AIM: To evaluate the relationship between intravitreal bevacizumab(IVB) treatment and the levels of vitreous vascular endothelial growth factor(VEGF), basic fibroblast growth factor(b FGF) and vitreous-retina surface ...AIM: To evaluate the relationship between intravitreal bevacizumab(IVB) treatment and the levels of vitreous vascular endothelial growth factor(VEGF), basic fibroblast growth factor(b FGF) and vitreous-retina surface fibrosis in patients with proliferative diabetic retinopathy(PDR).·METHODS: This study was a prospective, open-label,controlled, randomized clinical trial. Sixty-eight eyes of PDR patients(n =53) and macular hole patients(n =15)were enrolled in this study. Thirty-four eyes of the PDR patients received IVB before vitrectomy. Twenty-three of the 34 PDR patients received IVB treatment 5d before vitrectomy(subgroup a), and 11 of the 34 PDR patients received IVB treatment greater than 2wk prior to vitrectomy(subgroup b). Nineteen of the PDR patients did not receive IVB treatment at any time prior to vitrectomy. The levels of b FGF and VEGF in vitreous samples were measured using enzyme-linked immunosorbent assay(ELISA) and the degree of vitreoretinal fibrosis was characterized using clinical data and data obtained intra-operatively.·RESULTS: In PDR patients, VEGF and b FGF levels were significantly increased compared to non-PDR(control) subject's eyes(P <0.01). In PDR patients,vitreous VEGF levels were significantly decreased following IVB treatment compared to PDR patients that did not receive IVB treatment(P <0.01). The degree of vitreoretinal fibrosis was significantly increased in subgroup b compared to subgroup a(P <0.05) and to patients that did not receive IVB(P <0.05). Vitreous b FGF levels were significantly greater in subgroup b than subgroup a(P <0.01) or in patients who did not receive IVB treatment(P <0.05). A Spearman's rank correlationtest indicated that higher levels of vitreous b FGF, but not VEGF, correlated with the degree of vitreoretinal fibrosis.·CONCLUSION: We found that b FGF levels increase in PDR patient's vitreous after IVB treatment longer than two weeks prior to vitrectomy and correlated with the degree of fibrosis after IVB treatment. These findings suggest vitreous fibrosis is increased in PDR patients after IVB treatment may be due to increased levels of b FGF.展开更多
AIM:To evaluate predictive factors for postoperative visual function of primary chronic rhegmatgenous retinal detachment(RRD) after sclera buckling(SB).METHODS:Totally 48 patients(51 eyes) with primary chronic RRD wer...AIM:To evaluate predictive factors for postoperative visual function of primary chronic rhegmatgenous retinal detachment(RRD) after sclera buckling(SB).METHODS:Totally 48 patients(51 eyes) with primary chronic RRD were included in this prospective interventional clinical cases study,which underwent SB alone from June 2008 to December 2014.Age,sex,symptoms duration,detached extension,retinal hole position,size,type,fovea on/off,proliferative vitreoretinopathy(PVR),posterior vitreous detachment(PVD),baseline best corrected visual acuity(BCVA),operative duration,follow up duration,final BCVA were measured.Pearson correlation analysis,Spearman correlation analysis and multivariate linear stepwise regression were used to confirm predictive factors for better final visual acuity.Student's /-test,Wilcoxon twosample test,Chi-square test and logistic stepwise regression were used to confirm predictive factors for better vision improvement.RESULTS:Baseline BCVA was 0.8313±0.6911 logMAR and final BCVA was 0.4761±0.4956 logMAR.Primary surgical success rate was 92.16%(47/51).Correlation analyses revealed shorter symptoms duration(r=0.3850,P=0.0053),less detached area(P=0.5489,P<0.0001),fovea(P=0.4605,P=0.0007),no PVR(P=0.3138,P=0.0250),better baseline BCVA(P=0.7291,P<0.0001),shorter operative duration(P=0.3233,P=0.0207) and longer follow up(r=-0.3358,P=0.0160) were related with better final BCVA,while independent predictive factors were better baseline BCVA[partial R-square(PR^2)=0.5316,P<0.0001],shorter symptoms duration(PR^2=0.0609,P=0.0101),longer follow up duration(PR^2=0.0278,P=0.0477) and shorter operative duration(PR^2=0.0338,P=0.0350).Patients with vision improvement took up 49.02%(25/51).Univariate and multivariate analyses both revealed predictive factors for better vision improvement were better baseline vision[odds ratio(OR)=50.369,P=0.0041]and longer follow up duration(OR=1.144,P=0.0067).CONCLUSION:Independent predictive factors for better visual outcome of primary chronic RRD after SB are better baseline BCVA,shorter symptoms duration,shorter operative duration and longer follow up duration,while independent predictive factors for better vision improvement after operation are better baseline vision and longer follow up duration.展开更多
