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@#The retinal arterial macroaneurysm, also known as isolated aneurysm, is an acquired retinal vascular abnormality, which is characterized by fusiform or circular dilatation of the posterior polar retinal arteries, forming one or more aneurysms. Most of aneurysms are located on the temporal vessels of the retina. There are no clinical symptoms in the early stage. If the tumor ruptures and hemorrhage involving the macula, may suddenly appear central dark spots and vision loss. The hemorrhage may be located in the vitreous cavity, under the posterior vitreous boundary membrane, under the retinal inner boundary membrane, and subretinal region. Treatments for RAM include retinal laser photocoagulation, vitrectomy, intravitreal or intraretinal injection of tissue plasminogen activator, and anti-VEGF agent. In this paper, the latest research progress in the treatment of RAM is discussed and prospected.
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@#AIM:To evaluate the long-term efficacy and safety of retinal photocoagulation combined with intravitreal injection of Ranibizumab(IVR)and simple Ranibizumab in the treatment of branch retinal vein occlusion secondary macular edema(BRVO-ME).<p>METHODS: The literatures related to randomized controlled clinical studies on the treatment of BRVO-ME with laser and Ranibizumab in Embase, The Cochrane Library, PubMed, China National Knowledge Infrastructure(CNKI), Wanfang Database and China Science and Technology Journal Database(VIP)were systematically retrieved, and the risk assessment was carried out and data indicators were extracted for the included studies. RevMan 5.3 software was used for data analysis and funnel plot was used to evaluate publication bias.<p>RESULTS: Totally 7 studies were included, with 641 eyes. There was no significant difference in the best corrected visual acuity(BCVA)between the laser combined with Ranibizumab group and the simple Ranibizumab group at 12mo \ and 24mo \ after treatment. There was no significant difference in central foveal thickness between the two groups at 12mo \ and 24mo \. There were no statistically significant differences in the injection times of Ranibizumab and the incidence of final adverse events between the two groups at 12mo and 24mo after treatment.<p>CONCLUSION: Compared with the treatment of BRVO-ME with simple Ranibizumab, there was no significant difference in the long-term efficacy of vision and central foveal thickness for the laser combined with Ranibizumab, and there was no significant difference in the injection times and safety of Ranibizumab.
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@#AIM: To explore the influencing factors and coping strategies of adverse reaction after retinal laser photocoagulation.<p>METHODS: Retrospective analysis of 1 165 cases of adverse reactions in patients with retinal laser photocoagulation in our hospital.<p>RESULTS: The present study included 50 patients with adverse reactions in 1 165 patients(4.29%), including 13 patients with nausea and vomiting(1.12%), 21 patients with dizziness, chest tightness, cold sweat(1.80%), 4 cases with yawning and drowsiness(0.34%), 12 cases with syncope(1.03%), and no death. There was no difference in the incidence of adverse reactions between men and women(3.68% <i>vs</i> 5.14%, χ2=1.474, <i>P</i>=0.225); there was a difference in the incidence of adverse reactions among patients of different ages(χ2=48.817, <i>P</i><0.05)and under 40. The incidence of adverse reactions was higher than that of patients aged 40 and older, and the incidence of adverse reactions in men under 40 was significantly lower than that in women(8.46% <i>vs</i> 18.60%, χ2=6.094, <i>P</i>=0.014). The adverse reactions of patients with different fundus diseases were different.<p>CONCLUSION: The incidence and degree of postoperative adverse reactions in patients with fundus diseases treated by retinal laser photocoagulation are different, so we should understand the history and mental state of the patients in detail before operation, and prepare the patients with high risk factors and possible serious reactions in time to ensure the safety of the patients.
