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Objective To observe the short-term intraocular pressure after 25G+ pars plana vitrectomy (PPV) and analyze the possible influencing factors in rhegmatogenous retinal detachment (RRD) and proliferative diabetic retinopathy (PDR) eyes.Methods This is a retrospective case-control study.A total of 160 patients (163 eyes) of RRD and PDR who underwent 25G+ PPV were enrolled in this study.There were 88 males (89 eyes) and 72 females (74 eyes),with the mean age of(50.37± 13.24) years.There were 90 patients (92 eyes) with RRD (the RRD group) and 70 patients (74 eyes) with PDR (the PDR group).Best corrected visual acuity (BCVA) and intraocular pressure (IOP) were performed on all the patients.The BCVA was ranged from hand motion to 0.6.The average IOP was (12.61 ± 4.91) mmHg (1 mmHg=0.133 kPa).There were significant differences in crystalline state (x2=9.285,P=0.009),IOP (x2=58.45,P=0.000),history of PPV (x2=4.915,P=0.027) and hypertension (x2=24.018,P=0.000),but no significant difference in sex (x2=0.314,P=0.635) and age (x2=5.682,P=0.056) between the two groups.A non-contact tonometer has been used to measure IOP on postoperative day 1 and 3.The postoperative IOP distribution has been divided into five groups:severe ocular hypotension (≤5 mmHg),mild ocular hypotension (6-9 mmHg),normal (10-21 mmHg),mild ocular hypertension (22-29 mmHg),severe ocular hypertension (≥ 30 mmHg).Logistic regression analysis has been used to analyze the risk and protective factors.Results On the first day after surgery,there were 21 eyes (12.9％) in mild ocular hypotension,96 eyes (58.9％) in normal,22 eyes (13.4％) in mild ocular hypertension and 24 eyes (14.7％) in severe ocular hypertension.On the first day after surgery,there were 18 eyes (11.0％) in mild ocular hypotension,117 eyes (71.7％) in normal,23 eyes (14.1％) in mild ocular hypertension and 5 eyes (3.1％) in severe ocular hypertension.There was no significant difference of IOP distribution between the two groups (Z=-1.235,-1.642;P=0.217,0.101).The results of logistic regression analysis showed that silicone tamponade was a risk factor for ocular hypertension in PDR eyes on the first day after surgery [odds ratio (OR)=15.400,95％ confidence interval (CI) 3.670-64.590;P＜0.001],while intraocular lens was the risk factor for ocular hypotension in PDR eyes on third day after surgery (OR=19.000,95％CI 1.450-248.2;P=0.025).As for RRD eyes,the ocular hypotension before surgery was a risk factor for ocular hypertension on the third day after surgery (OR=3.755,95％CI 1.088-12.955;P=0.036).For all eyes,silicone tamponade (OR=0.236,95％CI 0.070-0.797),air tamponade (OR=0.214,95％CI 0.050-0.911) and inert gas tamponade (OR=0.092,95％CI 0.010-0.877) were protective factors for ocular hypotension on the first day after surgery (P=0.020,0.037,0.038);silicone tamponade was protective factor for ocular hypotension on the third day after surgery (OR=0.249,95％ CI 0.066-0.94,P=0.040);while aphakic eyes was the risk factor for ocular hypotension on third day after surgery (OR=7.765,95％ CI 1.377-43.794,P=0.020).The ocular hypotension before surgery was a risk factor for ocular hypertension on the third day after surgery (OR=4.034,95％ CI 1.475-11.033,P=0.007).Conclusions The abnormal IOP is common after 25G+ PPV with a rate from 28.3％ to 31.1％.Silicone tamponade,air tamponade and inert gases tamponade are protective factors for postoperative ocular hypotension,aphakic eye is risk factor for postoperative ocular hypotension.Ocular hypotension before surgery and silicone oil tamponade are risk factors for postoperative ocular hypertension.
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The exact pathophysiological mechanisms of diabetic retinopathy (DR) remain elusive.The inflammatory reaction,retinal vascular leakage and retinal neovascularization are main features of DR.Adiponectin (APN) is an endogenous biological active protein secreted by adipocytes.It can increase insulin sensitivity,regulate blood glucose and lipid metabolism,and has anti-inflammation and anti-neovascularization functions.It may be involved in the development of DR.This review summarized the studies on the association between APN and DR in recent years.
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Objective To study the relationship between macular pigment optical density (MPOD) and serum concentration of lutein and zeaxanthin in an adult population.Methods Twenty patients with mild cataract and 39 healthy subjects were enrolled in this study,including 15 males and 44 females.The average age was 43.75 years.Fifty-three subjects were non-smokers and 6 male subjects were smokers.Two subjects preferred meat diet,22 preferred meat-less diet,and 35 have balanced diet.MPOD was measured using heterochromatic flicker photometry at 0.25,0.5,1.0 and 1.75 degrees,and serum concentration of lutein and zeaxanthin was measured using high-performance liquid chromatography.The relationship between MPOD and serum concentration of lutein and zeaxanthin was analyzed.The differences of serum lutein and zeaxanthin between different gender,smokers and non-smokers and subjects with different dietary pattern were also analyzed.Results MPOD at 0.25,0.5,1.0 and 1.75 degrees were 0.59,0.48,0.34 and 0.18,and the average concentration of lutein and zeaxanthin were (0.45± 0.16) μmol/L and (0.11 ± 0.04) μmol/L respectively.Serum concentration of lutein and zeaxanthin in males were slightly higher than that in females,but it was not statistically significant (t=1.13,0.86;P=0.27,0.40).The differences of serum lutien and zeaxanthin between smokers and non-smokers (t=0.15,-0.11;P=0.87,0.91),among subjects of 3 dietary patterns groups were not statistically significant (Flutein=3.87,4.05,0.18;P=0.83,0.81,0.99.Fxeaxanbin=0.99,1.51,0.52;P=0.85,0.68,0.72).There was no correlation between MPOD and serum concentration of lutein (r=-0.06,-0.02,-0.07,0.03;P＞0.05) and zeaxanthin(r=0.02,0.12,0.09,0.11;P＞0.05).Conclusion MPOD was not statistically significantly correlated with serum concentration of lutein and zeaxanthin in the studied population.
