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The threshold micropulse laser is widely used in clinical practice as a safe,non-invasive laser for avariety of macular diseases.Compared with the conventional laser therapy,the subthreshold micropulse laser is selectively absorbed by the RPE and therefore it does not cause retinal damage.To explore the therapeutic mechanism and the safety,development of threshold micropulse laser in the treatment of various common macular diseases,and further clarify its indications and advantages,which are helpful for its wider clinical application.
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Objective To analyze the expression of VEGF,IL-33 and NO concentration after laser photocoagulation and subthreshold micropulse laser photocoagulation conventional in proliferative diabetic retinopathy (PDR) patients.Methods A case control study.The clinical data of 39 patients of PDR and 11 patients of idiopathic macular pucker (IMP) from Department of Ophthalmology,Central Theater General Hospital during November 2015 were collected in this study.PDR patients were assigned randomly into three groups.Fifteen PDR patients with 15 eyes were treated with conventional laser as group A.Thirteen PDR patients with 13 eyes were treated with subthreshold micropulse laser as group B.Eleven PDR patients with 11 eyes without any laser therapy were grouped as C.Eleven IMP patients were grouped as D.There was no difference of age (F=0.53,P=0.23),gender ratio (x2=0.55,P=0.91),body mass index (F=2.62,P=0.07),duration diabetes (F=0.29,P=0.75),glycoslated hemglobin (F=1.72,P=0.19) in four groups.All PDR patients were examined with FFA.Total protein was quantified by a bicinchoninic acid assay kit.Levels of VEGF,IL-33,NO were determined using enzyme-linked immunosorbent assay kits.Results There was no difference of total protein in four groups (F=1.78,P=0.17).Group C had a higher VEGF level than group A and B (F=7.84,P=0.002).Group A had a higher IL-33 level than group C (t=4.15,P=0.02).There was no difference of IL-33level in group B and C (t=1.34,P=0.20).Group D had a lower NO level than group A,B,C (F=38.42,P＜0.001).There was no difference of NO level in group A,B and C (F=3.29,P=0.06).Conclusions Both conventional laser photocoagulation and subthreshold micropulse laser photocoagulation can decrease vitreous VEGF level and subthreshold micropulse laser photocoagulation can induce less IL-33 level.
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Objective To investigate the effects of subthreshold micropulse yellow laser (577 nm) on vascular endothelial growth factor (VEGF),nerve growth factor (NGF) and Chemerin expressions in retina of early stage diabetic rats.Methods A total of 40 Brown Norway rats were treated with streptozocin (65 mg · kg-1) to establish the diabetic model.20 diabetic BN rats' right eyes were received subthreshold micropulse yellow laser (577 run) therapy after 2 weeks.The left eyes were used as control group.At 3 days,7 days,14 days,28 days after laser therapy,5 BN rats were randomly chosen to perform RT-PCR and Weston-blot.The expressions of mRNA and protein of VEGF,NGF and Chemerin were analyzed.Results The expression of VEGF mRNA and protein increased in control group at 3 days,7 days,14 days and 28 days (all P ＜ 0.05).Compared with the control group,VEGF mRNA and protein decreased in the subthreshold micropulse yellow laser (577 nm) group (all P ＜ 0.05).The expression of NGF mRNA and protein decreased in the control group at 3 days,7 days,14 days and 28 days (all P ＜ 0.05),however,the difference was not statistically significant between 3 days and 7 days(P ＞0.05).Compared with control group,NGF mRNA and protein increased in the subthreshold micropulse yellow laser (577 nm) group (all P ＜ 0.05),with maximum expression at 14 days.The expression of chemerin mRNA and protein increased at 3 days,7 days,14 days and 28 days in the control group (all P ＜0.05).Compared with the control group,chemerin mRNA and protein decreased in the subthreshold micropulse yellow laser (577 urn) group (all P ＜ 0.05).Conclusion Subthreshold micropulse yellow laser (577 urn) can suppress VEGF,Chemerin expression and upregulate NGF expression in early stage diabetic rats.
