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AIM: To investigate the changes and correlation of retinal nerve fiber layer(RNFL)and macular retinal thickness in children with anisometropic amblyopia.METHODS: A total of 159 cases(159 eyes)children with anisometropic amblyopia treated in our ophthalmology department from October 2020 to June 2021 were selected as the study group, and 159 cases(159 eyes)children with normal vision who examined in the ophthalmology department of our hospital in the same period and age group were selected as the control group. The study group received traditional comprehensive training combined with 4D visual training for amblyopia based on refractive correction and covering of healthy eyes. The RNFL and macular retinal thickness before and after treatment between the study group and the control group was compared, and the correlation between RNFL and macular retinal thickness before treatment in the study group was analyzed.RESULTS: The RNFL thickness of average, upper, lower, nasal and temporal in the study group before and after 3mo of treatment was higher than those of the control group, and the RNFL thickness of average, upper, lower, nasal and temporal before treatment in the study group was higher than those after 3mo of treatment(P<0.05). The average, inferior, nasal, temporal, nasal, and central retinal thickness of the outer ring of the macular area in the study group before treatment were higher than those in the same group after 3mo of treatment and the control group(P<0.05). Before treatment, there was a negative correlation between the thickness of the upper RNFL in the study group and the retinal thickness in the central macular area(r=-0.330, P<0.05), the thickness of the lower and nasal RNFL was positively correlated with the thickness of the temporal retina in the outer and inner rings of the macular area(all P<0.05), while the thickness of temporal RNFL was negatively correlated with the thickness of the nasal and temporal retina outside the macular area(r=-0.414, -0.462, all P<0.05).CONCLUSION: The changes in RNFL and macular retinal thickness in children with anisometropic amblyopia can hinder normal retinal development, and there is a certain correlation between RNFL and macular retinal thickness.
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AIM: To investigate the changes in retinal nerve fiber layer(RNFL)and macular retinal thickness(MRT)in children with refractive abnormalities and amblyopia, and their predictive value of outcome.METHODS: A total of 168 children with myopic refractive abnormalities and monocular amblyopia admitted to our hospital from January 2020 to October 2022 were selected as the observation group, with 118 cases of mild to moderate amblyopia and 50 cases of severe amblyopia, and 168 children with normal vision were included as the control group in a 1:1 ratio during the same period. The changes of RNFL and MRT in two groups of children were statistically counted, and the correlation between the severity of refractive abnormalities and RNFL and MRT in children with amblyopia was analyzed. Additionally, the observation group was divided into effective subgroup and ineffective subgroup based on the therapeutic effect. The general information, as well as RNFL and MRT of the effective subgroup and the ineffective subgroups before and after treatment were compared. Logistic was used to analyze the factors influencing efficacy, and ROC curves was plotted to analyze the predictive value of RNFL and MRT alone or in combination for efficacy.RESULTS: RNFL and MRT of cases of severe amblyopia were higher than those of the mild to moderate amblyopia and the control groups(all P<0.05); the severity of amblyopia in children with refractive abnormalities is positively correlated with RNFL and MRT(rs=0.745 and0.724, both P<0.001); among patients of mild to moderate and severe, there were statistically significant differences between the effective and ineffective subgroups in terms of initial treatment age, fixation form, treatment compliance, as well as RNFL, MRT, and their differences before and 1mo postoperatively(all P<0.05). Logistic analysis showed that initial treatment age, fixation nature, treatment compliance, RNFL and MRT before and 1mo postoperatively were all factors influencing the therapeutic effect of amblyopia with refractive abnormalities in children(all P<0.05); after 1mo of treatment, the combined prediction of RNFL and MRT was significantly better than that of single prediction in children with mild to severe amblyopia.CONCLUSION:There are differences in RNFL and MRT in children with abnormal refractive amblyopia, and they are closely related to the different degrees and curative effects of children. The combination of RNFL and MRT after 1mo of treatment has certain value in predicting children with different degrees of abnormal refractive amblyopia.
