ABSTRACT
AIM: To investigate the clinical effect of 25G+pars plana vitrectomy(PPV)combined with preoperative intravitreal injection of conbercept in the treatment of patients with proliferative diabetic retinopathy(PDR), and analyze the influence on visual acuity, central foveal thickness(CMT)and serum vascular endothelial growth factor(VEGF)level.METHODS: A retrospective study was conducted from October 2019 to January 2022. A total of 80 patients(87 eyes)with PDR were divided into the two groups according to the treatment method, with 40 patients(45 eyes)treated with 25G+PPV in the control group, and 40 patients(42 eyes)treated with 25G+PPV combined with preoperative intravitreal injection of conbercept in the observation group. The two groups were compared in terms of the best corrected visual acuity(BCVA), intraocular pressure, CMT and serum VEGF level before treatment and at 2wk, 1 and 3mo after treatment. The patients were followed up for 3mo, with postoperative complications and recurrence recorded.RESULTS: The incidence of intraoperative bleeding in the observation group was significantly lower than that in the control group(P<0.05). After treatment, the BCVA of the two groups was improved(P<0.05), CMT and serum VEGF level were decreased(P<0.05), but there was no significant change in intraocular pressure(P>0.05). The BCVA and CMT of observation group were lower than those of control group at 1 and 3mo after treatment(P<0.05). Serum VEGF level in the observation group was lower than that in the control group at 3mo after treatment(P<0.05). The incidence of complications in observation group(5%)within 3mo after treatment was significantly lower than that in control group(18%; P<0.05). There was no statistically significant difference in recurrence rate of PDR between the two groups(P>0.05).CONCLUSION: With few complications, 25G+PPV combined with preoperative intravitreal injection of conbercept is effective in the treatment of patients with PDR, which can better promote postoperative vision recovery, improve macular edema, and reduce serum VEGF level.
ABSTRACT
PURPOSE: To compare the intraocular pressure (IOP) in diabetic macular edema (DME) patients and macular edema associated with branch retinal vein occlusion (BRVO) patients after intravitreal preservative-free Triamcinolone injection.METHODS: This study included 36 patients diagnosed with DME and 44 patients diagnosed with BRVO with macular edema. Both groups were treated with intravitreal preservative-free Triamcinolone (Maqaid®, Wakamoto Pharmaceutical Co., Ltd., Tokyo, Japan) injection, and we compared the IOPs of the two groups determined before injection and at 1, 2, 3, and 6 months after injection. We also compared the IOP elevation ratios and durations, and central foveal thickness (CFT) changes using optical coherence tomography.RESULTS: In both groups, there was no statistical significance in the IOP before injection and at 1, 2, 3, and 6 months after injection. However, the IOP elevation ratio in the DME patients (38.9%) was significantly higher than that in the BRVO patients (15.9%) (p = 0.02). The duration of IOP elevation in the DME patients (1.14 ± 1.85 months) was significantly longer than that in the BRVO patients (0.30 ± 1.20 months) (p = 0.03). When the IOP was not controlled, we used IOP-lowering agents, and two patients in the DME were treated with glaucoma surgery. There was no statistical significance in the CFT before injection and at 1, 2, or 3 months after injection between the two groups (p = 0.72, p = 0.26, p = 0.66, p = 0.34, respectively). However, the CFT after 6 months was 328 ± 103 µm in the DME group and 434 ± 189 µm in the BRVO; this difference was significant (p < 0.01).CONCLUSIONS: Intravitreal injection of preservative-free Triamcinolone was effective in the treatment of both DME patients and macular edema patients associated with BRVO. Furthermore, Triamcinolone was more safely injected in macular edema associated with BRVO patients than in DME patients.
