ABSTRACT
In the expert consensus published by the Pediatrics in 2013,it was first proposed that anti-VEGF drugs can be considered for retinopathy ofprematurity (ROP) with stage 3,zone Ⅰ with plus disease.However,there are many problems worth the attention of ophthalmologists,including the advantages and disadvantages of anti-VEGF therapy compared with traditional laser therapy,systemic and ocular complications after anti-VEGF therapy,and what indicators are the end points of anti-VEGF therapy.Combined with this consensus and numerous research findings,we recommend that the first treatment for anti-VEGF or laser therapy should be considered from disease control effects.For the threshold and pre-threshold lesions,the effect of anti-VEGF therapy for zone Ⅱ lesions is better than that for zone Ⅰ lesions and the single-time effective rate is high.So,it is suggested that anti-VEGF therapy should be preferred for the first treatment.The choice of repeat treatment should be considered from the final retinal structure and functional prognosis.Laser therapy is advisable for the abnormal vascular regression slower and abnormalities in the posterior pole.It can reduce the number of reexaminations and prolong the interval between re-examinations.However,the premature use of laser has an inevitable effect on peripheral vision field.Excluding the above problems,supplemental therapy can still choose anti-VEGF therapy again.Most of the children with twice anti-VEGF therapy are sufficient to control the disease.Anti-VEGF therapy should be terminated when there are signs such as plus regression,threshold or pre-threshold lesions controlled without recurrence,peripheral vascularization,etc.
ABSTRACT
Surgical management of idiopathic macular hole (IMH) is a hot topic in the field of fundus disease,and its classical surgery is internal limiting membrane peeling.In recent years,many researchers explored inverted internal limiting membrane flap technique for IMH.However,how large the IMH is necessary for inverted internal limiting membrane flap technique? Does the inverted internal limiting membrane flap technique have more advantages in operating procedure,anatomical and functional recovery of IMH in comparison with internal limiting membrane peeling? Our clinical researches and relative literature showed that it is better to use inverted internal limiting membrane flap technique for ＞550 μm IMH.There is still no available evidence showed inverted internal limiting membrane flap technique is of more benefit to the anatomical repair and functional restoration in comparison with internal limiting membrane peeling for IMH.Some viewpoints in this field are open to question.
ABSTRACT
Objective To evaluate the therapeutic effects of flute-needle vacuum assistant hole closure technique for large idiopathic macular hole (IMH).Methods The clinical data of 25 eyes with IMH of 408-939 μm in 23 patients who received pars plana vitrectomy with internal limiting membrane (ILM) peeling and flute-needle vacuum assistant hole closure technique from Feburary in 2017 to June in 2018 in Peking University International Hospital were retrospectively analyzed.The changes of best corrected visual acuity (BCVA) before and after operation were evaluated.The shapes of the hole closure were categorized,and the manifestations of outer retina were observed by optical coherence tomography (OCT),including external limiting membrane (ELM) and ellipsoid zone(EZ).Results The hole closure rate after surgery were 100％ (25/25),with the U type closure in 16 eyes and V type closure in 9 eyes.The BCVA was 0.76 ± 0.27 after operation,which was significantly improved in comparison with 1.05 ±0.29 before operation (t =3.61,P =0.01).The ELM of OCT image was (1 050.00±380.39)μm before operation,and that after operation reduced to (623.32 ± 328.66) μm,showing a significant difference between them (t =6.63,P=0.00).A fully reduced EZ band was seen after operation in comparison with before operation ([1 147.28±354.41] μm versus ([818.28±247.33] μm) (t=4.12,P=0.00).Conclusions A combination procedure of vitrectomy with flute-needle vacuum assistant hole closure technique is effective for large IMH,which is beneficial to the anatomical repair and functional recovery of outer retina.
