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@#AIM: To evaluate the effect and safety of conbercept combined with trabeculectomy and retinal photocoagulation in the treatment of nevoascular glaucoma.<p>METHODS: A retrospectively analysis study. The clinical data of 47 patients(47 eyes)with neovascular glaucoma admitted to Shaanxi Eye hospital from January 2018 to December 2020. The patients were followed up for 6mo to observe the changes of visual acuity and intraocular pressure and the occurrence of complications before and after treatment.<p>RESULTS: At 6mo after compound trabeculectomy, the visual acuity of this group of patients improved in 25 eyes(53%), among which 8 eyes without light perception before operation, visual acuity increased to 0.2 and 0.02 respectively, to hand motion/30cm in 2 eyes,restoring light perception from no light perception 2 eyes; The visual acuity remained unchanged in 19 eyes(40%)and decreased in 3 eyes(6%). 40 eyes of 40 cases did not use any intraocular pressure lowering drugs, the intraocular pressure <21mmHg and the complete success rate was 85% at the 6mo follow up post-operatively. The intraocular pressures were 15.6±6.2, 12.8±5.9, 14.7±5.3, 17.1±6.9, 18.3±6.7mmHg at 1, 7d, 1, 3 and 6mo after compound trabeculectomy, which were different from the intraocular pressure at admission(46.0±11.9mmHg)and intravitreal intraocular pressure(39.9±12.5mmHg)after 3d of intravitreal injection of conbercept were significantly different(<i>F</i>=106.65, <i>P</i><0.001). Hyphema occurred in 3 eyes after compound trabeculectomy, and completely absorbed within 3-7d after conservative drug treatment.<p>CONCLUSION: Intravitreal injection of conbercept combined with compound trabeculectomy and retinal photocoagulation is safe and effective in the treatment of neovascular glaucoma.
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@#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.
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@#AIM: To observe the changes of the development of the anterior segment in children after the treatment of laser photocoagulation(LP)for retinopathy of prematurity(ROP)by corneal topographic. <p>METHODS: In this retrospective case study, 25 children(50 eyes)as ROP group and 23 children(46 eyes)born at term as control group had participated in the study. The best corrected visual acuity(BCVA)was examined in both groups, and converted to LogMAR vision when statistical analysis was performed. The observation indicators of the Sirius anterior segment analysis system in the study were as follows: the horizontal iris diameter(HVID), corneal radius of the thinnest point, the thinnest point of the cornea, the maximum curvature of the cornea, the maximum radius of cornea curvature, central corneal thickness(CCT), corneal volume(CV), anterior chamber depth(ACD), anterior chamber volume and the anterior chamber angle.<p>RESULTS: The HVID, the thinnest point of the cornea, ACD, and the anterior chamber volume in ROP group were smaller than that in the control group(all <i>P</i><0.05). The CV and the anterior chamber angle in ROP group were smaller than that in the control group, but there was no significant difference between the two groups(all <i>P</i>>0.05). The BCVA was significantly better in the control group than that in the ROP group(0.07±0.10 <i>vs</i> 0.24±0.25, <i>P</i><0.05). <p>CONCLUSION: The development of eye anterior ganglion tissues of the ROP group had changed with steeper cornea, shallower anterior chamber, smaller angle of the anterior chamber and poor BCVA. All of the changes above might make it easier for the development of refractive errors and glaucoma.