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Objective:To observe and analyze the superficial retinal blood flow density and its related influencing factors in the macular area of adolescents with different types of non-pathological high myopia (HM).Methods:A retrospective clinical study. From March to August 2022, 117 eyes of 117 adolescents who were admitted to Liaocheng Aier Eye Hospital due to myopia were included in the study. According to equivalent spherical degree (SE) and corneal curvature, subjects were divided into mild myopia or emmetropia group (control group), HM group, occult HM (OHM) group, and super HM (SHM) group, with 30 eyes, 28 eyes, 35 eyes, and 24 eyes, respectively. All subjects underwent medical optometry, intraocular pressure, optical coherence tomography (OCT), OCT angiography (OCTA), axial length (AL) and corneal curvature measurements. The diopter was SE. OCTA instrument was used to scan the macular region in the range of 6 mm×6 mm, and the software automatically divided it into three concentric circles centered on the fovea of the macular, namely, the central area with a diameter of 1 mm, the inner ring area with a diameter of 1-3 mm, and the outer ring area with a diameter of 3-6 mm. The superficial retinal vascular density (SRVD), vascular perfusion density (SBPD), the area, perimeter (PERIM), avascular index (AI) of foveal avascular area (FAZ) and retinal thickness were measured in the macular region as a whole and in different regions. One-way analysis of variance was used to compare the data among groups, and the least significant difference t-test was used to compare the data among groups. The correlation of AL, corneal curvature and intraocular pressure with SRVD and SBPD in macula was analyzed by Pearson correlation analysis. Results:There were significant differences in SRVD and SBPD in the central, inner and outer regions of macula in control group, HM group, OHM group and SHM group ( P<0.05). There were statistically significant differences in the thickness of the retina above, below and on the temporal side of the central and outer ring regions ( P<0.05). However, no statistically significant difference was in the thickness of the retina on the nasal side ( P>0.05). There was no significant difference in PERIM ( P>0.05). There were significant differences in FAZ area and AI ( P<0.05). Correlation analysis showed that AL was negatively correlated with SRVD and SBPD in macular whole and central, inner and outer ring regions ( P <0.05). Corneal curvature and SE were positively correlated with the SRVD and SBPD of macular whole, central area and outer ring area ( P<0.05). AL was negatively correlated with retinal thickness in the outer ring region ( P<0.05). SE was positively correlated with the thickness of the retina above, below and temporally in the outer ring region ( P<0.05). AL was negatively correlated with FAZ area and AI ( P<0.05). SE was positively correlated with FAZ area and PERIM ( P<0.05). Retinal thickness was positively correlated with SRVD and SBPD ( P<0.05). Conclusions:The SRVD and SBPD of different types of HM in adolescents decreases to different degrees. The thickness of the retina in the central region is thicker, and the retina in the outer ring region is thinner. With the decrease of SRVD, the retinal thickness gradually is thinner.
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AIM:To evaluate the efficacy of intravitreal dexamethasone implant(DEX-I)in the treatment of different types of macular edema secondary to retinal vein occlusion(RVO).METHODS:A retrospective observational case study was conducted. A total of 46 patients(46 eyes)who were diagnosed with RVO-macular edema(ME)and received DEX-I of 0.7 mg as the initial treatment in Dalian No.3 People's Hospital from July 2019 to June 2020 were collected. According to the morphological characteristics of optical coherence tomography(OCT), they were divided into diffuse retinal thickening type(DRT type, 13 patients, 13 eyes), cystoid macular edema type(CME type, 22 patients, 22 eyes )and serous retinal detachment type(SRD type, 11 patients, 11 eyes ). The best corrected visual acuity(BCVA)and central retinal thickness(CRT)of patients with three types of macular edema were observed and compared before treatment and 1, 2 and 3mo after treatment.RESULTS:Compared with before treatment, BCVA of patients with DRT, CME and SRD were significantly improved at 1, 2 and 3mo after treatment, and CRT was significantly decreased(all P<0.017). At 3mo after treatment, BCVA(0.21±0.12, 0.22±0.10LogMAR)of DRT and SRD patients was significantly better than that of CME(0.45±0.14LogMAR, both P<0.017), and CRT(254.08±49.07, 248.92±44.19μm)was significantly lower than that of CME(314.70±92.66 μm, both P<0.017).CONCLUSIONS: DEX-I is effective in the treatment of various OCT types of macular edema secondary to RVO, and the treatment response of CME type is worse than that of DRT and SRD types.
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AIM: To compare the efficacy and safety of intravitreal injection of aflibercept combined with posterior sub-fascial injection of triamcinolone acetonide in the treatment of wet age-related macular degeneration(ARMD)with poor response to anti-vascular endothelial growth factor drugs.METHODS: Retrospective cohort study. From June 2018 to May 2020, a total of 60 patients(60 eyes)with refractory ARMD who had poor response to the treatment of anti VEGF drug ranibizumab were randomly divided into the control group of aflibercept and the observation group of triamcinolone acetonide combined with aflibercept, with 30 patients(30 eyes)in each group. Once a month, the patients in the two groups received intravitreal injection of aflibercept alone or intravitreal injection of aflibercept combined with posterior sub-fascial injection of triamcinolone acetonide for three consecutive times. The changes of best corrected visual acuity(BCVA), central macular thickness(CMT)and intraocular pressure were reviewed before injection and 1, 3 and 6mo after the third injection.RESULTS: The BCVA and CMT of the two groups were significantly improved 1, 3 and 6mo after the injection of the drug(P<0.05). The mean intraocular pressure in the combined group was higher at 1mo after treatment than before, but it still within the normal range. There was a significant difference in intraocular pressure between the two groups(17.50±4.60 vs. 18.30±3.73mmHg, P<0.05).CONCLUSION: Triamcinolone acetonide injection under the posterior fascia of the eyeball combined with intravitreal injection of aflibercept in the treatment of wet ARMD can effectively reduce macular edema and improve vision, which is more safe and reliable.
