AIM:To investigate the predictive factors for shortterm effects of intravitreal bevacizumab injections on central subfield foveal thickness(CSFT)in patients with macular edema(ME)secondary to central retinal vein...AIM:To investigate the predictive factors for shortterm effects of intravitreal bevacizumab injections on central subfield foveal thickness(CSFT)in patients with macular edema(ME)secondary to central retinal vein occlusion(CRVO).·METHODS:This was a retrospective study in 60 eyes treated with intravitreal bevacizumab injections for ME due to CRVO.Follow-up was three months.The Early Treatment Diabetic Retinopathy Study(ETDRS)score and CSFT measured by spectral-domain optical coherence tomography(SD-OCT)were used to observe the changes in best-corrected visual acuity(BCVA).Baseline BCVA,CSFT,age,CRVO duration and the presence of cystoid macular edema(CME)or subretinal fluid(SRF)were analyzed as potential predictive factors of the effects of intravitreal bevacizumab injections.·R ESULTS:BCVA improved from 0.9 log MAR at baseline to 0.6 log MAR at 3mo,which was associated with a significant reduction in CSFT from 721μm to 392μm 3mo after injection.About 50%of CME cases and more than90%of SRF cases responded to treatment with a complete resolution at 3mo.Age(=0.036)and low baseline CSFT(=0.037)were associated with a good 3-month prognosis.Patients〉60 years old achieved better CME resolution(=0.031)and lower CSFT at 3mo(305μm 474μm,=0.003).·CONCLUSION:Intravitreal bevacizumab significantly improved visual acuity and CSFT in patients with CRVO after 3mo.Older age and lower baseline CSFT were good predictors of short-term CSFT outcomes.The retinal thickness response to bevacizumab might depend on the resolution of CME rather than SRF.展开更多
AIM:To report foveal thickness reduction in eyes with resolution of macular edema and recovery of a foveal depression after one-year of anti-vascular endothelial growth factor(anti-VEGF) therapy for center-involvin...AIM:To report foveal thickness reduction in eyes with resolution of macular edema and recovery of a foveal depression after one-year of anti-vascular endothelial growth factor(anti-VEGF) therapy for center-involving diabetic macular edema(DME).METHODS:Foveal thickness was assessed with optical coherence tomography to determine the central subfield foveal thickness(CSFT) and macular volume in 42 eyes with DME(CSFT〉275 μm). Evaluations also included measurement of best-corrected visual acuity(BCVA), and were performed at baseline, and upon foveal depression recovery achieved after 12 monthly intravitreal injections of either 1.5 mg/0.06 mL bevacizumab(n=21) or 0.5 mg/0.05 mL ranibizumab(n=21). Data was compared to 42 eyes of normally sighted, non-diabetic, healthy individuals with similar age, gender and race distributions.RESULTS:Mean baseline BCVA was 0.59±0.04 and 0.32± 0.03 log MAR(P〈0.001) after treatment and resolution of DME, with all, but 3 eyes, showing BCVA improvement. Mean CSFT before treatment was 422.0±20.0 μm, and after treatment, decreased to 241.6±4.6 μm(P〈0.001), which is significantly thinner than CSFT found in control subjects(272.0±3.4 μm; P〈0.001). Moreover, in 33/42 DM eyes(79%), CSTF was thinner than the matched control eye. Macular volume showed comparable results, but with lower differences between groups(control:8.5±0.4 mm^3; DME:8.2±1.0 mm^3; P=0.0267).CONCLUSION:DME eyes show significantly lower foveal thickness than matched controls after DME resolution achieved with one-year anti-VEGF therapy. Further investigation into the reasonsfor this presumable retinal atrophy using fluorescein angiography and functional parameters as well as establishing possible predictors is warranted. This finding should be considered during the treatment of DME.展开更多