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@#AIM: To compare the postoperative outcomes after segmental scleral buckling(SSB)surgery with minimal <i>in situ</i> conjunctival incision(MCI)and conventional limbal conjunctival incision(LCI). <p>METHODS: Prospective randomized controlled study. Eighty eyes of 80 patients with rhegmatogenous retinal detachment(RRD)who received SSB surgeries in our hospital from August 2016 to November 2018 were recruited. They were randomly divided into two groups. Patients in control group were performed with conventional LCI, while patients in observation group received MCI. The length of the surgery, the retinal reattachment rate and the visual analogue scale(VAS)for evaluating the pain on the first postoperative day, questionnaire scoring method for evaluating the postoperative comfort level(including foreign body sensation and tearing)on the first, seventh, fourteenth, and thirtieth days were recorded. <p>RESULTS: The difference of surgery time between the control group and the observation group was statistically significant(<i>t</i>=2.057, <i>P</i><0.05). There was no significance in retinal reattachment rate between two groups. At the first day after surgery, the postoperative pain of the observation group was significantly lower than the control group(<i>P</i><0.05). At the first and seventh day after surgery, the observation group had higher postoperative comfort questionnaire score than the control group(<i>P</i><0.01), however, at the fourteenth and thirtieth day after surgery, the score was similar between the two groups(<i>P</i>>0.05). <p>CONCLUSION: Using MCI in SSB operation could shorten the operation time and significantly reduced postoperative pain and discomfort level.
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Purpose: To determine the effect of ultra-widefield fluorescein angiography (UWFFA)-guided targeted retinal photocoagulation (TRP) in branch retinal vein occlusion (BRVO) with macular edema after intravitreal Ranibizumab (RBZ). Methods: 33 eyes of 32 treatment naïve patients diagnosed as BRVO with macular edema were prospectively randomized to 0.5 mg Ranibizumab only (RBZ group) (n = 17) or Ranibizumab with UWFFA-guided laser (RBZ + TRP group) (n = 16). Both groups received three injections at monthly intervals and PRN henceforth. RBZ + TRP group additionally underwent UWFFA-guided TRP of peripheral capillary nonperfusion areas 1 week post injection. Outcome measures included improvement in visual acuity, central subfoveal thickness (CST), and the number of injections required with a minimum follow-up of 9 months. Results: Both groups showed significant improvement in mean BCVA (25.7 ± 8.19 letters, P < 0.001 vs. 23.38 ± 7.56 letters, P < 0.001; in RBZ and RBZ + TRP group, respectively) and reduction in mean central subfoveal thickness (379.12 ± 242.7 ?m, P < 0.001 vs. 253.75 ± 137.9 ?m, P < 0.001 in RBZ and RBZ + TRP group, respectively) at 9 months. The number of injections in the RBZ group (5.76 ± 1.3) was significantly greater than RBZ + TRP (4.06 ± 0.99) (P < 0.001). Both groups had significant improvement in contrast sensitivity and mean deviation on visual fields; however, the difference between the groups was not significant (P = 0.62 and P = 0.79, respectively). Conclusion: UWFFA-guided TRP reduced the number of injections of Ranibizumab in patients having BRVO with macular edema, while maintaining similar benefits in the improvement of BCVA, central subfoveal thickness without deleterious effect on the visual field, and contrast sensitivity.
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@#AIM: To investigate the therapeutic effects of panretinal photocoagulation(PRP)with multiple wavelength and multispot pattern scan laser combined with conbercept for proliferative diabetic retinopathy.<p>METHODS: Retrospective case control study. A total of 102 eyes of 80 cases with proliferative diabetic retinopathy without proliferative fiber membrane from retinal or vitreous hemorrhage were recorded. The eyes were divided into two groups according to the therapeutic methods: group A included 60 eyes of 48 cases received only PRP; group B included 42 eyes of 32 cases received intravitreal injection of 0.5mg conbercept before PRP. All patients were given PRP with multiple wavelength and multispot pattern scan laser(NIDEK MC-500VIXI)and completed in twice with the interval time 3-7d. The patients were received supplementary laser therapy after 3mo according to fundus fluorescein angiography(FFA)results. The therapeutic effect and related complications were observed in two groups, the best corrected visual acuity(BCVA)of 3mo after PRP was recorded and the changes of central macular thickness(CMT)were compared. All patients were followed up for at least 3mo.<p>RESULTS: Incidence rate of vitreous hemorrhage and macular edema happened or became worse in group A was obviously higher than group B, the difference was statistically significant(<i>P</i><0.05). The effective rate was 73.33% in group A and 90.48% in group B at 3mo after PRP and the difference was statistically significant(<i>P</i><0.05). The CMT values at different time points after treatment in the two group showed a significant difference(<i>P</i><0.05).<p>CONCLUSION: Intravitreal injection of conbercept combined with PRP with multiple wavelength and multispot pattern scan laser as a treatment for early proliferative diabetic retinopathy can reduce vitreous hemorrhage in the process of PRP and macular edema, and is more effective with better visual acuity recovery compared with only PRP.
