Objective To observe the morphologic alterations of retina pigment epithelial around fluorescein leakage site using spectral-domain optical coherence tomography (SD-OCT) in acute central serous chorioretinopathy (CSC) before and after laser coagulation. Methods Twenty-four eyes of 24 consecutive patients with unilateral acute CSC who underwent laser photocoagulation (wave length: 561 nm, energy: 80-100 mW, spot diamteter: 100 μm, exposure time: 0.1 s) were enrolled in this retrospective study. The patients included 22 males and 2 females, with an average age of (39.2±7.2) years and an average duration of (1.1±0.6) months. The fluorescein leakage outside the foveal avascular zone and serous retinal detachment were found in all the eyes by fluorescein fundus angiography (FFA) and SD-OCT. Twenty-six leakage sites were observed in 24 eyes on FFA. There were 5 smoky leakage points (19.2%), 21 inky leakage points (80.8%). The retinal pigment epithelial (RPE) layer at leakage points were scanned by SD-OCT before and at 2 weeks, 2 months after treatment. SD-OCT showed that the RPE abnormalities were detected at all of the fluorescein leakage points, including serous pigment epithelial detachment (PED) in 16 leakage points (64.5%), protruding RPE in 5 leakage points (19.5%), and irregular RPE in 5 leakage points (19.2%). The morphologic alterations of RPE around fluorescein leakage point before and after laser coagulation were observed. Results At 2 weeks after laser photocoagulation, PED existed in 7 leakage points (26.9%), protruding RPE in 3 leakage points (11.5%), and irregular RPE in 16 leakage points (61.5%). At 2 months after laser photocoagulation, protruding RPE existed in 3 leakage points (11.5%), and irregular RPE in 5 leakage points (19.2%), including RPE defect in 2 leakage points. And there were undetectable RPE abnormalities in other 16 leakage points (61.5%). Conclusions In acute CSC, SD-OCT shows that morphologic features of the RPE layer are changed, including PED, protruding RPE, irregular RPE around the leakage point. After laser photocoagulation the abnormalities of RPE can also be altered from PED to irregular RPE, and RPE defect is observed in restricted regions.
Objective To investigate the changes of multifocal electroretinogram (mf-ERG) in type 2 diabetes without clinically apparent retinopathy. Methods Eighteen type 2 diabetes patients (32 eyes) without clinically observed retinopathy and 14 normal control eyes received mfERG examination. Results The latency of P1 wave in the ring one, ring two and ring three of diabetes were (48.47±2.33), (31.19±15.53), (15.67±5.73) ms respectively, which had significantly statistical difference with the normal control eyes (t=5.145，2.376，2.276；P＜0.05). The amplitude density of P1 wave of temporal retina in diabetes patients was (9.07±2.19) nV/deg2,which was significant different （t=-3.468,P＜0.05） with the normal control eyes (14.13±2.76) nV/deg2. Conclusion The latency of mf-ERG P1 wave is delayed, and the amplitude density of P1 wave of temporal retina is declined in type 2 diabetes patients without clinically apparent retinopathy.
ObjectiveTo evaluate the efficacy of intravitreal injection of anti-vascular endothelial growth factor (VEGF) drugs combined with retinal laser photocoagulation and anti-VEGF drugs alone in the treatment of retinal vein occlusion (RVO) combined with macular edema (ME). MethodsA evidence-based medicine study. Retinal vein occlusion (obstruction), macular edema, anti-vascular endothelial growth factor, bevacizumab, ranibizumab, conbercept, aflibercept, and retinal laser photocoagulation were the Chinese and English search terms. Related literature was searched in China National Knowledge Infrastructure, Wanfang, Weipu, PubMed, Embase, Cochrane Library. RVO combined with ME was selected as the research object, and the treatment plan was a clinical randomized controlled study comparing intravitreal injection of anti-VEGF drugs combined with laser photocoagulation and anti-VEGF drugs alone. The search time range was from January 2011 to February 2021. Repeated, incomplete or irrelevant literature, case reports and review literature were excluded. Review Manager 5.4 statistical software was used to conduct a meta-analysis of the literature. The weighted mean difference (WMD) and 95% confidence interval (CI) were selected as the estimated value of effect size, and the fixed effect model was used for analysis. The evaluation indicators were best corrected visual acuity (BCVA), center macular thickness (CMT), and the number of injections. ResultsAccording to the search strategy, 461 articles were initially retrieved, and 21 articles were finally included for meta-analysis. A total of 1156 patients were enrolled, of which 576 were treated with anti-VEGF drugs combined with laser photocoagulation (combined treatment group), and 580 were treated with anti-VEGF drugs alone (drug treatment group). Meta-analysis results showed that there was no statistically significant difference in BCVA and CMT between the drug treatment group and the combination treatment group at 6, 9, and 12 months after treatment (BCVA: WMD =－0.82, 95%CI －2.38-0.74, P=0.30; CMT: WMD=－3.12, 95%CI －17.25-11.01, P=0.67). For patients with branch retinal vein occlusion and ME, combined therapy can reduce the number of injections more effectively than drug therapy alone (WMD=－0.80, 95% CI －1.18-－0.42, Z=4.10, P＜0.000 1). ConclusionCompared with pure intravitreal injection of anti-VEGF drugs, combined retinal laser photocoagulation can not better improve BCVA and CMT in patients with RVO and ME. For patients with branch retinal vein occlusion and ME, combined retinal laser photocoagulation can effectively reduce the resistance. The number of VEGF injections.