Relationship between the continuity of ellipsoid zone and best corrected visu-al acuity in patients with idiopathic epiretinal membrane / 眼科新进展

Objective To investigate the relationship between the central foveal thickness(CFT),ellipsoid zone(EZ)interruption ratio and best corrected visual acuity(BCVA)in patients with idiopathic epiretinal membranes(iERM).Methods A retrospective case-control study was conducted.The cluster sampling method was used to select 336 iERM patients(500 eyes)who underwent physical examinations in 9 community hospitals of the Kailuan Group from 2014 to 2018.Among them,215 were male(64.0％)and 121 were female(36.0％),with an average age of 31-89(66.4±8.8)years.According to the gass classification,these patients were divided into three groups:gass 0 group(201 patients,305 eyes),gass 1 group(75 patients,101 eyes),and gass 2 group(60 patients,94 eyes).Pearson correlation analysis was used to evaluate the correlation between BCVA(converted to logMAR visual acuity)and gass classification,EZ interruption ratio,CFT.Results The average BCVA(logMAR)and CFT of 500 eyes were 0.45±0.28 and(337.6±101.8)μm,re-spectively,with EZ interruption in 86 eyes(17.2％).There were statistically significant differences in BCVA(logMAR)(0.62±0.29,0.48±0.23,0.26±0.32),CFT[(283.20±79.30)μm,(335.50±84.50)μm,(394.00±135.60)μm],and EZ interruption ratio(2.6％,20.8％,60.6％)among gass 0,gass 1 and gass 2 groups(all P＜0.05).Pearson correlation analysis showed that there was no correlation between age and BCVA among different groups(r2=0.021,P=0.314);BCVA was positively correlated with CFT(r2=0.531,P=0.000),EZ interruption ratio(r2=0.304,P=0.000),and gass classification(r2=0.587,P=0.000).Conclusion The EZ interruption may occur in the early stage of iERM.BCVA is correlated with CFT,EZ interruption ratio and gass classification;the incidence of EZ interruption in gass 2 iERM signifi-cantly increases.

Correlation between baseline aqueous humor cytokine levels and anti-vascu-lar endothelial growth factor treatment in patients with macular edema sec-ondary to retinal vein obstruction / 眼科新进展

Objective To analyze the effect of baseline cytokines in aqueous humor in predicting the improvement of the central macular thickness(CMT)and best corrected visual acuity(BCVA)of patients with macular edema secondary to retinal vein obstruction(RVO-ME)after anti-vascular endothelial growth factor(VEGF)treatment for 3 months.Meth-ods Totally 30 eyes of 30 patients initially diagnosed with RVO-ME in the Affiliated Eye Hospital of Nanjing Medical Uni-versity from October 2021 to January 2023 were enrolled.Aqueous humor was collected by anterior chamber puncture be-fore the anti-VEGF drug injection.The levels of 11 cytokines in aqueous humor,including VEGF,intercellular adhesion molecule(ICAM)-1,interleukins(ILs)and interferon-γ(IFN-γ),were measured by Luminex xMAP technology.The cor-relation between baseline aqueous humor cytokine levels and CMT,BCVA(logMAR)as well as their changes(difference between baseline and anti-VEGF treatment for 3 months)in RVO-ME patients was analyzed;the correlation between CMT and BCVA(logMAR)was analyzed at baseline and 3 months after anti-VEGF treatment.CMT and BCVA responders were defined as patients with 50％or more reduction in CMT and BCVA(logMAR)from baseline to the third month.A Logistic regression model was used to analyze the relationship between baseline aqueous humor cytokines and RVO-ME patients be-coming CMT or BCVA responders after 3 months of anti-VEGF treatment.Results Compared with baseline,the CMT sig-nificantly decreased and BCVA significantly improved in RVO-ME patients after anti-VEGF treatment for 3 months(both P＜0.001).The CMT was positively correlated with BCVA(logMAR)of RVO-ME patients at baseline and after anti-VEGF treatment for 3 months(P=0.026,0.002).At baseline,the levels of VEGF and IL-8 of RVO-ME patients were positively correlated with CMT(P=0.032,0.035);the levels of IL-6 and IL-8 were positively correlated with BCVA(logMAR)(P=0.018,0.002).The baseline IL-8 level in RVO-ME patients was negatively associated with the change in CMT(P=0.024).Logistic regression analysis showed that elevated baseline ICAM-1 level could increase the risk of RVO-ME patients becom-ing BCVA non-responders after 3 months of anti-VEGF treatment(P=0.023).Conclusion Baseline IL-8 and ICAM-1 may be predictors of CMT and BCVA improvement after anti-VEGF treatment of RVO-ME.

