AIM:To evaluate the clinical effect of a new surgery technique(covering corneal stromal lenticule,CSL)for macular hole(MH)in pathological myopia.METHODS:This was a prospective non-randomized series case study.Fourteen...AIM:To evaluate the clinical effect of a new surgery technique(covering corneal stromal lenticule,CSL)for macular hole(MH)in pathological myopia.METHODS:This was a prospective non-randomized series case study.Fourteen eyes of 14 patients whose axial length were more than 29 mm and suffered from MH and macular hole retinal detachment(MHRD)were included in this study.All cases were treated with 25-gauge pars plana vitrectomy(PPV)with internal limiting membrane(ILM)peeling,covering CSL and C_(3)F_(8) gas tamponade.These cases were followed for 6mo,and the best-corrected visual acuity(BCVA),healing status of MH,the reattached rate of retinal detachment(RD),and reoperation rate were analyzed.RESULTS:All cases were successfully performed the surgery and the postoperative follow-up was completed.After surgery,MHs were healed in all 14 eyes(100%,14/14)after assessed by optical coherence tomography.The reattachment of retina was achieved in all 6 eyes(100%,6/6)with MHRD.BCVA was improved in 12 eyes(85.71%,12/14),and had no significant change in 2 eyes(14.29%,2/14).The overall mean BCVA was improved from 1.80±0.77 to 0.82±0.46 logMAR(F=10.46,P<0.01).No serious complications occurred in all cases.CONCLUSION:The new surgery technique(covering CSL)has high reattached rate of RD and high healing rate of MH in pathological myopia in the preliminary study.And it can effectively improve the visual function of patients.This new technique offers meaningful new ideas for treating refractory MH in pathological myopia.展开更多
AIM： To investigate the effects of posterior scleral reinforcement（PSR） in the treatment of pathological myopia.·METHODS： The study included 52 eyes in 43 patients with pathological myopia who underwent PSR（...AIM： To investigate the effects of posterior scleral reinforcement（PSR） in the treatment of pathological myopia.·METHODS： The study included 52 eyes in 43 patients with pathological myopia who underwent PSR（PSR group）, and 52 eyes in 36 age- and myopia-matched patients who did not undergo such treatment as control group. Axial length, refraction error, best corrected visual acuity（BCVA）, and macular scans by optical coherence tomography（OCT） were recorded at baseline, 6mo, 1, 3and 5y after the surgery, and the complications were noted.·RESULTS： There were no statistical differences in axial length, refractive error, or BCVA between the PSR group and the control group at baseline. At the end of the follow-up, the mean axial length was 29.79 ±1.26 mm in the PSR group, which was significantly shorter than that in the control group（30.78±1.30 mm）（P 〈0.01）, and the mean refractive error was-16.86 ±2.53 D in the PSR group, which was significantly lower than that in the control group（-19.18 ±2.12 D）（P 〈0.01）. A statistically significant difference in BCVA was found between the PSR group（0.51 ±0.25 log MAR） and the control group（0.62±0.26 log MAR） at the postoperative 5-year follow-up（P 〈0.01）. There were no serious complications during the 5-year follow-up period.·CONCLUSION： PSR can prevent axial elongation and myopia progression in eyes with pathological myopia.展开更多
AIM:To observe the long-term clinical efficacy of intravitreal injections of conbercept,a novel vascular growth factor inhibitor,for the treatment of pathological myopia choroidal neovascularization(PM-CNV).METHODS:A ...AIM:To observe the long-term clinical efficacy of intravitreal injections of conbercept,a novel vascular growth factor inhibitor,for the treatment of pathological myopia choroidal neovascularization(PM-CNV).METHODS:A total of 67 eyes(from 67 patients;mean age,54.90±12.7y)with PM-CNV were retrospectively researched.Based on the different schemes used for the administration of the drug,the patients were divided into two groups:group A(n=35;average age,53.31±13.6y;average diopter,9.25±1.72 D),which received only one injection of pro re nata(PRN;1+PRN regimen),and group B(n=32;average age,56.49±11.8y;average diopter,9.63±2.24 D),which received one injection per month for 3mo(3+PRN regimen).Best-corrected visual acuity(BCVA)analysis,intraocular pressure(IOP)examination,slit-lamp microscopy,fundus examination and optical coherence tomography were per formed at each follow-up.The recurrence and treatment times of CNV were recorded.The patients were followed up for at least 12mo.RESULTS:The BCVA was increased in 29 eyes(82.9%)in group A and 30 eyes(93.75%)in group B;no increase or decrease was observed in 6(17.1%)and 2(6.25%)eyes in groups A and B,respectively.The BCVA(log MAR)values before treatment(0.67±0.48 and 0.71±0.56)were significantly higher than those 12mo after treatment(0.31±0.26 and 0.33±0.17)in groups A and B,respectively(P<0.05).The mean central macular thickness(CMT)values had significantly decreased from 346.49±65.99 and 360.10±82.31μm at baseline to 257.29±40.47 and 251.97±48.26μm in groups A and B,respectively,after 12mo of treatment.A total of 21 eyes in group A needed reinjection(60%;average number of injections,2.51±0.98);the corresponding values in group B were 6 eyes(18.75%;average number of injections,3.74±1.22).There were no adverse ocular and systemic complications during the treatment and follow-up.CONCLUSION:Intravitreal injection of conbercept with 1+PRN or 3+PRN improve the visual acuity,reduce macular edema and reduce the level of CMT in patients with PM-CNV.The 3+PRN regimen demonstrates a lower recurrence rate of CNV than the 1+PRN regimen,but requires more treatment.However,both treatment regimens demonstrate long-term safety and efficacy for the treatment of PM-CNV.展开更多
Myopic choroidal neovascularization(m CNV), one of the complications of pathological myopia, is also one of the leading causes of visual impairment worldwide. The socioeconomic impact of mC NV in Asian countries is pa...Myopic choroidal neovascularization(m CNV), one of the complications of pathological myopia, is also one of the leading causes of visual impairment worldwide. The socioeconomic impact of mC NV in Asian countries is particularly significant due to the rising incidence of pathological myopia. There have been major advances in the treatment of mC NV in the past few years. Previous treatment modalities, such as thermal laser photocoagulation and photodynamic therapy, aimed to prevent vision loss;however, newer modalities such as intravitreal anti-vascular endothelial growth factor(VEGF) agents have been shown to successfully restore vision in many patients. Challenges remain as long term safety and efficacy of anti-VEGF agents are unknown. This article aims to provide a review of the literature of the epidemiology, progression, clinical course and treatment modalities as well as areas of future developments related to myopic CNV.展开更多