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Purpose: To study the retinal and choroidal thickness variations on enhanced depth imaging optical coherence tomography scans in ocular albinism (OA) and compare with age?matched healthy subjects. Methods: This retrospective observational study had 48 eyes of 24 patients diagnosed clinically as OA and age, sex, and axial length?matched control healthy subjects. All patients underwent detailed ophthalmic examination and a single?line horizontal?raster enhanced depth imaging – optical coherence tomography scan (Spectralis, Heidelberg Engineering). Retinal and choroidal thickness was measured, compared, and analyzed between the two groups. Mann–Whitney U test was used for analysis between the two groups. P < 0.05 was considered significant. Results: The mean age was 28.3 ± 11.6 and 29.9 ± 10.6 years in the OA group and control group, respectively. Spherical equivalents ranged from ?8.5D to +10.5D in the OA group and from ?8.0D to +10.0D in the control group. The mean axial length between the two groups (P = 0.652) were comparable. The average retinal thickness (272 ± 34.3 vs. 213 ± 13.8 ?m; P < 0.001) was greater in the OA group as compared to controls. The mean choroidal thickness (184 ± 78.4 vs. 287 ± 46.4 ?m; P < 0.001) was significantly thinner in the OA group. Conclusion: Acquisition of OCT scans in OA can be challenging. This study showed that the subfoveal retinal thickness and choroidal thickness measured across the scans were significantly different in the OA group compared to controls. In the future, more studies are required to evaluate the role of the choroid and its relationship to emmetropization in albinism.
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Objective:To compare the efficacy and safety of intravitreal injection of anti-vascular endothelial growth factor drug conbercept and intravitreal dexamethasone implant Ozurdex in the treatment of diabetic macular edema (DME).Methods:A randomized controlled clinical study was performed.Thirty-six DME patients (36 eyes) were enrolled in Weifang Eye Hospital from March 2018 to June 2019.The patients were randomized into Ozurdex group and conbercept group via a random number table, with 18 eyes in each group.Patients received Ozurdex injection once, which was maintained for 6 months, or conbercept injection once a month for 3 times according to grouping.Before and after treatment, the best corrected visual acuity (BCVA) was examined with the International Standard Visual acuity chart and converted to logarithm of minimal angle resolution unit.The intraocular pressure (IOP) was measured using a non-contact tonometer.The central retinal thickness (CRT) was detected by optical coherence tomography (OCT).This study followed the Declaration of Helsinki and was approved by the Ethics Committee of Weifang Eye Hospital.Results:All patients were followed up for 6 months.In Ozurdex group, the BCVA pre-injection and at 1 month, 3, 4, 6 months after the first injection was 0.59±0.22, 0.53±0.20, 0.41±0.16, 0.38±0.19 and 0.56±0.19, respectively.The BCVA at 1 month, 3 and 4 months after the first injection were better than that before injection, and the differences were statistically significant (all at P<0.05).In conbercept group, the BCVA pre-injection and at 1 month, 3, 4, 6 months after the first injection were 0.60±0.23, 0.51±0.17, 0.29±0.13, 0.56±0.18 and 0.60±0.18, respectively.The BCVA at 1 month and 3 months after the first injection were better than that before injection, showing statistically significant differences (all at P<0.05).The CRT at 1 month, 3 and 4 months after the first injection were significantly lower than that before treatment in both the two groups (all at P<0.05).The CRT pre-injection was (498.61±77.14)μm in Ozurdex group, which was significantly higher than (462.17±48.74)μm at 6 months after the first injection ( P<0.05).No significant difference in CRT was found between pre-injection and 6 months after the first injection in conbercept group ( P>0.05).The incidence of high IOP in Ozurdex group was 33.3%(6/18), which was higher than 5.56%(1/18) in conbercept group, with a significant difference ( χ2=4.433, P=0.035).No adverse effects such as aggravation of cataract, lens injury, endophthalmitis, vitreous hemorrhage and retinal detachment was found during the follow-up. Conclusions:For DME, both conbercept and Ozurdex can improve BCVA and reduce CRT.Ozurdex shows durable efficacy and needs fewer injections than conbercept, but conbercept has less effect on IOP and is safer than Ozurdex.