Role of 0.01% Atropine in Progressive Myopia in Children

Objective: Role of 0.01% atropine in progressive myopia in children. Material and methods: After getting approval from the ethical committee of the Government medical college kota, we conducted a prospective study of 50 children from march 2021 to march 2022 for progressive myopia (>0.5 D/year) out of which 25 children got treatment in form of topical atropine 0.01%. The effectiveness of the drug was evaluated by calculating SE (Spherical Equivalent) at every visit. Mean change in SE was calculated before treatment and after treatment and a comparison of both the mean values was done for the efficacy of the drug. Results: Out of 25 treatment groups, 14 were males and 11 were females. There was 13 male and 12 female in the control group. The mean age was 9.7 years ± 2.3 years (range 5 years-14 years) and 12.1 years ± 2.9 years (6 years-16 years) in the atropine and control groups respectively. At baseline mean SE was found to be -2.9 ± 0.149 and -2.63 ± 0.268 whereas Best Corrected Visual Acuity (BCVA) was 0.438 ± 0.067 and 0.65 ± 0.14 in the atropine and control group respectively. The rate of myopia progression in study participants. The mean progression rate was found to be lower in the atropine group when compared before and after treatment (-0.97 ± 0.055 versus -0.23 ± 0.018). It was found to be 0.23 D/year which is supported by various previous studies like the atom 2 study in which myopic rate progression was 0.42 D after 12 months of atropine use. Conclusion: It can be concluded that 0.01% atropine eyedrops used once daily before bed can slow the progression of myopia with very good tolerance and few side effects, making it a recommended treatment to be included in our therapeutic routine.

Study-of-phacoemulsification-vs-phacotrabeculectomy-in-management-of-primary-angle-closure-glaucoma

Introduction: The study was conducted to evaluate IOP management by surgical modalities such as combined trabeculectomy and phacoemulsification and phacoemulsification surgery alone. Vision impairment is a major public health problem and the burden is increasing with increase in aged population. This study wasAims And Objectives: undertaken for study the IOP management by surgical modalities such as combined trabeculectomy and phacoemulsification and phacoemulsification surgery alone. A pre-designed prospective study was conducted at the OPD of upgraded Department of Ophthalmology at LLRM Medical College, Meerut. A total of 60 patients were divided in to two equal groups randomly and studied. Majority of the patients in both the groups wereObservation And Result: aged between 61 – 70 years. Females outnumbered males in this study which was statistically significant between the two groups. The mean pre- operative intra ocular pressure was 23.3 mm Hg in combined surgery group and 23.9 mm Hg in cataract surgery alone group. Mean Intra ocular pressure decreased regularly in each follow up more in combined group than the cataract surgery alone group. The mean intra ocular pressure after 1 years follow up in combined surgery group was 10.8 mm Hg and 13.4 mm Hg in the cataract surgery alone groups which was statistically significant. Mean BCVA before the operation was 3.2 in combined surgery group and 3.8 in cataract surgery before surgery. Mean BCVA declined after 1 year of follow up in combined surgery group was 1.9 and 2.7 in cataract surgery alone group which was statistically significant. The surgery success was complete in 80.0% of the combined surgery group and 60% of the cataract alone group. Criteria For Failure Of Surgeries Ÿ The IOP >23 MMHG at the end of 1 year or Ÿ The IOP not reduced by 20 % from base line at the end of 1 year Conclusion: This study was mainly undertaken to study the efficacy of combined trabeculectomy with cataract extraction and cataract only on primary angle closure glaucoma. This study had found that, the reduction of intra ocular pressure in both the groups but more prominent in combined surgery group than cataract alone surgery group.

Triamcinolone Acetonide combined with Aflibercept in the treatment of wet age-related macular degeneration with poor response to Ranibizumab / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To compare the efficacy and safety of intravitreal injection of aflibercept combined with posterior sub-fascial injection of triamcinolone acetonide in the treatment of wet age-related macular degeneration(ARMD)with poor response to anti-vascular endothelial growth factor drugs.METHODS: Retrospective cohort study. From June 2018 to May 2020, a total of 60 patients(60 eyes)with refractory ARMD who had poor response to the treatment of anti VEGF drug ranibizumab were randomly divided into the control group of aflibercept and the observation group of triamcinolone acetonide combined with aflibercept, with 30 patients(30 eyes)in each group. Once a month, the patients in the two groups received intravitreal injection of aflibercept alone or intravitreal injection of aflibercept combined with posterior sub-fascial injection of triamcinolone acetonide for three consecutive times. The changes of best corrected visual acuity(BCVA), central macular thickness(CMT)and intraocular pressure were reviewed before injection and 1, 3 and 6mo after the third injection.RESULTS: The BCVA and CMT of the two groups were significantly improved 1, 3 and 6mo after the injection of the drug(P<0.05). The mean intraocular pressure in the combined group was higher at 1mo after treatment than before, but it still within the normal range. There was a significant difference in intraocular pressure between the two groups(17.50±4.60 vs. 18.30±3.73mmHg, P<0.05).CONCLUSION: Triamcinolone acetonide injection under the posterior fascia of the eyeball combined with intravitreal injection of aflibercept in the treatment of wet ARMD can effectively reduce macular edema and improve vision, which is more safe and reliable.

