Objective To summarize the visual outcome of patients with severe ocular trauma treated with vitreous surgery. Methods Clinical data of 188(191 eyes) with severe ocular trauma treated with vitreous surgery in a period from November 1996 to April 1998 were analysed retrospectively. Results The study included penetrating injury in 56 eyes, foreign bodies in the posterior segment in 70 eyes, blunt injury in 41 eyes , and globe rupture in 24 eyes. Main complications included endophthalmitis in 35 eyes, choroidal bleeding in 20 eyes, retinal detachment in 60 eyes, and vitreous hemorrhage in 97 eyes. Post-opera-tively, out of 188 eyes, except for 3 of patients too young to examine, visual acuity improved in 133(70.7%), including 85(45.2%) with visal acuity 0.02-1.0, 46(24.5%) remained unchanged; and 9(4.8%) had worse vision. Among 34 with no-light-perception, 12 had light-perception or over. Conclusion A majority of severe trauma eyes can be salvaged with considerable visual recovery after adequate and timely vitreous surgery. (Chin J Ocul Fundus Dis,1999,15:4-6)
Objective To investigate the relationship of choroidal thickness and visual acuity after successful repair of rhegmatogenous retinal detachment (RRD) in eyes without high myopia. Methods Fifty-three eyes of 53 patients with RRD and without highly myopic eyes after anatomically successful surgical repair were enrolled in this study. The preoperative and postoperative best-corrected visual acuities (BCVA) were recorded. Spectral domain-optical coherence tomography (OCT) was used to assess the postoperative foveal structure, central foveal thicknesses (CFT) and choroidal thickness. The correlation between the postoperative BCVA and abnormality of the fovea, CFT and choroidal thickness was evaluated. According to the postoperative thickness of the choroid, the patients were divided into le;150.00 mu;m group and ＞150.00 mu;m group; the improvement of postoperative BCVA in the two groups was analyzed. The state of inside and outside section (IS/OS) and the external limiting membrane (ELM) was divided into reconstructed and un-reconstructed categories. The postoperative BCVA, CFT and choroidal thickness of two types were comparatively analyzed. Results At the last time of follow up, the mean BCVA was 0.52plusmn;0.47. The results of spectral domain OCT showed that the mean CFT was (207.45plusmn;63.63) and mean choroidal thickness was (175.46plusmn;62.68) mu;m. The postoperative BCVA correlated positively with IS/OS junction and choroidal thickness (r=4.92, 4.63; P＜0.05), but was insignificantly associated with ELM junction, whether subretinal fluids were present or not, whether epiretinal membrane was affected or not, whether there was macular edema or not and CFT (r=0.24, 1.20, 0.30, 0.03, 0.14; P＞0.05). Two weeks to three months after surgery, the improvement of BCVA in ＞150.00 mu;m group was significantly higher than that in le;150.00 mu;m group (t=-2.318, P＜0.05). Compared the reconstructed with un-reconstructed IS/OS eyes, the differences of mean BCVA and mean choroidal thickness were statistically significantly different (t=-5.253, 2.396; P＜0.05). The difference of mean CFT was not statistically significant (t=1.454，P＞0.05). Compared the reconstructed with un-reconstructed ELM eyes, the differences of mean BCVA and mean choroidal thickness were statistically significantly different (t=-5.940, 3.563;P＜0.05). The difference of mean CFT was not statistically significant (t=1.117, P＞0.05). Conclusion The choroidal thickness has a significant correlation with visual acuity after successful repair of RRD in eyes without high myopia.
