AIM:To report the effect of focal laser photocoagulation on both the severity of hard exudates(HEs) and the rate of disease progression in eyes with mild to moderate non-proliferative diabetic retinopathy(NPDR).METHOD...AIM:To report the effect of focal laser photocoagulation on both the severity of hard exudates(HEs) and the rate of disease progression in eyes with mild to moderate non-proliferative diabetic retinopathy(NPDR).METHODS: We retrospectively reviewed the medical records of 33 patients(60 eyes) who had been diagnosed with mild to moderate NPDR between January 2006 and December 2012.The patients were divided into 2 groups:Group A(38 eyes in 20 patients treated using focal laser photocoagulation) and Group B(treated without laser photocoagulation).We also reviewed the best corrected visual acuity measurements,and the fundus photographs taken at both baseline and follow-up visits. RESULTS: In Group A,HE severity grade had decreased significantly from baseline to the final visit(P <0.05),but this was not the case in Group B(P =0.662).The cumulative probabilities of retinopathy progression at 5y were 26% in Group A and 30% in Group B.KaplanMeier survival curves showed no significant difference between the groups with regard to retinopathy progression(P =0.805).CONCLUSION: Focal laser photocoagulation reduced the levels of HEs in eyes with mild to moderate NPDR.However,the treatment was not able to decelerate the progression of DR.展开更多
AIM: To assess efficacy of intravitreal conbercept(IVC) injection in combination with panretinal photocoagulation(PRP) vs PRP alone in patients with severe nonproliferative diabetic retinopathy(SNPDR) without macular ...AIM: To assess efficacy of intravitreal conbercept(IVC) injection in combination with panretinal photocoagulation(PRP) vs PRP alone in patients with severe nonproliferative diabetic retinopathy(SNPDR) without macular edema(ME).METHODS: Forty-eight patients with SNPDR without ME(56 eyes) were divided into the PRP group and IVC+PRP group(the pulse group) in this retrospective clinical study. Conbercept was intravitreally administered to patients in the pulse group 1 wk before treatment with PRP and followed up for 1, 3, and 6 mo. The best-corrected visual acuity(BCVA, log MAR), center foveal thickness(CFT), visual acuity(VA) improvement, and adverse reactions were compared between groups.RESULTS: In the PRP group, the BCVA reduced at 1 and 3 mo before improving at 6 mo. In the pulse group, baseline BCVA decreased continuously at 1 mo, increased at 3 and 6 mo. BCVA in the pulse group was better than that in the PRP group at 1, 3, and 6 mo. There was an increase in CFT in the PRP group during follow-up compared with baseline. In the pulse group, CFT was increased at 1 mo relative to baseline, steadily decreased to the baseline level at 3 and 6 mo. There was a more significant reduction in CFT in the pulse group during follow-up compared with the PRP group. The effective rates of VA in the PRP and the pulse groups were 81.48% and 100%, respectively. CONCLUSION: As PRP pretreatment, a single dose of IVC administration has beneficial effects for preventing PRPinduced foveal thickening and increasing VA in patients with SNPDR without ME.展开更多
·AIM:To assess the reproducibility of macular perfusion parameters in non-proliferative diabetic retinopathy(NPDR)patients measured by different examiners and two different sweep modes of optical coherence tomogr...·AIM:To assess the reproducibility of macular perfusion parameters in non-proliferative diabetic retinopathy(NPDR)patients measured by different examiners and two different sweep modes of optical coherence tomography angiography(OCTA).·METHODS:Ninety-eight(98 eyes)patients with NPDR were included in this study.All participates were performed three times using Cirrus OCTA with Angiography 3×3 mm^(2)and 6×6 mm^(2)sweep mode by two examiners.The macular foveal avascular zone(FAZ)and vessel density(VD)in the superficial retinal layer(SRL)were measured.The reproducibility of the measurements was evaluated with intraclass correlation coefficients(ICC)and coefficient of variation(CoV).·RESULTS:The intra-mode ICCs of Angiography 3×3 mm^(2)and 6×6 mm^(2)sweep mode were 0.957 to 0.959 and 0.964 to 0.977,respectively;and the inter-mode ICCs were 0.962 to 0.970.The intra-examiner ICCs of macular perfusion parameters were>0.950;and the inter-examiner ICCs were0.928 to 0.969.All CoVs were<1.0%.·CONCLUSION:Cirrus OCTA can measure macular perfusion parameters in NPDR patients with excellent reproducibility.The measurements of FAZ and VD in the SRL determined by Angiography 3×3 mm^(2)and 6×6 mm^(2)sweep mode are highly consistent and both sweep modes are suitable for macular perfusion parameters measurement.展开更多