ABSTRACT
Background The patients who have undergone successful surgery for retinal detachment (RD) cannot recover their vision quickly,and the reason is not very clearly now.Objective This study was to compare the ellipsoid zone integrity in macula and frequency and duration of subretinal fluid after scleral buckling and pars plana vitrectomy (PPV) in primary macula-off rhegmatogenous RD,and to discuss the sequent influence of subretinal fluid on postoperative visual acuity.Methods A retrospective analysis was carried out on 66 cases of rhegmatogenous RD in Peking University People's Hospital from January 2010 to January 2013.All the cases were divided into 2 groups:scleral buckling group and PPV group.The courses of disease,refractive status,best corrected visual acuity (BCVA) and complications were recorded.The duration of subretinal fluid and ellipsoid zone integrity in macula were observed and the occurrence rates of subretinal fluid were calculated 1 month after surgery.Results There were no statistic differences on age,gender,courses of disease,refractive status and LogMAR visual acuity (all at P＞0.05).The average duration of subretinal fluid was (96 ±60) days in scleral buckling group,and (21 ±6) days in PPV group,with a statistically significant difference between the two groups (t =7.966,P =0.000).The occurrence rate of subretinal fluid at 1 month after surgery was 78.6％ in the scleral buckling group and 12.5％ in the PPV group,with a statistically significant difference between the two groups (x2=26.891,P =0.000).The LogMAR visual acuity was significantly different between the patients with and without subretinal fluid at 1 month after scleral buckling surgery (t=3.185,P=0.003).The LogMAR visual acuity was not significantly different between the scleral buckling group and PPV group 6 months after scleral surgery (t =1.876,P =0.065).The LogMAR visual acuity was not significantly different between the patients with and without subretinal fluid at 6 month after scleral buckling surgery (t =1.755,P=0.087).After the subretinal fluid was reabsorbed,the LogMARs visual acuity were significantly different between the patients with intact ellipsoid zone and with disrupt ellipsoid zone in both groups (scleral buckling group:t=2.555,P=0.015;PPV group:t=4.005,P=0.001).Conclusions The disruption extent of the ellipsoid zone is related to the duration of RD,and the integrity affects the postoperative visual acuity distinctly.The subretinal fluid is removed more rapidly after PPV when compared with scleral buckling in macula-off rhegmatogenous RD.The subretinal fluid delays visual recovery postoperatively but the operation method does not influence final visual acuity seriously.
ABSTRACT
Background Anti-VEGF drugs are generally applied in the treatment of ocular neovascular diseases.However,the therapy effect is unsatisfactory in some patients.Studing the effect of hypoxia-inducible factor-1 (HIF-1),a upstream regulatory gene of VEGF,and its limiting enzyme prolyl-4-hydroxylase domain proteins (PHDs) is of important clinical significance.Objective This study was to investigate the negtive regulation of exogeneous PHDs on HIF-1 pathway in human RPE cells.Methods pFLAG-PHD1,pFLAG-PHD2 and pFLAG-PHD3 plasmids were constructed by extracting RNA from Hela cell line and coloning PHD1,PHD2 and PHD3 using reverse transcription PCR with restriction enzyme.The plasmids were identified by gene sequencing.ARPE-19 cells were cultured at 21％ O2 (normoxia group),1％ O2 (hypoxia group),or in hypoxia-mimicking agents (CoCl2,anoxia group),respectively,and then were transfected with plasmids encoding FLAG-tagged PHD1,PHD2,PHD3 and pFLAGCMV2 transfected cells served as blank control.The expressional intensities of PHD1,PHD2 and PHD3 in the cells were detected and compared among different groups by using Western blot assay.The transcriptional activity of HIF-1 in the cells was evaluated with dual luciierase reporter assay.Results Western blot assay showed that PHD1,PHD2 and PHD3 all were expressed in ARPE-19 cells in the normoxia group,hypoxia group and anoxia group.The expression was strong in PHD2 protein and was weak in PHD3 protein,a statistically significant difference was found between PHD2 protein expression and PHD1 or PHD3 expressions (all at P＜0.05).Endogenous HIF-1 activity was elevated in pFLAG-CMX transfected cells in the hypoxia group and anoxia group than that in the normoxia group.Compared with pFLAG-CMX transfected cells,no obvious change was seen in the endogenous HIF-1 activity in the normoxia group,however,HIF-1 activity was declined in the hypoxia group and anoxia group after pFLAG-PHD1,pFLAG-PHD2 or pFLAG-PHD3 transfection.Under the same oxygen environment,HIF-1 activity was lower in the pFLAG-PHD2 transfected cells than that in the pFLAG-PHD1 or pFLAG-PHD3 transfected cells (both at P＜0.05).Conclusions PHDs play a negative regulation to HIF-1 activating pathway in human RPE cells,especially in hypoxia and anoxia cells.Among PHDs proteins,PHD2 presents the strongest inhibition on HIF-1 activating pathway.
