Objective To evaluate the prognosis of retinopathy of prematurity (ROP) following the screening and treatment guidelines of the Chinese Ministry of Public Health. Methods From December 2003 to December 2010, 1379 premature infants diagnosed with ROP were followed by binocular indirect ophthalmoscopy or fundus photography using RetcamⅡ digital camera. For the stage 1 ROP, eyes were followed every 2 weeks until the ROP regressed. For the stage 2 ROP or pre-threshold disease, eyes were followed weekly. If the ROP decreased, eyes were followed every two weeks until the ROP regressed completely. For the stage 3 ROP or acute progressive ROP (AP-ROP), eyes were followed 2-3 times weekly. If the ROP progressed to threshold or type 1 pre-threshold disease, laser therapy was performed within 72 hours. After laser treatment, eyes were followed every 1 -2 weeks. Laser or cryotherapy was conducted when the ROP progressed after first treatment. Scleral buckle and vitrectomy with closed triple incisions was conducted when the ROP progressed to stage 4 and stage 5. The period the infants were followed ranged from 6 months to 2 years (average 152.3 days). ResultsA total of 2758 eyes of 1379 infants were diagnosed with ROP. The gestational age range was 26 . 35 weeks (average 30.6 weeks) and the birth weight of 800-2200 grams (average 1424.6 grams). Four hundred eyes (14.5%) of 206 infants with threshold or type 1 pre-threshold disease were given laser treatment. Three hundred and forty-five eyes (86.2%) completely regressed, and 55 eyes (13.8%) progressed to unfavorable structural outcomes. All 2358 eyes that did not reach threshold or type 1 prethreshold disease regressed completely. The total regression rate of our study was 980%. The incidence of unfavorable structural outcomes was 2.0% including stage 4 in 32 eyes (1.2%) and stage 5 in 13 eyes (0.5%). The retina reattatched in all 6 eyes treated with scleral buckle but macular traction remained at the optic disc. In the 39 eyes treated using vitrectomy with or without lensectomy, the retina reattached completely in 17 eyes at stage 4a. In 15 eyes at stage 4b, the retina reattached completely in 10 and remained detached in 5 eyes. In the 13 eyes at stage 5, the retina reattached completely in 4, and reattached mostly in 1 eye. Conclusion The incidence of severe ROP leading to unfavorable structural outcomes can be effectively reduced by screening and timely treatment.
ObjectiveTo evaluate the clinical features of 18 cases of juxtapapillary capillary hemangioma.MethodsIn 18 cases of 18 cases of juxtapapillary capillary hemangioma,the clinical datd of 19 eyes,the results of funds fluorescein angiography(FFA) of 16 eyes ,and the follow-up observation of 7eyes were retrospectively analyzed.ResultsIn 18 cases,the sex retio of male and female is 1:2 with the average age of 28.9 years.Peripheral retinal angioma was found in 3 cases(4eyes). In19 eyes,thr center of hemangioma was located beyond the rim of optic,most of which was in inferotemporal quadrant of the optic (7/19) with the size of 1-2.5 disc diameter (DD).Most of the tumors were red in colour (12/19).In the result of FFA of 16 eyes ,wash-out at the late phase was found in 13 eyes.decreased acuity was found in all 7 cases that were followed up more than 12 months (including 5 cases treated by laser photocoagulation).retinal detachment did't occur in 6 cases without exudative retinal detachment after being follow-up for 54.5 months of the average term.ConclusionMost of the juxtapiallary capillary hemangioma are orange or red oval tumors.The center of hemangioma are located beyond the rim of the optic.The patients often complain gradually decreased visual acuity when they are in prime of their life with exudation and edema in different degree around the tumor,FFA is helpful for the diagnosis and differential diagnosis of this disease.(Chin J Ocul Fundus Dis，2004，20：1-4)
Objective To observe the changes of disease course and the prognosis of visual acuity of Chinese patients with polypoidal choroidal vasculopathy ( PCV).Methods Visual acuity and fundus photochromes of 20 eyes of 15 consec utive patients with PCV were followed up with a mean of 19.1 months (range from 2 to 64 months), in which the fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) of 14 eyes of 10 patients were followed up with a mean of 21.0 (range from 3 to 53) months.Results Among the 20 eyes, the visual acuity was more than 0.3 in 5 eyes (25.0%), between 0.1 and 0.2 in 6 (30%) and less than 0.1 in 9 (45.0%). During the follow-up, the visual acuity was improved in 2 (10.0%), stable in 10 (50.0%)), and regressed in 8 (40.0%). Only 1 eye (5.0 %) developed to macula scar. The result of ICGA revealed the polypoidal lesions that were unchanged in 4 eyes(28.6%), regressed in 2 (14.3%), grew in 6 (42.7%), repeatedly grew and spontaneously regressed in 6 (42.7%).Conclusions There is a large variation in the visual prognosis in Chinese patients with PCV. The polypoidal lesions can repeatedly grow and spontaneously regress in the natural course. (Chin J Ocul Fundus Dis，2004，20：8-11)