AIM:To compare the macular structure including foveal thickness among patients with optic neuritis(ON)according to the etiology and to investigate the possible correlation between structural and visual outcomes METHOD...AIM:To compare the macular structure including foveal thickness among patients with optic neuritis(ON)according to the etiology and to investigate the possible correlation between structural and visual outcomes METHODS:In this retrospective cross-sectional study,the clinical data of patients with aquaporin-4 immunoglobulin G-related ON(AQP4 group,40 eyes),myelin oligodendrocyte glycoprotein IgG-related ON(MOG group,31 eyes),and multiple sclerosis-related ON(MS group,24 eyes)were obtained.The retinal thickness of the foveal,parafoveal and perifoveal regions were measured.Visual acuity(VA),visual field index and mean deviation were measured as visual outcomes.RESULTS:The AQP4 group showed a significantly thinner fovea(226.4±13.4μm)relative to the MOG(236.8±14.0μm,P=0.015)and MS(238.9±14.3μm,P=0.007)groups.The thickness in the parafoveal area also was thinner in the AQP4 group,though the difference in perifoveal retinal thickness was not significant.Foveal thickness was correlated with VA in the AQP4 group(coefficientρ=-0.418,P=0.014),but not in the MOG and MS groups(P=0.218 and P=0.138,respectively).There was no significant correlation between foveal thickness and visual field test in all three groups.CONCLUSION:The significant thinning in the fovea and parafoveal areas in the AQP4 group compared to the MOG and MS groups are found.Additionally,macular changes in AQP4-ON show a significant correlation with VA.The results provide the possibility that retinal structural damage could reflect functional damage in AQP4-ON,distinct from MOGON and MS-ON.展开更多
To investigate the foveal morphological changes and foveal avascular zone(FAZ)area before and after epiretinal membrane(ERM)surgery.Twenty-two eyes with treatmentnaive ERM were included in this retrospective study...To investigate the foveal morphological changes and foveal avascular zone(FAZ)area before and after epiretinal membrane(ERM)surgery.Twenty-two eyes with treatmentnaive ERM were included in this retrospective study.The central foveal thickness(CFT)and FAZ area were measured via swept-source optical coherence tomography(SS-OCT)and OCT angiography pre-and postoperatively.The unaffected fellow eyes were used as controls.The preoperative superficial FAZ area was significantly smaller in patients(0.08±0.04 mm^2)than in controls(0.33±0.09 mm^2;P〈0.001).The postoperative superficial FAZ(0.12±0.06 mm^2)area was significantly greater than the preoperative area(P〈0.001).The preoperative superficial FAZ area was strongly negatively correlated with CFT(P〈0.001,rho=-0.763).ERM induced significant foveal morphological changes and reduction of the superficial FAZ area.Foveal thickness was restored and FAZ area increased postoperatively.However,the process is rather slow and the recovery is incomplete.展开更多
AIM:To evaluate the changes in macular morphology and function after a single intravitreal injection of aflibercept in diabetic macular edema(DME)using optical coherence tomography angiography(OCTA)and MP-3 microperim...AIM:To evaluate the changes in macular morphology and function after a single intravitreal injection of aflibercept in diabetic macular edema(DME)using optical coherence tomography angiography(OCTA)and MP-3 microperimetry.METHODS:Twenty-eight patients(42 eyes)diagnosed with DME were treated with intravitreal injection of aflibercept.The changes in best corrected visual acuity(BCVA),central retinal thickness(CRT),foveal avascular zone(FAZ)area,vessel density of superficial retinal capillary plexus(SVD),vessel density of deep retinal capillary plexus(DVD),mean light sensitivity(MLS),2°fixation rate(P1),4°fixation rate(P2),and other indicators 1mo after treatment were compared;of these,BCVA was conver ted into logarithm of the minimum angle of resolution(logMAR),and the correlation among the factors was analyzed.RESULTS:After treatment,logMAR BCVA was 0.47±0.24,which was significantly better than that before treatment(0.63±0.28,P<0.001).The CRT was 359.21±107.87μm after treatment,which was significantly lower than before treatment(474.10±138.20μm,P<0.001).The FAZ area,SVD,and DVD were not significantly changed after treatment compared with the baseline.MLS was 22.16±4.20 dB after treatment,which was significantly higher than before treatment(19.63±4.23 dB,P<0.001).P2 significantly increased after treatment than before treatment(P=0.007).P1 had no significant change after treatment than before treatment(P=0.086).CONCLUSION:A single intravitreal injection of aflibercept effectively reduces macular edema and improves retinal sensitivity,fixation stability,and visual acuity,possibly without causing significant changes in the retinal vascular condition in a short time.展开更多