Comparison of 25-gauge+ and 27-gauge+ micro-invasive vitrectomy for vitreoretinal diseases / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To comparatively analyze the efficacy and safety between 25-gauge(25G+)and 27G+ micro-invasive vitrectomy for the treatment of vitreoretinal diseases.METHODS: The clinical data of 89 cases(89 eyes)of vitreoretinal disease who received vitrectomy at our hospital from March 2019 to April 2022 were retrospectively analyzed. They were divided into two groups according to surgery. A total of 45 cases(45 eyes)who received 25G+ micro-invasive vitrectomy were included in group A, and 44 cases(44 eyes)who received 27G+ micro-invasive vitrectomy were included in group B. Vitrectomy time, operation time, preoperative and postoperative best corrected visual acuity(BCVA), intraocular pressure, subjective comfort evaluation results and complications of the both groups were analyzed.RESULTS: There were no differences in vitrectomy time of the two groups(P>0.05), while the operation time of group B was shorter than that of group A(35.50±14.27min vs. 41.73±14.25min, P=0.042). The postoperative BCVA of the two groups were better than that before operation(P<0.05), while there was no significant difference between two groups(P>0.05). The postoperative intraocular pressure of the two groups was lower than that before operation(P<0.05), and it was slightly lower than group B at 1 and 7d after operation(P<0.05). As for the subjective comfort evaluation results, the scores of group A was higher than that of group B at 1d after operation(6.13±1.20 vs. 3.45±1.17, P<0.001); and there were no differences between two groups at 7d after operation(2.18±1.01 vs. 1.93±0.87, P=0.215). During the follow-up, 7(16%)eyes of incision leakage occurred in group A, of which 6(13%)eyes were transient hypotony, and 10(22%)eyes had conjunctival chemosis. In the group B, there was no incision leakage and transient hypotony, while conjunctival chemosis occurred in 2(4%)eyes at 1d after operation.CONCLUSION: Both 25G+ and 27G+ micro-invasive vitrectomy can improve visual acuity, stabilize intraocular pressure and be safe in patients with vitreoretinal disease. However, 27G+ micro-invasive vitrectomy has less leakage, stable intraocular pressure, shorter operation time and lower incidence of conjunctival chemosis.

Value of spectral domain-optical coherence tomography parameters on evaluating visual acuity improvement after internal limiting membrane peeling of macular hole / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To analyze the application value of spectral domain-optical coherence tomography(SD-OCT)parameters on evaluating visual acuity improvement after internal limiting membrane peeling of macular hole.METHODS: The retrospective analysis was performed on the clinical data of 82 patients(82 eyes)with idiopathic macular hole(IMH)who underwent vitrectomy + internal limiting membrane peeling + long-acting gas tamponade in the hospital between May 2019 and February 2021. The correlation between IMH closure and SD-OCT parameters at 3mo after surgery was analyzed, and the risk factors for poor postoperative visual acuity improvement were evaluated.RESULTS: Spearman rank correlation coefficient analysis showed that IMH closure at 3mo after operation was positively correlated with preoperative external limiting membrane(ELM)defect diameter(rs=0.308, P<0.05), and it was negatively correlated with preoperative macular hole index(MHI; rs=-0.266, P<0.05). Logistic regression analysis revealed that preoperative MHI≥0.5 was a protective factor affecting poor postoperative visual acuity improvement(OR=0.691, P<0.05).CONCLUSION: SD-OCT can predict the surgical efficacy by detecting the preoperative MHI and ELM defect diameter, and it is beneficial to judging the improvement of visual function.

Meta-analysis of the efficacy of intravitreal Ranibizumab combined with compound trabeculectomy and panretinal photocoagulation in the treatment of neovascular glaucoma / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To systematically evaluate the efficacy and safety of intravitreal ranibizumab combined with compound trabeculectomy and panretinal photocoagulation(PRP)compared with compound trabeculectomy combined with PRP in the treatment of neovascular glaucoma(NVG).METHODS: Databases including Wanfang database, China National Knowledge Infrastructure(CNKI), PubMed, EMbase, China Biomedical Document Service System(CBM), Clinicalkey, and Cochrane Library were retrieved. Literatures about intravitreal ranibizumab combined with compound trabeculectomy and PRP in the treatment of NVG in the experimental group and compound trabeculectomy and PRP in the treatment of NVG in the control group from creation of database to July 20, 2022 were searched. At the same time, relevant reference were consulted. The best corrected visual acuity, intraocular pressure, occurrence of complications and the success rate of the surgery were systematically evaluated.RESULTS: A total of 8 clinical studies were included, with 864 patients(864 eyes)with NVG. Meta-analysis showed that the intraocular pressure of patients in the experimental group was lower than that in the control group at 1wk, 1 and 3mo after surgery(1wk: MD=-4.00, 95%CI: -4.62～-3.38, P<0.05; 1mo: MD=-4.11, 95%CI: -4.66～-3.56, P<0.05; 3mo: MD=-4.58, 95%CI: -5.61～-3.55, P<0.05). The best corrected visual acuity of the experimental group was better than that of the control group at 1mo after surgery(MD=0.17, 95%CI: 0.11～0.23, P<0.05), but there was no significant difference at 1wk after surgery(MD=0.08, 95%CI: -0.13～0.29, P=0.47). The patients in the experimental group had fewer complications(OR=0.30, 95%CI: 0.18～0.52, P<0.05)and higher surgical success rate(OR=5.15, 95%CI: 2.78～9.53, P<0.05).CONCLUSION:With decreased intraocular pressure, improved visual acuity and surgical success rate, intravitreal ranibizumab combined with compound trabeculectomy and PRP was better than the compound trabeculectomy and PRP in the treatment of NVG.