Objective To investigate the therapeutic effects of retinal angioma. Methods The clinical data of 16 cases(20 e yes) were retrospectively analyzed, and the patients included 5 males and 11 females of 23.3 yeras old on average. Four cases in this series affected by bilateral retinal angiomas were identified as von Hippel-Lindou disease. The retinal an giomas were divided into 5 stages according to their degrees of developmnet from simple angiom without vessel dilation to feeder vessel dilation and intraretina l exudates, local retinal detachemnt, massive retinal detachment and complication occurrence in proper order. The methods of treatment were laser photocoagulati on, trans-scleral cryotherapy and vitreoretinal surgery. The patinets were followed up for 37.8 months on average. Results There were 10 eyes (2 in stage 1, 7 in stage 2, 1 in stage 3)treated with laser photocoagulation, and all of the angiomas were controlled after the treatment. The visual acuity im proved in 2 eyes, decreased in 4 eyes, and remained unchanged in 4 eyes. Cryothe r apy was performed on 7 eyes(5 in stage 3, 2 in stage 4). The visual deteriortion was found in 5 eyes; and the state of illness was stable in 3 eyes in stage 3 a nd aggravating in 4 eyes (2 in stage 3, 2 in stage 4). Vitreoretinal surgery was performed on 4 eyes including 2 which had been given photocoagulation, and the visual acuity improved in 2 eyes, decreased in 1 eye, and was unimproved in 1 ey e . The visual acuity decreased to no light perception in an untreated eye after 1.5 year follow-up. New angiomas occurred in 3 eyes with Von Hippel-Lindou disease in the follow-up period. Conclusion Laser photocoagulation is effective in treating the angiomas from stage 1 to 3. Cryotherapy can cause massive exudation and proliferation, and it is only suitable for a few patients in stage 3. The visual prognosis is more favorable in vitreoretinal surgery tha n other therapies for the patients in stage 4. (Chin J Ocul Fundus Dis, 2001,17:296-298)
ObjectiveTo explore optimal intensity of oral anticoagulation for patients with prosthetic heart valves in Northeast China. MethodsA total of 856 patients in Northeast China who underwent prosthetic heart valve replacement in the Department of Cardiovascular Surgery,Second Hospital of Jilin University from January 2005 to June 2013 were enrolled in this study. There were 406 male and 450 female patients with their age of 45.2±13.3 years. All the patients received low-intensity oral anticoagulation [international normalized ratio (INR) 1.5-2.2,aortic valve replacement (AVR):1.5-1.8,mitral valve replacement (MVR):1.8-2.2]. Patients were followed up after discharge,and the incidence of anticoagulation-related complications was summarized. ResultsThese patients were followed up for 1-78 (18.3±12.2) months,and the follow-up rate was 75.4%. Twelve patients (1.86%) had thromboembolic complications and 10 patients (1.55%) had hemorrhagic complications. Average warfarin dosage was 3.4±0.8 mg/day,and average INR was 1.94±0.54 during follow-up. ConclusionFor patients with prosthetic heart valves in Northeast China,low-intensity anticoagulation can produce satisfactory clinical outcomes to reduce the incidence of anticoagulation-related thromboembolic or hemorrhagic complications.
ObjectiveTo summarize the indication and surgical experiences of valve replacement, high-risk factors and long-term results for aortic regurgitation and large left ventricle. MethodsWe retrospectively analyzed the clinical data of 42 patients with aortic regurgitation and left ventricle end-diastolic diameter (LVEDD) ≥70 mm and left ventricle end-systolic diameter (LVESD) ≥ 50 mm in our hospital from March 2004 through December 2012. There were 38 males and 4 females,aged 16-73 (45.86±14.99) years. The patients underwent aortic valve replacement, who were evaluated by echocardiography at pre-operation, pre-discharge and early follow-up. The follow up period was 12-132 months. ResultsEarly death occurred in one patient. And five patients died during the follow-up. One week after surgery in 41 patients, LVEDD (62.00±13.21 mm), LVESD (50.71±14.02 mm), indexed LVEDD (35.23±8.58 mm/m2), indexed LVESD (28.92±9.08 mm/m2), LVEF (46.41%±12.49%), were significantly smaller than those before the operation (P<0.01). Heart function grades, preoperative EF, LVEDD and indexed LVEDD were the predictors for left ventricular function recovery. One-year, 5-year, 10-year survival rate was 92.9%, 90.2%, 83.8%, respectively. ConclusionMost of patients with aortic regurgitation and large left ventricle still have indications for surgical treatment, but severe left ventricular dysfunction and ventricular arrhythmia are high risk factors for long-term survival.