Objective To observe the effect of laser-Doppler retinal blood flowmeter in diabetic retinopathy. Methods The blood flow volume (VOL), the blood flow velocity (FLW) and the erythrocyte flow velocity (VEL) of peri-papillary retina were measured with the non-invasive Heidelberg Retinal Flowmeter (HRF) in 108 patients (216 eyes) with diabetes and 32 patients (64 eyes) in normal control group. The patients with diabetes were divided into non-diabetic retinopathy (NDR) group (27 patients, 54 eyes) and non-proliferative diabetic retinopathy (NPDR) group (81 patients, 162 eyes). NPDR group were subdivided into 3 groups: 26 patients (52 eyes) in mild group, 24 patients (48 eyes) in moderate group, and 31 patients (62 eyes) in severe group. The foveal avascular zone area (FAZ) was measured by fundus flourescein angiography (FFA) in patients with diabetes and some in the control group. The data in each group were statistically analyzed. Results The parameter of retinal blood flow of temporal and nasal peri-papillary retina in NDR and NPDR group was significantly lower than that in the control group (Plt;0.05). With the degree of retinopathy becoming more severe, the FLW and VEL of temporal and nasal peri-papillary retina in NDR and mild NPDR group presented ascending tendency, reached the peak in moderate NPDR group, and then decreased. The change tendency of the FLW was more obviously. The VOL of temporal and nasal peri-papillary retina in moderate NPDR group was obviously higher than that in the other groups (Plt;0.01).The FLW and the VEL of temporal and nasal peri-papillary retina in moderate NPDR group were significantly higher than that in mild NPDR and NDR group (Plt;0.01). The FLW and the VEL of temporal peri-papillary retina in severe NPDR group were obviously higher than that in NDR group (Plt;0.01). Blood sugar value positively correlated with degree of diabetic retinopathy (r=0.172，P=0.046). The FLW and the VEL of temporal peri-papillary retina positively correlated with FAZ area in patients with diabetes (r=0.268, P=0.000；r=0.275, P=0.000). The FAZ area positively correlated with the degree of macular degeneration in patients with diabetes (r=0.559, P=0.000). Conclusion As a non-invasive method for measurement of retinal blood flow, HRF has important value in revealing the mechanism and degree of pathological changes and choice of treatment for diabetic retinopathy. (Chin J Ocul Fundus Dis,2007,23:256-259)
Objective To observe the therapeutic effect of ai-weizhi on anterior ischmic optic neuropathy (AION). Methods In 58 patients (60 eyes) who were diagnosed as with AION, 29 patients (30 eyes) underwent intravenous drip with ai-weizhi (1200 mg/d) (treatment group), and the other 29 patients (30 eyes) underwent intravenous drip with 1-2 kinds of thrombolytic coagulant or vasodilator (once per day) (control group) with the period of treatment of 15 days. In the control group, ocular local injection, including gluco-corticosteroid and 654-2 behind or beside the eyeball injected once per day or every 2 days for 3-5 times, was perfomed on 20 eyes simultaneously. The changes of visual acuity and ocular fundus of the patients after injection were recorded, and the visual field was counterchecked in the patients who had underwent the examination before the treatment. Results The visual acuity was better in treatment group than which in control group with a significant difference (t=2.74, Plt;0.01). The visual acuity in treatment group didnprime;t differ much from which in the control group 3 days after treatment (t=1.34, P＞0.05). At the 5th、10th and 15th day after treatment, the visual acuity was better in treatment group than which in control group with a significant difference(t=2.01, Plt;0.05; t=2.07, Plt;0.05；t=2.74, Plt;0.01). In 15 eyes in control group which had undergone examination of visual field, the visual field improved in 13 (87.00%) and of remained still in 2 (13.00%). In 13 eyes in treatment group which had undergone examination of visual field, the visual field improved in 4 (31.00%) and remained still in 9 (69.00%). There was a significant difference between the two groups (chi;2=9.66, Plt;0.01). Conclusion Ai-weizhi is efficacious in treatment of AION. (Chin J Ocul Fundus Dis, 2006, 22: 97-99)