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@#AIM:To discuss the effect of retinal photocoagulation combined with conbercept on the aqueous humor vascular endothelial growth factor(VEGF)and stromal cell-derived factor-1(SDF-1)in patients with diabetic retinopathy(DR). <p>METHODS: Totally 120 patients with DR were selected from September 2016 to September 2018 in our hospital, according to the random number table, they were divided into combined group and photocoagulation group, 60 cases in each group. The photocoagulation group was treated with retinal photocoagulation, and the combined group was treated with retinal photocoagulation combined intravitreal injection of conbercept. The aqueous humor VEGF, SDF-1, CMT, BCVA and complication were compared between the two groups. <p>RESULTS: The postoperative aqueous humor(151.46±18.52,186.74±20.17pg/mL), SDF-1(466.72±50.21, 534.46±56.24mg/L)in the combined group and photocoagulation group were significantly lower than those in the preoperative, the combined group were lower than the photocoagulation group(<i>P</i><0.05). The 1 and 3mo postoperative CMT, BCVA in the combined group and photocoagulation group were significantly lower than those in the preoperative, the combined group were lower than the photocoagulation group(<i>P</i><0.05). There was no significant difference of the complication rate between combined group and photocoagulation group(6.7% <i>vs</i> 5.0%, <i>P</i>>0.05). <p>CONCLUSION: Retinal photocoagulation combined with conbercept can effectively reduce the aqueous humor VEGF and SDF-1 in patients with DR, which is conducive to improving the therapeutic effect of patients, and it is safety.
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Purpose: This study aims to evaluate the incidence and risk factors for vitreous rebleed (VRB) following 25-gauge sutureless vitrectomy for vitreous hemorrhage (VH) in diabetic retinopathy. Methods: A retrospective review of 190 diabetic patients having undergone vitrectomy for VH at a tertiary eye care center was analyzed. Demographic data of patients along with risk factors such as blood sugar levels (BSL), blood pressure (BP), anticoagulant use, and pan-retinal photocoagulation status (PRP) were tabulated. Depending on the commencement of VRB, patients were divided into immediate rebleed-within 2 weeks and delayed rebleed-beyond 2–4 weeks. Results: Forty-one patients had VRB, out of which 18 patients had immediate VRB and 23 patients had delayed VRB. The average duration between vitrectomy and VRB was 3.28 months. Twenty-eight patients were male and 13 were females. Average age at presentation was 53.8 years. Thirty-four patients (82.9%) were found to have high BSL and 28 patients (68.3%) had high BP and they developed rebleed (P < 0.01) after an initial hemorrhage-free period (average = 5.15 months). Fifteen patients (36.6%) underwent first time PRP intraoperatively, and they had immediate rebleed (P < 0.01) without any hemorrhage-free period (average = 0.9 months). Eight patients (19.5%) were on perioperative anticoagulants; however, their statistical significance did not persist in the multivariable model. There were neither age nor gender predilection toward rebleed (P > 0.05). Conclusion: The incidence rate of VRB was found to be 21.6%. Age and gender did not contribute to rebleed. Intraoperative PRP was a risk factor for immediate rebleed. Poor glycemic and BP control was a risk factor for delayed rebleed.