基金Supported by Public Interest Research on Social Development Projects in Zhejiang Province (No.2011c23019)
文摘AIM: To evaluate the relationship between intravitreal bevacizumab(IVB) treatment and the levels of vitreous vascular endothelial growth factor(VEGF), basic fibroblast growth factor(b FGF) and vitreous-retina surface fibrosis in patients with proliferative diabetic retinopathy(PDR).·METHODS: This study was a prospective, open-label,controlled, randomized clinical trial. Sixty-eight eyes of PDR patients(n =53) and macular hole patients(n =15)were enrolled in this study. Thirty-four eyes of the PDR patients received IVB before vitrectomy. Twenty-three of the 34 PDR patients received IVB treatment 5d before vitrectomy(subgroup a), and 11 of the 34 PDR patients received IVB treatment greater than 2wk prior to vitrectomy(subgroup b). Nineteen of the PDR patients did not receive IVB treatment at any time prior to vitrectomy. The levels of b FGF and VEGF in vitreous samples were measured using enzyme-linked immunosorbent assay(ELISA) and the degree of vitreoretinal fibrosis was characterized using clinical data and data obtained intra-operatively.·RESULTS: In PDR patients, VEGF and b FGF levels were significantly increased compared to non-PDR(control) subject's eyes(P <0.01). In PDR patients,vitreous VEGF levels were significantly decreased following IVB treatment compared to PDR patients that did not receive IVB treatment(P <0.01). The degree of vitreoretinal fibrosis was significantly increased in subgroup b compared to subgroup a(P <0.05) and to patients that did not receive IVB(P <0.05). Vitreous b FGF levels were significantly greater in subgroup b than subgroup a(P <0.01) or in patients who did not receive IVB treatment(P <0.05). A Spearman's rank correlationtest indicated that higher levels of vitreous b FGF, but not VEGF, correlated with the degree of vitreoretinal fibrosis.·CONCLUSION: We found that b FGF levels increase in PDR patient's vitreous after IVB treatment longer than two weeks prior to vitrectomy and correlated with the degree of fibrosis after IVB treatment. These findings suggest vitreous fibrosis is increased in PDR patients after IVB treatment may be due to increased levels of b FGF.
文摘AIM:To evaluate predictive factors for postoperative visual function of primary chronic rhegmatgenous retinal detachment(RRD) after sclera buckling(SB).METHODS:Totally 48 patients(51 eyes) with primary chronic RRD were included in this prospective interventional clinical cases study,which underwent SB alone from June 2008 to December 2014.Age,sex,symptoms duration,detached extension,retinal hole position,size,type,fovea on/off,proliferative vitreoretinopathy(PVR),posterior vitreous detachment(PVD),baseline best corrected visual acuity(BCVA),operative duration,follow up duration,final BCVA were measured.Pearson correlation analysis,Spearman correlation analysis and multivariate linear stepwise regression were used to confirm predictive factors for better final visual acuity.Student's /-test,Wilcoxon twosample test,Chi-square test and logistic stepwise regression were used to confirm predictive factors for better vision improvement.RESULTS:Baseline BCVA was 0.8313±0.6911 logMAR and final BCVA was 0.4761±0.4956 logMAR.Primary surgical success rate was 92.16%(47/51).Correlation analyses revealed shorter symptoms duration(r=0.3850,P=0.0053),less detached area(P=0.5489,P<0.0001),fovea(P=0.4605,P=0.0007),no PVR(P=0.3138,P=0.0250),better baseline BCVA(P=0.7291,P<0.0001),shorter operative duration(P=0.3233,P=0.0207) and longer follow up(r=-0.3358,P=0.0160) were related with better final BCVA,while independent predictive factors were better baseline BCVA[partial R-square(PR^2)=0.5316,P<0.0001],shorter symptoms duration(PR^2=0.0609,P=0.0101),longer follow up duration(PR^2=0.0278,P=0.0477) and shorter operative duration(PR^2=0.0338,P=0.0350).Patients with vision improvement took up 49.02%(25/51).Univariate and multivariate analyses both revealed predictive factors for better vision improvement were better baseline vision[odds ratio(OR)=50.369,P=0.0041]and longer follow up duration(OR=1.144,P=0.0067).CONCLUSION:Independent predictive factors for better visual outcome of primary chronic RRD after SB are better baseline BCVA,shorter symptoms duration,shorter operative duration and longer follow up duration,while independent predictive factors for better vision improvement after operation are better baseline vision and longer follow up duration.
