ABSTRACT
Retinal degeneration mainly include age-related macular degeneration,retinitispigmentosa and Stargardt's disease.Although its expression is slightly different,its pathogenesis is photoreceptor cells and/or retinal pigment epithelial (RPE) cel 1 damage or degeneration.Because of the 1 ack of self-repairing and renewal of retinal photoreceptor cells and RPE cells,cell replacement therapy is one of the most effective methods for treating such diseases.The stem cells currently used for the treatment of retinal degeneration include embryonicstem cells (ESC) and various adult stem cells,such as retinal stem cells (RSC),induced pluripotent stem cells (iPSC).and mesenchymal stem cells (MSC).Understanding the currentbasic and clinical application progress ofESC,iPSC,RSC,MSC can provide a new idea for the treatment of retinal degeneration.
ABSTRACT
Radiotherapy is the prior treatment for uveal melanoma,but a major problem confronted most of the patients is radiation retinopathy,which accompanied with severe visual loss and secondary enucleation potential.There is no optium choice and normative strategy so far,the intraocular melanoma society has focused on application of anti-vascular endothelial growth factor drugs injection and glucocorticoids.This article reviews a series of potential managements for radiation retinopathy and its further stage.
ABSTRACT
Retinal angiomatous proliferation (RAP) is a genetic distinct subgroup of exudative age-related macular degeneration which shows a rapid and severe vision loss and high recurrence rates.The pathophysiological mechanisms of RAP is unclear.Recent histopathologic study and en face optical coherence tomography angiography have furthered our understanding of RAP.Clinical features frequently associated with RAP include bilateral disease,presence of reticular pseudodrusen and pigment epithelial detachments.Indocyanine green angiography is the gold standard diagnostic tool.Recently,more and more accurate optical coherence tomography has improved the acknowledgement of stage and diagnosis of RAP.The treatment efficacy of RAP is highly dependent on the stage.Anti-vascular endothelial growth factor therapy is currently the first line of treatment.Other treatment options including combination of photodynamic therapy with antiangiogenic agent intravitreal injections also achieve a reasonable therapeutic outcome.There remain several important questions such as pathogenesis and treatment regimen,to be answered in future RAP research studies.
ABSTRACT
Objective To observe the application value and therapeutic efficacy of wide-field digital pediatric retinal imaging system (Retcam Ⅲ) fundus fluorescein angiograms (FFA) assisted photocoagulation on familial exudative vitreoretinopathy (FEVR).Methods The study included 46 eyes of 34 patients with staging 2 FEVR.All patients received color fundus photography and FFA under general anesthesia.The blood vessel reliability of color fundus photography and FFA was comparatively determined.Binocular indirect ophthalmoscope laser photocoagulation was applied to peripheral retina with abnormal leakage as indicated by FFA,the wavelength was 532nm,the duration was 0.25 s and the energy was 200-280 mW.After laser photocoagulation,fundus imaging and FFA was repeated.Further laser photocoagulation was immediately added to areas with vessel leakage but missing the photocoagulation.After treatment,the mean follow-up duration was 14.4 months.The follow up focused on neovascularization,exudative lesions,vitreous traction and merging of photocoagulation spots within 3 months,and on fibrosis membrane resulting in macular traction,tractional retinal detachment,vitreous hemorrhage or Coats disease-like retinal exudates after 3 months.Results It was hard to identify the blood vessels based on the color fundus images and some avascular zone maybe missed.Neovascularization can't be determined by shape of the blood vessels.On the other hand,those new blood vessels can be easily recognized by FFA as leakage sites at the boundary of avascular zone.The surgeon could quickly and accurately locate the FEVR area guided by the color fundus images and FFA from same angle under binocular indirect ophthalmoscope.During the treatment,there was no retinal FEVR area missed laser photocoagulation for all patients.There was no neovascularization,exudative lesions,vitreous traction within 3 months,and no fibrosis membrane,tractional retinal detachment,vitreous hemorrhage or Coats disease-like retinal exudates after 3 months.There were no ocular and systemic complications during and after the FFA and laser photocoagulation.Conclusion Wide-field Retcam Ⅲ FFA can help retinal specialists to identify abnormal neovascularization,locate the lesion area,and thus increase the success rate of laser photocoagulation,reduce the ocular and systemic complications for FEVR.
ABSTRACT
The retinal vessel changes are the primary and major features of retinal vascular diseases.The retinal vessel is part of systemic vessels with its own characteristics to sustain normal retinal function.These basic characteristics are important to the correct understanding and proper treatment of retinal vascular diseases.Always keep in mind that the retinal vessels is one part of the systemic vascular system,thus retinal vascular diseases may have systemic etiology,and systemic drug administration may have a profound effects to the whole body.However retinal vascular system also has its own structural and functional characteristics,thus retinal vascular diseases are also different from the systemic diseases.Finally the main function of retinal vascular network is to maintain the neuro-retinal function,thus we should balance the vision protection and treatments against abnormal retinal blood vessels.Over-treatments may damage the retinal vision.
ABSTRACT
Intravitreal injection of antiangiogenic agents is widely used to treat retinal vascular disease.This therapy can induce regression of neovascular vessels; reduce intraocular inflammation and retinal vascular permeability,and control macular edema.However the action period of these agents is short,and thus this therapy need repeated injections which cause higher operation risk and cost.Retinal laser photocoagulation therapy can close retinal capillary non-perfusion area and neovascular vessels,reduce macular edema caused by vascular leakage.However,as its therapeutic effect is based on the destruction of the retinal tissues in the lesion area,this therapy need longer time to show its effects.When the disease is controlled by this method,it may already induce some structural irreversible damages to the retina,especially the macular.This is why the visual acuity is not satisfactory in some patients,even though the disease get controlled,macular edema gets disappeared and anatomical structure of retina get improved.Properly evaluating all the pros and cons of retinal photocoagulation and intravitreal injection of antiangiogenic agents,will allow us to explore a better way to combine these two therapies to treat retinal vascular diseases.