[Membrane peeling combined with intravitreal injection of bevacizumab for treatment of macular epiretinal membrane: analysis of 33 cases].

OBJECTIVE: To assess efficacy of membrane peeling combined with intravitreal injection of bevacizumab in the treatment of macular epiretinal membrane. METHODS: From January, 2012 to June, 2013, 33 patients (33 eyes) with the diagnosis of macular epiretinal membrane underwent vitreous surgery and membrane peeling. The patients were randomly divided into intravitreal bevacizumab group (IVB group) and non-intravitreal bevacizumab group (non-IVB group). All the patients underwent standard three-port vitrectomy and peeling of epiretinal membrane, with intravitreal injection of 1.5 mg bevacizumab at the end of operation in IVB group. The best corrected visual acuity and optical coherence tomography (OCT) were examined before and after the treatment. The patients were followed up for 3-14 months (mean 6.5 months). RESULTS: Macular epiretinal membranes were successfully peeled during operation in all the patients without postoperative intraocular infection or bleeding. Fifteen eyes received vitrectomy combined with intravitreal injection of bevacizumab, and 18 underwent only vitreous operation and membrane peeling. At the end of the follow up, the visual acuity improved in 11 eyes (73.3%) in IVB group, as compared to 13 eyes (72.2%) in the non-IVB group (P=0.627). Central macular thickness decreased by 143∓62 µm in IVB group and by 96∓28 µm in non-IVB group, showing a significant difference between the two groups (t=5.564, P<0.01). CONCLUSION: Vitrectomy and membrane peeling combined with intravitreal injection of bevacizumab can promote the recovery of macular morphology but not visual function, and its clinical use still needs to be tested in a long-term and large-sample randomized controlled study.

Clinical observation on juvenile macular hole without trauma and hypermyopia.

PURPOSE: To investigate the clinical characteristics of juvenile macular hole without trauma and hypermyopia, and research the mechanism of macular hole. METHODS: Sixty-seven patients less than 40 years of age were studied retrospectively from June 1998 to March 2003. Five cases (7 eyes) aged from 22 to 38 years were reported and the clinical characteristics that had macular hole without trauma or hypermyopia were summed up. RESULTS: There was 1 male and 4 females with visual acuity from 0.08 to 0.8. The images of optical coherence tomography (OCT) showed full thickness macular hole in 5 patients (7 eyes), and the diameters were from 87 to 1043 microm. Among them, 2 cases were combined with retina pigmentosa; 1 case with binocular Coat's disease; 1 case had bilateral macular hole combined with Eagles' disease; 1 case was combined with 2-2.5PD old retinochoroidal lesion under middle-peripheral fundus, and 1.5 PD retinal pigment epithelium (RPE) defect on the optical disk. CONCLUSION: The juvenile macular hole without trauma and hypermyopia combined the different retina vascular damages and the RPE defects.

[Contrast sensitivity function in myopic LASIK].

OBJECTIVE: To evaluate near contrast sensitivity function before and after myopic laser in situ keratomileusis (LASIK). METHODS: With FACT 101 test chart, static near contrast sensitivity was measured in randomly selected 47 subjects (93 eyes) before, 1 month and 6 months after LASIK. The contrast sensitivity was measured at 1.5, 3.0, 6.0, 12.0 and 18.0 cycles per degree (c/d) spatial frequency respectively and made comparison in them. RESULTS: The patients achieved the mean uncorrected visual acuity (UCVA) of 1.07 +/- 0.18 and 1.12 +/- 0.20 at postoperative 1-month and 6-months respectively. There was a general reduction in near contrast sensitivity in all spatial frequencies at postoperative 1-month when they were compared with the preoperative contrast sensitivity. The difference at 12 and 18 c/d spatial frequency was statistically significant (t test, P < 0.01). By the 6-month visit, all eyes showed a recovery of static contrast sensitivity function. The group of high myopia (preoperative > or = -6.00 D) and group with complaining of glare and halos after the surgery had a higher decrease rate of contrast sensitivity compared with that of the group preoperative < - 6.00 D and the group of patients without such complaints respectively. The differences at 6.0, 12.0 and 18.0 c/d spatial frequency at 1-month visit was statistically significant (t test, P < 0.05). CONCLUSIONS: The contrast sensitivity function test offers a more sensitive and comprehensive measure of functional vision than does standard Snellen acuity. The near contrast sensitivity in post-LASIK patients at early stage is reduced despite normal visual acuity and this can affect the quality of vision.