We report results in a 77-year-old male patient with visual loss from long-standing serpiginous choroidop- athy treated with bone marrow derived stem cells （BMSC） within the Stem Cell Ophthalmology Treatment Study ...We report results in a 77-year-old male patient with visual loss from long-standing serpiginous choroidop- athy treated with bone marrow derived stem cells （BMSC） within the Stem Cell Ophthalmology Treatment Study （SCOTS）. SCOTS is an Institutional Review Board approved clinical trial and the largest ophthal- mology stem cell study registered at the National Institutes of Health to date （ClinicalTrials.gov Identifier： NCT01920867）. Eight months after treatment by a combination of retrobulbar, subtenon, intravitreal and intravenous injection of BMSC, the patient＇s best corrected Snellen acuity improved from 20/80- to 20/60.1 in the right eye and from 20/50- to 20/20 3 in the left eye. The Early Treatment of Diabetic Retinopathy Study （ETDRS） visual acuity continued to improve over the succeeding 8 months and the optical coherence tomography macular volume increased. The increases in visual acuity and macular volume are encouraging and suggest that the use of BMSC as provided in SCOTS may be a viable approach to treating serpiginous choroidopathy.展开更多
●Multiple evanescent white dot syndrome(MEWDS)is a rare fundus disease,characterized by acute vision loss and visual field defects.Many previous studies have explained the possible pathogenesis and clinical features ...●Multiple evanescent white dot syndrome(MEWDS)is a rare fundus disease,characterized by acute vision loss and visual field defects.Many previous studies have explained the possible pathogenesis and clinical features of primary MEWDS.However,as the number of reported cases increases,secondary MEWDS occurs in other related retinal diseases and injuries,exhibiting some special characteristics.The associated retinal diseases include multifocal choroiditis/punctate inner choroidopathy(MFC/PIC),acute zonal occult outer retinopathy,best vitelliform macular dystrophy,pseudoxanthoma elasticum,and ocular toxoplasmosis.The related retinal injury is laser photocoagulation,surgery,and trauma.Although primary MEWDS often have a self-limiting course,secondary MEWDS may require treatment in some cases,according to the severity of concomitant diseases and complications.Notably,MEWDS secondary to MFC/PIC that is prone to forming choroidal neovascularization and focal choroidal excavation,needs positive treatment with corticosteroids.The possible underlying pathogenesis of secondary MEWDS is the exposure of choroidal antigen after the disruption of Bruch’s membrane.The MEWDS-related features in secondary MEWDS are still evanescent under most circumstances.Its prognosis and treatment depend on the severity of complications.Current studies propose that the etiology is associated with immune factors,including viral infection,inflammation in choroid and Bruch’s membrane,and antigen exposure caused by retinal and/or choroidal insults.More pathogenic studies should be conducted in the future.Accurate diagnosis for secondary MEWDS could benefit patients in aspects of management and prognosis.展开更多
AIM：To assess the correlation between choroidal thickness（CT） and the early stages of diabetic retinopathy（DR） in type 2 diabetic patients.METHODS：We divided 83 diabetic patients（51-80 years of age;50 females）...AIM：To assess the correlation between choroidal thickness（CT） and the early stages of diabetic retinopathy（DR） in type 2 diabetic patients.METHODS：We divided 83 diabetic patients（51-80 years of age;50 females） into non diabetic retinopathy group（NDR） and mild/moderate nonproliferative diabetic retinopathy（NPDR） group,and compared them with 26 non-diabetic control subjects（51-78 years of age;16 females）.Subfoveal choroidal thickness（SFCT） and parafoveal choroidal thickness（PFCT） were measured using enhanced depth imaging spectral-domain optical coherence tomography（EDI-OCT）.Ocular health status,disease duration,body mass index,and hemoglobin A1c（Hb A1c） were recorded.RESULTS：The mean ages of the NDR,NPDR,and control groups were 68.0±6.9y,67.8±6.4y,and 65.1±6.3y,respectively（P=0.17）.Pearson correlation of the right and left eyes for the control subjects was 0.95 and for the NDR subjects was 0.93.SFCT for the right eyes of the controls was 252.77± 41.10 μm,which was significantly thicker than that of the right eyes in NDR group（221.51±46.56 μm） and the worse eyes of the NPDR group（207.18±61.87 μm;ANOVA,P〈0.01）.In the diabetic patients pooled together,age was the only variable significantly associated with SFCT（multiple linear regression analysis,P=0.01）.CONCLUSION：CT decreased significantly in the NDR and mild/moderate NPDR eyes compared with the control eyes.Age is significantly associated with SFCT in the diabetic patients.Diabetic choroidopathy may be present before clinical retinopathy.展开更多
文摘We report results in a 77-year-old male patient with visual loss from long-standing serpiginous choroidop- athy treated with bone marrow derived stem cells （BMSC） within the Stem Cell Ophthalmology Treatment Study （SCOTS）. SCOTS is an Institutional Review Board approved clinical trial and the largest ophthal- mology stem cell study registered at the National Institutes of Health to date （ClinicalTrials.gov Identifier： NCT01920867）. Eight months after treatment by a combination of retrobulbar, subtenon, intravitreal and intravenous injection of BMSC, the patient＇s best corrected Snellen acuity improved from 20/80- to 20/60.1 in the right eye and from 20/50- to 20/20 3 in the left eye. The Early Treatment of Diabetic Retinopathy Study （ETDRS） visual acuity continued to improve over the succeeding 8 months and the optical coherence tomography macular volume increased. The increases in visual acuity and macular volume are encouraging and suggest that the use of BMSC as provided in SCOTS may be a viable approach to treating serpiginous choroidopathy.
