis. <p>METHODS:A total of 13 eyes(13 cases)with SCH related to intraocular surgery from June 2005 to June 2015 were included and respectively studied. The age of our cases ranged from 22 to 76. Of all, 4 eyes(31%)were concomitant with hypertension, 6 eyes(46%)with high myopia and 6 eyes(46%)with oculi hypertonia, respectively. Intraoperative expulsive SCH occurred in 8 eyes, while postoperative delayed SCH in 5 eyes. The most SCH(7 eyes)happened during the surgery of removing silicone oil, 4 eyes with SCH were related to extracapsular cataract extraction(ECCE), 1 SCH eye was complicated by ECCE combined with trabeculectomy and 1 SCH eye by lensectomy and vitrectomy. As for treatment, 5 eyes took medication alone, 4 eyes were performed drainage sclerotomy and gas tamponade, while the other 4 eyes were accomplished vitrectomy with adjunctive perfluoro-carbon liquids and silicone oil tamponade. <p>RESULTS:At the 10-month of follow-up, all eyes with SCH were resolved. Except 1 eye with no light perception owing to abandoning treatment, the sights of the other 12 eyes were between light perception and 0.4. <p>CONCLUSION:SCH complicated by intraocular surgery was rare but with devastating outcome. Aged patients, hypertension, high myopia and oculi hypertonia may be risk factors. In addition, surgical methods in the early years were likely correlated to the occurrence of SCH. Certain sight of the patients with SCH may be maintained after positive treatment.
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AIM: To analyze the clinical features of children ocular penetrating trauma,and hope to effectively assist to prevent pediatric ocular trauma METHODS: The data of 145 cases (145 eyes) with ocular penetrating trauma,hospitalized in Xijing Hospital from January 2012 to December 2016,were collected and retrospectively analyzed.All the data of injury factors and environment,age and gender of patients,lesions,treatment and prognosis were detailed studied.RESULTS: In all the 145 pediatric patients with ocular penetrating trauma,accounted for 8.5% of all the ocular trauma patients,there were 95 cases of male,and 50 of female.Penetrating injuries mainly occurred in age of 3-9.The main injuries of ocular perforating in children were scissors,and sharp objects of wooden and iron.The wound was often located in the cornea or the anterior sclera.Traumatic cataract,vitreous hemorrhage and endophthalmitis were the common complications.The visual acuity was severely damaged,and 90 cases (62.1%) of the children recovered better than 0.1 after effective treatment.CONCLUSION: The visual function of pediatric p0atients was seriously threatened after penetrating injuries.However,the damage of vision and the rate of blindness can be reduced effectively after timely and correct diagnosis and treatment.It is the most important that active and effective prevention in keep children away from penetrating injuries.
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<p><b>BACKGROUND</b>Diabetic macular edema (DME) is a common manifestation of diabetic retinopathy (DR) that forms the main cause of central visual impairment. This study aimed to compare the efficacy and safety of a single intravitreal injection of bevacizumab alone versus bevacizumab combined with triamcinolone acetonide in eyes with diabetic macular edema (DME).</p><p><b>METHODS</b>A total of 40 eyes in 40 Chinese patients (22 male and 18 female) diagnosed with diabetic macular edema were enrolled in this prospective, randomized, consecutive study. Among them, 21 patients in group 1 were treated with intravitreal injection of bevacizumab (1.25 mg/0.05 ml), and the other 19 patients in group 2 accepted intravitreal bavacizumab (1.25 mg/0.05 ml) combined with triamcinolone acetonide (2 mg/0.05 ml). All patients were examined at baseline and followed up at 4, 6 and 12 weeks after the injection. Changes in mean best correct visual acuity (BCVA) using ETDRS chart, central retina thickness (CRT) measured by optical coherence tomography (OCT), and intraocular pressure (IOP) were focused on.</p><p><b>RESULTS</b>In group 1, mean BCVA improved from (41.76 ± 15.59) letters (baseline) to (56.24 ± 18.56) letters, (52.57 ± 12.31) letters and (48.41 ± 17.90) letters at 4, 6 and 12 weeks post-injection, respectively (P = 0.004, P = 0.011 and P = 0.026, respectively). Mean CRT decreased from (525.76 ± 184.10) µm (baseline) to (270.33 ± 202.67)µm, (303.12 ± 168.43) µm and (402.26 ± 196.21) µm, respectively (P = 0.009, P = 0.016 and P = 0.030, respectively). In group 2, mean BCVA improved from (39.89 ± 12.27) letters (baseline) to (55.31 ± 19.27) letters, (51.25 ± 13.48) letters and (46.97 ± 16.23) letters at 4, 6 and 12 weeks after injection, respectively (P = 0.003, P = 0.010 and P = 0.027, respectively). Mean CRT decreased from (554.50 ± 169.05) µm (baseline) to (292.76 ± 196.05) µm, (323.46 ± 164.05) µm and (426.38 ± 169.05) µm, respectively (P = 0.009, P = 0.014 and P = 0.028, respectively). However, there was no significant difference between these two groups with regard to mean BCVA (F = 1.602, P = 0.216) and CRT (F = 0.412, P = 0.526). At 12 weeks after the injection, 11 of the patients in group 1 and nine patients in group 2 appeared recurrent macular edema and needed repeat injections. There was one patient in group 2 appeared transient intraocular pressure increases.</p><p><b>CONCLUSIONS</b>Intravitreal injection of bevacizumab combined with/without triamcinolone acetonide had a beneficial effect on DME. However, the significant effect was not permanent. Our results showed that no significant differences were detected between intravitreal bevacizumab combined with/without triamcinolone acetonide for the eyes with diabetic macular edema in Chinese patients.</p>