Objective To observe the efficacy of vitrectomy for vitreous hemorrhage in patients with polypoidal choroidal vasculopathy (PCV). Methods Fourteen patients (14 eyes) of PCV with vitreous hemorrhage diagnosed by routine ophthalmologic examination, A and/or B mode ultrasound, fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) were enrolled in this study. The patients included eight males (eight eyes) and six females (six eyes), with the mean age of (58.7plusmn;6.0) years. All patients received vitrectomy with silicone oil and C3F8 gas tamponade. There were eight eyes received photodynamic therapy (PDT) after surgery. The retinal reattachment, visual acuity, pathological lesion degree and complications were comparatively analyzed. Results Among 14 eyes, six eyes (42.9%) recovered, seven eyes (50.0%) improved, and one eye (7.1%) aggravated. Ten eyes achieved retinal reattachment after surgery, while four eyes developed retinal detachment after the first surgery. The retina remained attached in these three eyes after silicon oil tamponade, C3F8 gas tamponade and scleral buckling, respectively; but one eye maintained silicon oil without special treatment. Thirteen eyes (92.9%) achieved retinal reattachment finally. Five eyes of them occurred hyphema one to seven days after surgery, but hyphema was absorbed and intraocular pressure was stable after douche of anterior chamber and pharmacotherapy. The vision improved with more than two lines in one eyes, improved with one to two lines in one eye, unchanged in 10 eyes, and decreased in two eyes. Of eight eyes who underwent PDT, abnormal vessels regressed in five eyes, abnormal vessels remained in three eyes. Conclusions Vitrectomy can remove cloudy refracting media for PCV with vitreous hemorrhage. The combined treatment of vitrectomy and PDT can improve or stabilize visual function,is an effective therapy for the PCV with vitreous hemorrhage.
Objective To observe the effect of Chinese Herbal Preparation -Mingjing Granule on the recruitment and adhesion of bonemarrow derived cells (BMCs) to choroidal neovascu1arization (CNV) in mice induced by laser photocoagulation. Methods A total of 75 C57BL/6 mice were divided into treatment group (30 mice), control group (30 mice) and normal control group (15 mice). CNV was induced by krypton laser in the mice of treatment group and control group. BMCs from GFPtransgenic mice were injected through tail vein to those mice 0.5 -1.0 hours after laser surgery. On day one after laser surgery, the mice of treatment group were gavaged with 0.3 ml Mingjing Granule solution every day［30 g/(kg?d)］, while the control group mice were gavaged with distilled water. The mice of normal group fed with normal cereals. 7, 14, 28 days after treatment, choroidal flatmount were prepared to measure the CNV severity and BMCs recruitment. The choroidal histopathological change was observed by optical microscope. CXCR4 level in peripheral blood was measured by enzymelinked immuno sorbent assay (ELISA). Stromal cell derived factor1alpha; (SDF-1alpha;), vascular cell adhesion molecule-1 (VCAM-1), inter-cellular adhesion molecule 1 (ICAM-1) were detected by immunofluorescent staining. Results Choroidal flatmount showed that CNV developed in treatment group and control group, but not in normal group. On day seven and 14, CNV lesions in the treatment group showed less incorporation of BMCs and smaller CNV in size compared with the control group (t=10, 9; P=0.007, 0.024), histologic sections also showed less severe lesions in the treatment group. CXCR4 level in peripheral blood in the treatment group was less than that in the control group and normal control group on day seven and day 14（t=8.107, 2.747;P＜0.05). The expression of SDF-1alpha;, ICAM-1 and VCAM-1 in the treatment group was lower compared with the control group. Conclusions Mingjing Granule could inhibit the recruitment and adhesion of BMCs in peripheral blood to CNV at the early stage. The mechanism may be related with the action of Mingjing Granule in lowing chemokines levels in peripheral blood and expression of adhesion molecules around CNV.
