En-Face Optical Coherence Tomography Is Useful for Assessing Striated Lesions in Angioid Streaks: A Case Report.

Angioid streaks are mainly characterized by radially striated lesions around the optical disc and result in severe vision loss when choroidal neovascularization (CNV) develops at the macula. The prediction of visual prognosis in cases with angioid streaks remains an unsolved problem. In this study, we report the usefulness of en-face optical coherence tomography (OCT) to assess the bilateral striated lesions in angioid streaks. A 59-year-old female who was previously diagnosed with angioid streaks complained of decreased visual acuity in her left eye. However, on en-face OCT, the striated lesions in the right eye with better vision were shown as thicker continuous lesions than those in the left eye. Twenty-four months after the initial visit, her right visual acuity was worse than her left. En-face OCT showed fine-striated lesions extending from those thicker lesions to the macular area in the right eye. The thicker striated lesions observed at the initial visit may be a risk factor for future CNV development and vision loss. The evaluation of lesion size using en-face OCT may be useful for predicting the visual prognosis in angioid streaks.

Observation of the Curative Effect of the Dexamethasone Vitreous Cavity Implant for the Treatment of Irvine-Gass Syndrome.

Objective: To investigate the clinical efficacy of dexamethasone vitreous cavity implants (Ozurdex) for the treatment of macular edema (Irvine-Gass Syndrome) after cataract surgery. Method: Eight patients (eight eyes) with Irvine-Gass syndrome were enrolled for vitreous injections with Ozurdex. The patients included six men (six eyes) and two women (two eyes) with a mean age of 67.12 ± 11.92 years. Changes in the patients best-corrected visual acuity (BCVA), central macular thickness (CMT), and intraocular pressure were compared before and after treatment. Result: The mean visual acuity BCVA of the patients was 0.81 ± 0.26 before implantation, which improved to 0.20 ± 0.12, 0.13 ± 0.09, and 0.15 ± 0.13 at 2 weeks, 1 month, and 3 months after implantation, respectively ( P < 0.001). The patient's mean CMT before implantation was 703.00 ± 148.88 µm, and it reduced to 258.87 ± 37.40 µm, 236.25 ± 28.74 µm, and 278.00 ± 76.82 µm at 2 weeks, 1 month, and 3 months after implantation, respectively ( P < 0.001). Conclusion: The dexamethasone vitreous cavity implant (Ozurdex) is a safe and effective treatment, which can effectively improve patient's visual acuity and reduce macular edema associated with cataract surgery.

Observation of the Curative Effect of the Dexamethasone Vitreous Cavity Implant for the Treatment of Irvine-Gass Syndrome / 生物医学与环境科学（英文）

OBJECTIVE@#To investigate the clinical efficacy of dexamethasone vitreous cavity implants (Ozurdex) for the treatment of macular edema (Irvine-Gass Syndrome) after cataract surgery.@*METHOD@#Eight patients (eight eyes) with Irvine-Gass syndrome were enrolled for vitreous injections with Ozurdex. The patients included six men (six eyes) and two women (two eyes) with a mean age of 67.12 ± 11.92 years. Changes in the patients best-corrected visual acuity (BCVA), central macular thickness (CMT), and intraocular pressure were compared before and after treatment.@*RESULT@#The mean visual acuity BCVA of the patients was 0.81 ± 0.26 before implantation, which improved to 0.20 ± 0.12, 0.13 ± 0.09, and 0.15 ± 0.13 at 2 weeks, 1 month, and 3 months after implantation, respectively ( P < 0.001). The patient's mean CMT before implantation was 703.00 ± 148.88 μm, and it reduced to 258.87 ± 37.40 μm, 236.25 ± 28.74 μm, and 278.00 ± 76.82 μm at 2 weeks, 1 month, and 3 months after implantation, respectively ( P < 0.001).@*CONCLUSION@#The dexamethasone vitreous cavity implant (Ozurdex) is a safe and effective treatment, which can effectively improve patient's visual acuity and reduce macular edema associated with cataract surgery.