ABSTRACT
The compound excipient containing sodium stearyl fumarate and plasdone S-630 was prepared by applying spray drying method. The basic physical properties of compound excipient were studied by solubility test, scanning electron microscope, differential scanning calorimeter, X-ray diffraction and Fourier transform infra-red spectroscopy. The effect of compound excipient on moisture absorption and ferulic acid in vitro dissolution of spray drying power of angelica were investigated. The results showed that the chemical constituents of compound excipient did not change before and after spray drying. The water soluble compound excipient can improve significantly moisture absorption and has application prospect.
ABSTRACT
<p><b>OBJECTIVE</b>To determine the major factors affecting the conversion efficiency of naringin-HP-beta-CD that was enzymed to prepare naringenin were determined and select the process condition with high conversion efficiency, stable and suitable for industrial production.</p><p><b>METHOD</b>The dropping method was used to prepare naringin-HP-beta-CD, which was hydrolyzed by snailase to obtain naringenin. With the bioconversion rate as the index, the effects of pH value, temperature, reaction time, dosage of enzyme and concentration of naringin-HP-beta-CD on conversion rate of naringenin were detected for the purpose of optimizing the preparation condition. the conversion efficiency of naringin-HP-beta-CD was verified by scanning calorimetry, and the Hydrolysis product was identified by H-NMR, and 13C-NMR.</p><p><b>RESULT</b>The optimum enzymolysis of naringin-HP-beta-CD with snailase was 98.4% under the conditions of 37 degrees C, a pH 5.0 acetic acid- sodium acetate buffer solution for 12 hours. The substrate concentration was 30 g x L(-1) and the weight ratio of enzyme and substrate was 3: 5. Under the optimum enzymolysis condition, the conversion rate of naringin-HP-beta-CD was higher than naringin that was not entrapped with HP-beta-CD, with 272.25 reaction product relative molecules. The structure of naringenin was confirmed by the analysis of 1H-NMR and 13C-NMR.</p><p><b>CONCLUSION</b>Naringin which is entrapped with HP-beta-CD to prepare naringenin can significantly improve the conversion efficiency by shortening the reaction time, increasing the concentration of the substrate and reducing the amount of enzyme. Therefore, the process is stable and it was suitable for industrialization.</p>
Subject(s)
2-Hydroxypropyl-beta-cyclodextrin , Flavanones , Chemistry , Hydrolysis , Solubility , beta-Cyclodextrins , ChemistryABSTRACT
<p><b>OBJECTIVE</b>To prepare the solid dispersion of tanshinone II A (TS II A) by the combined application of nano-silica and poloxamer 188 (F68), in order to observe its dissolution and stability.</p><p><b>METHOD</b>Tanshinone II A solid dispersion was prepared by the solvent method with nano-silica and poloxamer 188 as binary vectors. Its physical characteristics, in vitro dissolution and stability were further assessed.</p><p><b>RESULT</b>The tanshinone II solid dispersion was prepared with the weight ratio of nano-silica and poloxamer 188 of 1: 3. The differential scanning calorimetry (DSC) demonstrated that Tanshinone II A existed in vectors as amorphous state. The in vitro dissolution of tanshinone II A solid dispersion is up to 90% at 60 min. Accelerating experiment showed that content and in vitro dissolution of tanshinone II A solid dispersion did not change after storage over 3 months.</p><p><b>CONCLUSION</b>Solid dispersion of binary vector of tanshinone II A can obviously improve the dissolution and stability of tanshinone II in practice.</p>
Subject(s)
Calorimetry, Differential Scanning , Abietanes , Chemistry , Drug Stability , Drugs, Chinese Herbal , Chemistry , SolubilityABSTRACT