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@#AIM: To investigate the prognostic factors associated with panretinal laser photocoagulation in patients with diabetic retinopathy(DR).<p>METHODS: Totally 182 patients(301 eyes)with DR from September 2015 to September 2017 in our hospital were collected. Preoperative automatic biochemical analyzer was used to examine blood biochemical indicators. According to the stage of disease, different treatments were given. Patients with early proliferative DR were underwent standard panretinal photocoagulation and suprahepatic retinal photocoagulation at high-risk. After 6mo follow-up of patients, record the prognosis of patients, screening for changes in visual acuity related factors.<p>RESULTS: Multivariate Logistic regression analysis showed that age, visual acuity at first visit, low density lipoprotein cholesterol, total cholesterol, triglyceride, high density lipoprotein cholesterol, glycosylated hemoglobin, severity of macular edema, hypertension and prognosis were correlated(<i>P</i><0.05).<p>CONCLUSION: Hypertension, age, hyperlipidemia, poor initial vision, high level of glycosylated hemoglobin and severe macular edema have some effects on the prognosis of DR patients after laser photocoagulation.
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@#AIM: To investigate the changes of retinal nerve fiber layer(RNFL)thickness in patients with diabetic retinopathy(DR)after 1a of panretinal photocoagulation(PRP)treatment. <p>METHODS: A total of 92 patients(92 eyes)with DR who underwent PRP in our hospital from May 2014 to June 2017 were enrolled. The DISC CIRCLE procedure of OCT was used to measure the preoperative and one-year postoperative RNFL of patients with DR in the range of 3.45mm diameter around the optic disc, using Follow-Up program automatic tracking mode. The statistical analysis was conducted according to the values obtained in the four quadrant(superior, nasal, temple and inferior). <p>RESULTS: The average RNFL thickness around optic disc of the patients with DR after 1a of PRP was significantly thinner than the preoperative, the difference was statistically significant(<i>P</i><0.05). <p>CONCLUSION: PRP treatment can lead to thinning of RNFL in the retina, which should given full attention and consideration the damage of RNFL in clinical practice. The function of protecting retinal nerve cells is of great significance for DR treatment.
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· AIM:To analyze the clinical effect of intravitreal injection of Conbercept combined with retinal laser photocoagulation in the treatment of patients with diabetic macular edema (DME).· METHODS:Totally 73 patients (80 eyes) with type 2 diabetes and DME were enrolled in our hospital from June 2015 to December 2016,according to different treatment methods,and they were randomly divided into control group and treatment group.The control group were treated with retinal laser photocoagulation,and the treatment group were treated with intravitreal injection combined with laser photocoagulation.We observed the best corrected visual acuity (BCVA),retinal thickness and complications during the operation before treatment and 3mo after treatment.· RESULTS:At 3mo after treatment,the improvement of BCVA,the decreased value of average retinal thickness and retinal thickness at inferior,superior,temple and nasal in the treatment group were better than those in the control group and those after treatment was better than before(P＜ 0.05).There was no statistically significant difference in the incidence of complications occurrence between the two groups (P＞0.05).None of the patients had severe ocular complications such as corneal edema,anterior chamber inflammatory reaction,retinal hemorrhage,neonatal vascular glaucoma,endophthalmitis,etc.during follow up period.· CONCLUSION:Compared with applying laser photocoagulation alone,intravitreal injection of conbercept combined for DME is more effective with improved visual acuity,restored retinal function,and has good safety.