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@#AIM:To explore the effect of retinal photocoagulation combined with Ranibizumab or Conbercept on central macular thickness, visual acuity recovery and adverse reactions in patients with macular edema(ME)secondary to retinal vein occlusion(RVO). <p>METHODS: Totally 384 cases of patients(384 eyes)with RVO-ME in our hospital were divided into Group A(205 cases)and Group B(179 cases). Group A was given retinal photocoagulation and ranibizumab intravitreal injection, and Group B was given retinal photocoagulation and conbercept intravitreal injection. The postoperative central macular thickness(CMT), best corrected visual acuity(BCVA), intraocular pressure(IOP)and adverse reactions were compared between the two groups.<p>RESULTS:There was no significant difference in the total effective rate of fundus fluorescein angiography(FFA)between the two groups after 3mo(<i>P</i>>0.05). There were significant differences in BCVA in the two groups at each time point(<i>P</i><0.05). There was no significant difference in BCVA between the two groups(<i>P</i>>0.05). The BCVA in two groups showed an upward trend after operation(<i>P</i><0.05). There was a statistically significant difference in MCT in the two groups at each time point(<i>P</i><0.05). There was no significant difference in MCT between the two groups(<i>P</i>>0.05). The MCT showed a downward trend in two groups after operation(<i>P</i><0.05). There was no significant difference in IOP in the two groups at each time point(<i>P</i>>0.05). There was no significant difference in IOP between the two groups(<i>P</i>>0.05). And there was no significant increase in IOP after operation(<i>P</i>>0.05). The drug injection frequency within 3mo in Group B was significantly less than that in Group A(<i>P</i><0.05), and there was no significant difference in the total incidence rate of adverse reactions between the two groups(5.4% <i>vs</i> 4.5%, <i>P</i>>0.05). <p>CONCLUSION: Retinal photocoagulation combined with ranibizumab or conbercept intravitreal injection can control the condition of RVO-ME patients, promote ME absorption, reduce CMT and improve visual acuity. The two drugs have effective time in single administration, and the drug administration frequency of conbercept are better than those of ranibizumab.
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·AIM:To observe the therapeutic effect of the mild form disseminated photocoagulation treatment for moderate non-proliferative diabetic retinopathy (MNPDR). ·METHODS: Prospective randomized controlled study. Totally 126 cases (209 eyes) with MNPDR were randomly assigned to two groups in ophthalmology department of Shanghai Shidong Hospital. There were 62 cases ( 103 eyes ) were treated with the mild form disseminated photocoagulation as the therapy group, 64 cases ( 106 eyes) were treated with control of blood glucose as the control group. All cases were followed up for 24mo. The best corrected visual acuity ( BCVA), fundus change and central visual field were observed and compared. · RESULTS: At 24mo after treatment, BCVA variety between two groups took on significant statistical difference which indicated that there were more eyes with improved or stable visual acuity in therapy group ( Hc=5. 942, P<0. 05). There was significant difference in fundus examination between two groups which indicated that there were more eyes with improved or stable fundus change in therapy group (Hc=12. 662, P<0. 05). There was no significant difference in average mean sensitivity (MS) between before and after laser therapy for 12mo (t=3. 1586, P>0. 05). During our follow-up, there were no complications likewise infection, hemorrhage, retinal membrane, injury of the macular fovear occurred. · CONCLUSION: The mild form disseminated photocoagulation therapy for moderate non-proliferative diabetic retinopathy is safe and effective without obvious complications, which can effectively delay the progression of diabetic retinopathy.