AIM:To evaluate the clinical application value of the artificial intelligence assisted pathologic myopia(PM-AI)diagnosis model based on deep learning.METHODS:A total of 1156 readable color fundus photographs were coll...AIM:To evaluate the clinical application value of the artificial intelligence assisted pathologic myopia(PM-AI)diagnosis model based on deep learning.METHODS:A total of 1156 readable color fundus photographs were collected and annotated based on the diagnostic criteria of Meta-pathologic myopia(PM)(2015).The PM-AI system and four eye doctors(retinal specialists 1 and 2,and ophthalmologists 1 and 2)independently evaluated the color fundus photographs to determine whether they were indicative of PM or not and the presence of myopic choroidal neovascularization(mCNV).The performance of identification for PM and mCNV by the PMAI system and the eye doctors was compared and evaluated via the relevant statistical analysis.RESULTS:For PM identification,the sensitivity of the PM-AI system was 98.17%,which was comparable to specialist 1(P=0.307),but was higher than specialist 2 and ophthalmologists 1 and 2(P<0.001).The specificity of the PM-AI system was 93.06%,which was lower than specialists 1 and 2,but was higher than ophthalmologists 1 and 2.The PM-AI system showed the Kappa value of 0.904,while the Kappa values of specialists 1,2 and ophthalmologists 1,2 were 0.968,0.916,0.772 and 0.730,respectively.For mCNV identification,the AI system showed the sensitivity of 84.06%,which was comparable to specialists 1,2 and ophthalmologist 2(P>0.05),and was higher than ophthalmologist 1.The specificity of the PM-AI system was 95.31%,which was lower than specialists 1 and 2,but higher than ophthalmologists 1 and 2.The PM-AI system gave the Kappa value of 0.624,while the Kappa values of specialists 1,2 and ophthalmologists 1 and 2 were 0.864,0.732,0.304 and 0.238,respectively.CONCLUSION:In comparison to the senior ophthalmologists,the PM-AI system based on deep learning exhibits excellent performance in PM and mCNV identification.The effectiveness of PM-AI system is an auxiliary diagnosis tool for clinical screening of PM and mCNV.展开更多
AIM:To evaluate the global trends in and explore hotspots of high myopia(HM)research.METHODS:This bibliometric analysis was used to reveal the publication trends in HM research field based on the Web of Science Core C...AIM:To evaluate the global trends in and explore hotspots of high myopia(HM)research.METHODS:This bibliometric analysis was used to reveal the publication trends in HM research field based on the Web of Science Core Collection(WoSCC).VOSviewer version 1.6.13 software was used to analyze the data and construct a knowledge map including the yearly publication number,journals,countries,international collaborations,authors,research hotspots,and intellectual base in HM.RESULTS:The search engine found 3544 peer-reviewed publications on HM between 2010 and 2019,and the yearly research output substantially elevated over the past decade.China is the top publishing country,and Sun Yatsen University was the most active academic institution.Jonas JB is the top publishing scientist,and Investigative Ophthalmology and Visual Science(IOVS)was the most productive journal.The highest cited references mainly focused on epidemiology and management.The keywords formed 6 clusters:1)refractive surgery;2)etiology and clinical characteristics;3)the mechanism of eye growth;4)management for myopic maculopathy;5)vitrectomy surgical treatment;6)myopia-associated glaucoma-like optic neuropathy.CONCLUSION:The evaluation of development trends based on the data extracted from WoSCC can provide valuable information and guidance for ophthalmologists and public health researchers to improve management procedures in HM field.展开更多
Objectives: To study the therapeutic effects of “Lingqi Huangban Granule” (LQHB) combined with intravitreal ranibizumab injection (IVR) for choroidal neovascularisation (CNV) in pathologic myopia (PM). Methods: This...Objectives: To study the therapeutic effects of “Lingqi Huangban Granule” (LQHB) combined with intravitreal ranibizumab injection (IVR) for choroidal neovascularisation (CNV) in pathologic myopia (PM). Methods: This was a prospective, comparative, interventional study. Eighty eyes of eighty consecutive patients with myopic CNV were randomized into control group (IVR, 40 eyes) and integrative therapy group (IVR + LQHB, 40 eyes), each with a follow-up period of 12 months. IVR was given with an “on demand” regimen (Pro re nata, PRN). Final best corrected visual acuity (BCVA) and its change from baseline were the main outcome measures. Changes in optical coherence tomography (OCT) and central retinal thickness (CRT) were the secondary outcome measures. Results: BCVA of patients in the integrative group improved significantly (from 47.10 ± 13.51 letters to 90.72 ± 12.98 letter, P 0.05), more than in the control group (from 42.90 ± 13.18 letters to 69.18±13.21 letters, P 0.05) since the third month after the initial treatment to the end of the follow-up. Mean OCT CRT reduced from 364.75 ± 69.31 to 278.93 ± 33.05 um (P 0.05) in the control group and from 370.73 ± 65.31 to 271.73 ± 46.44 um (P 0.05) in the integrative group, respectively. The mean number of intravitreal injections in the 1-year follow-up was also reduced. No ocular or systemic side effects were observed. Conclusion: LQHB combined with IVR therapy was an effective treatment for stabilizing and improving vision with fewer intravitreal injections. It appears to be an interesting option for this type of patient.展开更多
AIM： To investigate the effect of posterior scleral reinforcement （PSR） on circulation of pathologic myopia eyes with posterior staphyloma by optical coherence tomography angiography （OCTA）.METHODS： The study in...AIM： To investigate the effect of posterior scleral reinforcement （PSR） on circulation of pathologic myopia eyes with posterior staphyloma by optical coherence tomography angiography （OCTA）.METHODS： The study included 30 pathologic myopia eyes with posterior staphyloma which underwent PSR （PSR group） for 6 to 18mo ago, and 30 age and myopia matched eyes without PSR surgery as control group. Macular, choriocapillaris and radial peripapillary capillary （RPC） flow density were measured by OCTA, and the measurements were compared between groups. RESULTS： OCTA found no significant differences in macular flow density between PSR and control groups. For the superficial flow, whole enface flow density （WED）, fovea density （FD）, and parafoveal density （PD） were 46.55%±5.19% vs 47.29%±4.12% （P=0.542）, 31.45%±6.35% vs 31.17%±4.48% （P=0.841）, and 48.82%±5.66% vs 49.21%±4.15% （P=0.756） in PSR and control groups, respectively. For the deep flow, WED, FD, and PD were 52.07%±5.78% vs 53.95%±4.62% （P=0.168）, 29.62%±6.55% vs 29.50%±6.38% （P=0.940）, and 56.93%±6.17% vs 58.15%±5.13% （P=0.407） in PSR and control groups, respectively. The choriocapillary flow density was 61.18±3.25% in PSR group vs 60.88%±2.56% in control group （P=0.692）. Also, OCTA found no significant differences in RPCs flow density between PSR and control groups. The optic disc WED, inside disc flow density and peripapillary flow density were 48.47%±4.77% vs 48.11%±4.57% （P=0.813）, 45.47%±11.44% vs 46.68%±9.02% （P=0.709）, 54.32%±5.29% vs 52.47%±6.62% （P=0.349） in PSR and control groups, respectively.CONCLUSION： OCTA provides a non-invasive and quantitative approach for monitoring macular and papillary blood flow in pathologic myopia. PSR can not improve but may maintain the circulation of pathologic myopia eyes with posterior staphyloma.展开更多
