RESUMEN
Objective To analyze the influencing factors on clinical response to conbercept for diabetic maeular edema (DME).Methods A total of 51 patients (51 eyes) with DME who underwent intravitreal injection of conbercept were included in this retrospective study.The general information (age,sex,body mass index,smoking history,drinking history),blood glucose indicators (duration of diabetes,fasting blood glucose,HbA 1 c),blood pressure indicators (history of hypertension,systolic blood pressure,diastolic blood pressure),lipid indicators [total cholesterol (TC),high-density lipoprotein (HDL),apolipoprotein A (APOA)],biochemical indicators [neutrophil concentration,hemoglobin (HB),serum creatinine (Scr)] were collected.The best corrected visual acuity (BCVA) and macular central macular thickness (CMT) before and after treatment were comparatively analyzed.CMT reduced not less than 20％ and BCVA increased by 2 lines as effective standards.Univariate analysis and multivariate logistic regression analysis were used to determine the factors affecting the efficacy ofintravitreal injection ofconbercept in patients with DME.Results Univariate analysis showed that diastolic blood pressure,HDL,serum neutrophil concentration,baseline CMT and baseline BCVA were associated with edema regression (P＜ 0.05);HbA 1 c was associated with vision improvement (P＜ 0.05).Multivariate logistic regression analysis showed that there was a history of smoking (OR=0.122,95％ CI 0.017-0.887),low diastolic blood pressure (OR=0.850,95％CI 0.748-0.966),low HDL (OR=0.007,95％CI 0.000 1-0.440),thin baseline CMT (OR=0.986,95％CI 0.977-0.995) were independent risk factors for failure outcome of edema regression (P＜0.05);long duration of diabetes (OR=1.191,95％CI 1.011-1.404),high APOA (OR=l.007,95％ CI 1.000-1.013) were independent risk factors for failure outcome of vision improvement.Age,fasting blood glucose,systolic blood pressure,TC,HB,Scr and other indicators had no effect on the efficacy of edema regression and vision improvement after treatment (P＞ 0.05).Conclusions Smoking history,long duration of diabetes,low diastolic blood pressure,low HDL level,high APOA level and thin baseline CMT are independent risk factors for the treatment of DME with intravitreal injection of conbercept.
RESUMEN
Objective To determine whether the candidates who were disqualified for having phoria or tropia in People′s Liberation Army Air Force ( PLAAF) medical selection of flying cadets are qualified or not according to United States Air Force ( USAF) Medical Standards Directory , and to raise suggestions on revising PLAAF medical standards . Methods All the candidates who had participated in the final medical selection of flying cadets were reevaluated and determined as qualified or not according to USAF Medical Standards Directory .Results There was a marked difference between disqualification rates of PLAAF and USAF .13.87%of the candidates who were regerded as disqualified by PLAAF standards were qualified according to USAF Medical Standards Directory .These cadets might be eliminated by mistake . Conclusion The standard on heterophonies of the PLAAF is more stringent than that of the USAF .We shoucd revise PLAAF standards using USAF standards for reference .
RESUMEN
Background Retinal vein occlusion (RVO) is a common vasculoretinopathy in ophthalmology.No an effective treating way is confirmed so far,and some new approach is in exploration.Objective The present study aims to investigate the safety and feasibility of injection of tissue plasminogen activator into optic nerve for the treatment of RVO using flash visual evoked potential (F-VEP) and flash electroretinogram(F-ERG).Methods The recording electrodes for F-VEP were implanted into the skull of rabbits to investigate the safety and feasibility of injection of tPA into the optic nerve.25μg of tPA or 12.5μg tPA (0.1 mL) was injected in pars plane via the center of optical disc respectively in different groups (6 eyes in each group),and 0.1 mL of BSS was injected at the same method in control group.Other 6 eyes were as normal control group.Slit lamp biomicroscope,indirect ophthalmoscope,F-VEP and F-ERG examinations were performed in 1 day,3,4,14 and 28 days after injection.All experiments were conducted in accordance with the Association for Research in Vision and Ophthalmology statement on the use of animals in ophthalmic and Vision Research.Results No obvious evidence of optic nerve or retinal toxicity or damage was found by the examination of ophthalmoscope,F-VEP,and F-ERG after injection of tPA.No significantly differences were found in the mean latency of P_1 wave of F-VEP (P=0.411),the mean amplitude of P_1 wave of F-VEP (P=0.065),the mean latency and amplitude of ERG a-waves (P=0.627,P=0.725) as well as the mean latency and amplitude of ERG b-waves (P=0.257,P=0.096) among 25 μg of tPA group,12.5 μg tPA group,BSS group and control group.Conclusion The injection of tPA into optic nerve is a safe and simple procedure.This therapy may is a potential approach to the treatment of RVO.