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@#AIM: To discuss the measurement of retinal thickness in each macular region, fixation property, best corrected visual acuity(BCVA), eye axis and equivalent spherical power and treatment time for the children with hyperopia anisometropic amblyopia before and after treatment.<p>METHODS: This study was a prospective longitudinal controlled trial. The subjects were 40 hyperopia anisometropia children aged 4-8 years with monocular amblyopia who had not been treated with amblyopia before diagnosis in our hospital(20 cases of central fixation and 20 cases of paracentral fixation)from August 2018 to August 2019. Atropine mydriatic optometry, fundus macular fixation quality, ocular axis and optical coherence tomography(OCT)retinal thickness were used in the initial diagnosis and 6mo and 1a follow-up. Statistical analysis was used to analyze whether the macular retinal thickness of hyperopia amblyopia had changed in the treatment and the related factors, and whether had differences between different fixation properties.<p>RESULTS: There were significant differences in foveal retinal thickness and nasal retinal thickness of inner ring between central fixation group and paracentral fixation group at different measurement times(before treatment, 6 and 12mo after treatment)(<i>P</i><0.01). There were no significant changes in the other retinas in macular area(<i>P</i> >0.05). With the extension of treatment time, the foveal retinal thickness and the nasal retinal thickness of the inner ring in the central fixation group and the paracentral fixation group became thinner(all <i>P</i><0.05). At the same measurement time, the thickness of fovea and inner ring nasal retina in the central fixation group was thinner than that in the paracentral fixation group(all <i>P</i><0.05), and there were no significant differences in the thickness of other retinas in the macular region(all <i>P</i>>0.05). There were significant differences in ocular axis, BCVA and equivalent spherical power of amblyopia before and after treatment(all <i>P</i><0.05); With the extension of treatment time, the length of ocular axis and BCVA had increased and the degree of equivalent spherical mirror had decreased. The macular retinal thickness of hyperopia amblyopia was thicker than that of contralateral normal eyes, and the length of ocular axis was shorter than that of contralateral normal eyes(all <i>P</i><0.01). The axial length of amblyopia and normal eyes had changed significantly before and after treatment(all <i>P</i><0.01). The axial length of amblyopia was shorter than that of normal eyes. With the extension of treatment time, the axial length of amblyopia and normal eyes had become longer.<p>CONCLUSION:The thickness of macular retina in moderate and high amblyopic eyes was greater than that in contralateral normal eyes, and the ocular axis was shorter than that in contralateral normal eyes. After treatment, with the improvement of best corrected visual acuity, the retinal thickness of fovea and nasal side of inner ring in central fixation group and paracentral fixation group had decreased.
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Objective:To observe and analyze the changes of macular retinal thickness and related factors in children with occult myopia.Methods:A prospective longitudinal control study. From February 2021 to February 2022, 120 eyes of 60 children who first visited Department of Ophthalmology of The Affiliated Hospital of Chengde Medical College without any corresponding myopia correction treatment were included in the study. There were 32 males (64 eyes) and 28 females (56 eyes), with the age of 4-6 years. Visual acuity, medical optometry, corneal topography, spectral-domain optical coherence tomography (OCT) and axial length (AL) were measured at the first visit and 3, 6, 9 and 12 months. The children were divided into occult myopia group with 60 eyes of 30 cases and control group with 60 eyes of 30 cases according to visual acuity, equivalent spherical refraction (SE), AL and corneal curvature (CC). The macular fovea retinal thickness was measured by spectral-domain OCT enhanced deep imaging technique. According to the treatment and study of diabetic retinopathy, the retina within the 6 mm of the macular center was divided into three concentric circles with the macular fovea as the center, the central fovea of 1 mm, the inner ring of 1-3 mm and the outer ring of 3-6 mm. In the inner ring and outer ring, the retina was divided into 4 areas, upper and lower, left and right, with a total of 9 regions. The four regions of the inner ring and the outer ring were superior, inferior, nasal and temporal, respectively. The differences of AL, CC, SE, macular retinal thickness and the changes of related factors with time were compared between the occult myopia group and the control group. SE, AL, CC and retinal thickness in different macular regions of the two groups were compared by repeated measurement analysis of variance. In pairwise comparison, the minimum significant difference t test was used in different measurement time points, and the independent sample t test was used between groups at the same measurement time points. Results:At first diagnosis and after diagnosis, there were significant differences in SE ( F=783.710), AL ( F=742.192), macular fovea ( F=330.292), inferior and temporal ( F=158.250, 108.292) side of the outer ring retinal thickness in occult myopia group ( P <0.01). In the control group, there were significant differences in the retinal thickness of SE ( F=1 793.976), AL ( F=457.362), macular fovea ( F=31.029), inferior and temporal ( F=7.405, 77.245) side of the outer ring retinal thickness ( P<0.01). In both groups, with the prolongation of the time after the first diagnosis, the SE gradually increased, the AL gradually lengthened, and the thickness of the macular fovea, inferior and temporal side of the outer ring retinal thickness gradually thinned. Independent sample t test was performed on the data with differences between groups at the same time, and the results showed that at 3, 6, 9 and 12 months after first diagnosis, there were significant differences in SE, AL and CC between the occult myopia group and the control group ( t=-4.801,-11.532, 16.276, -17.145), AL ( t=24.203, 26.353, 27.057, 25.552); CC ( t=-23.362, -25.382, -25.890, -24.350; P<0.01). There were significant differences in macular fovea, inferior and temporal side of the outer ring retinal thickness at 6, 9 and 12 months, macular fovea ( t=-2.596, -2.542, -2.941; P<0.05), outer ring temporal ( t =-2.285, -2.610, -2.506; P<0.05). Conclusion:The SE and AL of the occult myopia group and the control group increase with time, and the former increase more rapidly than the latter; the macular fovea, inferior and temporal side of the outer ring retinal become thinner, and the former become thinner than the latter.