Efficacy of Aflibercept and Ranibizumab in the treatment of diabetic macular edema / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To compare the efficacy of aflibercept and ranibizumab in the treatment of diabetic macular edema(DME).METHODS: Prospective randomized controlled trial. A total of 35 patients(60 eyes)with non-proliferative diabetic retinopathy complicated with DME confirmed in our hospital from June 2020 to September 2021 were included. Intravitreal injection was performed using the 3+PRN protocol in all cases, of which 17 cases(30 eyes)received aflibercept treatment(aflibercept group)and 18 cases(30 eyes)received ranibizumab(ranibizumab group). The two groups were followed up for 12mo, observing the central macular thickness(CMT)and the best corrected visual acuity(BCVA)of the two groups, and recording the number of intravitreal injections and the occurrence of complications.RESULTS: After treatment, CMT and BCVA in the aflibercept group were significantly better than that in the ranibizumab group at 1, 3, 6 and 12 mo(all P<0.001). During the follow-up period, the number of intravitreal injections in the aflibercept group was lower than that in the ranibizumab group(4.23±0.86 vs. 6.40±0.97, P<0.05), there were no serious complications such as drug-related adverse reactions, intraocular infection, and vascular embolism in either group.CONCLUSION: Both aflibercept and ranibizumab have clear efficacy and safety in the treatment of DME, and aflibercept may be a more effective and convenient treatment option than ranibizumab for DME patients.

Visual outcome after manual small-incision cataract surgery by viscoexpression technique

Purpose: Globally, cataracts have remained the major cause of blindness. Cataract accounts for 62.6% of blindness affecting 9� million people. The only treatment for cataracts is surgical removal of cataracts. The surgical procedures include phacoemulsification and extracapsular cataract extraction (ECCE). In India, there is a huge backlog of cataract patients. Phacoemulsification is preferred nowadays for early visual rehabilitation, but in developing countries like ours, where facilities are not widely available, small-incision cataract surgery (SICS) is a cost-effective alternative as no machine is required. Also, it provides early visual rehabilitation as it is sutureless when compared to ECCE. So, manual SICS has emerged as a substitute for phacoemulsification and ECCE. The aim of the study was to evaluate the visual acuity and surgically induced astigmatism in patients more than 40 years of age, undergoing manual SICS with nucleus management by viscoexpression technique. Methods: This was a prospective study that included 50 patients over the age of 40 years undergoing manual SICS at a tertiary health-care center in North India by viscoexpression technique. Only those patients whose functional visual disability could be attributed to cataracts were included in the study. Preoperative and postoperative astigmatism were analyzed in the first, fourth, and sixth weeks. Results: Fifty patients who were undergoing manual SICS were analyzed. Preoperative best-corrected visual acuity (BCVA) and astigmatism were compared to postoperative BCVA and astigmatism. Of 50 patients, 48 (96%) patients were able to gain good vision after 6 weeks. Conclusion: This study showed early visual rehabilitation with less surgically induced astigmatism following manual SICS by viscoexpression technique.

Re-inventing the straight incision with a single central suture in manual small-incision cataract surgery to minimize surgically induced astigmatism

Purpose: To calculate the surgically induced astigmatism (SIA) in MSICS through a superiorly placed straight scleral incision closed with a single, central, perpendicular 10?0 polyamide suture and to document any suture?related complaints and complications. Methods: A retrospective, hospital?based study was carried out in 50 cases of uncomplicated senile cataract (>50 year) with nuclear sclerosis ? grade 4, 搘ith the rule� astigmatism who underwent MSICS through a superior, straight incision with a single, central, perpendicular 10?0 nylon suture. Patients with 揳gainst the rule� astigmatism, keratoconus, pre?existing corneal opacity, astigmatism >2D, distorted or oblique mires, and previous ocular surgeries and unwilling to participate were excluded. Results: The mean age of the patients was 64.81 + 2.824 years, with a male: female ratio of 1.38:1. The mean SIA at day 7, week 6, and 12 weeks was 0.539 + 0.118, 0.529 + 0.134, and 0.524 + 0.129, respectively. Only 6 patients (12%) complained of foreign body sensation. No patient developed any suture?related complications. Conclusion: SIA is significantly reduced in straight incision by applying a single, central, and perpendicular 10?0 polyamide suture, as compared to a straight incision without a suture.