Choroidal neovascularization(CNV)is an uncommon complication associated with a macular hole.In this case report of a rare condition,we present a pathologic myopia patient with a co-existent macular hole and choroidal ...Choroidal neovascularization(CNV)is an uncommon complication associated with a macular hole.In this case report of a rare condition,we present a pathologic myopia patient with a co-existent macular hole and choroidal neovascular membrane.The patient was treated with photodynamic therapy for CNV,and then vitreous surgery for the retinal detachment and macular hole.At the end of 4 years follow-up,her visual acuity was improved to 0.1 while the macular hole remained open.Optical coherence tomography is a useful inspection method of the diagnosis of CNV and macular hole.展开更多
Pathologic myopia is the major cause of the loss of the best-corrected visual acuity(BCVA)worldwide,especially in East Asian countries.The loss of BCVA is caused by the development of myopic macula patchy,myopic tract...Pathologic myopia is the major cause of the loss of the best-corrected visual acuity(BCVA)worldwide,especially in East Asian countries.The loss of BCVA is caused by the development of myopic macula patchy,myopic traction macula patchy,and myopic optic neuropathy(or glaucoma).The development of such vision-threatening complications is caused by eye deformity,characterized by a formation of posterior staphyloma.The recent advance in ocular imaging has greatly facilitated the clarification of pathologies and pathogenesis of pathological myopia and myopia-related complications.These technologies include ultra-wide field fundus imaging,swept-source optical coherence tomography,and 3D MRI.In addition,the new treatments such as anti-VEGF therapies for myopic choroid all neovascularization have improved the outcome of the patients.Swept-source OCT showed that some of the lesions of myopic maculopathy were not simply chorioretinal atrophy but were Bruch’s membrane holes.Features of myopic traction maculopathy have been analyzed extensively by using OCT.The understanding the pathophysiology of complications of pathologic myopia is considered useful for better management of this blinding eye disease.展开更多
Stickler syndrome (SS) is an autosomal dominant inherited genetic disorder that presents with hearing loss, a cleft palate, epiphyseal dysplasia, and degeneration, similar to arthritis and well known to be associated ...Stickler syndrome (SS) is an autosomal dominant inherited genetic disorder that presents with hearing loss, a cleft palate, epiphyseal dysplasia, and degeneration, similar to arthritis and well known to be associated with rhegmato-genous retinal detachments. A particular group of physical features called Pierre Robin sequence is also common in people with stickler syndrome. Pierre Robin sequence includes a cleft palate, glossoptosis, and micrognathia. We describe a case report of a family diagnosed with stickler syndrome presenting with Pierre Robin sequence and share some universal management steps for rhegmatogenous retinal detachment in stickler syndrome. Genetic testing is important to support the diagnosis and conduct screenings of family members.展开更多
AIM： To report the long-term surgical outcomes of pathologic myopic foveoschisis（MF） following vitrectomy.METHODS： We performed a retrospective case series analysis of 50 consecutive patients diagnosed with MF who...AIM： To report the long-term surgical outcomes of pathologic myopic foveoschisis（MF） following vitrectomy.METHODS： We performed a retrospective case series analysis of 50 consecutive patients diagnosed with MF who experienced vision loss due to progression of foveoschisis.The 50 patients（67 eyes） were treated in our hospital with vitrectomy with internal limiting membrane（ILM） peeling from December 2004 to September 2010.Best corrected visual acuity（BCVA）,refractive error,optical coherence tomography（OCT）,and routine examination results were analysed.The changes of BCVA,foveal anatomical features on OCT scan,and complications were the main outcome measures.RESULTS： The mean follow-up duration was 42±17mo（range 24 to 93mo）.BCVA improved significantly postoperatively（0.76±0.65 logM AR） compared with preoperative baselines（1.31±0.78 log MAR,P〈0.0001）,and in 53 eyes（79%） including 3 lines gain in 44 eyes（66%） at the last follow-up visit.OCT scans showed that central retinal thickness decreased from 580.0±270.0 μm preoperatively（n=67） to 179.7±84.7 μm postoperatively（n=58,P〈0.0001）.Total resolution of foveoschisis occurred in 41 eyes（61%）.Preoperative BCVA correlated well with postoperative BCVA,whereas other factors such as age,axial length,and refractive error were not correlated.The most common complications were cataract and full-thickness macular hole formation in 14 and 9 cases,respectively.CONCLUSION： Patients with progressive vision loss due to MF who were treated with vitrectomy with ILM peelingshow favourable outcomes.In most eyes,visual acuity and foveal structure remain stable during long-term observation.展开更多
AIM: To evaluate the visual outcomes of choroidal neovascularization (CNV) secondary to pathological myopia and the impact of novel risk factors affecting the final visual outcome. ·METHODS: Interventional case s...AIM: To evaluate the visual outcomes of choroidal neovascularization (CNV) secondary to pathological myopia and the impact of novel risk factors affecting the final visual outcome. ·METHODS: Interventional case series of 18 consecutive patients with pathological myopia treated with photodynamic therapy (PDT). Inclusion criteria were spherical equivalent -6D or worse or features of pathological myopia on retinal examination. The main outcome measure was final best -corrected visual acuity (BCVA). ·RESULTS: Of 18 eyes, 13 (72.2%) avoided moderate visual loss (≥3 lines of LogMAR BCVA) and 5 eyes (27.8%) improved by at least 1 line after 1 year. Patients with LogMAR BCVA ≤0.3 (Snellen equivalent 20/40) at one year were younger than those with BCVA 】0.3 (mean age 39.0 vs 61.6 years, P =0.001). A higher proportion of eyes with greatest linear dimension (GLD) of ≤1 000μm avoided moderate visual loss (100% vs 50%, P =0.026). Among patients who were treated within 2 weeks of visual symptoms, 88.9% avoided the loss of 3 or more lines compared to 55.6% for those who presented later. The mean improvement in LogMAR BCVA of those with GLD ≤1 000μm was +0.12 compared to a loss of 0.55 LogMAR units for those with GLD 】1 000μm (P =0.02). Visual outcomes were not associated with gender or refractive error.·CONCLUSION: Good visual outcome in myopic CNV is associated with younger age, smaller lesion size and earlier initiation of treatment. These factors are relevant for ophthalmologists considering treatment options for myopic CNV.展开更多