AIM: To evaluate the clinical efficacy and safety of ranibizumab for wet age-related macular degeneration (wAMD) in Chinese patients and to determine the mean number of injections administered over one year of foll...AIM: To evaluate the clinical efficacy and safety of ranibizumab for wet age-related macular degeneration (wAMD) in Chinese patients and to determine the mean number of injections administered over one year of follow-up. METHODS: This single centre, retrospective observational case series study included data from 121 patients with wAMD (121 eyes) who were diagnosed by indirect ophthalmoscopy, fluorescence fundus angiography (FFA), indocyanine green angiography, and optical coherence tomography. Ranibizumab was injected into the vitreous cavities once per month for 3mo and as needed afterwards. Changes in visual acuity and central foveal thickness (CFT) during the follow-up period were compared, and the mean number of injections over the year was calculated. Patients with one or more adverse events related to the drugs and injections were recorded for further adverse events analysis.RESULTS: The study population included 70 males and 51 females aged between 50 and 87y (mean: 71.32±9.41y). The mean number of injections over the first year was 5±1 (range: 3-9). The mean best-corrected visual acuity by Early Treatment Diabetic Retinopathy Study increased from 43.2±19.3 (95%CI: 39.8-46.7) at baseline to 51.7±20.1 (95%CI: 48.1-55.3), and central foveal thickness (CFT) decreased from 526.5±277.0 μm (95%CI: 476.6-576.4) to 258.2±161.6 μm (95%CI: 229.2-287.3) at 12mo. The differences were statistically significant (P〈0.001). Visual acuity significantly improved in 34.1% of the patients (38 eyes), stabilized in 66.1% of the patients (80 eyes), and significantly decreased in 2.5% of the patients (3 eyes). CFT at baseline was an independent risk factor of decreased CFT and increased visual acuity. None of the patients had severe adverse events during the follow-up period.CONCLUSION: Ranibizumab can effectively control disease progression and improve visual acuity in patients with wAMD. The disease conditions of most patients stabilized after a one-year treatment with an average of 5 injections.展开更多
AIM:To detect the association between macular pigment optical density(MPOD),which reflects the antioxidant ability of retina,and diabetic retinopathy(DR)and to investigate the correlated factors of MPOD.METHODS:...AIM:To detect the association between macular pigment optical density(MPOD),which reflects the antioxidant ability of retina,and diabetic retinopathy(DR)and to investigate the correlated factors of MPOD.METHODS: Totally 435 subjects of urban Chinese were recruited to the study and divided into 3 groups: non-diabetes mellitus controls(NDM),diabetic patients without retinopathy(DWR),and patients with early stage of non-proliferative diabetic retinopathy(DR).Demographic and lifestyle characteristics were ascertained by questionnaire.A food-frequency questionnaire,general physical and ophthalmic examinations were completed for all participants.MPOD was measured by heterochromatic flicker photometry.Foveal thickness was measured by optical coherence tomography.The difference of MPOD among 3 groups was analyzed by analysis of covariance.The correlation analyses of MPOD with the candidate influence factors were assessed using the generalized estimating equations(GEE) model.RESULTS: Of the 435 