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Objective To observe the baseline characteristics and visual outcomes after two years follow-up of exudative age-related macular degeneration (AMD) patients treated with ranibizumb. Methods Forty-four eyes of 44 patients with exudative AMD were enrolled into this retrospective study, 19 were men and 25 were women. The mean age was 78 years (range 64–92 years). All patients were underwent best corrected visual acuity (BCVA, Early Treatment of Diabetic Retinopathy Study), fundus color photography, fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA) and optical coherence tomography (OCT). The mean BCVA was (50.36±14.43) letters, the mean central foveal thickness (CFT) was (291.95± 82.19)μm, and the fluorescence leakage area of choroidal neovascularization (CNV) was (7.61±5.84) mm2. All patients received three initial intravitreous injection of ranibizumb (IVR) and were retreated with monthly IVR when needed. The mean follow up time was 25.6 months (range 24–29 months). On 1, 2, 3, 6, 12, 18 and 24 months after treatment, BCVA and OCT were repeated. On 3, 6, 12, 18 and 24 months after treatment, FFA and ICGA were repeated. The change of BCVA, CFT and fluorescence leakage area of CNV were observed. The association of baseline characteristics and two year visual outcomes were analyzed. Results On 1, 2, 3, 6, 12, 18 and 24 months after treatment, the BCVA were improved significantly (t=?1.89,?3.51,?4.61,?4.04,?5.77,?4.69;P0.05). Conclusion Two year visual outcomes of exudative AMD patients treated with ranibizumb is negative correlated with baseline BCVA and fluorescence leakage area of CNV, but not correlated with baseline CFT.
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Objective To compare the short-term efficacy of conbercept and ranibizumab for macular edema in central retinal vein occlusion (CRVO)and explore the relationship between the integrity of ellipsoidal zone and visual acuity.Methods Forty-four eyes of 44 patients with macular edema in CRVO were enrolled into this retrospective and comparative study.There were 15 eyes of 15 males,29 eyes of 29 females;age ranged from 49-61 years old,with an average age of (54.65±3.10) years.All patients were examined with best-corrected visual acuity (BCVA),intraocular pressure (IOP),slit lamp,fundus photograph,fundus fluorescein angiography (FFA),optical coherence tomography(OCT).BCVA were examined with interactional visual chart and recorded with logarithm of the minimum angle of resolution acuity.Twenty-three eyes were intravitreal injected with conbercept 0.5 mg (group A) and 21 eyes were intravitreal injected with ranibizumab 0.5 mg (group B).There was no statistical difference of age (t =-1.41),gender (x2 =0.55),the percentage of hypertension patients (x2 =0.27),average BCVA (t =-2.06),IOP (t=-2.52),central macular thickness (CMT) (t=-1.96),number of different integrity of ellipsoidal zone patients (x2 =1.00) and number of different types of macular edema patients (x2 =1.03)among the two groups (P＞0.05).The change in BCV.A.and CMT at 3,6 months between the two groups were compared.The relationship between BCVA at 6 months and BCVA,CMT at baseline were explored.The relationship between three groups of ellipsoidal zone and BCVA at baseline were evaluated.The change of BCVA after treatment between the three groups of ellipsoidal zone were Compared.The number of intravitreal injections between two groups was compared.Results During the 3,6 months after treatment,the mean BCVA were all improved with statistically difference in group A 0=5.13,7.39;P＜0.05) and group B (t=6.60,11.52;P＜0.05).There was no significant difference of BCVA at 3,6 moths between group A and group B (t=-0.99,-0.40;P＞0.05).During the 3,6 months after treatment,the mean CMT were all decreased with statistically difference in group A (t=11.58,i5.96;P＜0.05) and group B (t=18.77,35.16;P＜0.05).There was no significant difference of CMT at 3,6 months between group A and group B (t=-1.52,-1.63;P＞0.05).In both groups,BCVA at 6 months was related to BCVA at baseline (r=0.44,0.62;P＜0.05),but not related to CMT at baseline (r=0.19,0.01;P＞0.05).In the two groups,BCVA at baseline was related to the integrity of ellipsoidal zone (r=0.97,0.70;P＜0.05).There was statistical difference of the number of intravitreal injections in the two groups (t =-6.88,P＜0.05).There was no systemic or ocular serious side effects during the follow up.Conclusions Comparing to ranibizumab,conbercept has the same effective to the treatment of macular edema in CRVO,but the number of intravitreal injections is less.The integrity of ellipsoidal zone is related to BCVA.