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AIM: To analyze the effect of conbercept combined with laser photocoagulation on patients with macular edema secondary to branch retinal vein occlusion.METHODS: According to the random number table method, 102 patients(102 eyes)with macular edema secondary to branch retinal vein occlusion who treated in our hospital from January 2019 to June 2021 were divided into observation group and control group. There were 51 patients(51 eyes)in each group. The control group was treated with laser photocoagulation and the observation group was treated with conbercept combined with laser photocoagulation. The macular foveal retinal thickness, best corrected visual acuity and incidence of complications were compared among the patients of two groups.RESULTS: After treatment at 3mo, the retinal thickness of macular fovea in the observation group was lower than that in the control group(P<0.05), the best corrected visual acuity in the observation group was higher than that in the control group(P<0.05). The incidence of complications was not different between the two groups(P>0.05).CONCLUSION:The effect of conbercept combined with laser photocoagulation for macular edema secondary to branch retinal vein occlusion is remarkable to reduce the retinal thickness of macular fovea and improve the vision of patients and the complications did not increase compared with retinal laser photocoagulation therapy alone, which were safe and effective.
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Occult myopia refers to a special type of myopia, which is caused by the axial length beyond the normal range of children's normal age, and the corneal curvature is lower than the normal range of children with the normal age range of the vision. Because the vision of occult myopia children is within the normal range, it is easy to be ignored in myopia screening. Without timely myopia prevention and control, occult myopia is very easy to develop into dominant myopia, not only the visual development is seriously affected, but visual function will also produce irreversible changes. It is found that the axial length, corneal curvature, retina and chorioid of occult myopia are different from those of ordinary myopia. The change of these indicators can be used to assist the diagnosis and observe their development process. The purpose of this paper is to summarize the research progress at home and abroad on ocular axis length, corneal curvature, macular retinal thickness, macular choroidal thickness and other related factors in children with occult myopia, in order to provide references for related clinical research.
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OBJECTIVE@#To observe the effect of acupuncture on visual acuity, intraocular pressure, visual field, retinal and choroidal thickness on optic disc and macular area in patients with optic atrophy.@*METHODS@#A total of 33 patients with optic atrophy were treated with acupuncture. Acupuncture was given at Chengqi (ST 1), Shangjingming (Extra), Qiuhou (EX-HN 7) and Fengchi (GB 20) etc., 30 min each time, once a day, for 14 days. The visual acuity, intraocular pressure, visual field indexes (mean deviation [MD], pattern standard deviation [PSD] and visual field index [VFI]), optic disc retinal nerve fiber layer thickness, macular retinal thickness and choroidal thickness of optic disc and sub-foveal were compared before and after treatment.@*RESULTS@#Compared before treatment, the visual acuity was increased (P<0.05), the MD value was decreased (P<0.05), the thickness of nerve fiber layer on the upper temporal side of optic disc was thinner (P<0.05), and the choroidal thickness of average, nasal side and lower temporal side of optic disc was increased (P<0.05). There was significant correlation between visual field MD and retinal nerve fiber layer thickness in different quadrants before and after treatment (P<0.01).@*CONCLUSION@#Acupuncture could improve visual acuity, increase choroidal thickness in part of optic disc area in patients with optic atrophy.
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Humans , Acupuncture Therapy , Optic Atrophy/therapy , Optic Disk/diagnostic imaging , Retina/diagnostic imaging , Tomography, Optical CoherenceABSTRACT
@#AIM: To explore the efficacy of intravitreal injection of ranibizumab and conbercept in the treatment of exudative age-related macular degeneration(ARMD), and analyze the effects on best corrected visual acuity(BCVA), central retinal thickness(CRT)and complications of patients. METHODS: The clinical data of 60 patients(60 eyes)with exudative ARMD in the hospital between January 2017 and January 2020 were collected for retrospective analysis. According to different treatment drugs, they were divided into intravitreal injection of ranibizumab group(30 eyes)and intravitreal injection of conbercept group(30 eyes). The BCVA, CRT, choroidal neovascularization changes and occurrence of complications were compared between the two groups before treatment and 1, 2 and 3mo after treatment. RESULTS: After 1, 2 and 3mo treatment, the BCVA(LogMAR)of patients in the two groups was better than that before treatment(<i>P</i><0.05). The CRT was lower than that before treatment(<i>P</i><0.05), and the CRT at 1, 2 and 3mo after treatment in intravitreal injection of conbercept group was lower than that in intravitreal injection of ranibizumab group(<i>P</i><0.05). There were no significant differences in the recovery of choroidal neovascularization and the occurrence of complications between the two groups(<i>P</i>>0.05). CONCLUSION: Both intravitreal injection of ranibizumab and conbercept can achieve a good efficacy in the treatment of exudative ARMD, and there was no significant difference in the improvement of visual acuity between them. However, conbercept has obvious advantages in reducing CRT in the treatment of exudative ARMD.