Efficacy and safety of phacoemulsification cataract surgery with prophylactic vitreous injection of bevacizumab in the treatment of retinopathy: a systematic review and meta-analysis.

BACKGROUND: For patients with cataracts and retinopathy, phacoemulsification can improve the progress of the disease to a certain extent. However, the efficacy of phacoemulsification alone is often not ideal, and may even aggravate the prognostic effects, such as macular edema and slow visual recovery. Thus, an increasing number of clinicians have explored comprehensive therapy involving phacoemulsification combined with drug therapy, which has led to some research progress. However, there is still great controversy about the combined treatment. In this study, we performed a literature meta-analysis to systematically evaluate the clinical efficacy and safety of prophylactic intravitreal injection of bevacizumab combined with phacoemulsification for the treatment of cataracts complicated with retinopathy. METHODS: We searched the PubMed, Web of Science, Embase, and MEDLINE databases for English language papers related to these studies factors published between January 2001 and January 2021. The retrieved articles were screened and the quality of the included studies was evaluated. Meta-analysis was performed and RevMan5.3 was used to calculate the enhanced mean difference (MD). RESULTS: Six articles were finally included in this meta-analysis, involving a total of 325 cases with cataracts and retinopathy. The results showed that the best-corrected visual acuity at 1 month [MD =-0.06; 95% confidence interval (CI): (-0.09, -0.03); P=0.0002] and 3 months [MD =-0.09; 95% CI: (-0.11, -0.07); P<0.00001] in the preventive vitreous injection bevacizumab intervention group were significantly better than those of the control group (P<0.1). However, the best-corrected visual acuity at 6 months [MD =-0.02; 95% CI: (-0.07, 0.03); P=0.39] was not significantly different between these two groups (P>0.05). In addition, the central macular thickness of the preventive vitreous injection bevacizumab intervention group at 1 month after treatment [MD =-37.07; 95% CI: (-45.87, -28.27); P<0.00001], 3 months [MD =-15.26; 95% CI: (-23.87, -6.66); P=0.0005], and 6 months [MD =-26.77; 95% CI: (-37.51, -16.04); P<0.00001] were significantly different to the control group (P<0.05). DISCUSSION: The results of this study showed that prophylactic intravitreal injection of bevacizumab combined with phacoemulsification is a safe and effective treatment for patients with cataracts and retinopathy within 6 months after treatment.

Eye surface changes of diffuse diabetic macular edema treated by intravitreal injection of Conbercept / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the ocular surface changes of diffuse diabetic macular edema(DDME)treated by intravitreal injection of Conbercept. <p>METHODS: Twenty patients(20 eyes, right eyes)diagnosed as DDME and requiring vitreous injection of conbercept in the Department of Ophthalmology, the First Affiliated Hospital of Nanchang University from January 2019 to June 2019, were selected as experiment group. Experiment goup was treated with three vitreous injections of Conbercept. The left eyes of the patients without macular edema were treated as control group without any treatment. Before operation and on the first day after operation, we used corrected visual acuity, superficial punctate epithelial erosion(SPEE), lacrimal river height, intraocular pressure, symptom and sign scores, Schirmer I test(S I t)and corneal fluorescein staining(CSF)to estimate eyes.<p>RESULTS: Before treatment, there was no difference in intraocular pressure, the height of lacrimal river, OSDI score, S I t, CSF score between the two groups(<i>P</i>>0.05), and there was no superficial punctate epithelial erosion in both groups, but the corrected visual acuity of the control group was significantly better than that of the experimental group(0.50±0.20 <i>vs</i> 1.65±0.35, <i>P</i><0.05). After treatment, the corrected visual acuity, lacrimal river height and S I t in the experimental group were significantly lower than those in the control group, OSDI and CSF scores were significantly higher than those in the control group(all <i>P</i><0.05), and the intraocular pressure increased more significantly than that in the control group, but there was no difference between the two groups(<i>P</i>>0.05). Compared with before treatment, the corrected visual acuity of the experimental group was significantly improved, the lacrimal river height and S I t were significantly decreased, OSDI and CSF scores were significantly increased(<i>P</i><0.05), but the intraocular pressure had no significant change(<i>P</i>>0.05); the observation indexes of the control group had no significant changes(<i>P</i>>0.05).<p>CONCLUSION: Intravitreal injection of conbercept in the treatment of diffuse diabetic macular edema can damage the ocular surface.