●AIM:To evaluate the long-term effects of pattern scan laser(PASCAL)pan-retinal photocoagulation(PRP)on diabetic retinopathy(DR)in Chinese patients.●METHODS:In this retrospective study,we evaluated clinical data of ...●AIM:To evaluate the long-term effects of pattern scan laser(PASCAL)pan-retinal photocoagulation(PRP)on diabetic retinopathy(DR)in Chinese patients.●METHODS:In this retrospective study,we evaluated clinical data of 29 patients(53 eyes)with severe non-proliferative DR(SNPDR)or proliferative DR(PDR)who received PRP and follow-up at our hospital from 2008 to 2013.Sixteen patients(29 eyes)received PASCAL PRP and 13 patients(24 eyes)received 100-ms conventional laser PRP.●RESULTS:After long-term follow-up(mean,min-max days:719.8,290-1666 for PASCAL PRP vs 743.5,240-1348 for conventional PRP,P=0.569),patients receiving PASCAL PRP required fewer photocoagulation sessions than the conventional PRP group(2.6±1.0 vs 3.9±0.9,P<0.01).Best corrected visual acuity(BCVA)was reduced slightly in PASCAL PRP group while reduced significantly in conventional PRP group.At last visit,24 eyes in the PASCAL group(88.9%)and 21 eyes in the conventional group(91.7%)were improved or stable.Two eyes in PASCAL PRP group(7.4%)and 3 eyes in the conventional PRP group(12.5%)developed vitreous hemorrhage or vitreous fibrovascular proliferation.●CONCLUSION:PASCAL PRP is as effective and may be more conducive to maintaining visual acuity with less treatment sessions for DR treatment compared to conventional laser PRP.展开更多
The global incidence and prevalence of diabetes mellitus(DM)have reached epidemic proportions.Estimates indicate that more than 360 million people will be affected by DM by 2030.All of these individuals will be at ris...The global incidence and prevalence of diabetes mellitus(DM)have reached epidemic proportions.Estimates indicate that more than 360 million people will be affected by DM by 2030.All of these individuals will be at risk of developing diabetic retinopathy(DR).It is extremely important to categorize,classify and stage the severity of DR in order to establish adequate therapy.With proper management more than 90%of cases of visual loss can be prevented.The purpose of the current paper is to review the classification of DR with a special emphasis on the International Clinical Disease Severity Scale for DR.This new classification is simple to use,easy to remember and based on scientific evidence.It does not require specialized examinations such as optical coherence tomography or fluorescein angiography.It is based on clinical examination and applying the Early Treatment of Diabetic Retinopathy Study 4:2:1 rule.展开更多
Diabetes mellitus(DM)is a noncommunicable disease reaching epidemic proportions around the world.It affects younger individuals,including women of childbearing age.Diabetes can cause diabetic retinopathy(DR),which is ...Diabetes mellitus(DM)is a noncommunicable disease reaching epidemic proportions around the world.It affects younger individuals,including women of childbearing age.Diabetes can cause diabetic retinopathy(DR),which is potentially sight threatening when severe nonproliferative DR(NPDR),proliferative DR(PDR),or sight-threatening diabetic macular oedema(STDME)develops.Pregnancy is an independent risk factor for the progression of DR.Baseline DR at the onset of pregnancy is an important indicator of progression,with up to 10% of women with baseline NPDR progressing to PDR.Progression to sight-threatening DR(STDR)during pregnancy causes distress to the patient and often necessitates ocular treatment,which may have a systemic effect.Management includes prepregnancy counselling and,when possible,conventional treatment prior to pregnancy.During pregnancy,closer follow-up is required for those with a long duration of DM,poor baseline control of blood sugar and blood pressure,and worse DR,as these are risk factors for progression to STDR.Conventional treatment with anti-vascular endothelial growth factor agents for STDME can potentially lead to foetal loss.Treatment with laser photocoagulation may be preferred,and surgery under general anaesthesia should be avoided.This review provides a management plan for STDR from the perspective of practising ophthalmologists.A review of strategies for maintaining the eyesight of diabetic women with STDR with emphasis on prepregnancy counselling and planning,monitoring and safe treatment during pregnancy,and management of complications is presented.展开更多