Subject(s)
Humans , Glaucoma , Intraocular Pressure , Intravitreal Injections , Macular Edema , Retinal Vein Occlusion , Retinal Vein , Retinaldehyde , Tomography, Optical Coherence , TriamcinoloneABSTRACT
@#AIM: To evaluate the value of OCTA in the diagnosis and treatment of retinal vein occlusion.<p>METHODS: A retrospective case-control study was conducted to select 38 patients(38 eyes)with retinal vein occlusion diagnosed in ophthalmology clinic of Dalian Third People's Hospital from January to October 2018. The affected eyes were group A and the contralateral healthy eyes were group B. All patients underwent OCTA mode scanning of macular retina in the range of 3 mm×3 mm. Four layers of macular blood flow density maps were obtained, including surface retina, deep retina, outer retina and choroidal capillary layer. The area of vascularized area(FAZ)in the central fovea of the surface retina was measured. Image J software was used to calculate four layers of macular blood. Flow density(MVD)and OCT were used to measure the horizontal and vertical fovea thickness(CFT). <p>RESULTS: There were differences in FAZ measurements in superficial retina between group A and group B(<i>P</i><0.01), and in horizontal and vertical CFT measurements(<i>P</i><0.01). There were differences in MVD between group A and group B(<i>P</i><0.01). There was no difference in MVD results in outer retina(<i>P</i>=0.542)and choroidal capillary layer(<i>P</i>=0.489). BCVA was positively correlated with surface retinal FAZ, horizontal CFT and vertical CFT, and negatively correlated with surface retinal MVD and deep retinal MVD, respectively(<i>r</i>=-0.486, -0.465,all <i>P</i><0.01).<p>CONCLUSION: The application of OCTA examination has important guiding significance in indicating macular retinal microcirculation disorder and visual prognosis in patients with retinal vein occlusion.
ABSTRACT
Objective To analyze the characteristics of central macular retinal microvascular network morphology of retinopathy of prematurity (ROP) with optical coherence tomography angiography(OCTA).Methods The 7-15 years old ROP children with laser treatment history(ROP group,25 eyes of 14 patients) and full-term children(control group,40 eyes of 20 patients) were collected by cross-sectional study.The subjects in the two groups were examined by RTVue XR Avanti-OCTA,and several parameters including the detection of the best corrected visual acuity (BCVA),central foveal thickness (CFT),foveal avascular zone (FAZ),macular superficial retinal capillary plexus (SCP) density were recorded and analyzed statistically with t test in the two groups.Results The area of FAZ in ROP group was (0.04 ± 0.05) mm2,which was significantly less than that in control group [(0.29 ± 0.08) mm2] (P ＜ 0.001).The SCP density of ROP group was 42.70％ ± 5.90％,which was significantly higher than that in the control group (35.90％ ± 6.30％) (P ＜ 0.001).The CFT in ROP group was (328.50 ± 34.90) μm,which was significantly higher than that in the control group [(236.80 ± 23.40)μm] (P ＜ 0.001).The BCVA was 0.83 ± 0.14 in ROP group and 0.85 ±0.26 in the control group,respectively,without significant difference (P ＞ 0.05).Conclusion ROP children have smaller or undefined FAZ,the thickened CFT and the increased SCP density,and the BCVA is not affected by the FAZ area and CFT in this study.
ABSTRACT
AIM:To systematically evaluate the effects of non-steroidal anti-inflammatory drugs (NSAIDs)administrated at different time points on the incidence of cystoid macular edema (CME) following phacoem ulsification.METHODS:The Cochrane Library,PubMed,BMC,National Knowledge Infrastructure (CNKI),and VIP databases were searched to identify the clinical randomized controlled trials of comparing effects of NSAIDs administered at different time points on the incidence of CME and the central foveal thickness following phacoemulsification.The experiment group received topical NSAIDs preoperatively and postoperatively,while the control group received topical NSAIDs postoperatively.The RevMan software 5.2 and Stata software 12.0 were used in the Meta-analysis.RESULTS:Six studies were included in this Meta-analysis.No statistically differences were observed in the incidence of CME after 1wk postoperatively (OR=1.58,95％CI:0.48-5.18,P＞0.05),in the incidence of CME after 1 mo postoperatively (OR=0.78,95％CI:0.30-2.00,P＞ 0.05),in the central foveal thickness after 1wk postoperatively (WMD=-7.20,95％ CI:-15.17 to 0.77,P＞0.05),and in the central foveal thickness after 1mo postoperatively (WMD=-3.98,95％ CI:-14.05 to 6.08,P＞0.05).However,statistically significant differences were found in the incidence of CME after 3mo postoperatively (OR=0.22,95％ CI:0.11-0.43,P＜0.01)and in the central foveal thickness after 3mo postoperatively (WMD=-18.25,95 ％ CI:-33.80 to-2.70,P＜0.05).CONCLUSION:A combination of NSAIDs administrated preoperatively and postoperatively can reduce the incidence of the CME and the thickness of the macular centrall.Thereby,the effects of administrating NSAIDs both preoperatively and postoperatively have more advantages than that of administrating NSAIDs postoperatively alone.
