Research advances in animal models of diabetic retinopathy / 中国药理学通报

Diabetic retinopathy (DR) is one of the microvascular complications of diabetes. At present, the pathogenesis of DR is obscure and drugs can not meet clinical needs, however. Experimental animal model of DR is an effective tool to study its pathogenic mechanism and evaluate drug efficacy. In this paper, the research progress of experimental animal models of DR has been-reviewed in recent years, mainly using mice, zebrafish, and other experimental animals, which can be divided into two categories: induced type and genotype, according to the inducer.

Research progress of clinical application of optical coherence tomography angiography in diabetic retinopathy / 国际眼科杂志(Guoji Yanke Zazhi)

@#Optical coherence tomography angiography(OCTA), as a new imaging technology that has emerged in recent years, is characterized by non-invasiveness, high speed and high resolution. Compared with traditional contrast examination, OCTA is faster, safer and avoids the side effects and risks of traditional contrast agents. Now, OCTA has been gradually applied in the diagnosis, treatment and follow-up of eye diseases. Through real-time imaging of retinal choroidal blood vessels, this article reviews the research progress of clinical application of OCTA in diabetic retinopathy.

Automated analysis of microaneurysm lesions in standard seven-field color fundus photography / 上海交通大学学报（医学版）

Objective • To evaluate the accuracy and efficiency of the automated supervised machine-learning algorithm for microaneurysm lesion detection in seven-field color fundus photography. Methods • A total of 616 seven-field color fundus photographs were obtained from 44 patients with diabetic retinopathy (DR) from Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine from 2014 to 2016. Using the microaneurysm detection algorithm developed in this study, the automated identification and labeling of microaneurysm lesions in the standard seven-field color photography of DR were performed. The results were compared with manual labeling by ophthalmologists to evaluate the sensitivity and efficiency of the automated algorithm. Results • In the standard seven-field fundus color photographic image library, the automated algorithm achieved sensitivity of 94.15% in total and 93.09% in the optic disc field (F1), 94.84% in the macula field (F2), 95.16% in the temporal to macula field (F3), 94.99% in the superior temporal field (F4), 93.77% in the inferior temporal field (F5), 92.40% in the superior nasal field (F6) and 93.75% in the inferior nasal field (F7), and specificity of 98.05% in total and 98.02% in F1, 98.06% in F2, 97.97% in F3, 97.91% in F4, 98.07% in F5, 98.03% in F6 and 98.23% in F7. The cost of time per image was (9.2± 0.6) s, 93.2% less time than manual labeling. Conclusion • The automated microaneurysm detection algorithm can accurately and efficiently identify microaneurysm lesions in color fundus photography.

Effect analysis of Lvis stent-assisted coiling embolization of intracranial wide-necked microaneurysms / 中国脑血管病杂志

; Objective To investigate the safety and efficacy of Lvis stent in the treatment of intracranial wide-necked microaneurysms. Methods From May 2016 to May 2018, 54 consecutive patients with intracranial wide-necked microaneurysms and were treated with Lvis stent-assisted coiling embolization at Department of Neurosurgery, Sichuan Provincial People's Hospital were recruited. The clinical data and treatment outcomes were retrospectively analyzed. Raymond classification was used to evaluate the results of aneurysm embolization immediately after intervention and 6 to 12 months after interventioa Regular clinical follow-up was conducted at 1, 3, 6 and 12 months after intervention, and every year thereafter. Reexamination by DSA was performed at 6 to 12 months after surgery to evaluate aneurysm embolization, stent displacement, stent stenosis, etc. The modified Rankin scale (mRS) score was used to evaluate the prognosis. Results Lvis stent-assisted coiling embolization were all successfully performed in 54 patients. Immediate postoperative embolization results of 54 aneurysms; Raymond classification I in 49 cases (90. 7%); Raymond classification II in 5 cases (9. 3%). Complete stent expansion was in 53 patients and incomplete in 1 patient. Forty-there patients received DSA follow-up at 6-12 months after interventions, with Raymond classification I in 42 cases (97. 7%) and classification II in 1 case (2. 3%). Fifty-four cases had clinical follow-ups without recurrent bleeding, death or disability. The mRS score was 0 in 52 cases and 1 in 2 cases. None of the 54 patients had any stroke during the follow-up periods. Conclusions Lvis stent-assisted coiling embolization is safe and effective in the treatment of intracranial wide-necked microaneurysm. The long-term efficacy remains to be confirmed by larger studies with longer follow-up duration.

