ABSTRACT
@#Targeted retinal photocoagulation(TRP)refers to targeted photocoagulation of the non-perfusion areas(NPA)of the retina, which can greatly reduce the risk of complications of panretinal photocoagulation(PRP). Ultra-wide field fluorescein angiography(UWFFA)can clearly show NPA of the far peripheral retina, which is conducive to precise positioning and implementation of TRP therapy. At present, the safety of short-term TRP treatment programs for proliferative diabetic retinopathy(PDR)is reasonable, but the long-term efficacy is still uncertain. In the future, TRP may become an early treatment option for some PDR patients, by delaying PRP to maintain the visual acuity and central field of vision. Anti-vascular endothelial growth factor(VEGF)drugs are currently the first-line drugs for diabetic macular edema(DME), for which with retinal neovascularization(NV)or poor compliance, combined TRP therapy may be considered. The ischemic index(ISI)is used to quantitatively analyze NPA of the retina under the vision of UWFFA, which is expected to become an important index in the future to guide the selection of clinical TRP treatment options.
ABSTRACT
A 25-year-old man presented with decreased vision in the left eye with hypopigmented elevated subretinal lesion over the optic disk with abnormal vasculature, subretinal and retinal hemorrhages, and fluid in the macula. An area of high spike over the disk with corresponding orbital shadowing was seen on B scan ultrasonography. Fundus fluorescein angiography revealed abnormal vasculature. Systemic examination revealed facial angiofibroma, ashleaf spot, and dental pits with multiple cortical tubers on CT brain. Intravitreal injection of bevacizumab led to visual and tomographic improvement. Abnormal retinal vascularization and exudation in young individuals may be a presenting feature in tuberous sclerosis.
ABSTRACT
Objective To establish an experimental choroidal neovascularization(CNV)model in brown norway(BN)rats by laser infusion in order to study the evolution of CNV during 3 weeks with intravitreaI injection of 1 μl(25 μg)bevacizumab,and make a preliminary investigation of the treatment effect of bevacizumab on experimental CNV. Methods Four groups of 48 BN rats were photocoagulated by krypton laser in 1 eye to induce CNV model in 1 eye,in which 4 groups received 1 μl(25 μg)bevacizumab intravitreal injection 1 week after photocoagulation and the other groups received the same volume intravitreall injection of balanced salt solution(BSS)as control.Fundus fluorescein angiography(FFA)examinations were taken on 1,2,3 week and the eyes were enucleated and processed for histopathologic examination.The areas of CNV were measured in the early phase of FFA.FⅧ-Rag protein was investigated with immunohistoehemistry and was semiquantkatively analyzed. Results The area and the leakage of CNV in bevacizumab treated BN rat eyes were obviously reduced as compared with the control group at each interval.In the treatment group,the expression of FⅧ-Rag was depressed.The examination of FⅧ-Rag and FFA verified the depression of CNV as compared with the control group at each interval.The density of treatment was lower than of control group(P＜0.01).After bevacizumab treatment for 2 weeks,the area of CNV and the expression of FⅧ-Rag were decreased[(0.920±0.634)mm2 and 35.57±10.52,respectively),as compared with the control group[(2.489±0.590)mm2 and 175.37±25.20]. Conclusions Intravitreal bevacizumab injection can inhibit the development of CNV.