ObjectiveTo evaluate the efficacy in the treatment of age-related macular degeneration (AMD) by bevacizumab versus ranibizumab. MethodsA computerized search was conducted in the Embase, Ovid, PubMed, China National Knowledge Infrastructure (CNKI), WanFang Data and VIP database of Chinese journal. Randomized controlled trials (RCTs) comparing bevacizumab with ranibizumab for AMD from inception to November, 2013 were collected. Methodology qualifies of studies were performed by experienced reviewers according to the inclusion and exclusion criteria. Further, the materials were analyzed with software RevMan 5.2.6. Visual acuity and central foveal thickness before and 3, 6, 12 months after treatment between the two treatment methods were compared. ResultsA total of 5 RCTs were included in this meta analysis, including 1954 patients (967 patients in the bevacizumab group, 987 eyes in the ranibizumab group). There was no difference in improving visual acuity after treatment between two groups [3 months: weighted mean difference (WMD)=0.32, 95% CI: -0.84 -1.49, P=0.59; 6 months: WMD=0.47, 95% CI: -0.67 -1.62, P=0.42; 12 months: WMD=0.84, 95% CI: -0.23 -1.90, P=0.12]. There was no difference in cutting down the central foveal thickness after treatment between two groups (3 months: WMD=6.21, 95% CI: -6.23-18.65, P=0.33; 6 months: WMD=4.06, 95% CI: -6.16-14.27, P=0.44; 12 months: WMD=-5.39, 95% CI: -14.41-3.63, P=0.24). ConclusionBevacizumab has equal efficacy to ranibizumab in the treatment of AMD.
Objective To observe the characteristics of optical coherence tomography (OCT) of the macular in uveitis patients. Methods A total of 51 cases (78 eyes) of uveitis admitted to affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine from May 2011 to May 2012 were reviewed retrospectively. All patients were underwent OCT examination and classified according to characteristics of OCT. Results The characteristics of OCT in uveitis were classified into six groups. Macular edema including cystoid macular edema and diffuse edema was detected in 48 eyes (61.5%). Macular epiretinal membrane was found in 22 eyes (28.2%). Choroidal neovascularization and macular hole was found in 4 eyes (5.1%), respectively. Ten eyes (12.8%) showed macular atrophy and 22 eyes (28.2%) showed serous neuroepithelium detachment. Conclusions Macular OCT in uveitis patients displayed different morphological characteristics.
Objective To investigate the effects and mechanism of 17β-estradiol on the retinal neovasularization in rats with oxygen-induced retinopathy (OIR). MethodsA total of 48 SD rats were randomly divided into control group A, control group B, experimental group A and experimental group B with 12 rats in each group. The rats in control group A and experimental group A received a hypodermic injection of 0.1 ml PBS, and the rats in control group B and experimental group B group received an a hypodermic injection of 0.1 ml 17β-estradiol. At postnatal day 7 (P7) and P14, the mRNA expression of vascular endothelial growth factor (VEGF) and Hypoxia-inducible factor (HIF) -1α in the retina were measured by real-time polymerase chain reaction (RTPCR). At P14, endothelial cell nuclei breaking through the internal limiting membrane were counted after staining with hematoxylin and eosin (HE), and the protein expression of VEGF was measured after immunohistochemical staining. The changes of retinal ultrastructure were observed by transmission electron microscopy. ResultsAt P14, the difference of the number of endothelial cell nuclei among four groups was statistically significant(F=10.7, P＜0.05). The number of endothelial cell nuclei in experimental group A was increased greater than that in control group A (P＜0.05) and experimental group B(q=5.16，P＜0.05). But there was no difference between control group A and experimental group B (q=0.25，P＞0.05). The difference of VEGF protein expression among the four groups was statistically significant (P＜0.05). Comparing experimental group A with control group A, B and experimental group B, the difference was statistically significant (P＜0.05). In experimental group A there was ganglion cell swelling, pale staining cytoplasm and mitochondria vacuolizationin, while these were normal in other three groups. At P7 and P14, the differences of VEGF and HIF-1 mRNA expression among four groups were statistically significant(F=14.7,16.1, 13.4, 17.5; P=0.001, 0.005, 0.003, 0.009). At P7, the VEGF mRNA expression in control group B was more than that in control group A (q=5.22, P＜0.05). The VEGF mRNA expression in experimental group B was more than that in experimental group A (q=4.32, P＜0.05). At P14, the VEGF mRNA expression in control group B was more than that in control group A (q=3.72, P＜0.05), but there was no difference of HIF-1 mRNA expression between two groups. The VEGF and HIF-1 mRNA expression in experimental group B were both decreased more than those in experimental group A (q=5.12, 4.08;P＜0.05). Conclusions 17β-estradiol has the effect of two way regulation in VEGF mRNA, which increases VEGF expression in retina under hyperoxic conditions so as to develop the vascular system; which reduces VEGF and HIF-1α expression so as to prevent pathologic neovascularization under hypoxic conditions. It provides some protection from the damage of retinal neovascularization.
Objective To observe the neuroprotective effect of alpha;-lipoic acid (ALA) on cultured retinal ganglion cells (RGC-5) under elevated pressure in vitro. Methods Cultured RGC-5cells were divided randomly into 4 groups, including normal control group (group A), negative control group (group B), elevated pressure group (group C) and elevated pressure + ALA group (group D). The cells of group A and C were not intervened with ALA. The cells of group B were treated with 200 mu;mol/L ALA. The cells of group D were treated with different concentrations of ALA (50, 100, 200 mu;mol/L) for one hour. Then cells of group C and D were exerted to 50 mm Hg (1 mm Hg=0.133 kPa) for 24 hours, while the cells of group A and B were exerted to normal pressures for 24 hours. The cell viability was measured using the methyl thiazolyl tetrazolium (MTT) assay and apoptosis was evaluated using 4prime;,6-diamidino-2-phenylindole (DAPI) staining. Expression of MnSOD was determined by realtime polymerase chain reaction (RT-PCR) and Western blot, respectively. Results The cell viability of group B was (65.6plusmn;3.4)%, which lower than that in group D of three concentrations of ALA［(75.1plusmn;3.3)%, (81.8plusmn;2.9)%,(87.9plusmn;3.1)%］, the differences were significantly (t=5.108, 10.007, 12.513;P＜0.05). DAPI staining revealed that characteristic apoptotic changes, such as chromatin condensation,convoluted nuclei with cavitations, fragmentation of the nucleus, and apoptotic bodies appeared in RGC-5cells after 24 ours pressure. There was almost no evidence of apoptosis in group D. RT-PCR and Western blot analysis revealed that the expression of MnSOD mRNA and protein were weakly expressed in group C compared with control A (t=22.045，26.979;P＜0.01). Compared group C with group D, the level of MnSOD mRNA and protein in group D increased significantly (t=9.171, 12.267, 23.567, 7.723, 12.009, 28.198;P＜0.05).In addition, the presence of ALA was found to inhibit hydrostatic pressure induced damage of RGC-5cells in a dose-dependent manner (F=134.273,194.597;P＜0.01). Conclusion ALA can effectively improve the expression of MnSOD in RGC-5cells under the condition of elevated pressure, enhance the ability of RGC-5cells against oxidative damage.