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·AIM: To investigate the effect of calcium dobesilate on vitreous hemorrhage in patients with proliferative diabetic retinopathy ( PDR ) after pan retinal photocoagulation (PRP). ·METHODS:Totally 62 patients (30 cases with binocular lesions, 32 cases with monocular lesions, a total of 92 eyes) with PDR who were treated in our hospital from January 2015 to July 2017 were selected as the subjects. They were divided into the control group ( treated with pan retinal photocoagulation, n = 30, 17 cases with monocular lesions, 13 cases with binocular lesions, a total of 43 eyes ) and the study group ( treated with calcium dobesilate on the basis of treatment for the control group, n=32, 15 cases with monocular lesions, 17 cases with binocular lesions, a total of 49 eyes ). The recovery of visual acuity, blood rheology ( plasma viscosity, hematocrit, erythrocyte deformation index) and the incidence of complications such as vitreous hemorrhage in the two groups after surgery were observed. ·RESULTS: There was no significant difference between the two groups in the rate of excellent and good visual acuity, plasma viscosity, hematocrit or erythrocyte deformability index before treatment ( P>0. 05 ). After treatment, the rate of excellent and good visual acuity in the study group was significantly higher than that in the control group (P<0. 05). After treatment, the plasma viscosity and hematocrit decreased significantly while the erythrocyte deformability index significantly increased only in the study group, and changes of above -mentioned indexes in the study group were more obvious than those in the control group after treatment (P<0. 05). The incidence rate of vitreous hemorrhage and total incidence rate of complications in the study group were significantly lower than those in the control group ( P<0. 05). ·CONCLUSION: The application of calcium dobesilate in patients with PDR after pan retinal photocoagulation can effectively improve the recovery of visual acuity and reduce the incidence of complications such as vitreous hemorrhage. The mechanism may be related to effectively improving the hemodynamics.
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· AIM:To investigate the clinical efficacy of intravitreal injection of Ranibizumab combined with retinal photocoagulation (523 laser) in the treatment of central retinal vein occlusion (CRVO) with retinal neovascularization and macular edema.· METHODS:The subjects of this study were 70 patients (70 eyes) with CRVO and retinal neovascularization and macular edema treated in our hospital from January 2016 to January 2017.There were 35 patients (35 eyes) treated with intravitreal injection of ranibizumab combined 523 laser and enrolled in the observation group;35 patients (35 eyes) treated with 523 laser alone and selected as the control group.The medical records were retrospectively analyzed.The best corrected visual acuity and intraocular pressure (IOP) were observed before treatment and 3mo after treatment.The central retinal thickness (CRT) was measured by optical coherence tomography (OCT) and fundus fluorescein angiography (FFA) to evaluate the changes of retinal lesions progress and follow-up observation of the incidence of complications after treatment.· RESULTS:After 3mo of treatment,the best corrected visual acuity remained unchanged in both groups.There was no significant difference between the two groups in best corrected visual acuity improved by 1 lines,2 lines,3 lines and above (P＜ 0.05).There was no significant difference in intraocular pressure before and after operation,and in those between the two groups (P＞ 0.05).There was significant difference of CRT between the two groups,before and after treatment (P＜ 0.01);postoperatively CRT of observation group was significantly lower than that of the control group,the difference was statistically significant (P＜ 0.01).There were 25 cases (71％) of macular edema subsided detected by OCT and FFA 3mo after operation,which was significantly higher than that of the control group (19 eyes,54％),the difference was statistically significant (x2 =6.292,P =0.012).Neovascularization significantly relieved in both groups at 1mo after the operation.In the observation group,2 cases recurred 1mo after operation,the recurrence rate was 6％;10 cases recurred in the control group,and the recurrence rate was 29％.In the observation group,there were 3 cases of recurrence 3mo after operation,the recurrence rate was 9％,the recurrence of the control group was 19 cases,the recurrence rate was 54％,the difference was statistically significant (P＜0.05).· CONCLUSION:Intravitreal injection of ranibizumab combined with 523 laser can significantly improve visual acuity in patients with CRVO,which can effectively prevent the formation of retinal neovascularization and accelerate the exudation bleeding and edema absorption.