ABSTRACT
?AIM:To study the clinical value of non-steroidal anti-inflammatory drug in adjuvant treatment of intravitreal triamcinolone acetonide ( IVTA ) for macular edema caused by retinal vein occlusion ( RVO) .?METHODS: Forty - eight eyes in 48 patients were randomly divided into trial and control group ( 24 eyes each ) in this prospective study. In the trial group, additional pranoprofen drops was administered from 1d before IVTA to 30d after injection. Central foveal thickness ( CFT ) was measured with optical coherence tomography ( OCT ) . Available documents of best corrected visual acuity ( BCVA ) , CFT, intraocular pressure and complications pre- and post-injection at 3d, 1,2wk, 1 and 3mo were evaluated.?RESULTS: After IVTA, BCVA was improved in both groups at different levels; but there was no statistically significant between two groups at each time point ( P>0. 05). The CFT values were 629 ± 43μm vs 605 ± 57μm before IVTA in the trail vs control groups (P>0. 05). The values were 432±74μm vs 511±32μm (t=7. 533, P<0. 05), and 275±54μm vs 379±29μm (t=13. 212, P<0. 05) of the trial vs control groups at 1 and 3mo after IVTA, respectively. Ocular hypertension occurred in 5 eyes after injection in trail group, and was controlled with anti-glaucoma medication and one eye with filtration surgery. Progression of cataract was noted in 3 of 35 phakic eyes and cataract surgery was performed in 2 eyes at 4-12mo after injection in trail group. Progression of cataract was noted in 4 eyes and cataract surgery was performed in 2 eyes at 4- 12mo after injection in control group. No retinal detachment and endophthalmitis happened during the whole period of follow-up.?CONCLUSION: Application of non - steroidal anti -inflammatory eye drops in perioperative period can be useful to improve the outcome of IVTA for macular edema, which needs further evaluation.
ABSTRACT
PURPOSE: To evaluate segmentation reliability in diabetic macular edema (DME) estimates between a Cirrus™ HD-OCT image analysis algorithm and an Iowa reference algorithm, which are an automatic segmentation software. METHODS: Thirty eyes from 23 patients diagnosed with DME were included and underwent spectral-domain optical coherence scans (Cirrus™ HD-OCT). Central foveal thickness (CFT) and ganglion cell layer-inner plexiform layer segmentation data were compared with those produced by the Cirrus™ HD-OCT segmentation algorithm and Iowa reference algorithm. Measurement agreement was assessed using intraclass correlation (ICC) and segmentation errors were confirmed by 2 ophthalmologists. RESULTS: The mean CFT in the 1-mm central area determined by the manufacturer-supplied Cirrus software and Iowa reference algorithm was 512.07 ± 182.35 µm and 476.53 ± 32.36 µm, respectively (p < 0.05). The mean paired difference was 35.53 ± 92.46 µm (ICC, 0.929). Segmentation errors were demonstrated in eyes with a CFT less than 400 µm, specifically for 45% of scans obtained by the Cirrus algorithm and 9% from the Iowa algorithm; in eyes with a CFT equal to or higher than 400 µm, the error rates were 95% and 42%, respectively. CONCLUSIONS: CFT measurement in eyes with diabetic macular edema using the Cirrus algorithm and Iowa algorithm showed relatively high degrees of agreement and significant correlation. In eyes with a CFT equal to or higher than 400 µm, the Iowa algorithm showed higher reliability in retinal segmentation than the Cirrus algorithm.