Objective To observe ophthalmoscopic image characteristics of central serous chorioretinopathy (CSC). Methods Twenty-one eyes of the 18 patients diagnosed with CSC were enrolled in this study．The patients included 12 males (14 eyes) and six females (seven eyes)．The patients ages ranged from 26 to 47 years，with a mean age of (39.1plusmn;5.4) years. There were nine patients (11 eyes) with acute CSC, seven patients (seven eyes) with chronic CSC, and two patients (three eyes) with recurrent CSC. All the patients were examined using color fundus photography including infrared (IR), auto-fluorescence (AF), near infrared ray-auto-fluorescence (NIR-AF), fluorescein angiography (FA) and indocyanine green angiography (ICGA) photography. The ophthalmoscopic image characteristics of CSC were comparared. Results The circular serous retinal detachments of 21 eyes were depicted in color images of the ocular fundus, which in the IR showed the hypo-fluorescence. Ten eyes displayed mottled hyper-fluorescent spots associated with serous retinal detachments corresponding to the leakage points. The serous retinal detachments of 15 eyes in the AF images showed hypo-fluorescence, six eyes showed hyper-fluorescence. Fourteen eyes presented with hypo-or hyper-fluorescent spots corresponding to the leakage points, seven eyes presented without abnormal fluorescence corresponding to the leakage points. In addition, three eyes with acute CSC showed many scattered hyper-fluorescent spots, which showed hypo-fluorescence in the ICGA. The serous retinal detachment of 15 eyes exhibited hypo-fluorescence in the NIR-AF images, six eyes showed hyper-fluorescence. Fourteen eyes presented with hypo- or hyper-fluorescent spots corresponding to the leakage points, seven eyes presented without abnormal fluorescence corresponding to the leakage points. Twenty-one eyes in FA identified the leakage. Eight eyes showed regional choroidal delayed filling, 13 eyes exhibited regional choriocapillary dilatation during 1-5 minutes after injection of ICGA. During 1-5 minutes after injection of ICGA, six eyes showed more lesions than FA, three eyes showed obvious patchy hypo-fluorescence whereas the FA were normal. Conclusions CSC has its own characteristic fundus images in the IR, FA and NIR-A. FA is still the photographic method of choice, but ICGA can reveal lesions of the choroid in CSC. IR, FA and NIR-AF are not as good as FA and ICGA for detecting of leakage points.
Objective To observe the location of peripapillary choroidal watershed zones relative to the optic disc in the different types of glaucoma. Methods A total of 98 patients (98 eyes) with glaucoma (glaucoma group) were enrolled in this study. The eyes included 34 eyes with primary open-angle glaucoma (POAG group), 33 eyes with normal tension glaucoma (NTG group) and 31 eyes with chronic angle closure glaucoma (CACG group). Thirty-seven fellow eyes of 37 patients with monocular blunt trauma were selected in this study as control group. The differences of age (t=1.197), sex (chi;2=3.548), average diopter (t=-1.644) between glaucoma group and control group were not statistically significant (P＞0.05). The differences of age (F=2.645), sex (F=1.984), average diopter (F=2.621), and visual fields mean defect (MD) (F=0.899) between different types of glaucoma were also not statistically significan(P＞0.05).Simultaneous indocyanine green angiography (ICGA) and fundus fluorescein angiography (FFA) were performed on all subjects. The watershed zones were classified into three types according to its location relative to the optic disc: in type Ⅰ, the watershed zone did not include the optic disc or could not be observed; in type Ⅱ, the watershed zone partially included the optic disc; in type Ⅲ, the watershed zone completely included the optic disc. The location of watershed zones relative to the optic disc in the different types of glaucoma was comparatively analyzed. The relationship between watershed zones, type and age, and MD were also analyzed by Pearson analysis method. Results The constituent ratio of type Ⅱ and Ⅲ watershed zones were 81.6% and 56.8% in glaucoma group and control group, respectively; with a statistically significant difference (chi;2=8.756,P＜0.003). The constituent ratios of type Ⅱ and Ⅲ watershed zones were 82.4%, 90.9%, 71.1% in POAG, NTG and CACG group, respectively. No significant differences were found between POAG and NTG group (chi;2=1.039), POAG and CACG group (chi;2=1.039, 1.166;P＞0.05). But there was significant difference between NTG and CACG group (chi;2=4.107,P＜0.05). Significant differences were found between POAG and control group, NTG and control group (chi;2=5.352, 10.141;P＜0.05). No significant difference was found between CACG and control group (chi;2=1.444,P＞0.05). There was no correlation between age and watershed zone type (r=0.114,P＞0.05). The watershed zones type of glaucoma group positively correlated with MD (r=0.354,P=0.000). Conclusion The peripapillary choroidal watershed zones in glaucoma patients include the optic disc more than in healthy eyes.