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OBJECTIVES: To investigate the effect of laser pan-retinal photocoagulation with or without intravitreal bevacizumab injections on macular choroidal thickness parameters in eyes with high-risk proliferative diabetic retinopathy. METHODS: High-risk proliferative diabetic retinopathy patients undergoing laser treatment were prospectively enrolled in this study. One eye was randomly selected for laser treatment combined with bevacizumab injections, study group, whereas the corresponding eye was subjected to laser treatment alone, control group. Spectral-domain optical coherence tomography with enhanced depth imaging was used to measure the macular choroidal thickness prior to and 1 month after treatment. Measurements in both groups were compared. Clinicaltrials.gov: NCT01389505. RESULTS: Nineteen patients (38 eyes) with a mean±standard deviation age of 53.4±9.3 years were evaluated, and choroidal thickness measurements for 15 patients were used for comparison. The greatest measurement before treatment was the subfoveal choroidal thickness (341.68±67.66 μm and 345.79±83.66 μm for the study and control groups, respectively). No significant difference between groups was found in terms of macular choroidal thickness measurements at baseline or after treatment. However, within-group comparisons revealed a significant increase in choroidal thickness parameters in 10 measurements in the study group and in only 5 temporal measurements in the control group when 1-month follow-up measurements were compared to baseline values. CONCLUSIONS: The macular choroidal thickness does not appear to be significantly influenced by laser treatment alone but increases significantly when associated with bevacizumab injections in patients with proliferative diabetic retinopathy and macular edema. Because bevacizumab injections reduce short-term laser pan-retinal photocoagulation-induced macular edema, our findings suggest that the choroid participates in its pathogenesis.
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Humans , Male , Female , Middle Aged , Retina/pathology , Choroid/pathology , Angiogenesis Inhibitors/administration & dosage , Diabetic Retinopathy/therapy , Bevacizumab/administration & dosage , Visual Acuity , Retrospective Studies , Treatment Outcome , Laser Coagulation , Combined Modality Therapy , Tomography, Optical Coherence , Diabetic Retinopathy/pathology , Intravitreal InjectionsABSTRACT
AIM:To study the efficacy of conbercept intravitreal injection combined with retinal laser photocoagulation therapy and simple laser photocoagulation therapy on macular edema (ME) secondary to retinal vein occlusion (RVO).METHODS:Forty-eight patients (53 eyes) with macular edema secondary to retinal vein occlusion diagnosed by clinical examination from October 2014 to March 2015 were retrospectively analyzed.Among them,28 patients (31 eyes) were treated with conbercept intravitreal injection combined with retinal laser photocoagulation,which was defined as Group A.And simple laser group contained 20 patients (22 eyes),which was defined as Group B.The clinical data including the patients' best-corrected visual acuity (BCVA) and central retinal thickness (CMT) before treatment and 1wk and 3mo after treatment were observed.RESULTS:Followed up for 3mo,the average BCVA values of A and B were 0.44±0.25,0.56±0.24,respectively and the average CMT were 330.50 ± 121.71,354.67 ± 102.79μm at first week of treatment.There was no significant difference in BCVA and CMT of Group A compared with Group B.There was statistically significant in BCVA and CMT of Group A and Group B compared with before treatment (P＜0.05).The average BCVA values of A and B were 0.24±0.18,0.39±0.20,respectively and the average CMT were 252.62 ± 83.01,332.67 ± 102.33μ m at third month of treatment.There were statistically significant differences between the two groups and compared with before treatment (P＜0.05),and Group A was superior to Group B.CONCLUSION:Conbercept intravitreal injection combined with retinal laser photocoagulation therapy and simple laser photocoagulation treatment of macular edema secondary to retinal vein occlusion are both effective that macular edema is significantly reduced,and vision is stable and improved.But for serious cases,conbercept intravitreal injection can reduce retinal edema at first,then combine with retinal laser photocoagulation which has obvious therapeutic effect and it is better than simple laser photocoagulation treatment.