Background:Myopic maculopathy(MM)has become a major cause of visual impairment and blindness worldwide,especially in East Asian countries.Deep learning approaches such as deep convolutional neural networks(DCNN)have b...Background:Myopic maculopathy(MM)has become a major cause of visual impairment and blindness worldwide,especially in East Asian countries.Deep learning approaches such as deep convolutional neural networks(DCNN)have been successfully applied to identify some common retinal diseases and show great potential for the intelligent analysis of MM.This study aimed to build a reliable approach for automated detection of MM from retinal fundus images using DCNN models.Methods:A dual-stream DCNN(DCNN-DS)model that perceives features from both original images and corresponding processed images by color histogram distribution optimization method was designed for classification of no MM,tessellated fundus(TF),and pathologic myopia(PM).A total of 36,515 gradable images from four hospitals were used for DCNN model development,and 14,986 gradable images from the other two hospitals for external testing.We also compared the performance of the DCNN-DS model and four ophthalmologists on 3000 randomly sampledfundus images.Results:The DCNN-DS model achieved sensitivities of 93.3%and 91.0%,specificities of 99.6%and 98.7%,areas under the receiver operating characteristic curves(AUCs)of 0.998 and 0.994 for detecting PM,whereas sensitivities of 98.8%and 92.8%,specificities of 95.6%and 94.1%,AUCs of 0.986 and 0.970 for detecting TF in two external testing datasets.In the sampled testing dataset,the sensitivities of four ophthalmologists ranged from 88.3%to 95.8%and 81.1%to 89.1%,and the specificities ranged from 95.9%to 99.2%and 77.8%to 97.3%for detecting PM and TF,respectively.Meanwhile,the DCNN-DS model achieved sensitivities of 90.8%and 97.9%and specificities of 99.1%and 94.0%for detecting PMand T,respectively.Conclusions:The proposed DCNN-DS approach demonstrated reliable performance with high sensitivity,specificity,and AUC to classify different MM levels on fundus photographs sourced from clinics.It can help identify MM automatically among the large myopic groups and show great potential for real-life applications.展开更多
-yopia is the most common refractive disorder. High .myopia affects 27%-33% of all myopic eyes inAsia.1,2 ;The pathologic myopia （PM） is the most severe vision-threatening phenotype of high myopia.3 It is also the s...-yopia is the most common refractive disorder. High .myopia affects 27%-33% of all myopic eyes inAsia.1,2 ;The pathologic myopia （PM） is the most severe vision-threatening phenotype of high myopia.3 It is also the second most common cause of choroidal neovascularization （CNV） in Asia. Unlike age-related macular degeneration （AMD） which mostly effecting elders, PM causes severe vision loss in young adults, resulting in a significant impairment of their working ability.4 PM has become the second leading cause of low vision and blindness particularly among those aged at 40-49 years in some Asia countries.展开更多
Background Pathological myopia （PM） is the leading cause for choroidal neovascularization （CNV） in people below 50 years of age,the anti-vascular endothlial growth factor （VEGF） medicine is now available to trea...Background Pathological myopia （PM） is the leading cause for choroidal neovascularization （CNV） in people below 50 years of age,the anti-vascular endothlial growth factor （VEGF） medicine is now available to treat CNV secondary to PM.This study aimed to observe the efficacy of intravitreal ranibizumab for PM associated with subfoveal or juxtafoveal CNV in Chinese patients.Methods Fifty-four eyes of 52 consecutive patients were included,they treated with intravitreal ranibizumab 0.5 mg for PM associated with CNV.The best corrected visual acuity （BCVA） of Snellen chart,letters of ETDRS chart,retinal thickness,leakage of CNV lesion,and complications with surgery were analyzed pre-and post-treatment.Eligibility criteria included diopter ≥-8.0 D or eye axis ≥28 mm with fundus changes of PM （lacquer crack,optic disc atrophy,chorioretinal atrophy,posterior scleral staphyloma）; CNV secondary to PM; subfoveal or juxtafoveal CNV.Results For 54 affected eyes of 52 consecutive patients,the average BCVA of Snellen chart and letters of ETDRS chart were 0.29 and 30.4,respectively; fundus fluorescein angiography （FFA）/indocyanine green angiography （ICGA） showed CNV leakage,and average retinal thickness on optical coherence tomography （OCT） was 267.2 μm before treatment.Injections of ranibizumab ranged from 1 to 4 （mean 2.2）.Follow-up time varied from 12 to 36 months （mean 31.9 months）.At the last visit,the BCVA of Snellen chart was increased by three lines （mean 0.65） （P 〈0.01）; the letters of ETDRS chart were increased to 17.0 letters （mean 47.4,P 〈0.01）; the visual acuity increased more than 15 letters in 30 eyes （55.5%）,decreased in 1 eye （1.9%）; the retinal thickness on OCT images was decreased by 17.0 μm （mean 250.2 μm） （P=0.082）; no active leakage from the CNV lesion occurred in 18 eyes （33.3%）,reduced leakage in 30 eyes （55.6%）,and no change in 6 eyes （11.1%） as shown by FFA/ICGA.Increased retinoschisis was observed in one eye after the second injection.Conclusions Intravitreal ranibizumab for neovascular PM was well tolerated in Chinese patients,with functional and anatomic improvements in a short-term study,while a long-term study is still needed.展开更多
Background Intravitreal ranibizumab injection is effecitve on treating myopic CNVs,but it could be a risk factor for developing more severe retinoschisis in eyes with preexisted retinoschisis and epiretinal membrane.T...Background Intravitreal ranibizumab injection is effecitve on treating myopic CNVs,but it could be a risk factor for developing more severe retinoschisis in eyes with preexisted retinoschisis and epiretinal membrane.This study aimed to explore the incidence and features of retinoschisis after intravitreal ranibizumab injection for myopic choroidal neovascularization.Methods Eighty-three eyes of 81 patients with choroidal neovascularization secondary to pathologic myopia were treated with intravitreal ranibizumab injection.The best corrected visual acuity and optical coherence tomography （OCT） images were recorded at baseline and every month thereafter.Central retina thickness and maximal retina thickness were measured.The subjects were divided into three groups.Eleven eyes that had retinoschisis and epiretinal membrane were in group 1,six eyes that had simple epiretinal membrane were in group 2,and 66 eyes that had neither retinoschisis nor epiretinal membrane were in group 3.Six contralateral eyes in group 1 which had retinoschisis and epiretinal membrane but were not treated with intravitreal ranibizumab injection were set as the control group.Results Seven of the 11 eyes in group 1 developed more severe retinoschisis,the mean maximal retinal thickness increased from （380.28±90.13） to （467.00±70.20） μm （P 〈0.05）.The retinoschisis of all 6 eyes of the control group did not aggravate.Compared with the control group,the aggravation ratio of retinoschisis increased significantly （P 〈0.05）.No new onset of retinoschisis took place in group 2 and group 3.Conclusion Intravitreal ranibizumab injection may be a risk factor for aggravation of retinoschisis in eyes with preexisted retinoschisis and epiretinal membrane.展开更多
基金Supported by Medical Research Project of Sichuan(No.S23090).