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@#AIM: To explore the long-term efficacy of vitrectomy combined with or without anti-VEGF in the treatment of proliferative diabetic retinopathy(PDR).<p>METHODS: Randomized controlled trials(RCTs)comparing the efficacy of vitrectomy combined with or without anti-VEGF therapy for PDR were retrieved from databases including PUBMED, EMBASE, Cochrane Central Register of Controlled Trials(CENTRAL)and Web of Science. The retrieval time was from the establishment of the databases to July 2020. According to the inclusion and exclusion criteria, the literature was selected, then data extraction and quality evaluation was completed. Primary evaluation measures included postoperative incidence of retinal detachment, central retinal thickness(CRT), and best corrected visual acuity(BCVA). <p>RESULTS: In this article, 11 randomized controlled studies(880 eyes)were included. Meta-analysis results showed that the incidence of retinal detachment after vitrectomy was significantly lower in PDR patients who received anti-VEGF injection before vitrectomy than in patients who did not receive anti-VEGF injection \〖Risk ratio(<i>RR</i>)=0.39, 95% Confidence interval(<i>CI</i>)0.22 to 0.71, <i>P</i>=0.002\〗. There were significant differences in the incidence of retinal detachment after vitrectomy between the anti-VEGF group and the non-VEFG group in both Asian and non-Asian populations(Asian:<i> RR</i>=0.20, 95%<i>CI</i> 0.05 to 0.87, <i>P</i>=0.03; Non-Asian:<i> RR</i>=0.46, 95%<i>CI</i> 0.24 to 0.89, <i>P</i>=0.02). The central retinal thickness of PDR patients who received preoperative anti-VEGF therapy was significantly lower than that of patients who did not receive anti-VEGF therapy 3 and 6mo after PPV(<i>MD</i>=-78.49, 95%<i>CI</i> -94.81 to -62.17, <i>P</i><0.00001. <i>MD</i>= -39.62, 95%<i>CI</i> -48.44 to -30.80, <i>P</i><0.00001). The BCVA at 6mo after PPV in PDR patients with preoperative anti-VEGF treatment was better than that in patients without preoperative anti-VEGF treatment(<i>MD</i>=-0.16, 95%<i>CI</i> -0.21 to -0.10, <i>P</i><0.00001).<p>CONCLUSION: Anti-VEGF injection before PPV can effectively reduce the incidence of retinal detachment, alleviate postoperative macular edema, reduce the central retinal thickness, and improve BCVA in PDR patients.
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@#AIM: To observe and compare the changes of macular vascular density and retinal thickness in children and adolescents with different degrees using optical coherence tomography angiography(OCTA), then analyze their correlation.<p>METHODS: Our prospective cross-sectional study included 230 eyes of 115 children and adolescents aged 6-18a. According to spherical equivalent power(SE), they were divided into four groups: emmetropia group(32 eyes of 16 cases), mild myopia group(94 eyes of 47 cases), moderate myopia group(68 eyes of 34 cases), and high myopia group(36 eyes of 18 cases). Using RTVue XR scans of the 6mm×6mm region of the macula, the system automatically divided it into three rings: 1mm(fovea)ring, 1mm-3mm(parafovea)ring, and 3mm-6mm(perifovea)ring. And each ring was further divided into four quadrants: temporal(T), superior(S), nasal(N), and inferior(I). Quantitatively analysis was performed for the superficial and deep capillary densities and retinal thickness of each sector.<p>RESULTS: The superficial capillary density in the macula was in turn significantly decreased as in emmetropia(44.4±3.5)%, mild myopia(44.8±3.8)%, moderate myopia(44.3±3.8)%, and high myopia(42.6±4.5)% groups(<i>F</i>=2.963,<i>P</i>=0.033). The superficial capillary density of parafovea's temporal side were(46.1±3.5)%,(46.8±5.1)%,(46.2±4.3)%, and(43.8±5.5)% in the four groups, respectively(<i>F</i>=3.436, <i>P</i>=0.018). Similarly, the deep capillary density of the four groups was(49.9±4.1)%,(48.4±4.7)%,(47.9±5.5)%, and(45.3±4.7)%, respectively(<i>F</i>=4.806, <i>P</i>=0.003). The deep capillary density of the perifovea was(49±4.4)%,(47.2±5.2)%,(46.6±6)%, and(43.6±5.1)% in the 4 groups, respectively(<i>F</i>=5.495, <i>P</i>=0.001). The retinal thickness of the four groups was 293.9±12.9, 295.5±13.0, 290.9±12.0, and 284.5±10.7 μm(<i>F</i>=6.606, <i>P</i><0.001). The superficial capillary densities of parafoveal's temporal and nasal sides were positively correlated with SE(<i>r</i>=0.221, 0.219, <i>P</i>=0.001, 0.001). The deep capillary density of perifovea's temporal, superior, nasal and inferior side were positively correlated with SE(<i>r</i>=0.172, 0.200, 0.250, 0.296, <i>P</i>=0.011, 0.003, <0.001, <0.001). The central retinal thickness except the fovea were positively correlated with SE(<i>P</i><0.05).<p>CONCLUSION: With the increase of myopia degree of children and adolescents, the superficial capillaries density in the macula decreases, especially in the parafovea's temporal side; as well as the deep capillaries density, especially decreases in the perifovea. The central retinal thickness decreases in both parafovea and perifovea. With the myopia degree of children and adolescents increases, the structure and capillary circulation of the macula will be influenced, especially in the high myopia group.