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AIM: To evaluate the efficacy of intravitreal Conbercept combined with retinal photocoagulation in treating diabetic retinopathy (DR) with diabetic macular edema (DME). METHODS: Prospective case study. Totally 48 patients (80 eyes) diagnosed as DR with DME randomized to combined group and laser group. Among them, there were 4 patients with 5 eyes in the moderate stage of non-proliferative DR (NPDR), 38 patients with 65 eyes in the severe stage of NPDR, and 6 cases with 10 eyes in the stage of proliferative DR (PDR). Intravitreal conbercept (IVC) and pan retinal photocoagulation (PRP) were performed in the combined group; the macular grid pattern laser photocoagulation and PRP were performed in the laser group. Best corrected visual acuity (BCVA), central macular thickness (CMT) and laser energy were tested at baseline and repeated at 1wk,1,3,6,and 12mo after PRP. RESULTS: Repeated measures showed an effect of treatment in combined group. Combined group induced increased BCVA at 1wk, 1 and 3mo after PRP, and remained stable in 6 and 12mo after PRP. Laser group induced increased BCVA at 1 and 3mo after PRP, and remained stable in 1wk,6 and 12mo after PRP. Combined group induced decreased CMT at 1wk, 1 and 3mo post PRP,and remained stable in 6 and 12mo after PRP. Laser group induced decreased CMT at 1 and 3mo after PRP, and remained stable in 1wk,6 and 12mo post PRP. There was no laser spot fusion was observed in the two groups during the follow- up. Laser energy in the combined group was lower than that in the laser group. No complications were observed during the follow-up. CONCLUSION: IVC and retinal photocoagulation significantly improves visual and anatomic outcomes in patients with DR complicated with DME. Long - term efficacy remains to be seen.
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@#AIM: To observe the clinical outcome of non-vascularization area after laser photocoagulation in the patients with retinopathy of prematurity(ROP)to lay the foundation for the clinical treatment of ROP. <p>METHODS: For a prospective follow-up observation from June 2014 to June 2016, 186 cases(372 eyes)underwent retinal laser photocoagulation were screened out in the ROP screening clinic and neonatal intensive care unit(NICU)bedside screening by the cooperative group of screening for ROP in our hospital. Non-vascularization area were exist in 26 cases(32 eyes). There were 17 male patients(18 eyes)and 9 females(14 eyes), the gestational age at birth was 29.4±0.4wk, and the average birth weight was 1222.8±70.3g. Among these cases, 10 patients(12 eyes)developed pre-threshold type 1 ROP, 12 patients(14 eyes)developed threshold ROP, and 4 cases(6 eyes)developed aggressive posterior-ROP. The Retcam fundus photography was performed at 1, 3, 8 and 12wk after laser surgery respectively. The changes of the non-vascularization area, the lesions and the additional lesions were observed. During following-up, if the lesions were found to increase, retinal laser photocoagulation or intravitreal injection of anti- vascular endothelial growth factor(VEGF)would be performed, until the lesions were completely under control. <p>RESULTS: In the all 26 patients, non-vascularization areas were found in 1wk after laser resection, but the lesions ridge dissipated from the stage 3 to stage 2 and stage 1. The dissipation were more obviously in patients with ROP of pre-threshold type 1. The range of non-vascularization areas was narrowed at 3wk in 27 eyes(84%), and the retinal vessels continued to develop to the surrounding areas,but in the other 5 eyes(16%),the non-vascularization areas were not significantly narrowed, the lesion ridge developed stage 3-4, with bleeding and proliferation phenomenon, then we timely to gave additional retinal laser photocoagulation. In these 5 eyes, 3(9%)developed threshold ROP, and 2 developed aggressive posterior-ROP. At the 8th week, 3 eyes(9%)of the 5 eyes were found with additional photocoagulation, the condition was controlled and stable. In 2 eyes(6%), the neovascularization disappeared in the ridge and the lesion was not found, then intravitreal injection of anti-VEGF were given. At the 12th week, the additional lesions in the 2 eyes had subsided, the ridge subsided, and the retinal blood vessels to the temporal shaped slightly stiff.<p>CONCLUSION: Retinal laser photocoagulation is an effective method for the treatment of retinopathy in premature infants. Most retinal blood vessels would develope in missing areas after the laser photocoagulation. A small proportion of patients need timely replenishment of laser photocoagulation treatment, if necessary, combined with intravitreal injection of anti-VEGF.