Objective To evaluate the influence factor of the prognosis of traumatic subretinal hemorrhage after vitreo-retinal surgery. Methods The clinical data of 50 patients with traumatic subretinal hemorrhage who had undergone vitreo-retinal surgery were retrospectively analyzed. All patients had ocular traurnatie history and subretinal hemorrhage diagnosed by fundus and B-scan examination; the preoperative visual acuity was less than 0. 1. According to different conditions, the traumatic eyes were treated with vitreo-retinal surgery, combined with lensectomy, retinotomy or silicone oil tamponade, respectively. The period of follow-up after surgery was 2-53 months, and the average period was 7.27 months. The corrected visual acuity and retinal reattachment at the last follow-up were observed. The visual acuity ≥0. 1 was the standard of good prognosis; retina[ reattachment was observed by indirect ophthalmoscope and color fundus photography. The prognostic factors mainly included type of injury, open or closed injury, the disease course, preoperative visual acuity, retinal detachment, hemorrhagic choroidal detachment, vitreous hemorrhage, the sites of submacular hemorrhage, methods of surgery. The relationships between those prognostic factors and visual acuity outcome or retinal reattachment were analyzed by χ2 test and logistic regression analysis. Results About 46.0% patients had good prognosis of the visualacuity. In the eyes with preoperative visual acuity of no light perception to hand moving and finger counting to 0. 1, the rate of good visual aeuitywas 34. 2% and 83.3%, respectively; the difference between the two groups was significant(χ2=8. 860, P = 0.003). In the eyes with or without preoperative retinal detachment, the rate of good visual acuity was 37.5% and 80. 0%, respectively; the difference between the two groups was significant (χ2=4. 232,P=0. 040). In the eyes with subretinal hemorrhage involving the macular fovea or not, the rate of good visual acuity was 34.4% and 66.7%, respectively; the difference between the two groups wassignificant (χ2 =4. 836,P=0. 028). All the other prognostic factors had no obvious effect on the retinal reattachment after the surgery. Conclusion Preoperative visual acuity, retinal detachment and submacular retinal hemorrhage were the important influence factors associated with prognostic visual acuity of eyes with traumatic subretinal hemorrhage after vitreo-retinal surgery.
ABSTRACT
ObjectiveTo evaluate and compare the prognosis of idiopathic macular holes (IMH) and traumatic macular holes (TMH) treated by pars plana vitrectomy (PPV). Methods The clinical data of 72 IMH eyes and 55 TMH eyes, which were treated by PPV between November 2001 and December 2007,were retrospectively reviewed. The visual outcomes and macular anatomic closure were evaluated, and their relationships with prognostic factors including the size of macular hole (MH), preoperative visual acuity (VA) and duration of disease were analyzed. Results The closure rate of IMH (100. 0%) was significant higher than that of TMH (85.5%) (P=0. 001). The postoperative VA of IMH and TMH were (0. 25±0.02) and (0. 21±0. 21) respectively, both significantly increased compare to their preoperative VA (t=-6. 841, -4. 093; P=0.000). VA-increased IMH and TMH eyes had same VA (χ2=3. 651, P=0.07).Pre-PPV VA≥0. 1 IMH eyes had better outcomes than Pre-PPV VA＜0. 1 IMH eyes (χ2 = 12.04, P=0. 001), while Pre-PPV VA had no effects on TMH outcomes (χ2=0. 371, P=0. 486). IMH eyes with small holes had better outcomes (t=2. 476, P=0. 016), and TMH eyes with small holes had better closure (t= -4. 042, P＜0. 001). The duration of disease had no significant influence on TMH visual (χ2=0. 704,P = 0. 401 ) and anatomic (χ2 = 0. 166, P= 0. 684) outcomes. Conclusions PPV is an effective treatment for MH. The closure rate of IMH is higher than that of TMH. The diameter of MH and preoperative VA are major factors for IMH outcomes, and the duration of disease and preoperative VA have no effects on postoperative VA in TMH.