文摘AIM:To evaluate the clinical effect of a new surgery technique(covering corneal stromal lenticule,CSL)for macular hole(MH)in pathological myopia.METHODS:This was a prospective non-randomized series case study.Fourteen eyes of 14 patients whose axial length were more than 29 mm and suffered from MH and macular hole retinal detachment(MHRD)were included in this study.All cases were treated with 25-gauge pars plana vitrectomy(PPV)with internal limiting membrane(ILM)peeling,covering CSL and C_(3)F_(8) gas tamponade.These cases were followed for 6mo,and the best-corrected visual acuity(BCVA),healing status of MH,the reattached rate of retinal detachment(RD),and reoperation rate were analyzed.RESULTS:All cases were successfully performed the surgery and the postoperative follow-up was completed.After surgery,MHs were healed in all 14 eyes(100%,14/14)after assessed by optical coherence tomography.The reattachment of retina was achieved in all 6 eyes(100%,6/6)with MHRD.BCVA was improved in 12 eyes(85.71%,12/14),and had no significant change in 2 eyes(14.29%,2/14).The overall mean BCVA was improved from 1.80±0.77 to 0.82±0.46 logMAR(F=10.46,P<0.01).No serious complications occurred in all cases.CONCLUSION:The new surgery technique(covering CSL)has high reattached rate of RD and high healing rate of MH in pathological myopia in the preliminary study.And it can effectively improve the visual function of patients.This new technique offers meaningful new ideas for treating refractory MH in pathological myopia.
基金Supported by the Overseas Training Program for Medical Academic Leaders of Henan Province(No.2014005)the Project of Medical Science and Technology of f Henan Province(No.201304007)the Development Plan of Science and Technology of Henan Province(No.142102310110)
文摘AIM： To investigate the effects of posterior scleral reinforcement（PSR） in the treatment of pathological myopia.·METHODS： The study included 52 eyes in 43 patients with pathological myopia who underwent PSR（PSR group）, and 52 eyes in 36 age- and myopia-matched patients who did not undergo such treatment as control group. Axial length, refraction error, best corrected visual acuity（BCVA）, and macular scans by optical coherence tomography（OCT） were recorded at baseline, 6mo, 1, 3and 5y after the surgery, and the complications were noted.·RESULTS： There were no statistical differences in axial length, refractive error, or BCVA between the PSR group and the control group at baseline. At the end of the follow-up, the mean axial length was 29.79 ±1.26 mm in the PSR group, which was significantly shorter than that in the control group（30.78±1.30 mm）（P 〈0.01）, and the mean refractive error was-16.86 ±2.53 D in the PSR group, which was significantly lower than that in the control group（-19.18 ±2.12 D）（P 〈0.01）. A statistically significant difference in BCVA was found between the PSR group（0.51 ±0.25 log MAR） and the control group（0.62±0.26 log MAR） at the postoperative 5-year follow-up（P 〈0.01）. There were no serious complications during the 5-year follow-up period.·CONCLUSION： PSR can prevent axial elongation and myopia progression in eyes with pathological myopia.
文摘AIM:To observe the long-term clinical efficacy of intravitreal injections of conbercept,a novel vascular growth factor inhibitor,for the treatment of pathological myopia choroidal neovascularization(PM-CNV).METHODS:A total of 67 eyes(from 67 patients;mean age,54.90±12.7y)with PM-CNV were retrospectively researched.Based on the different schemes used for the administration of the drug,the patients were divided into two groups:group A(n=35;average age,53.31±13.6y;average diopter,9.25±1.72 D),which received only one injection of pro re nata(PRN;1+PRN regimen),and group B(n=32;average age,56.49±11.8y;average diopter,9.63±2.24 D),which received one injection per month for 3mo(3+PRN regimen).Best-corrected visual acuity(BCVA)analysis,intraocular pressure(IOP)examination,slit-lamp microscopy,fundus examination and optical coherence tomography were per formed at each follow-up.The recurrence and treatment times of CNV were recorded.The patients were followed up for at least 12mo.RESULTS:The BCVA was increased in 29 eyes(82.9%)in group A and 30 eyes(93.75%)in group B;no increase or decrease was observed in 6(17.1%)and 2(6.25%)eyes in groups A and B,respectively.The BCVA(log MAR)values before treatment(0.67±0.48 and 0.71±0.56)were significantly higher than those 12mo after treatment(0.31±0.26 and 0.33±0.17)in groups A and B,respectively(P<0.05).The mean central macular thickness(CMT)values had significantly decreased from 346.49±65.99 and 360.10±82.31μm at baseline to 257.29±40.47 and 251.97±48.26μm in groups A and B,respectively,after 12mo of treatment.A total of 21 eyes in group A needed reinjection(60%;average number of injections,2.51±0.98);the corresponding values in group B were 6 eyes(18.75%;average number of injections,3.74±1.22).There were no adverse ocular and systemic complications during the treatment and follow-up.CONCLUSION:Intravitreal injection of conbercept with 1+PRN or 3+PRN improve the visual acuity,reduce macular edema and reduce the level of CMT in patients with PM-CNV.The 3+PRN regimen demonstrates a lower recurrence rate of CNV than the 1+PRN regimen,but requires more treatment.However,both treatment regimens demonstrate long-term safety and efficacy for the treatment of PM-CNV.
文摘Myopic choroidal neovascularization(m CNV), one of the complications of pathological myopia, is also one of the leading causes of visual impairment worldwide. The socioeconomic impact of mC NV in Asian countries is particularly significant due to the rising incidence of pathological myopia. There have been major advances in the treatment of mC NV in the past few years. Previous treatment modalities, such as thermal laser photocoagulation and photodynamic therapy, aimed to prevent vision loss;however, newer modalities such as intravitreal anti-vascular endothelial growth factor(VEGF) agents have been shown to successfully restore vision in many patients. Challenges remain as long term safety and efficacy of anti-VEGF agents are unknown. This article aims to provide a review of the literature of the epidemiology, progression, clinical course and treatment modalities as well as areas of future developments related to myopic CNV.
