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Objective:To observe and analyze the risk factors of secondary intraocular hypertension in diabetic macular edema (DME) patients after treatment with dexamethasone vitreous cavity implant (DEX).Methods:A retrospective observational study. A total of 352 patients with type 2 diabetes mellitus (T2DM) secondary macular edema diagnosed by ophthalmic examination and treated with DEX in Department of Ophthalmology of Harbin 242 Hospital from January 2016 to March 2022 were included in the study. Among them, 221 were males and 131 were females, with the mean age of (55.56±8.09) years. There were 194 patients with disseminated macular edema, 158 patients with cystoid macular edema. All patients underwent vitreous cavity implantation of DEX. Intraocular pressure (IOP) was measured once a month for 3 months after treatment, with IOP over than 25 mm Hg (1 mm Hg=0.133 kPa) or higher than 10 mm Hg from baseline as secondary intraocular hypertension. The relevant clinical data were collected, and the risk factors of secondary intraocular hypertension in DME patients after DEX treatment were analyzed by binary logistic regression.Results:Among 352 patients, 116 patients (32.95%, 116/352) were in the intraocular hypertension. Among them, 29 patients (25.00%, 29/116), 69 patients (59.48%, 69/116) and 18 patients (15.52%, 18/116) occurred intraocular hypertension at 1, 2 and 3 months after treatment, respectively. Compared with the normal IOP group, the IOP in the intraocular hypertension group increased significantly at 1, 2 and 3 months after treatment, with statistical significance ( t=10.771, 21.116, 13.761; P<0.001). Compared with normal IOP group, the patients in the intraocular hypertension group had younger age ( t=6.967), longer duration of diabetes ( t=5.950), longer axial length (AL) ( t=14.989), higher proportion of DME grade 3 ( Z=6.284), higher proportion of DEX implantation in pars plana ( χ2=23.275), and higher HbA1c level ( t=10.764), the differences were statistically significant ( P<0.05). Logistic regression analysis showed that longer AL [odds ratio ( OR)=1.428, 95% confidence interval ( CI) 1.054-1.934], DEX implantation in pars plana ( OR=1.358, 95% CI 1.063-1.735), and higher HbA1c ( OR=1.702, 95% CI 1.225-2.366) were the risk factors for secondary intraocular hypertension in DME patients after DEX treatment ( P<0.05), older age was a protective factor ( OR=0.548, 95% CI 0.380-0.789, P<0.05). Conclusions:Long AL, DEX implantation in pars plana and high HbA1c are the risk factors for secondary intraocular hypertension after DEX treatment in DME patients, older age is a protective factor.
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@#AIM:To investigate the neuroprotective effect of vitreous cavity transplantation of bone marrow mesenchymal stem cells on rat glaucoma model. <p>METHODS: Rat primary bone marrow mesenchymal stem cells were extracted and identified; Lewis rats were randomly divided into 3 groups: Control group, Glaucoma group and bone marrow mesenchymal stem cell group(BMMSCs group), and rat glaucoma model were made: the left eye was the experimental eye(glaucoma), the right eye is the control eye, and identified them. Then vitreous cavity transplantation of bone marrow mesenchymal stem cells were performed; HE staining was used to observe the morphology of the retina; The number of retinal ganglion cells was detected by immunofluorescence; TUNEL staining was used to observe the apoptosis of retinal ganglion cells; The expression of IGF1 and BDNF protein in retinal tissue was detected by Western blot. <p>RESULTS: The intraocular pressure of the experimental eyes of the rats was significantly higher than that of the control eyes(<i>P</i><0.01), indicating that the glaucoma rat models were successfully constructed; In the Glaucoma group, the retinal nerve fibers were irregularly arranged, the number of retinal ganglion cells and retinal thickness were significantly lower than that of the control group(<i>P</i><0.01), and the number of apoptosis of retinal ganglion cells was significantly higher than that of the control group(<i>P</i><0.001); The retinal nerve fiber cells in the BMMSCs group were arranged neatly. The number of retinal ganglion cells and retinal thickness were significantly higher than those in the Glaucoma group(<i>P</i><0.05), and the number apoptosis of retinal ganglion cells was significantly lower than that of Glaucoma group(<i>P</i><0.01); The expression of IGF1 and BDNF in the retina of the Glaucoma group was significantly lower than that in the control group(<i>P</i><0.01), the expression of IGF1 and BDNF in the retina of the BMMSCs group was higher than that in the Glaucoma group(<i>P</i><0.05). <p>CONCLUSION:Bone marrow mesenchymal stem cell vitreous cavity transplantation can improve glaucoma in rats and protect retinal ganglion cells.
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?AIM: To explore the application of 25G vitreous cavity perfusion in phacoemulsification for cataract after vitrectomy.?METHODS:Forty-eight patients (50 eyes) with cataract after pars planavitrectomy in our hospital from September 2013 to September 2014 were selected to receive phacoemulsification and implantation of artificial lens with 25G vitreous cavity perfusion. Best corrected visual acuity ( BCVA ) , intraocular pressure ( IOP ) , postoperative discomfort, healing of scleral puncture and postoperative complications were observed.?RESULTS: All patients underwent surgery successfully. Compared to before operation, there was less patients with BCVA ≤0. 1, more patients with BCVA 0. 3-0. 5,>0. 5,>0. 3 (P0. 05). No obvious eye discomfort and severe complications after operation were observed.? CONCLUSION: The effect of 25G vitreous cavity perfusion in phacoemulsification for cataract after vitrectomy is good and it can maintain IOP, keep anterior chamber stable and decrease the complications risk.
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OBJECTIVE:To investigate the effect of intravitreal injection of ranibizumab on visual acuity and GAS6,SDF-1 and VEGF levels in serum of patients with proliferative diabetic retinopathy lesions. METHODS:56 patients diagnosed as prolifera-tive diabetic retinopathy in our hospital during Mar. 2012 to Mar. 2014 were analyzed retrospectively and divided into simple lateral eyes group(29 cases)and bilateral eyes group(27 cases). All patients received single intravitreal injection of ranibizumab. The se-rum levels of GAS6,SDF-1 and VEGF were detected before treatment and 1,4 and 8 weeks after treatment. The visual acuity of patients were detected before treatment and 1 week after treatment. RESULTS:1,4 and 8 weeks after treatment,the serum levels of GAS6,SDF-1 and VEGF in 2 groups were decreased significantly,with statistical significance(P0.05). 1 week after treatment,the number of letter which had been seen by patient’s BC-VA were increased,compared to before treatment,with statistical significance(P0.05). CONCLUSIONS:Intravitreal injection of ranibizumab can improve visual acuity of patients with pro-liferative diabetic retinopathy.