Objective To analyze the clinical features of retinal detachment in macular spontaneous hemorrhage to improve the level of diagnosis and treatment of this disease. Methods The serial clinical data of 23 patients (23 eyes) with subretinal hemorrhage in macular region with the area over 4DDtimes;5DD who were diagnosed in our hospital from Sep, 1998 to Mar, 2003 were analyzed retrospectively. The patients included 12 males (12 eyes) and 11 females (11 eyes) with the average age of 64.1 (47-75). Fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA) and B-scan examination were performed on the patients to analyze the pathogenic factors, and the visual acuity and manifestation of ocular fundus were observed during the 8-24 months followed-up period. Results The visual acuity decreased to less than 0.2 or light perception suddenly in all affected eyes. In 23 eyes, choroidal neovascularization (CNV) of age-related macular degeneration (AMD) was found in 7, polypoidal choroidal vasculopathy (PCV) was in 5, retinal macroaneurysm was in 2, and unknow pathogenic factor in 9. Among the 23 eyes, hemorrhage was absorbed and no cicatritial formation at the fovea in 3 eyes with the visual acuity of 0.4-0.8; scar and pigment proliferation in the hemorrhage area were seen in 12 eyes with the visual acuity of finger counting (FC) to 0.2; combined vitreous hemorrhage was found in 8 eyes, including massive scar in the macular area in 3 who had undergone vitrectomy with the visual acuity of FC/66cm to 0.2 and blindness in the other 5 eyes. Conclusion Spontaneous hemorrhagic retinal detachment always arises in old people whose symptoms were sudden decrease or loss of the visual acuity. The configuration of the hemorrhage is local and diffuse. The prognosis of the visual acuity of most of the patients is poor due to the serious tissue injury in macula area. (Chin J Ocul Fundus Dis, 2006, 22: 228-231)
Objective To verify the applicable significance of confocal scanning laser retinal tomography in agerelated macular degeneration (AMD). Methods Heidelberg confocal scanning laser tomography was used to measure 75 eyes of 59 patients with AMD, including 25 eyes of 20 patients with exudative AMD, 25 eyes of 16 patients with atrophic AMD, and 25 eyes of 23 patients with macular drusen. The differences of the width, volume and maximum height of Z profile signal of macula were analyzed. Results Z profile signal width in macular tomography of exudative AMD was wider than that of macular drusen; maximum height and volume in macular tomography of exudative AMD were larger than that of macular drusen (P＜0.01); Z profile signal width, maximum height，and volume in macular tomography of atrophic AMD were wider and larger than that of macular drusen (P＜0.05). Macular volume of exudative AMD was obviously larger than that of atrophic AMD (P＜0.01). Conclusion Confocal scanning laser tomography may be one of the useful methods for objective evaluation of morphologic change for the development of AMD. (Chin J Ocul Fundus Dis, 2002, 18: 262-265)
目的 初步探讨影响男性乳腺癌患者预后的因素。 方法 收集2003年1月－2011年12月经病理确诊、接受治疗、临床资料较完整的36例男性乳腺癌患者的临床资料。采用对数秩检验和Cox回归分析影响男性乳腺癌患者预后的因素。 结果 36例患者无进展生存期（PFS）为3～95个月，中位PFS为45个月。单因素分析显示：肿瘤直径（P=0.001）、阳性淋巴结（P=0.001）、TNM分期（P＜0.001）、手术方式（P=0.001）是影响预后的因素。多因素分析显示：阳性淋巴结（P=0.024）和TNM分期（P=0.022）是影响预后的主要因素。 结论 阳性淋巴结和TNM分期是影响预后的主要因素，以手术为主的综合治疗模式是提高男性乳腺癌患者生存率的重要措施。
ObjectiveTo observe the characteristic variation of the patients' inner and outer retina who had chronic central serous chorioretinopathy (CSC) after being treated of photodynamic therapy (PDT). MethodsNineteen patients with chronic CSC were recruited, including 15 eye of men and 4 eye of women, logMAR BCVA was 0.1-1.0, 0.39±0.30. Meanwhile, 24 healthy people were located in the control group. All the patients received PDT for the first time. All subjects including 24 healthy people underwent fourier domain optical coherence tomography (FD-OCT). Retinal thickness were investigated before PDT and 1, 4, 12, 20 weeks after PDT respectively. Data were recorded including inner layer and outer layer. Retinal thickness were compared in fovea (1 mm), parafovea (3 mm)and perifovea(5 mm). Paired-samples t test was used to compare retinal thickness before and after PDT. The statistical differences of patients and control group were evaluated by independent-samples t test. The correlations between the best logMAR corrected visual acuity (BCVA) was analyzed by Pearson statistical analyses. ResultsThe inner(F=13.814, 10.095, 4.689) and outer(F=9.354, 5.878, 3.978)layer fovea thickness of CSC subjects in 1, 4, 12 week was thinner, the difference was statistically significant (P < 0.05). The outer layer fovea thickness at P12(t=-3.725), parafovea of inner and outer retinal(t=-3.198, -2.722)was reduced when compared with control group, and differences have statistical sense, respectively (P < 0.05). There was correlation between logMAR BCVA and outer retinal thickness in fovea and parafovea (r=0.465, -0.728, -0.687; P < 0.05). ConclusionIn our study, the inner and outer layer retinal thickness decreased generally after the first time PDT in CSC patients.