participants,34 could not perform the MPOD measurements.Final analysis included 401 subjects,including 48 were in DR group,134 in DWR group,and 219 in NDM group.MPOD was not significantly different among DR(0.49 ±0.21),DWR(0.45 ±0.21),and NDM(0.49±0.17) groups(P=0.24) after adjustment for fasting plasma glycemia,central foveal thickness,green vegetables,Chinese wolfberry,carotene and vitamin E.For all the 401 participants included,MPOD was positively associated with central foveal thickness(E=0.0007,P=0.001),Chinese wolfberry(E=0.0345,P=0.01),and green vegetables(E=0.0596,P〈0.001) intake.CONCLUSION: The data suggest that MPOD level is not statistically significantly influenced by the onset of diabetes or early stage of DR in the studied population.MPOD level is positively associated with thicker central foveal thickness and higher intake of foods containing carotenoids.展开更多
AIM:To evaluate the therapeutic effect of combined phacovitrectomy with membrane peeling and intraocular lens(IOL)implantation in patients with severe idiopathic epiretinal membrane(iERM)and concurrent cataract.METHOD...AIM:To evaluate the therapeutic effect of combined phacovitrectomy with membrane peeling and intraocular lens(IOL)implantation in patients with severe idiopathic epiretinal membrane(iERM)and concurrent cataract.METHODS:A total of 34 eyes from 34 patients who underwent phacovitrectomy and epiretinal membrane(ERM)peeling at the First Affiliated Hospital of Zhejiang University between 2015 and 2017.The best-corrected visual acuity(BCVA)and central foveal thickness(CFT)were measured preoperatively and at 1,3,6 mo and 1 y postoperatively.Temporal changes and bivariate correlations of these parameters were analyzed.RESULTS:Mean logMAR BCVA improved and CFT decreased significantly(P<0.001)until 6 mo after surgery.Correlation analysis revealed a positive correlation between preoperative and postoperative logMAR BCVA(r=0.716,P<0.001 at 1 mo,r=0.417,P=0.014 at 3 mo,r=0.359,P=0.037 at 6 mo,and r=0.369,P=0.032 at 12 mo post-op respectively),but preoperative CFT was neither associated with postoperative CFT nor with postoperative logMAR BCVA.There was a positive correlation between CFT and logMAR BCVA at 1 mo(r=0.346,P=0.045),6 mo(r=0.347,P=0.045),and 12 mo(r=0.342,P=0.048)post-operatively.The intraand postoperative complications were relatively mild,and the incidences were generally low.CONCLUSION:For severe iERM patients with significant visual symptoms,combined phacovitrectomy with membrane peeling and IOL implantation is safe and effective in improving BCVA and decreasing CFT.Early surgery in selected patients may help preserving better visual function.展开更多
Background:Most patients of established retinitis pigmentosa(RP)have subnormal peripheral vision and heavily rely on central vision for their daily activities.Central visual acuity is dependent on photoreceptor surviv...Background:Most patients of established retinitis pigmentosa(RP)have subnormal peripheral vision and heavily rely on central vision for their daily activities.Central visual acuity is dependent on photoreceptor survival at the macula.Identification of structural changes that precede visual loss is essential.The aim of this study was to correlate the Spectral Domain-Optical Coherence Tomography(SD-OCT)characteristics with visual acuity in patients with typical RP.Methods:This was a retrospective,observational case series of 224 eyes of 113 RP patients conducted a tertiary eye care center.SD-OCT imaging was done for all eyes.Central retinal thickness(CRT),photoreceptor outer segment length(PROS),foveal outer segment pigment epithelial thickness(FOSPET)and ellipsoid zone(EZ)extent were measured.A new variable,FOSPET-PROS ratio(FPR),obtained by dividing FOSPET by PROS is defined and correlated to corrected distance visual acuity(CDVA)in logMAR using linear regression.Results:Out of 113 patients,71 were males and 42 females.Mean age of the patients was 35.4±15.1 years.Mean CDVA was 0.33±0.25 logMAR with no difference between the genders.Mean CRT(218.74±83.5μm)and FPR(1.63±0.22)significantly correlated to CDVA with a correlation coefficient of r=−0.139(p=0.048)and r=0.842(p=0.0001),respectively.FOSPET(mean=71.15±13.8μm)and PROS(mean=44.85±12.5μm)did not show a significant correlation to CDVA,independent of FPR.Conclusions:Retinal microstructural changes on SD-OCT,especially the FPR,can be used as a surrogate marker to monitor disease progression in the central retina in degenerative diseases like RP.展开更多