Relationship between BCVA and macular morphology in patients with diabetic macular edema / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To explore the relationship between the parameters of macular integrity assessment(MAIA), best corrected visual acuity(BCVA)and macular morphology in patients with diabetic macular edema. <p>METHODS: From March 2018 to January 2020, a total of 43 patients(74 eyes)with diabetic macular edema were randomly selected for treatment in the department of ophthalmology in our hospital.To compare the relationship between MAIA micro field meter parameters and the integrity of macular external membrane, junction of inner and outer photoreceptors(IS/OS)layer and hard exudation. Pearson correlation test was used to analyze the relationship between retinal thickness and retinal sensitivity. Pearson correlation test was used to analyze the correlation between retinal thickness, retinal sensitivity and BCVA in the intact and defect groups of IS/OS layer.<p>RESULTS: Compared with the IS/OS layer defect group, the levels of BCVA(LogMAR), central retinal thickness(CRT), elliptical area of binary contour 63(BCEA63), elliptical area of binary contour 95(BCEA95)and macular integrity index(MI)in the IS/OS layer intact group were lower, and the levels of average threshold(AT)and P2 were higher(all <i>P</i><0.01), but there was no significant difference in the levels of central retinal volume(CRV)and P1 between the two groups(all <i>P</i>>0.05). Compared with the external membrane defect group, the levels of BCVA(LogMAR), CRT and MI in the external membrane intact group were lower(all <i>P</i><0.05), but there was no significant difference in the levels of CRV, AT, P1, P2, BCEA63 and BCEA95 between the two groups(all <i>P</i>>0.05). Compare the group with and without hard exudation, there was no significant difference in eye parameters between the two groups(<i>P</i>>0.05).There was a significant negative correlation between retinal thickness and sensitivity in temporal, central and nasal sides of fovea(<i>P</i><0.05), but no significant correlation in the upper and lower parts of fovea(<i>P</i>>0.05). In the complete group of IS/OS layer, AT was significantly negatively correlated with CRT and BCVA, while CRT was significantly positively correlated with BCVA(all <i>P</i><0.05). In the IS/OS layer defect group, there was a significant negative correlation between AT and BCVA(<i>P</i><0.05).<p>CONCLUSION:MAIA in the diabetic macular edema is closely related to the morphology and structure of macular area, especially the integrity of IS/OS layer and outer membrane. MAIA may be an important index to evaluate the visual function of patients with diabetic macular edema.

Comparison of the efficacy of conbercept and intravitreal dexamethasone implant Ozurdex in the treatment of diabetic macular edema / 中华实验眼科杂志

Objective:To compare the efficacy and safety of intravitreal injection of anti-vascular endothelial growth factor drug conbercept and intravitreal dexamethasone implant Ozurdex in the treatment of diabetic macular edema (DME).Methods:A randomized controlled clinical study was performed.Thirty-six DME patients (36 eyes) were enrolled in Weifang Eye Hospital from March 2018 to June 2019.The patients were randomized into Ozurdex group and conbercept group via a random number table, with 18 eyes in each group.Patients received Ozurdex injection once, which was maintained for 6 months, or conbercept injection once a month for 3 times according to grouping.Before and after treatment, the best corrected visual acuity (BCVA) was examined with the International Standard Visual acuity chart and converted to logarithm of minimal angle resolution unit.The intraocular pressure (IOP) was measured using a non-contact tonometer.The central retinal thickness (CRT) was detected by optical coherence tomography (OCT).This study followed the Declaration of Helsinki and was approved by the Ethics Committee of Weifang Eye Hospital.Results:All patients were followed up for 6 months.In Ozurdex group, the BCVA pre-injection and at 1 month, 3, 4, 6 months after the first injection was 0.59±0.22, 0.53±0.20, 0.41±0.16, 0.38±0.19 and 0.56±0.19, respectively.The BCVA at 1 month, 3 and 4 months after the first injection were better than that before injection, and the differences were statistically significant (all at P<0.05).In conbercept group, the BCVA pre-injection and at 1 month, 3, 4, 6 months after the first injection were 0.60±0.23, 0.51±0.17, 0.29±0.13, 0.56±0.18 and 0.60±0.18, respectively.The BCVA at 1 month and 3 months after the first injection were better than that before injection, showing statistically significant differences (all at P<0.05).The CRT at 1 month, 3 and 4 months after the first injection were significantly lower than that before treatment in both the two groups (all at P<0.05).The CRT pre-injection was (498.61±77.14)μm in Ozurdex group, which was significantly higher than (462.17±48.74)μm at 6 months after the first injection ( P<0.05).No significant difference in CRT was found between pre-injection and 6 months after the first injection in conbercept group ( P>0.05).The incidence of high IOP in Ozurdex group was 33.3%(6/18), which was higher than 5.56%(1/18) in conbercept group, with a significant difference ( χ2=4.433, P=0.035).No adverse effects such as aggravation of cataract, lens injury, endophthalmitis, vitreous hemorrhage and retinal detachment was found during the follow-up. Conclusions:For DME, both conbercept and Ozurdex can improve BCVA and reduce CRT.Ozurdex shows durable efficacy and needs fewer injections than conbercept, but conbercept has less effect on IOP and is safer than Ozurdex.