RESUMEN
Objective To investigate the effect of retinectomy 360? for severe ocular rupture and evaluate the related factors associated with prognosis. Methods We retrospectively analyzed 28 consecutive patients (28 eyes), 18 men and 10 women, with severe ocular rupture admitted to the Chinese PLA General Hospital between January 1999 and October 2002. The patient′s ages ragned from 16 to 58 years, mean 29 years. According to the internation standardized classification of ocular trauma, the injuries located in zone Ⅰ in 5 eyes, zone Ⅰ-Ⅱ in 8 eyes,zone Ⅱ in 3 eyes, zone Ⅱ-Ⅲ in 5 eyes, zone Ⅲ in 7 eyes, zone Ⅱ in 3 eyes, zone Ⅱ-Ⅲ in 5 eyes and zone Ⅲ in 7 eyes. The presenting visual acuity was in grade 4 (0. 02 to light perception) in 19 eyes, and grade 5 in 9 eyes. In 28 patients, 13 had the total absence of iris and lens, 10 had iris deletion more than 1/2, and 15 had lens opacity or rupture. Ultrasound biomicroscopy and B-scan revealed ciliochoroidal detachment in 17 eyes. The B-scan revealed vitreous hemorrhage and retinal detachment in all paitents. The intraocular pressure was from 5 to 11 mm Hg in all patients. The therappeutic operative procedures which were performed by one surgeon in all of the affected eyes included standard 3-port pars plana vitrectomy with scleral encircling buckle, endophotocoagulation and tamponading with silicone oil in all patients; lensectomy in 15 eyes; 360? retinotomy and retinectomy at anterior equator in 16 patients, and posterior equator in 12 eyes. Results During the operation, all patients were confirmed with vitreous hemorrhage and retinal detachment, including hemorrhagic ciliary body detachment in 9 eyes, suprachoroidal hemorrhage in 12 eyes, retinal twisting like morning glory in 11 eyes, and retinal incarceration in 17 eyes. Postoperative follow-up In 26 eyes who were followed up postoperatively from 6 months to 46 months, retinal reattachment was found in 20 patients (76. 9%) in whom the retina of 3 was reattached after revitrectomy and the silicone oil of 8 was removed at the fourth month after operation. In 20 eyes with reattached retina, 14 (70. 0%) had corrected visual acuity of 0. 02 or more, including 7 (35. 0%) had 0. 05 or more, 3 had 0. 1 or more, and 1 had the best visual acuity of 0. 3. Conclusion Retinectomy may improve the prognosis of severe ocular rupture and save the visual function of some patients.
RESUMEN
Objectives:To investigate the effects of verapamil on serum induced proliferation of rabbit pigment epithelial(RPE) cells so as to search for simple and effective medicine on PVR. Methods:The rabbit RPE cells(passage 2 to 5) were cultured with various concentrations of verapamil in DMEM.The effects of verapamil on the cell cycle of RPE were analyzed with flow cytometry. Results:Verapamil significantly inhibited the serum induced proliferation of RPE cells, prevented RPE from G 1 phase transiting to S phase. Conclusions:Verapamil significantly inhibits RPE cell proliferation, and it may become a promising drug on PVR.
RESUMEN
Objective To evaluate the therapeutic effect of encircling scleral buckling surgery in rhegmatogenous retinal detachement (RRD) with vitrectomy. Methods The records of a series of 118 consecutive patients with RRD undergone encircling scleral buckling surgery and vitrectomy between 1995 1999 were reviewed. All of the patients underwent an onece vitrectomy, and they consisted of with encircling scleral buckling group and without encircling scleral buckling group. The difference of rate of retinal reattachment, and the relationship between the reattachment rate and the grade of PVR, position of retinal tear and the different intraocular tamponade substitute in both groups were analysed and compared. The average follow up period was 6.5 mons (1.5 mons 3 ys). Results The rate of retinal reattachment in this series of 118 cases was 81 4% (96/118) in which the encircling scleral buckling group accounted for 44 7% and the group without encircling scleral buckling accounted for 55.3%. There was no statistical difference of rate of retinal reattachment between both groups with PVR C, different intraocular tamponade and various positions of retinal tears, while the rate of retinal reattachment in cases of PVR D and retinal tears posterior to equator in group without encircling scleral buckling was significanthy higher than that in encircling scleral buckling group ( P
RESUMEN
ObjectiveTo investigate the etiological factors of endophthalmitis and evaluate the outcomes of vitrectomy for endophthalmitis.MethodsFrom January 1999 to December 2001, 53 consecutive patients (54 eyes ), 38 men and 15 women, diagnosed as endophthalmitis were retrospectively evaluated. The patients′ ages ranged from 1 year to 74 years (mean 32 years). Two patients (2 eyes) with mild inflammation received antibiotic medication therapy, 5 patients (5 eyes) with no light perception and severe inflammation underwent evisceration, and the other 46 patients (47 eyes) underwent pars plana vitrectomy. Postoperative follow-up ranged from 2 to 32 months (mean 10.5 months). ResultsEndophthalmitis was diagnosed as resulting from penetrating injury in 32 eyes (59.26%), endogenous endophthalmitis in 8 eyes (14.81%), cataract surgery in 7 eyes (12.96%), glaucoma surgery in 2 eyes (3.70%), vitrectomy in 3 eyes (5.56%), radial keratotomy in 1 eye (1.85%), and unknown reason in 1 eye (1.85%). The postoperative visual acuities (VA) of these patients increased significantly (P=0.003). The VA of the patients underwent vitrectomy in 3 days was obviously better than those after 3 days (P=0.014), and the VA of the patients underwent vitrectomy in 7 days was obviously beter than those after 7 days (P=0.021). Thirty-seven eyes (68.52%) had functional success (VA≥0.02), 47 eyes (87.04%) had anatomical success (VA