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Objective:To evaluate the efficacy of intravitreal injection of anti-vascular endothelial growth factor (VEGF) drugs combined with retinal laser photocoagulation and anti-VEGF drugs alone in the treatment of retinal vein occlusion (RVO) combined with macular edema (ME).Methods:A evidence-based medicine study. Retinal vein occlusion (obstruction), macular edema, anti-vascular endothelial growth factor, bevacizumab, ranibizumab, conbercept, aflibercept, and retinal laser photocoagulation were the Chinese and English search terms. Related literature was searched in China National Knowledge Infrastructure, Wanfang, Weipu, PubMed, Embase, Cochrane Library. RVO combined with ME was selected as the research object, and the treatment plan was a clinical randomized controlled study comparing intravitreal injection of anti-VEGF drugs combined with laser photocoagulation and anti-VEGF drugs alone. The search time range was from January 2011 to February 2021. Repeated, incomplete or irrelevant literature, case reports and review literature were excluded. Review Manager 5.4 statistical software was used to conduct a meta-analysis of the literature. The weighted mean difference (WMD) and 95% confidence interval ( CI) were selected as the estimated value of effect size, and the fixed effect model was used for analysis. The evaluation indicators were best corrected visual acuity (BCVA), center macular thickness (CMT), and the number of injections. Results:According to the search strategy, 461 articles were initially retrieved, and 21 articles were finally included for meta-analysis. A total of 1156 patients were enrolled, of which 576 were treated with anti-VEGF drugs combined with laser photocoagulation (combined treatment group), and 580 were treated with anti-VEGF drugs alone (drug treatment group). Meta-analysis results showed that there was no statistically significant difference in BCVA and CMT between the drug treatment group and the combination treatment group at 6, 9, and 12 months after treatment (BCVA: WMD =-0.82, 95% CI -2.38-0.74, P=0.30; CMT: WMD=-3.12, 95% CI -17.25-11.01, P=0.67). For patients with branch retinal vein occlusion and ME, combined therapy can reduce the number of injections more effectively than drug therapy alone ( WMD=-0.80, 95% CI -1.18--0.42, Z=4.10, P <0.000 1). Conclusion:Compared with pure intravitreal injection of anti-VEGF drugs, combined retinal laser photocoagulation can not better improve BCVA and CMT in patients with RVO and ME. For patients with branch retinal vein occlusion and ME, combined retinal laser photocoagulation can effectively reduce the resistance. The number of VEGF injections.
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Objective:To investigate the effects of leukocyte common antigen-related phosphatase receptor (LAR) on the regulation of visual plasticity in rats.Methods:Fourty newborn Wistar rats were randomly divided into 5 groups, with 8 rats in each group, and were executed at 1 week, 3, 5, 7 and 9 weeks postnatal, respectively.Thirty-two healthy and 10-week-old Wistar rats were randomly divided into a normal control group, a fluoxetine group, a binocular form deprivation (BFD) group and a BFD+ fluoxetine group, with 8 rats in each group.Rats in the fluoxetine group drinked water with the dosage of 0.2 mg/ml fluoxetine for 4 weeks.The rats in the BFD group received eyelids suture for 2 weeks to form BFD model.And the combination of fluoxetine administration and BFD was performed in the BFD+ Fluoxetine group.No intervention was conducted in the normal control group.The expressions of LAR and chondroitin sulfate proteoglycans (CSPGs) were detected by immunofluorescence.The expression of LAR in the visual cortex of rats was detected by Western blot.Results:LAR was distributed in the cell membrane, plasma and axon.CSPGs were distributed in the intercellular substance in visual cortex of rats.The fluorescence intensities of LAR and CSPGs increased with the postnatal development.The relative expression of LAR was (100.00±3.20)%, (108.37±2.26)%, (113.69±2.33)%, (131.83±3.78)% and (140.11 ±4.02)% at 1 week, 3, 5, 7 and 9 weeks postnatal, respectively, the difference was statistically significant ( F=31.70, P=0.001). The relative expression of LAR was increased according to the growth of age ( β=0.961, P=0.007). The relative expression of LAR was(100.00±2.96)%, (81.02±2.77)%, (71.99±3.09)% and (52.90±2.01)% in the normal control group, fluoxetine group, BFD group and fluoxetine+ BFD group, respectively, with a significantly difference among the groups ( F=18.16, P=0.015), the relative expressions of LAR protein in the fluoxetine group, BFD group and BFD+ fluoxetine group were significantly lower than that in the normal control group ( t=31.30, 36.10, 41.72; all at P<0.01). Conclusions:LAR may be involved in the regulation of visual plasticity as a specific receptor of CSPGs.
