Objective To observe the clinical effects of vitrectomy for advanced retinopathy of prematurity (ROP) and evaluate influence factors of anatomical recovery for stage 5 ROP. Methods Fifty-eight eyes of 40 infants with advanced ROP who underwent vitrectomy were retrospectively analyzed. There were 16 eyes of stage 4a, 7 eyes of stage 4b, and 35 eyes of stage 5 ROP. Eighteen eyes received laser photocoagulation, 2 eyes received cryotherapy, and 11 eyes received intravitreous injection of Bevacizumab (IVB) before surgery. The average follow-up time was 17.01 months. Anatomical outcome of retina after surgery was recorded by indirect ophthalmoscope and RetCamⅡ digital camera system. Visual outcome was measured by grating acuity test（lea gratingTM）, and was converted to Snellen acuity values for analysis. For those who cannot cooperate to accomplish the test, we use hand move, light perception and non-light perception to record visual outcome. ResultsAll 16 eyes of stage 4a were anatomically recovered (100.00%). 5/7 eyes of stage 4b were anatomically recovered (71.43%) and 2/7 eyes were anatomically failed(28.57%). 12/35 eyes of stage 5 were anatomically recovered (34.29%); 10/35 eyes were partial anatomically recovered (28.57%); 13 eyes were anatomically failed (37.14%). Anatomical outcome of stage 4a or 4b was better than stage 5 statistically（χ2=22.55，P＜0.05）. Of 16 eyes of stage 4a, 3 eyes were absent for visual function test. In the rest 13 eyes of stage 4a, VA of 6 eyes (46.15%) was between 0.03 and 0.07; 5 eyes (38.46%) were hand move; 2 eyes (15.39%) were light perception. Of 7 eyes of stage 4b, 2 eyes (28.57%) accomplished grating acuity test with VA of 0.008 and 0.017 respectively; 1 eye (14.29%) was hand move; 2 eyes (28.57%) were light perception; 2 eyes (28.57%) were nonlight perception. Of 35 eyes of stage 5, 5 eyes were absent for visual function test. In the rest 30 eyes of stage 5, VA of 2 eyes (6.67%) was 0.004; 4 eyes (13.33%) were hand move; 12 eyes (40.00%) were light perception; 12 eyes (40.00%) were non-light perception. Visual outcome of stage 5 was worse than stage 4a or 4b statistically（χ2=15.734，P＜0.05）.There was no statistically significant relationship between anatomical outcome and birth weight, gestational weeks, age at surgery, IVB therapy, laser or cryotherapy before surgery. ConclusionsVitrectomy can effectively control the lesions progress of stage 4a ROP, and achieve partially anatomically recovery of some stage 4b/5 patients. There was no statistically significant relationship between anatomical outcome and birth weight, gestational weeks, age at surgery, IVB, laser or cryotherapy before surgery.
Early detection and timely treatment hold the key to cure retinopathy of prematurity (ROP). ROP screening is carried out unevenly in China. Examination equipments and personnel experiences are the major factors to constraint ROP screening. In addition to strengthening personnel training, it is necessary to establish a standard guideline and pipeline for ROP consultation and referral. Laser photocoagulation and cryotherapy are the first options for the threshold ROP and Type 1 prethreshold ROP. Scleral buckling or vitrectomy is needed for advanced ROP when retinal detachment occurs. The clinical efficacy of intravitreal injection of bevacizumab (an anti-vascular endothelial growth factor monoclonal antibody) for severe ROP is encouraging, but needs further verification. Genetic interference and stem cell therapy will be the prosperous futures in the treatment of ROP. The screening and treatment of ROP in China is becoming more common and improved, but it is still a long way to go considering the huge population of China.
Objective To investigate the characteristics and diagnostic value of fundus fluorescein angiography (FFA) for familial exudative vitreoretinopathy (FEVR). Methods 34 children (68 eyes) with FEVR and 64 parents (128 eyes) were included. All the clients were received examinations of slit-lamp biomicroscopy and indirect ophthalmoscopy. Meanwhile the children were examined by RetcamⅡ,the best corrected visual acuity of parents were recorded. The children and their parents were classified according to the ocular findings. Among 68 eyes of children, 3 eyes (4.41%) were normal, 4 eyes (5.88%) were in stage 1, 7 eyes (10.29%) were in stage 2, 2 eyes (2.94%) were in stage 3, 8 eyes (11.76%) were in stage 4 and 44 eyes (64.71%) were in stage 5. Among 128 eyes of parents, 74 eyes (57.81%) were normal, 51 eyes (39.84%) were in stage 1, 1 eyes (0.78%) were in stage 2 and 2 eyes (1.56%) were in stage 5. FFA was performed on the children with RetcamⅡunder anesthesia and on the parents with HR2 in order to observe the FFA characteristics in different stage. Results FFA characteristics in children included uncompleted vascularization of the periphery, peripheral avascular zone (stage 1); neovascularization and/or peripheral subretinal and intraretinal exudation (stage 2); subtotal retinal detachment with attached fovea (stage 3); subtotal retinal detachment with detached fovea (stage 4) and total retinal detachment (stage 5). FFA characteristics in parents included abrupt cessation of the peripheral retinal capillary network and a peripheral avascular zone (stage 1); abnormal peripheral arteriovenous shunts, neovascularization or exudation (stage 2) and atrophia bulbi (stage 5). Conclusions FEVR in different stage has different FFA characteristics. FFA plays an important role in early diagnosis of FEVR.