25G lens resection combined with anterior vitrectomy in the treatment of congenital cataract / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To observe the clinical efficacy of 25G lens resection combined with anterior vitrectomy in the treatment of congenital cataract.<p>METHODS: This retrospective case series study included 55 eyes of 38 children with congenital cataract, age from 3mo to 5 years old, who were recruited between May 2013 and August 2017. The children were divided into two groups according to the different surgical methods. Group A(25 eyes of 17 children)received a 25G sutureless lensectomy combined with capsulotomy and anterior vitrectomy, and group B(30 eyes of 21 children)received a cataract phacoemulsification combined with capsulotomy and anterior vitrectomy. The mean follow-up time was 43.4(range: 36-74)mo. The postoperative best corrected visual acuity(BCVA), axial length, and complications were compared. <p>RESULTS: The age, sex distribution, duration, preoperative BCVA, and preoperative axial lengths were not significantly different between the two groups(<i>P</i>>0.05). The BCVA improved significantly at postoperative compared with BCVA at baseline in both gorups(Group A: <i>P</i><0.001; Group B: <i>P</i><0.001). The BCVA was better in Group A than Group B at 6mo postoperatively(<i>P</i>=0.043). No statistically significant difference was found in BCVA between the two groups at 12, 24 and 36mo after initial treatment(<i>P</i>=0.727, <i>P</i>=0.286, <i>P</i>=0.889). No statistically significant difference was found in axial lengths between 6mo of postoperation and preoperation in both groups(Group A: <i>P</i>=0.206, Group B: <i>P</i>=0.082). The mean postoperative axial lengths at 12, 24 and 36mo were longer than that at baseline in both group(Group A: <i>P</i>=0.023, <i>P</i>=0.015, <i>P</i><0.01, Group B: <i>P</i>=0.018, <i>P</i><0.01, <i>P</i><0.01). There were no significantly different in mean axial length after operation between the two groups(6mo: <i>P</i>=0.195, 12mo: <i>P</i>=0.313, 24mo: <i>P</i>=0.485, 36mo: <i>P</i>=0.089). The rate of postoperative complications was lower in Group A than Group B(<i>P</i>=0.042).<p>CONCLUSION: 25G sutureless lensectomy combined with capsulotomy and anterior vitrectomy is an effective and safe treatment method for congenital cataract, the visual acuity after treatment was improved significantly.

Meta-analysis of long-term efficacy of vitrectomy combined with anti-VEGF in the treatment of proliferative diabetic retinopathy / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To explore the long-term efficacy of vitrectomy combined with or without anti-VEGF in the treatment of proliferative diabetic retinopathy(PDR).<p>METHODS: Randomized controlled trials(RCTs)comparing the efficacy of vitrectomy combined with or without anti-VEGF therapy for PDR were retrieved from databases including PUBMED, EMBASE, Cochrane Central Register of Controlled Trials(CENTRAL)and Web of Science. The retrieval time was from the establishment of the databases to July 2020. According to the inclusion and exclusion criteria, the literature was selected, then data extraction and quality evaluation was completed. Primary evaluation measures included postoperative incidence of retinal detachment, central retinal thickness(CRT), and best corrected visual acuity(BCVA). <p>RESULTS: In this article, 11 randomized controlled studies(880 eyes)were included. Meta-analysis results showed that the incidence of retinal detachment after vitrectomy was significantly lower in PDR patients who received anti-VEGF injection before vitrectomy than in patients who did not receive anti-VEGF injection \〖Risk ratio(<i>RR</i>)=0.39, 95% Confidence interval(<i>CI</i>)0.22 to 0.71, <i>P</i>=0.002\〗. There were significant differences in the incidence of retinal detachment after vitrectomy between the anti-VEGF group and the non-VEFG group in both Asian and non-Asian populations(Asian:<i> RR</i>=0.20, 95%<i>CI</i> 0.05 to 0.87, <i>P</i>=0.03; Non-Asian:<i> RR</i>=0.46, 95%<i>CI</i> 0.24 to 0.89, <i>P</i>=0.02). The central retinal thickness of PDR patients who received preoperative anti-VEGF therapy was significantly lower than that of patients who did not receive anti-VEGF therapy 3 and 6mo after PPV(<i>MD</i>=-78.49, 95%<i>CI</i> -94.81 to -62.17, <i>P</i><0.00001. <i>MD</i>= -39.62, 95%<i>CI</i> -48.44 to -30.80, <i>P</i><0.00001). The BCVA at 6mo after PPV in PDR patients with preoperative anti-VEGF treatment was better than that in patients without preoperative anti-VEGF treatment(<i>MD</i>=-0.16, 95%<i>CI</i> -0.21 to -0.10, <i>P</i><0.00001).<p>CONCLUSION: Anti-VEGF injection before PPV can effectively reduce the incidence of retinal detachment, alleviate postoperative macular edema, reduce the central retinal thickness, and improve BCVA in PDR patients.