Protective effect of intravitreal injection of antioxidant NAC on retina in early diabetic rats / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the protective effect of the antioxidant N-acetylcysteine(NAC)on retina in early diabetic rats. <p>METHODS: Thirty healthy adult male SD rats were randomly assigned to the normal control group(CON group, <i>n</i>=10)and the diabetes group(DM group, <i>n</i>=20). After fasting for 12h, the DM group was injected with 1% streptozotocin(STZ)solution, according to 60mg/kg disposable left lower abdominal injection. After 72h, blood was taken from the rat tail vein to detect blood glucose, diabetic model animals were defined as ≥16.7mmol/L. Model rats were randomly divided into diabetes control group(group D)and NAC treatment group(group N). After the model was established, N group of rats were injected with 4μL 1.6μg/μL NAC through the vitreous cavity every week. Rats in CON group and D group were injected with 4μL 0.01mmol/L phosphate buffer saline. All the rats no diet water, group feeding. Body mass and blood glucose were recorded weekly. After the diabetes was modeled, 2mo killed the experimental animals. The thickness of the inner layer of the retina of rats in each group was determined by HE staining. The number of retinal ganglion cells and the level of pigment epithelial derived factor in the retina were measured by immunofluorescence.<p>RESULTS: The thickness of retinal kernel layer increased in group N compared with group D(<i>P</i><0.01), and there was no difference between group CON and group(<i>P</i>>0.05). Compared with CON group, the number of retinal ganglion cells decreased in group D(<i>P</i><0.01), and decreased slightly in group N(<i>P</i>>0.05). Retinal ganglion cells decreased in group D compared with group N(<i>P</i><0.01). Compared with CON group, PEDF expression decreased in group D(<i>P</i><0.01), and decreased slightly in group N(<i>P</i>>0.05). The expression of PEDF in group D decreased compared with group N(<i>P</i><0.01).<p>CONCLUSION: The protective effect of antioxidant NAC on retinal tissue in early diabetic rats may be due to the up-regulation of PEDF levels in the retina.