文摘AIM:To investigate the predictive factors for shortterm effects of intravitreal bevacizumab injections on central subfield foveal thickness(CSFT)in patients with macular edema(ME)secondary to central retinal vein occlusion(CRVO).·METHODS:This was a retrospective study in 60 eyes treated with intravitreal bevacizumab injections for ME due to CRVO.Follow-up was three months.The Early Treatment Diabetic Retinopathy Study(ETDRS)score and CSFT measured by spectral-domain optical coherence tomography(SD-OCT)were used to observe the changes in best-corrected visual acuity(BCVA).Baseline BCVA,CSFT,age,CRVO duration and the presence of cystoid macular edema(CME)or subretinal fluid(SRF)were analyzed as potential predictive factors of the effects of intravitreal bevacizumab injections.·R ESULTS:BCVA improved from 0.9 log MAR at baseline to 0.6 log MAR at 3mo,which was associated with a significant reduction in CSFT from 721μm to 392μm 3mo after injection.About 50%of CME cases and more than90%of SRF cases responded to treatment with a complete resolution at 3mo.Age(=0.036)and low baseline CSFT(=0.037)were associated with a good 3-month prognosis.Patients〉60 years old achieved better CME resolution(=0.031)and lower CSFT at 3mo(305μm 474μm,=0.003).·CONCLUSION:Intravitreal bevacizumab significantly improved visual acuity and CSFT in patients with CRVO after 3mo.Older age and lower baseline CSFT were good predictors of short-term CSFT outcomes.The retinal thickness response to bevacizumab might depend on the resolution of CME rather than SRF.
基金Supported by Fundacao de Amparoà Pesquisa do Estado de Sao Paulo(FAPESP)and FAEPA(Fundacao Apoioao Ensino Pesquisa e Assistência,HCFMRP-USP),(No.2010/013368)the initial trial was registered at clinical trials.gov(No.NCT01487629)
文摘AIM:To report foveal thickness reduction in eyes with resolution of macular edema and recovery of a foveal depression after one-year of anti-vascular endothelial growth factor(anti-VEGF) therapy for center-involving diabetic macular edema(DME).METHODS:Foveal thickness was assessed with optical coherence tomography to determine the central subfield foveal thickness(CSFT) and macular volume in 42 eyes with DME(CSFT〉275 μm). Evaluations also included measurement of best-corrected visual acuity(BCVA), and were performed at baseline, and upon foveal depression recovery achieved after 12 monthly intravitreal injections of either 1.5 mg/0.06 mL bevacizumab(n=21) or 0.5 mg/0.05 mL ranibizumab(n=21). Data was compared to 42 eyes of normally sighted, non-diabetic, healthy individuals with similar age, gender and race distributions.RESULTS:Mean baseline BCVA was 0.59±0.04 and 0.32± 0.03 log MAR(P〈0.001) after treatment and resolution of DME, with all, but 3 eyes, showing BCVA improvement. Mean CSFT before treatment was 422.0±20.0 μm, and after treatment, decreased to 241.6±4.6 μm(P〈0.001), which is significantly thinner than CSFT found in control subjects(272.0±3.4 μm; P〈0.001). Moreover, in 33/42 DM eyes(79%), CSTF was thinner than the matched control eye. Macular volume showed comparable results, but with lower differences between groups(control:8.5±0.4 mm^3; DME:8.2±1.0 mm^3; P=0.0267).CONCLUSION:DME eyes show significantly lower foveal thickness than matched controls after DME resolution achieved with one-year anti-VEGF therapy. Further investigation into the reasonsfor this presumable retinal atrophy using fluorescein angiography and functional parameters as well as establishing possible predictors is warranted. This finding should be considered during the treatment of DME.
