ABSTRACT
Floaters are entopic phenomenon created by vitreous opacities. Some researchers term it as “symptomatic vitreous turbidity”, which usually refers to primary type in clinic. With the increasing prevalence and aging of myopia worldwide, vitreous floaters are becoming increasingly prevalent in clinics but receiving less attention. Floaters can impair patients' vision and quality of life due to their discomfort and disorientation. A few patients become intolerable and express a strong desire for treatment. YAG laser vitreolysis for floaters has garnered considerable attention in recent years. Although some doctors still have concerns about its efficacy and safety, a handful of studies have found some beneficial effects in recent years. The author has gained expertise in clinical practice in recent years. In this review, we talk about what causes floaters and how to classify them. We also talk about the clinical indications, how YAG laser ablation works, and whether or not it is safe.
ABSTRACT
AIM: To investigate the risk factors associated with neovascular glaucoma(NVG)after pars plana vitrectomy(PPV)for proliferative diabetic retinopathy(PDR).METHODS: The PDR patients who received 23G PPV treatment at Shenyang He Eye Specialist Hospital from October 2015 to September 2020 and were followed up for at least 12mo with complete data were retrospectively collected. The patients were divided into two groups according to the occurrence of NVG during follow-up. The preoperative and intraoperative variables between two groups were compared. The cumulative hazard ratio for NVG was evaluated. RESULTS: A total of 151 PDR patients(169 eyes)with a mean follow-up of 18.07±12.55(1～79)mo were included, of which 30(17.8%)eyes developed NVG, the mean time of occurrence was 6.27±4.01(1～17)mo, and 50%(15 eyes)of NVG occurred within 5mo after vitrectomy. The cumulative hazard ratios of NVG at postoperative 3, 6 and 12mo were 4.8%, 12.6% and 18.1%, respectively. Multivariate logistic regression analysis showed that preoperative best corrected visual acuity(OR=3.077, 95%CI: 1.203～7.869, P=0.019), preoperative iris rubeosis(OR=7.897, 95%CI: 1.313～47.498, P=0.024), and contralateral NVG(OR=22.108, 95%CI: 1.562～312.861, P=0.022)were risk factors with the occurrence of NVG, while the number of intraoperative retinal laser photocoagulation(OR=0.772, 95%CI: 0.666～0.893, P=0.001)was the protective factor with the occurrence of NVG.CONCLUSIONS: The incidence of NVG in PDR eyes after PPV was 17.8%, of which 50% occurred within 5mo after surgery. PDR eyes with poor baseline visual acuity, iris rubeosis, and contralateral NVG are prone to postoperative NVG, and sufficient intraoperative retinal laser photocoagulation has a certain protective effect. PDR eyes after PPV should be closely followed up for 1a.
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AIM: To investigate the annual eye examination of diabetic patients in Shenyang and analyze the associated factors by using the Chinese version of the Compliance with Annual Diabetic Eye Exam Survey(CADEES)questionnaire.METHODS: This is a cross-sectional study. The diabetic patients who first visited Shenyang He Eye Specialist Hospital from November 2021 to October 2022 were collected. The Chinese version of the CADEES questionnaire was used to investigate the previous annual eye examinations of these patients, and no fundus examination in the past 1a was defined as poor participation. Factors associated with poor participation in annual eye examinations were identified by multivariate binary logistic regression analyses.RESULTS: A total of 468 patients were collected, including 192 males and 276 females, with an average age of 67.42±10.66 years. There were 330 patients without diabetic retinopathy(DR)and 138 patients with DR, among which 88 patients had vision-threatening diabetic retinopathy(VTDR)and 50 patients had non-vision-threatening diabetic retinopathy(NVTDR). 34.2%(160 cases)of patients had poor annual eye examination. The multivariate logistic regression analysis showed that, after controlling gender, age and other influencing factors, patients in rural area(OR=1.704, 95%CI: 1.019～2.850, P=0.042), VTDR(OR=1.948, 95%CI: 1.145～3.313, P=0.014), the item 7(I have felt blue, downhearted, or depressed over the past 4wk; OR=0.624, 95%CI: 0.401～0.971, P=0.037)and item 42(I receive a reminder from my eye doctor's office when it is time to schedule an exam; OR=0.618, 95%CI: 0.387～0.989, P=0.045)of CADEES questionnaire were risk factors for poor participation in the annual ophthalmic examination.CONCLUSIONS: Approximately one-third of diabetic patients in the Shenyang region may not follow the guidelines for DR annual eye examination. Healthcare providers should improve DR health education, increasing eye exam participation through necessary reminders.
ABSTRACT
@#Persistent corneal epithelial defect(PED)can occur after corneal herpes simplex virus infection, corneal transplantation, and intraocular surgery in diabetic patients. Although the incidence is not high, it can cause serious consequences if not properly managed, such as corneal infection or exacerbation, stromal ulcers, perforation, scarring, and even loss of vision. The pathogenic causes of PED are diverse and can be mediated by multiple mechanisms. In clinical practice, even with aggressive treatment, the corneal epithelium in PED eyes is difficult to heal and presents a challenge for treatment. At present, the standard treatment for PED management mainly includes the use of bandage soft contact lenses and artificial tears, aiming at the barrier protection for the corneal epithelium. The new treatment mainly focuses on epithelial regeneration and corneal nerve re-innervation. In addition, several drugs and methods with potential therapeutic value have emerged in recent years. In this review, we talk about how are the PEDs spread, what causes them, how are they diagnosed and how are they treated. We also talk about some new therapies and research process.