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Objective To compare the efficacy and safety of modified panretinal photocoagulation (MPRP) and traditional panretinal photocoagulation (PRP) for diabetic retinopathy (DR).Methods The clinical case-control methods were used.A total of 53 patients (106 eyes) who were confirmed as severe nonproliferative diabetic retinopathy (NPDR) or mild proliferative diabetic retinopathy (PDR) after fundus fluorescein angiography (FFA) between October 2013 to January 2017 were enrolled in this study,and the two eyes of each patients were in the same degree of DR,with the 53 right eyes undergoing MPRP (treatment group) and the 53 left eyes receiving PRP (control group).Various including visual acuity,intraocular pressure,mydriatic fundus photography and optical coherence tomography (OCT) findings were observed at 1 day,1 week,1 month,3 months and 6 months after laser treatment,and FFA examination was performed 3 months and 6 months after laser treatment for the comparison of the efficacy and safety in the two groups,Results There was no statistically significant difference in the best-corrected visual between the two groups after treatment (all P ＞ 0.05),but the average visual acuity of the treatment group was higher than that in the control group.The retinal nonperfusion area and new blood vessels disappeared in 39 eyes (73.6％) in the treatment group,and the effective rate was 91％,while the area and new blood vessels disappeared in 29 eyes (54.7％) in the control group,and the effective rate was 75％.There were significant differences in the retinal nonperfusion disappearance and the effective rate of the two groups (both P ＜0.05).Conelusion MPRP is an effective and safe technique in the treatment of diabetic retinopathy,which is superior to traditional PRP.
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Objective To study the effects of lucentis preventing vitreous hemorrhage after vitrectomy for diabetic retinopathy combined with iris neovascularization.Methods The clinical data of 70 patients (70 eyes) underwent vitrectomy for diabetic retinopathy combined with iris neovascularization during 2009 to 2015 in our hospital were retrospectively analyzed.The control group (30 eyes) accepted panretinal photocoagulation (PRP),re-vitrectomy,cyclocryotherapy,and the study group (40 eyes) had the 0.5mg lucentis in addition.The follow-up time was 3 months,and the visual acuity,IOP,vitreous hemorrhage,INV regression and complication were observed.Results At 1 month,2 months in the follow-up,the visual acuity of study group was better than the control group,but there was no significant difference along with the follow up.The average preoperative IOP was (26.312 ±4.566) mmHg (1 kPa =7.5 mmHg) in the study group and (24.586 ±5.783) mmHg in the control group,and at the end of the follow up,IOP was (18.576 ±4.762) mmHg in the study group and (28.587 ±7.786) mmHg in the control group,there was statistical difference between the two groups (P =0.041).The intraoperative and postoperative anterior chamber or vitreous hemorrhage occurred in 15 cases,5 cases of the control group,and 3 cases,1 case of the control group,there were significant differences (all P =0.000).At the end of the follow up,3 eyes (7.5％) developed to NVG in the study group and 10 eyes (33.3％) in the control group,there was statistical difference (P ＜ 0.05).Conclusion Lucentis can effectively eliminate the new vessels,reduce the incidence of neovascularization glaucoma and vitreous hemorrhage for patients after vitrectomy for diabetic retinopathy combined with iris neovascularization,and improve the visual acuity in a short time.
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Objective To observe the curative effects of anti-vascular endothelial growth factor (anti-VEGF) intracameral and intravitreal injection,trabeculectomy and pan-retinal photocoagulation by indirect ophthalmoscope for neovascular glaucoma (NVG).Methods NVG patients with uncontrolled intraocular pressure (IOP) and retinopathy was enrolled from May,2014 to May,2016.Eighteen patients were enrolled with 15 males(15 eyes) and 3 females(3 eyes) with age at (61.7 ± 13.9) years old.Anti-VEGF intracameral and intravitreal injection with anterior chamber puncture was performed in the first day of sequential treatment.Trebeculectomy was performed 3-5 days after injection and finally the pan-retinal photocoagulation was started 5-7 days after anti-glaucoma surgery.The best corrected visual acuity (BCVA),IOP,cornea,neovascularization of iris and retinal disease were observed and recorded.Results The diagnosis included 1 eye with central retinal artery occlusion (CRAO),6 eyes with central retinal vein occlusion (CRVO),5 eyes with branch retinal vein occlusion,5 eyes with proliferative diabetic retinopathy and 2 eyes with combined CRAO and CRVO.IOP before and after treatment were (43.5 ±5.1) mmHg (1 kPa =7.5 mmHg) and (15.2 ± 2.2) mmHg,there was significantly statistical difference (t =21.68,P ＜0.001).The categories of antiglaucoma medicines were 5.1 ± 0.5 and 0.5 ± 1.0 before and after treatment respectively,and the difference was statistical significant (t =12.30,P ＜ 0.001).BCVA was improved in 4 eyes,maintained in 13 eyes and decreased in only 1 eye.Conclusion The sequential treatment including anti-VEGF intracameral and intravitreal injection,trabeculectomy and pan-retinal photocoagulation by indirect ophthalmoscope is safe and effective.