基金Supported by the New Faculty Startup Fund of Seoul National University(Jung JH).
文摘AIM:To compare the macular structure including foveal thickness among patients with optic neuritis(ON)according to the etiology and to investigate the possible correlation between structural and visual outcomes METHODS:In this retrospective cross-sectional study,the clinical data of patients with aquaporin-4 immunoglobulin G-related ON(AQP4 group,40 eyes),myelin oligodendrocyte glycoprotein IgG-related ON(MOG group,31 eyes),and multiple sclerosis-related ON(MS group,24 eyes)were obtained.The retinal thickness of the foveal,parafoveal and perifoveal regions were measured.Visual acuity(VA),visual field index and mean deviation were measured as visual outcomes.RESULTS:The AQP4 group showed a significantly thinner fovea(226.4±13.4μm)relative to the MOG(236.8±14.0μm,P=0.015)and MS(238.9±14.3μm,P=0.007)groups.The thickness in the parafoveal area also was thinner in the AQP4 group,though the difference in perifoveal retinal thickness was not significant.Foveal thickness was correlated with VA in the AQP4 group(coefficientρ=-0.418,P=0.014),but not in the MOG and MS groups(P=0.218 and P=0.138,respectively).There was no significant correlation between foveal thickness and visual field test in all three groups.CONCLUSION:The significant thinning in the fovea and parafoveal areas in the AQP4 group compared to the MOG and MS groups are found.Additionally,macular changes in AQP4-ON show a significant correlation with VA.The results provide the possibility that retinal structural damage could reflect functional damage in AQP4-ON,distinct from MOGON and MS-ON.
文摘To investigate the foveal morphological changes and foveal avascular zone(FAZ)area before and after epiretinal membrane(ERM)surgery.Twenty-two eyes with treatmentnaive ERM were included in this retrospective study.The central foveal thickness(CFT)and FAZ area were measured via swept-source optical coherence tomography(SS-OCT)and OCT angiography pre-and postoperatively.The unaffected fellow eyes were used as controls.The preoperative superficial FAZ area was significantly smaller in patients(0.08±0.04 mm^2)than in controls(0.33±0.09 mm^2;P〈0.001).The postoperative superficial FAZ(0.12±0.06 mm^2)area was significantly greater than the preoperative area(P〈0.001).The preoperative superficial FAZ area was strongly negatively correlated with CFT(P〈0.001,rho=-0.763).ERM induced significant foveal morphological changes and reduction of the superficial FAZ area.Foveal thickness was restored and FAZ area increased postoperatively.However,the process is rather slow and the recovery is incomplete.
文摘AIM:To evaluate the changes in macular morphology and function after a single intravitreal injection of aflibercept in diabetic macular edema(DME)using optical coherence tomography angiography(OCTA)and MP-3 microperimetry.METHODS:Twenty-eight patients(42 eyes)diagnosed with DME were treated with intravitreal injection of aflibercept.The changes in best corrected visual acuity(BCVA),central retinal thickness(CRT),foveal avascular zone(FAZ)area,vessel density of superficial retinal capillary plexus(SVD),vessel density of deep retinal capillary plexus(DVD),mean light sensitivity(MLS),2°fixation rate(P1),4°fixation rate(P2),and other indicators 1mo after treatment were compared;of these,BCVA was conver ted into logarithm of the minimum angle of resolution(logMAR),and the correlation among the factors was analyzed.RESULTS:After treatment,logMAR BCVA was 0.47±0.24,which was significantly better than that before treatment(0.63±0.28,P<0.001).The CRT was 359.21±107.87μm after treatment,which was significantly lower than before treatment(474.10±138.20μm,P<0.001).The FAZ area,SVD,and DVD were not significantly changed after treatment compared with the baseline.MLS was 22.16±4.20 dB after treatment,which was significantly higher than before treatment(19.63±4.23 dB,P<0.001).P2 significantly increased after treatment than before treatment(P=0.007).P1 had no significant change after treatment than before treatment(P=0.086).CONCLUSION:A single intravitreal injection of aflibercept effectively reduces macular edema and improves retinal sensitivity,fixation stability,and visual acuity,possibly without causing significant changes in the retinal vascular condition in a short time.