文摘AIM:To evaluate the clinical application value of the artificial intelligence assisted pathologic myopia(PM-AI)diagnosis model based on deep learning.METHODS:A total of 1156 readable color fundus photographs were collected and annotated based on the diagnostic criteria of Meta-pathologic myopia(PM)(2015).The PM-AI system and four eye doctors(retinal specialists 1 and 2,and ophthalmologists 1 and 2)independently evaluated the color fundus photographs to determine whether they were indicative of PM or not and the presence of myopic choroidal neovascularization(mCNV).The performance of identification for PM and mCNV by the PMAI system and the eye doctors was compared and evaluated via the relevant statistical analysis.RESULTS:For PM identification,the sensitivity of the PM-AI system was 98.17%,which was comparable to specialist 1(P=0.307),but was higher than specialist 2 and ophthalmologists 1 and 2(P<0.001).The specificity of the PM-AI system was 93.06%,which was lower than specialists 1 and 2,but was higher than ophthalmologists 1 and 2.The PM-AI system showed the Kappa value of 0.904,while the Kappa values of specialists 1,2 and ophthalmologists 1,2 were 0.968,0.916,0.772 and 0.730,respectively.For mCNV identification,the AI system showed the sensitivity of 84.06%,which was comparable to specialists 1,2 and ophthalmologist 2(P>0.05),and was higher than ophthalmologist 1.The specificity of the PM-AI system was 95.31%,which was lower than specialists 1 and 2,but higher than ophthalmologists 1 and 2.The PM-AI system gave the Kappa value of 0.624,while the Kappa values of specialists 1,2 and ophthalmologists 1 and 2 were 0.864,0.732,0.304 and 0.238,respectively.CONCLUSION:In comparison to the senior ophthalmologists,the PM-AI system based on deep learning exhibits excellent performance in PM and mCNV identification.The effectiveness of PM-AI system is an auxiliary diagnosis tool for clinical screening of PM and mCNV.
基金Supported by Natural Science Key Research Project of the Education Department of Liaoning Province(No.ZD2020003)Natural Science Foundation of Liaoning Province(No.2019-MS-376)。
文摘AIM:To evaluate the global trends in and explore hotspots of high myopia(HM)research.METHODS:This bibliometric analysis was used to reveal the publication trends in HM research field based on the Web of Science Core Collection(WoSCC).VOSviewer version 1.6.13 software was used to analyze the data and construct a knowledge map including the yearly publication number,journals,countries,international collaborations,authors,research hotspots,and intellectual base in HM.RESULTS:The search engine found 3544 peer-reviewed publications on HM between 2010 and 2019,and the yearly research output substantially elevated over the past decade.China is the top publishing country,and Sun Yatsen University was the most active academic institution.Jonas JB is the top publishing scientist,and Investigative Ophthalmology and Visual Science(IOVS)was the most productive journal.The highest cited references mainly focused on epidemiology and management.The keywords formed 6 clusters:1)refractive surgery;2)etiology and clinical characteristics;3)the mechanism of eye growth;4)management for myopic maculopathy;5)vitrectomy surgical treatment;6)myopia-associated glaucoma-like optic neuropathy.CONCLUSION:The evaluation of development trends based on the data extracted from WoSCC can provide valuable information and guidance for ophthalmologists and public health researchers to improve management procedures in HM field.
文摘Objectives: To study the therapeutic effects of “Lingqi Huangban Granule” (LQHB) combined with intravitreal ranibizumab injection (IVR) for choroidal neovascularisation (CNV) in pathologic myopia (PM). Methods: This was a prospective, comparative, interventional study. Eighty eyes of eighty consecutive patients with myopic CNV were randomized into control group (IVR, 40 eyes) and integrative therapy group (IVR + LQHB, 40 eyes), each with a follow-up period of 12 months. IVR was given with an “on demand” regimen (Pro re nata, PRN). Final best corrected visual acuity (BCVA) and its change from baseline were the main outcome measures. Changes in optical coherence tomography (OCT) and central retinal thickness (CRT) were the secondary outcome measures. Results: BCVA of patients in the integrative group improved significantly (from 47.10 ± 13.51 letters to 90.72 ± 12.98 letter, P 0.05), more than in the control group (from 42.90 ± 13.18 letters to 69.18±13.21 letters, P 0.05) since the third month after the initial treatment to the end of the follow-up. Mean OCT CRT reduced from 364.75 ± 69.31 to 278.93 ± 33.05 um (P 0.05) in the control group and from 370.73 ± 65.31 to 271.73 ± 46.44 um (P 0.05) in the integrative group, respectively. The mean number of intravitreal injections in the 1-year follow-up was also reduced. No ocular or systemic side effects were observed. Conclusion: LQHB combined with IVR therapy was an effective treatment for stabilizing and improving vision with fewer intravitreal injections. It appears to be an interesting option for this type of patient.
基金Supported by National Natural Science Foundation of China(No.81570891No.81272981)+4 种基金the Beijing Municipal Administration of Hospitals'Ascent Plan(No.DFL20150201)Science&Technology Project of Beijing Municipal Science&Technology Commission(No.Z151100001615052)Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support(No.ZYLX201307)Beijing Natural Science Foundation(No.7151003)Advanced Health Care Professionals Development Project of Beijing Municipal Health Bureau(No.2014-2-003)
文摘AIM： To investigate the effect of posterior scleral reinforcement （PSR） on circulation of pathologic myopia eyes with posterior staphyloma by optical coherence tomography angiography （OCTA）.METHODS： The study included 30 pathologic myopia eyes with posterior staphyloma which underwent PSR （PSR group） for 6 to 18mo ago, and 30 age and myopia matched eyes without PSR surgery as control group. Macular, choriocapillaris and radial peripapillary capillary （RPC） flow density were measured by OCTA, and the measurements were compared between groups. RESULTS： OCTA found no significant differences in macular flow density between PSR and control groups. For the superficial flow, whole enface flow density （WED）, fovea density （FD）, and parafoveal density （PD） were 46.55%±5.19% vs 47.29%±4.12% （P=0.542）, 31.45%±6.35% vs 31.17%±4.48% （P=0.841）, and 48.82%±5.66% vs 49.21%±4.15% （P=0.756） in PSR and control groups, respectively. For the deep flow, WED, FD, and PD were 52.07%±5.78% vs 53.95%±4.62% （P=0.168）, 29.62%±6.55% vs 29.50%±6.38% （P=0.940）, and 56.93%±6.17% vs 58.15%±5.13% （P=0.407） in PSR and control groups, respectively. The choriocapillary flow density was 61.18±3.25% in PSR group vs 60.88%±2.56% in control group （P=0.692）. Also, OCTA found no significant differences in RPCs flow density between PSR and control groups. The optic disc WED, inside disc flow density and peripapillary flow density were 48.47%±4.77% vs 48.11%±4.57% （P=0.813）, 45.47%±11.44% vs 46.68%±9.02% （P=0.709）, 54.32%±5.29% vs 52.47%±6.62% （P=0.349） in PSR and control groups, respectively.CONCLUSION： OCTA provides a non-invasive and quantitative approach for monitoring macular and papillary blood flow in pathologic myopia. PSR can not improve but may maintain the circulation of pathologic myopia eyes with posterior staphyloma.