文摘AIM:To report the effect of focal laser photocoagulation on both the severity of hard exudates(HEs) and the rate of disease progression in eyes with mild to moderate non-proliferative diabetic retinopathy(NPDR).METHODS: We retrospectively reviewed the medical records of 33 patients(60 eyes) who had been diagnosed with mild to moderate NPDR between January 2006 and December 2012.The patients were divided into 2 groups:Group A(38 eyes in 20 patients treated using focal laser photocoagulation) and Group B(treated without laser photocoagulation).We also reviewed the best corrected visual acuity measurements,and the fundus photographs taken at both baseline and follow-up visits. RESULTS: In Group A,HE severity grade had decreased significantly from baseline to the final visit(P <0.05),but this was not the case in Group B(P =0.662).The cumulative probabilities of retinopathy progression at 5y were 26% in Group A and 30% in Group B.KaplanMeier survival curves showed no significant difference between the groups with regard to retinopathy progression(P =0.805).CONCLUSION: Focal laser photocoagulation reduced the levels of HEs in eyes with mild to moderate NPDR.However,the treatment was not able to decelerate the progression of DR.
文摘AIM: To assess efficacy of intravitreal conbercept(IVC) injection in combination with panretinal photocoagulation(PRP) vs PRP alone in patients with severe nonproliferative diabetic retinopathy(SNPDR) without macular edema(ME).METHODS: Forty-eight patients with SNPDR without ME(56 eyes) were divided into the PRP group and IVC+PRP group(the pulse group) in this retrospective clinical study. Conbercept was intravitreally administered to patients in the pulse group 1 wk before treatment with PRP and followed up for 1, 3, and 6 mo. The best-corrected visual acuity(BCVA, log MAR), center foveal thickness(CFT), visual acuity(VA) improvement, and adverse reactions were compared between groups.RESULTS: In the PRP group, the BCVA reduced at 1 and 3 mo before improving at 6 mo. In the pulse group, baseline BCVA decreased continuously at 1 mo, increased at 3 and 6 mo. BCVA in the pulse group was better than that in the PRP group at 1, 3, and 6 mo. There was an increase in CFT in the PRP group during follow-up compared with baseline. In the pulse group, CFT was increased at 1 mo relative to baseline, steadily decreased to the baseline level at 3 and 6 mo. There was a more significant reduction in CFT in the pulse group during follow-up compared with the PRP group. The effective rates of VA in the PRP and the pulse groups were 81.48% and 100%, respectively. CONCLUSION: As PRP pretreatment, a single dose of IVC administration has beneficial effects for preventing PRPinduced foveal thickening and increasing VA in patients with SNPDR without ME.
基金Supported by National Natural Science Foundation of China(No.82070920)Major Clinical Research Projects of the Three-Year Action Plan for Promoting Clinicial Skills and Clinical Innovation in Municipal Hospitals(No.SHDC2020CR1043B-010)。
文摘·AIM:To assess the reproducibility of macular perfusion parameters in non-proliferative diabetic retinopathy(NPDR)patients measured by different examiners and two different sweep modes of optical coherence tomography angiography(OCTA).·METHODS:Ninety-eight(98 eyes)patients with NPDR were included in this study.All participates were performed three times using Cirrus OCTA with Angiography 3×3 mm^(2)and 6×6 mm^(2)sweep mode by two examiners.The macular foveal avascular zone(FAZ)and vessel density(VD)in the superficial retinal layer(SRL)were measured.The reproducibility of the measurements was evaluated with intraclass correlation coefficients(ICC)and coefficient of variation(CoV).·RESULTS:The intra-mode ICCs of Angiography 3×3 mm^(2)and 6×6 mm^(2)sweep mode were 0.957 to 0.959 and 0.964 to 0.977,respectively;and the inter-mode ICCs were 0.962 to 0.970.The intra-examiner ICCs of macular perfusion parameters were>0.950;and the inter-examiner ICCs were0.928 to 0.969.All CoVs were<1.0%.·CONCLUSION:Cirrus OCTA can measure macular perfusion parameters in NPDR patients with excellent reproducibility.The measurements of FAZ and VD in the SRL determined by Angiography 3×3 mm^(2)and 6×6 mm^(2)sweep mode are highly consistent and both sweep modes are suitable for macular perfusion parameters measurement.