ABSTRACT
Objective To evaluate the long-term results of vitreoretinal surgery without use of intraocular silicone oil or gas in patients with diabetic tractional retinal detachment (DTRD).Methods The clinical interventional case series study included 104 patients (112 eyes) with DTRD,who were consecutively treated by pars plana vitrectomy without use of intraocular silicone oil or gas.Among the eyes,there were 6 eyes with iris neovascularization (INV),1 eye with neovascular glaucoma (NVG) and 50 eyes with macular retinal detachment.There were no pre-existing retinal holes or breaks prior to surgery nor any iatrogenie retinal breaks developed during vitrectomy.Cataract removal combined with intraoeular lens implant surgeries were performed on 15 eyes.Follow-up duration varied from 12 to 65 months (mean: 29 months).Results Subretinal fluid was completely absorbed within 2 months after surgery.In 107 eyes (95.54%),the retina reattached after surgery and remained attached till the end of follow-up period.Best corrected visual acuity (BCVA) improved in 79 eyes (70.53%),remained unchanged in 14 eyes (12.500%) and got worse in 19 eyes (16.79%).The BCVA improving rate was lower in the macular detached group (33 eyes/50 eyes,66.00% Vs 46 eyes/62 eyes,74.19%,χ2=0.89,P=0.344).No obviously aggravated opacity of lens was observed after vitreoretinal surgeries in the eyes without cataract surgeries.Seven (6.25%) eyes showed INV (5 new onset eyes),and none of them developed into NVG.In multivariate logistic regression,factors associated with postoperative rubeosis iridis were pre-existing rubeosis iridis I-adjusted odds ratio (OR)= 10.2],low preoperative BCVA (OR= 11.1) and low postoperative BCVA (OR = 16.7).Conclusions Vitreoretinal surgery for DTRD may not necessarily be combined with silicone oil or gas tamponade if there are no preoperative or intraoperative retinal breaks,and only using irrigation fluid could access a good long-term prognosis result.
ABSTRACT
Objective To observe the change of diffusion upper limit of macromolecules through pathological retina and the difference between the layers of retina. Methods Retinal edema was emulated by establishing branch retinal vein occlusion(RVO)model in miniature pig eyes under photodynamic method.Two days later,the retinas of both eyeballs were peeled off.The diffusion test apparatus was designed by ourselves.FITC-dextrans of various molecular weights(4.4,9.3,19.6,38.9,71.2 and 150 kDa)and Carboxyfluorescein(376 Da)were dissolved in RPMI-1640 solutions and diffused through inner or outer surface of retina.The rate of transretinal diffusion was determined with a spectrophotometer.Theoretical maximum size of molecule(MSM)was calculated by extrapolating the trend-linear relationship with the diffusion rate.In separate experiments to determine the sites of barrier tO diffusion,FITC-dextrans were applied to either the inner or outer retinal surface,processed as frozen sections.and viewed with a fluorescence microscope. Results FITC-dextrans applying tO inner retinal surface,4.4 kDa dextrans were largely blocked by inner nuclear layer(INL);19.6-71.2 kDa dextrans were blocked by the nerve fiber layer(NFL)and inner plexiform layer;150 kDa dextrans were blocked by NFL.FITC-dextrans applying to outer retinal surface,most dextrans with various molecular weights were blocked before outer nuclear layer(ONL).No matter applying to the inner or outer surface,Carboxyfluorescein can diffuse through the whole retina and aggregate at INL and ONL.After RVO,the inner part of retina became edema and cystoid,loosing the barrier function.Compared with the normal retina,the MSM in RVO tissues increased(6.5±0.39nm Vs 6.18±0.54nm,t=4.143,P=0.0001). Conclusions After RVO,the barrier function of inner part of retinal is destroyed and the upper limit of diffusion macromolecule size increased.which is nevertheless limited.ONL acts as bottle-neck barriers to diffusion,if the outer part of retina is damaged,the change of the diffusion upper limit will be prominent.
