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.
ObjectiveTo observe the effect of segmental scleral buckling on the treatment of rhegmatogenous retinal detachment (RRD) with multiple retinal breaks. MethodsThis is a retrospective study. Seventeen patients (17 eyes) suffering from RRD with multiple retinal breaks were enrolled in this study. There were 8 eyes with the retinal breaks located in different quadrants and 9 eyes located in different latitudes within the same quadrant. Three were 3 eyes with 2 retinal breaks, 5 eyes with 3 retinal breaks, 9 eyes with more than 3 retinal breaks. The forms of retinal breaks included U-shaped break (4 eyes), tear break (1 eye), degenerative break (3 eyes) or U-shaped breaks combined with degenerative breaks (7 eyes), U-shaped breaks combined with tear breaks (1 eye), tear breaks combined with degenerative breaks (1 eye). The best corrected vision acuity (BCVA) was count finger to 0.8. The segmental scleral buckling was performed in all patients with the reasonable combination of silicon sponges and tires. The mean follow-up was 9.3 months (from 6 to 12 months). The BCVA, retinal attachment and complications were observed in the follow-up. ResultsFifteen eyes were reattached without recurrent of retinal detachment (88.2%). One eye with recurrent retinal detachment after 3 months due to proliferative vitreoretinopathy, and was partly reattached after vitrectomy combined with silicon oil tamponade. Retina remained detached in 2 eyes (11.8%), including 1 eye reattached after combined with gas tamponade, and 1 eye with vitrectomy. Sixteen eyes were completely reattached (94.1%), including 14 eyes were underwent only 1 operation (82.4%). The BCVA were improved more than 2 lines in 9 eyes (52.9%), 1 to 2 lines in 5 eyes (29.4%), and only 3 eyes (17.7%) without improvement. All patients have no serious complications during the operations. ConclusionFor certain patients suffering from RRD with multiple retinal breaks, a reasonable design of segmental scleral buckling can effectively increase the success rate of retinal reattachment (82.4%).
Objective To investigate the serum levels of vitamin B12 and folic acid (FA) of exudative agerelated macular degeneration (AMD).Methods A total of 84 patients with exudative AMD（AMD group）and 78 patients with non-exudative AMD （control group） diagnosed at Xijing Hospital between June 2008 and September 2009 were assessed in this study. Serum vitamin B12 and FA levels were measured by chemiluminescence immunoassay. The statistical information of epidemiology and risk factors exposure histories were collected and compared.Results AMD group had significantly lower serum vitamin B12 levels ［（247.51plusmn;93.92）ng/ml］ compared with the control group ［（312.52plusmn;143.08） ng/ml］，the difference was statistical significance (t=5.013, P＜0.001). Serum FA levels in AMD group ［（5.64plusmn;3.72）ng/ml］ were slightly lower than the control group ［（10.14plusmn;4.48） ng/ml］, the difference was not statistical significance (t=0.780, P=0.437).Conclusion People with lower serum vitamin B12have higher risk of exudative AMD. Low levels of serum vitamin B12 may relate with the occurrence of exudative AMD.
ObjectiveTo observe the imaging features of short-wave length fundus autofluorescence (SW-AF), near-infrared fundus autofluorescence (NIR-AF)and spectral-domain optical coherence tomograph (SD-OCT) in acute central serous chorioretinopathy (CSC). MethodsThis is a retrospective observational consecutive case series study. Eighty-two eyes with acute CSC from 76 patients were enrolled in this study.There were 50 males (56 eyes) and 26 females (26 eyes), average age was (41.32±7.37) years old, average course of the disease was (0.47±1.73) months. The routine clinical examinations included best corrected visual acuity, slit lamp microscope, indirect ophthalmoscope, fundus fluorescein angiography (FFA), SW-AF, NIR-AF and SD-OCT. The imaging features of NIR-AF, SW-AF, SD-OCT and FFA in same eye with acute CSC were analyzed comparatively. ResultsSD-OCT showed retinal pigment epithelium (RPE) detachment corresponding to RPE leakage point on FFA images in all CSC eyes. RPE leakage points in all eyes corresponding to local hypo-NIR-AF, whereas corresponding to normal SW-AF. NIR-AF demonstrated the area of decreased AF corresponding to serous retinal detachment in all eyes, of which, the area of hypo-SW-AF was consistent with that of sensory retinal detachment in 75 eyes. Except for RPE leaking fluorescein in 82 eyes, FFA showed window defects corresponding to clusters of hypo-NIR-AF in 45 eyes, of which, 27 eyes showed hypo-SW-AF appearing concurrently with the locations of window defects of FFA. In 18 eyes, the extent and amount of hypo-SW-AF were less than that of hypo-NIR-AF. ConclusionsThere was local RPE detachment in all eyes with acute CSC. The locations of sensory retinal detachment, local RPE detachment and RPE depigmentation showed hypo-NIR-AF. The locations of sensory retinal detachment and RPE depigmentation showed hypo-SW-AF in most of acute CSC eyes.