Objective o compare the differences in the choroidal thickness at 1500 μm nasal or temporal to the fovea between three measurements of different imaging modes. Methods In this retrospective study, 21 eyes from 20 patients diagnosed with central serous chorioretinopathy (CSC), whose retinas tilt over 5.0 degree to the horizontal line were included (retina tilt group). The control group (retinal horizontal group) also included 21 eyes from 20 individuals whose retinas are horizontal indicated by retinal tilt angle measurement. There were no statistical significance (t=0.00, -0.345, 0.489; P＞0.05) in gender, age and spherical equivalent distributions between the two groups. The choroidal thickness at 1500 μm nasal or temporal to the fovea was measured by spectral-domain optical coherence tomography (COT) enhanced depth scanning under three modes (1∶1 pixel, 1∶1 micron and continuous measurement). The differences of choroidal thickness between these three measure modes were analyzed by a paired t test. Results The choroidal thickness was (304.81±87.74), (342.86±91.43), (307.86±89.35) μm respectively measured by 1∶1 pixel, 1∶1 micron and continuous measurement modes in retinal tilt group. The choroidal thickness measured by 1∶1 pixel was increased compare to that by 1∶1 micron, the difference was statistically significant (t=-8.499, P＜0.01). The choroidal thickness measured by continuous measurement mode was the same of that by 1∶1 micron, the difference was not statistically significant (t=-0.790, P＞0.05). In retinal horizontal group, the choroidal thickness measured by these 3 modes was the same, the difference was not statistically significant (t=-1.521, -1.822; P＞0.05). Conclusions Spectralis OCT with 1∶1 pixel mode exhibits horizontally compressed image, the values of choroidal thickness under tilted retinas measured by this condition were significantly greater than the true ones. The choroidal thickness measured by 1∶1 micron mode measurement is more accurate. Continuous measurement mode provides more accurate and convenient choroidal thickness measurement during follow up of patients.
Objective To analyze and reveal the domestic and abroad studies on polypoidal choroidal vasculopathy (PCV) by bibliometric. Methods Foreign articles were searched from American Institute of Scientific Information online database of web of science (WOS) database, Chinese articles were searched from China National Knowledge Infrastructure (CNKI) database. The age distribution, national and regional, funding agency and citation of the PCV literatures published before December 31 2012 were analyzed by software Bibexcel and SPSS 17.0. Results Totally 696 literatures were analyzed, including 440 foreign literatures and 256 Chinese literatures. The numbers of foreign literatures were gradually increased since 2000, significantly after 2007, reached the maximum at 2011. The literatures were mainly in English, the number of the literatures of China ranked 4th of all countries. The National Natural Science Foundation of China ranked No.5 of funding agency. Citations gradually increased since 2000, increased significantly after 2008; there were 30 highfrequency subjects, and hot topics were clustered into 5 categories: treatment of PCV, genetics studies of PCV, detection, diagnosis and epidemiology of PCV, relationships between PCV and macular degeneration, related cytokine of PCV. Chinese literatures increased since 2000, significantly after 2006, and reached the maximum at 2010; there were 15 literatures supported by National Natural Science Foundation of China; Citation of Chinese literatures gradually increased since 2001, and reached the maximum at 2012. There were 30 highfrequency subjects, and hot topics were clustered into 5 categories: genetics and cytokine studies of PCV, detection and diagnosis of PCV, treatment of PCV, PCV and macular diseases, PCV and vitreous hemorrhage. Conclusions Literatures of PCV were gradually increased since 2000, abroad and domestic literatures of PCV reached maximum at 2011 and 2010 respectively. The abroad research of PCV focuses on 5 categories: treatment of PCV, genetics studies of PCV, detection, diagnosis and epidemiology of PCV, relationships between PCV and macular degeneration, related cytokine of PCV. The domestic research focuses on genetics and cytokine studies of PCV, detection and diagnosis of PCV, treatment of PCV, PCV and macular diseases, PCV and vitreous hemorrhage.