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AIM:To investigate the clinical effect of panretinal photocoagulation (PRP) combined with calcium dobesilate in treatment of diabetic retinopathy (DR).METHODS:Selected 120 cases (240 eyes) of DR diagnosed in our hospital from January 2011 to January 2016 were retrospectively analyzed.According to whether calcium dobesilate was used, the treatment group was divided into two groups.Sixty cases were treated with PRP combined with calcium dobesilate, and 60 cases in the control group were treated with PRP only.The BCVA, CMT and clinical efficacy of the two groups were compared.RESULTS:Before treatment, there was no significant difference on BCVA between combined group and control group (P>0.05).After treatment, BCVA of combined group was higher than that of the control group (P0.05);after treatment, the combination group on CMT, neovascularization and fluorescein leakage area value were less than the control group (P<0.01).After treatment, combined group was appearance effect in 65.0%, effective in 30.0%, invalid in 5.0%, the control group was 50.8%, effective 36.7%, invalid 12.5%, all statistically significant differences between the two groups (P<0.05).CONCLUSION:PRP combined with calcium dobesilate in treatment of DR has a more significant clinical effect than PRP alone.
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Neovascular glaucoma (NVG) is a dreadful pathology and it will be rapid spontaneous evolution responsible for eventual visual loss in many cases,with poor therapeutic efficiency.The main challenges in clinical practice for the management of NVG are as follows:(1) What is the goal of NVG treatment,to decrease intraocular pressure (IOP) or to reserve visual function? (2) How to create an optimal condition or timing for the treatment of primary disease? (3)What is exactly the key of NVG treatment? Anti-vascular endothelial growth factor (VEGF) medication,anti-glaucoma surgery or pan-retinal photocoagulation (PRP) for strict control of clinical situations potentially responsible for retinal ischemia ? (4)How to set up a comprehensive management strategy for NVG? In this paper,we established a comprehensive treatment strategy for NVG,including a core aim for preserving visual function,a goal of completing PRP and the main methods of anti-VEGF injection and anti-glaucoma surgery in order to preserve visual status of NVG patients as much as possible.
ABSTRACT
?AlM:To observe the clinical effect of the intravitreal Ranibizumab ( lVR ) combined with retinal photocoagulation for the neovascular glaucoma ( NVG) . ? METHODS: Clinical data of 30 patients with the neovascular glaucoma ( 36 eyes ) in our hospital from Ocuober 2012 to Sepember 2013 were analyzed retrospectively. All eyes accepted the photocoagulation 7d after lVR (0. 05mL/1. 25mg). Visual acuity, intraocular pressure ( lOP) , the degradation of iris neovascularization and complications were observed and compared statistically before treatment and 1wk, 1, 3mo after treatment. ?RESULTS:The new vessels on the iris and the angle of anterior chamber regressed completely in all eyes 5d after lVR, the mean time was 3. 7±1. 4d. The differences were statistically significant when compared lOP ( 18. 2±2. 1, 16. 8 ± 3. 1, 17. 2 ± 2. 4mmHg,) at 1wk, 1, 3mo postoperatively with 30. 5±3. 6mmHg preoperatively. The visual acuity of all the eyes was stable and rose slightly. ? CONCLUSlON: lVB combined with retinal photocoagulation can make the new vessels on the iris and the angle of anterior chamber regression and to lower the lOP. No serious complications were observed after treatment. lt is a new security and effective method for neovascular glaucoma.