文摘AIM: To evaluate the clinical efficacy and safety of ranibizumab for wet age-related macular degeneration (wAMD) in Chinese patients and to determine the mean number of injections administered over one year of follow-up. METHODS: This single centre, retrospective observational case series study included data from 121 patients with wAMD (121 eyes) who were diagnosed by indirect ophthalmoscopy, fluorescence fundus angiography (FFA), indocyanine green angiography, and optical coherence tomography. Ranibizumab was injected into the vitreous cavities once per month for 3mo and as needed afterwards. Changes in visual acuity and central foveal thickness (CFT) during the follow-up period were compared, and the mean number of injections over the year was calculated. Patients with one or more adverse events related to the drugs and injections were recorded for further adverse events analysis.RESULTS: The study population included 70 males and 51 females aged between 50 and 87y (mean: 71.32±9.41y). The mean number of injections over the first year was 5±1 (range: 3-9). The mean best-corrected visual acuity by Early Treatment Diabetic Retinopathy Study increased from 43.2±19.3 (95%CI: 39.8-46.7) at baseline to 51.7±20.1 (95%CI: 48.1-55.3), and central foveal thickness (CFT) decreased from 526.5±277.0 μm (95%CI: 476.6-576.4) to 258.2±161.6 μm (95%CI: 229.2-287.3) at 12mo. The differences were statistically significant (P〈0.001). Visual acuity significantly improved in 34.1% of the patients (38 eyes), stabilized in 66.1% of the patients (80 eyes), and significantly decreased in 2.5% of the patients (3 eyes). CFT at baseline was an independent risk factor of decreased CFT and increased visual acuity. None of the patients had severe adverse events during the follow-up period.CONCLUSION: Ranibizumab can effectively control disease progression and improve visual acuity in patients with wAMD. The disease conditions of most patients stabilized after a one-year treatment with an average of 5 injections.
基金Supported by the National Natural Science Foundation of China(No.81070734)Beijing Natural Science Foundation(No.7131007)Beijing Education Commission(No.KZ201110025028)
文摘AIM:To detect the association between macular pigment optical density(MPOD),which reflects the antioxidant ability of retina,and diabetic retinopathy(DR)and to investigate the correlated factors of MPOD.METHODS: Totally 435 subjects of urban Chinese were recruited to the study and divided into 3 groups: non-diabetes mellitus controls(NDM),diabetic patients without retinopathy(DWR),and patients with early stage of non-proliferative diabetic retinopathy(DR).Demographic and lifestyle characteristics were ascertained by questionnaire.A food-frequency questionnaire,general physical and ophthalmic examinations were completed for all participants.MPOD was measured by heterochromatic flicker photometry.Foveal thickness was measured by optical coherence tomography.The difference of MPOD among 3 groups was analyzed by analysis of covariance.The correlation analyses of MPOD with the candidate influence factors were assessed using the generalized estimating equations(GEE) model.RESULTS: Of the 435 participants,34 could not perform the MPOD measurements.Final analysis included 401 subjects,including 48 were in DR group,134 in DWR group,and 219 in NDM group.MPOD was not significantly different among DR(0.49 ±0.21),DWR(0.45 ±0.21),and NDM(0.49±0.17) groups(P=0.24) after adjustment for fasting plasma glycemia,central foveal thickness,green vegetables,Chinese wolfberry,carotene and vitamin E.For all the 401 participants included,MPOD was positively associated with central foveal thickness(E=0.0007,P=0.001),Chinese wolfberry(E=0.0345,P=0.01),and green vegetables(E=0.0596,P〈0.001) intake.CONCLUSION: The data suggest that MPOD level is not statistically significantly influenced by the onset of diabetes or early stage of DR in the studied population.MPOD level is positively associated with thicker central foveal thickness and higher intake of foods containing carotenoids.