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Objective To determine the association of-429T/C and G1704T polymorphisms in the receptor for advanced glycation end products gene with proliferative diabetic retinopathy (PDR).Methods Case-control study.From the Beijing Desheng Diabetic Eye Study cohort of 1467 patients with type 2 diabetes mellitus (T2DM),a total of 97 patients with PDR and 105 diabetic patients without retinopathy (DWR,duration of diabetes 15 years) were included for this study.Questionnaires were collected and general ophthalmologic examinations were performed.Biochemical analysis was conducted.DNA was extracted from peripheral venous blood.The-429T/C and G1704T single nucleotide polymorphisms were detected by the means of PCR-restrication fragment length polymorphisms.Results The frequency distribution of-429T/C in DWR group was 81.0％ in TT,16.1％ in TC,2.9％ in CC.The frequency distribution of-429T/C in PDR group was 77.3％ in TT,20.6％ in TC,2.1％ in CC.There was no significant statistical difference between the two groups (x2 =0.40,P＞0.05).Frequency of the-429T/C minor allele C in the DWR and PDR group were 11.0％ and 12.4％,respectively,with no significant statistical difference between the two groups (x2 =0.20,P＞0.05).The frequency distribution of G1704T in DWR group was 66.7％ in GG,29.5％ in GT,3.8％ in TT.The frequency distribution of G1704T in PDR group was 78.4％ in GG,21.6％ in GT.There was no significant statistical difference between the two groups (x2 =3.44,P＞0.05).Frequency of the G1704T minor allele T in the DWR and PDR group were 18.6 ％ and 10.8 ％,respectively,in which significant difference was found within the two groups (x2 =4.79,OR=1.88,95％CI:1.06-3.33,P＜0.05).Conclusions G1704T polymorphism is associated with PDR presence and 1704G allele may increase the risk of PDR.
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Pars plana vitrectomy (PPV) is a common vitreoretinal surgical procedure. With its rapid advances many vitreoretinal diseases that have the potential to blind can now be treated. Although surgical complications are decreasing due to the improvement of surgical tools and techniques, these are not uncommon in our daily clinical practice. The sclerotomy-related complications, for example, are of great concern because they can result in retinal detachment and loss of vision. This article will review the common sclerotomy-re-lated complications including the sclerotomy-related retinal breaks and detachment, fibrovaacular ingrowth into the sclerotomy site, and vitreous incarceration. The risk factors and the practical measures to prevent these complications are also discussed. (Ophthalmol CHN, 2009, 18: 225-228)
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Objective To observe the morphological characteristics of congenital optic disc pit with maculopathy, the natural de-velopment, and changes after laser photocoagulation. Design Retrospective case series. Participants Twelve cases with congenital optic disc pit. Methods Records of 12 patients with congenital optic disc pit with maculopathy were reviewed. Clinical examination includes optical coherence tomography (OCT), color fundus photography, and fluorescein angiography (FA). The data was analyzed with the exist-ing theory of pathogenesis of the disease. Main Outcome Measures Visual acuity and morphology of macupopathy. Results All the patients were noted to have serous maculopathy associated with optic disc pit. Serous detachment of neuro-retina was found in two pa-tients, schisis of neuro-retina in two patients, and both serous detachment and schisis of nearo-retina were observed in other patients. Two patients were associated with choroidal coloboma. Four patients were treated with laser photocoagulation, in which 3 patients had vision improved. Conclusions Schisis and detachment of neuro-retina are the important morphologic changes of congenital optic disc pit with maculopthy. Proper understanding of the relationship between the development of the disease and these changes will be helpful to study its pathogenesis. Patients may benefit in part from laser photocoagulation. (Ophthalmol CHN, 2009, 18: 233-236)
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Objective To determine the risk factors of light perception and no light perception appearenee after vitrectomy for pro-liferative diabetic retinopathy (PDR). Design Retrospective, noncomparative case series. Participants 242 patients (288 eyes) who un-derwent vitrectomy for PDR. Methods 288 eyes of participants from 2002 to 2006 at Beijing Tongren Eye Center were reviewed. Cases that had postoperative visual acuity of light perception (LP) and no light perception (NLP) were recorded and PDR stages, traction reti-nal detachment involving macula, postoperative retinal detachment, postoperative vitreous hemorrhage, postoperative neovascular glauco-ma and re-operations were analyzed. Main Outcome Measures Postoperative complications, PDR stage, macular disorder. Results Subjects were divided into two groups. LP/NLP group included eyes that had postoperative visual acuity of light perception and no light perception (totally 14 eyes in this group). Another group (control group) included eyes that had postoperative visual acuity of hand mo-tion or better (totally 274 eyes in this group). When compared with control group, the LP/NLP group had significantly higher prevalence of PDR 6, traction retinal detachment involving macula, postoperative retinal detachment, postoperative vitreous hemorrhage, postopera-tive neovascular glaucoma and reoperation (P value was 0.042, 0.048, 0.048, 0.000, 0.000, 0.000, respectively). Conclusion Risk factors of light perception and no light perception after vitrectomy for PDR include PDR stage 6, traction retinal detachment involving macula, postoperative retinal detachment, postoperative, vitreous hemorrhage, postoperative neovascular glaucoma and re-operation. (Ophthalmol CHN, 2009, 18: 251-253)