ObjectivesTo evaluate the therapeutic effect of argon laser photocoagulation combined with intravitreous injection of triamcinolone acetonide (TA) on ischemic central retinal vein occlusion (CRVO).MethodsArgon laser photocoagulation combined with intravitreous injection of TA was performed on 17 patients (17 eyes) with CRVO between December 2003 and July 2004.ResultsDuring the follow-up of 4-10 months, the visual acuity improved in 16 patients, including alleviated or even disappeared cystoid macular edema (CME) in 5, and recurred macular edema in 5 with decreased visual acuity after 3 months. Six patients had increased ocular pressure after intra-ocular injection which alleviated after treated suitably. No neovascularization in angle or secondary neovascular glaucoma was found.ConclusionArgon laser photocoagulation combined with intravitreous injection of TA may improve the visual acuity and reduce complications in ischemic CRVO, though macular edema may recur in some cases. (Chin J Ocul Fundus Dis, 2005,21:224-225)
Objective To evaluate the clinical features of macular retinoschisis (MRS) and macular retinal detachment without hole (MRDH) in highly myopic eyes. Methods The clinical data of 19 patients (24 eyes) with MRS and MRDH from 186 patients (349 eyes) with high myopia were retrospectively analyzed. All of the patients had undergone the examinations of subjective refraction, binocular indirect ophthalmoscope, slit lamp microscope combined with Goldmann threemirror contact lens, fundus images, A/Bscan ultrasonography, and optical coherence tomography (OCT). Results In 349 eyes, 24 (6.9％) had MRS and (or) MRDH at the posterior pole. The results of ocualr fundus examinations showed that all of the 24 eyes (100%) had posterior scleral staphyloma (PS), 2 (8.3%) had vitreomacular traction (VMT), 2 (8.3%) had macular local superficial retinal detachment, and 1 (4.2%) had fullthickness macular hole. The results of Bscan ultrasonography also indicated PS in all 24 eyes (100%), macular local superficial retinal detachment in 7 (29.2%) with a bowlike configuration formed by the detached retina and the coneshaped roof of PS, and VMT in 2 (8.3%). The results of OCT revealed macular outerlayer retinoschisis (ORS) in 22 eyes (91.7%) in which 8 (36.4%) also had macular innerlayer retinoschisis (IRS); MRDH in 5 eyes (20.8%) in which ORS was found in 3 (60.0%) and simplex MRDH in 2 (40.0%) including 1 with VMT; VMT in 13 eyes (54.2%); cystoid macular edema (CME) in 3 eyes (12.5%); and lamellar macular hole in 4 eyes (16.7%). Conclusions MRS and MRDH are common complications in highly myopic eyes with posterior scleral staphyloma.OCT is more sensitive and accurate in detecting MRS and MRDH than routine ophthalmoscopic examination and B-scan ultrasonography.
ObjectiveTo evaluate short and medium term results of nitinol self-expending stent (LifeStent) implantation for iliac arteriosclerosis obliteran. MethodsThe clinical data of 75 limbs iliac artery occlusions in 64 patients from June 2011 to June 2014 in this hospital were analyzed retrospectively. The postoperative ankle brachial index (ABI), limb salvage rate, primary and secondary patency rate, and postoperative complications were evaluated. ResultsThere were 75 limbs iliac artery occlusions in 64 patients (54 males and 10 females), 11 lesions were type A of TASCⅡ, 26 lesions were type B of TASCⅡ, 29 lesions were type C of TASCⅡ, 9 lesions were type D of TASCⅡ. The postoperative ABI was significantly higher than that preoperative ABI (0.94±0.16 versus 0.29±0.20, t=-24.7, P < 0.01). The following-up time was (22±10) months, 5 patients were lost to follow-up. In 12 and 24 months after surgery, the cumulative primary patency rates were 79% and 60%, respectively, the cumulative second patency rates were 91% and 84%, respectively, the limb salvage rates were 96% and 94%, respectively. Complications occurred in 5 patients (7.8%). There was no severe complications and inhospital mortality. ConclusionClinical efficacy of short and medium term is satisfactory by nitinol self-expending stents implantation (LifeStent) for iliac arteriosclerosis obliteran, but long term efficacy remains to be further studied.
Objective To investigate the effect of tranilast on wound healing and the mechanism of inhibiting scar hyperplasia in mice, and to study the relationship between the inhibiting ability of tranilast on scar hyperplasia and administration time. Methods Sixty-six Kunming mice were selected to build deep II degree burn model, and were randomly divided into the control group (18 mice), the early intervention group (18 mice), the medium intervention group (18 mice), and the late intervention group (12 mice). The mice in the early intervention group, the medium-term intervention group, and the late intervention group were given tranilast 200 mg/(kg·d) by gastrogavage at immediate, 7 days, and 14 days after burn respectively, and the mice in the control group were managed with same amount of normal saline every day. The wound healing was observed regularly. At 14, 28, and 42 days in the early and medium intervention groups and at 28 and 42 days in the late intervention group, fresh tissues were taken from 6 mice to observe the shape of mast cells by toluidine blue staining, collagen content by Masson staining; the collagen type I and collagen type III content were measured to calculate the I/III collagen content ratio by immunohistochemistry method, the contents of transforming growth factor β1 (TGF-β1) and histamine were detected by ELISA; and the ultrastructure of fibroblasts was observed under transmission electron microscope. Results There was no significant difference in wound healing time between groups (F=1.105,P=0.371). The mast cells number, collagen content, TGF-β1 content, histamine content, and the I/III collagen content ratio in the early intervention group were significantly less than those in the other groups (P<0.05). Significant difference was found in mast cells number, collagen content, and histamine content between control group and medium or late intervention group at the other time points (P<0.05) except between control group and late intervention group at 42 days (P>0.05). Compared with the control group, the activity of fibroblasts in the early intervention group was obviously inhibited, and the arrangement of the fibers was more regular; the fibroblast activity in the medium and late intervention groups was also inhibited obviously. Conclusion Tranilast has no obvious effect on the wound healing time in mice. Tranilast intervention shows the inhibitory effect on the scar hyperplasia which can significantly reduce the number of mast cells, the content of histamine and TGF-β1, inhibit the ability of fibroblasts synthetic collagen and adjust the proportion of collagen synthesis. The immediate tranilast intervention may have the best inhibitory effect on scar hyperplasia.