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Objective To observe the morphologic alterations of retina pigment epithelial around fluorescein leakage site using spectral-domain optical coherence tomography (SD-OCT) in acute central serous chorioretinopathy (CSC) before and after laser coagulation.Methods Twenty-four eyes of 24 consecutive patients with unilateral acute CSC who underwent laser photocoagulation (wave length:561 nm,energy:80-100 mW,spot diamteter:100 μm,exposure time:0.1 s) were enrolled in this retrospective study.The patients included 22 males and 2 females,with an average age of (39.2± 7.2) years and an average duration of (1.1 ± 0.6) months.The fluorescein leakage outside the foveal avascular zone and serous retinal detachment were found in all the eyes by fluorescein fundus angiography (FFA) and SD-OCT.Twenty-six leakage sites were observed in 24 eyes on FFA.There were 5 smoky leakage points (19.2％),21 inky leakage points (80.8 ％).The retinal pigment epithelial (RPE) layer at leakage points were scanned by SD-OCT before and at 2 weeks,2 months after treatment.SD-OCT showed that the RPE abnormalities were detected at all of the fluorescein leakage points,including serous pigment epithelial detachment (PED) in 16 leakage points (64.5％),protruding RPE in 5 leakage points (19.5％),and irregular RPE in 5 leakage points (19.2％).The morphologic alterations of RPE around fluorescein leakage point before and after laser coagulation were observed.Results At 2 weeks after laser photocoagulation,PED existed in 7 leakage points (26.9％),protruding RPE in 3 leakage points (11.5％),and irregular RPE in 16 leakage points (61.5％).At 2 months after laser photocoagulation,protruding RPE existed in 3 leakage points (11.5％),and irregular RPE in 5 leakage points (19.2％),including RPE defect in 2 leakage points.And there were undetectable RPE abnormalities in other 16 leakage points (61.5％).Conclusions In acute CSC,SD-OCT shows that morphologic features of the RPE layer are changed,including PED,protruding RPE,irregular RPE around the leakage point.After laser photocoagulation the abnormalities of RPE can also be altered from PED to irregular RPE,and RPE defect is observed in restricted regions.
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Objective To characterize the changes of retinal structure and visual field mean defects (MD) in early Parkinson's disease (PD) and the related factors.Methods Twenty-five patients with early stage PD and 33 normal controls were enrolled in this study.PD patients were evaluated by unified Parkinson's disease rating scale (UPDRS) and Hoehn-Yahr (H-Y) stage in off period.All subjects undertook retina of retinal nerve fiber layer (RNFL) and macular examinations by optical coherence tomography (OCT),and MD by automatic visual field analyzer.Results (1) The average thicknesses of RNFL and C11 quadrant RNFL were thinner in PD group [(96.2 ±7.6) μm and (124.4 ± 18.4) μm] than in healthy controls [(102.6 ± 5.0) μm and (135.4 ± 21.8) μm,respectively,P =0.000 and P =0.047].Moreover,PD patients had a thinner average thickness of macular[(277.2 ±9.6) μm vs (285.8 ± 12.6)μm,P=0.006],and smaller macular volume compared with controls [(10.0 ± 0.3) mm3 vs (10.3 ±0.4) mm3,P =0.006].However,there was no significant difference in MD between PD and control subjects [(0.43 ± 2.75) dB vs (-0.18 ± 1.41) dB,P =0.322].(2) Pearson's correlation analysis showed that H-Y stage was negative correlated with the average RNFL thickness (r =-0.569),average macular thickness and volume (r=-0.501 and r=-0.417) in PD patients (all P＜0.05).Conclusions PD patients have thinner average thicknesses of RNFL,C11 quadrant RNFL and macular,smaller macular volume than those in normal controls.There were no significant differences in MD between two groups.There were negative relationships between H-Y stage,and retinal thickness and volume of PD patients.
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BACKGROUND:Treatment methods of pterygium mainly include pterygium excision,pterygium excision combined with local application of mitomycin,pterygium excision combined with conjunctival flap transfusion and pterygium excision combined with autologous corneal limbus stem cell transplantation.Dry eye commonly occurred in many patients following pterygium excision.OBJECTIVE:To evaluate the effects of stem cell transplantation of limbus cornea and simple excision of pterygium on tear film stability.METHODS:Eighty patients(eighty eyes)with pterygium were involved in this clinical experiment.All patients were randomly divided into 2 groups:Group A accepted simple excision of pterygium in 40 patients with 40 eyes under a 10-fold microscope,and Group B accepted excision of pterygium with stem cell transplantation of limbus cornea in 40 patients with 40 eyes under a 10-fold microscope,in which a free transplantation of the superotemporal limbus stem with an adjacent piece of conjunctiva was transplanted in the excision area.Slit-lamp examination,tear film break-up time and questionnaire on dry eye were performed before operation,at one week post-operation,and at three months post-operation.RESULTS AND CONCLUSION:In both groups,following surgery,some patients affected dryness,foreign body sensation,burning sensation.These symptoms were more in the group A compared with group B(P ＜ 0.05).Implant was red 1 week following surgery in the group B,and confluence was found,without infection or rejection.The tear film break-up time was prolonged in the group B compared with the group A at 1 week following surgery,and no significant difference was determined at 3 months.Results indicated that compared with simple excision of pterygium,combined excision of pterygium with stem cell transplantation of limbus cornea obtained better outcomes,and could decrease the manifestations of dry eye and maintain better tear film stability in patients with pterygium.
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Objective To detect the changes of soluble αB-crystallin in X-ray irradiated rat lens,and to explore the potential role of αB-crystallin in the pathogenesis of radiation-induced cataract.Methods The radiation cataract model was established with the accelerator linear in male Sprague-Dawley(SD)rats.The rats were divided into normal control group,experimental control group and X-irradiated group(the doses were 5,15,and 25 Gy,respectively).The rats were killed at 3 morlths post-irradiation,and the lenses were carefully isolated and homogenized.The protein changes of αB-crystallin in lens supernatant were measured by Western blotting.Results Typical radiation-induced cataract was observed in 15 and 25 Gy groups,while the lenses of the normal control group,experimental control group and the 5 Gy irradiation group remained transparent.The αB-crystallin protein level was significandy decreased in a dose-dependent manner(5 Gy group:0.871±0.085;15 Gy group:0.643±0.096;25 Gy group:0.338±0.160;F=40.764,P＜0.05).Conclusions The decreased expression of the molecular chaperone αB-crystallin in X-irradiated rat lens indicates its important role in the pathogenesis of irradiation cataract.