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AIM: To explored the treatment effects of retinal laser photocoagulation and the applications of color Doppler flow imaging(CDFI) in the diabetic retinopathy.METHODS: We collected 60 patients(120 eyes) with diabetic retinopathy(Ⅲ~Ⅳstage) from February 2013 to February 2014 in Anyang Eye Hospital admitted in fundus disease department.The health control (HC) group of 55 normal people was established simultaneously.Ocular blood flow velocity of the 55 normal people (110 eyes) and the 60 patients (120 eyes) was examined by CDFI of central retinal artery (CRA) and posterior ciliary artery (PCAs) using the PHILIPS HD6.Peak systolic velocity(PSV) was recorded.The examinations of CDFI, electroretinogram(ERG) and the vision were performed in pre-operation, 1,7d, 1, 3 and 6mo postoperatively.RESULTS: Compared the PSV of CRA of the DR group before and after photocoagulation to the data of the HC group, there was a significant difference(P0.05).Compared the aA and bA of ERG of the DR group before and after photocoagulation to the data of the HC group, there was a significant difference(P0.05).The vision of 49 cases(98 eyes) was improved 1 to 3 rows, the effective rate was 82%.The vision of 11 cases(22 eyes) remained constant.CONCLUSION: Retinal laser photocoagulation is an effective treatment to diabetic retinopathy patients, which can significantly reduce the peak systolic velocity of the central retinal artery, improve and stabilize the condition, protect visual function in long-term clinical effect.Color doppler flow imaging can observe the changes of ocular vessel flow velocity in diabetic` eyes noninvasively, repeatedly and in real time, providing a basis for clinical treatments.
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RESUMO Objetivo: Comparar a efetividade da dipirona versus o ibuprofeno para a redução da dor na fotocoagulação da retina (FR). Método: Foi realizado um estudo controlado, duplo cego e randomizado englobando trinta e quatro pacientes com retinopatia diabética separados em dois grupos. Grupo A recebeu 1000mg de dipirona e o grupo B recebeu 600mg de ibuprofeno. A dor foi avaliada pela escala visual analógica. Resultado: A média do escore da dor nos grupos A e B foi de 5,2 ± 2.6 e 4,5 ± 1,4, respectivamente. Não houve diferença estatística entre os grupos (p=0,34). O mesmo foi observado quanto à analise entre dor leve, moderada e grave (p=0,09). Os grupos foram semelhantes quanto à idade e sexo. Conclusão: Os medicamentos foram equivalentes ou equipotentes em reduzir a dor ocular durante a fotocoagulação a laser da retina.
ABSTRACT Objective: To compare the effectiveness of metamizole versus ibuprofen for the reduction of pain in retinal photocoagulation (RP). Method: A double-masked randomized controlled study was performed. Thirty-four patients with diabetic retinopathy were enrolled. The patients were randomized into two groups. Group A received oral 1000 mg metamizole. Group B received an oral intake of 600 mg ibuprofen. Pain during RP was assessed using a visual analog scale. Results: The mean pain scores for groups A and B were 5.2±2.6 and 4.5±1.4 (p=0.34). There were no significant differences in the mean pain scores between the two groups. The same is observed when analyzing by low, medium and high pain (p=0.09). The groups were similar in age and gender. Conclusion: Both drugs were equivalents or equipotent in reduce ocular pain during retinal photocoagulation.
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Humans , Male , Female , Dipyrone/therapeutic use , Ibuprofen/therapeutic use , Laser Coagulation/methods , Diabetic Retinopathy/surgery , Analgesia , Pain, Postoperative/prevention & control , Pain, Postoperative/drug therapy , Pain Measurement , Double-Blind Method , Prospective Studies , Eye Pain/prevention & control , Eye Pain/drug therapyABSTRACT
El desprendimiento de retina (DR) produce pérdida visual. El desgarro en herradura (DH) es la lesión retiniana mayormente asociada a los desprendimientos de retina y aparece con frecuencia en población. La fotocoagulación focal láser (FCF) de desgarros reduce el riesgo de presentar desprendimiento de retina, por tanto se debería realizar este tratamiento a las lesiones retinianas.
Retinal detachment produces visual loss. Horseshoe retinal tears is directly associated with retinal detachment and it is usually found in general population. Retinal laser photocoagulation signifi cantly reduces the incidence of retinal detachment.