Effects of blunt trauma of eye on retinal nerve fibre layer / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To study the effects of blunt trauma of eye on visual acuity and retinal nerve fiber layer(RNFL).<p>METHODS: A prospective observational study was done on the patients of a road traffic accident(RTA)having blunt trauma injury of the eye from august 2018 to July 2019 at the Department of Ophthalmology, Hind Institute of Medical Sciences, Barabanki. Patients between the age group of 20 to 65 years undergoing RTA with ocular complaints were included in this study. Colour vision, contrast sensitivity, and best-corrected visual acuity(BCVA)were recorded, RNFL analysis was done through OCT.<p>RESULT: A total of 108 patients were enrolled in this study and were grouped as 54 cases and 54 controls. The mean age was 43±2.3 years with 11(20.4%)females and 43(79.6%)males in the case group. At initial visit after RTA, the difference between color vision, contrast sensitivity and BCVA between right and left eyes of cases and controls were significant. After a follow up of 3mo only significant difference was noted in contrast sensitivity between cases and control groups. Change in color vision and BCVA after 3mo was insignificant. Similarly, an initial significant difference was noted in mean RNFL thickness between cases and control groups, but after follow up of 3mo mean RNFL thickness difference was significant only in superior and temporal quadrants.<p>CONCLUSION:RTA or blunt trauma of eye can lead to persistent RNFL thinning and decreased visual function.

Safety and efficacy of glued intraocular lens implantation in eyes with inadequate capsular support

Background: Aim of the study was to analyze the postoperative visual outcomes, complication rate of fibrin glue-assisted, suture-less posterior chamber (PC) intraocular lens (IOL) implantation technique in eyes with inadequate capsule support at a tertiary eye care hospital.Methods: This is a retrospective, nonrandomized case series. This study analyzes 50 eyes which underwent PC-IOL implantation by fibrin glue-assisted, suture-less technique. All patients who had IOL implants by the fibrin glue-assisted PC-IOL technique from 2017 to 2019 were included in the study. Intra- and post-operative complications were analyzed. The postoperative best corrected visual acuity (BCVA) was evaluated and recorded at the end of 6 months.Results: Mean age of distribution are 42.94 years in glued IOL implantation. Among 50 cases 30 are males and 20 are females. There is significant difference in BCVA between preoperatively and postoperatively, p value for pre-operative to post-operative vision in glued intraocular lens group is <0.0001 i.e. there is definite improvement in vision  in glued intraocular group. BCVA ≥6/24 was 18 (48%) in Glued IOL subjects.Conclusions: Glued IOL implantation is a feasible option in rehabilitating patients with aphakia without adequate capsular support.

Comparison of the efficacy of two Conbercept regimens in the treatment of polypoid choroidal angiopathy / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To observe the efficacy of two conbercept regimens in the treatment of polypoid choroidal angiopathy.<p>METHODS: Twenty-one patients with polypoidal choroidal vasculopathy who met the inclusion criteria and were treated in our hospital were randomly divided into two groups. The group A(9 patients and 9 eyes)was treated with 3+Q12W scheme, namely, 0.5mg conbercept ophthalmic injection was intravitreally injected every 4wk for 3 consecutive times, and then 1 time every 12wk. In the group B(12 patients and 12 eyes), 3+TAE scheme was carried out, that is 0.5mg conbercept ophthalmic injection was intravitreally injected every 4wks for 3 consecutive times. The time of next injection was determined according to the evaluation results of each visit. The interval to the next visit/treatment was ≥ 4wk and ≤ 12wk. The best corrected visual acuity(BCVA), central retinal thickness(CRT)and the frequency of injection were compared between the two groups at 12 and 48wk after treatment, respectively.<p>RESULTS: BCVA of the group A was 74.78±11.23 letters and 74.67±13.94 letters at 12 and 48wk after treatment, which increased by 7.00±4.21 letters and 6.89±4.48 letters at the baseline before treatment, respectively. BCVA in the group B was 77.83±5.46 letters and 77.58±8.59 letters respectively at 12 and 48wk after treatment, which were 8.75±7.54 letters and 8.50±5.60 letters higher than the baseline before treatment. At the 12 and 48wk after injection, the average CRT in the group A was 276.33±44.34μm and 240.56±40.11μm, respectively, which were 43.22±42.21μm and 79.00±53.64μm lower than the baseline before treatment. At the 12 and 48wk after injection, the average CRT in the group B was 271.58±63.08μm and 241.00±43.91 μm, which were 57.42±45.33μm and 88.00±61.16μm lower than the baseline before treatment, respectively. The average times of intravitreal injection of conbercept were 6.00±0.00 and 7.75±1.14 times in the 3+Q12W group and the 3+TAE group, respectively.<p>CONCLUSION: Two different regimens of conbercept could reduce the CRT and improve the visual acuity of the patients with polypoidal choroidal vasculopathy. And the times of intravitreal injection in the 3+Q12W administration group were less than those in the3+TAE administration group.