FILM: finding the location of microaneurysms on the retina

Diabetes retinopathy (DR) is one of the leading cause of blindness among people suffering from diabetes. It is a lesion based disease which starts off as small red spots on the retina. These small red lesions are known as microaneurysms (MA). These microaneurysms gradually increase in size as the DR progresses, which eventually leads to blindness. Thus, DR can be prevented at a very early stage by eliminating the retinal microaneurysms. However, elimination of MA is a two step process. The first step requires detecting the presence of MA on the retina. The second step involves pinpointing the location of MA on the retina. Even though, these two steps are interdependent, there is no model available that can perform both steps simultaneously. Most of the models perform the first step successfully, while the second step is performed by opthamologists manually. Hence we have proposed an object detection model that integrates the two steps by detecting (first step) and pinpointing (second step) the MA on the retina simultaneously. This would help the opthamologists in directly finding the exact location of MA on the retina, thereby simplifying the process and eliminating any manual intervention.

Case of Renal Microaneurysms and Multiple Renal Infarctions in a Patient with Systemic Lupus Erythematosus

Systemic lupus erythematosus (SLE) is a chronic inflammatory, heterogeneous autoimmune disease characterized by autoantibody production and the potential involvement of almost every organ system. Although vasculitis usually confined to small vessels is a fairly common feature of SLE, ischemic vasculitis with an aneurysm is an uncommon feature. In particular, renal arterial microaneurysms and multiple renal infarctions are very rarely reported in patients with SLE. Furthermore, to the best of the authors' knowledge, there is no report on renal arterial microaneurysms associated with SLE in Korea. Here, this paper presents a case of renal microaneurysms and multiple renal infarctions in a 41-year-old woman with SLE.

Microaneurysm Turnover after the Use of Dexamethasone and Bevacizumab to Treat Diabetic Macular Edema

PURPOSE: To evaluate microaneurysm (MA) turnover and changes in central retinal thickness after intravitreal dexamethasone implantation or intravitreal bevacizumab injection to treat diabetic macular edema. METHODS: Sixty eyes with diabetic macular edema were evaluated. In all, 30 eyes received intravitreal dexamethasone implants (group A) and 30 received bevacizumab injections (group B). All patients were followed-up at 3 and 6 months. MA formation, disappearance, and turnover (MA formation rate minus disappearance rate) were evaluated. When the disappearance rate was greater than the formation rate (so the turnover was ≤0), the microaneurysms were considered to have resolved. Central retinal thickness (CRT) was measured using optical coherence tomography at all visits. RESULTS: In group A, MA turnover was 86.6% at 3 months and 53.3% at 6 months, and thus decreased slightly over time, but was not eliminated. In group B, MA turnover was 56.6% at 3 months and 13.3% at 6 months; the between-group difference was statistically significant (p = 0.014). CRT decreased in both groups, but significantly less so in group B 3 months after injection. However, no significant between-group difference was apparent 6 months after injection. CONCLUSIONS: There were no significant between-group differences in either CRT or MA turnover 3 months after injection. However, at 6 months, dexamethasone implantation showed slightly better results than intravitreal bevacizumab injection. However, further research on long-term MA turnover is required.

Simultaneous Multiple Basal Ganglia and Cerebellar Hemorrhage: Case Report

A 35-year-old man presented with simultaneous multiple intracranial hematomas in the right cerebellar dentate nucleus and left basal ganglia. The hematomas were visible by computed tomography performed within two hours of the patient's arrival. The initial computed tomography showed acute hemorrhage in the left basal ganglia and dentate nucleus in cerebellum. The patient then experienced a change of consciousness due to newly developed hydrocephalus, and emergent extra-ventricular drainage was performed. By discharge, fortunately, the patient was fully recovered.

Analysis of Angiographically Unrecognized, Incidental Microaneurysm during Aneurysmal Operation

OBJECT: Microaneuryms were unvisible in angiograms and incidentaly detected during operation. Increasing the frequency of endovascular surgery, they have dangerous risk during procedure. So we analyzed the unvisible reason and report operation method. MATERIAL AND METHOD: Twenty-six cases of angiographically unrecognized microaneurysm were operated from January 1993 to May 1998. They consisted of 3.8% of 684 operated cases of intracranial aneurysms at the same period. The most common site of angiographically unrecognized microaneurysm was the internal carotid artery(11 cases): one arose from the posterior communicating artery, 9 from the anterior choroidal artery, 1 from the internal carotid artery bifurcation. RESULT: According to the intraoperative findings, we analyzed the possible reasons why these microaneurysms were not visible in the pre-operative angiograms; 19 cases in low type, 4 cases in hidden type, 3 cases in sandwiched type. We performed direct aneurysmal neck clippings in 9 cases and wrap-clip reinforcements in 8 cases, wrappings in 9 cases. CONCLUSION: We have to consider that angiographically unrecognized microaneurysm may be found during the direct operation of intracranial aneurysm and also during the endovascular surgery. Also, the wrapping technique is found to be less secure and needs regular follow-up angiography.

Etiology and Pathogenesis of Hypertensive Intracerebral Hemorrhage

Although the relationship between hypertension and intracerebral hemorrhage is well established, the mechanism which precipitates definitely arterial rupture and the natural course of hematoma in the brain have long been disputed. In this article, the literatures regarding the etiology and pathogenesis of hypertensive intracerebral hemorrhage were reviewed.