ABSTRACT
Objective To evaluate improvement of visual acuity for advanced proliferative diabetic retinopathy eyes with different complications after vitrectomy. Methods Four groups of advanced proliferative diabetic retinopathy (APDR) in 314 eyes with diabetes type Ⅱ and type Ⅰ were analyzed retrospectively: vitreous hemorrhage with limited traction retinal detachment (VH), extensive fibrovascular membranes with traction retinal detachment (TD), combined rhegmatogenous and traction retinal detachment (CRT) and cataract with vitreous hemorrhage or and traction retinal detachment (CHD). Results 0.1 or better postoperative visual acuity was achieved in 59.5% of type Ⅱ and 66.7% of type Ⅰ in the VH group; 39.4% of type Ⅱ and 52.6% of type Ⅰ in the extensive TD group; 31.6% of the CRT group; 62.5% of the CHD group. The major intraoperative complication is iatrogenic retinal breaks. The causes of postoperative visual loss in present study included neovascular glaucoma (2.8% of type Ⅰ and 0.4% of type Ⅱ in aphakia, 25% of type Ⅱ in aphakia and 4.2% in pseudophakia), retinal detachment and CRAO. Conclusion The majority of APDR eyes obtained better visual improvement after vitrectomy and photocoagulation.
ABSTRACT
Objective To evaluate the therapeutic effects of treatments of eye-retaining and enucleation for choroidal melanomas. Methods The clinical data of 44 patients (44 eyes) with choroidal melanomas after eye-retaining treatments and enucleation surgery were retrospectively analyzed. The metastasis, retention rate of eyeball after eye-retaining treatment, and visual acuity prognosis were observed and analyzed. In 44 eyes treated by eye-retaining therapy, transpupillary thermotherapy (TTT) was performed primaryly on 7 (15.9%),~ 106 Ru brachytherapy on 25 (56.8%), and local resection of tumor combined with ~ 106 Ru brachytherapy on 12 (27.3%).The average follow-up period was 13.3 months. Results Forty-four patients had no melanoma metastasis during the follow-up period. In 39 patients (88.6%) who had their eyes retained successfully, the retention rate of eyeball was 100%, 92.9%, and 83.3% in 6, 14, and 24 eyes with small, middle, and large tumor, respectively. In the patients treated by eye-retaining therapy, the visual acuity was ≥0.3 in 11 (28.2%), ≥0.05-
ABSTRACT
Objective To investigate the difference of curative effect of various surgical methods for the treatment of idiopathic senile macular hole. Methods A retrospective analysis was made for 86 eyes with stage Ⅱ Ⅳ idiopathic full thickness macular hole treated with various modes of operation,ie, single vitrectomy (7 eyes),vitrectomy combined with autologous platelet concentrate (APC) as an adjuvant (40 eyes), vitrectomy with internal limiting membrane (ILM) peeling (14 eyes), vitrectomy with both ILM peeling and APC treatment (25 eyes). The main outcome measures included anatomic reattachment rate,change of visual acuity,findings of optic coherence tomography (OCT), Amsler grid and intra or postoperative complication evaluations. Results (1) In visual acuity improvement, the APC group (80.0%) was significantly better than anyone of the other three groups ( P
ABSTRACT
Objective To evaluate the success rate and the risk of impairing vision for epimacular surgery. Methods A retrospective analysis of 57 eyes with epimacular membrane after surgery was made, and the changes in visual acuity and near visual acuity, in different etiology, improvement in distortion, as well as intraoperative and postoperative complications were compared. Results The eyes of 78 8% achieved a visual improvement of more than 2 lines. The visual improvement after surgery of epimacular membranes was the most in buckling group, then in macular hole with epimacular membrane and idiopathic eyes, the change was very limited in macular traction syndrome. The improvement of near visual acuity is usually better than distant visual acuity. The improvement rate of distortion is of 65 0%. The main intraoperative complication was reopen of the primary hole(4 eyes) and the formation of new hole(5 eyes). Conclusion Surgical peeling for epimacular membranes can improve the visual acuity and distorted vision,particularly in epimacular membrane after buckling surgeries, with macular hole and idiopathic eyes. possible risks might be present in surgical manipulation.