The correlation between visual acuity and microperimetry evaluation of macular edema / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To analyze the correlation between subjective mean sensitivity and visual function <i>via</i> macular microperimetry.<p>METHODS: Totally 164 eyes of 127 patients with macular edema were involved in this study. According to different diseases, they were divided into 3 groups: age-related macular degeneration(AMD)(38 eyes), retinal vein occlusion(RVO)(43 eyes)and diabetic macular edema(83 eyes)groops. All patients underwent the examinations of optometry, optical coherence tomography scanner(OCT)and microperimeter. Correlation analysis was performed using Pearson, and <i>t</i>-test among groups.<p>RESULTS: Mean sensitivity(MS)values and fixation rate(P1, P2)of total patients with macular edema were significantly correlated with their BCVA, meanwhile the CRT was negatively correlated. MS values were significantly correlated with BCVA in AMD group, but the P1, P2 and CRT were not correlated. In DME and CRVO groups, MS values and P1, P2 were significantly correlated with BCVA, and CRTs were negatively correlated in DME but not correlated in CRVO. In BRVO group, MS values and CRTs were all not correlated with BCVA.<p>CONCLUSION:Microperimetry is probably a better subjective assessment for AMD macular function than OCT, and could be combined with OCT for function follow-up in DME and CRVO patients. For BRVO microperimetry might indicate certain macular dysfunction that could not be detected by VA or CCT. Microperimetry could be a subjective examination for the assessment of macular edema combined with OCT.

Meta-analysis of two kinds of Nd:YAG laser posterior capsulotomy in the treatment of posterior capsular opacification / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To systematically evaluate the efficacy and safety of two different kinds of Nd:YAG laser posterior capsulotomy in the treatment of posterior capsular opacification after cataract surgery and provide reliable evidence for the selection of posterior capsulotomy in clinical practice.<p>METHODS: A literature search was implemented in CNKI, Wanfang database, VIP database, PubMed, Medline and Cochrane Library from 2000-01-01 to 2019-12-31. Two researchers independently performed literature search, screening, quality evaluation, and data extraction. Meta-analysis was performed by RevMan 5.3 software. The mean difference and 95% confidence interval were used to measure the measurement data, including best corrected visual acuity, postoperative intraocular pressure, and laser energy. The odds ratio was used to measure the count data, including the rate of lens damage and the incidence of vitreous floaters.<p>RESULTS: A total of 7 studies were included, including Nd:YAG laser circular posterior capsulotomy and cruciate posterior capsulotomy in 432 eyes. The Meta-analysis showed that there was no significant difference in postoperative best corrected visual acuity between the circular posterior capsulotomy group and the cruciate posterior capsulotomy group, <i>MD</i>=-0.01(95% <i>CI</i>: -0.03-0.01,<i> P</i>=0.32); there was no significant difference in postoperative IOP between the circular posterior capsulotomy group and the cruciate posterior capsulotomy group, <i>MD</i>=-0.60(95% <i>CI</i>: -1.31-0.11,<i> P</i>=0.10); there was no significant difference in laser energy between the two groups, <i>MD</i>=18.82(95% <i>CI</i>: -11.88-49.51, <i>P</i>=0.23); there was also no significant difference in the rate of lens damage and the incidence of vitreous floaters, <i>OR</i>=0.97(95% <i>CI</i>: 0.50-1.87, <i>P</i>=0.93); <i>OR</i>=2.88(95% <i>CI</i>: 0.28-29.26, <i>P</i>=0.37). <p>CONCLUSION:In the treatment of posterior capsular opacification after cataract surgery with Nd:YAG laser posterior capsulotomy, there is no significant difference in efficacy and safety between circular posterior capsulotomy and cruciate posterior capsulotomy.