基金Public Welfare Technology Project of Science Technology Department of Zhejiang Province,China(No.2012C23068)
文摘Choroidal neovascularization(CNV)is an uncommon complication associated with a macular hole.In this case report of a rare condition,we present a pathologic myopia patient with a co-existent macular hole and choroidal neovascular membrane.The patient was treated with photodynamic therapy for CNV,and then vitreous surgery for the retinal detachment and macular hole.At the end of 4 years follow-up,her visual acuity was improved to 0.1 while the macular hole remained open.Optical coherence tomography is a useful inspection method of the diagnosis of CNV and macular hole.
文摘Pathologic myopia is the major cause of the loss of the best-corrected visual acuity(BCVA)worldwide,especially in East Asian countries.The loss of BCVA is caused by the development of myopic macula patchy,myopic traction macula patchy,and myopic optic neuropathy(or glaucoma).The development of such vision-threatening complications is caused by eye deformity,characterized by a formation of posterior staphyloma.The recent advance in ocular imaging has greatly facilitated the clarification of pathologies and pathogenesis of pathological myopia and myopia-related complications.These technologies include ultra-wide field fundus imaging,swept-source optical coherence tomography,and 3D MRI.In addition,the new treatments such as anti-VEGF therapies for myopic choroid all neovascularization have improved the outcome of the patients.Swept-source OCT showed that some of the lesions of myopic maculopathy were not simply chorioretinal atrophy but were Bruch’s membrane holes.Features of myopic traction maculopathy have been analyzed extensively by using OCT.The understanding the pathophysiology of complications of pathologic myopia is considered useful for better management of this blinding eye disease.
文摘Stickler syndrome (SS) is an autosomal dominant inherited genetic disorder that presents with hearing loss, a cleft palate, epiphyseal dysplasia, and degeneration, similar to arthritis and well known to be associated with rhegmato-genous retinal detachments. A particular group of physical features called Pierre Robin sequence is also common in people with stickler syndrome. Pierre Robin sequence includes a cleft palate, glossoptosis, and micrognathia. We describe a case report of a family diagnosed with stickler syndrome presenting with Pierre Robin sequence and share some universal management steps for rhegmatogenous retinal detachment in stickler syndrome. Genetic testing is important to support the diagnosis and conduct screenings of family members.
基金Supported by the National Key Basic Research Program of China(No.2013CB967503)
文摘AIM： To report the long-term surgical outcomes of pathologic myopic foveoschisis（MF） following vitrectomy.METHODS： We performed a retrospective case series analysis of 50 consecutive patients diagnosed with MF who experienced vision loss due to progression of foveoschisis.The 50 patients（67 eyes） were treated in our hospital with vitrectomy with internal limiting membrane（ILM） peeling from December 2004 to September 2010.Best corrected visual acuity（BCVA）,refractive error,optical coherence tomography（OCT）,and routine examination results were analysed.The changes of BCVA,foveal anatomical features on OCT scan,and complications were the main outcome measures.RESULTS： The mean follow-up duration was 42±17mo（range 24 to 93mo）.BCVA improved significantly postoperatively（0.76±0.65 logM AR） compared with preoperative baselines（1.31±0.78 log MAR,P〈0.0001）,and in 53 eyes（79%） including 3 lines gain in 44 eyes（66%） at the last follow-up visit.OCT scans showed that central retinal thickness decreased from 580.0±270.0 μm preoperatively（n=67） to 179.7±84.7 μm postoperatively（n=58,P〈0.0001）.Total resolution of foveoschisis occurred in 41 eyes（61%）.Preoperative BCVA correlated well with postoperative BCVA,whereas other factors such as age,axial length,and refractive error were not correlated.The most common complications were cataract and full-thickness macular hole formation in 14 and 9 cases,respectively.CONCLUSION： Patients with progressive vision loss due to MF who were treated with vitrectomy with ILM peelingshow favourable outcomes.In most eyes,visual acuity and foveal structure remain stable during long-term observation.
基金Dr. Tan receives travel support from BayerBayer. Dr. Lim receives travel support from Novartis, Bayer and Heidelberg Engineering
文摘AIM: To evaluate the visual outcomes of choroidal neovascularization (CNV) secondary to pathological myopia and the impact of novel risk factors affecting the final visual outcome. ·METHODS: Interventional case series of 18 consecutive patients with pathological myopia treated with photodynamic therapy (PDT). Inclusion criteria were spherical equivalent -6D or worse or features of pathological myopia on retinal examination. The main outcome measure was final best -corrected visual acuity (BCVA). ·RESULTS: Of 18 eyes, 13 (72.2%) avoided moderate visual loss (≥3 lines of LogMAR BCVA) and 5 eyes (27.8%) improved by at least 1 line after 1 year. Patients with LogMAR BCVA ≤0.3 (Snellen equivalent 20/40) at one year were younger than those with BCVA 】0.3 (mean age 39.0 vs 61.6 years, P =0.001). A higher proportion of eyes with greatest linear dimension (GLD) of ≤1 000μm avoided moderate visual loss (100% vs 50%, P =0.026). Among patients who were treated within 2 weeks of visual symptoms, 88.9% avoided the loss of 3 or more lines compared to 55.6% for those who presented later. The mean improvement in LogMAR BCVA of those with GLD ≤1 000μm was +0.12 compared to a loss of 0.55 LogMAR units for those with GLD 】1 000μm (P =0.02). Visual outcomes were not associated with gender or refractive error.·CONCLUSION: Good visual outcome in myopic CNV is associated with younger age, smaller lesion size and earlier initiation of treatment. These factors are relevant for ophthalmologists considering treatment options for myopic CNV.
基金The research has been supported by the Qingdao Science and Technology Demonstration and Guidance Project(Grant No.20-3-4-45-nsh)Academic Promotion Plan of Shandong First Medical University&Shandong Academy of Medical Sciences(Grant No.2019ZL001)National Science and Technology Major Project of China(Grant No.2017ZX09304010).