基金Supported by National Natural Science Foundation of China(No.81670866)Sun Yat-Sen University Clinical Research 5010 Project(No.2013007).
文摘●AIM:To evaluate the long-term effects of pattern scan laser(PASCAL)pan-retinal photocoagulation(PRP)on diabetic retinopathy(DR)in Chinese patients.●METHODS:In this retrospective study,we evaluated clinical data of 29 patients(53 eyes)with severe non-proliferative DR(SNPDR)or proliferative DR(PDR)who received PRP and follow-up at our hospital from 2008 to 2013.Sixteen patients(29 eyes)received PASCAL PRP and 13 patients(24 eyes)received 100-ms conventional laser PRP.●RESULTS:After long-term follow-up(mean,min-max days:719.8,290-1666 for PASCAL PRP vs 743.5,240-1348 for conventional PRP,P=0.569),patients receiving PASCAL PRP required fewer photocoagulation sessions than the conventional PRP group(2.6±1.0 vs 3.9±0.9,P<0.01).Best corrected visual acuity(BCVA)was reduced slightly in PASCAL PRP group while reduced significantly in conventional PRP group.At last visit,24 eyes in the PASCAL group(88.9%)and 21 eyes in the conventional group(91.7%)were improved or stable.Two eyes in PASCAL PRP group(7.4%)and 3 eyes in the conventional PRP group(12.5%)developed vitreous hemorrhage or vitreous fibrovascular proliferation.●CONCLUSION:PASCAL PRP is as effective and may be more conducive to maintaining visual acuity with less treatment sessions for DR treatment compared to conventional laser PRP.
文摘The global incidence and prevalence of diabetes mellitus(DM)have reached epidemic proportions.Estimates indicate that more than 360 million people will be affected by DM by 2030.All of these individuals will be at risk of developing diabetic retinopathy(DR).It is extremely important to categorize,classify and stage the severity of DR in order to establish adequate therapy.With proper management more than 90%of cases of visual loss can be prevented.The purpose of the current paper is to review the classification of DR with a special emphasis on the International Clinical Disease Severity Scale for DR.This new classification is simple to use,easy to remember and based on scientific evidence.It does not require specialized examinations such as optical coherence tomography or fluorescein angiography.It is based on clinical examination and applying the Early Treatment of Diabetic Retinopathy Study 4:2:1 rule.
基金National University of Malaysia,Bangi,Selangor,Malaysia for English Editing,No.GP-K009894(2015).
文摘Diabetes mellitus(DM)is a noncommunicable disease reaching epidemic proportions around the world.It affects younger individuals,including women of childbearing age.Diabetes can cause diabetic retinopathy(DR),which is potentially sight threatening when severe nonproliferative DR(NPDR),proliferative DR(PDR),or sight-threatening diabetic macular oedema(STDME)develops.Pregnancy is an independent risk factor for the progression of DR.Baseline DR at the onset of pregnancy is an important indicator of progression,with up to 10% of women with baseline NPDR progressing to PDR.Progression to sight-threatening DR(STDR)during pregnancy causes distress to the patient and often necessitates ocular treatment,which may have a systemic effect.Management includes prepregnancy counselling and,when possible,conventional treatment prior to pregnancy.During pregnancy,closer follow-up is required for those with a long duration of DM,poor baseline control of blood sugar and blood pressure,and worse DR,as these are risk factors for progression to STDR.Conventional treatment with anti-vascular endothelial growth factor agents for STDME can potentially lead to foetal loss.Treatment with laser photocoagulation may be preferred,and surgery under general anaesthesia should be avoided.This review provides a management plan for STDR from the perspective of practising ophthalmologists.A review of strategies for maintaining the eyesight of diabetic women with STDR with emphasis on prepregnancy counselling and planning,monitoring and safe treatment during pregnancy,and management of complications is presented.
