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find Keyword "视网膜出血/治疗" 3 results
  • 激光治疗黄斑区视网膜前出血一例

    Release date:2016-09-02 05:46 Export PDF Favorites Scan
  • 新生儿视网膜出血

    新生儿视网膜出血(RH)是指新生儿在出生1个月内发生的RH。其发生可能与分娩方式、孕母患病及胎儿疾病等因素有关。经阴道分娩引起的胎头受压以及胎头急速下降引起的压力急剧变化可能是其发生的重要原因。多表现为双眼出血。出血常位于视网膜后极部,以浅层出血为主。出血形态可以是点状、线状及火焰状。通常病情较轻,预后较好,出血可于2周内完全吸收,目前认为尚无需治疗。少数严重出血或黄斑、玻璃体积血吸收缓慢,可能影响患儿视功能发育,导致弱视发生。对新生儿RH与儿童弱视之间的关系、新生儿RH是否需要干预以及如何干预,是今后新生儿RH研究的方向。

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  • Combination therapy for thick submacular hemorrhage

    ObjectiveTo observe the efficacy and safety of vitrectomy combined with submacular injection of tissue-type plasminogen activator (t-PA), gas filling and anti-VEGF drugs (multiple therapy) for thick submacular hemorrhage.MethodsA retrospective case study. From January 2014 to June 2018, 24 patients (24 eyes) with thick submacular hemorrhage who received multiple therapy at the Department of Ophthalmology of Peking University Third Hospital were included in the study. Among them, there were 15 males and 9 females with the average age of 69.05±8.86 years. The average submacular bleeding time was 17.15±10.30 days, the average bleeding area was 13.85±8.63 DD. Seventeen eyes showed hemorrhagic RPE detachment. The international standard visual acuity chart was used to BCVA examination, which was converted to logMAR visual acuity in statistics. The frequency domain OCT was used to measure the height of the foveal elevation. The average logMAR BCVA of the affected eye was 1.37±0.38. The average height of the macular fovea was 824.94±294.38 μm. All eyes underwent 23G or 25G vitrectomy. During the operation, 0.1-0.5 ml t-PA (10 μg/0.1 ml) was injected under the macula. The vitreous cavity was filled with 15% C3F8 after gas-liquid exchange in 13 eyes, and 11 eyes were filled with sterilized air. Eleven eyes were injected with anti-VEGF drugs at the end of the operation, and anti-VEGF drugs were given PRN treatment according to the activity of the lesion. The average follow-up time after treatment was 27.90±22.21 months. The absorption of bleeding under the macula, the improvement of vision, the occurrence of rebleeding and treatment-related complications were observed and recorded. The Wilcoxon rank sum test was performed to compare the BCVA and the height of foveal elevation before and after treatment.ResultsOne month after the treatment, the blood in the fovea of all affected eyes was cleared. At the last follow-up, the logMAR BCVA and macular foveal elevation were 0.82±0.28 and 253.88±71.75 μm, respectively. Compared with those before treatment, the difference was statistically significant (Z=-3.727, -3.234; P<0.001, <0.001). The average intravitreal injection of anti-VEGF drugs was 1.08 times. During the operation, a tiny hole was formed in the center of the macula when t-PA was injected under the retina. Two eyes showed mild vitreous hemorrhage early after the operation. During the follow-up period, bleeding recurred in 2 eyes.ConclusionsVitrectomy combined with submacular injection of t-PA, gas filling, and anti-VEGF drugs is an optimal combination for the treatment of thick submacular hemorrhage. It can effectively remove submacular hemorrhage, improve vision, reduce foveal elevation with good safety.

    Release date:2020-12-18 07:08 Export PDF Favorites Scan
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