文摘AIM:To evaluate the therapeutic effect of combined phacovitrectomy with membrane peeling and intraocular lens(IOL)implantation in patients with severe idiopathic epiretinal membrane(iERM)and concurrent cataract.METHODS:A total of 34 eyes from 34 patients who underwent phacovitrectomy and epiretinal membrane(ERM)peeling at the First Affiliated Hospital of Zhejiang University between 2015 and 2017.The best-corrected visual acuity(BCVA)and central foveal thickness(CFT)were measured preoperatively and at 1,3,6 mo and 1 y postoperatively.Temporal changes and bivariate correlations of these parameters were analyzed.RESULTS:Mean logMAR BCVA improved and CFT decreased significantly(P<0.001)until 6 mo after surgery.Correlation analysis revealed a positive correlation between preoperative and postoperative logMAR BCVA(r=0.716,P<0.001 at 1 mo,r=0.417,P=0.014 at 3 mo,r=0.359,P=0.037 at 6 mo,and r=0.369,P=0.032 at 12 mo post-op respectively),but preoperative CFT was neither associated with postoperative CFT nor with postoperative logMAR BCVA.There was a positive correlation between CFT and logMAR BCVA at 1 mo(r=0.346,P=0.045),6 mo(r=0.347,P=0.045),and 12 mo(r=0.342,P=0.048)post-operatively.The intraand postoperative complications were relatively mild,and the incidences were generally low.CONCLUSION:For severe iERM patients with significant visual symptoms,combined phacovitrectomy with membrane peeling and IOL implantation is safe and effective in improving BCVA and decreasing CFT.Early surgery in selected patients may help preserving better visual function.
文摘Background:Most patients of established retinitis pigmentosa(RP)have subnormal peripheral vision and heavily rely on central vision for their daily activities.Central visual acuity is dependent on photoreceptor survival at the macula.Identification of structural changes that precede visual loss is essential.The aim of this study was to correlate the Spectral Domain-Optical Coherence Tomography(SD-OCT)characteristics with visual acuity in patients with typical RP.Methods:This was a retrospective,observational case series of 224 eyes of 113 RP patients conducted a tertiary eye care center.SD-OCT imaging was done for all eyes.Central retinal thickness(CRT),photoreceptor outer segment length(PROS),foveal outer segment pigment epithelial thickness(FOSPET)and ellipsoid zone(EZ)extent were measured.A new variable,FOSPET-PROS ratio(FPR),obtained by dividing FOSPET by PROS is defined and correlated to corrected distance visual acuity(CDVA)in logMAR using linear regression.Results:Out of 113 patients,71 were males and 42 females.Mean age of the patients was 35.4±15.1 years.Mean CDVA was 0.33±0.25 logMAR with no difference between the genders.Mean CRT(218.74±83.5μm)and FPR(1.63±0.22)significantly correlated to CDVA with a correlation coefficient of r=−0.139(p=0.048)and r=0.842(p=0.0001),respectively.FOSPET(mean=71.15±13.8μm)and PROS(mean=44.85±12.5μm)did not show a significant correlation to CDVA,independent of FPR.Conclusions:Retinal microstructural changes on SD-OCT,especially the FPR,can be used as a surrogate marker to monitor disease progression in the central retina in degenerative diseases like RP.