基金Supported by the National Natural Science Foundation of China(No.82171073No.82101147).
文摘●Multiple evanescent white dot syndrome(MEWDS)is a rare fundus disease,characterized by acute vision loss and visual field defects.Many previous studies have explained the possible pathogenesis and clinical features of primary MEWDS.However,as the number of reported cases increases,secondary MEWDS occurs in other related retinal diseases and injuries,exhibiting some special characteristics.The associated retinal diseases include multifocal choroiditis/punctate inner choroidopathy(MFC/PIC),acute zonal occult outer retinopathy,best vitelliform macular dystrophy,pseudoxanthoma elasticum,and ocular toxoplasmosis.The related retinal injury is laser photocoagulation,surgery,and trauma.Although primary MEWDS often have a self-limiting course,secondary MEWDS may require treatment in some cases,according to the severity of concomitant diseases and complications.Notably,MEWDS secondary to MFC/PIC that is prone to forming choroidal neovascularization and focal choroidal excavation,needs positive treatment with corticosteroids.The possible underlying pathogenesis of secondary MEWDS is the exposure of choroidal antigen after the disruption of Bruch’s membrane.The MEWDS-related features in secondary MEWDS are still evanescent under most circumstances.Its prognosis and treatment depend on the severity of complications.Current studies propose that the etiology is associated with immune factors,including viral infection,inflammation in choroid and Bruch’s membrane,and antigen exposure caused by retinal and/or choroidal insults.More pathogenic studies should be conducted in the future.Accurate diagnosis for secondary MEWDS could benefit patients in aspects of management and prognosis.
文摘AIM：To assess the correlation between choroidal thickness（CT） and the early stages of diabetic retinopathy（DR） in type 2 diabetic patients.METHODS：We divided 83 diabetic patients（51-80 years of age;50 females） into non diabetic retinopathy group（NDR） and mild/moderate nonproliferative diabetic retinopathy（NPDR） group,and compared them with 26 non-diabetic control subjects（51-78 years of age;16 females）.Subfoveal choroidal thickness（SFCT） and parafoveal choroidal thickness（PFCT） were measured using enhanced depth imaging spectral-domain optical coherence tomography（EDI-OCT）.Ocular health status,disease duration,body mass index,and hemoglobin A1c（Hb A1c） were recorded.RESULTS：The mean ages of the NDR,NPDR,and control groups were 68.0±6.9y,67.8±6.4y,and 65.1±6.3y,respectively（P=0.17）.Pearson correlation of the right and left eyes for the control subjects was 0.95 and for the NDR subjects was 0.93.SFCT for the right eyes of the controls was 252.77± 41.10 μm,which was significantly thicker than that of the right eyes in NDR group（221.51±46.56 μm） and the worse eyes of the NPDR group（207.18±61.87 μm;ANOVA,P〈0.01）.In the diabetic patients pooled together,age was the only variable significantly associated with SFCT（multiple linear regression analysis,P=0.01）.CONCLUSION：CT decreased significantly in the NDR and mild/moderate NPDR eyes compared with the control eyes.Age is significantly associated with SFCT in the diabetic patients.Diabetic choroidopathy may be present before clinical retinopathy.