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@#Amblyopia is a common eye disease in children. If not corrected and treated in time, it will cause irreversible damage to children's vision, resulting in loss of vision in one or both eyes. The pathogenesis of amblyopia is complex, and the specific pathogenesis is not clear at present, mainly focusing on the central theory and peripheral theory. Traditionally, there was no obvious organic change in the fundus of amblyopia patients. In recent years, optical coherence tomography(OCT)technology has developed rapidly. As a convenient and intuitive ophthalmic examination method, OCT has been increasingly used in retinal examination of amblyopia patients due to its advantages of safety, non-invasive, non-contact and rapid and clear. The abnormal anatomy structures of the amblyopia patients in fundus structure are also gradually been found. Providing some evidence and basis for peripheral theory of pathogenesis of amblyopia, amblyopia examine, postoperative evaluation and prognosis. In this article, the applications of OCT in retinal thickness, choroid thickness and vessel density are reviewed.
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@#AIM: To investigate the effect of modified Zhujing pill on retinal thickness and apoptosis in form deprivation myopia(FDM)mice.<p>METHODS: Totally 72 C57BL/6J mice aged 3-week-old were randomly divided into control group 1, model group 1, intervention group 1, control group 2, model group 2 and intervention group 2, with 12 mice in each group. The first three groups were tested for 3wk and the last three groups were tested for 6wk, except for the groups of control 1 and control 2, all the mice used translucent goggles to cover their right eyes for form deprivation. The mice of intervention 1 and intervention 2 were respectively given intragastric administration modified Zhujing pill suspension 0.546g/(kg·d)(0.1mL/d)for 3wk at the beginning and after 3wk of the experiment. Same amount of saline was given to mice in other groups at the same time of modeling. The eye axis was measured before and after the experiment. At the end of the experiment, the eye of mice was taken for HE staining to observe the thickness changes of each layer of retina. Immunohistochemistry(IHC)and western blotting(WB)were used to detect Bcl-2 and Caspase3 expression of protein.<p>RESULTS: At the end of the experiment, the axis of model group 1 was significantly higher than that of control group 1(<i>P</i><0.01), the axis of intervention group 1 was significantly lower than that of model group 1(<i>P</i><0.01), and the axis of model group 2 was significantly higher than that of control group 2(<i>P</i><0.01), the eye axis of intervention group 2 was significantly lower than that of model group 2(<i>P</i><0.01); HE staining showed that the thickness of NFL and ONL of model group 1 was significantly thinner than that of control group 1(<i>P</i><0.01). The thickness of INL of model group 1 was significantly thinner than that of control group 1(<i>P</i><0.05), and the thickness of NFL, INL and ONL of intervention group 1 was significantly higher than that of model group 1(<i>P</i><0.05); The thickness of NFL, INL and ONL model group 2 was significantly thinner than that of control group 1(<i>P</i><0.01); IHC testing showed that the average optical density of Bcl-2 protein in model group 1 was significantly lower than that of control group 1(<i>P</i><0.05), which in intervention group 1 was significantly higher than that of model group 1(<i>P</i><0.01), and which in the average optical density of Bcl-2 protein of model group 2 was significantly lower than that of control group 2(<i>P</i><0.01), which in intervention group 2 was significantly higher than that of model group 2(<i>P</i><0.01); Caspase 3 protein average optical density of model group 1 was significantly higher than that of control group 1(<i>P</i><0.01), which in intervention group 1 was significantly lower than that of model group 1(<i>P</i><0.01), which in model group 2 was significantly higher than that of control group 2(<i>P</i><0.05), which in intervention group 2 was significantly lower than that of model group 2(<i>P</i><0.01); WB test proved that the relative expression level of Bcl-2 protein in model group 1 was significantly lower than that of control group 1(<i>P</i><0.01), which in intervention group 1 was significantly higher than that of model group 1(<i>P</i><0.01), and which in model group 2 was significantly lower than that of control group 2(<i>P</i><0.01), which in intervention group 2 was significantly higher than that of model group 2(<i>P</i><0.01); The relative expression level of Caspase3 protein in model group 1 was significantly higher than that of control group 1(<i>P</i><0.01), which in intervention group 1 was significantly lower than that of model group 1(<i>P</i><0.01), the intervention group 2 was significantly lower than that of model group 2. <p>CONCLUSION: The results show that the modified Zhujing pill can interfere with the pathological changes of retinal thickness thinning in the process of myopia and formed myopia mice by regulating the expression of apoptosis-related proteins Bcl-2 and Caspase3, and alleviating the apoptosis of retinal cells in myopia formation and myopia mice.