Objective To investigate the degree of retinal developmen t in pret erm infants and compare the electroretinograms between preterm and fullterm in fants. Methods Flash electroretinogram (ERG) were obtained wit h contact lens el ectrodes in one eye from ten preterm infants (10 eyes) and twenty full-term inf a nts (20 eyes) in seven days after birth. The rod cell, cone cell, maximal combi nation, oscillatory potentials, and 30 Hz flicker responses were recorded. Results Compared with the full-term infants, the implicit time of rod cell respon s e (t=3.216，P=0.003) was longer and the amplitudes were lower (t=6.0 50，P=0.000) in the preterm infants; the difference of implicit time of maximal response was not significant (t=0.465，P=0.650; t=1.068，P=0.295), while th e amplitudes dec reased (t=6.584, P=0.000; t=6.649, P=0.000). The a- and b-wav e implicit time of cone response was not differed much between the two groups (t=0.077, P=0.939; t=0.935,P=0.358); the amplitudes was obvious lower in preterm group (t =3 .417，P=0.002；t=6.310，P=0.000); the difference of implicit t ime of 30 Hz flic ker betw een the two groups was not significant (t=3.745，P=0.001). The difference of b/a value of maximal combination response was not obvious between the two groups ( t=0.215, P=0.831). Conclusions The development of retinal function is slower in preterm infants than that in full-term ones．
Objective To observe the expression of erythropoietin (EPO) and its receptor (EPOR) mRNA and protein levels in retinae of mice with oxygen-induced retinopathy, and to evaluate the effect of EPO and EPOR in retinal vascular develo pment and in the occurrence and development of oxygen-induced retinopathy. Methods One hundred and thirty-two 7-day-old C57BL/6J mice were divided into two g rou ps: normal control group (control group) and oxygen-induced retinopathy group (experimental group). The proliferative neovascular response was estimated by obse rving the vascular pattern in adenosine diphosphatease (ADPase) stained retina flat-mounts by executing 6 mice in each group at the 12th, 15th, and 17th day, respectively. The expression of EPO, EPOR mRNA was determined by reverse transcription-polym erase chain reaction (RT-PCR), and the protein levels of EPO and E PO R were determined by immunohistochemistry. RT-PCR and immunohistochemistry were done every other day from the 7th to the 21st day. Results In the control group, retinal vascularization was found. In the experimental group, the large vesse ls were constricted straight, the branches decreased, and alarge nonperfusion area was observed at the 12th day; the large vessels were dilated and tortuous and neovascularization occurred at the 15th day; a mass of neovascularization was found and the vascular net structure of the deep and shallow layer was destroye d at the 17th day. The expression of EPO mRNA decreased from the 7th day and kee p decreasing in the whole oxygen-breathing duration in the experimental group. A fter the mice were returned to room air, the expression increased obviously from the 15th day and kept the high level until the 21st day. The expression of EPO mRNA increased at the 7th day and reached the peak at the 11th day, and kept the high level until the 21st day. The changes of protein levels of these three fac tors were later than that of their mRNA, but had the same trend. The difference of the expression between the two groups at the different time point was signifi cant except for the 7thday point (Plt;0.05). Conclusion It 's suggested that EPO and EPOR played important roles on the development of normal retina vascularizati on and the pathogenesis of ROP, which may provide new conception and method for the prevention and treatment of the oxygen-induced retinopathy.
High myopia is frequently associated with retinal degenerative changes (such as myopic foveoschisis, macular hole and its related retinal detachment, and choroidal neovascularization) which are the major causes of visual loss in high myopic eyes. Optical coherence tomography may help us to understand the macular lesions in high myopia. Peeling of internal limiting membrane and removal of posterior vitreous cortex at an appropriate time, are believed to facilitate restoring the retinal flexibility and resolution of myopic foveoschisis, and promote the macular hole closure and retinal reattachment. Antiangiogenesis treatment combined with photodynamic therapy and (or) corticosteroid therapy are the future options to treat myopic choroidal neovascularization. Correctly understanding and mastering the methods and timing of diagnosis and treatment of high myopiarelated macular degeneration, and taking targeted interventions to enable patients to be rational and effective treated, are the keys to further reduce the damage of visual function in patients with high myopia.