Analysis on Bevacizumab with PDT for CSC / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To study the influence of intravitreal injection of bevacizumab combined with photon dynamic treatment ( PDT ) in the treatment of central serous choroiretinopathy (CSC). METHODS:We selected 82 CSC patients treated in the hospital between February 2012 and April 2015, who were diagnosed by optical coherence tomography (OCT) and fundus fluorescein angiography (FFA) and all got the disease monocularly, and divided them into two groups called control group (n=35) and research group (n=47) by different methods, the patients of control group were treated by PDT method, while the patients of research group were treated by vitreous bevacizumab injection combined with PDT. Then compare the number of treatment times, the rate of flat pigment epithelial detachment(PED), macular subretinal fluid absorption, OCT indexes such as volume of the macular central hub, average thickness of central macular with diameter of 6mm and thickness of central macular region below 1mm range, the difference of corrected vision and clinical efficacy of two groups before and after the treatment. RESULTS:There were 32 eyes which were treated once, and 3 eyes which were treated twice in the control group, the average treatment times was 1.25士0.20; however, there were 9 eyes which were treated three times,10 eyes twice,28 eyes once, the average treatment number was 1.48士0.22, the treatment times of two groups had no statistical difference (t= 1.209, P>0.05). On the other hand,13 eyes' PED (37%) was flat in the control group,22 eyes (63%) which macular retinal subepithelial serous absorption;30 eyes' PED (64%) was flat in the research group,17 eyes (36%) which macular retinal subepithelial serous absorption. The rate of flat PED and macular retinal subepithelial serous absorption of two groups had obvious statistical difference (P<0.05). The OCT indexes such as volume of the macular central hub, average thickness of central macular with diameter of 6mm and thickness of central macular region bellow 1mm of two groups had no statistical difference before the treatment (P>0.05), in contrast these OCT indexes were all much lower than control group after the treatment, and the results had obvious statistical difference (P < 0. 05). Besides,these OCT indexes after treatment were all much lower than that of two groups before treatment respectively,and it also had obvious statistical difference (P< 0. 05). After 1 - month's treatment, the LogMAR corrected vision of two groups had no statistical difference (P>0.05). While the LogMAR corrected vision of research groups had statistical difference with control group after 3mo and 6mo (P<0.05). There were 6 invalid cases, 15 improvement cases, 8 excellence cases and 6 healing cases in the control group; the total effective rate of control group was 83%. While there were 3 invalid cases, 8 improvement cases, 20 excellence cases, 16 healing cases in the research group, the total effective rate of research group was 94%. The effective rate of two groups had obvious statistical difference (P<0.05). CONCLUSION: In the treatment of chronic CSC with PED patients, the method of vitreous bevacizumab injection combined with low dose PDT has better effect on PED flat, promoting macular subretinal serous absorption, reducing macular thickness and improving visual acuity.

Effect of vitreomacular adhesion on the anti-VEGF treatment in patients with macular edema induced by branch retinal vein occlusion / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To observe the the effect of vitreomacular adhesion on the anti-vascular endothelial growth factor (VEGF) treatment in patients with macular edema (ME) induced by branch retinal vein occlusion (BRVO).METHODS:A retrospective clinical study.Totally 58 patients(60 eyes) were induced in this study during April 2014 to May 2016,who were diagnosed with macular edema due to branch retinal vein occlusion.All subjects were assigned to 2 groups according to the examination of optical coherence tomography (OCT):combined with vitreomacular adhesion groups (Group A) and uncombined with vitreomacular adhesion groups (Group B).The basic situation of the two groups was as follows:Group A:23 cases (24 eyes),the average age was 55.91± 7.34,the mean disease course was 3.4±1.01mo,the mean macular central retinal thickness (CMT) was 463.26±53.73μm and the average BCVA was 0.63±0.11;Group B:35 cases (36 eyes),the average age was 56.33± 5.34,the mean disease course was 2.82± 1.33mo,the mean CMT was 482.90± 37.43μ m and the average BCVA was0.59±0.12.All cases received vitreous injection of 0.5mg Conbercept.Injections were repeated based on the visual changes and the OCT findings.The follow-up time was more than 6mo.BCVA,CMT,and the numbers of injections of two groups were recorded at pre-operation and postoperative 1,6mo and the statistical analysis was conducted.RESULTS:BCVA and CMT of the most patients were improved compared to prior treatment and the difference had statistical significance (P ＜ 0.05).There were significant differences on CMT between two groups at 1 and 6mo after treatment (t=9.13,10.01;P＜0.05).While BCVA between two groups at 1 and 6mo after treatment was not statistically different (t=2.13,5.32;P＞0.05).At 6mo after treatment,the average numbers of injections in combined vitreomacular adhesion groups were 4.38±0.97 times and the average numbers of injections in uncombined vitreomacular adhesion groups were 3.56 ± 0.71 times.The difference had statistical significance (t=4.56,P＜ 0.05).Systematic adverse reactions and persistent intraocular pressure elevation,retinal detachment,endophthalmitis,vitreous hemorrhage were never found in the follow-up period.CONCLUSION:Vitreous injection of anti-VEGF treatment for macular edema induced by branch retinal vein occlusion has good clinical results.However,if there is merged with vitreomacular adhesion at the same time,the treatment effect of anti-VEGF will be weakened to some extent.