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Aim: The aim of the study was to assess the effect of combined phacoemulsification and single intraoperative intravitrealinjection of bevacizumab on the central macular thickness (CMT) in diabetic patients.Materials and Methods: A prospective observational study was conducted on 30 eyes with diabetic retinopathy from February2018 to February 2019. All patients underwent thorough ophthalmic evaluation. Phacoemulsification performed by a singlesurgeon using either 0.5% topical proparacaine eye drops or sub-tenon local anesthesia as per the preference of the surgeonin individual case. Bevacizumab 0.05 ml (1.25 mg) was injected intravitreal using a 30-gauge needle through the pars planainto the vitreous cavity after intraocular lens implantation. Patients were followed postoperatively at day 1 then at 1 week and1 month, respectively, for recording the CMT and best corrected visual acuity at 1 month postoperatively.Results: The mean CMT for all the patients at post-operative day 1 and month 1 was 277.96 ± 142.40 μm and 289.50 ± 155.74 μm,respectively. Patients with <10 years of diabetes had mean CMT of 329.09 μm and 318.90 μm, at post-operative day 1 and at1 month, respectively, while those with diabetes more than 10 years had mean CMT of 248.36 μm and 272.47 μm, respectively.In mild non-proliferative diabetic retinopathy (NPDR) and stable proliferative diabetic retinopathy group no significant worseningoccurred in CMT thickness, while in moderate NPDR, four out of 13 cases showed significant increase in CMT (>10%) at 1 month. Insevere NPDR, out of 4 cases 1 case showed significant increase in CMT while other three cases showed modest reduction of CMT.Conclusion: Intravitreal administration of 1.25 mg bevacizumab at the time of cataract surgery is a safe and effective way inavoiding new onset maculopathy in diabetic retinopathy patients. It is also effective to treat pre-existing clinically significantmacular edema and prevent its progression to some extent in few cases.
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@#AIM: To study the differences of binocular vessel density and retinal thickness in patients with anisometropia, including refractive index, axial length, vessel density in 3 mm×3 mm macular area and peripapillary area, nerve fiber thickness of 3mm×3mm macular area. And to study the relationship between axial length and vessel density, as well as retinal thickness, analyze its clinical significance in the occurrence and development of anisometropia.<p>METHODS: A retrospective analysis was performed on 27 patients with anisometropia in our hospital. All the patients received the examinations including binocular diopter, intraocular pressure, axial length, vessel density in 3mm×3mm macular area and peripapillary area, retinal thickness in macular area. SPSS 23.0 and paired <i>t</i>-test was used to analyze and compare the differences. <p>RESULTS: In all 27 patients, the refractive index and axial length of the one with a higher degree were greater than that of the low eye(<i>t</i>=-3.559, 3.083, <i>P</i><0.05). There were no statistically significant differences in superficial vessel density, deep vessel density, and retinal thickness in the macular area(1mm and 3mm)(<i>P</i>>0.05). In the all patients, the vessel density with a higher degree in the optic disc was higher(<i>t</i>=2.36, <i>P</i>=0.022).The vessel density of eyes with a higher degree in the superior nasal square(SN)was lower(<i>t</i>=-2.154, <i>P</i>=0.036). Refractive state, superficial and deep vessel density of foveal, deep parafoveal vessel density, retinal thinkness of foveal and parafoveal were correlated with the optic axis(<i>r</i>=-0.897, 0.458, 0.446, -0.328, 0.301, -0.397, <i>P</i><0.05).<p>CONCLUSION: There was no difference in the superficial and deep vessel density in 3mm×3mm macular area of the Patients with ametropia as well as retinal thickness. The binocular vessel density in the optic disc and the SN square were difference, and there was nodegree eye of refractive error difference in the residual papillary area. The axial length is related to the refractive state, the vessel density in the superficial and deep fovea of the macula, the vessel density in the deep parafovea of the macula, the retinal thickness in the fovea and the parafovea of the macula.
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@#AIM:To evaluate the short-term efficacy and safety of intravitreal dexamethasone implant(IDI)for patients with retinal vein occlusion-related macular edema(RVO-ME)by using optical coherence tomography(OCTA).<p>METHODS: Seventeen eyes in 17 patients with RVO-ME were treated with intravitreal injection of sustained-release IDI. The best corrected visual acuity(BCVA), central macular thickness(CMT)and superficial retinal vascular network were observed at baseline, 1d, 1mo, 2mo, 3mo, 4mo and 6mo.<p>RESULTS: CMT was significantly reduced from baseline by 24h after injection and improved further during the 3mo follow-up, and the improvement of visual acuity was consistent with that of CMT. OCTA showed improvement from baseline in terms of decreased number and size of cysts and restoration of the retinal vascular network. A slight increase in intraocular pressure was observed in 2 eyes after injection. There were no systemic side effects associated with injection or medication during follow-up.<p>CONCLUSION: CMT reduced as early as 24h after the injection of IDI, with further reduction during follow-up, and OCTA could visually observe the changes of retinal vascular network in macular area.