ABSTRACT
Objective To investigate the effect of triamcinolone acetonide (TA) with different dosage and excipient on retina. Methods Thirty-two purebred New Zealand white rabbits randomly divided into 4 groups underwent intravitreous injection with TA. Group 1:4 mg TA without excipient; group 2:25 mg TA without excipient; group 3:4 mg TA with excipient; group 4:25 mg TA with excipient. Electroretinography (ERG) was performed on each rabbit before intravitreal injection, 1 week, 1 and 2 months after the injection. All the animals were killed and the eyeballs were extirpated 2 months after the injection, and pathological examinations including light and electron microscopy were performed. Results No significant difference was found in the latent period of ERG at the points of time before and after the injection in all the groups, but the amplitudes of ERG waves was lower in groups containing excipient than that before the treatment (P
ABSTRACT
Objective To observe the characteristics of the images of optical coherence tomography (OCT) performed on the patients with vitreomacular traction syndrome and its clinical significance. Methods The clinical data of 25 patients with vitreomacular traction syndrome diagnosed by OCT, fundus fluorescein angiography, and B-scan ultrasonography and confirmed by surgical treatment were retrospectively analyzed. The features of images of OCT in vitreomacular traction syndrome were observed. Results Five types were found in the images of OCT in the patients with vetreomacular traction syndrome. The main characteristic of the images of OCT in the patients with vitreomacular traction was the highly reflective band of the vitreous posterior cortex inservion at fovea. In 25 patients, vitreomacular traction associated with macular edema was found in 10, macular hole in 3, macular epiretinal membrane in 6, retinoschisis in 1, and retinal detachment in 5. Conclusion OCT is a potential powerful toll for detecting and monitoring vitreomacular traction syndrome.
ABSTRACT
Objective To observe and classify the characteristics of optical coherence tomography (OCT) for several common diseases which could lead to submacular choroidal neovascularization (CNV), and to provide the warrant to make the differential diagnosis and treatment of CNV. Methods The data of OCT of 165 patients (187 eyes) with CNV due to AMD, CEC, high myopia and ICNV diagnosed by fundus photography and fundus fluorescein angiography (FFA) were retrospectively analyzed, and the images of OCT were classified considering the results of FFA, and the characteristics of different types of the images were sumerized. Results Well-defined fusiform thickening of retinal pigment epithelial (RPE) and choriocapillary layer in CNV with well-defined border (60 eyes), dispersed backscattering increase in poorly-defined CNV (101 eyes), optic darkspace beneath RPE layer in serous detachment of RPE layer (19 eyes), quickly decreased high backscattering region under RPE layer in hemorrhagic detachment of RPE layer (11 eyes), slight to moderate backscattering region between RPE layer in fibrovascular detachment of RPE layer (10 eyes), and detachment of neurepithelial layer from RPE layer with the optic darkspace between the layers in detachment of neurepithelial layer (45 eyes) were observed. Conclusions The images of OCT for the common diseases which could lead to submacular choroidal neovascularization may be divided into 6 types. Analyzing the characteristics of images of OCT is helpful in differential diagnosis and treatment of CNV.
ABSTRACT
Objective To explore the histopathological changes of the pigs′ eyes in vivo after radial optic neurotomy (RON), and provide the experimental foundation for the safety of RON. Methods A total of 12 healthy miniature pigs were used in the experiment, in whom 8 were executed at the 1~st , 3~rd , 7~th , and 48~th day respectively after underwent RON in both eyes, and 4 were executed at the 120~th day after underwent RON unilaterally (the other eye was as the control in 2 and underwent single vitrectomy in 2). All the enucleated eyes were cut in sections routinely and embeded in paraffin. The sections were stained by HE, Masson trichrome staining or Luxol fast blue staining and the different sections of optic nerve were observed by light microscope. Results No damages of the major vessel wall were found and the cerebral pia mater of orbital optic nerves kept integrated. At the 1~st day after the operation, the incisions came into being and local hemorrhages infiltrated into the circumambience and backside. The vacuole-like change induced by the demyelination of optic nerve fiber located at the incisions. At the 3~rd day, the vacuole-like changes widened. At the 7~th day, the fibroblasts aggregated at the incision, with hyperplastic neuroglia cells and dispersed pigmented granules. Lymphocytes and monocytes were the major infiltrated inflammatory cells. At the 48~th day, collagen filled in the incisions and aggregated neuroglia cells of the rear optic nerves behind the incision were found, which showed weak staining with obvious boundary which was somewhat beyond the midline of optic nerves. At the 120~th day, localized atrophy of optic nerve occurred under the incision. No abnormal pathological findings were found in the normal eyes and the eyes undergo vitrectomy. Conclusions Localized atrophy of optic nerves comes into being after the normal pig eyes in vivo underwent RON. The surgery is safe to some extent.