文摘Background:Myopic maculopathy(MM)has become a major cause of visual impairment and blindness worldwide,especially in East Asian countries.Deep learning approaches such as deep convolutional neural networks(DCNN)have been successfully applied to identify some common retinal diseases and show great potential for the intelligent analysis of MM.This study aimed to build a reliable approach for automated detection of MM from retinal fundus images using DCNN models.Methods:A dual-stream DCNN(DCNN-DS)model that perceives features from both original images and corresponding processed images by color histogram distribution optimization method was designed for classification of no MM,tessellated fundus(TF),and pathologic myopia(PM).A total of 36,515 gradable images from four hospitals were used for DCNN model development,and 14,986 gradable images from the other two hospitals for external testing.We also compared the performance of the DCNN-DS model and four ophthalmologists on 3000 randomly sampledfundus images.Results:The DCNN-DS model achieved sensitivities of 93.3%and 91.0%,specificities of 99.6%and 98.7%,areas under the receiver operating characteristic curves(AUCs)of 0.998 and 0.994 for detecting PM,whereas sensitivities of 98.8%and 92.8%,specificities of 95.6%and 94.1%,AUCs of 0.986 and 0.970 for detecting TF in two external testing datasets.In the sampled testing dataset,the sensitivities of four ophthalmologists ranged from 88.3%to 95.8%and 81.1%to 89.1%,and the specificities ranged from 95.9%to 99.2%and 77.8%to 97.3%for detecting PM and TF,respectively.Meanwhile,the DCNN-DS model achieved sensitivities of 90.8%and 97.9%and specificities of 99.1%and 94.0%for detecting PMand T,respectively.Conclusions:The proposed DCNN-DS approach demonstrated reliable performance with high sensitivity,specificity,and AUC to classify different MM levels on fundus photographs sourced from clinics.It can help identify MM automatically among the large myopic groups and show great potential for real-life applications.
基金This study was supported by grants from the China National Basic Research Program （973 Program, No. 2011CB707506）, China National Natural Science Foundation （No. 81271030 and No. 81100678）, Shanghai Key Basic Research Grant （No. 11JC141601）, Shanghai Scholar Leadship Grant （No. 12XD1404100）, and Shanghai Committee of Science and Technology Guide Grant （No. 114119a7000）.
文摘-yopia is the most common refractive disorder. High .myopia affects 27%-33% of all myopic eyes inAsia.1,2 ;The pathologic myopia （PM） is the most severe vision-threatening phenotype of high myopia.3 It is also the second most common cause of choroidal neovascularization （CNV） in Asia. Unlike age-related macular degeneration （AMD） which mostly effecting elders, PM causes severe vision loss in young adults, resulting in a significant impairment of their working ability.4 PM has become the second leading cause of low vision and blindness particularly among those aged at 40-49 years in some Asia countries.
文摘Background Pathological myopia （PM） is the leading cause for choroidal neovascularization （CNV） in people below 50 years of age,the anti-vascular endothlial growth factor （VEGF） medicine is now available to treat CNV secondary to PM.This study aimed to observe the efficacy of intravitreal ranibizumab for PM associated with subfoveal or juxtafoveal CNV in Chinese patients.Methods Fifty-four eyes of 52 consecutive patients were included,they treated with intravitreal ranibizumab 0.5 mg for PM associated with CNV.The best corrected visual acuity （BCVA） of Snellen chart,letters of ETDRS chart,retinal thickness,leakage of CNV lesion,and complications with surgery were analyzed pre-and post-treatment.Eligibility criteria included diopter ≥-8.0 D or eye axis ≥28 mm with fundus changes of PM （lacquer crack,optic disc atrophy,chorioretinal atrophy,posterior scleral staphyloma）; CNV secondary to PM; subfoveal or juxtafoveal CNV.Results For 54 affected eyes of 52 consecutive patients,the average BCVA of Snellen chart and letters of ETDRS chart were 0.29 and 30.4,respectively; fundus fluorescein angiography （FFA）/indocyanine green angiography （ICGA） showed CNV leakage,and average retinal thickness on optical coherence tomography （OCT） was 267.2 μm before treatment.Injections of ranibizumab ranged from 1 to 4 （mean 2.2）.Follow-up time varied from 12 to 36 months （mean 31.9 months）.At the last visit,the BCVA of Snellen chart was increased by three lines （mean 0.65） （P 〈0.01）; the letters of ETDRS chart were increased to 17.0 letters （mean 47.4,P 〈0.01）; the visual acuity increased more than 15 letters in 30 eyes （55.5%）,decreased in 1 eye （1.9%）; the retinal thickness on OCT images was decreased by 17.0 μm （mean 250.2 μm） （P=0.082）; no active leakage from the CNV lesion occurred in 18 eyes （33.3%）,reduced leakage in 30 eyes （55.6%）,and no change in 6 eyes （11.1%） as shown by FFA/ICGA.Increased retinoschisis was observed in one eye after the second injection.Conclusions Intravitreal ranibizumab for neovascular PM was well tolerated in Chinese patients,with functional and anatomic improvements in a short-term study,while a long-term study is still needed.
文摘Background Intravitreal ranibizumab injection is effecitve on treating myopic CNVs,but it could be a risk factor for developing more severe retinoschisis in eyes with preexisted retinoschisis and epiretinal membrane.This study aimed to explore the incidence and features of retinoschisis after intravitreal ranibizumab injection for myopic choroidal neovascularization.Methods Eighty-three eyes of 81 patients with choroidal neovascularization secondary to pathologic myopia were treated with intravitreal ranibizumab injection.The best corrected visual acuity and optical coherence tomography （OCT） images were recorded at baseline and every month thereafter.Central retina thickness and maximal retina thickness were measured.The subjects were divided into three groups.Eleven eyes that had retinoschisis and epiretinal membrane were in group 1,six eyes that had simple epiretinal membrane were in group 2,and 66 eyes that had neither retinoschisis nor epiretinal membrane were in group 3.Six contralateral eyes in group 1 which had retinoschisis and epiretinal membrane but were not treated with intravitreal ranibizumab injection were set as the control group.Results Seven of the 11 eyes in group 1 developed more severe retinoschisis,the mean maximal retinal thickness increased from （380.28±90.13） to （467.00±70.20） μm （P 〈0.05）.The retinoschisis of all 6 eyes of the control group did not aggravate.Compared with the control group,the aggravation ratio of retinoschisis increased significantly （P 〈0.05）.No new onset of retinoschisis took place in group 2 and group 3.Conclusion Intravitreal ranibizumab injection may be a risk factor for aggravation of retinoschisis in eyes with preexisted retinoschisis and epiretinal membrane.
